1
|
Ng MHS, Zainal NH, Newman MG. Positive reappraisal coping mediates the relationship between parental abuse and lack of affection on adulthood generalized anxiety severity. J Anxiety Disord 2024; 102:102826. [PMID: 38244467 PMCID: PMC10993168 DOI: 10.1016/j.janxdis.2024.102826] [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] [Received: 07/05/2023] [Revised: 12/23/2023] [Accepted: 01/05/2024] [Indexed: 01/22/2024]
Abstract
Exposure to parental abuse and lack of parental affection during childhood are risk factors for adulthood psychopathology. Tendency to engage in positive reappraisal may be a plausible mechanism underlying this relationship. The current study examined if positive reappraisal coping mediated the relationship between maternal/paternal abuse/affection and adulthood generalized anxiety disorder (GAD) symptoms. Participant data (N = 3294) from the Midlife Development in the United States study was collected in three waves, spaced nine years apart. Longitudinal structural equation mediation modeling examined whether positive reappraisal coping at Time 2 mediated the relationship between maternal/paternal abuse/affection at Time 1 and GAD symptoms at Time 3, controlling for GAD symptoms at Time 1. Positive reappraisal coping mediated maternal/paternal childhood abuse - GAD symptom severity and maternal/paternal childhood affection - GAD severity relations. Maternal and paternal abuse was associated with lower positive reappraisal tendencies, predicting increased GAD symptom severity. Conversely, higher maternal/paternal affection was associated with increased positive reappraisal, predicting lower GAD severity. Incremental prediction revealed that childhood abuse to GAD severity via positive reappraisal path was significant for maternal but not paternal abuse, whereas affection from both parents remained significant. Positive reappraisal coping may be a possible mechanism linking childhood experiences to adulthood GAD severity.
Collapse
Affiliation(s)
- Matthew H S Ng
- Rehabilitation Research Institute of Singapore, Nanyang Technological University, Singapore.
| | - Nur Hani Zainal
- Department of Health Care Policy, Harvard Medical School, USA; Department of Psychology, National University of Singapore, Singapore
| | | |
Collapse
|
2
|
Liu Q, Zhou B, Zhang X, Qing P, Zhou X, Zhou F, Xu X, Zhu S, Dai J, Huang Y, Wang J, Zou Z, Kendrick KM, Becker B, Zhao W. Abnormal multi-layered dynamic cortico-subcortical functional connectivity in major depressive disorder and generalized anxiety disorder. J Psychiatr Res 2023; 167:23-31. [PMID: 37820447 DOI: 10.1016/j.jpsychires.2023.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 08/16/2023] [Accepted: 10/05/2023] [Indexed: 10/13/2023]
Abstract
Comorbidity has been frequently observed between generalized anxiety disorder (GAD) and major depressive disorder (MDD), however, common and distinguishable alterations in the topological organization of functional brain networks remain poorly understood. We sought to determine a robust and sensitive functional connectivity marker for diagnostic classification and symptom severity prediction. Multi-layered dynamic functional connectivity including whole brain, network-node and node-node layers via graph theory and gradient analyses were applied to functional MRI resting-state data obtained from 31 unmedicated GAD and 34 unmedicated MDD patients as well as 33 age and education matched healthy controls (HC). GAD and MDD symptoms were assessed using Penn State Worry Questionnaire and Beck Depression Inventory II, respectively. Three network measures including global properties (i.e., global efficiency, characteristic path length), regional nodal property (i.e., degree) and connectivity gradients were computed. Results showed that both patient groups exhibited abnormal dynamic cortico-subcortical topological organization compared to healthy controls, with MDD > GAD > HC in degree of randomization. Furthermore, our multi-layered dynamic functional connectivity network model reached 77% diagnostic accuracy between GAD and MDD and was highly predictive of symptom severity, respectively. Gradients of functional connectivity for superior frontal cortex-subcortical regions, middle temporal gyrus-subcortical regions and amygdala-cortical regions contributed more in this model compared to other gradients. We found shared and distinct cortico-subcortical connectivity features in dynamic functional brain networks between GAD and MDD, which together can promote the understanding of common and disorder-specific topological organization dysregulations and facilitate early neuroimaging-based diagnosis.
Collapse
Affiliation(s)
- Qi Liu
- The Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China
| | - Bo Zhou
- The Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China
| | - Xiaodong Zhang
- The Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China
| | - Peng Qing
- The Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China
| | - Xinqi Zhou
- Institute of Brain and Psychological Sciences, Sichuan Normal University, Chengdu, 610066, China
| | - Feng Zhou
- Faculty of Psychology, Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing, 400715, China
| | - Xiaolei Xu
- School of Psychology, Shandong Normal University, Jinan, 250014, China
| | - Siyu Zhu
- School of Sport Training, Chengdu Sport University, Chengdu, 610041, China
| | - Jing Dai
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for NeuroInformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 610054, China
| | - Yulan Huang
- The Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China
| | - Jinyu Wang
- The Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China
| | - Zhili Zou
- The Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China
| | - Keith M Kendrick
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for NeuroInformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 610054, China
| | - Benjamin Becker
- The Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China; State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, Pokfulam, Hong Kong; Department of Psychology, The University of Hong Kong, Hong Kong, Pokfulam, Hong Kong; The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for NeuroInformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 610054, China.
| | - Weihua Zhao
- The Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China; The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for NeuroInformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 610054, China.
| |
Collapse
|
3
|
Khan AR, Altalbe A. Potential impacts of Russo-Ukraine conflict and its psychological consequences among Ukrainian adults: the post-COVID-19 era. Front Public Health 2023; 11:1280423. [PMID: 37841733 PMCID: PMC10568327 DOI: 10.3389/fpubh.2023.1280423] [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: 08/22/2023] [Accepted: 09/15/2023] [Indexed: 10/17/2023] Open
Abstract
Background Since February 2022, the nation of Ukraine has become entangled in an escalating conflict that erupted after coronavirus outbreak fostering a situation of indeterminacy and precariousness, which adversely affected several facets, especially psychological well-being. However, there is a lack of empirical evidence on the psychological well-being of Ukrainians during the Russo-Ukraine war, as well as their coping strategies in response to the war's repercussions. Consequently, this investigation endeavors to explore the prevalence of symptoms associated with depression, anxiety, stress, and insomnia and to correlate these symptoms with Ukrainians' effective coping mechanisms during the ongoing war. Methods An online survey was administered in Ukraine from June to August 2022 due to the ongoing Russo-Ukraine conflict. The survey employed a quota sampling technique, targeting 2,664 individuals (≥18 years). Out of the total sample, 1,833 valid responses were obtained, yielding a response rate of 68. 81%. Depression, anxiety, and stress were measured using the depression, anxiety, and stress scale-21 (DASS-21), while the Pittsburgh sleep quality index (PSQI) was utilized to evaluate insomnia symptoms. In addition, Brief-COPE was adopted to evaluate the coping mechanisms of the selected study participants. Results Of 1,833 Ukrainian adults, 60.5% had symptoms of stress; 62.4% of them reported symptoms of anxiety; and 58.2% reported symptoms of depression. Symptom criteria for insomnia were found in about 21.8% of the study sample. The factors of sex, living area, area occupied by Russian forces, and having older adults and children in the house were statistically significant with symptoms of depression, anxiety, stress, and insomnia. The productive coping strategies of self-distraction, using instrumental support, planning, and behavioral disengagement, were observed as statistically significant with four psychological constructs. Conclusion The study outcomes highlight a substantial prevalence of symptoms related to depression, anxiety, stress, and insomnia attributed to the accumulated consequences of ongoing conflict and the COVID-19 outbreak. The aforementioned findings emphasize the imperative of providing healthcare services and facilitating effective coping strategies among Ukrainians amid the ongoing war.
Collapse
Affiliation(s)
- Ahsan Riaz Khan
- Department of Interventional and Vascular Surgery, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
- National United Engineering Laboratory for Biomedical Material Modification, Branden Industrial Park, Qihe Economic and Development Zone, Dezhou, China
| | - Ali Altalbe
- Department of Computer Engineering, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
- Faculty of Computing and Information Technology, King Abdulaziz University, Jeddah, Saudi Arabia
| |
Collapse
|
4
|
Crișan CA, Milhem Z, Stretea R, Hossu RM, Florean IS, Cherecheș RM. Coping Mechanisms during the War in Ukraine: A Cross-Sectional Assessment among Romanian Population. Healthcare (Basel) 2023; 11:healthcare11101412. [PMID: 37239702 DOI: 10.3390/healthcare11101412] [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: 04/13/2023] [Revised: 05/07/2023] [Accepted: 05/11/2023] [Indexed: 05/28/2023] Open
Abstract
On 24 February 2022, the Russian Federation invaded Ukraine, starting a military conflict that soon turned into a full-scale war. The Romanians have been actively involved in helping their neighbors, causing the accumulation of emotional and mental pressure upon the Romanian population exposed to such a close military conflict. This cross-sectional study assessed, through an online survey (1586 adult Romanian residents), the primary coping mechanisms, quality of life and anxiety levels in response to the psychological trauma associated with the Russo-Ukrainian war. Based on the results, focusing on and venting emotions along with behavioral disengagement were the coping strategies that had the strongest negative impact on anxiety and well-being. On the other hand, positive reinterpretation and growth were associated with less anxiety, a higher degree of overall health and better quality of life. To the best of our knowledge, this study is the first of its kind to be performed among the Romanian population so far. Thus, we equip mental health practitioners with the tools (real-life evidence data) that will allow them to establish a more meaningful doctor-patient relationship, maximizing therapy results.
Collapse
Affiliation(s)
- Cătălina Angela Crișan
- Department of Neurosciences, Psychiatry and Pediatric Psychiatry, Faculty of Medicine, Iuliu Hațieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania
| | - Zaki Milhem
- Department of Neurosciences, Psychiatry and Pediatric Psychiatry, Faculty of Medicine, Iuliu Hațieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania
| | - Roland Stretea
- Clinical Hospital of Infectious Diseases, 400347 Cluj-Napoca, Romania
| | | | - Ionuț Stelian Florean
- Department of Clinical Psychology and Psychotherapy, Babeş-Bolyai University, 400084 Cluj-Napoca, Romania
| | - Răzvan Mircea Cherecheș
- RoNeuro Institute, Center for Research and Diagnosis of Neurological Diseases, 400012 Cluj-Napoca, Romania
- Department of Public Health, College of Political, Administrative and Communication Sciences, Babeș-Bolyai University, 400591 Cluj-Napoca, Romania
| |
Collapse
|
5
|
Barber KE, Zainal NH, Newman MG. The mediating effect of stress reactivity in the 18-year bidirectional relationship between generalized anxiety and depression severity. J Affect Disord 2023; 325:502-512. [PMID: 36642311 PMCID: PMC9930685 DOI: 10.1016/j.jad.2023.01.041] [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] [Received: 07/06/2022] [Revised: 01/05/2023] [Accepted: 01/08/2023] [Indexed: 01/15/2023]
Abstract
BACKGROUND Generalized anxiety disorder (GAD) and major depressive disorder (MDD) often precede and predict one another. Heightened stress reactivity may be a mediation mechanism underlying the long-term connections between GAD and MDD. However, cross-sectional studies on this topic have hindered directional inferences. METHOD The present study examined stress reactivity as a potential mediator of the sequential associations between GAD and MDD symptoms in a sample of 3,294 community-dwelling adults (M age = 45.6, range = 20-74). Participants completed three waves of measurement (T1, T2, and T3) spaced nine years apart. GAD and MDD symptom severity were assessed at T1, T2, and T3 (Composite International Diagnostic Interview-Short Form). Stress reactivity (Multidimensional Personality Questionnaire) was measured at T2. RESULTS Structural equation mediation modeling demonstrated that higher T1 GAD symptoms positively predicted more severe T3 MDD symptoms via T2 stress reactivity, controlling for T1 MDD (d = 0.45-0.50). However, T2 stress reactivity was not a significant mediator in the relationship between T1 MDD severity and T3 GAD symptoms after controlling for T1 GAD. Direct effects indicated that T1 GAD positively predicted T3 MDD 18 years later and vice versa (d = 1.29-1.65). LIMITATIONS Stress reactivity was assessed using a self-report measure, limiting conclusions to perceived (vs. physiologically indexed) stress reactivity. CONCLUSIONS These findings indicate that stress reactivity may be one mechanism through which GAD leads to later MDD over prolonged durations. Overall, results suggest that targeting stress reactivity in treatments for GAD may reduce the risk of developing subsequent MDD.
Collapse
Affiliation(s)
- Kathryn E Barber
- Department of Psychology, Marquette University, United States of America; Department of Psychology and Psychiatry, The Pennsylvania State University, United States of America.
| | - Nur Hani Zainal
- Department of Public Health, Harvard Medical School, United States of America
| | - Michelle G Newman
- Department of Psychology and Psychiatry, The Pennsylvania State University, United States of America
| |
Collapse
|
6
|
Ghafaji H, Nordenmark TH, Western E, Sorteberg W, Karic T, Sorteberg A. Coping strategies in patients with good outcome but chronic fatigue after aneurysmal subarachnoid hemorrhage. Acta Neurochir (Wien) 2023; 165:1007-1019. [PMID: 36912975 PMCID: PMC10068657 DOI: 10.1007/s00701-023-05549-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 02/28/2023] [Indexed: 03/14/2023]
Abstract
BACKGROUND Fatigue is a highly prevalent and debilitating symptom among patients in the chronic phase of aneurysmal subarachnoid haemorrhage (aSAH) with no identified effective treatment. Cognitive therapy has been shown to have moderate effects on fatigue. Delineating the coping strategies used by patients with post-aSAH fatigue and relating them to fatigue severity and emotional symptoms could be a step towards developing a behavioural therapy for post-aSAH fatigue. METHODS Ninety-six good outcome patients with chronic post-aSAH fatigue answered the questionnaires Brief COPE, (a questionnaire defining 14 coping strategies and three Coping Styles), the Fatigue Severity Scale (FSS), Mental Fatigue Scale (MFS), Beck Depression Inventory (BDI-II) and Beck Anxiety Inventory (BAI). The Brief COPE scores were compared with fatigue severity and emotional symptoms of the patients. RESULTS The prevailing coping strategies were "Acceptance", "Emotional Support", "Active Coping" and "Planning". "Acceptance" was the sole coping strategy that was significantly inversely related to levels of fatigue. Patients with the highest scores for mental fatigue and those with clinically significant emotional symptoms applied significantly more maladaptive avoidant strategies. Females and the youngest patients applied more "Problem-Focused" strategies. CONCLUSION A therapeutic behavioural model aiming at furthering "Acceptance" and reducing passivity and "Avoidant" strategies may contribute to alleviate post-aSAH fatigue in good outcome patients. Given the chronic nature of post-aSAH fatigue, neurosurgeons may encourage patients to accept their new situation so that they can start a process of positive reframing instead of being trapped in a spiral of futile loss of energy and secondary increased emotional burden and frustration.
Collapse
Affiliation(s)
- Hajar Ghafaji
- Department of Neurosurgery, Oslo University Hospital, Oslo, Norway. .,Faculty of MedicineInstitute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Tonje Haug Nordenmark
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
| | - Elin Western
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | | | - Tanja Karic
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Angelika Sorteberg
- Department of Neurosurgery, Oslo University Hospital, Oslo, Norway.,Faculty of MedicineInstitute of Clinical Medicine, University of Oslo, Oslo, Norway
| |
Collapse
|
7
|
Torinomi C, Lindenberg K, Möltner A, Herpertz SC, Holm-Hadulla RM. Predictors of Students' Mental Health during the COVID-19 Pandemic: The Impact of Coping Strategies, Sense of Coherence, and Social Support. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16423. [PMID: 36554304 PMCID: PMC9778699 DOI: 10.3390/ijerph192416423] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/28/2022] [Accepted: 12/05/2022] [Indexed: 06/17/2023]
Abstract
Young people and women seem to suffer more from social restrictions due to the COVID-19 pandemic than do others. Findings from pre-pandemic surveys identified students as a specific risk group for developing anxiety and depressive symptoms. Recent studies have indicated that students especially denoted a decrease in mental health during the pandemic. In a sample of n = 1938 university students (67.6% female), we investigated protective factors that are associated with mental health (defined as the absence of any mental disorder) and more specifically, the absence of major depression during the pandemic despite social restrictions. Investigated protective factors were social support, sense of coherence and situational coping strategies. The results of the multiple logistic regression analyses revealed that male gender, high sense of coherence and specific coping strategies could be identified to be associated with mental health in general and the absence of major depression. Protective coping strategies that were related to mental health in general were lower substance use, lower behavioral disengagement, higher positive reframing and lower self-blame. Protective coping strategies that were associated with the absence of major depression specifically were higher use of instrumental support, lower substance use, lower behavioral disengagement, higher positive reframing, higher emotional support, lower self-blame and lower humor. Social support was related to the absence of major depression, but not to mental health in general. Higher age in university students was associated with better mental health, but not with the absence of major depression specifically. These findings indicate that sense of coherence and situational coping strategies can buffer the adverse effect of social restrictions on mental health and thus, can serve as important resilience factors. Moreover, they highlight the political relevance of promoting specific coping strategies to foster mental health in students encompassing adverse events and social restrictions.
Collapse
Affiliation(s)
- Charlotte Torinomi
- Department of Child and Adolescent Psychotherapy, Institute of Psychology, Goethe-University Frankfurt, 60486 Frankfurt, Germany
| | - Katajun Lindenberg
- Department of Child and Adolescent Psychotherapy, Institute of Psychology, Goethe-University Frankfurt, 60486 Frankfurt, Germany
| | - Andreas Möltner
- Dean’s Office, Medical Faculty, Heidelberg University, 69120 Heidelberg, Germany
| | - Sabine C. Herpertz
- Department of General Psychiatry, Centre for Psychosocial Medicine, Heidelberg University Hospital, 69115 Heidelberg, Germany
| | - Rainer M. Holm-Hadulla
- Department of General Psychiatry, Centre for Psychosocial Medicine, Heidelberg University Hospital, 69115 Heidelberg, Germany
| |
Collapse
|
8
|
Long-term disability in common mental disorders in Chinese community: evidence from a five-year follow-up study. BMC Psychiatry 2022; 22:727. [PMID: 36419029 PMCID: PMC9682650 DOI: 10.1186/s12888-022-04382-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 11/10/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Common mental disorders are general term for mental disorders with high disability rates and significant social burden. The purpose of this study was to determine the degree of long-term disability associated with common mental disorders and to interpret the relationship between common mental disorders and long-term disability. METHODS Participants in the 2013 China Mental Health Survey were followed up by telephone between April and June 2018. This study evaluated long-term disability over a five-year period using the World Health Organization's Disability Assessment Schedule 2.0. Poisson regression was used to analyze the relationship between common mental disorders and long-term disability. RESULTS A total of 6269 patients were followed up by telephone. In patients with common mental disorders, the prevalence of disability ranged from 7.62% to 43.94%. The long-term disabilities were significantly associated with dysthymic disorder (DD, RR:2.40; 95% CI:1.87-3.03), major depressive disorder (MDD, RR:1.63; 95% CI:1.34-1.98), generalized anxiety disorder (GAD, RR:1.95; 95% CI:1.15-3.09), obsessive-compulsive disorder (OCD, RR:1.68; 95% CI:1.24-2.22) and alcohol use disorder (AUD, RR: 1.42; 95% CI:0.99-1.96). CONCLUSIONS In China, common mental disorders raise the risk of long-term disability, and there is a critical need for monitoring patients with DD, MDD, GAD, OCD, and AUD. For improved quality of life and reduced disability levels, more resources need to be dedicated to mental health in the future.
Collapse
|
9
|
Why Sleep is Key: Poor Sleep Quality is a Mechanism for the Bidirectional Relationship between Major Depressive Disorder and Generalized Anxiety Disorder Across 18 Years. J Anxiety Disord 2022; 90:102601. [PMID: 35850001 PMCID: PMC9945467 DOI: 10.1016/j.janxdis.2022.102601] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 06/05/2022] [Accepted: 06/27/2022] [Indexed: 02/08/2023]
Abstract
BACKGROUND Generalized anxiety disorder (GAD) and major depressive disorder (MDD) reliably precede and predict one another. However, there is insufficient data on mediators through which the longitudinal GAD-MDD association unfold. Based on insomnia theories, such as the hyperarousal model of sleep, we tested the degree to which poor global sleep quality functioned as a mediator of the prospective bidirectional anxiety-depression relationship. METHOD Participants were 3,294 community-dwelling adults who partook in three measurement waves nine years apart. The Composite International Diagnostic Interview-Short Form assessed GAD and MDD in-person at baseline (Time 1 [T1]), Time 2 (T2; nine years after T1), and 18 years later (T3). T2 global sleep quality was measured using the multiple-domain Pittsburgh Sleep Quality Index self-report at T2. We used longitudinal structural equation modeling mediation analyses. RESULTS Analyses showed that higher T1 MDD and GAD severity individually predicted lower T2 global sleep quality (Cohen's d = -0.561 to -0.480) and less T2 global sleep quality, thereby forecasted both higher T3 MDD and GAD (d = -0.275 to -0.190). Poorer T2 global sleep quality significantly mediated the T1 GAD-T3 MDD relation, explaining 41% of the association. Worse global sleep quality at T2 also significantly mediated the T1 MDD-T3 GAD association, mediating 11% of the T1 MDD-T3 GAD pathway. The results remained similar after controlling for multiple sociodemographic and clinical variables. CONCLUSIONS Findings offer evidence for transdiagnostic theories of sleep and insomnia. Theoretical and clinical implications, such as prioritizing sleep improvement in cognitive-behavioral therapies, are also discussed.
Collapse
|
10
|
Finlay KA, Madhani A, Anil K, Peacock SM. Patient-to-Patient Interactions During the Pain Management Programme: The Role of Humor and Venting in Building a Socially Supportive Community. FRONTIERS IN PAIN RESEARCH 2022; 3:875720. [PMID: 35571144 PMCID: PMC9091594 DOI: 10.3389/fpain.2022.875720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 03/21/2022] [Indexed: 11/20/2022] Open
Abstract
Objectives Social support is most positively perceived when there is an optimal match between a patient's need for communication and the purpose of their interaction. Maladaptive communication patterns may inhibit social bonding or mutual support, negatively impacting clinical outcomes. This study aimed to identify how people with chronic pain naturalistically converse together about their pain in the context of a Pain Management Programme (PMP). Methods Seven participants (4 females; 3 males) with ongoing chronic pain who were attending a PMP in a regional hospital in the United Kingdom were audio/video recorded during breaks in their PMP. Interactions were transcribed using Jeffersonian Transcription and analyzed using Conversation Analysis. Results Two conversational mechanisms were identified: (1) Conversational humor; and (2) A venting cycle. Participants used their pain-related experiences construct a motive for a joke, then proceeded to deliver the joke, which initiated a joke return from observers. The sequence was completed by a collaborative punchline. In the venting cycle, an initial complaint was escalated by the sharing of comparable experiences, after which the vent was concluded through a joke punchline, acting as a pivot to move the conversation forwards, terminating the venting. Conclusions Humorous interpersonal interactions about chronic pain provided a forum for social support-building within the PMP. Humor was affiliative and built social collaboration, helping individuals to together make sense of their pain in a prosocial atmosphere, approaching pain-related experiences with levity. Patient-to-patient interactions within the PMP were strongly prosocial and inclusive, potentially facilitating enhanced PMP clinical outcomes through collaboration.
Collapse
Affiliation(s)
- Katherine A. Finlay
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
- *Correspondence: Katherine A. Finlay
| | - Adam Madhani
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
| | - Krithika Anil
- Peninsula Allied Health Centre, School of Health Professions, University of Plymouth, Plymouth, United Kingdom
| | - Sue M. Peacock
- Pain in the Mind, Independent Practice, The Saxon Clinic, Milton Keynes, United Kingdom
| |
Collapse
|