1
|
Zhang Y, Ding X, Liu Y, Han Y, Wang G, Cai M, Zhang Y, Hu DY. The Relationship Between Social Support and Suicide Resilience in Chinese Cancer Patients: A Serial Multiple Mediation Model Through Self-care Self-efficacy and Meaning in Life. Cancer Nurs 2024; 47:E236-E244. [PMID: 36728059 DOI: 10.1097/ncc.0000000000001202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND A growing body of literature has shown a higher risk of suicide in cancer patients compared with the general population. Early detection of factors related to suicide resilience in cancer patients could prevent loss of life. OBJECTIVE The study aimed to investigate the serial-multiple mediation of self-care self-efficacy and meaning in life in the relationship between social support and suicide resilience among Chinese cancer patients. METHODS A cross-sectional investigation of 287 cancer patients using a battery of self-reported questionnaires was performed. For preliminary analyses, descriptive, univariate, and Pearson correlation analyses were performed. Mediation analyses were tested using a serial-multiple mediation model (PROCESS model 6). RESULTS Mediation analysis indicated the indirect effects of social support on suicide resilience mediated solely by either self-care self-efficacy (point estimate = 0.20; 95% confidence interval [CI], 0.12-0.30), or by meaning in life (point estimate = 0.06; 95% CI, 0.01-0.12), or by the multiple mediation of self-care self-efficacy to meaning in life (point estimate = 0.03; 95% CI, 0.01-0.06). CONCLUSIONS The findings demonstrated the crucial direct or indirect effects of social support, self-care self-efficacy, and meaning in life on facilitating cancer patients' suicide resilience. IMPLICATIONS FOR PRACTICE Oncology nurses, as 24-hour care providers for cancer patients, may interact with and be important sources for the psychosocial care of cancer patients at risk of suicide. Prevention and intervention efforts must be directed at assisting cancer patients, improving self-care self-efficacy, and finding meaning in life after a cancer diagnosis.
Collapse
Affiliation(s)
- Yinying Zhang
- Author Affiliations: Department of Nursing, Union Hospital (Drs Yinying Zhang, Ding, Liu, Han, Cai, and Hu), and School of Nursing (Drs Zhang and Zhang), Tongji Medical College, Huazhong University of Science and Technology; and Wuhan Mental Health Center (Dr Wang), Wuhan, China
| | | | | | | | | | | | | | | |
Collapse
|
2
|
Bokor J, Krause S, Torok D, Eszlari N, Sutori S, Gal Z, Petschner P, Anderson IM, Deakin B, Bagdy G, Juhasz G, Gonda X. "Out, out, brief candle! Life's but a walking shadow": 5-HTTLPR Is Associated With Current Suicidal Ideation but Not With Previous Suicide Attempts and Interacts With Recent Relationship Problems. Front Psychiatry 2020; 11:567. [PMID: 32670107 PMCID: PMC7331851 DOI: 10.3389/fpsyt.2020.00567] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 06/03/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Suicide is an unresolved psychiatric and public health emergency, claiming 800,000 lives each year, however, its neurobiological etiology is still not understood. In spite of original reports concerning the involvement of 5-HTTLPR in interaction with recent stress in the appearance of suicidal ideation and attempts, replication studies have yielded contradictory results. In our study, we analyzed the association between 5-HTTLPR and lifetime suicide attempts, current suicidal ideation, hopelessness and thoughts of death as main effects, and in interaction with childhood adversities, recent stress, and different types of recent life events in a general population sample. METHODS Two thousand and three hundred fifty-eight unrelated European volunteers were genotyped for 5-HTTLPR, provided phenotypic data on previous suicide attempts, and current suicidal ideation, hopelessness and thoughts about death, and information on childhood adversities and recent life events. Logistic and linear regression models were run with age, gender, and population as covariates to test for the effect of 5-HTTLPR as a main effect and in interaction with childhood adversities and recent life events on previous suicide attempts and current suicidal ideation. Benjamini-Hochberg FDR Q values were calculated to correct for multiple testing. RESULTS 5-HTTLPR had no significant effect on lifetime suicide attempts either as a main effect on in interaction with childhood adversities. 5-HTTLPR had a significant main effect on current suicidal ideation in the dominant model (Q=0.0344). 5-HTTLPR did not interact with childhood adversities or total number of recent life events on any phenotypes related to current suicidal risk, however, a significant interaction effect between 5-HTTLPR and current relationship problems emerged in the case of current suicidal ideation in the dominant model (Q=0.0218) and in the case of thoughts about death and dying in the dominant (Q=0.0094) and additive models (Q=0.0281). CONCLUSION While 5-HTTLPR did not influence previous suicide attempts or interacted with childhood adversities, it did influence current suicidal ideation with, in addition, an interaction with recent relationship problems supporting the involvement of 5-HTTLPR in suicide. Our findings that 5-HTTLPR impacts only certain types of suicide risk-related behaviors and that it interacts with only distinct types of recent stressors provides a possible explanation for previous conflicting findings.
Collapse
Affiliation(s)
- Janos Bokor
- Department of Forensic and Insurance Medicine, Semmelweis University, Budapest, Hungary
| | - Sandor Krause
- Nyírő Gyula National Institute of Psychiatry and Addictions, Budapest, Hungary
| | - Dora Torok
- Department of Pharmacodynamics, Faculty of Pharmacy, Semmelweis University, Budapest, Hungary
| | - Nora Eszlari
- Department of Pharmacodynamics, Faculty of Pharmacy, Semmelweis University, Budapest, Hungary.,NAP-2-SE New Antidepressant Target Research Group, Hungarian Brain Research Program, Semmelweis University, Budapest, Hungary
| | - Sara Sutori
- Department of Pharmacodynamics, Faculty of Pharmacy, Semmelweis University, Budapest, Hungary.,Faculty of Humanity and Social Sciences, Institute of Psychology, Pazmany Peter Catholic University, Budapest, Hungary
| | - Zsofia Gal
- Department of Pharmacodynamics, Faculty of Pharmacy, Semmelweis University, Budapest, Hungary
| | - Peter Petschner
- Department of Pharmacodynamics, Faculty of Pharmacy, Semmelweis University, Budapest, Hungary.,MTA-SE Neuropsychopharmacology and Neurochemistry Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
| | - Ian M Anderson
- Neuroscience and Psychiatry Unit, Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biological, Medical and Human Sciences, The University of Manchester and Manchester Academic Health Sciences Centre, Manchester, United Kingdom
| | - Bill Deakin
- Neuroscience and Psychiatry Unit, Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biological, Medical and Human Sciences, The University of Manchester and Manchester Academic Health Sciences Centre, Manchester, United Kingdom
| | - Gyorgy Bagdy
- Department of Pharmacodynamics, Faculty of Pharmacy, Semmelweis University, Budapest, Hungary.,NAP-2-SE New Antidepressant Target Research Group, Hungarian Brain Research Program, Semmelweis University, Budapest, Hungary.,MTA-SE Neuropsychopharmacology and Neurochemistry Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
| | - Gabriella Juhasz
- Department of Pharmacodynamics, Faculty of Pharmacy, Semmelweis University, Budapest, Hungary.,MTA-SE Neuropsychopharmacology and Neurochemistry Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary.,SE-NAP-2 Genetic Brain Imaging Migraine Research Group, Semmelweis University, Budapest, Hungary
| | - Xenia Gonda
- NAP-2-SE New Antidepressant Target Research Group, Hungarian Brain Research Program, Semmelweis University, Budapest, Hungary.,MTA-SE Neuropsychopharmacology and Neurochemistry Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary.,Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| |
Collapse
|
3
|
Efstathiou V, Papadopoulou A, Christodoulou C, Gournellis R, Michopoulos I, Ferentinos P, Papageorgiou C, Douzenis A. The Relationship between Hopelessness and Clinical Characteristics of Hospitalized Patients with Recent Suicide Attempt. Issues Ment Health Nurs 2018; 39:876-882. [PMID: 30252555 DOI: 10.1080/01612840.2018.1491656] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
This study aimed to assess hopelessness in 170 hospitalized individuals with recent suicide attempt and examine its association with patients' characteristics, with a view to improving awareness in health professionals and especially nurses, who are among the first to take care of these patients. Participants completed Beck Hopelessness Scale and Beck Depression Inventory. More than half (51.18%) experienced moderate-to-severe hopelessness. A multiple linear regression analysis showed that age, attempted suicide method, past suicide attempt, and psychiatric diagnosis contributed statistically significantly to hopelessness prediction. Hopelessness assessment could efficiently help health professionals to minimize both inpatient suicide and suicidal acts after discharge.
Collapse
Affiliation(s)
- Vasiliki Efstathiou
- a Second Department of Psychiatry , National and Kapodistrian University of Athens, Medical School "Attikon" University General Hospital , Athens , Greece
| | - Athanasia Papadopoulou
- a Second Department of Psychiatry , National and Kapodistrian University of Athens, Medical School "Attikon" University General Hospital , Athens , Greece
| | - Christos Christodoulou
- a Second Department of Psychiatry , National and Kapodistrian University of Athens, Medical School "Attikon" University General Hospital , Athens , Greece
| | - Rossetos Gournellis
- a Second Department of Psychiatry , National and Kapodistrian University of Athens, Medical School "Attikon" University General Hospital , Athens , Greece
| | - Ioannis Michopoulos
- a Second Department of Psychiatry , National and Kapodistrian University of Athens, Medical School "Attikon" University General Hospital , Athens , Greece
| | - Panagiotis Ferentinos
- a Second Department of Psychiatry , National and Kapodistrian University of Athens, Medical School "Attikon" University General Hospital , Athens , Greece
| | - Charalabos Papageorgiou
- b First Department of Psychiatry , National and Kapodistrian University of Athens, Medical School, "Eginition" Hospital , Athens , Greece
| | - Athanassios Douzenis
- a Second Department of Psychiatry , National and Kapodistrian University of Athens, Medical School "Attikon" University General Hospital , Athens , Greece
| |
Collapse
|
4
|
Zannas AS. Gene-environment Interactions in Late Life: Linking Psychosocial Stress with Brain Aging. Curr Neuropharmacol 2018; 16:327-333. [PMID: 29119927 PMCID: PMC5843983 DOI: 10.2174/1570159x15666171109121452] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 08/22/2017] [Accepted: 11/07/2017] [Indexed: 01/01/2023] Open
Abstract
Gene-environment interactions (GxE) can have lasting consequences on brain structure and function, potentially contributing to diverse neuropsychiatric phenotypes. This has been extensively demonstrated by studies examining GxE in childhood and early adulthood, whereas much fewer studies have addressed this question in late life. The relative paucity of studies examining GxE in late life may stem from the working hypothesis that brains become less malleable to environmental inputs as life progresses. However, while some components of brain plasticity decline with increasing age, others are retained and may even become more pronounced in old ages. Moreover, the micro- and macro-structural brain changes that accrue as a result of aging-related morbidities are likely to accentuate the susceptibility of neural circuits to environmental stressors as life advances. Supporting this hypothesis, psychosocial stress can increase the risk for late-life neuropsychiatric syndromes, especially when afflicting genetically predisposed individuals. This article reviews evidence showing how gene-stress interactions can impact the aging brain and related phenotypes in late life, and it discusses the potential mechanisms underlying such GxE and their implications for the prevention and treatment of late-life neuropsychiatric syndromes.
Collapse
Affiliation(s)
- Anthony S. Zannas
- Address correspondence to this author at the Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Kraepelinstrasse 2-10, Munich, 80804, Germany; Tel: +498930622567; E-mail:
| |
Collapse
|
5
|
Mota NP, Han S, Harpaz-Rotem I, Maruff P, Krystal JH, Southwick SM, Gelernter J, Pietrzak RH. Apolipoprotein E gene polymorphism, trauma burden, and posttraumatic stress symptoms in U.S. military veterans: Results from the National Health and Resilience in Veterans Study. Depress Anxiety 2018; 35:168-177. [PMID: 29172227 PMCID: PMC5794529 DOI: 10.1002/da.22698] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2017] [Revised: 08/11/2017] [Accepted: 10/05/2017] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Previous research examining the association between apolipoprotein E (APOE) gene polymorphism and risk for posttraumatic stress disorder (PTSD) has been inconsistent due to the use of small and select samples. This study examined the relation between APOE genotype and PTSD symptoms in two nationally representative samples of U.S. military veterans. The potential effect of cumulative trauma burden and social support in moderating this association was also evaluated. METHODS The main sample consisted of 1,386 trauma-exposed European American (EA) veterans (mean age: 62-63 years) who participated in the National Health and Resilience in Veterans Study (NHRVS) in 2011. The independent replication sample consisted of 509 trauma-exposed EA veterans from the 2013 NHRVS. RESULTS APOE ε4 allele carriers reported significantly greater severity of PTSD symptoms than noncarriers in the main, but not the replication, sample. In both samples, the interaction of APOE ε4 carrier status and cumulative trauma burden was associated with greater severity of PTSD symptoms (F range = 2.53-8.09, all P's < .01), particularly re-experiencing/intrusion symptoms (F range = 3.59-4.24, P's < .001). Greater social support was associated with lower severity of PTSD symptoms among APOE ε4 allele carriers with greater cumulative trauma burden (β range -.27 to -.60, P's < .05). CONCLUSION U.S. military veterans who are APOE ε4 allele carriers and exposed to a high number of traumas may be at increased risk for developing PTSD symptoms than ε4 noncarriers. Greater social support may moderate this association, thereby highlighting the potential importance of social support promoting interventions in mitigating the effect of ε4 × cumulative trauma burden on PTSD risk.
Collapse
Affiliation(s)
- Natalie P. Mota
- Department of Clinical Health Psychology, Max Rady College of Medicine, University of Manitoba, Canada
| | - Shizhong Han
- Department of Psychiatry, University of Iowa Carver College of Medicine,Iowa City, Iowa, USA
| | - Ilan Harpaz-Rotem
- Clinical Neurosciences Division, U.S. Department of Veterans Affairs National Center for PTSD, VA Connecticut Healthcare System, West Haven, CT, USA,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Paul Maruff
- Florey Institute of Neuroscience and Mental Health, University of Melbourne and Cogstate, Ltd., Melbourne, Australia
| | - John H. Krystal
- Clinical Neurosciences Division, U.S. Department of Veterans Affairs National Center for PTSD, VA Connecticut Healthcare System, West Haven, CT, USA,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Steven M. Southwick
- Clinical Neurosciences Division, U.S. Department of Veterans Affairs National Center for PTSD, VA Connecticut Healthcare System, West Haven, CT, USA,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Joel Gelernter
- Clinical Neurosciences Division, U.S. Department of Veterans Affairs National Center for PTSD, VA Connecticut Healthcare System, West Haven, CT, USA,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Robert H. Pietrzak
- Clinical Neurosciences Division, U.S. Department of Veterans Affairs National Center for PTSD, VA Connecticut Healthcare System, West Haven, CT, USA,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| |
Collapse
|
6
|
Leighton C, Botto A, Silva JR, Jiménez JP, Luyten P. Vulnerability or Sensitivity to the Environment? Methodological Issues, Trends, and Recommendations in Gene-Environment Interactions Research in Human Behavior. Front Psychiatry 2017; 8:106. [PMID: 28674505 PMCID: PMC5475387 DOI: 10.3389/fpsyt.2017.00106] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 05/31/2017] [Indexed: 12/29/2022] Open
Abstract
Research on the potential role of gene-environment interactions (GxE) in explaining vulnerability to psychopathology in humans has witnessed a shift from a diathesis-stress perspective to differential susceptibility approaches. This paper critically reviews methodological issues and trends in this body of research. Databases were screened for studies of GxE in the prediction of personality traits, behavior, and mental health disorders in humans published between January 2002 and January 2015. In total, 315 papers were included. Results showed that 34 candidate genes have been included in GxE studies. Independent of the type of environment studied (early or recent life events, positive or negative environments), about 67-83% of studies have reported significant GxE interactions, which is consistent with a social susceptibility model. The percentage of positive results does not seem to differ depending on the gene studied, although publication bias might be involved. However, the number of positive findings differs depending on the population studied (i.e., young adults vs. older adults). Methodological considerations limit the ability to draw strong conclusions, particularly as almost 90% (n = 283/315) of published papers are based on samples from North America and Europe, and about 70% of published studies (219/315) are based on samples that were also used in other reports. At the same time, there are clear indications of methodological improvements over time, as is shown by a significant increase in longitudinal and experimental studies as well as in improved minimum genotyping. Recommendations for future research, such as minimum quality assessment of genes and environmental factors, specifying theoretical models guiding the study, and taking into account of cultural, ethnic, and lifetime perspectives, are formulated.
Collapse
Affiliation(s)
- Caroline Leighton
- Departamento de Psiquiatria y Salud Mental Oriente, Universidad de Chile, Santiago, Chile.,Millennium Institute for Research in Depression and Personality - MIDAP, Ministry of Economy, Santiago, Chile
| | - Alberto Botto
- Departamento de Psiquiatria y Salud Mental Oriente, Universidad de Chile, Santiago, Chile.,Millennium Institute for Research in Depression and Personality - MIDAP, Ministry of Economy, Santiago, Chile
| | - Jaime R Silva
- Millennium Institute for Research in Depression and Personality - MIDAP, Ministry of Economy, Santiago, Chile.,Centro de Apego y Regulación Emocional (CARE), Facultad de Psicología, Universidad del Desarrollo, Santiago, Chile.,Clinica Alemana de Santiago, Santiago, Chile
| | - Juan Pablo Jiménez
- Departamento de Psiquiatria y Salud Mental Oriente, Universidad de Chile, Santiago, Chile.,Millennium Institute for Research in Depression and Personality - MIDAP, Ministry of Economy, Santiago, Chile
| | - Patrick Luyten
- Millennium Institute for Research in Depression and Personality - MIDAP, Ministry of Economy, Santiago, Chile.,Clinical Psychology, University of Leuven, Leuven, Belgium.,Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
| |
Collapse
|
7
|
Hollingshaus MS, Coon H, Crowell SE, Gray DD, Hanson HA, Pimentel R, Smith KR. Differential Vulnerability to Early-Life Parental Death: The Moderating Effects of Family Suicide History on Risks for Major Depression and Substance Abuse in Later Life. BIODEMOGRAPHY AND SOCIAL BIOLOGY 2016; 62:105-125. [PMID: 27050036 PMCID: PMC4929083 DOI: 10.1080/19485565.2016.1138395] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Only a portion of those individuals exposed to parental death in early life (PDE) develop behavioral health disorders. We utilized demographic pedigree data from the Utah Population Database to test for differential vulnerability to PDE by creating a risk score of familial susceptibility to suicide (FS) at the population level. Using logistic panel regression models, we tested for multiplicative interactions between PDE and FS on the risks of major depressive disorder (MDD) and substance abuse (SA), measured using Medicare claims, after age 65. The final sample included 155,983 individuals (born 1886-1944), yielding 1,431,060 person-years at risk (1992-2009). Net of several potential confounders, including probability of survival to age 65, we found an FS × PDE interaction for females, in which PDE and FS as main effects had no impact but jointly increased MDD risk. No statistically significant main or interactive effects were found for SA among females or for either phenotype among males. Our findings are consistent with a differential vulnerability model for MDD in females, in which early-life stress increases the risk for poor behavioral health only among the vulnerable. Furthermore, we demonstrate how demographic and pedigree data might serve as tools for investigating differential vulnerability hypotheses.
Collapse
Affiliation(s)
- Michael S. Hollingshaus
- Michael S. Hollingshaus, Department of Sociology, University of Utah, 380 S 1530 E Rm 301, Salt Lake City, UT 84112,
| | | | | | | | | | | | | |
Collapse
|
8
|
Wang X, Cai L, Qian J, Peng J. Social support moderates stress effects on depression. Int J Ment Health Syst 2014; 8:41. [PMID: 25422673 PMCID: PMC4242489 DOI: 10.1186/1752-4458-8-41] [Citation(s) in RCA: 133] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Accepted: 10/24/2014] [Indexed: 01/14/2023] Open
Abstract
This study examined the moderator effect of social support on the relationship between stress and depression of university students. A total of 632 undergraduate students completed the measures of perceived stress, perceived social support, and depression. Hierarchical regression analysis showed that social support moderated the association between stress and depression. Undergraduate students with high stress reported higher scores in depression than those with low stress with low social support level. However, the impact of stress on depression was much smaller in the high social support group compared with that in the low social support group.
Collapse
Affiliation(s)
- Xingmin Wang
- Anhui Provincial Committee Party School, Hefei, China
| | - Lin Cai
- Department of International Exchange and Cooperation, Kunming University, Kunming, China
| | - Jing Qian
- School of Business, Beijing Normal University, Beijing, China
| | - Jiaxi Peng
- Department of Psychology, Fourth Military Medical University, Xi'an, China
| |
Collapse
|