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Lafrenaye-Dugas AJ, Bélanger RE, Poliakova N, Riva M, Fletcher C, Godbout N, Fraser S, Courtemanche Y, Moisan C, Muckle G. Profiles of childhood adversities in Inuit from Nunavik: description and associations with indicators of socioeconomic characteristics, support, and community involvement. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2024; 115:97-113. [PMID: 37079263 PMCID: PMC10830971 DOI: 10.17269/s41997-023-00750-z] [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: 09/15/2021] [Accepted: 01/30/2023] [Indexed: 04/21/2023]
Abstract
OBJECTIVES Distress and associated health problems reported by Nunavik Inuit emanate from heterogeneous roots, including adverse childhood experiences. This study aims to (1) identify distinct childhood adversity profiles and (2) examine associations between these profiles and sex, socioeconomic characteristics, social support, and community involvement among Nunavimmiut. METHODS In a sample of 1109 adult Nunavimmiut, sex, socioeconomic characteristics, support, community involvement, residential school attendance, and 10 forms of adverse childhood experiences (ACEs) were documented using questionnaires. Latent class analyses and weighted comparisons were performed for three subgroups: 18-49 years; 50 years and above with experience of residential school; and 50 years and above without experience of residential school. The analysis design, the manuscript drafts, and the key findings were discussed and co-interpreted with the collaboration of community representatives, taking into consideration Inuit culture and needs. RESULTS A total of 77.6% of Nunavimmiut reported having experienced at least one form of childhood adversity. Three ACE profiles were identified among the 18-49-year-olds: low ACEs (43.0%), household stressors (30.7%), and multiple ACEs (26.3%). Two profiles characterized ACEs experienced among the 50-year-olds and over with and without history of residential schooling: low ACEs (80.1% and 77.2%, respectively) and multiple ACEs (19.9% and 22.8%, respectively). Among the group of 18-49-year-olds, as compared to the low ACE profile, the profile with household stressors included proportionally more women (odds ratio [OR] = 1.5) and was associated with lower involvement in volunteering and community activities (mean score reduced by 0.29 standard deviation [SD]) and lower family cohesion (SD = - 0.11), while the multiple ACE profile was related to a lower rate of employment (OR = 0.62), lower family cohesion (SD = - 0.28), and lower satisfaction with ability to practice traditional activities (SD = - 0.26). CONCLUSION Childhood adversities among Nunavimmiut do not occur in isolation and experiencing multiple forms of childhood adversities predicts lower socioeconomic status, support, and community involvement in adulthood. Implications for the planning of health and community services in Nunavik are discussed.
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Affiliation(s)
- Anne-Julie Lafrenaye-Dugas
- Population Health and Optimal Health Practices Axis, CHU de Québec - Université Laval Research Centre, Québec, QC, Canada.
- Département de pédiatrie, Faculté de Médecine, Université Laval, Québec, QC, Canada.
| | - Richard E Bélanger
- Population Health and Optimal Health Practices Axis, CHU de Québec - Université Laval Research Centre, Québec, QC, Canada
- Département de pédiatrie, Faculté de Médecine, Université Laval, Québec, QC, Canada
| | - Natalia Poliakova
- Population Health and Optimal Health Practices Axis, CHU de Québec - Université Laval Research Centre, Québec, QC, Canada
| | | | - Christopher Fletcher
- Population Health and Optimal Health Practices Axis, CHU de Québec - Université Laval Research Centre, Québec, QC, Canada
| | | | | | - Yohann Courtemanche
- Population Health and Optimal Health Practices Axis, CHU de Québec - Université Laval Research Centre, Québec, QC, Canada
| | - Caroline Moisan
- Population Health and Optimal Health Practices Axis, CHU de Québec - Université Laval Research Centre, Québec, QC, Canada
- École de psychologie, Faculté des sciences sociales, Université Laval, Québec, QC, Canada
| | - Gina Muckle
- Population Health and Optimal Health Practices Axis, CHU de Québec - Université Laval Research Centre, Québec, QC, Canada
- École de psychologie, Faculté des sciences sociales, Université Laval, Québec, QC, Canada
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Toohey S, Wray A, Hunter J, Waldrop I, Saadat S, Boysen-Osborn M, Sudario G, Smart J, Wiechmann W, Pressman SD. Comparing the Psychological Effects of Manikin-Based and Augmented Reality-Based Simulation Training: Within-Subjects Crossover Study. JMIR MEDICAL EDUCATION 2022; 8:e36447. [PMID: 35916706 PMCID: PMC9379786 DOI: 10.2196/36447] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 03/27/2022] [Accepted: 06/23/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Patient simulators are an increasingly important part of medical training. They have been shown to be effective in teaching procedural skills, medical knowledge, and clinical decision-making. Recently, virtual and augmented reality simulators are being produced, but there is no research on whether these more realistic experiences cause problematic and greater stress responses as compared to standard manikin simulators. OBJECTIVE The purpose of this research is to examine the psychological and physiological effects of augmented reality (AR) in medical simulation training as compared to traditional manikin simulations. METHODS A within-subjects experimental design was used to assess the responses of medical students (N=89) as they completed simulated (using either manikin or AR) pediatric resuscitations. Baseline measures of psychological well-being, salivary cortisol, and galvanic skin response (GSR) were taken before the simulations began. Continuous GSR assessments throughout and after the simulations were captured along with follow-up measures of emotion and cortisol. Participants also wrote freely about their experience with each simulation, and narratives were coded for emotional word use. RESULTS Of the total 86 medical students who participated, 37 (43%) were male and 49 (57%) were female, with a mean age of 25.2 (SD 2.09, range 22-30) years and 24.7 (SD 2.08, range 23-36) years, respectively. GSR was higher in the manikin group adjusted for day, sex, and medications taken by the participants (AR-manikin: -0.11, 95% CI -0.18 to -0.03; P=.009). The difference in negative affect between simulation types was not statistically significant (AR-manikin: 0.41, 95% CI -0.72 to 1.53; P=.48). There was no statistically significant difference between simulation types in self-reported stress (AR-manikin: 0.53, 95% CI -2.35 to 3.42; P=.71) or simulation stress (AR-manikin: -2.17, 95% CI -6.94 to 2.59; P=.37). The difference in percentage of positive emotion words used to describe the experience was not statistically significant between simulation types, which were adjusted for day of experiment, sex of the participants, and total number of words used (AR-manikin: -4.0, 95% CI -0.91 to 0.10; P=.12). There was no statistically significant difference between simulation types in terms of the percentage of negative emotion words used to describe the experience (AR-manikin: -0.33, 95% CI -1.12 to 0.46; P=.41), simulation sickness (AR-manikin: 0.17, 95% CI -0.29 to 0.62; P=.47), or salivary cortisol (AR-manikin: 0.04, 95% CI -0.05 to 0.13; P=.41). Finally, preexisting levels of posttraumatic stress disorder, perceived stress, and reported depression were not tied to physiological responses to AR. CONCLUSIONS AR simulators elicited similar stress responses to currently used manikin-based simulators, and we did not find any evidence of AR simulators causing excessive stress to participants. Therefore, AR simulators are a promising tool to be used in medical training, which can provide more emotionally realistic scenarios without the risk of additional harm.
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Affiliation(s)
- Shannon Toohey
- Department of Emergency Medicine, University of California, Irvine, Orange, CA, United States
| | - Alisa Wray
- Department of Emergency Medicine, University of California, Irvine, Orange, CA, United States
| | - John Hunter
- Department of Psychological Science, University of California, Irvine, Irvine, CA, United States
| | - Ian Waldrop
- Department of Psychological Science, University of California, Irvine, Irvine, CA, United States
| | - Soheil Saadat
- Department of Emergency Medicine, University of California, Irvine, Orange, CA, United States
| | - Megan Boysen-Osborn
- Department of Emergency Medicine, University of California, Irvine, Orange, CA, United States
| | - Gabriel Sudario
- Department of Emergency Medicine, University of California, Irvine, Orange, CA, United States
| | - Jonathan Smart
- Department of Emergency Medicine, University of California, Irvine, Orange, CA, United States
| | - Warren Wiechmann
- Department of Emergency Medicine, University of California, Irvine, Orange, CA, United States
| | - Sarah D Pressman
- Department of Psychological Science, University of California, Irvine, Irvine, CA, United States
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Kulkarni J, Leyden O, Gavrilidis E, Thew C, Thomas EHX. The prevalence of early life trauma in premenstrual dysphoric disorder (PMDD). Psychiatry Res 2022; 308:114381. [PMID: 34999294 DOI: 10.1016/j.psychres.2021.114381] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 12/09/2021] [Accepted: 12/29/2021] [Indexed: 11/16/2022]
Abstract
Early life trauma is a risk factor for many mental disorders; however, there is a lack of research exploring early life trauma in Premenstrual Dysphoric Disorder (PMDD), a debilitating form of Premenstrual Syndrome (PMS). This descriptive study aimed to determine the prevalence of early life trauma in women with PMDD and characterise type and age of trauma experience. Data for 100 women diagnosed with PMDD was extracted from the Monash Alfred Women's Mental Health Clinic Database. Experience of early life trauma was subclassified into four types (Physical abuse, sexual abuse, emotional abuse and/or neglect) and four age groups (0-5, 6-10, 11-14 and/or 15-18 years old). Prevalence of early life trauma was calculated and compared with Australian population estimates. Eighty-three percent of women with PMDD had experienced early life trauma, with emotional abuse being the most common (71%). All types of trauma were more common amongst PMDD women than the general Australian population. Trauma prevalence was similar across the four age groups, ranging from 59 to 66%. Of note, 51.8% women experienced trauma across all age groups. Our results suggest a strong association between early life trauma and PMDD. Emotional abuse and/or chronic trauma across childhood may be most strongly associated with PMDD.
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Affiliation(s)
- Jayashri Kulkarni
- Monash Alfred Psychiatry Research Centre, The Alfred Hospital and Monash University, Central Clinical School, Melbourne, VC, Australia.
| | - Olivia Leyden
- Monash Alfred Psychiatry Research Centre, The Alfred Hospital and Monash University, Central Clinical School, Melbourne, VC, Australia
| | - Emorfia Gavrilidis
- Monash Alfred Psychiatry Research Centre, The Alfred Hospital and Monash University, Central Clinical School, Melbourne, VC, Australia
| | - Caroline Thew
- Monash Alfred Psychiatry Research Centre, The Alfred Hospital and Monash University, Central Clinical School, Melbourne, VC, Australia
| | - Elizabeth H X Thomas
- Monash Alfred Psychiatry Research Centre, The Alfred Hospital and Monash University, Central Clinical School, Melbourne, VC, Australia
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Recognizing and Breaking the Cycle of Trauma and Violence Among Resettled Refugees. CURRENT TRAUMA REPORTS 2021; 7:83-91. [PMID: 34804764 PMCID: PMC8590436 DOI: 10.1007/s40719-021-00217-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2021] [Indexed: 10/25/2022]
Abstract
Purpose of Review The number of refugees across the globe continues to grow, leaving a large proportion of the global population in a vulnerable state of health. However, the number of robust clinical interventions has not kept apace. This paper provides a general review of literature on the trauma and violence that refugees face, the impact on health outcomes, and some of the promising models for clinical intervention. Recent Findings Refugees experience a cycle of trauma, violence, and distress that begins before migration and continues during migration and after resettlement. It has been challenging to develop robust clinical interventions due to the cumulative and cyclic effects of trauma, as well as the unique experiences of trauma that each refugee community and each refugee individual faces. Summary Trauma-informed care is a critical component of health care. Developing stronger guidelines for trauma-informed care will help clinicians better provide inclusive and equitable care for refugee patients.
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Graham KL, Paun O, Stillerman A. The Impact of Adverse Childhood Experiences on Cognition in African American Older Adults: An Integrated Literature Review. Res Gerontol Nurs 2021; 14:265-272. [PMID: 34542345 DOI: 10.3928/19404921-20210825-04] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The current integrative literature review examined the existing evidence on the connection between adverse childhood experiences (ACEs) and cognitive changes in African American older adults. Using the Covidence platform, several databases were searched, resulting in 266 publications dated 2008-2020. Ten articles met inclusion criteria and were reviewed. Findings indicate that four ACEs (physical, sexual, and verbal abuse, and low socioeconomic status) are associated with impaired cognition in African American older adults. Four gaps were identified: lack of (a) older adult participants in research investigating original and expanded ACEs; (b) exclusively African American samples of participants in studies examining the relationship between ACEs and cognition; (c) consensus about what specific ACEs contribute to changes in cognition in older adults; and (d) information about successful interventions created to prevent and mitigate the effects of ACEs in older adults. This review provides a synthesis of the limited evidence on the effects of ACEs on cognition among other outcomes. Findings on the effects of ACEs on African American older adults' cognition are limited, thus making a compelling case for further investigating the role of childhood adversity in the disparity of cognitive changes in African American communities. [Research in Gerontological Nursing, 14(5), 265-272.].
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Galván ST, Flores-López M, Romero-Sanchiz P, Requena-Ocaña N, Porras-Perales O, Nogueira-Arjona R, Mayoral F, Araos P, Serrano A, Muga R, Pavón FJ, García-Marchena N, de Fonseca FR. Plasma concentrations of granulocyte colony-stimulating factor (G-CSF) in patients with substance use disorders and comorbid major depressive disorder. Sci Rep 2021; 11:13629. [PMID: 34211033 PMCID: PMC8249412 DOI: 10.1038/s41598-021-93075-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 06/21/2021] [Indexed: 12/13/2022] Open
Abstract
Granulocyte colony-stimulating factor (G-CSF) has raised much interest because of its role in cocaine addiction in preclinical models. We explored the plasma concentrations of G-CSF in patients diagnosed with substance use disorder (SUD) and highly comorbid psychiatric disorders. In particular, we investigated the association between G-CSF concentrations and comorbid major depressive disorder (MDD) in patients with cocaine and alcohol use disorders (CUD and AUD, respectively). Additionally, patients with MDD but not SUD were included in the study. Three hundred and eleven participants were enrolled in this exploratory study: 136 control subjects, 125 patients with SUD (SUD group) from outpatient treatment programs for cocaine (N = 60, cocaine subgroup) and alcohol (N = 65, alcohol subgroup), and 50 patients with MDD but not SUD (MDD group) from primary-care settings. Participants were assessed based on DSM-IV-TR criteria, and a blood sample was collected to examine the plasma concentrations of G-CSF. G-CSF concentrations were negatively correlated with age in the entire sample (r = - 0.233, p < 0.001) but not in the patients with MDD. G-CSF concentrations were lower in patients with SUD than in controls (p < 0.05), specifically in the cocaine subgroup (p < 0.05). Patients with SUD and comorbid MDD had lower G-CSF concentrations than patients with SUD but not comorbid MDD or controls (p < 0.05). In contrast, patients with MDD but not SUD showed no differences compared with their controls. The negative association between G-CSF concentrations and age in the sample was not observed in patients with MDD. G-CSF concentrations were decreased in patients with SUD and comorbid MDD but not in patients with MDD. Therefore, G-CSF may be useful to improve the stratification of patients with dual diagnosis seeking treatment. Further investigation is needed to explore the impact of sex and type of drug on the expression of G-CSF.
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Affiliation(s)
- Sandra Torres Galván
- Laboratorio de Medicina Regenerativa, Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, Avda. Carlos Haya 82, sótano, 29010, Málaga, Spain
- Instituto de Investigación Biomédica de Málaga-IBIMA, Málaga, Spain
- Facultad de Farmacia, Universidad Complutense de Madrid, Madrid, Spain
| | - María Flores-López
- Laboratorio de Medicina Regenerativa, Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, Avda. Carlos Haya 82, sótano, 29010, Málaga, Spain
- Instituto de Investigación Biomédica de Málaga-IBIMA, Málaga, Spain
- Facultad de Psicología, Universidad de Málaga, Málaga, Spain
| | - Pablo Romero-Sanchiz
- Laboratorio de Medicina Regenerativa, Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, Avda. Carlos Haya 82, sótano, 29010, Málaga, Spain
- Instituto de Investigación Biomédica de Málaga-IBIMA, Málaga, Spain
- Department of Psychology, University of Roehampton, London, UK
| | - Nerea Requena-Ocaña
- Laboratorio de Medicina Regenerativa, Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, Avda. Carlos Haya 82, sótano, 29010, Málaga, Spain
- Instituto de Investigación Biomédica de Málaga-IBIMA, Málaga, Spain
| | - Oscar Porras-Perales
- Laboratorio de Medicina Regenerativa, Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, Avda. Carlos Haya 82, sótano, 29010, Málaga, Spain
- Instituto de Investigación Biomédica de Málaga-IBIMA, Málaga, Spain
- Facultad de Psicología, Universidad de Málaga, Málaga, Spain
- Unidad de Gestión Clínica del Corazón, Hospital Universitario Virgen de La Victoria, Málaga, Spain
| | - Raquel Nogueira-Arjona
- Laboratorio de Medicina Regenerativa, Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, Avda. Carlos Haya 82, sótano, 29010, Málaga, Spain
- Instituto de Investigación Biomédica de Málaga-IBIMA, Málaga, Spain
- Department of Psychology, University of Roehampton, London, UK
| | - Fermín Mayoral
- Laboratorio de Medicina Regenerativa, Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, Avda. Carlos Haya 82, sótano, 29010, Málaga, Spain
- Instituto de Investigación Biomédica de Málaga-IBIMA, Málaga, Spain
| | - Pedro Araos
- Laboratorio de Medicina Regenerativa, Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, Avda. Carlos Haya 82, sótano, 29010, Málaga, Spain
- Instituto de Investigación Biomédica de Málaga-IBIMA, Málaga, Spain
- Facultad de Psicología, Universidad de Málaga, Málaga, Spain
| | - Antonia Serrano
- Laboratorio de Medicina Regenerativa, Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, Avda. Carlos Haya 82, sótano, 29010, Málaga, Spain
- Instituto de Investigación Biomédica de Málaga-IBIMA, Málaga, Spain
| | - Roberto Muga
- Unidad de Adicciones- Servicio de Medicina Interna. Institut D'Investigació en Ciències de La Salut Germans Trias I Pujol (IGTP), Campus Can Ruti, Carrer del Canyet s/n, 08916, Badalona, Spain
- Departamento de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Francisco Javier Pavón
- Laboratorio de Medicina Regenerativa, Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, Avda. Carlos Haya 82, sótano, 29010, Málaga, Spain.
- Instituto de Investigación Biomédica de Málaga-IBIMA, Málaga, Spain.
- Unidad de Gestión Clínica del Corazón, Hospital Universitario Virgen de La Victoria, Málaga, Spain.
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain.
| | - Nuria García-Marchena
- Facultad de Farmacia, Universidad Complutense de Madrid, Madrid, Spain.
- Unidad de Adicciones- Servicio de Medicina Interna. Institut D'Investigació en Ciències de La Salut Germans Trias I Pujol (IGTP), Campus Can Ruti, Carrer del Canyet s/n, 08916, Badalona, Spain.
| | - Fernando Rodríguez de Fonseca
- Laboratorio de Medicina Regenerativa, Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, Avda. Carlos Haya 82, sótano, 29010, Málaga, Spain.
- Instituto de Investigación Biomédica de Málaga-IBIMA, Málaga, Spain.
- Facultad de Farmacia, Universidad Complutense de Madrid, Madrid, Spain.
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Oswald LM, Dunn KE, Seminowicz DA, Storr CL. Early Life Stress and Risks for Opioid Misuse: Review of Data Supporting Neurobiological Underpinnings. J Pers Med 2021; 11:315. [PMID: 33921642 PMCID: PMC8072718 DOI: 10.3390/jpm11040315] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/09/2021] [Accepted: 04/13/2021] [Indexed: 01/02/2023] Open
Abstract
A robust body of research has shown that traumatic experiences occurring during critical developmental periods of childhood when neuronal plasticity is high increase risks for a spectrum of physical and mental health problems in adulthood, including substance use disorders. However, until recently, relatively few studies had specifically examined the relationships between early life stress (ELS) and opioid use disorder (OUD). Associations with opioid use initiation, injection drug use, overdose, and poor treatment outcome have now been demonstrated. In rodents, ELS has also been shown to increase the euphoric and decrease antinociceptive effects of opioids, but little is known about these processes in humans or about the neurobiological mechanisms that may underlie these relationships. This review aims to establish a theoretical model that highlights the mechanisms by which ELS may alter opioid sensitivity, thereby contributing to future risks for OUD. Alterations induced by ELS in mesocorticolimbic brain circuits, and endogenous opioid and dopamine neurotransmitter systems are described. The limited but provocative evidence linking these alterations with opioid sensitivity and risks for OUD is presented. Overall, the findings suggest that better understanding of these mechanisms holds promise for reducing vulnerability, improving prevention strategies, and prescribing guidelines for high-risk individuals.
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Affiliation(s)
- Lynn M. Oswald
- Department of Family and Community Health, University of Maryland School of Nursing, Baltimore, MD 21201, USA;
| | - Kelly E. Dunn
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21230, USA;
| | - David A. Seminowicz
- Department of Neural and Pain Sciences, School of Dentistry, University of Maryland, Baltimore, MD 21201, USA;
- Center to Advance Chronic Pain Research, University of Maryland, Baltimore, MD 21201, USA
| | - Carla L. Storr
- Department of Family and Community Health, University of Maryland School of Nursing, Baltimore, MD 21201, USA;
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Ruiz-Párraga GT, Serrano-Ibáñez ER, Gómez-Pérez L, Ramírez-Maestre C, Esteve R, López-Martínez AE. The relevance of psychological strength for physical and psychological well-being in trauma-exposed women. Scand J Psychol 2021; 62:386-392. [PMID: 33547651 DOI: 10.1111/sjop.12711] [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: 02/03/2020] [Accepted: 01/04/2021] [Indexed: 02/05/2023]
Abstract
Traumatic experiences have consistently been linked to poor health and well-being, particularly in women. Psychological factors have been theorized to directly affect the reporting of physical symptoms and perceptions of general health. Posttraumatic stress disorder (PTSD) has been proposed as a major pathway through which trauma affects health and emotion dysregulation. Trauma is considered to be a key psychological variable in the pathogenesis of PTSD. Fortunately, not all women who have experienced trauma manifest adverse effects. Resilience acts as a psychological protective variable following trauma. The present study tested a hypothetical model of the contribution of resilience, emotional dysregulation, and PTSD symptoms to physical and psychological well-being in a large sample of trauma-exposed women. A transversal study with 753 female participants is used. Structural modeling was used to test linear associations between variables. After experiencing trauma, resilience was negatively and significantly associated with emotional dysregulation, which, in turn, was positively associated with PTSD symptoms. Both resilience and PTSD symptoms were associated with physical and psychological well-being. The results suggest that resilience and emotional dysregulation are relevant to the health and well-being of women with PTSD symptoms and may help guide the development of psychological treatment in this group. Therefore, these findings may be relevant in promoting health and well-being in such women, and may help to identify individuals who would receive the most benefit from interventions addressing emotional regulation and psychological resilience.
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Affiliation(s)
- Gema T Ruiz-Párraga
- Facultad de Psicología, Universidad de Málaga, Instituto de Investigaciones Biomédicas de Málaga, Málaga, Spain
| | - Elena R Serrano-Ibáñez
- Facultad de Psicología, Universidad de Málaga, Instituto de Investigaciones Biomédicas de Málaga, Málaga, Spain
| | - Lydia Gómez-Pérez
- Facultad de Psicología, Universidad Pontificia Católica de Chile, Santiago de Chile, Chile
| | - Carmen Ramírez-Maestre
- Facultad de Psicología, Universidad de Málaga, Instituto de Investigaciones Biomédicas de Málaga, Málaga, Spain
| | - Rosa Esteve
- Facultad de Psicología, Universidad de Málaga, Instituto de Investigaciones Biomédicas de Málaga, Málaga, Spain
| | - Alicia E López-Martínez
- Facultad de Psicología, Universidad de Málaga, Instituto de Investigaciones Biomédicas de Málaga, Málaga, Spain
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Wagner B, Latimer J, Adams E, Carmichael Olson H, Symons M, Mazzucchelli TG, Jirikowic T, Watkins R, Cross D, Carapetis J, Boulton J, Wright E, McRae T, Carter M, Fitzpatrick JP. School-based intervention to address self-regulation and executive functioning in children attending primary schools in remote Australian Aboriginal communities. PLoS One 2020; 15:e0234895. [PMID: 32579567 PMCID: PMC7314028 DOI: 10.1371/journal.pone.0234895] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Accepted: 06/04/2020] [Indexed: 11/18/2022] Open
Abstract
Executive functioning and self-regulation influence a range of outcomes across the life course including physical and mental health, educational success, and employment. Children prenatally exposed to alcohol or early life trauma (ELT) are at higher risk of impairment of these skills and may require intervention to address self-regulation deficits. Researchers partnered with the local Aboriginal health organization and schools to develop and pilot a manualized version of the Alert Program® in the Fitzroy Valley, north Western Australia, a region with documented high rates of fetal alcohol spectrum disorder and ELT. This self-controlled cluster randomized trial evaluated the effect of an 8-week Alert Program® intervention on children's executive functioning and self-regulation skills. Following parent or caregiver consent (referred to hereafter as parent), 271 students were enrolled in the study. This reflects a 75% participation rate and indicates the strong community support that exists for the study. Teachers from 26 primary school classrooms across eight Fitzroy Valley schools received training to deliver eight, one-hour Alert Program® lessons over eight-weeks to students. Student outcomes were measured by parent and teacher ratings of children's behavioral, emotional, and cognitive regulation. The mean number of lessons attended by children was 4.2. Although no significant improvements to children's executive functioning skills or behavior were detected via the teacher-rated measures as hypothesized, statistically significant improvements were noted on parent-rated measures of executive functioning and behavior. The effectiveness of future self-regulation programs may be enhanced through multimodal delivery through home, school and community based settings to maximize children's exposure to the intervention. Despite mixed findings of effect, this study was an important first step in adapting and evaluating the Alert Program® for use in remote Australian Aboriginal community schools, where access to self-regulation interventions is limited.
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Affiliation(s)
- Bree Wagner
- Alcohol and Pregnancy and Fetal Alcohol Spectrum Disorder Research Team, Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
- * E-mail:
| | - Jane Latimer
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Emma Adams
- Alcohol and Pregnancy and Fetal Alcohol Spectrum Disorder Research Team, Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - Heather Carmichael Olson
- Seattle Children’s Research Institute, Seattle, Washington, United States of America
- University of Washington School of Medicine, Seattle, Washington, United States of America
| | - Martyn Symons
- National Health and Medical Research Council FASD Research Australia Centre of Research Excellence, Perth, Western Australia, Australia
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - Trevor G. Mazzucchelli
- Child and Family Research Group, School of Psychology, Curtin University, Perth, Western Australia, Australia
- Brain, Behaviour and Mental Health Research Group, School of Psychology, Curtin University, Perth, Western Australia, Australia
| | - Tracy Jirikowic
- Division of Occupational Therapy, Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, Washington, United States of America
| | - Rochelle Watkins
- National Health and Medical Research Council FASD Research Australia Centre of Research Excellence, Perth, Western Australia, Australia
| | - Donna Cross
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
- Health Promotion and Education Research Team, Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
- CoLab–Collaborate for Kids, Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - Jonathan Carapetis
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
- Perth Children’s Hospital, Perth, Western Australia, Australia
| | - John Boulton
- The University of Newcastle, Newcastle, New South Wales, Australia
| | - Edie Wright
- Western Australian Department of Education Kimberley Education Region, Broome, Western Australia, Australia
| | - Tracy McRae
- Alcohol and Pregnancy and Fetal Alcohol Spectrum Disorder Research Team, Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - Maureen Carter
- Nindilingarri Cultural Health Services, Fitzroy Crossing, Western Australia, Australia
| | - James P. Fitzpatrick
- Alcohol and Pregnancy and Fetal Alcohol Spectrum Disorder Research Team, Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
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10
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Hodes GE, Epperson CN. Sex Differences in Vulnerability and Resilience to Stress Across the Life Span. Biol Psychiatry 2019; 86:421-432. [PMID: 31221426 PMCID: PMC8630768 DOI: 10.1016/j.biopsych.2019.04.028] [Citation(s) in RCA: 238] [Impact Index Per Article: 47.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 04/08/2019] [Accepted: 04/25/2019] [Indexed: 12/12/2022]
Abstract
Susceptibility and resilience to stress depend on 1) the timing of the exposure with respect to development, 2) the time across the life span at which effects are measured, and 3) the behavioral or biological phenotype under consideration. This translational review examines preclinical stress models that provide clues to causal mechanisms and their relationship to the more complex phenomenon of stress-related psychiatric and cognitive disorders in humans. We examine how genetic sex and epigenetic regulation of hormones contribute to the proximal and distal effects of stress at different epochs of life. Stress during the prenatal period and early postnatal life puts male offspring at risk of developing diseases involving socialization, such as autism spectrum disorder, and attention and cognition, such as attention-deficit/hyperactivity disorder. While female offspring show resilience to some of the proximal effects of prenatal and early postnatal stress, there is evidence that risk associated with developmental insults is unmasked in female offspring following periods of hormonal activation and flux, including puberty, pregnancy, and perimenopause. Likewise, stress exposures during puberty have stronger proximal effects on girls, including an increased risk of developing mood-related and stress-related illnesses, such as depression, anxiety, and posttraumatic stress disorder. Hormonal changes during menopause and andropause impact the processes of memory and emotion in women and men, though women are preferentially at risk for dementia, and childhood adversity further impacts estradiol effects on neural function. We propose that studies to determine mechanisms for stress risk and resilience across the life span must consider the nature and timing of stress exposures as well as the sex of the organism under investigation.
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Affiliation(s)
- Georgia E. Hodes
- School of Neuroscience, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - C. Neill Epperson
- Department of Psychiatry, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, USA
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11
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Sturycz CA, Hellman N, Payne MF, Kuhn BL, Hahn B, Lannon EW, Palit S, Güereca YM, Toledo TA, Shadlow JO, Rhudy JL. Race/Ethnicity Does Not Moderate the Relationship Between Adverse Life Experiences and Temporal Summation of the Nociceptive Flexion Reflex and Pain: Results From the Oklahoma Study of Native American Pain Risk. THE JOURNAL OF PAIN 2019; 20:941-955. [PMID: 30776495 DOI: 10.1016/j.jpain.2019.02.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 02/11/2019] [Accepted: 02/11/2019] [Indexed: 12/22/2022]
Abstract
Adverse life experiences (ALEs) are associated with hyperalgesia and chronic pain, but the underlying mechanisms are poorly understood. One potential mechanism is hyperexcitability of spinal neurons (ie, central sensitization). Given that Native Americans (NAs) are more likely to have ALEs and to have a higher prevalence of chronic pain, the relationship between ALEs and spinal hyperexcitability might contribute to their pain risk. The present study assessed temporal summation of the nociceptive flexion reflex (TS-NFR; a correlate of spinal hyperexcitability) and pain (TS-Pain) in 246 healthy, pain-free non-Hispanic whites and NAs. The Life Events Checklist was used to assess the number of ALEs. Multilevel growth models were used to predict TS-NFR and TS-Pain, after controlling for age, perceived stress, psychological problems, negative and positive affect, and painful stimulus intensity. ALEs and negative affect were significantly associated with greater pain, but not enhanced TS-Pain. By contrast, ALEs were associated with enhanced TS-NFR. Race did not moderate these relationships. This finding implies that ALEs promote hyperalgesia as a result of increased spinal neuron excitability. Although relationships between ALEs and the nociceptive flexion reflex/pain were not stronger in NAs, given prior evidence that NAs experience more ALEs, this factor might contribute to the higher prevalence of chronic pain in NAs. PERSPECTIVE: This study found a dose-dependent relationship between ALEs and spinal neuron excitability. Although the relationship was not stronger in NAs than non-Hispanic whites, given prior evidence that NAs experience more ALEs, this could contribute to the higher prevalence of chronic pain in NAs.
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Affiliation(s)
| | - Natalie Hellman
- Department of Psychology, The University of Tulsa, Tulsa, Oklahoma
| | - Michael F Payne
- Department of Psychology, The University of Tulsa, Tulsa, Oklahoma
| | - Bethany L Kuhn
- Department of Psychology, The University of Tulsa, Tulsa, Oklahoma
| | - Burkhart Hahn
- Department of Psychology, The University of Tulsa, Tulsa, Oklahoma
| | - Edward W Lannon
- Department of Psychology, The University of Tulsa, Tulsa, Oklahoma
| | - Shreela Palit
- Department of Psychology, The University of Tulsa, Tulsa, Oklahoma
| | - Yvette M Güereca
- Department of Psychology, The University of Tulsa, Tulsa, Oklahoma
| | - Tyler A Toledo
- Department of Psychology, The University of Tulsa, Tulsa, Oklahoma
| | - Joanna O Shadlow
- Department of Psychology, The University of Tulsa, Tulsa, Oklahoma
| | - Jamie L Rhudy
- Department of Psychology, The University of Tulsa, Tulsa, Oklahoma.
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12
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D'Agata AL, Wu J, Welandawe MKV, Dutra SVO, Kane B, Groer MW. Effects of early life NICU stress on the developing gut microbiome. Dev Psychobiol 2019; 61:650-660. [PMID: 30697700 DOI: 10.1002/dev.21826] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 12/11/2018] [Accepted: 12/12/2018] [Indexed: 02/06/2023]
Abstract
Succession of gut microbial community structure for newborns is highly influenced by early life factors. Many preterm infants cared for in the NICU are exposed to parent-infant separation, stress, and pain from medical care procedures. The purpose of the study was to investigate the impact of early life stress on the trajectory of gut microbial structure. Stool samples from very preterm infants were collected weekly for 6 weeks. NICU stress exposure data were collected daily for 6 weeks. V4 region of the 16S rRNA gene was amplified by PCR and sequenced. Zero-inflated beta regression model with random effects was used to assess the impact of stress on gut microbiome trajectories. Week of sampling was significant for Escherichia, Staphylococcus, Enterococcus, Bifidobacterium, Proteus, Streptococcus, Clostridium butyricum, and Clostridium perfringens. Antibiotic usage was significant for Proteus, Citrobacter, and C. perfringens. Gender was significant for Proteus. Stress exposure occurring 1 and 2 weeks prior to sampling had a significant effect on Proteus and Veillonella. NICU stress exposure had a significant effect on Proteus and Veillonella. An overall dominance of Gammaproteobacteria was found. Findings suggest early life NICU stress may significantly influence the developing gut microbiome, which is important to NICU practice and future microbiome research.
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Affiliation(s)
- Amy L D'Agata
- College of Nursing, University of Rhode Island, Kingston, Rhode Island.,College of Nursing, University of South Florida, Tampa, Florida
| | - Jing Wu
- Computer Science and Statistics, University of Rhode Island, Kingston, Rhode Island
| | | | - Samia V O Dutra
- College of Nursing, University of South Florida, Tampa, Florida
| | - Bradley Kane
- College of Nursing, University of South Florida, Tampa, Florida
| | - Maureen W Groer
- College of Nursing, University of South Florida, Tampa, Florida
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13
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Radford K, Delbaere K, Draper B, Mack HA, Daylight G, Cumming R, Chalkley S, Minogue C, Broe GA. Childhood Stress and Adversity is Associated with Late-Life Dementia in Aboriginal Australians. Am J Geriatr Psychiatry 2017; 25:1097-1106. [PMID: 28689644 DOI: 10.1016/j.jagp.2017.05.008] [Citation(s) in RCA: 95] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Revised: 05/09/2017] [Accepted: 05/10/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVES High rates of dementia have been observed in Aboriginal Australians. This study aimed to describe childhood stress in older Aboriginal Australians and to examine associations with late-life health and dementia. DESIGN A cross-sectional study with a representative sample of community-dwelling older Aboriginal Australians. SETTING Urban and regional communities in New South Wales, Australia. PARTICIPANTS 336 Aboriginal and/or Torres Strait Islander Australians aged 60-92 years, of whom 296 were included in the current analyses. MEASUREMENTS Participants completed a life course survey of health, well-being, cognition, and social history including the Childhood Trauma Questionnaire (CTQ), with consensus diagnosis of dementia and Alzheimer disease. RESULTS CTQ scores ranged from 25-117 (median: 29) and were associated with several adverse childhood indicators including separation from family, poor childhood health, frequent relocation, and growing up in a major city. Controlling for age, higher CTQ scores were associated with depression, anxiety, suicide attempt, dementia diagnosis, and, specifically, Alzheimer disease. The association between CTQ scores and dementia remained significant after controlling for depression and anxiety variables (OR: 1.61, 95% CI: 1.05-2.45). In contrast, there were no significant associations between CTQ scores and smoking, alcohol abuse, diabetes, or cardiovascular risk factors. CONCLUSIONS Childhood stress appears to have a significant impact on emotional health and dementia for older Aboriginal Australians. The ongoing effects of childhood stress need to be recognized as people grow older, particularly in terms of dementia prevention and care, as well as in populations with greater exposure to childhood adversity, such as Aboriginal Australians.
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Affiliation(s)
- Kylie Radford
- Neuroscience Research Australia, Sydney, NSW, Australia; Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia.
| | - Kim Delbaere
- Neuroscience Research Australia, Sydney, NSW, Australia; Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Brian Draper
- Neuroscience Research Australia, Sydney, NSW, Australia; Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Holly A Mack
- Neuroscience Research Australia, Sydney, NSW, Australia; Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Gail Daylight
- Neuroscience Research Australia, Sydney, NSW, Australia
| | - Robert Cumming
- School of Public Health, University of Sydney, Sydney, NSW, Australia
| | | | | | - Gerald A Broe
- Neuroscience Research Australia, Sydney, NSW, Australia; Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
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14
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Mitkovic Voncina M, Pejovic Milovancevic M, Mandic Maravic V, Lecic Tosevski D. Timeline of Intergenerational Child Maltreatment: the Mind-Brain-Body Interplay. Curr Psychiatry Rep 2017; 19:50. [PMID: 28664328 DOI: 10.1007/s11920-017-0805-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
PURPOSE OF REVIEW Still obscure mechanisms of intergenerational child maltreatment (ITCM) have been investigated partially, from various psychological and biological perspectives and from various time perspectives. This review is aimed at integrating the findings on different temporal ITCM pathways, emphasizing the mind-brain-body interplay. RECENT FINDINGS Psychological mediators of ITCM involve attachment, mentalization, dissociation, social information processing, personality traits, and psychiatric disorders. Neurobiological findings mostly refer to the neural correlates of caregiving and attachment behaviors, affected by several physiological systems (stress-response, immune, oxytocin), which also affect physical health. The latest research clusters around the epigenetic pathways of ITCM, suggesting the additional, prenatal, and preconception forms of transmission. Data suggest that ITCM needs to be conceptualized as a longitudinal process, with various interrelated psychological, neurodevelopmental, and somatic paths. Future research and prevention should take into account both, each path and each phase of ITCM, in an integrative way.
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Affiliation(s)
- Marija Mitkovic Voncina
- Institute of Mental Health, Palmoticeva 37, Belgrade, 11000, Serbia.,Belgrade University, Faculty of Medicine, Belgrade, Serbia
| | - Milica Pejovic Milovancevic
- Institute of Mental Health, Palmoticeva 37, Belgrade, 11000, Serbia.,Belgrade University, Faculty of Medicine, Belgrade, Serbia
| | | | - Dusica Lecic Tosevski
- Institute of Mental Health, Palmoticeva 37, Belgrade, 11000, Serbia. .,Belgrade University, Faculty of Medicine, Belgrade, Serbia. .,Serbian Academy of Sciences and Arts, Belgrade, Serbia.
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15
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An Attachment-Based Model of the Relationship Between Childhood Adversity and Somatization in Children and Adults. Psychosom Med 2017; 79:506-513. [PMID: 27941580 DOI: 10.1097/psy.0000000000000437] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE An attachment model was used to understand how maternal sensitivity and adverse childhood experiences are related to somatization. METHODS We examined maternal sensitivity at 6 and 18 months and somatization at 5 years in 292 children in a longitudinal cohort study. We next examined attachment insecurity and somatization (health anxiety, physical symptoms) in four adult cohorts: healthy primary care patients (AC1, n = 67), ulcerative colitis in remission (AC2, n = 100), hospital workers (AC3, n = 157), and paramedics (AC4, n = 188). Recall of childhood adversity was measured in AC3 and AC4. Attachment insecurity was tested as a possible mediator between childhood adversity and somatization in AC3 and AC4. RESULTS In children, there was a significant negative relationship between maternal sensitivity at 18 months and somatization at age 5 years (B = -3.52, standard error = 1.16, t = -3.02, p = .003), whereas maternal sensitivity at 6 months had no significant relationship. In adults, there were consistent, significant relationships between attachment insecurity and somatization, with the strongest findings for attachment anxiety and health anxiety (AC1, β = 0.51; AC2, β = 0.43). There was a significant indirect effect of childhood adversity on physical symptoms mediated by attachment anxiety in AC3 and AC4. CONCLUSIONS Deficits in maternal sensitivity at 18 months of age are related to the emergence of somatization by age 5 years. Adult attachment insecurity is related to somatization. Insecure attachment may partially mediate the relationship between early adversity and somatization.
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16
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Jungling A, Reglodi D, Karadi ZN, Horvath G, Farkas J, Gaszner B, Tamas A. Effects of Postnatal Enriched Environment in a Model of Parkinson's Disease in Adult Rats. Int J Mol Sci 2017; 18:E406. [PMID: 28216584 PMCID: PMC5343940 DOI: 10.3390/ijms18020406] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 02/01/2017] [Accepted: 02/06/2017] [Indexed: 01/01/2023] Open
Abstract
Environmental enrichment is a widespread neuroprotective strategy during development and also in the mature nervous system. Several research groups have described that enriched environment in adult rats has an impact on the progression of Parkinson's disease (PD). The aim of our present study was to examine the effects of early, postnatal environmental enrichment after 6-hydroxydopamine-induced (6-OHDA) lesion of the substantia nigra in adulthood. Newborn Wistar rats were divided into control and enriched groups according to their environmental conditions. For environmental enrichment, during the first five postnatal weeks animals were placed in larger cages and exposed to intensive complex stimuli. Dopaminergic cell loss, and hypokinetic and asymmetrical signs were evaluated after inducing PD with unilateral injections of 6-OHDA in three-month-old animals. Treatment with 6-OHDA led to a significant cell loss in the substantia nigra of control animals, however, postnatal enriched circumstances could rescue the dopaminergic cells. Although there was no significant difference in the percentage of surviving cells between 6-OHDA-treated control and enriched groups, the slightly less dopaminergic cell loss in the enriched group compared to control animals resulted in less severe hypokinesia. Our investigation is the first to provide evidence for the neuroprotective effect of postnatal enriched environment in PD later in life.
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Affiliation(s)
- Adel Jungling
- Department of Anatomy, University of Pecs Medical School, Pecs 7624, Hungary.
| | - Dora Reglodi
- Department of Anatomy, University of Pecs Medical School, Pecs 7624, Hungary.
| | | | - Gabor Horvath
- Department of Anatomy, University of Pecs Medical School, Pecs 7624, Hungary.
| | - Jozsef Farkas
- Department of Anatomy, University of Pecs Medical School, Pecs 7624, Hungary.
| | - Balazs Gaszner
- Department of Anatomy, University of Pecs Medical School, Pecs 7624, Hungary.
| | - Andrea Tamas
- Department of Anatomy, University of Pecs Medical School, Pecs 7624, Hungary.
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Human amygdala engagement moderated by early life stress exposure is a biobehavioral target for predicting recovery on antidepressants. Proc Natl Acad Sci U S A 2016; 113:11955-11960. [PMID: 27791054 DOI: 10.1073/pnas.1606671113] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Amygdala circuitry and early life stress (ELS) are both strongly and independently implicated in the neurobiology of depression. Importantly, animal models have revealed that the contribution of ELS to the development and maintenance of depression is likely a consequence of structural and physiological changes in amygdala circuitry in response to stress hormones. Despite these mechanistic foundations, amygdala engagement and ELS have not been investigated as biobehavioral targets for predicting functional remission in translational human studies of depression. Addressing this question, we integrated human neuroimaging and measurement of ELS within a controlled trial of antidepressant outcomes. Here we demonstrate that the interaction between amygdala activation engaged by emotional stimuli and ELS predicts functional remission on antidepressants with a greater than 80% cross-validated accuracy. Our model suggests that in depressed people with high ELS, the likelihood of remission is highest with greater amygdala reactivity to socially rewarding stimuli, whereas for those with low-ELS exposure, remission is associated with lower amygdala reactivity to both rewarding and threat-related stimuli. This full model predicted functional remission over and above the contribution of demographics, symptom severity, ELS, and amygdala reactivity alone. These findings identify a human target for elucidating the mechanisms of antidepressant functional remission and offer a target for developing novel therapeutics. The results also offer a proof-of-concept for using neuroimaging as a target for guiding neuroscience-informed intervention decisions at the level of the individual person.
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18
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Westfall NC, Nemeroff CB. State-of-the-Art Prevention and Treatment of PTSD: Pharmacotherapy, Psychotherapy, and Nonpharmacological Somatic Therapies. Psychiatr Ann 2016. [DOI: 10.3928/00485713-20160808-01] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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19
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Morris MJ, Le V, Maniam J. The impact of poor diet and early life stress on memory status. Curr Opin Behav Sci 2016. [DOI: 10.1016/j.cobeha.2016.04.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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