Frequency of stressful life events and associations with mental health and general subjective health in the general population

Trajectories of depressive and anxiety symptoms and associated risk factors during the COVID-19 pandemic in Germany: A longitudinal cohort study

BACKGROUND

Most COVID-19-related mental health research focused on average levels of mental health parameters in the general population. However, considering heterogeneous groups and their long-term responses could deepen our understanding of mental health during community crises. This four-wave study aimed to (1) identify subgroups with different trajectories of depressive and anxiety symptoms in the German general population, and (2) investigate associated risk factors.

METHODS

We analyzed self-report data from N = 1257 German adults participating in a European cohort study, assessed in summer 2020 (T1), and at 6 (T2), 12 (T3), and 30 months (T4). Depressive and anxiety symptoms were measured using the PHQ-4. Sociodemographic, health-related, and pandemic-related variables were assessed at baseline. We applied growth mixture modeling to identify subgroups of symptom trajectories and conducted multinomial logistic regression to examine factors associated with class membership.

RESULTS

We identified six symptom trajectories: Low-stable (n = 971, 77.2 %), Continuous deterioration (n = 30, 2.4 %), Transient deterioration (n = 75, 6.0 %), Continuous improvement (n = 97, 7.7 %), Transient improvement (n = 38, 3.0 %) and Chronicity (n = 46, 3.7 %). Age, education, work status, mental health diagnoses, self-reported health, and pandemic-related news consumption were significantly associated with subgroup membership.

LIMITATIONS

The generalizability of the study is constrained by an unrepresentative sampling method, a notable dropout rate, and limited consideration of risk factors.

CONCLUSION

Most people experienced low symptoms or improvement during the pandemic, while others experienced chronic or transient symptoms. Specific risk factors were associated with these trajectories, revealing nuanced mental health dynamics.

War-Related Life Course Stress and Late-Life Subjective Age in Northern Vietnam

Background and Objectives

The role of early life stressors in subjective aging is weakly understood, especially in low- to middle-income countries. This paper investigated how early life stressors encountered in armed conflict influence subjective age among Vietnamese older adults who experienced war over decades of their early life.

Research Design and Methods

We analyzed survey data from the 2018 Vietnam Health and Aging Study involving 2,447 Vietnamese older adults who encountered diverse war-related stressors in early adulthood. The analytical sample (N = 2,341) included 50.9% women and 49.1% men, with an average age of 69.8. 41.1% are military veterans. We conducted survey-adjusted multinomial logistic regression analyses with mediation to predict the probability of feeling younger or older than one's chronological age. We examined how childhood adversity (i.e., childhood hunger and low parental SES) and wartime stressors (i.e., war-related violence, malevolent environment, and military service) influenced late-life subjective age, both directly and as mediated by late-life mental, functional, and physical health.

Results

We found significant associations between early adulthood war-related stressors and subjective age. Formal military service significantly lessened the relative risk of feeling subjectively old, and more plentiful wartime violence exposures significantly increased the risk of feeling younger than one's chronological age. Violence exposure's effects were both direct and indirect through functional and mental health. Conversely, greater exposure to wartime malevolent conditions (e.g., shortages of clean water and evacuations) and multiple episodes of severe hunger in childhood increased the risk of feeling older, effects both direct and mediated by late-life functional and mental health.

Discussion and Implications

Results suggest wartime stressors, especially war's malevolent environments and severe childhood hunger, experienced in many conflict-affected populations globally, have the potential to subjectively "age" survivors. Yet, not all war exposures are equal, and some may yield psychological and socioeconomic resources that support healthy aging.

COVID-19 stressful life events and mental health: Personality and coping styles as moderators

OBJECTIVE

To examine the role of COVID-19-specific stressful life events (SLE) in predicting depression, anxiety, and life satisfaction, and if personality traits (extraversion and neuroticism), and coping styles (problem-focused coping and avoidance coping) moderated these relations.

PARTICIPANTS

Data were collected from 371 college students (Mage = 20.59; SDage = 2.58) from one large university of the Mid-Atlantic region in the U.S.

METHODS

Participants completed an online survey measuring COVID-19 related stressful life events (adapted from a tool developed to measure stressful life events during the SARS pandemic; Costa et al., 2001; Main et al., 2011), personality (the Mini-Markers; Saucier, 1994), coping styles (by using a measure developed by Aldrige-Gerry et al., 2011), depression (PHQ-9; Kroenke et al., 2011), anxiety (GAD-7; Spitzer et al., 2006), and life satisfaction (Student's Life Satisfaction Scale, Huebner, 1996) between March 27th and April 27th, 2020.

RESULTS

Path analysis results showed that extraversion and avoidance coping style moderated the effects of SLE on depression and anxiety symptoms; neuroticism and avoidance coping style moderated the relation between SLE and life satisfaction. The moderation results also differed by gender.

CONCLUSIONS

These findings indicated that the COVID-19 pandemic had deleterious effects on college students' mental health, where extraversion emerged as a protective factor, while neuroticism and avoidance coping style were risk factors. These findings underscore the importance of paying special attention to college students' mental health needs and promoting appropriate coping strategies in the light of the current pandemic.

How socio-political change is associated with the number of individually reported negative life events: a population-based study using the German reunification 1989/1990 as an example

BACKGROUND

Socio-political change often leads to disruptions in employment and social networks, which can exacerbate health issues and increase mortality rates. These consequences are likely observed as an increase in negative life events (NLEs), serving as indicators of the broader social and health impacts. Using the German reunification in 1989/1990 as an example, this study investigates changes in reported numbers of NLEs and differences regarding sociodemographic characteristics.

METHODS

We used data from the population-based Study of Health in Pomerania (SHIP-START-0, SHIP-Life-Events and Gene-Environment Interaction in Depression; N=1932). Numbers of NLEs in different categories (work/financial, social/interpersonal, illness (own) and illness/death (others)) were measured retrospectively in 5-year intervals (1980-2004) using a semistructured interview. Pre-reunification and post-reunification changes were modelled using piecewise mixed-effects Poisson regressions with the 1990-1994 interval (reunification) as change point. Interactions with age, sex and education were examined.

RESULTS

The number of most NLE categories, except social/interpersonal NLEs, increased at reunification. Whereas work/financial NLEs slightly decreased post-reunification, illness-related NLEs continued to increase. Higher numbers of social/interpersonal NLEs were found with younger age. More illness-related NLEs were reported with older age, lower education (illness (own)) and by women (illness/death (others)). However, the majority reported no NLEs at reunification (68.2%-80.7%, varying by category).

CONCLUSION

Our findings suggest that although some individuals experience a marked increase in NLEs due to socio-political changes, many remain unaffected, emphasising the need for a differentiated understanding of these effects. This increase in NLEs may partly account for ongoing health and well-being disparities among countries with differing transformation histories.

Stressful life events are associated with self-reported fatigue and depressive symptoms in patients with mild traumatic brain injury

OBJECTIVE

To examine the associations between recent stressful life events and self-reported fatigue and depressive symptoms in patients with mild traumatic brain injury.

DESIGN

Observational cohort study.

PARTICIPANTS

Patients (aged 18-68 years) with mild traumatic brain injury (n = 99) or lower extremity orthopaedic injury (n = 34).

METHODS

Data on stressful life events and self-reported symptoms were collected 3 months post-injury. Stressful life events in the last 12 months were assessed as part of a structured interview using a checklist of 11 common life events, self-reported fatigue with Barrow Neurological Institute Fatigue Scale, and depressive symptoms with Beck Depression Inventory - Fast Screen.

RESULTS

Median number of stressful life events was 1 (range 0-7) in the mild traumatic brain injury group and 1.5 (range 0-6) in the orthopaedic injury group. The groups did not differ significantly in terms of fatigue or depressive symptoms. In the mild traumatic brain injury group, the total number of recent stressful life events correlated significantly with self-reported fatigue (rs = 0.270, p = 0.007) and depressive symptoms (rs = 0.271, p = 0.007).

CONCLUSION

Stressful life events are associated with self-reported fatigue and depressive symptoms in patients with mild traumatic brain injury. Clinicians should consider stressful life events when managing patients who experience these symptoms, as this may help identifying potential targets for intervention.

Prevalence of COVID-19 anxiety, geriatric anxiety, and related factors among the elderly in Quchan, Iran during the COVID-19 pandemic: a cross-sectional study

BACKGROUND

Anxiety is a prevalent mental disorder among the elderly, leading to discomfort, disability, increased expenses, reduced quality of life, and dysfunction. Consequently, this study was conducted to determine the prevalence of COVID-19 anxiety and geriatric anxiety, along with the factors influencing anxiety, in the elderly population served by urban healthcare centres in Quchan.

METHODS

This cross-sectional study involved 650 elderly individuals aged 60-95 years. The participants were selected using a two-stage cluster sampling method. Data were collected through three questionnaires: the Geriatric Anxiety Inventory (GAI), the Corona Disease Anxiety Scale (CDAS), and a questionnaire on factors contributing to anxiety. Data analysis was performed using simple and multiple regression with IBM SPSS 24.

RESULTS

The prevalence of geriatric anxiety among the elderly was 40.3%, while the prevalence of COVID-19 anxiety (moderate and severe) was 22.8%. Significant relationships were observed between geriatric anxiety and substance abuse, stressful life events, comorbidities, COVID-19 anxiety, financial support, loneliness, walking habits, and sleep patterns (P < 0.05).

CONCLUSION

COVID-19 anxiety and geriatric anxiety are prevalent concerns among the elderly. Factors like substance abuse, stressful life events, COVID-19-related anxiety, comorbidity, living alone, lack of financial support, and poor walking and sleeping habits, which affect anxiety in the elderly, it is essential to address these factors in life planning and provide services through relevant organisations, healthcare teams, and initiatives by the elderly themselves.

Negative Stressful Life Events and Social Support Are Associated With White Matter Integrity in Depressed Patients and Healthy Control Participants: A Diffusion Tensor Imaging Study

BACKGROUND

Negative stressful life events and deprivation of social support play critical roles in the development and maintenance of major depressive disorder (MDD). The present study aimed to investigate in a large sample of patients with MDD and healthy control participants (HCs) whether these effects are also reflected in white matter (WM) integrity.

METHODS

In this diffusion tensor imaging study, 793 patients with MDD and 793 age- and sex-matched HCs were drawn from the Marburg-Münster Affective Disorders Cohort Study (MACS) and completed the Life Events Questionnaire (LEQ) and Social Support Questionnaire (SSQ). Generalized linear models were performed to test voxelwise associations between fractional anisotropy (FA) and diagnosis (analysis 1), LEQ (analysis 2), and SSQ (analysis 3). We examined whether SSQ interacts with LEQ on FA or is independently associated with improved WM integrity (analysis 4).

RESULTS

Patients with MDD showed lower FA in several frontotemporal association fibers compared with HCs (pTFCE-FWE = .028). Across both groups, LEQ correlated negatively with FA in widely distributed WM tracts (pTFCE-FWE = .023), while SSQ correlated positively with FA in the corpus callosum (pTFCE-FWE = .043). Modeling the combined association of both variables on FA revealed significant-and antagonistic-main effects of LEQ (pTFCE-FWE = .031) and SSQ (pTFCE-FWE = .037), but no interaction of SSQ × LEQ.

CONCLUSIONS

Our results indicate that negative stressful life events and social support are both related to WM integrity in opposing directions. The associations did not differ between patients with MDD and HCs, suggesting more general, rather than depression-specific, mechanisms. Furthermore, social support appears to contribute to improved WM integrity independent of stressful life events.

[Life events related to the German reunification and their associations with psychosocial health in a sample of northeast Germany]

Objectives: The aim of the present study was to investigate (1) the type and frequency of reported life events of the East German population related to the German reunification and (2) their associations with psychosocial health. Methods: Data of 2247 participants of the Study of Health in Pomerania was used.These qualitative responses were analysed using quantitative content analysis. Their associations with subjective physical and mental health, optimism, social support, depressive symptoms, and chronic stress were examined. Results: Eight life event categories were identified (education, employment-related changes, material changes, new opportunities, personal life events, politics, separations, reunifications). Especially, experiencing new opportunities was associated with a higher level of optimism as well as a lower level of depressive symptoms and chronic stress. Conclusions: In this study, events frequently described in the literature (e.g., employment-related and social changes) were confirmed and systematized.The observed associations of these events with psychosocial factors should be examined further in future studies.

Gender, life events, and mental well-being in emerging adulthood

BACKGROUND

Emerging adulthood is a critical period of life involving many life transitions that may generate stress and compromise health and mental well-being.

AIMS

To know the most frequent life events of women and men in emerging adulthood, analyzing also the relevance that such stressors have on their psychological well-being and life satisfaction. A second aim is to determine the relevance of age, educational level, most frequent life events, coping styles, and perceived social support as risk and protective factors for well-being.

METHOD

The sample consisted of 2,000 individuals from the general Spanish population (55% women), aged between 18 and 29, who were assessed using five questionnaires and scales measuring life events, coping styles, life satisfaction, psychological well-being, and social support.

RESULTS

The findings showed that 90% of the sample had experienced one or more life events during the previous year and that a higher number of life events experienced over the past year was associated with lower mental well-being. Multiple regression analyses made clear that, although some events experienced in the previous year (namely, family conflicts and change in the relationship with parents) were associated with lower women's and men's well-being, the most important determinants of well-being in either gender were coping styles; however, some predictors of women's well-being proved different from those of men. In the case of women, family and intimate partner conflicts predicted lower life satisfaction and psychological well-being was lower in the case of family conflicts. As for men, work or academic life events predicted lower life satisfaction.

CONCLUSION

These research findings are relevant for the design of programs and strategies to improve mental well-being in emerging adulthood.

Sport and physical exercise in sustainable mental health care of common mental disorders: Lessons from the COVID-19 pandemic

The large-scale disruptions to physical activity during the coronavirus pandemic have been found to be a leading predictor of common mental disorders. In addition, regular physical exercise has been found to alleviate anxiety, sadness and depression during the pandemic. These findings, together with numerous studies published before the pandemic on the effects of physical activity on mental health, should be considered in the provision of mental health care following the pandemic. Cross-sectional research has revealed that all types of exercise and sport are associated with a reduced mental health burden. Therefore, the effectiveness of exercise and sport participation in sustainable mental health care as well as the causal relationship between exercise, psychosocial health and common mental disorders merit further investigation. Physical activity and sport, with their global accessibility, significant and clinically meaningful efficacy as well as virtual absence of adverse effects, offer a promising option for the promotion of mental health, including the prevention and treatment of common mental disorders. Physical exercise and sport are likely to become valuable public mental health resources in the future.

Trajectories of stressful life events and long-term changes in mental health outcomes, moderated by family functioning? the TRAILS study

PURPOSE

We assessed the association between trajectories of stressful life events (SLEs) throughout adolescence and changes in mental health from childhood to young adulthood. Further, we assessed whether family functioning moderated this association.

METHODS

Data of the first six waves of the TRAILS study (2001-2016; n = 2229) were used, a cohort followed from approximately age 11 to 23. We measured SLEs (death of a family member or other beloved one, delinquency, moving, victim of violence, parental divorce, and sexual harassment) at ages 14, 16 and 19. Family functioning was measured at all six time points using the Family Assessment Device (FAD), and mental health was measured through the Youth/Adult Self-Report at ages 11 and 23. Latent class growth analyses (LCGA) were used to examine longitudinal trajectories and associations.

RESULTS

We identified three SLE trajectories (low, middle, high) throughout adolescence, and found no significant associations between these trajectories and changes in mental health from childhood to young adulthood. Family functioning and SLE trajectories were significantly associated, however, the association of SLE trajectories and changes in mental health was not modified by family functioning. Mental health problems at age 11 increased the likelihood of high SLE trajectories during adolescence, and of experiencing negative family functioning.

CONCLUSION

Experiencing SLEs throughout adolescence does not have a direct impact on changes in mental health from childhood to young adulthood, but early adolescence mental health problems increase the likelihood of experiencing SLEs.

Insights Into Sibling Relationships and Longevity From Genetics of Healthy Ageing Nonagenarians: The Importance of Optimisation, Resilience and Social Networks

Understanding how to “Age Longer and Age Well” is a priority for people personally, for populations and for government policy. Approximately ten percent of nonagenarians reach 90 years and beyond in good condition and seem to have a combination of both age-span and health-span. However, the factors which contribute to human longevity remain challenging. Culture is a shared system of learning ideas, feelings, and survival strategies. It has a strong influence on each person’s psychological development, behavior, values and beliefs. Nonagenarians have rich life experiences that can teach us much about aging well; they are rich reservoirs of genetic, lifestyle and psychological information which can help understanding about how to live longer and better. Sibling or trio nonagenarians are important sources of family beliefs and behaviors upon which individual personalities may have been built. Their personal family histories and narratives are powerful tools that help to determine familial traits, beliefs and social behaviors which may help establish factors important in the siblings’ longevity. Using purposefully selected subjects, recruited to the Genetics of Healthy Ageing (GeHA) project in four European countries, this research used the simple life story and qualitative research methods to analyze contrasting and distinctive questions about the interface between the psychological and social worlds as presented in the nonagenarian siblings’ insights about their longevity. Their stories aimed to give better understanding about which psychological aspects of their common life journey and the degree of emotional support in their sibling relationships may have supported their paths to longevity. The most universal finding in each of the four European countries was that nonagenarians demonstrated high positivity, resilience and coping skills and were supported in social networks. Around this theme, nonagenarians reported “being happy,” “always cheerful,” “never melancholy” and having a contentment with a “rich life” and family relationships which fits with accumulating evidence that life satisfaction comes from a perceived self-efficacy and optimism. Most sibling relationships in this study, when analyzed according to the Gold classification, fit the “congenial” or “loyal” relationship type – demonstrating a healthy respect for the others’ opinion without overt dependence, which may help individual coping and survival mechanisms.

Stressful Life Events and Chinese Older People Depression: Moderating Role of Social Support

Aim: This study analyzes the effects of retrospective stressful life events on current depression among Chinese older people and how these effects are moderated by social support. Stressful life events comprise bereavement, divorce, health adversities, accidents, and financial losses due to fraud.

Data and Method: Data were drawn from the China Health and Retirement Longitudinal Study (CHARLS) of the 2015 panel, and responses from 9,619 older people aged over 60 years were used. The least-squares regression method was applied to measure the linear effects. Propensity score matching minimized selection bias and enabled the measurement of the net effects of stressful life events. The bias-corrected matching estimator was also used to correct the inexact matching bias from propensity score matching.

Result: Experienced stressful life events and exposure to cumulative stressful life events were found to lead to depression in older people. When older people experienced stressful life events but with more social activities, and higher satisfaction and frequent contact with children, their depressive levels were lower. The results of the propensity score matching showed that stressful life events resulted in depression in older people. Furthermore, individuals with family support were able to moderate stressful life events effects; however, the moderating effects of social activity separately were negligible. In sum, with the moderating role of family support and social activity, the average differences in older people depression caused by stressful life events decreased.

Conclusion: Experiencing stressful life events is detrimental to the psychological health of the older people. Social support, including family support and social activity, has buffered detrimental effects on depression caused by stressful life events.

Interpretations: The study underscores the need to supply effective interventions for the older people who experienced stressful life events. First, society should improve the capability of community care centers to supply mental health services. Second, family members should pay attention to mental condition of older people, and specific support should concord with the needs of Chinese older people. In addition, support suppliers can move from being confined to kinship relationships to close relationships, such as the community partners and neighbors.

A Structural Equation Model of Self-Regulation and Healthy Habits as an Individual Protective Tool in the Context of Epidemics-Evidence From COVID-19

Objective: The present study aims to explore the mediation role of self-regulation on health-related behaviors adoption or maintenance, mental health, and well-being during the COVID-19 confinement in a sample of adults in Portugal. Design: One-hundred fifty individuals (118 females, 32 males; Mage = 33.57 year; SD = 12.71) filled an online survey to assess self-regulation, healthy behaviors, mental health, and well-being perception, during the early months of the pandemic (June-August, 2020). Main Outcome Measures: Self-regulation capacity, adoption or maintenance of healthy habits, mental health, including stress management, and the perception of one's well-being were evaluated using a structural equation model (SEM). Results: Self-regulation had direct effects on healthy habits and mental health and indirect effects on well-being and mental health mediated by healthy habits. In specific, a positive direct effect on healthy habits (β = 0.497, p < 0.001) and a negative direct effect on mental health (β = -0.428, p < 0.001); and a positive indirect effect on well-being perception, mediated by healthy behaviors and mental health (β = 0.253, p = 0.003), and a negative indirect effect on mental health, mediated by healthy habits (β = -0.208, p = 0.003). Additionally, healthy habits exerted direct effects on well-being perception and mental health. A positive direct effect on well-being perception (β = 0.254, p = 0.012), and a negative direct effect on mental health (β = -0.418, p < 0.001) were further observed. No direct effect of mental health was observed in well-being perception (β = -0.199, p = 0.068). Finally, a negative correlation was observed between self-regulation and weeks of confinement (r = -0.208, p = 0.021). Conclusion: Self-regulation seems to be a good indicator of adopting a healthy lifestyle and better mental health and well-being in the context of the COVID-19 pandemic. Future preventive actions and interventions to build long-term global preparedness for future health emergencies, such as COVID-19, should explore the importance of self-regulation as an important individual and collective protective factor.

P2X7R antagonists in chronic stress-based depression models: a review

Depression affects around 320 million people worldwide. Growing evidence proposes the immune system to be the core interface between psychosocial stress and the neurobiological and behavioural features of depression. Many studies have identified purinergic signalling via the P2X7 receptor (P2X7R) to be of great importance in depression genesis yet only a few have evaluated P2X7R antagonists in chronic stress-based depression models. This review summarizes their findings and analyses their methodology. The four available studies used three to nine weeks of unpredictable, chronic mild stress or unpredictable, chronic stress in male mice or rats. Stress paradigm composition varied moderately, with stimuli being primarily psychophysical rather than psychosocial. Behavioural testing was performed during or after the last week of stress application and resulted in depressive-like behaviours, immune changes (NLRP3 assembly, interleukin-1β level increase, microglia activation) and neuroplasticity impairment. During the second half of each stress paradigm, a P2X7R antagonist (Brilliant Blue G, A-438079, A-804598) was applied. Studies differed with regard to antagonist dosage and application timing. Nonetheless, all treatments attenuated the stress-induced neurobiological changes and depressive-like behaviours. The evidence at hand underpins the importance of P2X7R signalling in chronic stress and depression. However, improvements in study planning and reporting are necessary to minimize experimental bias and increase data purview. To achieve this, we propose adherence to the Research Domain Criteria and the STRANGE framework.