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Cohen S, Goldsmith DR, Ning CS, Addington J, Bearden CE, Cadenhead KS, Cannon TD, Cornblatt BA, Keshavan M, Mathalon DH, Perkins DO, Seidman LJ, Stone WS, Tsuang MT, Woods SW, Walker EF, Miller BJ. Sleep disturbance, suicidal ideation and psychosis-risk symptoms in individuals at clinical high risk for psychosis. Psychiatry Res 2024; 341:116147. [PMID: 39197223 DOI: 10.1016/j.psychres.2024.116147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Revised: 07/02/2024] [Accepted: 08/13/2024] [Indexed: 09/01/2024]
Abstract
Insomnia and suicidal ideation (SI) are common in schizophrenia, including in individuals at clinical high-risk for psychosis (CHR-P). Previous studies have found associations between sleep disturbance, SI, and psychopathology in schizophrenia. We explored these associations in a CHR-P cohort. We leveraged data from CHR-P individuals in the North American Prodrome Longitudinal Studies (NAPLS-3) (n = 688) cohort. We investigated relationships between sleep disturbance (Scale of Prodromal Symptoms [SOPS]; Calgary Depression Scale for Schizophrenia [CDSS], and the Pittsburgh Sleep Quality Index [PSQI]), suicidal ideation (CDSS), and psychosis-risk symptoms. The prevalence of terminal insomnia, sleep disturbance, and SI in NAPLS3 was 25 %, 69 %, and 29 %, respectively. After controlling for potential confounders, multiple indices of sleep disturbance (SOPS, PSQI: OR = 1.05-1.40) were significant indicators of concurrent SI. Terminal insomnia was not associated with conversion to psychosis. Multiple indices of sleep problems were associated with higher total and subscale psychosis-risk symptom scores (β = 0.09-0.39). Sleep problems are prevalent and associated with SI and more severe psychosis-risk symptoms in CHR-P individuals. These findings underscore the importance of designing longitudinal intervention studies to investigate whether the treatment of sleep disturbances may reduce suicidality and symptoms in this population.
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Affiliation(s)
- Simon Cohen
- Department of Psychiatry, Keck School of Medicine of University of Southern California, Los Angeles, CA, United States
| | - David R Goldsmith
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States
| | - Courtney S Ning
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States
| | - Jean Addington
- Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | - Carrie E Bearden
- Semel Institute for Neuroscience and Human Behavior, Departments of Psychiatry and Biobehavioral Sciences and Psychology, University of California, Los Angeles, CA, United States
| | - Kristin S Cadenhead
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States
| | - Tyrone D Cannon
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States; Department of Psychology, Yale University, New Haven, CT, United States
| | - Barbara A Cornblatt
- Department of Psychiatry, The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States
| | - Matcheri Keshavan
- Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts Mental Health Center, Boston, MA, United States
| | - Daniel H Mathalon
- Department of Psychiatry and Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, United States
| | - Diana O Perkins
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Larry J Seidman
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - William S Stone
- Department of Psychology, Emory University, Atlanta, GA, United States
| | - Ming T Tsuang
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States
| | - Scott W Woods
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Elaine F Walker
- Department of Psychology, Emory University, Atlanta, GA, United States
| | - Brian J Miller
- Department of Psychiatry and Health Behavior, Augusta University, 997 Saint Sebastian Way, Augusta, GA 30912, United States.
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Kuang Y, Liao X, Jiang Z, Gu Y, Liu B, Tan C, Zhang W, Li K. Federated learning-based prediction of depression among adolescents across multiple districts in China. J Affect Disord 2024:S0165-0327(24)01689-6. [PMID: 39389117 DOI: 10.1016/j.jad.2024.10.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Revised: 10/03/2024] [Accepted: 10/07/2024] [Indexed: 10/12/2024]
Abstract
Depression in adolescents is a serious mental health condition that can affect their emotional and social well-being. Detailed understanding of depression patterns and status of depressive symptoms in adolescents could help identify early intervention targets. Despite the growing use of artificial intelligence for diagnosis and prediction of mental health conditions, the traditional centralized machine learning methods require aggregating adolescents' data; this raises concerns about confidentiality and privacy, which hampers the clinical application of machine learning algorithms. In this study, we use federated learning to solve those problems. We included 583,405 middle and high school adolescents from 20 districts in Chengdu China, and collected from three aspects: individuals, families, and schools, containing 11 psychological phenomena to evaluate the status of depressive symptoms. We compared federated and local training frameworks; the results showed the area under the receiver operating characteristic curve for depression increased by up to 20 % (from 0.7544 with local training to 0.9064 with federated training). Moreover, based on the best-performing model, the XGBoost model, we explore the data heterogeneity in federated learning and found that stress, student burnout, and social connection were the three most important predictors of depression symptoms. We then assessed the impact of each subdimension of depression symptoms, results show that sleep was the most impact one which may provide clues to predict depression symptoms in early stage and improve control and prevention efforts.
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Affiliation(s)
- Yalan Kuang
- Mental Health Center and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Xiao Liao
- Mental Health Center and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Zekun Jiang
- Mental Health Center and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu 610041, China; College of Computer Science, Sichuan University, Chengdu 610041, China
| | - Yonghong Gu
- Mental Health Center and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Bo Liu
- Walmart Global Tech, Sunnyvale, CA 94086, USA
| | | | - Wei Zhang
- Mental Health Center and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu 610041, China; Med-X Center for Informatics, Sichuan University, Chengdu 610041, China.
| | - Kang Li
- Mental Health Center and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu 610041, China; Med-X Center for Informatics, Sichuan University, Chengdu 610041, China; Shanghai Artificial Intelligence Laboratory, Shanghai 200240, China.
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3
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Deng W, Chong B, Addington J, Bearden CE, Cadenhead KS, Cornblatt BA, Keshavan M, Mathalon DH, Perkins DO, Stone W, Walker EF, Woods SW, Cannon TD. Beyond the Descriptive: A Comprehensive, Multi-domain Validation of Symptom Trajectories for Individuals at Clinical High Risk for Psychosis. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2024:S2451-9022(24)00269-6. [PMID: 39260565 DOI: 10.1016/j.bpsc.2024.08.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Revised: 08/21/2024] [Accepted: 08/28/2024] [Indexed: 09/13/2024]
Abstract
BACKGROUND Although the Clinical High-Risk for Psychosis (CHR-P) criteria are widely used to ascertain individuals at heightened risk for imminent onset of psychosis, it remains controversial whether CHR-P status define a diagnostic construct in its own right. In a prior study, CHR-P non-converters were observed to follow three distinct trajectories in symptoms and functioning: remission, partial remission, and maintenance of symptoms and functional impairments at subthreshold levels of intensity. METHODS Here, we utilized the North American Prodrome Longitudinal Study Phase 3 (NAPLS3) sample (N = 806) to determine whether: 1) the same trajectory groups can be detected when assessing symptoms at 2-month intervals over an 8-month period and 2) the resulting trajectory groups differ from each other and from healthy controls and converting CHR-P cases in terms of risk factors, comorbidities, and functional outcomes. RESULTS Three distinctive subgroups within the CHR non-converters were identified, largely paralleling those previously observed. Importantly, these extracted groups, along with non-CHR controls and CHR converters, differ from each other significantly with respect to putative etiological risk factors (e.g., predicted risk scores, physiological and self-report measures of stress), affective comorbidities, as well as functional outcomes, providing converging evidence supporting the validity of the identified trajectory groups. CONCLUSIONS This pattern, along with the fact that even the subgroup of CHR-P nonconverters showing a remission trajectory deviated from healthy controls, supports treating the CHR-P syndrome not just as a status that denotes risk for onset of full psychosis, but also as a marker of ongoing distress for a population in need of interventions.
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Affiliation(s)
| | | | | | - Carrie E Bearden
- Department of Psychiatry and Biobehavioral Sciences and Psychology, UCLA
| | | | | | - Matcheri Keshavan
- Department of Psychiatry, Harvard Medical School; Beth Israel Deaconess Hospital
| | | | | | - William Stone
- Department of Psychiatry, Harvard Medical School; Beth Israel Deaconess Hospital
| | | | | | - Tyrone D Cannon
- Department of Psychology, Yale University; Department of Psychiatry, Yale University
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Dicker-Oren SD, Gelkopf M, Greene T. Momentary stress-induced food craving: An ecological momentary assessment study comparing perceived interpersonal and non-interpersonal stressors. Stress Health 2024; 40:e3402. [PMID: 38635310 DOI: 10.1002/smi.3402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 02/08/2024] [Accepted: 04/03/2024] [Indexed: 04/19/2024]
Abstract
Daily-life stressors and food cravings are dynamic and vary within and across persons. Some evidence suggests interpersonal stressors increase appetite. However, little is known about the association of food craving with different types of stressors at the momentary level in the general population. We aimed to explore the momentary relationships between daily-life stressful events and food craving in a non-clinical community sample, and to compare the associations with food craving when the most stressful event was perceived as interpersonal versus non-interpersonal. We used ecological momentary assessment (EMA) to collect reports on the most stressful event, perceived stressor type, stressor appraisal, and food craving from 123 adults three times a day scheduled at fixed intervals over 10 days. Mixed effects random intercepts and slopes models examined the within- and between-person associations. Experiencing a stressor was significantly positively associated with within-person food craving at the same measurement. No differences in momentary food craving were found when the most stressful event was perceived as interpersonal or non-interpersonal (within-person level). However, frequently reporting the most stressful event as interpersonal (vs. non-interpersonal) was positively associated with food craving across the study (between-person level), particularly when the stressor was appraised as more unpleasant. Daily-life stressors were associated with momentary food craving. Individuals who generally perceived interpersonal stressors as their most stressful event tended to experience food cravings. Future research could further investigate the role of interpersonal stressors as a factor for overeating in daily life and the potential benefits of stress management in interventions.
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Affiliation(s)
- Sheila Daniela Dicker-Oren
- Department of Community Mental Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Marc Gelkopf
- Department of Community Mental Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Talya Greene
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
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Dougherty EN, Bottera AR, Murray MF, Ekwonu A, Wildes JE, Haedt-Matt AA. Habitual behavioural control moderates the relation between daily perceived stress and purging. EUROPEAN EATING DISORDERS REVIEW 2024. [PMID: 38995266 DOI: 10.1002/erv.3126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 06/06/2024] [Accepted: 06/30/2024] [Indexed: 07/13/2024]
Abstract
OBJECTIVE Evidence suggests that interpersonal stress plays a role in maintaining binge eating and purging (e.g., self-induced vomiting, misuse of laxatives). Stress is especially likely to promote engagement in maladaptive behaviour if the behaviour is habitual; therefore, individuals whose binge eating and/or purging are habitual may be particularly likely to engage in these behaviours in the context of interpersonal stress. We aimed to investigate this hypothesis in a sample of women with binge eating and/or purging using ecological momentary assessment (EMA). METHOD Women (N = 81) with binge-eating and/or purging symptoms completed a self-report measure assessing habit strength of binge eating and purging followed by a 14-day EMA protocol assessing daily perceived interpersonal stress and binge-eating and purging episodes. RESULTS Habit strength of purging moderated the within-person effect of interpersonal stress on purging frequency, such that higher daily stress was associated with greater same-day purging frequency when purging was more habitual. Contrary to expectations, the interactive effect of habit strength of binge eating and daily interpersonal stress on same-day binge-eating frequency was non-significant. CONCLUSIONS Findings suggest that individuals with habitual purging may be vulnerable to engaging in purging when they are experiencing high levels of interpersonal stress.
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Affiliation(s)
- Elizabeth N Dougherty
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | | | - Matthew F Murray
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - Adaora Ekwonu
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - Jennifer E Wildes
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - Alissa A Haedt-Matt
- Department of Psychology, Illinois Institute of Technology, Chicago, IL, USA
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Farina EA, Mourgues-Codern C, Sibarium E, Powers AR. Recent social stress and severity of auditory hallucinations. Schizophr Res 2024; 269:64-70. [PMID: 38733801 PMCID: PMC11180583 DOI: 10.1016/j.schres.2024.04.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 04/27/2024] [Indexed: 05/13/2024]
Abstract
BACKGROUND AND HYPOTHESIS Hearing voices is a common and often distressing experience for people with psychosis, and many individuals experience medication-resistant auditory verbal hallucinations (AVH). Psychosocial interventions are often employed to address distress over hearing voices. However, although links have been made between adverse social experiences and psychosis broadly, no work has yet delineated the relationship between day-to-day social stress and hallucination severity. We aimed to define that relationship in both clinical and non-clinical voice-hearers. STUDY DESIGN A sample of 278 participants with a history of hearing voices was selected from the Yale Control Over Perceptual Experiences (COPE) Project. They were administered self-report measures of recent stress and recent auditory experiences within a cross-sectional design. Regression models were used to evaluate whether self-reported aspects of recent stress-and social stress in particular-were related to recent frequency of and distress over hearing voices. Related demographics and clinical characteristics were included as covariates. STUDY RESULTS A significant relationship was observed between recent social stress and both recent frequency of and distress over hearing voices. While other aspects of recent stress were also related to recent distress over voices, social stressors uniquely predicted distress over voice-hearing, beyond the influence of other stressors. Depressive symptom severity was also related to distress over voices. CONCLUSIONS Results suggest that daily social stress may be an important consideration and a potential treatment target for individuals experiencing clinical distress over auditory hallucinations.
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Affiliation(s)
- Emily A Farina
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, USA
| | | | - Ely Sibarium
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, USA
| | - Albert R Powers
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, USA.
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Thomas TA, Schmid AM, Kessling A, Wolf OT, Brand M, Steins-Loeber S, Müller A. Stress and compulsive buying-shopping disorder: A scoping review. Compr Psychiatry 2024; 132:152482. [PMID: 38603938 DOI: 10.1016/j.comppsych.2024.152482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 03/26/2024] [Accepted: 04/02/2024] [Indexed: 04/13/2024] Open
Abstract
INTRODUCTION Theoretical frameworks of behavioral addictions mostly acknowledge the role of stress in the development and maintenance of these disorders, models of compulsive buying-shopping disorder (CBSD) however rarely incorporated stress. The association between stress and CBSD has not been reviewed yet. METHODS A scoping review was conducted to evaluate empirical results on the association between stress and CBSD. A comprehensive search string was employed in three databases. RESULTS 16 studies were included. Correlative studies suggested significant correlations between general perceived stress and CBSD symptom severity. Studies involving mean comparisons found higher general perceived stress levels in persons with problematic buying-shopping behavior/CBSD compared to control participants (large effects). Mixed results were found in studies involving regression/structural equation models and ecological momentary assessments. One study with a stress/negative mood induction observed more CBSD symptoms in a high stress group compared to a low stress group. DISCUSSION The studies are heterogeneous concerning design, samples and measures. Only very few studies surpass the level of cross-sectional correlative data which limits the ability to draw clear conclusions. Future research should study the impact of experimentally induced stress on CBSD symptoms, examine the relationship between stress and CBSD longitudinally and assess objective stress markers.
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Affiliation(s)
- Tobias A Thomas
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hanover, Germany.
| | - Anna M Schmid
- Department of Clinical Psychology and Psychotherapy, Otto-Friedrich-University of Bamberg, Bamberg, Germany
| | - Annica Kessling
- Department of General Psychology, Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Duisburg, Germany
| | - Oliver T Wolf
- Department of Cognitive Psychology, Institute of Cognitive Neuroscience, Faculty of Psychology, Ruhr University Bochum, Bochum, Germany
| | - Matthias Brand
- Department of General Psychology, Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Duisburg, Germany; Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen, Germany
| | - Sabine Steins-Loeber
- Department of Clinical Psychology and Psychotherapy, Otto-Friedrich-University of Bamberg, Bamberg, Germany
| | - Astrid Müller
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hanover, Germany
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Cowan HR, Williams TF, Mittal VA, Addington J, Bearden CE, Cadenhead KS, Cannon TD, Cornblatt BA, Keshevan M, Perkins DO, Mathalon DH, Stone W, Woods SW, Walker EF. The Complex Latent Structure of Attenuated Psychotic Symptoms: Hierarchical and Bifactor Models of SIPS Symptoms Replicated in Two Large Samples at Clinical High Risk for Psychosis. Schizophr Bull 2024:sbae042. [PMID: 38728417 DOI: 10.1093/schbul/sbae042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/12/2024]
Abstract
BACKGROUND AND HYPOTHESIS The Structured Interview for Psychosis-Risk Syndromes (SIPS) and other assessments of psychosis risk define clinical high risk for psychosis (CHR) by the presence of attenuated psychotic symptoms. Despite extensive research on attenuated psychotic symptoms, substantial questions remain about their internal psychometric structure and relationships to comorbid non-psychotic symptoms. STUDY DESIGN Hierarchical and bifactor models were developed for the SIPS in a large CHR sample (NAPLS-3, N = 787) and confirmed through preregistered replication in an independent sample (NAPLS-2, N = 1043). Criterion validity was tested through relationships with CHR status, comorbid symptoms/diagnoses, functional impairment, demographics, neurocognition, and conversion to psychotic disorders. STUDY RESULTS Most variance in SIPS items (75%-77%) was attributable to a general factor. Hierarchical and bifactor models included a general factor and five specific/lower-order factors (positive symptoms, eccentricity, avolition, lack of emotion, and deteriorated thought process). CHR participants were elevated on the general factor and the positive symptoms factor. The general factor was associated with depressive symptoms; functional impairment; and mood, anxiety, and schizotypal personality diagnoses. The general factor was the best predictor of psychotic disorders (d ≥ 0.50). Positive symptoms and eccentricity had specific effects on conversion outcomes. The deteriorated thought process was least meaningful/replicable. CONCLUSIONS Attenuated psychotic symptoms, measured by the SIPS, have a complex hierarchical structure with a strong general factor. The general factor relates to internalizing symptoms and functional impairment, emphasizing the roles of general psychopathological distress/impairment in psychosis risk. Shared symptom variance complicates the interpretation of raw symptom scores. Broad transdiagnostic assessment is warranted to model psychosis risk accurately.
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Affiliation(s)
- Henry R Cowan
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, OH, USA
- Department of Psychology, Michigan State University, East Lansing, MI, USA
| | - Trevor F Williams
- Department of Psychology, Northwestern University, Evanston, IL, USA
| | - Vijay A Mittal
- Department of Psychology, Northwestern University, Evanston, IL, USA
- Departments of Psychiatry and Medical Social Sciences, Northwestern University, Evanston, IL, USA
| | - Jean Addington
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Carrie E Bearden
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
- Department of Psychology, University of California Los Angeles, Los Angeles, CA, USA
| | - Kristin S Cadenhead
- Department of Psychiatry, University of California San Diego, San Diego, USA
| | - Tyrone D Cannon
- Department of Psychology, Yale University, New Haven, CT, USA
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | - Barbara A Cornblatt
- Department of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, NY, USA
| | - Matcheri Keshevan
- Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston, MA, USA
| | - Diana O Perkins
- Department of Psychiatry, University of North Carolina, Chapel Hill, Chapel Hill, NC, USA
| | - Daniel H Mathalon
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA
| | - William Stone
- Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston, MA, USA
| | - Scott W Woods
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | - Elaine F Walker
- Department of Psychology, Emory University, Atlanta, GA, USA
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Threeton EM, Morris PE, Buckner JD. Sexual orientation-based microaggressions and cannabis use outcomes among sexual minority individuals: The impact of negative affect and coping-motivated cannabis use. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2024; 160:209293. [PMID: 38272122 PMCID: PMC11060912 DOI: 10.1016/j.josat.2024.209293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 10/02/2023] [Accepted: 01/11/2024] [Indexed: 01/27/2024]
Abstract
INTRODUCTION Sexual minority individuals report significantly more cannabis use and problems than their heterosexual peers, possibly due to their frequent experiences with sexual orientation-based microaggressions. As a result, sexual minority individuals may turn to cannabis use to cope with the negative affect associated with these experiences. No known studies have tested this hypothesis; therefore, the current study tested if sexual orientation microaggressions are positively associated with negative affect (anxiety and depression), cannabis coping motives, and cannabis-related outcomes (frequency, problems); if coping motives are positively associated with cannabis-related outcomes; and if negative affect and cannabis use to cope with negative affect serially mediate the relation between sexual orientation microaggressions and cannabis-related outcomes. METHODS Sexual minority undergraduate students who reported cannabis use in the past three months (N = 328; 71.3 % cis-female) completed an online survey. RESULTS Microaggressions were significantly positively correlated with anxiety, depression, coping-motivated cannabis use, cannabis-related problems, non-sexual orientation-related stress, and overt sexual orientation-based discrimination. Additionally, after controlling for non-sexual orientation-related stress and overt sexual orientation-based discrimination, microaggressions were indirectly positively related to cannabis use frequency and problems via the sequential effects of negative affect and coping motives. This relation remained significant when examining negative affect specific to sexual orientation microaggressions and cannabis use to cope with this microaggressions-specific negative affect. CONCLUSIONS Results highlight the adverse impact of sexual orientation microaggressions in terms of negative affect and negative cannabis-related outcomes.
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Affiliation(s)
- Evan M Threeton
- Louisiana State University, Department of Psychology, 236 Audubon Hall, Baton Rouge, LA 70803, USA
| | - Paige E Morris
- Louisiana State University, Department of Psychology, 236 Audubon Hall, Baton Rouge, LA 70803, USA
| | - Julia D Buckner
- Louisiana State University, Department of Psychology, 236 Audubon Hall, Baton Rouge, LA 70803, USA.
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10
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Nolan RP, Syed F, Stogios N, Maunder R, Sockalingam S, Tai ES, Cobain M, Peiris RG, Huszti E. The evaluation of goal-directed activities to promote well-being and health in heart failure: EUROIA scale. J Patient Rep Outcomes 2024; 8:47. [PMID: 38683439 PMCID: PMC11058156 DOI: 10.1186/s41687-024-00723-x] [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: 08/29/2023] [Accepted: 04/14/2024] [Indexed: 05/01/2024] Open
Abstract
BACKGROUND The EvalUation of goal-diRected activities to prOmote well-beIng and heAlth (EUROIA) scale is a novel patient-reported measure that was administered to individuals with chronic heart failure (CHF). It assesses goal-directed activities that are self-reported as being personally meaningful and commonly utilized to optimize health-related quality of life (HRQL). Our aim was to evaluate psychometric properties of the EUROIA, and to determine if it accounted for novel variance in its association with clinical outcomes. METHODS This study was a secondary analysis of the CHF-CePPORT trial, which enrolled 231 CHF patients: median age = 59.5 years, 23% women. Baseline assessments included: EUROIA, Kansas City Cardiomyopathy Questionnaire-Overall Summary (KCCQ-OS), Patient Health Questionnaire-9 for depression (PHQ-9), and the Generalized Anxiety Disorder-7 (GAD-7). 12-month outcomes included health status (composite index of incident hospitalization or emergency department, ED, visit) and mental health (PHQ-9 and GAD-7). RESULTS Exploratory Principal Axis Factoring identified four EUROIA factors with satisfactory internal reliability: i.e., activities promoting eudaimonic well-being (McDondald's ω = 0.79), social affiliation (⍺=0.69), self-affirmation (⍺=0.73), and fulfillment of social roles/responsibilities (Spearman-Brown coefficient = 0.66). Multivariable logistic regression indicated that not only was the EUROIA inversely associated with incidence of 12-month hospitalization/ED visits independent of the KCCQ-OS (Odds Ratio, OR = 0.95, 95% Confidence Interval, CI, 0.91, 0.98), but it was also associated with 12-month PHQ-9 (OR = 0.91, 95% CI, 0.86, 0.97), and GAD-7 (OR = 0.94, 95% CI, 0.90, 0.99) whereas the KCCQ-OS was not. CONCLUSION The EUROIA provides a preliminary taxonomy of goal-directed activities that promote HRQL among CHF patients independently from a current gold standard state-based measure. CLINICAL TRIAL REGISTRATION NCT01864369; https://classic. CLINICALTRIALS gov/ct2/show/NCT01864369 .
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Affiliation(s)
- Robert P Nolan
- Behavioral Cardiology Research Unit, Peter Munk Cardiac Centre and Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada.
- Institute of Medical Science, University of Toronto Faculty of Medicine, Toronto, ON, Canada.
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
| | - Fatima Syed
- Behavioral Cardiology Research Unit, Peter Munk Cardiac Centre and Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto Faculty of Medicine, Toronto, ON, Canada
| | - Nicolette Stogios
- Behavioral Cardiology Research Unit, Peter Munk Cardiac Centre and Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto Faculty of Medicine, Toronto, ON, Canada
| | - Robert Maunder
- Institute of Medical Science, University of Toronto Faculty of Medicine, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, Sinai Health System, Toronto, ON, Canada
| | - Sanjeev Sockalingam
- Institute of Medical Science, University of Toronto Faculty of Medicine, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Department of Education, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - E Shyong Tai
- Division of Endocrinology, National University Hospital, Singapore, Singapore
| | | | - Rachel G Peiris
- Behavioral Cardiology Research Unit, Peter Munk Cardiac Centre and Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto Faculty of Medicine, Toronto, ON, Canada
| | - Ella Huszti
- Biostatistics Research Unit, University Health Network, Toronto, ON, Canada
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11
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Martin JC, Clark SR, Hartmann S, Schubert KO. A Tale of Three Spectra: Basic Symptoms in Clinical-High-Risk of Psychosis Vary Across Autism Spectrum Disorder, Schizotypal Personality Disorder, and Borderline Personality Disorder. SCHIZOPHRENIA BULLETIN OPEN 2024; 5:sgae017. [PMID: 39183768 PMCID: PMC11341945 DOI: 10.1093/schizbullopen/sgae017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/27/2024]
Abstract
Background and Hypothesis The clinical-high-risk (CHR) approach was developed to prevent psychosis through the detection of psychosis risk. CHR services are transdiagnostic in nature, therefore the appropriate management of comorbidity is a central part of care. Differential diagnosis is particularly challenging across 3 common comorbidities, schizotypal personality disorder (SPD), autism spectrum disorder (ASD), and borderline personality disorder (BPD). Phenomenological research indicates a disturbance of "basic self" may differentiate between these commonly comorbid disorders and can be captured by Huber's basic symptoms (BS) concept. We investigated whether BS vary across these disorders and may inform differential diagnosis in young person's meeting CHR criteria. Study Design A total of 685 participants meeting CHR criteria from the NAPLS-3 cohort completed the COGDIS items of the schizophrenia proneness instrument, a measure of BS, as well as the structured interview for DSM-5 (SCID-5). A logistic regression model was used to investigate the variation of COGDIS across SPD, ASD, and BPD, while controlling for age and SIPs positive severity. Study Results Meeting COGDIS criteria was positively associated with SPD (OR = 1.72, CI = [1.31-2.28], P = .001) but not ASD nor BPD. Conclusions Our results indicate that "basic self-disturbance" as indicated by COGDIS differs across SPD, ASD, and BPD. COGDIS may be useful to inform the management of comorbidities in CHR services, by providing insight into subtle subjective experiences that may benefit from disorder-specific interventions.
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Affiliation(s)
- James C Martin
- Discipline of Psychiatry, Adelaide Medical School, The University of Adelaide, North Terrace, Adelaide, South Australia, Australia
| | - Scott R Clark
- Discipline of Psychiatry, Adelaide Medical School, The University of Adelaide, North Terrace, Adelaide, South Australia, Australia
- Discipline of Psychiatry, Basil Hetzel Institute, Woodville, South Australia, Australia
| | - Simon Hartmann
- Discipline of Psychiatry, Adelaide Medical School, The University of Adelaide, North Terrace, Adelaide, South Australia, Australia
| | - K Oliver Schubert
- Discipline of Psychiatry, Adelaide Medical School, The University of Adelaide, North Terrace, Adelaide, South Australia, Australia
- Division of Mental Health, Northern Adelaide Local Health Network, SA Health, South Australia
- Headspace Early Psychosis, Sonder, South Australia
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12
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Doran K, Witmer S, Yoon KL, Fischer ER, Ebangwese A, Sharma S, Duggirala GSC, Chen LK. Gauging the stress of long-term care nursing assistants using ecological momentary assessment, wearable sensors and end of day reconstruction. Int J Older People Nurs 2024; 19:e12592. [PMID: 38098142 DOI: 10.1111/opn.12592] [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: 07/07/2023] [Revised: 11/14/2023] [Accepted: 11/18/2023] [Indexed: 01/26/2024]
Abstract
BACKGROUND Nursing assistants working in long-term care (LTC) often report that their job is stressful. To reduce their work stress, a better understanding of their stress profile is needed. OBJECTIVE We aimed to pilot test methods to identify and understand stressors that LTC nursing assistants experience. METHODS We asked each participant to provide wearable sensor/watch data, ecological momentary assessment (EMA) surveys and end of day review data over two eight-hour working shifts. RESULTS Eight nursing assistants participated. All participants worked in a common continuing care retirement community in Maryland, United States of America. Our stress assessment method revealed 83 stressful events that were classified under 10 categories. Most of the reported events were rated as having a mild to low-moderate intensity. The three most common causes of stress were work demands and pressure (28.35%), heavy workload and staffing (19.69%), and safety issues and COVID-19 concerns (17.32%). We also explored the difference between stress events and intensity among different shifts. Disrespect from residents (22.73%) was the most commonly reported stressor during day shifts. Feeling rushed was the most commonly reported stressor during the evening (22.47%) and the night (38.46%) shifts. CONCLUSIONS We found stress was commonly reported. Stress intensity conflicted with prior literature, and we explored possible explanations. IMPLICATIONS FOR PRACTICE We discuss potential implications for these findings, modification of our methods to increase feasibility, the utility of these data collection methods for future work and suggest next steps.
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Affiliation(s)
- Kelly Doran
- University of Maryland, Baltimore School of Nursing In Baltimore, Baltimore, Maryland, USA
| | - Susanna Witmer
- University of Maryland, Baltimore School of Nursing In Baltimore, Baltimore, Maryland, USA
| | - K Lira Yoon
- University of Maryland, Baltimore County In Baltimore, Baltimore, Maryland, USA
| | - Ethan Ray Fischer
- University of Maryland, Baltimore County In Baltimore, Baltimore, Maryland, USA
| | - Abaneh Ebangwese
- University of Maryland, Baltimore School of Nursing In Baltimore, Baltimore, Maryland, USA
| | - Shifali Sharma
- University of Maryland, Baltimore County In Baltimore, Baltimore, Maryland, USA
| | | | - Lujie Karen Chen
- University of Maryland, Baltimore County In Baltimore, Baltimore, Maryland, USA
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13
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Nowak MK, Kronenberger WG, Rettke D, Ogbeide O, Klemsz LM, Quinn PD, Mickleborough TD, Newman SD, Kawata K. Neuro-ophthalmologic and blood biomarker responses in ADHD following subconcussive head impacts: a case-control trial. Front Psychiatry 2023; 14:1230463. [PMID: 38076682 PMCID: PMC10710155 DOI: 10.3389/fpsyt.2023.1230463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 11/09/2023] [Indexed: 02/12/2024] Open
Abstract
Introduction This clinical trial aimed to determine the influence of attention-deficit/hyperactivity disorder (ADHD) on neuro-ophthalmologic function and brain-derived blood biomarkers following acute subconcussive head impacts. Methods The present trial consisted of age- and sex-matched samples with a ratio of 1:1 between two groups with a total sample size of 60 adults (age ± SD; 20.0 ± 1.8 years). Soccer players diagnosed with and medicated daily for ADHD were assigned into an ADHD group (n = 30). Soccer players without ADHD were assigned into a non-ADHD group (n = 30). Participants performed 10 soccer headers with a soccer ball projected at a velocity of 25mph. King-Devick test (KDT), near point of convergence (NPC), and serum levels of NF-L, tau, GFAP, and UCH-L1 were assessed at baseline (pre-heading) and at 2 h and 24 h post-heading. Results There were no statistically significant group-by-time interactions in outcome measures. However, at baseline, the ADHD group exhibited lower neuro-ophthalmologic functions compared to the non-ADHD group (NPC: p = 0.019; KDT: p = 0.018), and persisted at 2 h-post (NPC: p = 0.007; KDT: p = 0.014) and 24 h-post heading (NPC: p = 0.001). NPC significantly worsened over time in both groups compared to baseline [ADHD: 2 h-post, 1.23 cm, 95%CI:(0.77, 1.69), p < 0.001; 24 h-post, 1.68 cm, 95%CI:(1.22, 2.13), p = 0.001; Non-ADHD: 2 h-post, 0.96 cm, 95%CI:(0.50, 1.42), p < 0.001; 24 h-post, 1.09 cm, 95%CI:(0.63, 1.55), p < 0.001]. Conversely, improvements in KDT time compared to baseline occurred at 2 h-post in the non-ADHD group [-1.32 s, 95%CI:(-2.55, -0.09), p = 0.04] and at 24 h-post in both groups [ADHD: -4.66 s, 95%CI:(-5.89, -3.43), p < 0.001; Non-ADHD: -3.46 s, 95%CI:(-4.69, -2.23), p < 0.001)]. There were no group-by-time interactions for GFAP as both groups exhibited increased levels at 2 h-post [ADHD: 7.75 pg./mL, 95%CI:(1.41, 14.10), p = 0.019; Non-ADHD: 7.91 pg./mL, 95%CI:(1.71, 14.14), p = 0.015)] that returned to baseline at 24 h-post. NF-L levels increased at 2 h-post heading in the ADHD group [0.45 pg./mL, 95%CI:(0.05, 0.86), p = 0.032], but no significant NF-L changes were observed in the non-ADHD group over time. Discussion Ten soccer headers elevated GFAP levels and NPC impairment in both groups. However, persisting group difference in NPC, blunted KDT performance, and increased NF-L levels in the ADHD group suggest that ADHD may reduce neuro-ophthalmologic function and heighten axonal response to soccer headers. Clinical trial registration ClinicalTrials.gov, identifier ID: (NCT04880304).
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Affiliation(s)
- Madeleine K. Nowak
- National Center for PTSD at VA Boston Healthcare System, Boston, MA, United States
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, United States
- Department of Kinesiology, School of Public Health-Bloomington, Indiana University, Bloomington, IN, United States
| | - William G. Kronenberger
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Devin Rettke
- Department of Kinesiology, School of Public Health-Bloomington, Indiana University, Bloomington, IN, United States
| | - Osamudiamen Ogbeide
- Department of Kinesiology, School of Public Health-Bloomington, Indiana University, Bloomington, IN, United States
| | - Lillian M. Klemsz
- Department of Kinesiology, School of Public Health-Bloomington, Indiana University, Bloomington, IN, United States
| | - Patrick D. Quinn
- Department of Applied Health Science, School of Public Health-Bloomington, Indiana University, Bloomington, IN, United States
- Program in Neuroscience, College of Arts and Sciences, Indiana University, Bloomington, IN, United States
| | - Timothy D. Mickleborough
- Department of Kinesiology, School of Public Health-Bloomington, Indiana University, Bloomington, IN, United States
| | - Sharlene D. Newman
- Alabama Life Research Institute, University of Alabama, Tuscaloosa, AL, United States
| | - Keisuke Kawata
- Department of Kinesiology, School of Public Health-Bloomington, Indiana University, Bloomington, IN, United States
- Program in Neuroscience, College of Arts and Sciences, Indiana University, Bloomington, IN, United States
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Morris MC, Moradi H, Aslani M, Sims M, Schlundt D, Kouros CD, Goodin B, Lim C, Kinney K. Predicting incident cardiovascular disease among African-American adults: A deep learning approach to evaluate social determinants of health in the Jackson heart study. PLoS One 2023; 18:e0294050. [PMID: 37948388 PMCID: PMC10637695 DOI: 10.1371/journal.pone.0294050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 10/24/2023] [Indexed: 11/12/2023] Open
Abstract
The present study sought to leverage machine learning approaches to determine whether social determinants of health improve prediction of incident cardiovascular disease (CVD). Participants in the Jackson Heart study with no history of CVD at baseline were followed over a 10-year period to determine first CVD events (i.e., coronary heart disease, stroke, heart failure). Three modeling algorithms (i.e., Deep Neural Network, Random Survival Forest, Penalized Cox Proportional Hazards) were used to evaluate three feature sets (i.e., demographics and standard/biobehavioral CVD risk factors [FS1], FS1 combined with psychosocial and socioeconomic CVD risk factors [FS2], and FS2 combined with environmental features [FS3]) as predictors of 10-year CVD risk. Contrary to hypothesis, overall predictive accuracy did not improve when adding social determinants of health. However, social determinants of health comprised eight of the top 15 predictors of first CVD events. The social determinates of health indicators included four socioeconomic factors (insurance status and types), one psychosocial factor (discrimination burden), and three environmental factors (density of outdoor physical activity resources, including instructional and water activities; modified retail food environment index excluding alcohol; and favorable food stores). Findings suggest that whereas understanding biological determinants may identify who is currently at risk for developing CVD and in need of secondary prevention, understanding upstream social determinants of CVD risk could guide primary prevention efforts by identifying where and how policy and community-level interventions could be targeted to facilitate changes in individual health behaviors.
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Affiliation(s)
- Matthew C. Morris
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, Mississippi, United States of America
| | - Hamidreza Moradi
- Department of Data Science, University of Mississippi Medical Center, Jackson, Mississippi, United States of America
- Department of Computer Science, University of North Carolina Agricultural and Technical State University, Greensboro, North Carolina, United States of America
| | - Maryam Aslani
- Department of Data Analytics, University of North Texas, Denton, Texas, United States of America
| | - Mario Sims
- Department of Social Medicine, Population, and Public Health, University of California, Riverside, California, United States of America
| | - David Schlundt
- Department of Psychology, Vanderbilt University, Nashville, Tennessee, United States of America
| | - Chrystyna D. Kouros
- Department of Psychology, Southern Methodist University, Dallas, Texas, United States of America
| | - Burel Goodin
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, Texas, United States of America
- Department of Anesthesiology, Washington University in St. Louis, St. Louis, Missouri, United States of America
| | - Crystal Lim
- Department of Health Psychology, University of Missouri, Columbia, Missouri, Texas, United States of America
| | - Kerry Kinney
- Department of Psychology, Vanderbilt University, Nashville, Tennessee, United States of America
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15
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SheikhBahaei S, Millwater M, Maguire GA. Stuttering as a spectrum disorder: A hypothesis. CURRENT RESEARCH IN NEUROBIOLOGY 2023; 5:100116. [PMID: 38020803 PMCID: PMC10663130 DOI: 10.1016/j.crneur.2023.100116] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 09/26/2023] [Accepted: 10/24/2023] [Indexed: 12/01/2023] Open
Abstract
Childhood-onset fluency disorder, commonly referred to as stuttering, affects over 70 million adults worldwide. While stuttering predominantly initiates during childhood and is more prevalent in males, it presents consistent symptoms during conversational speech. Despite these common clinical manifestations, evidence suggests that stuttering, may arise from different etiologies, emphasizing the need for personalized therapy approaches. Current research models often regard the stuttering population as a singular, homogenous group, potentially overlooking the inherent heterogeneity. This perspective consolidates both historical and recent observations to emphasize that stuttering is a heterogeneous condition with diverse causes. As such, it is crucial that both therapeutic research and clinical practices consider the potential for varied etiologies leading to stuttering. Recognizing stuttering as a spectrum disorder embraces its inherent variability, allowing for a more nuanced categorization of individuals based on the underlying causes. This perspective aligns with the principles of precision medicine, advocating for tailored treatments for distinct subgroups of people who stutter, ultimately leading to personalized therapeutic approaches.
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Affiliation(s)
- Shahriar SheikhBahaei
- Neuron-Glia Signaling and Circuits Unit, National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health (NIH), Bethesda, 20892, MD, USA
| | - Marissa Millwater
- Neuron-Glia Signaling and Circuits Unit, National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health (NIH), Bethesda, 20892, MD, USA
| | - Gerald A. Maguire
- CenExel Research/ American University of Health Sciences, Signal Hill, CA, 90755, USA
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16
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Muniandy M, Richdale AL, Lawson LP. Stress and well-being in autistic adults: Exploring the moderating role of coping. Autism Res 2023; 16:2220-2233. [PMID: 37698532 DOI: 10.1002/aur.3028] [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: 04/26/2023] [Accepted: 08/24/2023] [Indexed: 09/13/2023]
Abstract
The wider stress literature points to negative associations between stress and well-being. Similarly, the use of engagement coping strategies and disengagement coping strategies in the face of stress are related to improved and reduced well-being respectively. However, in the autistic population stress and coping research is limited to date, and the extent to which coping may moderate the relationship between stress and well-being is not known. Using data from an Australian online study, we explored the potential moderating (i.e. buffering or exacerbating) role of coping in the relationship between stress and well-being in a sample of autistic adults (N = 86). Our findings indicated that increased stress was associated with lower well-being. Further, moderation analyses showed that while both engagement coping (e.g. problem solving, positive appraisal) and disengagement coping (e.g., self-distraction, being in denial) strategies had significant positive and negative direct effects on well-being respectively; engagement coping also moderated the relationship between stress and well-being, buffering the impact of stress on well-being. Our results illustrate the different underlying mechanisms by which coping strategies may be associated with stress and well-being. They also highlight the potential protective role of engagement coping strategies, which can be incorporated into the promotion and maintenance of well-being in autistic adults.
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Affiliation(s)
- Melanie Muniandy
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Queensland, Australia
| | - Amanda L Richdale
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Queensland, Australia
| | - Lauren P Lawson
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Queensland, Australia
- Department of Psychology, Counselling & Therapy, School of Psychology & Public Health, La Trobe University, Victoria, Australia
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17
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Lee SH, Shin DI, Lee SS. The insufficiency of a simple stress question in assessing stress for chronic daily headache in clinical practice. Clin Neurol Neurosurg 2023; 233:107944. [PMID: 37634396 DOI: 10.1016/j.clineuro.2023.107944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 08/12/2023] [Accepted: 08/14/2023] [Indexed: 08/29/2023]
Abstract
BACKGROUND In managing chronic daily headaches (CDH), a comprehensive approach is necessary to evaluate stress, a closely linked factor. However, limited time and costs often lead to the use of a simple stress question in clinical settings. This study aims to assess the validity of using a simple stress question for CDH patients and explore its implications for clinical practice. METHODS We recruited 103 patients with CDH who completed structured self-administered questionnaires, including a simple stress question ("Have you had any stress or concerns in the last 4 weeks?") and validated Korean versions of questionnaires for depression, anxiety, insomnia, and the Brief Encounter Psychosocial Instrument (BEPSI). A headache specialist conducted clinical interviews. The stress group consisted of patients who acknowledged overt stress (answering "yes" to the simple question) and covert stress (initially answering "no" but later admitting during the interview). Results showed no statistical difference between the subgroups, so they were combined as the "acknowledged stress" group. RESULTS Out of 103 patients, 54.4% had chronic migraine, 45.6% had chronic tension-type headache, and 66 patients (64.1%) acknowledged experiencing stress. No significant differences were found in demographic and clinical characteristics, BEPSI stress assessment, or depression, anxiety, and insomnia profiles between patients with overt stress (n = 51) and covert stress (n = 15). The average BEPSI score was 2.3 ± 0.9, with 45.6% of patients exceeding the criteria (>2.4). Two (5.4%) patients in denial of stress had scores above the BEPSI criteria. Among patients below the criteria of BEPSI, 21 acknowledged stress, while 35 denied stress, with no significant differences observed. CONCLUSIONS This study suggests the limitations of relying solely on a simple stress question for assessing stress in patients with CDH in clinical practice. It is possible to encounter covert stress, include individuals who do not exhibit noticeable stress, and misclassify stress levels. To overcome these limitations, it is necessary to foster a supportive environment for open communication on stress and implement a comprehensive assessment strategy when needed.
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Affiliation(s)
- Sung-Hyun Lee
- Department of Neurology, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Republic of Korea.
| | - Dong-Ick Shin
- Department of Neurology, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Republic of Korea
| | - Sang-Soo Lee
- Department of Neurology, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Republic of Korea
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18
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Thomas AJ, Mitchell ES, Pike KC, Woods NF. Stressful life events during the perimenopause: longitudinal observations from the seattle midlife women's health study. Womens Midlife Health 2023; 9:6. [PMID: 37667359 PMCID: PMC10478480 DOI: 10.1186/s40695-023-00089-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 08/29/2023] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND Midlife is a time of increased responsibilities for women who have multiple roles including taking care of children, caring for elderly parents, managing households, and working outside the home. With little time for themselves, women additionally experience stressful life events (SLEs). The purpose of this study was to describe the longitudinal patterns of SLEs of women during midlife and to identify predictors of the SLE longitudinal patterns using baseline data of socio-economic factors and demographic characteristics. METHODS Women who were part of the Seattle Midlife Women's Health Study (SMWHS), a longitudinal study spanning more than 23 years, who had SLEs measured at baseline and at years 2, 7, and 10 were included in these analyses (N = 380 women at baseline). The Life Event Scale (LES), a 70-item scale based on a yes/no response and a Likert-based scoring system with 0 (no effect) to 4 (large effect), was used to determine the total and impact scores of midlife women. The LES was adapted to midlife women from the Norbeck Scale for younger, pregnant women. Analytic strategies consisted of a group-based trajectory model (GBTM) to examine subgroups of women with similar exposure to SLEs using socio-economic factors (gross family income, education, race/ethnicity, employment), demographic variables (age, marital status, being a parent), and menopausal transition stage to differentiate trajectories over time. RESULTS Approximately 86% of women had medium high exposure to undesirable SLEs with a slight decrease (65.5%), or a sharp decrease (20.1%), over 10 years. The majority (approximately 64%) had moderate, sustained impact ratings, while approximately 35% had impact ratings that decreased over time. Most women (approximately 88%) reported desirable life events, which were sustained over the ten years, and which may help to balance or offset the high ratings of undesirable stressful life events. The rated impact of these desirable events decreased slightly over time for 65% of the sample. Socio-economic factors, demographic variables, and menopausal transition stages were not significant predictors of any of the four GBTMs. CONCLUSION Midlife women experience SLEs throughout the menopausal transition. Most of these midlife women had had a large amount of sustained stress over 10 years although all trajectories decreased to some extent over time. Since the menopausal transition stages were not significant predictors of the ratings of SLEs, a more complex set of factors, including social as well as biological, may explain the ratings of the women over the course of this ten-year observational study.
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Affiliation(s)
| | | | - Kenneth C Pike
- Office of Nursing Research, University of Washington, Seattle, WA, USA
| | - Nancy Fugate Woods
- Biobehavioral Nursing and Health Informatics, University of Washington, Seattle, WA, USA
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19
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Buckner JD, Morris PE, Threeton EM, Zvolensky MJ. Cannabis and Nicotine Dual Use among Sexual Minority Individuals: Relations to Cannabis Use and Negative Affect. Subst Use Misuse 2023; 58:1813-1817. [PMID: 37622481 PMCID: PMC10786340 DOI: 10.1080/10826084.2023.2250427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
Background: Sexual minority individuals report significantly more cannabis use and use-related problems than their heterosexual peers, and emerging data indicate sexual minority individuals who use cannabis are at greater risk for dual use of nicotine products (combustible smoking, e-cigarette use) than heterosexual individuals. Although cannabis-nicotine dual use is related to worse cannabis outcomes and negative affect, little work has identified factors related to dual use among sexual minority individuals or tested if sexual orientation-based discrimination (microaggressions, overt discrimination) is related to dual use. Objectives: The current study tested if cannabis-nicotine dual use is related to more frequent cannabis use, more cannabis-related problems, negative affect, and discrimination among sexual minority undergraduate students who endorsed current (past three-month) cannabis use (N = 328), 43.6% of whom endorsed dual nicotine use. Cannabis-nicotine dual use was related to more frequent cannabis use, more cannabis-related problems, more anxiety (but not depression), and more sexual orientation-based microaggressions and microaggressions-related negative affect (but not overt discrimination or non-sexual orientation-based daily stressors). Conclusions/Importance: Overall, this is the first known study to identify that sexual orientation-based discrimination is related to cannabis-nicotine dual use and that dual use is related to more frequent cannabis use, use-related problems, and negative affect (especially anxiety) among this underrepresented group.
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Affiliation(s)
- Julia D. Buckner
- Louisiana State University, Department of Psychology, 236 Audubon Hall, Baton Rouge, LA 70803, USA
| | - Paige E. Morris
- Louisiana State University, Department of Psychology, 236 Audubon Hall, Baton Rouge, LA 70803, USA
| | - Evan M. Threeton
- Louisiana State University, Department of Psychology, 236 Audubon Hall, Baton Rouge, LA 70803, USA
| | - Michael J. Zvolensky
- Department of Psychology, University of Houston, Houston, TX, USA
- Department of Behavioral Sciences, University of Texas MD Anderson Cancer Center, Houston, TX, USA
- HEALTH Institute, University of Houston, Houston, TX, USA
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20
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Halverson TF, Dillon KH, Weber DM, Dennis PA, Beckham JC, Calhoun PS, Kimbrel NA. Interpersonal stress and nonsuicidal self-injury disorder in veterans: An ecological momentary assessment study. Suicide Life Threat Behav 2023; 53:546-556. [PMID: 37052380 PMCID: PMC10523856 DOI: 10.1111/sltb.12963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 02/24/2023] [Accepted: 04/01/2023] [Indexed: 04/14/2023]
Abstract
INTRO Nonsuicidal self-injury (NSSI) is associated with marked functional impairment and is a robust predictor of suicide attempts. Prevalence rates of NSSI, and self-directed violence more broadly, are elevated among military veterans. Despite the inclusion of interpersonal difficulty in the diagnostic criteria for NSSI disorder, the relationship between interpersonal risk factors and NSSI is not well-characterized, especially among veterans. This ecological momentary assessment (EMA) study investigated the hypothesis that interpersonal stressors and associated distress would precede and predict NSSI urge and engagement-but not vice versa-via cross-lagged multilevel modeling. METHOD Forty veterans with NSSI disorder completed a 28-day EMA protocol with three daily prompts assessing NSSI urges, NSSI engagement, the occurrence of interpersonal stressors, and associated subjective interpersonal distress. RESULTS Interpersonal stressors preceded and predicted subsequent NSSI urges, but not NSSI engagement, whereas subjective interpersonal distress preceded and predicted both NSSI urges and NSSI engagement. CONCLUSION Results identified interpersonal stressors as a risk factor for NSSI urges, and interpersonal distress as a risk factor for both NSSI urges and NSSI engagement. Findings highlight the importance of temporally assessing interpersonal factors related to NSSI and suggest that interpersonal distress may be a modifiable risk factor for NSSI.
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Affiliation(s)
- Tate F Halverson
- Durham Veterans Affairs Health Care System, Durham, North Carolina, USA
- VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, North Carolina, USA
| | - Kirsten H Dillon
- Durham Veterans Affairs Health Care System, Durham, North Carolina, USA
- VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, North Carolina, USA
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Danielle M Weber
- Durham Veterans Affairs Health Care System, Durham, North Carolina, USA
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Paul A Dennis
- Durham Veterans Affairs Health Care System, Durham, North Carolina, USA
- VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, North Carolina, USA
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Jean C Beckham
- Durham Veterans Affairs Health Care System, Durham, North Carolina, USA
- VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, North Carolina, USA
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Patrick S Calhoun
- Durham Veterans Affairs Health Care System, Durham, North Carolina, USA
- VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, North Carolina, USA
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
- VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, North Carolina, USA
| | - Nathan A Kimbrel
- Durham Veterans Affairs Health Care System, Durham, North Carolina, USA
- VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, North Carolina, USA
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
- VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, North Carolina, USA
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Fowler N, Mikhail ME, Neale M, Keel PK, Katzman DK, Sisk CL, Burt SA, Klump KL. Between- and within-person effects of stress on emotional eating in women: a longitudinal study over 49 days. Psychol Med 2023; 53:5167-5176. [PMID: 37650340 PMCID: PMC10471857 DOI: 10.1017/s0033291722002185] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 04/24/2022] [Accepted: 06/24/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Stress is associated with binge eating and emotional eating (EE) cross-sectionally. However, few studies have examined stress longitudinally, limiting understanding of how within-person fluctuations in stress influence EE over time and whether stress is a risk factor or consequence of EE. Additionally, little is known regarding how the biological stress response relates to EE. METHODS We used an intensive, longitudinal design to examine between-person and within-person effects of major life stress, daily stress, and cortisol on EE in a population-based sample of women (N = 477; ages 15-30; M = 21.8; s.d. = 3.0) from the Michigan State University Twin Registry. Participants reported past year major life stress, then provided daily ratings of EE and stress for 49 consecutive days. Hair cortisol concentration (HCC) was collected as a longitudinal biological stress measure. RESULTS Women reported greater EE when they experienced greater mean stress across days (between-person effects) or greater stress relative to their own average on a given day (within-person effects). Daily stress was more strongly associated with EE than major life stress. However, the impact of daily stress on EE was amplified in women with greater past year major life stress. Finally, participants with lower HCC had increased EE. CONCLUSIONS Findings confirm longitudinal associations between stress and EE in women, and highlight the importance of within-person shifts in stress in EE risk. Results also highlight HCC as a novel biological stress measure that is significantly associated with EE and may overcome limitations of prior physiological stress response indicators.
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Affiliation(s)
- Natasha Fowler
- Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, Oregon, USA
| | - Megan E. Mikhail
- Department of Psychology, Michigan State University, East Lansing, Michigan, USA
| | - Michael Neale
- Department of Psychiatry, Human Genetics, and Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Pamela K. Keel
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | - Debra K. Katzman
- Division of Adolescent Medicine, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Cheryl L. Sisk
- Neuroscience Program, Michigan State University, East Lansing, Michigan, USA
| | - S. Alexandra Burt
- Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, Oregon, USA
| | - Kelly L. Klump
- Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, Oregon, USA
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22
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Turner DP, Caplis E, Bertsch J, Houle TT. Information theory and headache triggers. Headache 2023; 63:899-907. [PMID: 37395303 PMCID: PMC10436193 DOI: 10.1111/head.14583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 04/28/2023] [Accepted: 05/05/2023] [Indexed: 07/04/2023]
Abstract
OBJECTIVES This secondary analysis evaluated the information content exhibited by various measurement strategies of commonly perceived causes, or "triggers," of headache attacks. BACKGROUND When evaluating triggers of primary headache attacks, the variation observed in trigger candidates must be measured to compare against the covariation in headache activity. Given the numerous strategies that could be used to measure and record headache trigger variables, it is useful to consider the information contained in these measurements. METHODS Using previously collected data from cohort and cross-sectional studies, online data sources, and simulations, the Shannon information entropy exhibited by many common triggers was evaluated by analyzing available time-series or theoretical distributions of headache triggers. The degree of information, reported in bits, was compared across trigger variables, measurement strategies, and settings. RESULTS A wide range of information content was observed across headache triggers. Due to lack of variation, there was little information, near 0.00 bits, in triggers like red wine and air conditioning. Most headache triggers exhibited more information when measured using an ordinal scale of presence/degree (e.g., absent, mild, moderate, severe) versus a present/absent binary coding. For example, the trigger "joy" exhibited 0.03 bits when assessed using binary coding but 1.81 bits when coded using an ordinal scale. More information was observed with the use of count data (0.86 to 1.75 bits), Likert rating scales (1.50 to 2.76 bits), validated questionnaires (3.57 to 6.04 bits), weather variables (0.10 to 8.00 bits), and ambulatory monitoring devices (9.19 to 12.61 bits). CONCLUSIONS Although commonly used, all binary-coded measurements contain ≤1.00 bit of information. Low levels of information in trigger variables make associations with headache activity more difficult to detect. Assessments that balance information-rich measurements with reasonable participant burden using efficient formats (e.g., Likert scales) are recommended to enhance the evaluation of the association with headache activity.
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Affiliation(s)
- Dana P Turner
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Emily Caplis
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Julia Bertsch
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Timothy T Houle
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Georgiades A, Almuqrin A, Rubinic P, Mouhitzadeh K, Tognin S, Mechelli A. Psychosocial stress, interpersonal sensitivity, and social withdrawal in clinical high risk for psychosis: a systematic review. SCHIZOPHRENIA (HEIDELBERG, GERMANY) 2023; 9:38. [PMID: 37330526 DOI: 10.1038/s41537-023-00362-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 02/28/2023] [Indexed: 06/19/2023]
Abstract
Stress has repeatedly been implicated in the onset and exacerbation of positive symptoms of psychosis. Increasing interest is growing for the role of psychosocial stress in the development of psychosis symptoms in individuals at Clinical High Risk (CHR) for psychosis. A systematic review was therefore conducted to summarize the existing evidence base regarding psychosocial stress, interpersonal sensitivity, and social withdrawal in individuals at CHR for psychosis. An electronic search of Ovid (PsychINFO, EMBASE, MEDLINE, and GLOBAL HEALTH) was conducted until February 2022. Studies that examined psychosocial stress in CHR were included. Twenty-nine studies were eligible for inclusion. Psychosocial stress, interpersonal sensitivity, and social withdrawal were higher in CHR individuals compared to healthy controls and there was some evidence of their association with positive symptoms of psychosis. Two types of psychosocial stressors were found to occur more frequently with CHR status, namely daily stressors, and early and recent trauma, while significant life events did not appear to be significant. Greater exposure to psychosocial stress, emotional abuse, and perceived discrimination significantly increased risk of transition to psychosis in CHR. No studies examined the role of interpersonal sensitivity on transition to psychosis in CHR. This systematic review provides evidence for the association of trauma, daily stressors, social withdrawal, and interpersonal sensitivity with CHR status. Further studies investigating the impact of psychosocial stress on psychosis symptom expression in individuals at CHR and its effects on transition to psychosis are therefore warranted.
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Affiliation(s)
- A Georgiades
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience (IoPPN), King's College London, London, UK.
- Brent Early Intervention Service, CNWL, NHS Foundation Trust, 27-29 Fairlight Avenue, London, NW10 8AL, UK.
| | - A Almuqrin
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience (IoPPN), King's College London, London, UK
| | - P Rubinic
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience (IoPPN), King's College London, London, UK
| | - K Mouhitzadeh
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience (IoPPN), King's College London, London, UK
| | - S Tognin
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience (IoPPN), King's College London, London, UK
| | - A Mechelli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience (IoPPN), King's College London, London, UK
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Deng W, Addington J, Bearden CE, Cadenhead KS, Cornblatt BA, Mathalon DH, Perkins DO, Seidman LJ, Tsuang MT, Woods SW, Walker EF, Cannon TD. Characterizing sustained social anxiety in individuals at clinical high risk for psychosis: trajectory, risk factors, and functional outcomes. Psychol Med 2023; 53:3644-3651. [PMID: 35144716 PMCID: PMC10277760 DOI: 10.1017/s0033291722000277] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 01/07/2022] [Accepted: 01/20/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND While comorbidity of clinical high-risk for psychosis (CHR-P) status and social anxiety is well-established, it remains unclear how social anxiety and positive symptoms covary over time in this population. The present study aimed to determine whether there are more than one covariant trajectory of social anxiety and positive symptoms in the North American Prodrome Longitudinal Study cohort (NAPLS 2) and, if so, to test whether the different trajectory subgroups differ in terms of genetic and environmental risk factors for psychotic disorders and general functional outcome. METHODS In total, 764 CHR individuals were evaluated at baseline for social anxiety and psychosis risk symptom severity and followed up every 6 months for 2 years. Application of group-based multi-trajectory modeling discerned three subgroups based on the covariant trajectories of social anxiety and positive symptoms over 2 years. RESULTS One of the subgroups showed sustained social anxiety over time despite moderate recovery in positive symptoms, while the other two showed recovery of social anxiety below clinically significant thresholds, along with modest to moderate recovery in positive symptom severity. The trajectory group with sustained social anxiety had poorer long-term global functional outcomes than the other trajectory groups. In addition, compared with the other two trajectory groups, membership in the group with sustained social anxiety was predicted by higher levels of polygenic risk for schizophrenia and environmental stress exposures. CONCLUSIONS Together, these analyses indicate differential relevance of sustained v. remitting social anxiety symptoms in the CHR-P population, which in turn may carry implications for differential intervention strategies.
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Affiliation(s)
- Wisteria Deng
- Department of Psychology, Yale University, New Haven, CT, USA
| | - Jean Addington
- Department of Psychiatry, Hotchkiss Brain Institute, Calgary, Canada
| | - Carrie E. Bearden
- Department of Psychiatry and Biobehavioral Sciences and Psychology, UCLA, Los Angeles, USA
| | | | | | | | - Diana O. Perkins
- Department of Psychiatry, University of North Carolina, Chapel Hill, USA
| | - Larry J. Seidman
- Department of Psychiatry, Harvard Medical School, Boston, USA
- Massachusetts General Hospital, Boston, USA
| | | | - Scott W. Woods
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | - Elaine F. Walker
- Department of Psychology and Psychiatry, Emory University, Atlanta, USA
| | - Tyrone D. Cannon
- Department of Psychology, Yale University, New Haven, CT, USA
- Department of Psychiatry, Yale University, New Haven, CT, USA
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Shanbhog M S, Medikonda J. A clinical and technical methodological review on stress detection and sleep quality prediction in an academic environment. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2023; 235:107521. [PMID: 37044054 DOI: 10.1016/j.cmpb.2023.107521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 02/13/2023] [Accepted: 03/28/2023] [Indexed: 05/08/2023]
Abstract
BACKGROUND Mental health in recent times is a much talked about topic and its effects on the sleep health of the students are said to result in long-term health issues if not identified and resolved. Students who are subjected to psychological stress have often been reported to have lower sleep quality which together has affected the academic performance of the students. OBJECTIVE While stress has its adverse effect on students'quality of sleep, an effort is also made to identify standard techniques and tools to automatically assess stress levels and sleep quality in a non-invasive environment among students only. This article mainly focuses on the Clinical and technical methodology employed in stress level detection and sleep quality prediction among students. METHODS This study was conducted by examining all research studies conducted in the past with respect to students in an academic setting from year 2000 to early 2022. The papers under study where finalised based on different methodologies involved in stress level detection and sleep quality prediction considering both in unimodal and multimodal measurements. RESULTS While questionnaires and physiological signals are used as a standard measuring tool, it is mostly used in a unimodal environment to measure students' mental stress or sleep quality in academic settings. CONCLUSION This paper describes in detail the clinical aspect of the association between mental stress, sleep quality, and academic performance in students followed by technical aspects to analyse the stress levels and sleep quality both qualitatively and quantitatively in an academic environment.
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Affiliation(s)
- Sharisha Shanbhog M
- Biomedical Engineering, Manipal Institute of Technology, Manipal, Manipal Academy of Higher Education, Manipal-576104 India.
| | - Jeevan Medikonda
- Biomedical Engineering, Manipal Institute of Technology, Manipal, Manipal Academy of Higher Education, Manipal-576104 India.
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Vos G, Trinh K, Sarnyai Z, Rahimi Azghadi M. Generalizable machine learning for stress monitoring from wearable devices: A systematic literature review. Int J Med Inform 2023; 173:105026. [PMID: 36893657 DOI: 10.1016/j.ijmedinf.2023.105026] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 02/21/2023] [Accepted: 02/23/2023] [Indexed: 03/06/2023]
Abstract
INTRODUCTION Wearable sensors have shown promise as a non-intrusive method for collecting biomarkers that may correlate with levels of elevated stress. Stressors cause a variety of biological responses, and these physiological reactions can be measured using biomarkers including Heart Rate Variability (HRV), Electrodermal Activity (EDA) and Heart Rate (HR) that represent the stress response from the Hypothalamic-Pituitary-Adrenal (HPA) axis, the Autonomic Nervous System (ANS), and the immune system. While Cortisol response magnitude remains the gold standard indicator for stress assessment [1], recent advances in wearable technologies have resulted in the availability of a number of consumer devices capable of recording HRV, EDA and HR sensor biomarkers, amongst other signals. At the same time, researchers have been applying machine learning techniques to the recorded biomarkers in order to build models that may be able to predict elevated levels of stress. OBJECTIVE The aim of this review is to provide an overview of machine learning techniques utilized in prior research with a specific focus on model generalization when using these public datasets as training data. We also shed light on the challenges and opportunities that machine learning-enabled stress monitoring and detection face. METHODS This study reviewed published works contributing and/or using public datasets designed for detecting stress and their associated machine learning methods. The electronic databases of Google Scholar, Crossref, DOAJ and PubMed were searched for relevant articles and a total of 33 articles were identified and included in the final analysis. The reviewed works were synthesized into three categories of publicly available stress datasets, machine learning techniques applied using those, and future research directions. For the machine learning studies reviewed, we provide an analysis of their approach to results validation and model generalization. The quality assessment of the included studies was conducted in accordance with the IJMEDI checklist [2]. RESULTS A number of public datasets were identified that are labeled for stress detection. These datasets were most commonly produced from sensor biomarker data recorded using the Empatica E4 device, a well-studied, medical-grade wrist-worn wearable that provides sensor biomarkers most notable to correlate with elevated levels of stress. Most of the reviewed datasets contain less than twenty-four hours of data, and the varied experimental conditions and labeling methodologies potentially limit their ability to generalize for unseen data. In addition, we discuss that previous works show shortcomings in areas such as their labeling protocols, lack of statistical power, validity of stress biomarkers, and model generalization ability. CONCLUSION Health tracking and monitoring using wearable devices is growing in popularity, while the generalization of existing machine learning models still requires further study, and research in this area will continue to provide improvements as newer and more substantial datasets become available.
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Affiliation(s)
- Gideon Vos
- College of Science and Engineering, James Cook University, James Cook Dr, Townsville, 4811, QLD, Australia
| | - Kelly Trinh
- College of Science and Engineering, James Cook University, James Cook Dr, Townsville, 4811, QLD, Australia
| | - Zoltan Sarnyai
- College of Public Health, Medical, and Vet Sciences, James Cook University, James Cook Dr, Townsville, 4811, QLD, Australia
| | - Mostafa Rahimi Azghadi
- College of Science and Engineering, James Cook University, James Cook Dr, Townsville, 4811, QLD, Australia.
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27
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Zielinski MJ, Veilleux JC, Fradley MF, Skinner KD. Perceived emotion invalidation predicts daily affect and stressors. ANXIETY, STRESS, AND COPING 2023; 36:214-228. [PMID: 35135399 PMCID: PMC9357853 DOI: 10.1080/10615806.2022.2033973] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 01/19/2022] [Accepted: 01/21/2022] [Indexed: 01/10/2023]
Abstract
BACKGROUND AND OBJECTIVES Perceived emotion invalidation is linked to the development or worsening of a variety of emotional and physical health conditions. However, prior studies are largely cross-sectional and whether there are day-to-day effects of generally feeling invalidated is unknown. DESIGN We examined the relations between perceived emotion invalidation and momentary affect, average daily affect, and the experience of daily stressors among a sample of young adults using ecological momentary assessment (EMA). METHODS Participants (n = 86) completed measures of perceived emotion invalidation and emotional reactivity at baseline then completed one week of EMA including: (1) 7x/day reports of current affect and social context and (2) 1x/day index of experienced stressors and their intensity. RESULTS Higher perceived emotion invalidation predicted lower momentary positive affect. Perceived invalidation also interacted with social context such that higher emotion invalidation predicted greater negative affect when participants were with non-close others (i.e., co-workers, acquaintances). Only participants with high perceived emotional invalidation experienced increased stress alongside heightened daily negative affect. CONCLUSIONS These results provide preliminary evidence that feeling emotionally invalidated may predict affective experiences, including how emotions are momentarily experienced and how life stressors are interpreted when they are later reflected on.
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Affiliation(s)
- Melissa J Zielinski
- Psychiatric Research Institute, University of Arkansas for Medical Science, Little Rock, AR, USA
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, USA
| | - Jennifer C Veilleux
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, USA
| | - Marley F Fradley
- Psychiatric Research Institute, University of Arkansas for Medical Science, Little Rock, AR, USA
| | - Kayla D Skinner
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, USA
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28
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Veilleux JC, Warner EA, Chamberlain KD, Brott KH, Schreiber RE, Clift JB. Contextual variation in beliefs about emotion and associated emotion regulation efforts. MOTIVATION AND EMOTION 2023. [DOI: 10.1007/s11031-022-09992-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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29
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Suddell S, Müller-Glodde M, Lumsden J, Looi CY, Granger K, Barnett JH, Robinson OJ, Munafò MR, Penton-Voak IS. Emotional bias training as a treatment for anxiety and depression: evidence from experimental medicine studies in healthy and medicated samples. Psychol Med 2023; 53:696-705. [PMID: 34057058 PMCID: PMC9975995 DOI: 10.1017/s0033291721002014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 02/28/2021] [Accepted: 04/29/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND Anxiety and depression are leading causes of disability worldwide, yet individuals are often unable to access appropriate treatment. There is a need to develop effective interventions that can be delivered remotely. Previous research has suggested that emotional processing biases are a potential target for intervention, and these may be altered through brief training programs. METHODS We report two experimental medicine studies of emotional bias training in two samples: individuals from the general population (n = 522) and individuals currently taking antidepressants to treat anxiety or depression (n = 212). Participants, recruited online, completed four sessions of EBT from their own home. Mental health and cognitive functioning outcomes were assessed at baseline, immediately post-training, and at 2-week follow-up. RESULTS In both studies, our intervention successfully trained participants to perceive ambiguous social information more positively. This persisted at a 2-week follow-up. There was no clear evidence that this change in emotional processing transferred to improvements in symptoms in the primary analyses. However, in both studies, there was weak evidence for improved quality of life following EBT amongst individuals with more depressive symptoms at baseline. No clear evidence of transfer effects was observed for self-reported daily stress, anhedonia or depressive symptoms. Exploratory analyses suggested that younger participants reported greater treatment gains. CONCLUSIONS These studies demonstrate the effectiveness of delivering a multi-session online training program to promote lasting cognitive changes. Given the inconsistent evidence for transfer effects, EBT requires further development before it can be considered as a treatment for anxiety and depression.
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Affiliation(s)
- Steph Suddell
- School of Psychological Science, University of Bristol, 12a Priory Road, Bristol BS8 1TU, UK
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, UK
| | - Maren Müller-Glodde
- School of Psychological Science, University of Bristol, 12a Priory Road, Bristol BS8 1TU, UK
| | - Jim Lumsden
- School of Psychological Science, University of Bristol, 12a Priory Road, Bristol BS8 1TU, UK
- Medical Research Council (MRC) Integrative Epidemiology Unit at the University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, UK
| | - Chung Yen Looi
- School of Psychological Science, University of Bristol, 12a Priory Road, Bristol BS8 1TU, UK
- Cambridge Cognition Ltd., Tunbridge Court, Tunbridge Lane, Bottisham, Cambridge CB25 9TU, UK
| | - Kiri Granger
- Cambridge Cognition Ltd., Tunbridge Court, Tunbridge Lane, Bottisham, Cambridge CB25 9TU, UK
| | - Jennifer H. Barnett
- Cambridge Cognition Ltd., Tunbridge Court, Tunbridge Lane, Bottisham, Cambridge CB25 9TU, UK
- Department of Psychiatry, University of Cambridge, Herchel Smith Building, Robinson Way, Cambridge CB2 0SZ, UK
| | - Oliver J. Robinson
- Institute of Cognitive Neuroscience, University College London, Alexandra House, 17-19 Queen Square, Bloomsbury, London WC1N 3AR, UK
| | - Marcus R. Munafò
- School of Psychological Science, University of Bristol, 12a Priory Road, Bristol BS8 1TU, UK
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, UK
- Medical Research Council (MRC) Integrative Epidemiology Unit at the University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, UK
| | - Ian S. Penton-Voak
- School of Psychological Science, University of Bristol, 12a Priory Road, Bristol BS8 1TU, UK
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, UK
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Ristanovic I, Vargas TG, Damme KSF, Mittal VA. Hippocampal subfields, daily stressors, and resting cortisol in individuals at clinical high-risk for psychosis. Psychoneuroendocrinology 2023; 148:105996. [PMID: 36495626 PMCID: PMC9898196 DOI: 10.1016/j.psyneuen.2022.105996] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 10/17/2022] [Accepted: 11/28/2022] [Indexed: 12/03/2022]
Abstract
INTRODUCTION The hippocampus, comprised of functionally distinct subfields, both regulates stress and is affected by it during psychosis pathogenesis. Hippocampal abnormalities are evident across psychosis spectrum and are associated with aberrant cortisol levels and greater environmental stressors exposure. These associations, particularly at the subfield-level, are poorly understood in individuals at clinical high-risk (CHR) for psychosis. This represents a significant literature gap given this critical pathogenetic period is characterized by an interplay between environmental stressors and biological susceptibility. METHODS A total of 121 participants including 51 CHR (mean age=18.61) and 70 healthy controls (HC; mean age=18.3) were enrolled in the study. Participants completed a structural scan, salivary cortisol assays, and a self-report measure assessing distress from daily stressors exposure (DSI). Hippocampal subfield segmentation was conducted using Freesurfer. RESULTS Smaller hippocampal subfields were associated with greater stress levels. Greater DSI was associated with lower volumes in CA1 (r = -0.38) and CA2/3 (r = -0.29), but not in CA4/DG (r = -0.28), presubiculum (r = -0.09), or subiculum (r = -0.17). Higher resting cortisol was associated with lower volumes in presubiculum (r = -0.4) but not subiculum (r = -0.22), CA1 (r = 0.08), CA2/3 (r = 0.1), or CA4/DG (r = -0.005). Regressions indicated effects for CA1 and DSI (β = 0.57, p = .03) and presubiculum and cortisol (β = 0.61, p = .02) are specific to CHR participants relative to HCs. CONCLUSIONS The findings provided insights into links between stress and brain vulnerability during psychosis-risk period. Regional differences highlighted potentially different mechanisms by which stress impacts specific subfields. Presubiculum may be more susceptible to the impact of early stress on HPA-axis and cornu amonis to acute stressors.
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Affiliation(s)
- Ivanka Ristanovic
- Northwestern University, Department of Psychology, Evanston, IL 60208, USA; Institute for Innovations in Developmental Sciences (DevSci), Northwestern University, Evanston, Chicago, IL, USA.
| | - Teresa G Vargas
- Northwestern University, Department of Psychology, Evanston, IL 60208, USA; Institute for Innovations in Developmental Sciences (DevSci), Northwestern University, Evanston, Chicago, IL, USA
| | - Katherine S F Damme
- Northwestern University, Department of Psychology, Evanston, IL 60208, USA; Institute for Innovations in Developmental Sciences (DevSci), Northwestern University, Evanston, Chicago, IL, USA
| | - Vijay Anand Mittal
- Northwestern University, Department of Psychology, Evanston, IL 60208, USA; Institute for Innovations in Developmental Sciences (DevSci), Northwestern University, Evanston, Chicago, IL, USA; Northwestern University, Department of Psychiatry, Chicago, IL 60611, USA; Northwestern University, Medical Social Sciences, Chicago IL 60611, USA; Norhtwestern University, Institute for Policy Research, Evanston, IL 60208, USA
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Bonazza F, Politi G, Leone D, Vegni E, Borghi L. Psychological factors in functional hypothalamic amenorrhea: A systematic review and meta-analysis. Front Endocrinol (Lausanne) 2023; 14:981491. [PMID: 36777338 PMCID: PMC9911452 DOI: 10.3389/fendo.2023.981491] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 01/16/2023] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Psychological factors have been found to be associated with functional hypothalamic amenorrhea (FHA); however, their role in the onset or persistence of FHA is still understudied. The study aims to assess the associations of psychological factors with the presence vs the absence of FHA. METHODS A systematic literature search has been conducted across the major databases (PubMed, PsycINFO, Scopus, and Embase) to explore the psychological factors associated with FHA. The search was limited to English-written articles published from 2000 onwards. Articles were selected based on stringent inclusion/exclusion criteria. After data extraction, meta-analysis and meta-synthesis were conducted. RESULTS Of 349 retrieved articles, eight studies were included. Findings indicate that the main psychological factors associated to FHA seem to be depression and eating attitudes, especially drive for thinness. FHA women present higher levels of anxiety, sleep disorders, dysfunctional attitudes, and alexithymia. The meta-analysis on drive for thinness revealed that the pooled MD across the studies was statistically significant both in the fixed 0.63 (95% CI: 0.31-0.95) and random model 0.70 (95% CI: 0.13-1.26). Likewise, as for depression, the pooled MD across the studies was statistically significant both in the fixed 0.60 (95% CI: 0.36-0.84) and random model 0.61 (95% CI: 0.20-1.01). DISCUSSION Findings showed the association of psychological factors and FHA and recognized their involvement in the persistence of the disorder. A multidisciplinary approach should involve a collaborative process between gynecologists, clinical psychologists, and psychiatrists, from diagnosis to treatment. Longitudinal studies should be implemented with a comparison/control group or by including clinical psychologists in the psychological assessment and study design.
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Affiliation(s)
- Federica Bonazza
- Department of Health Sciences, University of Milan, Milan, Italy
- *Correspondence: Federica Bonazza,
| | - Giuliana Politi
- Azienda Socio-Sanitaria Territoriale (ASST) Santi Paolo e Carlo, San Paolo University Hospital, Milan, Italy
| | - Daniela Leone
- Department of Health Sciences, University of Milan, Milan, Italy
- Azienda Socio-Sanitaria Territoriale (ASST) Santi Paolo e Carlo, San Paolo University Hospital, Milan, Italy
| | - Elena Vegni
- Department of Health Sciences, University of Milan, Milan, Italy
- Azienda Socio-Sanitaria Territoriale (ASST) Santi Paolo e Carlo, San Paolo University Hospital, Milan, Italy
| | - Lidia Borghi
- Department of Health Sciences, University of Milan, Milan, Italy
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Muniandy M, Richdale AL, Lawson LP. Coping-resilience profiles and experiences of stress in autistic adults. Autism Res 2022; 15:2149-2166. [PMID: 36114687 PMCID: PMC9826183 DOI: 10.1002/aur.2817] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 09/01/2022] [Indexed: 01/11/2023]
Abstract
Emerging studies allude to high stress in autistic adults. Considering the detrimental impact of stress on health outcomes, examining individual resources which may influence the extent to which stress is experienced (e.g., coping and resilience) is vital. Using a person-focused approach, this study aimed to identify coping-resilience profiles, and examine their relations to general perceived stress and daily hassles in a sample of autistic adults (N = 86; aged 19-74 years). Cluster analysis identified four coping-resilience profiles (i.e., high cope/ low resilience, low cope/ high resilience, engage cope/ high resilience, and disengage cope/ low resilience). The high cope/ low resilience and disengage cope/ low resilience groups had significantly higher general perceived stress than the remaining groups. No significant group differences were noted in relation to daily hassles. Jointly addressing coping and resilience may be beneficial on the perceived stress experienced in autistic adults. The use of coping-resilience profiles may also allow for the personalization of stress management and support options in the autistic adult population.
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Affiliation(s)
- Melanie Muniandy
- Olga Tennison Autism Research Centre, School of Psychology and Public HealthLa Trobe UniversityBundooraVictoriaAustralia,Cooperative Research Centre for Living with Autism (Autism CRC), The University of QueenslandBrisbaneAustralia
| | - Amanda L. Richdale
- Olga Tennison Autism Research Centre, School of Psychology and Public HealthLa Trobe UniversityBundooraVictoriaAustralia,Cooperative Research Centre for Living with Autism (Autism CRC), The University of QueenslandBrisbaneAustralia
| | - Lauren P. Lawson
- Olga Tennison Autism Research Centre, School of Psychology and Public HealthLa Trobe UniversityBundooraVictoriaAustralia,Cooperative Research Centre for Living with Autism (Autism CRC), The University of QueenslandBrisbaneAustralia
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Braun A, Liu L, Bearden CE, Cadenhead KS, Cornblatt BA, Keshavan M, Mathalon DH, McGlashan TH, Perkins DO, Seidman LJ, Stone W, Tsuang MT, Walker EF, Woods SW, Cannon TD, Addington J. Bullying in clinical high risk for psychosis participants from the NAPLS-3 cohort. Soc Psychiatry Psychiatr Epidemiol 2022; 57:1379-1388. [PMID: 35113189 DOI: 10.1007/s00127-022-02239-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 01/22/2022] [Indexed: 11/21/2022]
Abstract
PURPOSE Bullying is associated with a heightened risk for poor outcomes, including psychosis. This study aimed to replicate previous findings on bullying prevalence in clinical high-risk (CHR) individuals, to assess the longitudinal course of clinical and functional variables between bullied and non-bullied CHR and the association of bullying with premorbid functioning, clinical outcome, transition to psychosis and risk of violence. METHODS The sample consisted of 691 CHR participants and 96 healthy controls. Participants reported whether they had experienced bullying and how long it had lasted. Assessments included DSM-5 diagnoses, attenuated psychotic symptoms, negative symptoms, social and role functioning, depression, stress, premorbid functioning, and risk of violence. The bullied and non-bullied CHR groups were compared at baseline and further longitudinally on clinical and functioning variables and transition to psychosis. RESULTS Bullying was more prevalent among CHR individuals than healthy controls. Bullied CHR had a higher prevalence of PTSD and more severe depression and stress at baseline than non-bullied CHR. There was no impact of bullying on clinical and functional variables over time. Bullying was not related to final clinical status or transition to psychosis. However, bullied participants had poorer premorbid functioning and a greater risk of violence. CONCLUSION While bullying may not impact the likelihood of CHR individuals to transition to psychosis, it may be a risk factor for development of the at-risk state and may be related to a greater risk of violence. Future studies should consider bullying perpetration among CHR individuals.
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Affiliation(s)
- Amy Braun
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
| | - Lu Liu
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
| | - Carrie E Bearden
- Departments of Psychiatry and Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA
| | | | | | - Matcheri Keshavan
- Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston, MA, USA
| | - Daniel H Mathalon
- Department of Psychiatry, UCSF, and SFVA Medical Center, San Francisco, CA, USA
| | | | - Diana O Perkins
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - Larry J Seidman
- Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston, MA, USA
| | - William Stone
- Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston, MA, USA
| | - Ming T Tsuang
- Department of Psychiatry, UCSD, San Diego, CA, USA.,Institute of Genomic Medicine, University of California, La Jolla, CA, USA
| | - Elaine F Walker
- Departments of Psychology and Psychiatry, Emory University, Atlanta, GA, USA
| | - Scott W Woods
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | - Tyrone D Cannon
- Department of Psychology, Yale University, New Haven, CT, USA
| | - Jean Addington
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada.
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Langer M, König CJ, Siegel R, Fredenhagen T, Schunck AG, Hähne V, Baur T. Vocal-Stress Diary: A Longitudinal Investigation of the Association of Everyday Work Stressors and Human Voice Features. Psychol Sci 2022; 33:1027-1039. [PMID: 35640140 DOI: 10.1177/09567976211068110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The human voice conveys plenty of information about the speaker. A prevalent assumption is that stress-related changes in the human body affect speech production, thus affecting voice features. This suggests that voice data may be an easy-to-capture measure of everyday stress levels and can thus serve as a warning signal of stress-related health consequences. However, previous research is limited (i.e., has induced stress only through artificial tasks or has investigated only short-term or extreme stressors), leaving it open whether everyday work stressors are associated with voice features. Thus, our participants (111 adult working individuals) took part in a 1-week diary study (Sunday until Sunday), in which they provided voice messages and self-report data on daily work stressors. Results showed that work stressors were associated with voice features such as increased speech rate and voice intensity. We discuss theoretical, practical, and ethical implications regarding the voice as an indicator of psychological states.
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Affiliation(s)
- Markus Langer
- Industrial and Organizational Psychology, Saarland University
| | | | - Rudolf Siegel
- Industrial and Organizational Psychology, Saarland University
| | | | | | - Viviane Hähne
- Industrial and Organizational Psychology, Saarland University
| | - Tobias Baur
- Human-Centered Artificial Intelligence, Augsburg University
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Srem-Sai M, Quansah F, Hagan JE, Ankomah F, Frimpong JB, Ogum PN, Schack T. Re-assessing the Psychometric Properties of Stress Appraisal Measure in Ghana Using Multidimensional Graded Response Model. Front Psychol 2022; 13:856217. [PMID: 35664186 PMCID: PMC9161214 DOI: 10.3389/fpsyg.2022.856217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 03/31/2022] [Indexed: 11/13/2022] Open
Abstract
Despite the widespread use of the stress appraisal measure questionnaire in sport psychology literature, information on the psychometric properties of this survey instrument across different cultures and samples is still lacking. This study sought to validate the stress appraisal measure among male football players in the Ghana’s Premier League using the multidimensional item response theory. The descriptive cross-sectional survey design was adopted to recruit 424 footballers from the 2020/2021 Ghana Premier League season using the census approach. The 28-item Stress Appraisal Measure was used to assess six (6) appraisal mechanisms under primary and secondary cognitive appraisals. The ordered polytomous item response theory was used for analyzing the data. The study found that although some items were problematic, the majority of them were found to have good item parameters, effective scale option functioning, and provided adequate empirical information in the measurement of stress appraisal. This research concluded that the stress appraisal measure has promising applicability among male footballers who participated in the premier league in Ghana. Future researchers are encouraged to re-validate the stress appraisal measure with a different sample to contribute to the understanding of the applicability of the instrument in non-western populations.
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Affiliation(s)
- Medina Srem-Sai
- Department of Health, Physical Education, Recreation and Sports, University of Education, Winneba, Ghana
| | - Frank Quansah
- Department of Educational Foundations, University of Education, Winneba, Ghana
| | - John Elvis Hagan
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast, Ghana
- Neurocognition and Action-Biomechanics-Research Group, Faculty of Psychology and Sports Science, Bielefeld University, Bielefeld, Germany
- *Correspondence: John Elvis Hagan Jr.,
| | - Francis Ankomah
- Department of Education and Psychology, University of Cape Coast, Cape Coast, Ghana
- Department of Education, Seventh Day Adventist (SDA) College of Education, Asokore, Ghana
| | - James Boadu Frimpong
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast, Ghana
| | - Prosper Narteh Ogum
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast, Ghana
| | - Thomas Schack
- Neurocognition and Action-Biomechanics-Research Group, Faculty of Psychology and Sports Science, Bielefeld University, Bielefeld, Germany
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Mourgues C, Hammer A, Fisher V, Kafadar E, Quagan B, Bien C, Jaeger H, Thomas R, Sibarium E, Negreira AM, Sarisik E, Polisetty V, Nur Eken H, Imtiaz A, Niles H, Sheldon AD, Powers AR. Measuring Voluntary Control Over Hallucinations: The Yale Control Over Perceptual Experiences (COPE) Scales. Schizophr Bull 2022; 48:673-683. [PMID: 35089361 PMCID: PMC9077437 DOI: 10.1093/schbul/sbab144] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Auditory verbal hallucinations (AVH) frequently cause significant distress and dysfunction, and may be unresponsive to conventional treatments. Some voice-hearers report an ability to fully control the onset and offset of their AVH, making them significantly less disruptive. Measuring and understanding these abilities may lead to novel interventions to enhance control over AVH. Fifty-two voice-hearers participated in the pilot study. 318 participants with frequent AVH participated in the validation study. A pool of 59 items was developed by a diverse team including voice-hearers and clinicians. After the pilot study, 35 items were retained. Factorial structure was assessed with exploratory (EFA, n = 148) and confirmatory (CFA, n = 170) factor analyses. Reliability and convergent validity were assessed using a comprehensive battery of validated phenomenological and clinical scales. CFA on the final 18 items supported two factors for a Methods of Control Scale (5 items each, average ω = .87), and one factor for a Degree of Control Scale (8 items, average ω = .95). Correlation with clinical measures supported convergent validity. Degree of control was associated with positive clinical outcomes in voice-hearers both with and without a psychosis-spectrum diagnosis. Degree of control also varied with quality of life independently of symptom severity and AVH content. The Yale control over perceptual experiences (COPE) Scales robustly measure voice-hearers' control over AVH and exhibit sound psychometric properties. Results demonstrate that the capacity to voluntarily control AVH is independently associated with positive clinical outcomes. Reliable measurement of control over AVH will enable future development of interventions meant to bolster that control.
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Affiliation(s)
| | | | | | - Eren Kafadar
- Yale University School of Medicine, New Haven, CT,USA
| | | | - Claire Bien
- Yale University School of Medicine, New Haven, CT,USA
| | - Hale Jaeger
- Yale University School of Medicine, New Haven, CT,USA
| | - Rigi Thomas
- Southwest College of Naturopathic Medicine, Tempe, AZ, USA
| | - Ely Sibarium
- Yale University School of Medicine, New Haven, CT,USA
| | | | - Elif Sarisik
- Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Vasishta Polisetty
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Hatice Nur Eken
- School of Medicine, Vanderbilt University, Nashville, TN, USA
| | - Ayyub Imtiaz
- Faculty of Medicine, Health Sciences Center, Kuwait University, Kuwait City, Kuwait
| | - Halsey Niles
- Yale University School of Medicine, New Haven, CT,USA
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The association of stress and physical activity: Mind the ecological fallacy. GERMAN JOURNAL OF EXERCISE AND SPORT RESEARCH 2022. [DOI: 10.1007/s12662-022-00823-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AbstractPsychological stress and physical activity are interrelated, constituting a relevant association to human health, especially in children. However, the association’s nature remains elusive, i.e., why psychological stress predicts both decreased and increased physical activity. To test whether effects vary as a function of the level of analyses, we derived intensive longitudinal data via accelerometers and stress questionnaires from 74 children across 7 days as they went about their daily routines (n = 513 assessments). Multilevel modelling analyses revealed that between children, higher psychological stress predicted decreased physical activity (standardized beta coefficient = −0.14; p = 0.046). Concurrently, within those children, higher psychological stress predicted increased physical activity across days (standardized beta coefficient = 0.09; p = 0.015). Translated to practice, children who experienced more stress than others moved less, but children were more active on days when they experienced heightened stress. This suggests that the analyses level is crucial to the understanding of the association between psychological stress and physical activity and should be considered to receive unequivocal results. If replicated, e.g., including high-frequency sampling and experimental manipulation in everyday life for in-depth insights on underlying mechanisms and causality, our findings may be translated to individually tailored (digital) prevention and intervention strategies which target children’s distress-feelings despite impairing their heightened physical activity in stressful situations and identify tipping points of chronic stress phases. Therefore, we especially call for more intensive longitudinal data approaches to tackle thus far neglected within-subject issues in the field of physical activity, sport and exercise research.
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38
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Larrazabal MA, Naragon-Gainey K, Conway CC. Distress Tolerance and Stress-induced Emotion Regulation Behavior. JOURNAL OF RESEARCH IN PERSONALITY 2022. [DOI: 10.1016/j.jrp.2022.104243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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39
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North American Prodrome Longitudinal Study (NAPLS 3): Methods and baseline description. Schizophr Res 2022; 243:262-267. [PMID: 32317224 PMCID: PMC7572535 DOI: 10.1016/j.schres.2020.04.010] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 02/10/2020] [Accepted: 04/06/2020] [Indexed: 12/19/2022]
Abstract
The North American Prodrome Longitudinal Study (NAPLS) is a consortium of nine programs focusing on youth at clinical high risk (CHR) for psychosis. Funded by the National Institute of Mental Health (NIMH), the sites are located at Emory University, Harvard University, University of Calgary, University of California at Los Angeles, at San Diego, and at San Francisco, University of North Carolina Chapel Hill, Yale University, and Zucker Hillside Hospital. There have been two previous endeavors completed by this consortium, known as NAPLS-1 and NAPLS-2. This paper first offers an overview of the methodology of the third phase of the NAPLS consortium, the second five-year prospective study NAPLS-3, which aims to determine mechanisms of the development of psychosis. In addition, we report on the ascertainment and demographics of the 710 CHR participants in NAPLS-3.
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40
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Ren X, Zhao X, Li J, Liu Y, Ren Y, Pruessner JC, Yang J. The Hippocampal-Ventral Medial Prefrontal Cortex Neurocircuitry Involvement in the Association of Daily Life Stress With Acute Perceived Stress and Cortisol Responses. Psychosom Med 2022; 84:276-287. [PMID: 35149637 DOI: 10.1097/psy.0000000000001058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Daily life stressors include everyday irritants, hassles, and inconveniences, such as problems in traffic and unexpected work deadlines. A growing body of research has suggested higher daily stress is associated with blunted cortisol response to acute psychosocial stressors. However, so far, the neural mechanism underlying this association has not been elucidated. The current study aimed to examine the role of stress neurocircuitry between the hippocampus and the ventral medial prefrontal cortex in this relationship. METHODS To this end, as an index of daily stress in 44 young healthy individuals (23 females; mean [standard deviation] age = 19.07 [1.11] years), the total stressful rating score of daily life stress events that occurred in a 24-hour period was quantified. Individuals were then administered a modified version of the Montreal Imaging Stress Task while undergoing functional magnetic resonance imaging scans, and their saliva samples were collected for assessment of the stress hormone cortisol. RESULTS Results revealed that a higher level of daily stress was associated with lower salivary cortisol secretion (r = -0.39, p = .008) and lower activation of the left hippocampus (tpeak = -5.51) in response to the Montreal Imaging Stress Task. Furthermore, a higher level of daily stress was associated with stronger functional connectivity between the left hippocampus and the ventral medial prefrontal cortex/subgenual anterior cingulate cortex (tpeak = 4.91, R2= 0.365). CONCLUSIONS Taken together, the current study suggested a possible neurocircuitry of the hippocampus and ventral medial prefrontal cortex in the relationship between daily life stress and acute psychosocial stress.
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Affiliation(s)
- Xi Ren
- From the Faculty of Psychology (X. Ren, Zhao, Li, liu, Y. Ren, Yang), Southwest University, Chongqing, China; and Department of Psychology (Pruessner), University of Constance, Constance, Germany
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41
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Lee S, Lee HJ, Cho CH. Mediation Effect of Insomnia Symptoms on Relation Between Stress and Quality of Life. Psychiatry Investig 2022; 19:229-238. [PMID: 35291194 PMCID: PMC8958211 DOI: 10.30773/pi.2021.0344] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 01/23/2022] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE Among various causes of insomnia, stress is the most common and representative cause. Insomnia is also known to negatively affect the quality of life (QoL). The objective of this study was to explore the effect of stress on QoL and the mediating role of insomnia symptoms in the relationship between stress and QoL. METHODS In this study, the mediating effect of insomnia symptoms on the relationship between stress and QoL was analyzed by enrolling 3,714 participants from the Ansung and Ansan cohorts of the Korea Association Resource project from 2001 to 2004. These cohort participants were asked about how much they felt stressed during their everyday life. Insomnia symptoms were evaluated by asking participants whether they had trouble sleeping such as difficulty in falling asleep, disrupted sleep, and early morning awakening due to the lack of a validated questionnaire for this cohort. QoL was evaluated using the World Health Organization QoL Scale Brief Version. RESULTS In total, stress was positively associated with insomnia symptoms, which in turn predicted QoL. The same result could be derived from subgroup analysis according to sex, and it was confirmed that insomnia symptoms acted as a mediating factor more significantly in female than in male. CONCLUSION In this study, insomnia symptoms were confirmed to act as a significant mediating factor between stress and QoL, suggesting that insomnia symptoms should be actively identified and controlled to alleviate the negative effect of stress on QoL in clinical practice.
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Affiliation(s)
- Seulki Lee
- Department of Psychiatry, College of Medicine, Chungnam National University, Daejeon, Republic of Korea.,Department of Psychiatry, Chungnam National University Sejong Hospital, Sejong, Republic of Korea
| | - Heon-Jeong Lee
- Department of Psychiatry, Chronobiology Institute, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Chul-Hyun Cho
- Department of Psychiatry, College of Medicine, Chungnam National University, Daejeon, Republic of Korea.,Department of Psychiatry, Chungnam National University Sejong Hospital, Sejong, Republic of Korea
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42
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Dalton ED. Exercise-related coping beliefs predict physical activity levels in response to naturally occurring stress: A daily diary study of college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022; 70:411-419. [PMID: 32343219 DOI: 10.1080/07448481.2020.1752218] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 01/31/2020] [Accepted: 03/29/2020] [Indexed: 06/11/2023]
Abstract
Objective The present study sought to examine whether beliefs about physical activity as a means of coping with stress predicted college students' exercise levels following naturally occurring stressors. Participants: One-hundred and twenty-seven undergraduate students were recruited from psychology courses at a large, urban university in the southwestern United States. Methods: Participants completed baseline measures and daily assessments for two weeks; data were analyzed using hierarchical linear modeling. Results: Beliefs about the coping properties of physical activity significantly moderated the effects of daily stress (b = 0.19, SE = 0.09, p = .02), and combined daily and chronic stress (b = 0.01, SE = 0.01, p < .01), on students' daily exercise. Conclusions: College students' beliefs about physical activity are associated with changes in their daily exercise following exposure to naturally-occurring stressors. Such beliefs may be amenable to intervention to promote adaptive coping with stress and enhanced physical activity.
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Affiliation(s)
- Elizabeth D Dalton
- Department of Psychology, Elizabethtown College, Elizabethtown, Pennsylvania, USA
- Department of Psychology,University of California, Los Angeles, Los Angeles, California, USA
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Nealis LJ, Sherry SB, Lee-Baggley DL. Perfectionism and Stressful Perseveration in the Psychophysiological Experience of Stress: A 7-Day Multi-Method Study. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2021. [DOI: 10.1007/s10862-021-09932-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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44
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Zaks N, Velikonja T, Parvaz MA, Zinberg J, Done M, Mathalon DH, Addington J, Cadenhead K, Cannon T, Cornblatt B, McGlashan T, Perkins D, Stone WS, Tsuang M, Walker E, Woods SW, Keshavan MS, Buysse DJ, Velthorst E, Bearden CE. Sleep Disturbance in Individuals at Clinical High Risk for Psychosis. Schizophr Bull 2021; 48:111-121. [PMID: 34536012 PMCID: PMC8781348 DOI: 10.1093/schbul/sbab104] [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] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Disturbed sleep is a common feature of psychotic disorders that is also present in the clinical high risk (CHR) state. Evidence suggests a potential role of sleep disturbance in symptom progression, yet the interrelationship between sleep and CHR symptoms remains to be determined. To address this knowledge gap, we examined the association between disturbed sleep and CHR symptoms over time. METHODS Data were obtained from the North American Prodrome Longitudinal Study (NAPLS)-3 consortium, including 688 CHR individuals and 94 controls (mean age 18.25, 46% female) for whom sleep was tracked prospectively for 8 months. We used Cox regression analyses to investigate whether sleep disturbances predicted conversion to psychosis up to >2 years later. With regressions and cross-lagged panel models, we analyzed longitudinal and bidirectional associations between sleep (the Pittsburgh Sleep Quality Index in conjunction with additional sleep items) and CHR symptoms. We also investigated the independent contribution of individual sleep characteristics on CHR symptom domains separately and explored whether cognitive impairments, stress, depression, and psychotropic medication affected the associations. RESULTS Disturbed sleep at baseline did not predict conversion to psychosis. However, sleep disturbance was strongly correlated with heightened CHR symptoms over time. Depression accounted for half of the association between sleep and symptoms. Importantly, sleep was a significant predictor of CHR symptoms but not vice versa, although bidirectional effect sizes were similar. DISCUSSION The critical role of sleep disturbance in CHR symptom changes suggests that sleep may be a promising intervention target to moderate outcome in the CHR state.
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Affiliation(s)
- Nina Zaks
- Department of Psychiatry, Icahn School of Medicine, Mount Sinai, NY, USA
| | - Tjasa Velikonja
- Department of Psychiatry, Icahn School of Medicine, Mount Sinai, NY, USA,Evidence Based Practice Unit, Anna Freud National Centre for Children and Families, London, UK
| | - Muhammad A Parvaz
- Department of Psychiatry, Icahn School of Medicine, Mount Sinai, NY, USA,Department of Neuroscience, Icahn School of Medicine, Mount Sinai, NY, USA
| | - Jamie Zinberg
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Monica Done
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Daniel H Mathalon
- San Francisco VA Health Care System,University of California, San Francisco, CA, USA
| | - Jean Addington
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Kristin Cadenhead
- Department of Psychiatry, University of California San Diego (UCSD), La Jolla, CA, USA
| | - Tyrone Cannon
- Departments of Psychiatry and Psychology, Yale University, New Haven, CT, USA
| | - Barbara Cornblatt
- Department of Psychology, Hofstra North Shore-LIJ School of Medicine, Hempstead, NY, USA,Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, and Feinstein Institute for Medical Research, Garden City, NY, USA
| | - Thomas McGlashan
- Departments of Psychiatry and Psychology, Yale University, New Haven, CT, USA
| | - Diana Perkins
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - William S Stone
- Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Ming Tsuang
- Department of Psychiatry, University of California San Diego (UCSD), La Jolla, CA, USA
| | - Elaine Walker
- Department of Psychology, Emory University, Atlanta, Georgia, USA
| | - Scott W Woods
- Departments of Psychiatry and Psychology, Yale University, New Haven, CT, USA
| | - Matcheri S Keshavan
- Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Daniel J Buysse
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Eva Velthorst
- Department of Psychiatry, Icahn School of Medicine, Mount Sinai, NY, USA,Seaver Center of Research and Treatment, Icahn School of Medicine, Mount Sinai, NY, USA
| | - Carrie E Bearden
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA,Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA,To whom correspondence should be addressed; A7-460 Semel Institute, Los Angeles, CA 90095, USA; tel: 310-206-2983, fax: 310-794-9517, e-mail:
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45
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Seng EK. Stress and migraine: I know it when I see it. Headache 2021; 61:1153-1155. [PMID: 34510442 DOI: 10.1111/head.14200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 07/23/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Elizabeth K Seng
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA.,Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA.,Montefiore Headache Center, Montefiore Medical Center, Bronx, NY, USA
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46
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Halverson TF, Meyer-Kalos PS, Perkins DO, Gaylord SA, Palsson OS, Nye L, Algoe SB, Grewen K, Penn DL. Enhancing stress reactivity and wellbeing in early schizophrenia: A randomized controlled trial of Integrated Coping Awareness Therapy (I-CAT). Schizophr Res 2021; 235:91-101. [PMID: 34332429 DOI: 10.1016/j.schres.2021.07.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 03/14/2021] [Accepted: 07/19/2021] [Indexed: 11/18/2022]
Abstract
Individuals with schizophrenia spectrum disorders (SSD) are at heightened risk for exposure to stressful life events which can lead to increased sensitivity to stress and a dysregulated stress response, which are in turn associated with poor long-term functioning. Stress reactivity is thus a promising treatment target in the early stages of SSD. Integrated-Coping Awareness Therapy (I-CAT) is a manualized intervention integrating mindfulness and positive psychology to target a dysregulated stress response in SSD. The current study is a preliminary randomized-controlled trial (RCT) comparing I-CAT (n = 18) with treatment as usual (TAU; n = 18) in individuals in the early stages of SSD. I-CAT was hypothesized to be more effective than TAU on primary outcomes: increasing positive emotions, decreasing negative emotions, reducing stress, and improving functioning and quality of life; and secondary outcomes: reducing symptoms, increasing mindfulness, and improving overall well-being. Excellent therapy attendance rates, low study attrition, and positive participant feedback demonstrated that I-CAT was a feasible and well-tolerated psychosocial intervention. Results suggest I-CAT led to greater reduction in symptoms (i.e., overall, negative, and disorganized symptoms), increased observational mindfulness, increased endorsement of a sense of purpose in life, and preservation of work abilities and school social functioning compared with TAU. Future work should replicate and extend these findings in a larger-scale RCT.
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Affiliation(s)
- Tate F Halverson
- Department of Psychology and Neuroscience, The University of North Carolina at Chapel Hill, United States of America.
| | - Piper S Meyer-Kalos
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, United States of America
| | - Diana O Perkins
- Department of Psychiatry, The University of North Carolina at Chapel Hill, United States of America
| | - Susan A Gaylord
- Department of Physical Medicine and Rehabilitation, The University of North Carolina at Chapel Hill, United States of America
| | - Olafur S Palsson
- Department of Medicine, The University of North Carolina at Chapel Hill, United States of America
| | - Lana Nye
- College of Social Work, The University of Utah, United States of America
| | - Sara B Algoe
- Department of Psychology and Neuroscience, The University of North Carolina at Chapel Hill, United States of America
| | - Karen Grewen
- Department of Psychiatry, The University of North Carolina at Chapel Hill, United States of America
| | - David L Penn
- Department of Psychology and Neuroscience, The University of North Carolina at Chapel Hill, United States of America; School of Behavioural and Health Sciences, Australian Catholic University, Australia
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Ajibewa TA, Robinson LE, Toledo-Corral C, Miller AL, Sonneville KR, Hasson RE. Acute Daily Stress, Daily Food Consumption, and the Moderating Effect of Disordered Eating among Adolescents with Overweight/Obesity. Child Obes 2021; 17:391-399. [PMID: 33902320 DOI: 10.1089/chi.2021.0017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objective: The purpose of this study was to examine the associations between acute daily stress dimensions (frequency, sum) and food intake in adolescents with overweight/obesity, and to explore the potential moderating effect of disordered eating behaviors on these associations. Methods: One hundred eighty-two adolescents with overweight/obesity (65% females; 68.7% non-white; 16.2 ± 1.8 years of age) were included in this analysis. Acute daily stress was measured using the Daily Stress Inventory, and daily caloric intake was measured using a food frequency questionnaire. Disordered eating behavior was assessed using the Eating Attitudes Test (EAT-26). Results: Acute daily stress frequency (B = 0.013 ± 0.003; p < 0.001) and acute daily stress sum (B = 0.003 ± 0.001; p < 0.001) were associated with greater daily caloric intake. Disordered eating behavior moderated the association between acute daily stress frequency and caloric intake (pinteraction = 0.039), with greater daily caloric intake among those with higher levels of disordered eating. Disordered eating behavior did not significantly moderate the association between acute daily stress sum and daily caloric intake (pinteraction = 0.053). Conclusions: These findings suggest that greater exposure to acute daily stressors may increase daily food intake in adolescents with overweight/obesity, with greater susceptibility among those engaging in high levels of disordered eating. Longitudinal research is warranted to elucidate the long-term effect of acute daily stressors and disordered eating on food intake among adolescents with overweight/obesity. The Health and Culture Project is registered at www.clinicaltrials.gov (No. NCT02938663).
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Affiliation(s)
- Tiwaloluwa A Ajibewa
- Movement Science Program, University of Michigan School of Kinesiology, Ann Arbor, MI, USA.,University of Michigan Childhood Disparities Research Laboratory, Ann Arbor, MI, USA
| | - Leah E Robinson
- Movement Science Program, University of Michigan School of Kinesiology, Ann Arbor, MI, USA
| | - Claudia Toledo-Corral
- Department of Health Sciences, California State University Northridge, Northridge, CA, USA
| | - Alison L Miller
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Kendrin R Sonneville
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA.,Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Rebecca E Hasson
- Movement Science Program, University of Michigan School of Kinesiology, Ann Arbor, MI, USA.,University of Michigan Childhood Disparities Research Laboratory, Ann Arbor, MI, USA.,Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA.,Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
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Houle TT, Deng H, Tegeler CH, Turner DP. Continuous updating of individual headache forecasting models using Bayesian methods. Headache 2021; 61:1264-1273. [PMID: 34435659 DOI: 10.1111/head.14182] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 05/06/2021] [Accepted: 06/07/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To illustrate the benefits of deploying individual headache forecasting models using continuous updating with Bayesian methods. BACKGROUND The ability to reliably forecast headache attacks within an individual over time would enhance the study of attacks and allow preemptive treatment. However, deploying a suitable forecasting model in a clinical setting will likely involve several unique challenges related to heterogeneity in the predictor weights, limited or sparse data, and the need for a quick "warm-up." The use of Bayesian methods offers solutions to each of these specific challenges. METHODS This was a post hoc analysis of a cohort study of individuals with episodic migraine attacks. Individuals completed daily diaries that allowed the estimation of several forecasting models, each using different types of ancillary information incorporated into formal prior probability distributions. An in silico analysis was conducted that mimicked the deployment of these models in a clinical-like setting where the parameters of the models were continuously updated and evaluated each day using root mean square error (RMSE). RESULTS Individuals (N = 95) were followed for 50 days and contributed 3359 days of nonmissing diary data. During the observation period, there were 1293/3359 (38.5%) days with a headache attack. Self-reported baseline headache frequency was associated with the corresponding predicted probability of future attacks, r = 0.15-0.39. At Day 25, the correlation between baseline information and predicted attack likelihood was r = 0.29 (95% CI: 0.09-0.47). Additionally, the use of prior probability distributions for model parameters improved the model fit, especially early in the deployment of the models (e.g., Day 5 RMSE 0.45 vs. 0.43). Models using informative prior probability distributions outperformed the models estimated without this information during the first 42 days of observation, although performance became more similar as more data were collected. CONCLUSIONS This analysis demonstrates the value of Bayesian methods in using additional available information to improve forecasting model performance, especially early in the deployment of a forecasting model. To obtain the full value of such models or to apply any model in clinical settings, a model with adequate discrimination and calibration will be needed.
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Affiliation(s)
- Timothy T Houle
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Hao Deng
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Charles H Tegeler
- Department of Neurology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Dana P Turner
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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Burma JS, Lapointe AP, Soroush A, Oni IK, Smirl JD, Dunn JF. The validity and reliability of an open source biosensing board to quantify heart rate variability. Heliyon 2021; 7:e07148. [PMID: 34124405 PMCID: PMC8173091 DOI: 10.1016/j.heliyon.2021.e07148] [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: 08/05/2020] [Revised: 01/17/2021] [Accepted: 05/24/2021] [Indexed: 11/18/2022] Open
Abstract
Background Heart rate variability (HRV) is a popular tool to quantify autonomic function. However, this typically requires an expensive 3-12 lead electrocardiogram (ECG) and BioAmp system. This investigation sought to determine the validity and reliability of an OpenBCI cyton biosensing board (open source) for accurately quantifying HRV. New method A cyton board with a 3-lead ECG was employed to acquire heart rate waveform data, which was processed to obtain HRV within both time- and frequency-domains. The concurrent validity was compared to a simultaneous recording from an industry-standard 3-lead ECG (ADInstruments) (n = 15). The reliability of the cyton board was compared between three days within a 7-day timespan (n = 10). Upright quiet-stance short-term HRV metrics were quantified in time- and frequency-domains. Results The two devices displayed excellent limits of agreements (all log mean differences ±0.4) and very high between-device variable associations (all r 2 > 0.98). Between the three time points in the same subjects, no differences were noted within time- (all p > 0.71) or frequency-domains (all p > 0.88) across testing points. Finally, all HRV metrics exhibited excellent levels of reliability through high Cronbach's Alpha (all ≥0.916) and intraclass correlation coefficients (all ≥0.930); and small standard error of the measurement (all ≤0.7) and typical error of the measurement (all ≤0.1) metrics. Comparison with existing methods The cyton board with 3-lead ECG was compared with an industry-standard ADInstruments ECG during HRV assessments. There were no significant differences between devices with respect to time- and frequency-domains. The cyton board displayed high-levels of between-day reliability and provided values harmonious to previous ECG literature highlighting the applicability for longitudinal studies. Conclusion With proper background knowledge regarding ECG principles and a small degree of set-up complexity, an open source cyton board can be created and employed to perform multimodal HRV assessments at a fraction of the cost (~4%) of an industry-standard ECG setup.
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Affiliation(s)
- Joel S. Burma
- Cerebrovascular Concussion Laboratory, University of Calgary, Alberta, Canada
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Integrated Concussion Research Program, University of Calgary, Calgary, AB, Canada
| | - Andrew P. Lapointe
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Integrated Concussion Research Program, University of Calgary, Calgary, AB, Canada
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Ateyeh Soroush
- Integrated Concussion Research Program, University of Calgary, Calgary, AB, Canada
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Ibukunoluwa K. Oni
- Integrated Concussion Research Program, University of Calgary, Calgary, AB, Canada
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Jonathan D. Smirl
- Cerebrovascular Concussion Laboratory, University of Calgary, Alberta, Canada
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Integrated Concussion Research Program, University of Calgary, Calgary, AB, Canada
| | - Jeff F. Dunn
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Integrated Concussion Research Program, University of Calgary, Calgary, AB, Canada
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Corresponding author.
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Lin TT, Jones KK, Martyn-Nemeth P, Zenk SN. Associations between Daily Work Hassles and Energy-Balance Behaviors in Female African American Workers: An Ecological Momentary Assessment Study. Ethn Dis 2021; 31:177-186. [PMID: 33883858 DOI: 10.18865/ed.31.2.177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objective Despite their high rate of labor force participation, African American women earn less and are overrepresented in service jobs that tend to have fewer benefits, longer work hours, and less flexibility. The aim of our study was to examine associations between work-related daily hassles and energy balance behaviors among female African American workers. Design A secondary analysis of a 7-day intensive longitudinal study using ecological momentary assessment (EMA). Setting Metropolitan area of Chicago, Illinois, United States; July 2012 through January 2013. Participants A convenience sample of 70 female African American workers. Methods EMA was used to collect information over seven days on work hassles and energy balance behaviors: empty calorie food intake; moderate-to-vigorous physical activity (MVPA); sedentary behavior; sleep duration; and sleep disturbance. Within-person associations between daily work hassles and each of these daily energy balance behaviors were analyzed using person fixed-effects regression. Results A total of 334 person-day observations from 70 female African American workers were included in the final analysis. Reporting at least one daily work hassle was associated with same-day higher empty calorie food intake (OR: 2.2, 95% CI: 1.0, 4.6) and more daily minutes of sedentary behavior (b: 35.8, 95% CI; .2, 71.3). However, no significant associations were found between prior-day work hassles and either food intake or sedentary behavior. Daily work hassles were not related to MVPA, sleep duration, or sleep disturbance. Conclusions Our study showed that daily work hassles were associated with female African American workers' empty calorie food intake and sedentary behaviors. Strategies to eliminate daily work hassles may help to improve their energy balance behaviors.
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Affiliation(s)
- Ting-Ti Lin
- Department of Health System Science, College of Nursing, University of Illinois at Chicago, IL.,School of Nursing, National Defense Medical Center, Taipei City, Taiwan
| | - Kelly K Jones
- National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD
| | - Pamela Martyn-Nemeth
- Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, IL
| | - Shannon N Zenk
- National Institute of Nursing Research, National Institutes of Health, Bethesda, MD
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