Negative life events and stress sensitivity in youth's daily life: an ecological momentary assessment study

Negative life events and sleep disturbance among adolescents: Intolerance of uncertainty as mediator and moderator

BACKGROUND

While negative life events (NLEs) have been linked to an increased risk of sleep disturbance among adolescents, the mechanisms of this impact still lack further examination. The current study aimed to explore whether intolerance of uncertainty (IU), a dispositional transdiagnostic vulnerability factor for psychopathology, could act as a mediator and/or moderator in the link from NLEs to sleep disturbance.

METHODS

A longitudinal nested subsample of 54,240 Chinese adolescents (aged 9-19) were surveyed at baseline (Timepoint 1) and six months later (Timepoint 2). They completed questionnaires to assess their IU, NLEs, sleep disturbance and sociodemographic characteristics. Mediation and moderation analyses were conducted to test our hypotheses.

RESULTS

Upon adjusting for covariates, IU was found to mediate the relationship between NLEs and residual changes in sleep disturbance over a six-month period, with the mediation effect accounting for 31.8%. Additionally, the moderating role of IU in this relationship was also identified, suggesting that a high level of IU exacerbated the effect of NLEs on sleep disturbance.

CONCLUSIONS

In conclusion, our findings shed light on the dual roles of IU in the link from NLEs to sleep disturbance, holding significant practical implications for preventing and intervening in sleep disturbance among adolescents. To mitigate the risk of sleep disturbance among adolescents experiencing NLEs, timely assessments of IU and tailored interventions to enhance uncertainty tolerance are necessary.

The experience sampling methodology in psychosis risk states: A systematic review

The experience sampling method (ESM) is a structured diary technique, which is used to assess thoughts, mood and appraise subjective experiences in daily life. It has been recognized as a useful tool for understanding the characteristics, dynamics, and underlying mechanisms of prodromal symptoms of psychosis. The present systematic review aimed to provide a qualitative synthesis of findings provided by the ESM studies conducted in people with psychosis risk states. A systematic review of the MEDLINE, ERIC, Academic Search Ultimate, and Health Source: Nursing/Academic Edition databases, utilizing search terms related to the ESM and the risk of psychosis was conducted. Out of 1069 publication records identified, 77 studies met the inclusion criteria for the review. Data were synthesized around the following topics: 1) assessment of symptoms dynamics and social functioning; 2) assessment of the mechanisms contributing to the emergence of psychotic experiences and 3) assessment of stress sensitivity. The studies have shown that negative emotions are associated with subsequent development of paranoia. The tendency to draw hasty conclusions, aberrant salience, self-esteem, and emotion regulation were the most frequently reported mechanisms associated with the emergence of psychotic experiences. Studies using the ESM also provided evidence for the role of stress sensitivity, in the development of psychotic symptoms. The ESM has widely been applied to studies investigating psychosis risk states, using a variety of protocols. Findings from this systematic review might inform future studies and indicate potential targets for interventions.

Stress, Environment and Early Psychosis

Existing literature provides extended evidence of the close relationship between stress dysregulation, environmental insults, and psychosis onset. Early stress can sensitize genetically vulnerable individuals to future stress, modifying their risk for developing psychotic phenomena. Neurobiological substrate of the aberrant stress response to hypothalamic-pituitary-adrenal axis dysregulation, disrupted inflammation processes, oxidative stress increase, gut dysbiosis, and altered brain signaling, provides mechanistic links between environmental risk factors and the development of psychotic symptoms. Early-life and later-life exposures may act directly, accumulatively, and repeatedly during critical neurodevelopmental time windows. Environmental hazards, such as pre- and perinatal complications, traumatic experiences, psychosocial stressors, and cannabis use might negatively intervene with brain developmental trajectories and disturb the balance of important stress systems, which act together with recent life events to push the individual over the threshold for the manifestation of psychosis. The current review presents the dynamic and complex relationship between stress, environment, and psychosis onset, attempting to provide an insight into potentially modifiable factors, enhancing resilience and possibly influencing individual psychosis liability.

Association between Negative Life Events and Somatic Symptoms: A Mediation Model through Self-Esteem and Depression

The purpose of this study was to investigate the serial multiple mediation of self-esteem and depression in the relationship between negative life events and somatic symptoms in Chinese medical students. We recruited a total of 3383 medical students for this study, and used the Patient Health Questionnaire-15 to assess the somatic symptoms of subjects; the Adolescent Self-Rating Life Events Check List to assess negative life events; the Rosenberg Self-Esteem Scale to assess self-esteem; and the Patient Health Questionnaire for depression. Descriptive analysis and statistical tests were then performed on the collected data. We showed that 39.17% of the medical students had mild somatic symptoms, 24.14% had moderate somatic symptoms, and 5.66% had severe somatic symptoms; we observed significant differences in somatic symptoms among genders, living expenses, and one-child. For negative life events, interpersonal stress was the most important predictor of somatization during the regression analysis. In addition, we observed significance for both the direct and part of the indirect paths from negative life events to somatic symptoms using mediation model analysis. However, we noted that there was no significance for the path through negative life events and self-esteem to somatic symptoms. This study revealed a high prevalence of somatic symptoms among Chinese medical students, and the findings suggested that interventions aimed at reducing somatization in this population should consider the impact of negative life events, particularly those related to interpersonal stress. One potential approach to mitigating the effects of negative life events on somatization is to enhance self-esteem and decrease the level of depression among medical students.