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Bouizegarene N, Ramstead MJD, Constant A, Friston KJ, Kirmayer LJ. Narrative as active inference: an integrative account of cognitive and social functions in adaptation. Front Psychol 2024; 15:1345480. [PMID: 38903472 PMCID: PMC11188712 DOI: 10.3389/fpsyg.2024.1345480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 04/30/2024] [Indexed: 06/22/2024] Open
Abstract
While the ubiquity and importance of narratives for human adaptation is widely recognized, there is no integrative framework for understanding the roles of narrative in human adaptation. Research has identified several cognitive and social functions of narratives that are conducive to well-being and adaptation as well as to coordinated social practices and enculturation. In this paper, we characterize the cognitive and social functions of narratives in terms of active inference, to support the claim that one of the main adaptive functions of narrative is to generate more useful (i.e., accurate, parsimonious) predictions for the individual, as well as to coordinate group action (over multiple timescales) through shared predictions about collective behavior. Active inference is a theory that depicts the fundamental tendency of living organisms to adapt by proactively inferring the causes of their sensations (including their own actions). We review narrative research on identity, event segmentation, episodic memory, future projections, storytelling practices, enculturation, and master narratives. We show how this research dovetails with the active inference framework and propose an account of the cognitive and social functions of narrative that emphasizes that narratives are for the future-even when they are focused on recollecting or recounting the past. Understanding narratives as cognitive and cultural tools for mutual prediction in social contexts can guide research on narrative in adaptive behavior and psychopathology, based on a parsimonious mechanistic model of some of the basic adaptive functions of narrative.
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Affiliation(s)
- Nabil Bouizegarene
- Department of Psychology, University of Quebec at Montreal, Montreal, QC, Canada
- Research Center, Montreal University Institute of Mental Health, Montreal, QC, Canada
| | - Maxwell J. D. Ramstead
- VERSES Research Lab, Los Angeles, CA, United States
- Wellcome Centre for Human Neuroimaging, University College London, London, United Kingdom
| | - Axel Constant
- School of Engineering and Informatics, The University of Sussex, Brighton, United Kingdom
- Culture and Mental Health Research Unit, Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada
- Division of Social and Transcultural Psychiatry, Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Karl J. Friston
- VERSES Research Lab, Los Angeles, CA, United States
- Wellcome Centre for Human Neuroimaging, University College London, London, United Kingdom
| | - Laurence J. Kirmayer
- Culture and Mental Health Research Unit, Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada
- Division of Social and Transcultural Psychiatry, Department of Psychiatry, McGill University, Montreal, QC, Canada
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Aschbacher K, Mather M, Lehrer P, Gevirtz R, Epel E, Peiper NC. Real-time heart rate variability biofeedback amplitude during a large-scale digital mental health intervention differed by age, gender, and mental and physical health. Psychophysiology 2024; 61:e14533. [PMID: 38454612 DOI: 10.1111/psyp.14533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 12/06/2023] [Accepted: 01/08/2024] [Indexed: 03/09/2024]
Abstract
Heart rate variability biofeedback (HRVB) is an efficacious treatment for depression and anxiety. However, translation to digital mental health interventions (DMHI) requires computing and providing real-time HRVB metrics in a personalized and user-friendly fashion. To address these gaps, this study validates a real-time HRVB feedback algorithm and characterizes the association of the main algorithmic summary metric-HRVB amplitude-with demographic, psychological, and health factors. We analyzed HRVB data from 5158 participants in a therapist-supported DMHI incorporating slow-paced breathing to treat depression or anxiety symptoms. A real-time feedback metric of HRVB amplitude and a gold-standard research metric of low-frequency (LF) power were computed for each session and then averaged within-participants over 2 weeks. We provide HRVB amplitude values, stratified by age and gender, and we characterize the multivariate associations of HRVB amplitude with demographic, psychological, and health factors. Real-time HRVB amplitude correlated strongly (r = .93, p < .001) with the LF power around the respiratory frequency (~0.1 Hz). Age was associated with a significant decline in HRVB (β = -0.46, p < .001), which was steeper among men than women, adjusting for demographic, psychological, and health factors. Resting high- and low-frequency power, body mass index, hypertension, Asian race, depression symptoms, and trauma history were significantly associated with HRVB amplitude in multivariate analyses (p's < .01). Real-time HRVB amplitude correlates highly with a research gold-standard spectral metric, enabling automated biofeedback delivery as a potential treatment component of DMHIs. Moreover, we identify demographic, psychological, and health factors relevant to building an equitable, accurate, and personalized biofeedback user experience.
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Affiliation(s)
| | - Mara Mather
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California, USA
- Department of Psychology, University of Southern California, Los Angeles, California, USA
- Department of Biomedical Engineering, University of Southern California, Los Angeles, California, USA
| | - Paul Lehrer
- Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, Monmouth Junction, New Jersey, USA
| | - Richard Gevirtz
- Department of Clinical Psychology, California School of Professional Psychology, Alliant International University, San Diego, California, USA
| | - Elissa Epel
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, California, USA
| | - Nicholas C Peiper
- Meru Health, San Mateo, California, USA
- Department of Epidemiology and Population Health, University of Louisville, Louisville, Kentucky, USA
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Kłosińska U, Leszko M. Family relationships as a source of narrative identity of people with advanced dementia. BMC Geriatr 2023; 23:546. [PMID: 37684570 PMCID: PMC10492413 DOI: 10.1186/s12877-023-04258-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 08/27/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND The growing body of research on narrative identity, while helpful, rarely focuses on people with dementia. In this paper, we explore how individuals living with advanced dementia construct their narrative identities in relation to their family experiences, which play a crucial role in shaping identity as shown by recent studies. METHODS We conducted a qualitative study using data from 15 semi-structured interviews with people aged 66 to 94 who have advanced dementia. The data were analyzed using a textual-oriented discourse analysis. RESULTS We identified two discourses-autobiographical and economic-that organize their narrative identities. Through the autobiographical discourse, participants emphasized their sense of belonging within a social group and their role as custodians of family identity. Within the economic discourse, they negotiated their social utility and value, particularly in response to demeaning discourses targeting individuals who do not accumulate wealth. In the structural analysis, we identified two narrative types-looped or unfolding-that depend on their affective experiences related to their family. We especially explored how the repetition of narrative threads by individuals with dementia might indicate a traumatic background rather than just memory disruptions. CONCLUSIONS This study provides insights into the narrative identities of individuals with advanced dementia, shedding light on the intersection of family experiences and identity formation in this population.
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Affiliation(s)
- Urszula Kłosińska
- Faculty of Psychology, SWPS University of Social Sciences and Humanities, ul. Ostrowskiego 30B, Wrocław, 53-238, Poland.
| | - Magdalena Leszko
- Department of Psychology, University of Szczecin, Szczecin, Poland
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Kim Y, Lin J, Epel ES, Carver CS. A Lens on Caregiver Stress in Cancer: Longitudinal Investigation of Cancer-Related Stress and Telomere Length Among Family Caregivers of Adult Patients With Cancer. Psychosom Med 2023; 85:527-534. [PMID: 37260287 PMCID: PMC10524877 DOI: 10.1097/psy.0000000000001220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVE Family members are typically the primary caregivers of patients with chronic illnesses. Family caregivers of adult relatives with cancer are a fast-growing population, yet the physical consequences of their stress due to the cancer in the family have been poorly understood. This study examined the bidirectional relations of the perceived stress of family caregivers of individuals recently diagnosed with cancer and leukocyte cellular aging indexed by telomere length for 2 years. METHODS Family caregivers ( N = 168; mean age = 51 years, 70% female, 46% Hispanic, 36% spouse to the patient) of patients with colorectal cancer provided psychological data and peripheral blood samples approximately 4 (T1), 12 (T2), and 21 months (T3) after diagnosis. Time-lagged cross-panel modeling was used to test the associations of perceived cancer-related stress and telomere length, controlling for age, sex, and body mass index. RESULTS Cancer-related stress was highest at T1 and decreased by 1 year. Greater cancer-related stress predicted longer telomere length at subsequent assessments for 2 years ( β ≥ 0.911, p ≤ .019). However, telomere length did not change significantly for 2 years overall and did not prospectively predict cancer-related stress over this period. CONCLUSIONS Findings suggest the need to better understand how the perceived stress of colorectal cancer caregivers, which tends to be intense for a relatively short period compared with dementia caregiving, may impact immune cell distributions and telomere length. These findings emphasize the need for further knowledge about psychobiological mechanisms of how cancer caregiving may impact cellular aging.
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Affiliation(s)
| | - Jue Lin
- Department of Biochemistry and Biophysics, University of California, San Francisco
| | - Elissa S. Epel
- Department of Psychiatry, University of California, San Francisco
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Büyükbayram Z, Aksoy M, Yılmaz R. Difficult lives: A descriptive and relational study on the coping with stress and care burden of caregivers of patients with epilepsy. Epilepsy Behav 2023; 145:109297. [PMID: 37336137 DOI: 10.1016/j.yebeh.2023.109297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 05/30/2023] [Accepted: 06/01/2023] [Indexed: 06/21/2023]
Abstract
AIM This study was conducted to examine the relationship between coping with stress status and the burden of care of the caregivers of patients with epilepsy. MATERIALS AND METHODS This descriptive correlational study was carried out with a total of 230 voluntary caregivers of patients with epilepsy who visited the neurology clinics and outpatient clinics of a training and research hospital in the southeastern part of Turkiye between March 2022 and February 2023. Study data were collected through the Personal Information Form, the Zarit Caregiver Burden Assessment and the Ways of Coping Scale. Descriptive statistics and multiple regression analysis were used for the evaluation of the data. FINDINGS While the mean score of the caregivers from the Zarit Caregiver Burden Assessment was 41.20 ± 12.44, they had mean scores of 12.12 ± 3.25, 8.93 ± 1.93, 12.24 ± 3.61, 8.77 ± 3.17, and 7.89 ± 1.95, respectively, from the self-confident approach, optimistic approach, helpless approach, submissive approach, and social support-seeking approach sub-dimensions. In the study, a moderate positive statistically significant relationship was found between the caregivers' burden of care and the mean scores of the helpless and submissive approach sub-dimensions(p < 0.05). CONCLUSION The caregivers' burden of care and coping with stress were at moderate levels. The helpless approach, which is one of the ineffective methods of coping with stress, was found to be higher. The helpless and submissive approaches were found to increase in this study as the caregivers' burden of care increased. IMPLICATIONS The use of effective coping skills to reduce the level of personal burden of care would improve the caregiver's physical health and psychological well-being.
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Affiliation(s)
- Zeliha Büyükbayram
- Siirt University, Faculty of Health Sciences, Department of Internal Medicine Nursing, Siirt, Turkey.
| | - Meyreme Aksoy
- Siirt University, Faculty of Health Sciences, Department of Nursing Fundamentals, Siirt, Turkey.
| | - Rıdvan Yılmaz
- Gazi Yaşargil Education and Research Hospital, Diyarbakır, Turkey.
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Roy B, Malviya L, Kumar R, Mal S, Kumar A, Bhowmik T, Hu JW. Hybrid Deep Learning Approach for Stress Detection Using Decomposed EEG Signals. Diagnostics (Basel) 2023; 13:diagnostics13111936. [PMID: 37296788 DOI: 10.3390/diagnostics13111936] [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: 04/16/2023] [Revised: 05/14/2023] [Accepted: 05/26/2023] [Indexed: 06/12/2023] Open
Abstract
Stress has an impact, not only on a person's physical health, but also on the ability to perform at the workplace in daily life. The well-established relation between psychological stress and its pathogeneses highlights the need for detecting psychological stress early, in order to prevent disease advancement and to save human lives. Electroencephalography (EEG) signal recording tools are widely used to collect these psychological signals/brain rhythms in the form of electric waves. The aim of the current research was to apply automatic feature extraction to decomposed multichannel EEG recordings, in order to efficiently detect psychological stress. The traditional deep learning techniques, namely the convolution neural network (CNN), long short-term memory (LSTM), bidirectional long short-term memory (BiLSTM), gated recurrent unit (GRU) and recurrent neural network (RNN) models, have been frequently used for stress detection. A hybrid combination of these techniques may provide improved performance, and can handle long-term dependencies in non-linear brain signals. Therefore, this study proposed an integration of deep learning models, called DWT-based CNN, BiLSTM, and two layers of a GRU network, to extract features and classify stress levels. Discrete wavelet transform (DWT) analysis was used to remove the non-linearity and non-stationarity from multi-channel (14 channel) EEG recordings, and to decompose them into different frequency bands. The decomposed signals were utilized for automatic feature extraction using the CNN, and the stress levels were classified using BiLSTM and two layers of GRU. This study compared five combinations of the CNN, LSTM, BiLSTM, GRU and RNN models with the proposed model. The proposed hybrid model performed better in classification accuracy compared to the other models. Therefore, hybrid combinations are appropriate for the clinical intervention and prevention of mental and physical problems.
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Affiliation(s)
- Bishwajit Roy
- Department of Computer Science Engineering-AI & ML, Siliguri Institute of Technology, Siliguri 734009, India
| | - Lokesh Malviya
- School of Computing Science and Engineering, Vellore Institute of Technology Bhopal University, Bhopal 466114, India
| | - Radhikesh Kumar
- Department of Computer Science and Engineering, National Institute of Technology, Patna 800001, India
| | - Sandip Mal
- School of Computing Science and Engineering, Vellore Institute of Technology Bhopal University, Bhopal 466114, India
| | - Amrendra Kumar
- Department of Civil Engineering, Roorkee Institute of Technology, Roorkee 247667, India
| | - Tanmay Bhowmik
- Department of Computer Science and Engineering, Pandit Deendayal Energy University, Gandhinagar 382426, India
| | - Jong Wan Hu
- Department of Civil and Environmental Engineering, Incheon National University, Incheon 22022, Republic of Korea
- Incheon Disaster Prevention Research Center, Incheon National University, Incheon 22022, Republic of Korea
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Adler JM, Manning RB, Hennein R, Winschel J, Baldari A, Bogart KR, Nario-Redmond MR, Ostrove JM, Lowe SR, Wang K. Narrative identity among people with disabilities in the United States during the Covid-19 pandemic: The interdependent self. JOURNAL OF RESEARCH IN PERSONALITY 2022; 101:104302. [PMID: 36185499 PMCID: PMC9514959 DOI: 10.1016/j.jrp.2022.104302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 07/24/2022] [Accepted: 09/22/2022] [Indexed: 11/16/2022]
Abstract
This study examines narrative identity among a large, diverse sample of people with disabilities (PWDs) in the United States during the "second wave" of the Covid-19 pandemic (October-December 2020). The study relied on abductive analyses, combining a purely inductive phase of inquiry followed by two rounds of investigation that filtered inductive insights through three theoretical lenses: social-ecological theory, the theory of narrative identity, and perspectives from the interdisciplinary field of disability studies. The central result was the identification of a particular configuration of self, one that was demonstrably interdependent with both immediate interpersonal contexts and with broader cultural contexts. This interdependent self was interpreted in both positive and negative ways by PWDs. These findings invite future inquiry into commonplace conceptualizations of an independent self at the center of personality research and suggest that dominant conceptualizations of "the good life" may overly emphasize independence.
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Affiliation(s)
- Jonathan M Adler
- Olin College of Engineering, 1000 Olin Way, MH 368, Needham, MA 02492, USA
| | - Robert B Manning
- Department of Social and Behavioral Sciences, Yale School of Public Health, 60 College Street, New Haven, CT 06510, USA
| | - Rachel Hennein
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, 60 College Street, New Haven, CT 06510, USA
- Yale School of Medicine, 333 Cedar St, New Haven, CT 06510, USA
| | - Julia Winschel
- Department of Social and Behavioral Sciences, Yale School of Public Health, 60 College Street, New Haven, CT 06510, USA
| | - Alessandra Baldari
- Department of Psychology, Yale University, 2 Hillhouse Ave., New Haven, CT 06510, USA
| | - Kathleen R Bogart
- School of Psychological Science, Oregon State University, 2950 SW Jefferson Way, Corvallis, OR 97331, USA
| | - Michelle R Nario-Redmond
- Departments of Psychology and Biomedical Humanities, Hiram College, 11730 Garfield Road, Hiram, OH 44234, USA
| | - Joan M Ostrove
- Department of Psychology, Macalester College, 1600 Grand Avenue, Saint Paul, MN 55105, USA
| | - Sarah R Lowe
- Department of Social and Behavioral Sciences, Yale School of Public Health, 60 College Street, New Haven, CT 06510, USA
| | - Katie Wang
- Department of Social and Behavioral Sciences, Yale School of Public Health, 60 College Street, New Haven, CT 06510, USA
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Snodgrass JG, Lacy MG, Cole SW. Internet gaming, embodied distress, and psychosocial well-being: A syndemic-syndaimonic continuum. Soc Sci Med 2022; 295:112728. [PMID: 31879045 PMCID: PMC7289667 DOI: 10.1016/j.socscimed.2019.112728] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 11/28/2019] [Accepted: 12/09/2019] [Indexed: 02/03/2023]
Abstract
We examine internet gaming-related suffering as a novel syndemic most prevalent among contemporary emerging adults. Synthetic analysis of our prior research on internet gaming and health affirms how social factors and mental and physical wellness mutually condition each other in this online play context. Employing biocultural anthropological mixed methods, we focus on statistical interactions between intensive gaming and social well-being in relation to genomic markers of immune function. We show that among gamers with low social well-being, intensive game play is associated with compromised immunity markers, but among those with robust social connection, that same play correlates with decreased activation of stress-related immunity activation. The apparently beneficial interaction of higher social well-being and intensive game play resonates with an emerging body of research showing how positive practices-in this case, engaged and pleasurable videogame play-can increase resilience to the negative linked psychological and genomic responses to precarity. Based on these findings, we argue, in relation to gaming behaviors, a syndemics analysis could usefully be expanded by attending to both sides of the synergistic interaction between two social conditions: not just exacerbation of dysfunction in relation to their combined effect, but also non-additive enhancement of health that may stem from such combinations. We draw on literature emphasizing the relevance to health of "eudaimonic" well-being-psychosocial processes that transcend immediate self-gratification and involve the pursuit of meaningful and pro-social goals. On that basis, we propose the term "syndaimonics" to capture synergies between social context and mental flourishing, which, in this context and presumably others, can illuminate sources of health resilience and overall improved psychosocial wellbeing.
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Affiliation(s)
- Jeffrey G. Snodgrass
- Department of Anthropology, Colorado State University, Fort Collins, CO, 80523-1787, USA,Corresponding author. (J.G. Snodgrass)
| | - Michael G. Lacy
- Department of Sociology, Colorado State University, Fort Collins, CO, 80523-1784, USA
| | - Steven W. Cole
- Division of Hematology-Oncology, Department of Medicine, University of California, Los Angeles School of Medicine, Los Angeles, CA, 90095, USA,Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles School of Medicine, Los Angeles, CA, 90095, USA
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Chen Y, Wang L, Jiang D, Zhu S, Research Team W, Chen G, Gan Y. Vulnerability to early stressful life events: The moderating role of HOMER1 gene in the gene × environment interaction. EUROPEAN JOURNAL OF DEVELOPMENTAL PSYCHOLOGY 2022. [DOI: 10.1080/17405629.2021.2011717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Yidi Chen
- School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, China
| | - Lizhong Wang
- WeGene, Shenzhen Zaozhidao Technology Co. Ltd., Shenzhen, P. R. China
- Shenzhen WeGene Clinical Laboratory, Shenzhen, P. R. China
| | - Dongdong Jiang
- School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, China
- Zhejiang University of Technology; Hangzhou, China
| | - Shanshan Zhu
- School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, China
| | - WeGene Research Team
- WeGene, Shenzhen Zaozhidao Technology Co. Ltd., Shenzhen, P. R. China
- Shenzhen WeGene Clinical Laboratory, Shenzhen, P. R. China
| | - Gang Chen
- WeGene, Shenzhen Zaozhidao Technology Co. Ltd., Shenzhen, P. R. China
- Shenzhen WeGene Clinical Laboratory, Shenzhen, P. R. China
- Hunan Provincial Key Lab on Bioinformatics, School of Computer Science and Engineering, Central South University, Changsha, P. R. China
| | - Yiqun Gan
- School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, China
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Luo D, Wang Y, Cai X, Li R, Li M, Liu H, Xu J. Resilience Among Parents of Adolescents With Type 1 Diabetes: Associated With Fewer Parental Depressive Symptoms and Better Pediatric Glycemic Control. Front Psychiatry 2022; 13:834398. [PMID: 35492685 PMCID: PMC9043445 DOI: 10.3389/fpsyt.2022.834398] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 03/22/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Although pediatric resilience plays a significant role in resisting negative moods and improving glycaemic control, little research exists regarding resilience among the parents of adolescents with Type 1 diabetes. OBJECTIVE To investigate parental resilience's correlations with parental depressive symptoms, parental diabetes distress, and pediatric glycaemic control. METHODS This cross-sectional study recruited adolescents with Type 1 diabetes and their parents from two hospitals. The parents completed questionnaires. The 10-item Connor-Davidson Resilience Scale measured resilience; the Problem Areas in Diabetes Survey-Parent Revised version measured diabetes distress; the Patient Health Questionnaire-9 measured depressive symptoms. Standard glycated hemoglobin tests were performed on the adolescents. RESULTS Data from 224 parents (77.2% female, Mage = 39.88 [SD = 5.02], age range = 30-56 years) of adolescents (50.9% boys, Mage = 13.54 years [SD = 2.48], age range = 10-19 years) were available. More than half (52.7%) of parents exceeded the criterion score for high resilience. Parental resilience was significantly negatively associated with parental depressive symptoms and diabetes distress. Parents from the high-resilience group reported fewer depressive symptoms than those from the low-resilience group. In multivariate regressions, greater parental resilience is consistently related to better pediatric glycaemic control beyond parental psychological risk factors. CONCLUSIONS This study highlights the importance of parental resilience for parental mental health and glycaemic control among adolescents with Type 1 diabetes. The appropriate resilience support programme might be developed for parents, especially for those existing depressive symptoms and diabetes distress.
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Affiliation(s)
- Dan Luo
- School of Nursing, Nanjing University of Chinese Medicine, Jiangsu, China
| | - Yubing Wang
- Department of Endocrinology, Children's Hospital Affiliated to Nanjing Medical University, Jiangsu, China
| | - Xue Cai
- School of Nursing, Peking University, Beijing, China
| | - Ruxue Li
- School of Nursing, Peking University, Beijing, China
| | - Mingzi Li
- School of Nursing, Peking University, Beijing, China
| | - Haiyan Liu
- Department of Neurology, The Second Affiliated Hospital of Xuzhou Medical University, Jiangsu, China
| | - Jingjing Xu
- Department of Endocrinology, The First Affiliated Hospital With Nanjing Medical University (Jiangsu Province Hospital), Jiangsu, China
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Costa MSA, Vilhena E, Leite Â, Almeida AC, Pereira MG. Quality of Life in Caregivers of Type 2 Diabetes Patients After Patient's Surgery: a Path Analysis. Int J Behav Med 2021; 29:438-447. [PMID: 34608592 DOI: 10.1007/s12529-021-10028-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Type 2 diabetes Mellitus is a chronic disease, and one of its complications may result in amputation. The goal of this study was to evaluate the impact of psychosocial variables, over time, on quality of life (QoL) of caregivers of patients (N = 110) who had undergone a recent amputation. METHOD A longitudinal design was employed: (T1) 1 month after the patient's surgery; (T2) 7 months after; and (T3) 10 months after. Burden Assessment Scale, Family Assessment Device, Revised Impact of Events Scale, Family Disruption from Illness Scale, and Short Form Health Survey were used. A path analysis model was tested. RESULTS Burden, perception of family functioning, and traumatic symptoms at T1 showed a positive impact on the perception of family functioning, at T2. Traumatic symptoms, at T1, predicted traumatic symptoms at T2 being also a mediator between those symptoms (T1) and physical QoL (T3). Physical and traumatic symptoms, at T1 predicted physical symptoms, at T2 affecting both mental and physical QoL (T3), being also a mediator in these relationships. Burden (T1) also had a direct effect on mental QoL (T3) and at T2 had an impact on physical QoL (T3) mediating also the relationship between burden/physical symptoms at T1 and physical QoL, at T3. CONCLUSION Intervention should focus on physical and traumatic symptoms as well as burden since they were both mediators regarding mental and physical QoL.
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Affiliation(s)
- M Suely Alves Costa
- Research Center in Psychology (CIPsi), School of Psychology, University of Minho, Campus de Gualtar, 4710-245, Braga, Portugal
| | - Estela Vilhena
- 2Ai School of Technology, IPCA, 4750-810, Barcelos, Portugal
| | - Ângela Leite
- Research Center in Psychology (CIPsi), School of Psychology, University of Minho, Campus de Gualtar, 4710-245, Braga, Portugal
| | - Ana C Almeida
- Research Center in Psychology (CIPsi), School of Psychology, University of Minho, Campus de Gualtar, 4710-245, Braga, Portugal
| | - M Graça Pereira
- Research Center in Psychology (CIPsi), School of Psychology, University of Minho, Campus de Gualtar, 4710-245, Braga, Portugal.
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12
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Dunlop WL. The cycle of life and story: Redemptive autobiographical narratives and prosocial behaviors. Curr Opin Psychol 2021; 43:213-218. [PMID: 34419896 DOI: 10.1016/j.copsyc.2021.07.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 07/18/2021] [Accepted: 07/23/2021] [Indexed: 11/18/2022]
Abstract
Adults often understand their lives by constructing personal stories and then living into them. Time and time again, a positive relation has been found between the tendency to build redemptive personal stories wherein negative and challenging experiences ultimately give way to positive endings and prosocial behavior. Here, I review the relevant literature in the interest of advancing the notion that redemptive stories and prosociality exist in a virtuous cycle. Engaging in prosocial acts can stimulate the redemptive framing of one's past. By the same measure, once formed, individuals work to bring the story to life, and the ethos of redemption holds the potential to stimulate and sustain prosocial behavior.
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Affiliation(s)
- William L Dunlop
- Department of Psychology, University of California, Riverside, Riverside, CA, 92521, USA; Department of Psychology, Aarhus University, 8000 Aarhus C, Denmark.
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Vanaken L, Vanderveren E, Waters TEA, Bijttebier P, Fivush R, Hermans D. It's all in the details: An investigation of the subcomponents of narrative coherence in relation to mental health. APPLIED COGNITIVE PSYCHOLOGY 2021. [DOI: 10.1002/acp.3859] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Lauranne Vanaken
- Centre for the Psychology of Learning and Experimental Psychopathology, Faculty of Psychology and Educational Sciences KU Leuven Leuven Belgium
| | - Elien Vanderveren
- Centre for the Psychology of Learning and Experimental Psychopathology, Faculty of Psychology and Educational Sciences KU Leuven Leuven Belgium
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience Maastricht University Maastricht The Netherlands
| | - Theodore E. A. Waters
- Department of Psychology New York University – Abu Dhabi Abu Dhabi United Arab Emirates
| | - Patricia Bijttebier
- School Psychology and Development in Context, Faculty of Psychology and Educational Sciences KU Leuven Leuven Belgium
| | - Robyn Fivush
- Institute for the Liberal Arts Emory University Atlanta Georgia USA
| | - Dirk Hermans
- Centre for the Psychology of Learning and Experimental Psychopathology, Faculty of Psychology and Educational Sciences KU Leuven Leuven Belgium
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Dunlop WL. Everything you wanted to know about redemptive stories* (*but were afraid to ask). JOURNAL OF RESEARCH IN PERSONALITY 2021. [DOI: 10.1016/j.jrp.2021.104078] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Vanaken L, Smeets T, Bijttebier P, Hermans D. Keep Calm and Carry On: The Relations Between Narrative Coherence, Trauma, Social Support, Psychological Well-Being, and Cortisol Responses. Front Psychol 2021; 12:558044. [PMID: 33643119 PMCID: PMC7905304 DOI: 10.3389/fpsyg.2021.558044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 01/04/2021] [Indexed: 11/17/2022] Open
Abstract
In order to explain trauma resilience, previous research has been investigating possible risk and protective factors, both on an individual and a contextual level. In this experimental study, we examined narrative coherence and social support in relation to trauma resilience. Participants were asked to write about a turning point memory, after which they did the Maastricht Acute Stress Test, our lab analog of a traumatic event. Following, half of the participants received social support, whereas the other half did not. Afterwards, all participants wrote a narrative on the traumatic event. Moment-to-moment fluctuations in psychological and physiological well-being throughout the experiment were investigated with state anxiety questionnaires and cortisol measures. Results showed that narratives of traumatic experiences were less coherent than narratives of turning point memories. However, contrary to our predictions, coherence, and, in particular, thematic coherence, related positively to anxiety levels. Possibly, particular types of thematic coherence are a non-adaptive form of coping, which reflect unfinished attempts at meaning-making and are more similar to continuous rumination than to arriving at a resolution. Furthermore, coherence at baseline could not buffer against the impact of trauma on anxiety levels in this study. Contrary to our hypotheses, social support did not have the intended beneficial effects on coherence, neither on well-being. Multiple explanations as to why our support manipulation remained ineffective are suggested. Remarkably, lower cortisol levels at baseline and after writing about the turning point memory predicted higher coherence in the trauma narratives. This may suggest that the ability to remain calm in difficult situations does relate to the ability to cope adaptively with future difficult experiences. Clinical and social implications of the present findings are discussed, and future research recommendations on the relations between narrative coherence, social support, and trauma resilience are addressed.
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Affiliation(s)
- Lauranne Vanaken
- Centre for the Psychology of Learning and Experimental Psychopathology, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Tom Smeets
- Department of Medical and Clinical Psychology, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands
| | - Patricia Bijttebier
- Faculty of Psychology and Educational Sciences, School Psychology and Development in Context, KU Leuven, Leuven, Belgium
| | - Dirk Hermans
- Centre for the Psychology of Learning and Experimental Psychopathology, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
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16
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Stigma associated with parental depression or cancer: Impact on spouse and offspring's cortisol levels and socioemotional functioning. Dev Psychopathol 2021; 32:1822-1837. [DOI: 10.1017/s0954579420001431] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
AbstractStress associated with caring for a mentally ill spouse can adversely affect the health status of caregivers and their children. Adding to the stress of caregiving is the stigma often placed against spouses and children of people with mental illness. Contrary to mental illness, many physical disorders such as cancer may be less stigmatized (expect pulmonary cancer). In this study, we measured externalized and internalized stigma, as well as psychological (depressive symptoms and stressful life events) and physiological (basal salivary cortisol levels) markers of stress in 115 spouses and 154 children of parents suffering from major depressive disorder, cancer, or no illness (control group). The results show that spouses and children from families with parental depression present significantly more externalized stigma than spouses and children from families with parental cancer or no illness, although we find no group differences on internalized stigma. The analysis did not show a significant group difference either for spouses or their children on depressive symptomatology, although spouses from the parental depression group reported greater work/family stress. Finally, we found that although for both spouses children the awakening cortisol response was greater on weekdays than on weekend days, salivary cortisol levels did not differ between groups. Bayes factor calculated on the null result for cortisol levels was greater than 100, providing strong evidence for the null hypothesis H0. Altogether, these results suggest an impact of stigma toward mental health disorder on psychological markers of stress but no impact of stigma on physiological markers of stress. We suggest that these results may be due to the characteristics of the families who participated in the present study.
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17
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Fishbane MD. Healing Intergenerational Wounds: An Integrative Relational-Neurobiological Approach. FAMILY PROCESS 2019; 58:796-818. [PMID: 31518458 DOI: 10.1111/famp.12488] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Old resentments and unfinished business from the family of origin can constrain adults in current relationships with parents or siblings and negatively affect relationships with partners or children. This article explores how old wounds get reactivated in current relationships and contribute to the intergenerational transmission of painful legacies and trauma. Building on intergenerational family theory and interpersonal neurobiology, the dynamics of reactivity and pathways for growth are explored. While much of the time the human brain is on autopilot, driven by habits and emotional reactivity, we are capable of bringing prefrontal thoughtfulness and choice to close relationships. Rather than being victims of parents or our past, we can become authors of our own relational life. Interventions are offered to help adult clients "wake from the spell of childhood," heal intergenerational wounds, and "grow up" relationships with family of origin. The damage caused by parent-blaming in therapy is explored and contrasted with Ivan Boszormenyi-Nagy's emphasis on rejunctive action and cultivating resources of trustworthiness in intergenerational relationships. The family is considered both in its cultural context-including stressors and resources for resilience-and in its life cycle context. Aging in the intergenerational family is discussed, focusing on ways adult children and their parents can grow and flourish with the challenges at this time of life. Throughout, the theme of relational ethics-how we can live according to our values and "reach for our best self" in intergenerational relationships-informs the discussion.
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18
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Snodgrass JG, Lacy MG, Dengah HJF, Polzer ER, Else RJ, Arevalo JMG, Cole SW. Positive mental well-being and immune transcriptional profiles in highly involved videogame players. Brain Behav Immun 2019; 82:84-92. [PMID: 31376495 PMCID: PMC6800642 DOI: 10.1016/j.bbi.2019.07.035] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 07/30/2019] [Accepted: 07/30/2019] [Indexed: 12/14/2022] Open
Abstract
Previous research has identified a link between experiencing life as meaningful and purposeful-what is referred to as "eudaimonia"-and reduced expression of a stress-induced gene profile known as the "conserved transcriptional response to adversity" (CTRA). In the current study, we examine whether similar links between eudaimonic well-being and CTRA reduction occur in a sample of 56 individuals with a particularly strong engagement with virtual worlds: avid online videogame players. Results consistently linked higher eudaimonic well-being, and more specifically the social well-being subdomain of eudaimonia, to lower levels of CTRA gene expression. That favorable psychobiological relationship between eudaimonia and CTRA appeared most strongly among individuals reporting high levels of positive psychosocial involvement with gaming. Findings are consistent with the hypothesis that committed social/recreational activity may help damp CTRA expression especially among persons who are already experiencing some kind of threshold of positive eudaimonic experience.
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Affiliation(s)
- Jeffrey G Snodgrass
- Department of Anthropology and Geography, Colorado State University, Fort Collins, CO 80523-1787, USA.
| | - Michael G Lacy
- Department of Sociology, Colorado State University, Fort Collins, CO 80523-1784, USA
| | - H J François Dengah
- Department of Sociology, Social Work, and Anthropology, Utah State University, Logan, UT 84322-0230, USA
| | - Evan R Polzer
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO 80045, USA
| | - Robert J Else
- Department of Anthropology, University of Alabama, Tuscaloosa, AL 35487-0210, USA
| | - Jesusa M G Arevalo
- Division of Hematology-Oncology, Department of Medicine, University of California, Los Angeles School of Medicine, Los Angeles, CA 90095, USA
| | - Steven W Cole
- Division of Hematology-Oncology, Department of Medicine, University of California, Los Angeles School of Medicine, Los Angeles, CA 90095, USA; Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles School of Medicine, Los Angeles, CA 90095, USA
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Pouraboli B, Poodineh Z, Jahani Y. The Effect of Relaxation Techniques on Anxiety, Fatigue and Sleep Quality of Parents of Children with Leukemia under Chemotherapy in South East Iran. Asian Pac J Cancer Prev 2019; 20:2903-2908. [PMID: 31653133 PMCID: PMC6982664 DOI: 10.31557/apjcp.2019.20.10.2903] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Indexed: 11/25/2022] Open
Abstract
Introduction: Cancer can cause emotional stress in parents, which has a negative impact on the quality of their life. Also, anxiety and psychological stress have a negative effect on the health of parents, and fatigue causes a sense of weakness and reduces the capacity for mental and physical activity, and insomnia, as well as stress and inability to perform their occupational and social functions. This study aimed to determine the effect of relaxation techniques on anxiety, fatigue, and sleep quality of parents of children with leukemia under chemotherapy in South East Iran in 2015. Methods: This is a randomized controlled trial study. The study population included parents of children with leukemia undergoing chemotherapy who were admitted to a teaching hospital in South East Iran. One hundred twenty parents were randomly assigned to control and intervention groups, and the experimental group was provided with Benson relaxation technique. Data collection tool included a demographic questionnaire, state-trait anxiety inventory, Brief Fatigue Inventory, and sleep quality inventory. Data analysis was done by SPSS 16 and paired t-test, Wilcoxon, Mann-Whitney, regression, One - Way ANOVA and Pearson tests were performed, and p ≤ 0.05 was statistically significant. Results: The mean score of state anxiety in the intervention group was 60.86 ± 8.95 and 35.95 ± 4.61 before and after the intervention, respectively. The mean score of trait anxiety was 56.56 ± 4.75 and 34.45 ± 4.95. The mean score of the fatigue was 73.83 ± 14.63 and 43.71 ± 11. 06, and the mean score of the quality of sleep was 13.5 ± 6.05 and 5.7 ± 3.43 before and after the intervention respectively. There was a statistically significant difference among state-trait anxiety, fatigue, and sleep quality in intervention and control groups after the intervention. There was a statistically significant negative correlation between fatigue and age, but there was no statistically significant relationship among the mean fatigue, weight, the number of sons and daughters, education, occupation, gender, place of residence and income (p> 0.05). There was no statistically significant relationship among the quality of sleep of parents, education, gender, and place of residence, but there was a statistically significant relationship between state anxiety and education (p≤0.05). Conclusion: The results can predispose family-centered nursing care to support more the parents of children with cancer in the face of the stress of illness. Developing programs for training muscle relaxation techniques will improve family functioning and mental health.
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Affiliation(s)
- Batool Pouraboli
- School of Nursing and Midwifery, Department of Pediatric and Neonatal Nursing, Tehran University of Medical Sciences, Tehran, Iran
| | - Zeynab Poodineh
- Department of Community Health, Nursing and Midwifery School of Razi, Kerman University of Medical Sciences, Kerman, Iran
| | - Younes Jahani
- Department of Biostatistic, Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
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