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Marheinecke R, Winter AC, Strauss B, Engert V. Specific challenges of researching stress in the context of quiet political repression. COMPREHENSIVE PSYCHONEUROENDOCRINOLOGY 2024; 19:100248. [PMID: 39055390 PMCID: PMC11269800 DOI: 10.1016/j.cpnec.2024.100248] [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: 04/10/2024] [Revised: 06/26/2024] [Accepted: 06/27/2024] [Indexed: 07/27/2024] Open
Abstract
Political repression beneath the threshold of criminal prosecution is a phenomenon of past and present, predominantly authoritarian, regimes. This so-called quiet repression includes measures such as the limitation of freedom of speech, surveillance of (perceived) political opponents, or the spreading of rumors to socially isolate targets. Such experiences of chronic stress show significant psychological and physiological health consequences in affected individuals. However, societal awareness of quiet repression measures remains limited, hindering victims' access to support and complicating healthcare interventions. In the current paper, we present the design of a study conducted with individuals who endured quiet repression measures in the former German Democratic Republic (GDR), a socialist state closely aligned with the former Soviet Union. We discuss the challenges encountered over the course of the study, and present the solutions found. Although every study population has their unique challenges and needs, we wish to inform future sensitive research within the realm of quiet political repression. Given the limited understanding of the phenomenon, there is a pressing need for further investigation aiming to improve acceptance and care for past and future victims.
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Affiliation(s)
- Ruth Marheinecke
- Institute for Psychosocial Medicine, Psychotherapy and Psychooncology, Jena University Hospital, Friedrich-Schiller University, Jena, Germany
| | - Ann-Christin Winter
- Department of Clinical Psychology, Justus-Liebig University, Gießen, Germany
| | - Bernhard Strauss
- Institute for Psychosocial Medicine, Psychotherapy and Psychooncology, Jena University Hospital, Friedrich-Schiller University, Jena, Germany
- German Center for Mental Health (DZPG), Partner Site Halle-Jena-Magdeburg, Germany
| | - Veronika Engert
- Institute for Psychosocial Medicine, Psychotherapy and Psychooncology, Jena University Hospital, Friedrich-Schiller University, Jena, Germany
- German Center for Mental Health (DZPG), Partner Site Halle-Jena-Magdeburg, Germany
- Center for Intervention and Research on Adaptive and Maladaptive Brain Circuits Underlying Mental Health (C-I-R-C), Halle-Jena-Magdeburg, Germany
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2
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Kaimal A, Hooversmith JM, Cherry AD, Garrity JT, Al Mansi MH, Martin NM, Buechter H, Holmes PV, MohanKumar PS, MohanKumar SMJ. Prenatal exposure to bisphenol A and/or diethylhexyl phthalate alters stress responses in rat offspring in a sex- and dose-dependent manner. FRONTIERS IN TOXICOLOGY 2023; 5:1264238. [PMID: 38152552 PMCID: PMC10751317 DOI: 10.3389/ftox.2023.1264238] [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: 07/24/2023] [Accepted: 11/29/2023] [Indexed: 12/29/2023] Open
Abstract
Background: Prenatal exposures to endocrine disrupting chemicals (EDCs) are correlated with adverse behavioral outcomes, but the effects of combinations of these chemicals are unclear. The aim of this study was to determine the dose-dependent effects of prenatal exposure to EDCs on male and female behavior. Methods: Pregnant Sprague-Dawley rats were orally dosed with vehicle, bisphenol A (BPA) (5 μg/kg body weight (BW)/day), low-dose (LD) diethylhexyl phthalate (DEHP) (5 μg/kg BW/day), high-dose (HD) DEHP (7.5 mg/kg BW/day), a combination of BPA and LD-DEHP (B + D (LD)), or a combination of BPA and HD-DEHP (B + D (HD)) on gestational days 6-21. Adult offspring were subjected to the Open Field Test (OFT), Elevated Plus Maze (EPM), and Shock Probe Defensive Burying test (SPDB) in adulthood. Body, adrenal gland, and pituitary gland weights were collected at sacrifice. Corticosterone (CORT) was measured in the serum. Results: Female EDC-exposed offspring showed anxiolytic effects in the OFT, while male offspring were unaffected. DEHP (HD) male offspring demonstrated a feminization of behavior in the EPM. Most EDC-exposed male offspring buried less in the SPDB, while their female counterparts showed reduced shock reactivity, indicating sex-specific maladaptive alterations in defensive behaviors. Additionally, DEHP (LD) males and females and B + D (LD) females displayed increased immobility in this test. DEHP (LD) alone and in combination with BPA led to lower adrenal gland weights, but only in male offspring. Finally, females treated with a mixture of B + D (HD) had elevated CORT levels. Conclusion: Prenatal exposure to BPA, DEHP, or a mixture of the two, affects behavior, CORT levels, and adrenal gland weights in a sex- and dose-dependent manner.
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Affiliation(s)
- Amrita Kaimal
- Neuroendocrine Research Laboratory, University of Georgia, Athens, GA, United States
- Biomedical and Translational Sciences Institute, Neuroscience Division, University of Georgia, Athens, GA, United States
| | - Jessica M. Hooversmith
- Behavioral Neuropharmacology Laboratory, University of Georgia, Athens, GA, United States
| | - Ariana D. Cherry
- Neuroendocrine Research Laboratory, University of Georgia, Athens, GA, United States
| | - Jillian T. Garrity
- Neuroendocrine Research Laboratory, University of Georgia, Athens, GA, United States
| | - Maryam H. Al Mansi
- Neuroendocrine Research Laboratory, University of Georgia, Athens, GA, United States
| | - Nicholas M. Martin
- Neuroendocrine Research Laboratory, University of Georgia, Athens, GA, United States
| | - Hannah Buechter
- Neuroendocrine Research Laboratory, University of Georgia, Athens, GA, United States
| | - Philip V. Holmes
- Biomedical and Translational Sciences Institute, Neuroscience Division, University of Georgia, Athens, GA, United States
- Behavioral Neuropharmacology Laboratory, University of Georgia, Athens, GA, United States
| | - Puliyur S. MohanKumar
- Neuroendocrine Research Laboratory, University of Georgia, Athens, GA, United States
- Biomedical and Translational Sciences Institute, Neuroscience Division, University of Georgia, Athens, GA, United States
| | - Sheba M. J. MohanKumar
- Neuroendocrine Research Laboratory, University of Georgia, Athens, GA, United States
- Biomedical and Translational Sciences Institute, Neuroscience Division, University of Georgia, Athens, GA, United States
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3
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Davis MM, Surabhi DM, Telzer EH, Rudolph KD. Risk for Depressive Symptoms Among Adolescents with a History of Adversity: Unique Role of Stress Appraisals. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01538-5. [PMID: 37233840 DOI: 10.1007/s10578-023-01538-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/28/2023] [Indexed: 05/27/2023]
Abstract
Lifetime social adversity predicts elevated depressive symptoms in adolescence. However, most adversity-exposed youth do not develop depression, highlighting the importance of examining risk and protective factors. The present study leveraged a multi-method approach, incorporating self-report, interview, and independent coding to examine whether appraisals of recent stressors moderate the effect of social adversity on depressive symptoms in 81 adolescent girls (Mage = 16.30 years, SD = .85). We utilized semi-structured interviews of lifetime adversity and recent stressors and semi-structured interviews and self-reports of depressive symptoms. Stress appraisals were calculated by regressing youths' subjective estimations of event stressfulness and dependence on estimations of independent coders. Lifetime social adversity predicted elevated depressive symptoms more strongly in girls who appraised interpersonal events as more stressful and dependent on their actions, providing insight into individual differences in depressive symptoms in adversity-exposed adolescents.
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Affiliation(s)
- Megan M Davis
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, 235 E. Cameron Street, Chapel Hill, NC, 27599, USA.
| | - Divya M Surabhi
- University of Illinois College of Medicine at Chicago, 1853 W. Polk Street, Chicago, IL, USA
| | - Eva H Telzer
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, 235 E. Cameron Street, Chapel Hill, NC, 27599, USA
| | - Karen D Rudolph
- University of Illinois at Urbana-Champaign, 606 E. Daniel Street, Champaign, IL, USA
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4
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Coimbra BM, Hoeboer CM, van Zuiden M, Williamson RE, D'Elia AT, Mello AF, Mello MF, Olff M. The relationship between tonic immobility and the development, severity, and course of posttraumatic stress disorder: Systematic and meta-analytic literature review. J Anxiety Disord 2023; 97:102730. [PMID: 37229971 DOI: 10.1016/j.janxdis.2023.102730] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 05/10/2023] [Accepted: 05/18/2023] [Indexed: 05/27/2023]
Abstract
BACKGROUND Tonic immobility (TI) is a reflexive, involuntary response that causes motor inhibition, vocal suppression, and analgesia. TI is elicited by extreme fear and perception of entrapment in a life-threatening situation. Research suggests that TI is a frequent peritraumatic response and may be related to subsequent posttraumatic stress disorder (PTSD). However, findings are mixed and, as of yet, no systematic or meta-analytic review examining associations between TI and PTSD has been published. OBJECTIVE We systematically and meta-analytically reviewed the literature and investigated whether TI is associated with the development, severity, and course of PTSD. Additionally, we evaluated whether different types of traumatic events are differentially associated with TI, and whether TI severity differs according to sex. METHODS A systematic literature search was conducted using Embase, PubMed, PsycINFO, and Scopus. Meta-analyses were performed on the included articles. RESULTS We identified 27 eligible articles. We found a significant association between TI and PTSD symptom severity (r = 0.39, 95% CI: 0.34-0.44; p < .0001). TI was more severe among females (Cohen's d=0.37, 95% CI: 0.25-0.48; p < .0001) and was more often elicited in situations involving interpersonal violence. We found limited longitudinal data to perform a meta-analysis of the association between TI and the development and/or course of PTSD. However, the literature available seems to support the role of TI in both the development and course of PTSD. CONCLUSIONS Peritraumatic TI is associated with PTSD symptom severity, occurs more often during interpersonal violence, and is more severe among females. More longitudinal research is needed to investigate the role of TI in psychopathology development and course.
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Affiliation(s)
- Bruno Messina Coimbra
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Amsterdam Public Health Research Institute and Amsterdam Neuroscience Research Institute, Amsterdam, the Netherlands; Program for Research and Care on Violence and PTSD (PROVE), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.
| | - Chris Maria Hoeboer
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Amsterdam Public Health Research Institute and Amsterdam Neuroscience Research Institute, Amsterdam, the Netherlands
| | - Mirjam van Zuiden
- Department of Clinical Psychology, Utrecht University, Utrecht, the Netherlands
| | - Rachel E Williamson
- Department of Psychology, University of Montana, Missoula, MT, United States
| | - Ana Teresa D'Elia
- Program for Research and Care on Violence and PTSD (PROVE), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Andrea Feijo Mello
- Program for Research and Care on Violence and PTSD (PROVE), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Marcelo Feijo Mello
- Program for Research and Care on Violence and PTSD (PROVE), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Miranda Olff
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Amsterdam Public Health Research Institute and Amsterdam Neuroscience Research Institute, Amsterdam, the Netherlands; ARQ National Psychotrauma Centre, Diemen, the Netherlands
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5
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Bassil K, Krontira AC, Leroy T, Escoto AIH, Snijders C, Pernia CD, Pasterkamp RJ, de Nijs L, van den Hove D, Kenis G, Boks MP, Vadodaria K, Daskalakis NP, Binder EB, Rutten BPF. In vitro modeling of the neurobiological effects of glucocorticoids: A review. Neurobiol Stress 2023; 23:100530. [PMID: 36891528 PMCID: PMC9986648 DOI: 10.1016/j.ynstr.2023.100530] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 02/15/2023] [Accepted: 02/16/2023] [Indexed: 02/25/2023] Open
Abstract
Hypothalamic-pituitary adrenal (HPA)axis dysregulation has long been implicated in stress-related disorders such as major depression and post-traumatic stress disorder. Glucocorticoids (GCs) are released from the adrenal glands as a result of HPA-axis activation. The release of GCs is implicated with several neurobiological changes that are associated with negative consequences of chronic stress and the onset and course of psychiatric disorders. Investigating the underlying neurobiological effects of GCs may help to better understand the pathophysiology of stress-related psychiatric disorders. GCs impact a plethora of neuronal processes at the genetic, epigenetic, cellular, and molecular levels. Given the scarcity and difficulty in accessing human brain samples, 2D and 3D in vitro neuronal cultures are becoming increasingly useful in studying GC effects. In this review, we provide an overview of in vitro studies investigating the effects of GCs on key neuronal processes such as proliferation and survival of progenitor cells, neurogenesis, synaptic plasticity, neuronal activity, inflammation, genetic vulnerability, and epigenetic alterations. Finally, we discuss the challenges in the field and offer suggestions for improving the use of in vitro models to investigate GC effects.
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Affiliation(s)
- Katherine Bassil
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Anthi C Krontira
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany.,International Max Planck Research School for Translational Psychiatry, Munich, Germany
| | - Thomas Leroy
- Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium
| | - Alana I H Escoto
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Clara Snijders
- Department of Psychiatry, McLean Hospital, Harvard Medical School, Belmont, MA, USA
| | - Cameron D Pernia
- Department of Psychiatry, McLean Hospital, Harvard Medical School, Belmont, MA, USA
| | - R Jeroen Pasterkamp
- Department of Translational Neuroscience, University Medical Center (UMC) Utrecht Brain Center, Utrecht University, Utrecht, the Netherlands
| | - Laurence de Nijs
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Daniel van den Hove
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Gunter Kenis
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Marco P Boks
- Psychiatry, UMC Utrecht Brain Center, Utrecht, the Netherlands
| | - Krishna Vadodaria
- Salk Institute for Biological Studies, La Jolla, San Diego, United States
| | | | - Elisabeth B Binder
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany.,International Max Planck Research School for Translational Psychiatry, Munich, Germany
| | - Bart P F Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
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6
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Shikimoto R, Nozaki S, Sawada N, Shimizu Y, Svensson T, Nakagawa A, Mimura M, Tsugane S. Coping in Mid- to Late Life and Risk of Mild Cognitive Impairment Subtypes and Dementia: A JPHC Saku Mental Health Study. J Alzheimers Dis 2022; 90:1085-1101. [PMID: 36213991 PMCID: PMC9741735 DOI: 10.3233/jad-215712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND The relationship between coping in mid- to late life and cognitive functions remains unclear. OBJECTIVE To investigate the relationship between habitual coping behaviors of a large Japanese population in their mid- to late-lives and their risk of cognitive decline 15 years later. METHODS Overall 1,299 participants were assessed for coping behaviors (in 2000) and cognition (2014-2015). We used the Stress and Coping Inventory to assess the frequency of six coping behaviors (i.e., consulting, planning, positive reappraisal, avoidance, fantasizing, and self-blame). Logistic regression analyses were conducted to examine odds ratios (ORs) for the diagnosis of mild cognitive impairment (MCI), MCI subtypes (single- and multiple-domain MCI), and dementia for coping behaviors. RESULTS Among the eligible 1,015 participants (72.6 [SD = 5.5] years old in 2014-2015), the numbers for cognitively normal, single-domain MCI, multiple-domain MCI, and dementia were 650 (64.0%), 116 (11.4%), 213 (21.0%), and 36 (3.5%), respectively. Among the six coping behaviors, avoidant coping was significantly associated with noticeable cognitive decline (multiple-domain MCI and dementia). This association remained significant after adjusting for sex, age, education, diagnosis of current major depressive disorder, past history of ischemic heart disease, diabetes, regular alcohol consumption, and smoking (OR = 2.52, 95% CI = 1.23 to 5.15). No significant association with other coping behaviors was found. CONCLUSION Avoidant coping in mid- and late life is associated with cognitive decline among older people.
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Affiliation(s)
- Ryo Shikimoto
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan,
Center for Supercentenarian Medical Research, Keio University School of Medicine, Tokyo, Japan
| | - Shoko Nozaki
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan,
Department of Psychiatry, National Hospital Organization Shimofusa Psychiatric Medical Center, Chiba, Japan,Correspondence to: Shoko Nozaki, MD, PhD, Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582 Japan. Tel.: +81 3 3353 1211; Department of Psychiatry, National Hospital Organization Shimofusa Psychiatric Medical Center, 578 Heta-cho, Midori-ku 266-0007, Chiba-city, Chiba, Japan. E-mail: and Norie Sawada, MD, PhD, Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan. Tel.: +81 3 3547 5201 (extension3338); E-mail:
| | - Norie Sawada
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan,Correspondence to: Shoko Nozaki, MD, PhD, Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582 Japan. Tel.: +81 3 3353 1211; Department of Psychiatry, National Hospital Organization Shimofusa Psychiatric Medical Center, 578 Heta-cho, Midori-ku 266-0007, Chiba-city, Chiba, Japan. E-mail: and Norie Sawada, MD, PhD, Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan. Tel.: +81 3 3547 5201 (extension3338); E-mail:
| | - Yoko Shimizu
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Thomas Svensson
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan,
Department of Bioengineering, Precision Health, Graduate School of Engineering, The University of Tokyo, Bunkyo-ku, Tokyo, Japan,
School of Health Innovation, Kanagawa University of Human Services, Kawasaki-ku, Kawasaki-shi, Kanagawa, Japan,
Department of Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Atsuo Nakagawa
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Shoichiro Tsugane
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan,National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
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7
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Doba K, Saloppé X, Choukri F, Nandrino JL. Childhood trauma and posttraumatic stress symptoms in adolescents and young adults: The mediating role of mentalizing and emotion regulation strategies. CHILD ABUSE & NEGLECT 2022; 132:105815. [PMID: 35914329 DOI: 10.1016/j.chiabu.2022.105815] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 07/13/2022] [Accepted: 07/20/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES Childhood trauma (physical, emotional, sexual abuse and/or physical and emotional neglect) represents a specific risk for developmental perturbations and long-term negative outcomes. Adolescents and young adults with childhood trauma have rarely experienced a single type of traumatic event but rather multiple traumatic experiences. However, studies on adolescent PTSD are sparse. This study examines the possible mediating role of mentalizing, cognitive and interpersonal emotion regulation strategies between multiple types of childhood trauma exposure and PTSD in adolescents and young adults. METHODS The sample consisted of 456 adolescents and young adults aged 15 and 25, recruited from four high schools and one university. Participants completed self-report questionnaires assessing childhood trauma, mentalizing, cognitive and interpersonal strategies of emotion regulation and PTSD. RESULTS Structural Equation Modeling revealed that multiple types of childhood trauma exposure have a significant indirect effect on PTSD symptoms through its association with hypomentalizing and maladaptive cognitive strategies of emotion regulation (i.e. self-blame, rumination, catastrophizing). Results also showed a significant indirect effect between multiple types of childhood trauma exposure and PTSD symptoms through its association with hypomentalizing and maladaptive interpersonal strategies of emotion regulation (i.e. emotional reactivity and tendency to avoid emotional connection). Indirect paths were also run in reverse to control for the direction of the effect. CONCLUSION Our findings show that exposure to multiple types of childhood trauma contributes to severe PTSD through several complex pathways including both hypomentalizing and maladaptive emotion regulation strategies in adolescence and young adulthood.
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Affiliation(s)
- Karyn Doba
- University of Lille, CNRS, UMR 9193-SCALab, Sciences Cognitives et Sciences Affectives, F-59000 Lille, France; Fondation Santé des Etudiants de France, Clinique FSEF Villeneuve d'Ascq, 59653 Villeneuve d'Ascq, France.
| | - Xavier Saloppé
- University of Lille, CNRS, UMR 9193-SCALab, Sciences Cognitives et Sciences Affectives, F-59000 Lille, France
| | - Fatima Choukri
- University of Lille, CNRS, UMR 9193-SCALab, Sciences Cognitives et Sciences Affectives, F-59000 Lille, France
| | - Jean-Louis Nandrino
- University of Lille, CNRS, UMR 9193-SCALab, Sciences Cognitives et Sciences Affectives, F-59000 Lille, France; Fondation Santé des Etudiants de France, Clinique FSEF Villeneuve d'Ascq, 59653 Villeneuve d'Ascq, France
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8
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Agoston AM, Bhatia A, Bleacher JC, Smith A, Hill K, Edwards S, Cochran A, Routly M. PTSD Risk Factors and Acute Pain Intensity Predict Length of Hospital Stay in Youth after Unintentional Injury. CHILDREN 2022; 9:children9081222. [PMID: 36010111 PMCID: PMC9406594 DOI: 10.3390/children9081222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 07/27/2022] [Accepted: 08/09/2022] [Indexed: 11/16/2022]
Abstract
Background: Many hospitals have adopted screening tools to assess risk for posttraumatic stress disorder (PTSD) after pediatric unintentional injury in accordance with American College of Surgeons recommendations. The Screening Tool for Early Predictors of PTSD (STEPP) is a measure initially developed to identify youth and parents at high risk for meeting diagnostic criteria for PTSD after injury. Acute pain during hospitalization has also been examined as a potential predictor of maladaptive outcomes after injury, including PTSD. We investigated in a retrospective cohort study whether the STEPP, as well as acute pain intensity during hospitalization, would predict maladaptive outcomes during the peri-trauma in addition to the post-trauma period, specifically length of hospitalization. Methods: A total of 1123 youths aged 8–17 (61% male) and their parents were included. Patients and parents were administered the STEPP for clinical reasons while hospitalized. Acute pain intensity and length of stay were collected through retrospective chart review. Results: Adjusting for demographics and injury severity, child but not parent STEPP total predicted length of stay. Acute pain intensity, child threat to life appraisal, and child pulse rate predicted length of stay. Conclusions: Acute pain intensity and child PTSD risk factors, most notably child threat to life appraisal, predicted hospitalization length above and beyond multiple factors, including injury severity. Pain intensity and child appraisals may not only serve as early warning signs for maladaptive outcomes after injury but also indicate a more difficult trajectory during hospitalization. Additional assessment and treatment of these factors may be critical while youth are hospitalized. Utilizing psychology services to support youth and integrating trauma-informed care practices during hospitalization may support improved outcomes for youth experiencing unintentional injury.
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Affiliation(s)
- Anna Monica Agoston
- Center for Pain Relief, Children’s Healthcare of Atlanta, Atlanta, GA 30322, USA
- Division of Pediatric Anesthesiology, Emory University, Atlanta, GA 30322, USA
- Correspondence: ; Tel.: +1-503-830-4305; Fax: +1-404-785-6223
| | - Amina Bhatia
- Division of Surgery, Emory University, Atlanta, GA 30322, USA
| | - John C. Bleacher
- Division of Trauma Services, Children’s Healthcare of Atlanta, Atlanta, GA 30322, USA
| | - Alexis Smith
- Division of Trauma Services, Children’s Healthcare of Atlanta, Atlanta, GA 30322, USA
| | - Karen Hill
- Division of Trauma Services, Children’s Healthcare of Atlanta, Atlanta, GA 30322, USA
| | - Susanne Edwards
- Division of Trauma Services, Children’s Healthcare of Atlanta, Atlanta, GA 30322, USA
| | - Alicia Cochran
- Division of Trauma Services, Children’s Healthcare of Atlanta, Atlanta, GA 30322, USA
| | - Maia Routly
- Division of Trauma Services, Children’s Healthcare of Atlanta, Atlanta, GA 30322, USA
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9
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Myburgh-Jacobsz CE, Malan L, von Känel R, Steyn HS, Malan NT. Stress-induced cardiac troponin T, S100B and estradiol responses in defensive copers: The SABPA study. Int J Psychophysiol 2022; 177:159-170. [DOI: 10.1016/j.ijpsycho.2022.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 05/09/2022] [Accepted: 05/10/2022] [Indexed: 11/30/2022]
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10
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Al Ali S, Pihl-Thingvad J, Elklit A. The influence of coping and cognitive appraisal in predicting Posttraumatic Stress Disorder: A prospective study on workplace violence in psychiatric staff in Denmark. Work 2022; 71:641-649. [DOI: 10.3233/wor-205177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND: Since psychiatric staff experience a high occurrence of workplace violence and subsequent Posttraumatic Stress Disorder (PTSD), it is important to assess the behavioral and cognitive risk factors of PTSD in this population. OBJECTIVE: The current study assesses the incidence of PTSD 12 months after the occurrence of WV. Furthermore, it examines possible prospective associations between coping strategies and cognitive appraisals, respectively, and PTSD. METHODS: This prospective cohort study was conducted with staff from 18 psychiatric wards in Denmark (n = 183) who had reported an incidence of workplace violence. Most subjects were women (83.3%). RESULTS: The incidence of PTSD was 9.8%. The main analysis showed a significant relationship between negative cognitive appraisals about the self and PTSD (OR = 2.87, p < .05), and a coping strategy of self-blame and PTSD (OR = 2.21, p < .05). CONCLUSIONS: Certain dysfunctional coping strategies and negative cognitive appraisals seems to predict posttraumatic stress in an occupational context. Information about these processes could be important for preventive strategies in the workplace.
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Affiliation(s)
- Sara Al Ali
- National Center of Psychotraumatology, Department of Psychology, University of Southern Denmark, Odense, Denmark
- Department of Occupational and Environmental Medicine, Odense University Hospital, Odense, Denmark
| | - Jesper Pihl-Thingvad
- Department of Occupational and Environmental Medicine, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Ask Elklit
- National Center of Psychotraumatology, Department of Psychology, University of Southern Denmark, Odense, Denmark
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11
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Carvalho T, Pinto-Gouveia J, Cunha M, da Motta C. Experiential avoidance, uncompassionate self-responding, and peritraumatic depersonalization/derealization: A novel mediation model for war-related PTSD symptomatology. J Clin Psychol 2022; 78:1074-1092. [PMID: 34993963 DOI: 10.1002/jclp.23303] [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: 10/31/2020] [Revised: 11/29/2021] [Accepted: 12/20/2021] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To explore a novel model for war-related posttraumatic stress disorder (PTSD) symptomatology including emotion regulation processes, namely experiential avoidance (EA) and uncompassionate self-responding (USR), mediating the impact of childhood threat memories, combat exposure distress, combat and noncombat threats, and peritraumatic depersonalization/derealization (PDD) on PTSD symptomatology. METHOD A sample of 650 male Portuguese Overseas War veterans filled self-report instruments. RESULTS The model explained 59% of the variance of PTSD symptomatology. Both EA and USR mediated the effects of noncombat threats and PDD on PTSD. Additionally, EA mediated combat exposure distress and USR mediated childhood threat memories. Combat exposure distress, combat and noncombat threats, and PDD showed direct effects on PTSD symptomatology. CONCLUSION The findings help to better understand the relationship between predictive factors of war-related PTSD in clinical and research settings, providing novel insights on the effects of combat exposure distress, and the different effects of combat and noncombat-related threats on PTSD.
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Affiliation(s)
- Teresa Carvalho
- Cognitive-Behavioral Research Centre (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal.,Instituto Superior Miguel Torga, Coimbra, Portugal
| | - José Pinto-Gouveia
- Cognitive-Behavioral Research Centre (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
| | - Marina Cunha
- Cognitive-Behavioral Research Centre (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal.,Instituto Superior Miguel Torga, Coimbra, Portugal
| | - Carolina da Motta
- Cognitive-Behavioral Research Centre (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal.,School of Psychology and Life Sciences, Lusófona University, Lisbon, Portugal.,Digital Human-Environment Interaction Lab (HEI-Lab), Lisboa, Portugal
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12
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Dehelean L, Papava I, Musat MI, Bondrescu M, Bratosin F, Bucatos BO, Bortun AMC, Mager DV, Romosan RS, Romosan AM, Paczeyka R, Cut TG, Pescariu SA, Laza R. Coping Strategies and Stress Related Disorders in Patients with COVID-19. Brain Sci 2021; 11:brainsci11101287. [PMID: 34679351 PMCID: PMC8533929 DOI: 10.3390/brainsci11101287] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 09/25/2021] [Accepted: 09/25/2021] [Indexed: 01/31/2023] Open
Abstract
Patients with severe COVID-19 experience high-stress levels and thus are at risk for developing acute stress disorder (ASD) and/or post-traumatic stress disorder (PTSD). The present study aims to search for correlations between psychiatric response to stress and coping strategies among individuals with acute vs. remitted COVID-19. Ninety subjects with COVID-19 were included in the study, divided into two samples by disease category. Our focus was analysing the perceived stress intensity according to NSESSS and PCL-C-17 scales, and coping strategies with COPE-60. High NSESSS scores were found in 40% of acute patients, and 15.6% of remitted patients had high PCL-C-17 scores fulfilling the criteria for PTSD. We found a negative correlation between stress level and disease category. Acute patients used significantly more engagement and emotion-focused coping methods, but less disengagement types of coping than patients in the remitted phase. Remitted patients under high stress levels are prone to use disengagement and emotion-focused coping strategies. In conclusion, remitted COVID-19 patients experience lower levels of stress and use less emotion-focused strategies, except among those who developed PTSD post-COVID-19 infection, presenting with high-stress levels and using more disengagement and emotion-focused types of coping strategies.
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Affiliation(s)
- Liana Dehelean
- Department of Neurosciences-Psychiatry, “Victor Babes” University of Medicine and Pharmacy, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania; (L.D.); (M.B.); (B.O.B.); (A.-M.C.B.); (R.S.R.); (A.-M.R.)
- Center for Cognitive Research in Neuropsychiatric Pathology, “Victor Babes” University of Medicine and Pharmacy, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania
- Timis County Emergency Clinical Hospital “Pius Brinzeu”, Liviu Rebreanu, Nr. 156, 300723 Timisoara, Romania;
| | - Ion Papava
- Department of Neurosciences-Psychiatry, “Victor Babes” University of Medicine and Pharmacy, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania; (L.D.); (M.B.); (B.O.B.); (A.-M.C.B.); (R.S.R.); (A.-M.R.)
- Center for Cognitive Research in Neuropsychiatric Pathology, “Victor Babes” University of Medicine and Pharmacy, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania
- Timis County Emergency Clinical Hospital “Pius Brinzeu”, Liviu Rebreanu, Nr. 156, 300723 Timisoara, Romania;
- Correspondence: (I.P.); (M.I.M.)
| | - Madalina Iuliana Musat
- Neuropsychiatry Hospital Craiova—Psychiatry Clinic I, Aleea Potelu 24, 200317 Craiova, Romania
- Correspondence: (I.P.); (M.I.M.)
| | - Mariana Bondrescu
- Department of Neurosciences-Psychiatry, “Victor Babes” University of Medicine and Pharmacy, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania; (L.D.); (M.B.); (B.O.B.); (A.-M.C.B.); (R.S.R.); (A.-M.R.)
- Timis County Emergency Clinical Hospital “Pius Brinzeu”, Liviu Rebreanu, Nr. 156, 300723 Timisoara, Romania;
- Doctoral School, University of Medicine and Pharmacy ‘’Victor Babes’’ Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania;
| | - Felix Bratosin
- Department of Infectious Diseases, University of Medicine and Pharmacy ‘’Victor Babes’’ Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania; (F.B.); (R.L.)
- Clinical Hospital of Infectious Diseases and Pneumophtisiology ‘’Doctor Victor Babes’’ Timisoara, Gheorghe Adam, Nr. 13, 300310 Timisoara, Romania;
| | - Bianca Oana Bucatos
- Department of Neurosciences-Psychiatry, “Victor Babes” University of Medicine and Pharmacy, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania; (L.D.); (M.B.); (B.O.B.); (A.-M.C.B.); (R.S.R.); (A.-M.R.)
- Timis County Emergency Clinical Hospital “Pius Brinzeu”, Liviu Rebreanu, Nr. 156, 300723 Timisoara, Romania;
- Doctoral School, University of Medicine and Pharmacy ‘’Victor Babes’’ Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania;
| | - Ana-Maria Cristina Bortun
- Department of Neurosciences-Psychiatry, “Victor Babes” University of Medicine and Pharmacy, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania; (L.D.); (M.B.); (B.O.B.); (A.-M.C.B.); (R.S.R.); (A.-M.R.)
- Timis County Emergency Clinical Hospital “Pius Brinzeu”, Liviu Rebreanu, Nr. 156, 300723 Timisoara, Romania;
- Doctoral School, University of Medicine and Pharmacy ‘’Victor Babes’’ Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania;
| | - Daniela Violeta Mager
- Timis County Emergency Clinical Hospital “Pius Brinzeu”, Liviu Rebreanu, Nr. 156, 300723 Timisoara, Romania;
| | - Radu Stefan Romosan
- Department of Neurosciences-Psychiatry, “Victor Babes” University of Medicine and Pharmacy, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania; (L.D.); (M.B.); (B.O.B.); (A.-M.C.B.); (R.S.R.); (A.-M.R.)
- Center for Cognitive Research in Neuropsychiatric Pathology, “Victor Babes” University of Medicine and Pharmacy, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania
- Timis County Emergency Clinical Hospital “Pius Brinzeu”, Liviu Rebreanu, Nr. 156, 300723 Timisoara, Romania;
| | - Ana-Maria Romosan
- Department of Neurosciences-Psychiatry, “Victor Babes” University of Medicine and Pharmacy, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania; (L.D.); (M.B.); (B.O.B.); (A.-M.C.B.); (R.S.R.); (A.-M.R.)
- Doctoral School, University of Medicine and Pharmacy ‘’Victor Babes’’ Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania;
| | - Roxana Paczeyka
- Clinical Hospital of Infectious Diseases and Pneumophtisiology ‘’Doctor Victor Babes’’ Timisoara, Gheorghe Adam, Nr. 13, 300310 Timisoara, Romania;
| | - Talida Georgiana Cut
- Doctoral School, University of Medicine and Pharmacy ‘’Victor Babes’’ Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania;
- Department of Infectious Diseases, University of Medicine and Pharmacy ‘’Victor Babes’’ Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania; (F.B.); (R.L.)
- Clinical Hospital of Infectious Diseases and Pneumophtisiology ‘’Doctor Victor Babes’’ Timisoara, Gheorghe Adam, Nr. 13, 300310 Timisoara, Romania;
| | - Silvius Alexandru Pescariu
- Department VI, Cardiology, University of Medicine and Pharmacy “Victor Babes” Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania;
| | - Ruxandra Laza
- Department of Infectious Diseases, University of Medicine and Pharmacy ‘’Victor Babes’’ Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania; (F.B.); (R.L.)
- Clinical Hospital of Infectious Diseases and Pneumophtisiology ‘’Doctor Victor Babes’’ Timisoara, Gheorghe Adam, Nr. 13, 300310 Timisoara, Romania;
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Verstraeten BSE, Elgbeili G, Hyde A, King S, Olson DM. Maternal Mental Health after a Wildfire: Effects of Social Support in the Fort McMurray Wood Buffalo Study. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2021; 66:710-718. [PMID: 33172310 PMCID: PMC8320544 DOI: 10.1177/0706743720970859] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Following disasters, perinatal women are vulnerable to developing post-traumatic stress disorder (PTSD)-like symptoms. Little is known about protective factors. We hypothesized that peritraumatic stress would predict PTSD-like symptoms in pregnant and postpartum women and would be moderated by social support and resilience. METHOD Women (n = 200) who experienced the 2016 Fort McMurray Wood Buffalo wildfire during or shortly before pregnancy completed the Peritraumatic Distress Inventory (PDI), Peritraumatic Dissociative Experiences Questionnaire, and the Impact of Event Scale-Revised for current PTSD-like symptoms. They also completed scales of social support (Social Support Questionnaire-Short Form) and resilience (Connor-Davidson Resilience Scale). RESULTS Greater peritraumatic distress (r = 0.56) and dissociative experiences (r = 0.56) correlated with more severe PTSD-like symptoms. Greater social support satisfaction was associated with less severe post-traumatic stress symptoms but only when peritraumatic distress was below average; at more severe levels of PDI, this psychosocial variable was not protective. CONCLUSIONS Maternal PTSD-like symptoms after a wildfire depend on peritraumatic distress and dissociation. Higher social support satisfaction buffers the association with peritraumatic distress, although not when peritraumatic reactions are severe. Early psychosocial interventions may protect perinatal women from PTSD-like symptoms after a wildfire.
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Affiliation(s)
| | - Guillaume Elgbeili
- 26632Douglas Mental Health University Institute, Montréal, Québec, Canada
| | - Ashley Hyde
- 12357Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Suzanne King
- Department of Psychiatry, 5620McGill University, Montréal, Québec, Canada
| | - David M Olson
- Department of Obstetrics & Gynecology, 3158University of Alberta, Edmonton, Alberta, Canada.,Department of Pediatrics, 3158University of Alberta, Edmonton, Alberta, Canada.,Department of Physiology, 3158University of Alberta, Edmonton, Alberta, Canada
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14
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Carmassi C, Marazziti D, Mucci F, Della Vecchia A, Barberi FM, Baroni S, Giannaccini G, Palego L, Massimetti G, Dell'Osso L. Decreased Plasma Oxytocin Levels in Patients With PTSD. Front Psychol 2021; 12:612338. [PMID: 34276462 PMCID: PMC8280334 DOI: 10.3389/fpsyg.2021.612338] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 03/24/2021] [Indexed: 11/22/2022] Open
Abstract
Introduction Although the pathophysiology of post-traumatic stress disorder (PTSD) is still unclear, growing preclinical evidences suggest that oxytocin (OT), a pleiotropic hormone, is possibly involved. However, direct studies on OT levels or clinical trials with this exogenous hormone in patients with PTSD led to inconsistent findings. Therefore, the aim of the present study was at exploring and comparing the plasma OT levels in a group of patients with PTSD and matched healthy subjects as the control group. Materials and Methods Twenty-six outpatients (13 men, 13 women, mean age: 40.3 ± 11.5 years) suffering from PTSD, according to the Diagnostic and Statistical Manual for Mental Disorders, fifth edition (DSM-5), and 26 healthy subjects (13 men, 13 women, mean age: 43.8 ± 12.7 years) were included. The patients were assessed through the structured clinical interview for DSM-5 research version, patient edition (SCID-I/P), and the Impact for Event Scale revised (IES-R). All fasting subjects underwent three venous blood samples for the subsequent oxytocin radioimmunoassay. We used unpaired Student’s t-test to assess OT levels and the intergroup difference of demographic characteristics, while anxiety, avoidance, and hyperarousal scores were compared among groups adjusting for the effect of gender and age by means of analysis of covariance (ANCOVA). The correlations between different variables were investigated by Pearson’s method. Results The most common traumatic events of patients with PTSD were the following: severe car accident, physical violence, sexual violence, sudden death of a loved one, and natural disaster. The IES total score was 55 ± 15. Student’s t-test revealed that the patients showed significantly lower OT levels (mean ± SD, pg/ml) than healthy control subjects (4.37 ± 1.61 vs 5.64 ± 2.17, p < 0.001). We detected no correlation between the IES total score, subscales, or single items and OT plasma levels. Again, no difference between men and women was detected in the patients’ group, while healthy control women showed higher OT levels than men. Discussion Our study, while reporting the presence of decreased plasma OT levels in outpatients with PTSD of both sexes, as compared with healthy control subjects, would support the possible involvement of OT in the pathophysiology of PTSD. However, given the complexity of the clinical picture, future investigations are necessary to better deepen the role and level of OT in PTSD.
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Affiliation(s)
- Claudia Carmassi
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
| | - Donatella Marazziti
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy.,Unicamillus-Saint Camillus International University of Medical and Health Sciences, Rome, Italy
| | - Federico Mucci
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, Siena, Italy.,Department of Psychiatry, North-Western Tuscany Region, NHS Local Health Unit, Viareggio, Italy
| | - Alessandra Della Vecchia
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
| | - Filippo Maria Barberi
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
| | - Stefano Baroni
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
| | | | | | - Gabriele Massimetti
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
| | - Liliana Dell'Osso
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
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15
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He L, Geng Y, Pan Y, Tian J, He X, Deng X, Duan W, Peng H. Study protocol for a network meta-analysis of digital-technology-based psychotherapies for PTSD in adults. BMJ Open 2020; 10:e038951. [PMID: 33303442 PMCID: PMC7733188 DOI: 10.1136/bmjopen-2020-038951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Studies on various types of digital-technology-based psychotherapies (DTPs) have indicated that they are effective for post-traumatic stress disorder (PTSD) symptom relief among adults. The intervention efficacy or effectiveness hierarchy, however, is still not clear. Therefore, we propose to conduct a network meta-analysis to assess the relative effectiveness of various types of DTPs. We aim to establish the differential effectiveness of these therapies in terms of symptom reduction and provide high-quality evidence for treating PTSD. METHODS AND ANALYSES We will search Embase, CINAHL, MEDLINE, HealthSTAR, the Cochrane Library, PsycINFO, PubMed, the Chinese Biomedical Literature Database, clinical trials (eg, ClinicalTrials.gov) and other academic platforms for relevant studies, mainly in English and Chinese (as we plan to conduct a trial on PTSD patients in Wuhan, China, based on the results of this network meta-analysis), from inception to October 2020. Randomised controlled trials (RCTs) and meta-analyses investigating the effectiveness of any DTPs for PTSD patients for any controlled condition will be included. The number of intervention sessions and the research duration are unlimited; the effects for different durations will be tested via sensitivity analysis. For this project, the primary measure of outcome will be PTSD symptoms at the end of treatment using raw scores for one widely used PTSD scale, PCL-5. Secondary outcome measures will include (1) dropout rate; (2) effectiveness at longest follow-up, but not more than 12 months and (3) patients' functional recovery ratio (such as the return-to-work ratio or percentage of sick leave). Bayesian network meta-analysis will be conducted for all relative outcome measures. We will perform subgroup analysis and sensitivity analysis to see whether the results are influenced by study characteristics. The Grading of Recommendations, Assessments, Development, and Evaluation framework will be adopted to evaluate the quality of evidence contributing to network estimates of the primary outcome. ETHICS AND DISSEMINATION The researchers of the primary trials already have had ethical approval for the data used in our study. We will present the results of this meta-analysis at academic conferences and publish them in peer-reviewed journals. PROSPERO REGISTRATION NUMBER CRD42020173253.
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Affiliation(s)
- Longtao He
- Research Institute of Social Development, Southwestern University of Finance and Economics, Chengdu, Sichuan, China
| | - Yanling Geng
- Department of Social Work, Northwest University, Xi'an, Shanxi, China
| | - Yangu Pan
- Research Institute of Social Development, Southwestern University of Finance and Economics, Chengdu, Sichuan, China
| | - Jinhui Tian
- Evidence-Based Medicine Centre & School of Basic Science, Lanzhou University, Lanzhou, Gansu, China
| | - Xinyu He
- School of Social Development, Xihua University, Chengdu, Sichuan, China
| | - Xiangshu Deng
- Research Institute of Social Development, Southwestern University of Finance and Economics, Chengdu, Sichuan, China
| | - Wenjie Duan
- Department of Social Work, East China University of Science and Technology, Shanghai, China
| | - Huamin Peng
- Department of Social Work and Social Policy, Nanjing University, Nanjing, China
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16
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Kunz S, Stadler C, Peter C. Longitudinal course and predictors of posttraumatic stress symptoms after spinal cord injury. Psychol Health 2020; 36:1115-1134. [PMID: 33017196 DOI: 10.1080/08870446.2020.1826483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE This study examined longitudinal changes in post-traumatic stress symptoms (PTSS) in individuals newly diagnosed with spinal cord injury (SCI) and tested various psychosocial and injury-related characteristics as predictors for interindividual differences in symptom courses. DESIGN Longitudinal data from the larger Swiss Spinal Cord Injury Cohort Study were used. The sample consisted of 269 patients (70.6% male; Mage = 53.21) admitted for inpatient rehabilitation to SCI rehabilitation centers. MAIN OUTCOME MEASURE PTSS were measured at one and six months after injury using the Impact of Event Scale-6. RESULTS Latent change score modelling revealed no average change in PTSS in the sample, but significant variability in the individual symptom courses. Reliable change index analyses suggest that among individuals with an initial PTSS severity of clinical concern (n = 65), only 27.7% showed clinically significant decreases over time. Predictors explained 34% of the variance in PTSS change. Loss appraisals (β = .30, p < .001) and cause of injury (β = .16, p = .018) emerged as unique predictors. CONCLUSION Clinically elevated PTSS one month after SCI typically remain across the following months highlighting the need for early screening and intervention. Low loss appraisals were related to decreases in symptom severity and might therefore be a suitable intervention target for reducing PTSS after SCI.
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Affiliation(s)
- Simon Kunz
- Empowerment, Participation, & Social Integration Unit, Swiss Paraplegic Research, Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | | | - Claudio Peter
- Empowerment, Participation, & Social Integration Unit, Swiss Paraplegic Research, Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
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17
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Allen JO, Watkins DC, Mezuk B, Chatters L, Johnson-Lawrence V. Mechanisms of Racial Health Disparities: Relationships between Coping and Psychological and Physiological Stress Responses. Ethn Dis 2020; 30:563-574. [PMID: 32989356 PMCID: PMC7518539 DOI: 10.18865/ed.30.4.563] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Objective Psychological distress and physiological dysregulation represent two stress response pathways linked to poor health and are implicated in racial disparities in aging-related health outcomes among US men. Less is known about how coping relates to these stress responses. The purpose of this exploratory study was to examine whether midlife and older men's coping strategies and behaviors accounted, in part, for Black-White disparities in men's psychological and physiological stress responses. Methods We examined racial differences in 12 coping strategies (COPE Inventory subscales, religious/spiritual coping, and behaviors such as stress eating and substance use) and their relationships with psychological distress (Negative Affect scale) and physiological dysregulation (blunted diurnal cortisol slopes) using regression models and cross-sectional data from 696 Black and White male participants aged 35-85 years in the National Survey of Midlife Development in the United States (MIDUS) II, 2004-2006. Results Black men exhibited more psychological distress and physiological dysregulation than White men. Black and White men reported comparable use of most coping strategies, none of which demonstrated similar relationships with both stress responses. Coping strategies explained variations in psychological distress consistent with conventional protective-harmful categorizations. Coping accounted for racial disparities in men's psychological distress, as Black men reported using harmful strategies more often and were more susceptible to their negative effects. Neither differential use of coping strategies nor differing relationships accounted for racial disparities in physiological dysregulation. Conclusions Findings revealed complex relationships between coping and psychological and physiological stress responses and suggest the importance of differing approaches to reducing associated racial health disparities among men.
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Affiliation(s)
- Julie Ober Allen
- Population Studies Center, Institute for Social Research, University of Michigan, Ann Arbor, MI
| | | | - Briana Mezuk
- School of Public Health, University of Michigan, Ann Arbor, MI
| | - Linda Chatters
- Schools of Social Work and Public Health, University of Michigan, Ann Arbor, MI
| | - Vicki Johnson-Lawrence
- College of Human Medicine, Family Medicine, Division of Public Health, Michigan State University, Flint, MI
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18
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Stress perception following childhood adversity: Unique associations with adversity type and sex. Dev Psychopathol 2020; 32:343-356. [PMID: 30846020 DOI: 10.1017/s0954579419000130] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Childhood adversity is associated with poor mental and physical health outcomes across the life span. Alterations in the hypothalamic-pituitary-adrenal axis are considered a key mechanism underlying these associations, although findings have been mixed. These inconsistencies suggest that other aspects of stress processing may underlie variations in this these associations, and that differences in adversity type, sex, and age may be relevant. The current study investigated the relationship between childhood adversity, stress perception, and morning cortisol, and examined whether differences in adversity type (generalized vs. threat and deprivation), sex, and age had distinct effects on these associations. Salivary cortisol samples, daily hassle stress ratings, and retrospective measures of childhood adversity were collected from a large sample of youth at risk for serious mental illness including psychoses (n = 605, mean age = 19.3). Results indicated that childhood adversity was associated with increased stress perception, which subsequently predicted higher morning cortisol levels; however, these associations were specific to threat exposures in females. These findings highlight the role of stress perception in stress vulnerability following childhood adversity and highlight potential sex differences in the impact of threat exposures.
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Olff M, Bakker A, Frewen P, Aakvaag H, Ajdukovic D, Brewer D, Elmore Borbon DL, Cloitre M, Hyland P, Kassam-Adams N, Knefel M, Lanza JA, Lueger-Schuster B, Nickerson A, Oe M, Pfaltz MC, Salgado C, Seedat S, Wagner A, Schnyder U. Screening for consequences of trauma - an update on the global collaboration on traumatic stress. Eur J Psychotraumatol 2020; 11:1752504. [PMID: 32489523 PMCID: PMC7241533 DOI: 10.1080/20008198.2020.1752504] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
This letter provides an update on the activities of "The Global Collaboration on Traumatic Stress" (GC-TS) as first described by Schnyder et al. in 2017. It presents in further detail the projects of the first theme, in particular the development of and initial data on the Global Psychotrauma Screen (GPS), a brief instrument designed to screen for the wide range of potential outcomes of trauma. English language data and ongoing studies in several languages provide a first indication that the GPS is a feasible, reliable and valid tool, a tool that may be very useful in the current pandemic of the coronavirus disease 2019 (COVID-19). Further multi-language and cross-cultural validation is needed. Since the start of the GC-TS, new themes have been introduced to focus on in the coming years: a) Forcibly displaced persons, b) Global prevalence of stress and trauma related disorders, c) Socio-emotional development across cultures, and d) Collaborating to make traumatic stress research data "FAIR". The most recent theme added is that of Global crises, currently focusing on COVID-19-related projects.
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Affiliation(s)
- Miranda Olff
- Department of Psychiatry, Amsterdam Neuroscience & Public Health, Amsterdam UMC, Amsterdam, The Netherlands
- ARQ National Psychotrauma Centre, Diemen, The Netherlands
| | - Anne Bakker
- Department of Psychiatry, Amsterdam UMC, Amsterdam, The Netherlands
| | - Paul Frewen
- Department of Psychiatry, Western University, London, Canada
| | - Helene Aakvaag
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
| | - Dean Ajdukovic
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Zagreb, Zagreb, Croatia
| | - Douglas Brewer
- Ramsay Health Care, The Hollywood Clinic, Perth, Australia
| | - Diane L. Elmore Borbon
- Policy Program, UCLA-Duke University National Center for Child Traumatic Stress, Washington, DC, USA
| | - Marylène Cloitre
- National Center for PTSD Dissemination and Training Division, Department of Psychiatry and Behavioral Sciences, VA Palo Alto Health Care System, Stanford University, Menlo Park, CA, USA
| | - Philip Hyland
- Department of Psychology, Maynooth University, Maynooth, Co. Kildare, Ireland
| | - Nancy Kassam-Adams
- Center for Injury Research and Prevention, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- Center for Pediatric Traumatic Stress, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Juliana A. Lanza
- Traumatic Stress Unit, Psychiatric Emergency Hospital, Buenos City, Argentina
- Human Factors, Emergency Medical Care System (SAME), Buenos Aires City, Argentina
| | | | | | - Misari Oe
- Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Japan
| | - Monique C. Pfaltz
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Zurich, Switzerland
| | - Carolina Salgado
- Department of Psychiatry, Medical School of Universidad Catolica Del Maule, Chile
| | - Soraya Seedat
- Department of Psychiatry, Faculty of Medicine & Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Anne Wagner
- Department of Psychology, Ryerson University, Toronto, Canada and Remedy, Toronto, Canada
| | - Ulrich Schnyder
- Department of Psychiatry, Amsterdam Neuroscience & Public Health, Amsterdam UMC, Amsterdam, The Netherlands
- ARQ National Psychotrauma Centre, Diemen, The Netherlands
- Department of Psychiatry, Amsterdam UMC, Amsterdam, The Netherlands
- Department of Psychiatry, Western University, London, Canada
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Zagreb, Zagreb, Croatia
- Ramsay Health Care, The Hollywood Clinic, Perth, Australia
- Policy Program, UCLA-Duke University National Center for Child Traumatic Stress, Washington, DC, USA
- National Center for PTSD Dissemination and Training Division, Department of Psychiatry and Behavioral Sciences, VA Palo Alto Health Care System, Stanford University, Menlo Park, CA, USA
- Department of Psychology, Maynooth University, Maynooth, Co. Kildare, Ireland
- Center for Injury Research and Prevention, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- Center for Pediatric Traumatic Stress, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- University of Vienna, Vienna, Austria
- Traumatic Stress Unit, Psychiatric Emergency Hospital, Buenos City, Argentina
- Human Factors, Emergency Medical Care System (SAME), Buenos Aires City, Argentina
- Faculty of Psychology, Clinical Psychology, University of Vienna, Vienna, Austria
- UNSW School of Psychology, UNSW Sydney, Australia
- Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Japan
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Zurich, Switzerland
- Department of Psychiatry, Medical School of Universidad Catolica Del Maule, Chile
- Department of Psychiatry, Faculty of Medicine & Health Sciences, Stellenbosch University, Cape Town, South Africa
- Department of Psychology, Ryerson University, Toronto, Canada and Remedy, Toronto, Canada
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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Abstract
Mixed affective states occur in approximately 40% of patients with mood disorders and are burdened with a significant rate of comorbidities, including addictive disorders (AD). The co-occurrence of mixed features and AD represents a challenge for clinicians because the reciprocal, negative influence of these conditions leads to a worse course of illness, treatment resistance, unfavorable outcome, and higher suicide risk. This article discusses clinical presentation, possible common pathogenetic pathways, and treatment options. Further investigations are required to clarify the determinants and the implications of this co-occurrence, and to detect suitable approaches in clinical management.
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Schirmbeck F, Konijn M, Hoetjes V, Vermeulen J, Zink M, Dekker J, de Haan L. Stressful experiences affect the course of co-occurring obsessive-compulsive and psychotic symptoms: A focus on within-subject processes. Schizophr Res 2020; 216:69-76. [PMID: 31919031 DOI: 10.1016/j.schres.2019.12.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 10/26/2019] [Accepted: 12/22/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Obsessive-compulsive symptoms (OCS) frequently occur in patients with psychotic disorders and are associated with higher burden and poorer prognosis. This study prospectively investigated the effect of stressful experiences on the severity of OCS and co-occurring psychotic and affective symptoms, with a focus on within-subject processes. METHOD Monthly assessments over 6 months in patients with a psychotic disorder (n = 56) and unaffected siblings (n = 49) resulted in 309 and 277 observations, respectively. Linear mixed-effects models investigated the disaggregated effects of within-subject changes and between-subject differences in stressful events on OCS, positive, negative and depressive symptoms. Subsequently, moderating effects of coping strategies and dysfunctional metacognitive beliefs were assessed. Mediation analyses investigated direct and indirect effects of stressful events on OCS four weeks later. RESULTS Stressful experiences were associated with severity in almost all symptom domains on the between- and within-subject levels. Dysfunctional coping and metacognitive beliefs moderated these associations. Patients and siblings with a tendency for passive coping showed higher within-subject increase in depressive symptoms, whereas passive coping and dysfunctional beliefs moderated the association between stressful experiences and severity of positive symptoms and OCS on the between-subject level. Effects of stressful experiences on OCS four weeks later were partially mediated by depressive and positive symptoms in patients and siblings. CONCLUSIONS Findings suggest that severity and variability of co-occurring psychopathology can partly be explained by recent stressful events and the way individuals cope with these experiences. The implementation of coping-oriented interventions could possibly help to prevent development and/or aggravation of co-occurring symptom severity.
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Affiliation(s)
- Frederike Schirmbeck
- Amsterdam University Medical Center, Location Meibergdreef, University of Amsterdam, Department of Psychiatry, Amsterdam, the Netherlands; Arkin Institute for Mental Health, Amsterdam, the Netherlands.
| | - Max Konijn
- Amsterdam University Medical Center, Location Meibergdreef, University of Amsterdam, Department of Psychiatry, Amsterdam, the Netherlands
| | - Vera Hoetjes
- Amsterdam University Medical Center, Location Meibergdreef, University of Amsterdam, Department of Psychiatry, Amsterdam, the Netherlands
| | - Jentien Vermeulen
- Amsterdam University Medical Center, Location Meibergdreef, University of Amsterdam, Department of Psychiatry, Amsterdam, the Netherlands
| | - Mathias Zink
- Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany; District Hospital Mittelfranken, Ansbach, Germany
| | - Jack Dekker
- Arkin Institute for Mental Health, Amsterdam, the Netherlands
| | - Lieuwe de Haan
- Amsterdam University Medical Center, Location Meibergdreef, University of Amsterdam, Department of Psychiatry, Amsterdam, the Netherlands; Arkin Institute for Mental Health, Amsterdam, the Netherlands
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22
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Schweizer T, Renner F, Sun D, Kleim B, Holmes EA, Tuschen-Caffier B. Psychophysiological reactivity, coping behaviour and intrusive memories upon multisensory Virtual Reality and Script-Driven Imagery analogue trauma: A randomised controlled crossover study. J Anxiety Disord 2018; 59:42-52. [PMID: 30269002 PMCID: PMC6249992 DOI: 10.1016/j.janxdis.2018.08.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 08/11/2018] [Accepted: 08/14/2018] [Indexed: 01/17/2023]
Abstract
BACKGROUND Peri- and post-traumatic factors predict the differential development of stress-associated mental disorders. Prospective designs assessing these risk factors in real-time under controlled experimental conditions can overcome limitations of retrospective designs. Therefore, we aimed to investigate multi-sensory, experimental analogues of a traumatic experience delivered in Virtual Reality (VR) or Script-Driven Imagery (SDI). METHODS In a randomised controlled crossover design, differences in the induced analogue trauma symptoms between multi-sensory analogue trauma by either VR or SDI versus a neutral condition were assessed in 127 non-clinical participants. RESULTS Analogue symptoms (psychophysiological responses, coping behaviour and intrusive memories of the experimental trauma) increased following analogue trauma in both VR and SDI, with more analogue symptoms for VR. Psychophysiological arousal was in general higher in VR. LIMITATIONS The analogue trauma situation of a car park fire that was used may be infrequent in real life. CONCLUSIONS Multisensory (vision, olfaction, hearing) analogue trauma in VR and SDI offers a useful tool for the induction and real-time assessment of peri- and post-traumatic risk factors for analogue stress-associated psychopathology. VR was more effective in inducing analogue symptoms than SDI, even though the latter might be more personalised. New experimental models for studying trauma exposure and responses may contribute to a better understanding of risk factors and help to identify and protect individuals at risk.
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Affiliation(s)
- Tina Schweizer
- Department of Psychology, Clinical Psychology and Psychotherapy, University of Freiburg, 79085 Freiburg, Germany.
| | - Fritz Renner
- Department of Psychology, Clinical Psychology and Psychotherapy, University of Freiburg, 79085 Freiburg, Germany; MRC Cognition and Brain Sciences Unit, University of Cambridge, CB2 7EF Cambridge, United Kingdom
| | - Dali Sun
- Department of Computer Science, University of Freiburg, 79110 Freiburg, Germany
| | - Birgit Kleim
- Department of Experimental Psychopathology and Psychotherapy, University of Zurich, 8050 Zurich, Switzerland; Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, 8032 Zurich, Switzerland
| | - Emily A Holmes
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, SE-171 65 Solna, Sweden
| | - Brunna Tuschen-Caffier
- Department of Psychology, Clinical Psychology and Psychotherapy, University of Freiburg, 79085 Freiburg, Germany
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23
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Schönfeld P, Brailovskaia J, Zhang XC, Margraf J. Self-Efficacy as a Mechanism Linking Daily Stress to Mental Health in Students: A Three-Wave Cross-Lagged Study. Psychol Rep 2018; 122:2074-2095. [PMID: 30235979 DOI: 10.1177/0033294118787496] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND OBJECTIVES While stress is generally well established to be predictive for different indicators of mental health, little is known about the longitudinal effects of daily life stressors and the role of self-evaluation factors. We tested whether perceived general self-efficacy is a mediator for the association between daily life stressors and psychopathological symptoms as well as subjective well-being. METHODS Data derived from 2160 Chinese university students was assessed at three time points with one-year intervals. We used the Brief Daily Stressor Screening, the General Self-Efficacy Scale, the Positive Mental Health Scale, and the Depression Anxiety and Stress Scales. Total, direct, and indirect effects were estimated using 95% bootstrapped confidence intervals and structural equation modeling. RESULTS Latent variable mediation analyses showed that daily stressors were associated with increased symptoms of depression, anxiety, and stress and with decreased subjective well-being. All cross-lagged mediational paths via self-efficacy were significant in predicting positive and negative mental health. CONCLUSIONS Considering stress of daily life as well as including the two dimensions of mental health may be important for future research and practice. This study provides novel evidence for mediating stress effects by perceived self-efficacy, which should be focused in intervention- and prevention-based approaches.
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Affiliation(s)
- Pia Schönfeld
- Mental Health Research & Treatment Center, Ruhr-Universität Bochum, Germany
| | - Julia Brailovskaia
- Mental Health Research & Treatment Center, Ruhr-Universität Bochum, Germany
| | - Xiao Chi Zhang
- Mental Health Research & Treatment Center, Ruhr-Universität Bochum, Germany
| | - Jürgen Margraf
- Mental Health Research & Treatment Center, Ruhr-Universität Bochum, Germany
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24
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Langenhof MR, Komdeur J. Why and how the early-life environment affects development of coping behaviours. Behav Ecol Sociobiol 2018; 72:34. [PMID: 29449757 PMCID: PMC5805793 DOI: 10.1007/s00265-018-2452-3] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 01/19/2018] [Accepted: 01/25/2018] [Indexed: 01/02/2023]
Abstract
Understanding the ways in which individuals cope with threats, respond to challenges, make use of opportunities and mediate the harmful effects of their surroundings is important for predicting their ability to function in a rapidly changing world. Perhaps one of the most essential drivers of coping behaviour of adults is the environment experienced during their early-life development. Although the study of coping, defined as behaviours displayed in response to environmental challenges, has a long and rich research history in biology, recent literature has repeatedly pointed out that the processes through which coping behaviours develop in individuals are still largely unknown. In this review, we make a move towards integrating ultimate and proximate lines of coping behaviour research. After broadly defining coping behaviours (1), we review why, from an evolutionary perspective, the development of coping has become tightly linked to the early-life environment (2), which relevant developmental processes are most important in creating coping behaviours adjusted to the early-life environment (3), which influences have been shown to impact those developmental processes (4) and what the adaptive significance of intergenerational transmission of coping behaviours is, in the context of behavioural adaptations to a fast changing world (5). Important concepts such as effects of parents, habitat, nutrition, social group and stress are discussed using examples from empirical studies on mammals, fish, birds and other animals. In the discussion, we address important problems that arise when studying the development of coping behaviours and suggest solutions.
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Affiliation(s)
- M. Rohaa Langenhof
- Behavioural Physiology and Ecology Group, Groningen Institute for Evolutionary Life Sciences, University of Groningen, Groningen, Netherlands
| | - Jan Komdeur
- Behavioural Physiology and Ecology Group, Groningen Institute for Evolutionary Life Sciences, University of Groningen, Groningen, Netherlands
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25
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Zandara M, Garcia-Lluch M, Villada C, Hidalgo V, Salvador A. Searching for a job: Cardiac responses to acute stress and the mediating role of threat appraisal in young people. Stress Health 2018; 34:15-23. [PMID: 28417549 DOI: 10.1002/smi.2757] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Revised: 03/13/2017] [Accepted: 03/16/2017] [Indexed: 11/09/2022]
Abstract
Being unemployed and looking for a job has become a source of stress for many people in several European countries. However, little attention has been paid to the impact of this stressful situation on the individuals' psychophysiological stress responses. The aim of this study was to investigate the effect of being an unemployed job seeker on cognitive threat appraisal and cardiac responses to a psychosocial stressor. We exposed a group of unemployed job seekers (N = 42) and a matched group of unemployed non-job seekers (N = 40) to a standardized social stressor in form of job interview, the Trier Social Stress Test. Our results showed that unemployed job seekers manifest lower cardiac responses, along with a lower cognitive threat appraisal, compared to non-job seekers. Moreover, we observed a full mediating role of cognitive threat appraisal on the relationship between being an unemployed job seeker and cardiac responses to stress. These findings reveal that being unemployed and looking for a job has an effect on physiological responses to acute stress, as well as the importance of psychological process related to the situation. These responses might lead to negative health and motivational consequences. Theoretical and practical implications are discussed.
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Affiliation(s)
- M Zandara
- Research Institute on Personnel Psychology, Organizational Development and Quality of Working Life (IDOCAL), Department of Social Psychology, University of Valencia, Valencia, Spain
| | - M Garcia-Lluch
- Laboratory of Social Cognitive Neuroscience, Department of Psychobiology, IDOCAL, University of Valencia, Valencia, Spain
| | - C Villada
- Laboratory of Social Cognitive Neuroscience, Department of Psychobiology, IDOCAL, University of Valencia, Valencia, Spain.,Department of health psychology, Area of Psychobyology, Miguel Hernández de Elche University (UMH), Alicante, Spain
| | - V Hidalgo
- Laboratory of Social Cognitive Neuroscience, Department of Psychobiology, IDOCAL, University of Valencia, Valencia, Spain.,Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
| | - A Salvador
- Research Institute on Personnel Psychology, Organizational Development and Quality of Working Life (IDOCAL), Department of Social Psychology, University of Valencia, Valencia, Spain.,Laboratory of Social Cognitive Neuroscience, Department of Psychobiology, IDOCAL, University of Valencia, Valencia, Spain
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26
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An overview of posttraumatic stress disorder genetic studies by analyzing and integrating genetic data into genetic database PTSDgene. Neurosci Biobehav Rev 2017; 83:647-656. [DOI: 10.1016/j.neubiorev.2017.08.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Revised: 07/08/2017] [Accepted: 08/30/2017] [Indexed: 01/08/2023]
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27
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Hyun MH, Bae SM. The influences of cognitive appraisal, physical injury, coping strategy, and forgiveness of others on PTSD symptoms in traffic accidents using hierarchical linear modeling. Medicine (Baltimore) 2017; 96:e7705. [PMID: 28858087 PMCID: PMC5585481 DOI: 10.1097/md.0000000000007705] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The purpose of this study was to identify how physical injury, perceived threat, forgiveness of others, and problem-focused coping influence the change of posttraumatic stress disorder (PTSD) symptoms. One hundred twenty patients who had experienced a traumatic vehicle accident participated in 1 to 2 months after the accident; 70 of these people involved at 6 months after the accident. We used a hierarchical linear model analysis to verify the impacts of predictors on change of PTSD symptoms as time passed. The results showed that PTSD symptoms decreased over time, and greater perceived threat would worsen PTSD symptoms and more forgiveness would decrease PTSD symptoms. On the other hand problem-focused coping and physical injury severity were not significantly related to the PTSD symptoms. Specifically, greater perceived threat was found to be related with a deceleration of the decrease in PTSD symptoms, whereas greater forgiveness of others was associated with an acceleration of this decrease. However, problem-focused coping and physical injury severity had no influence on the change rate of PTSD symptoms. Cognitive variable could be more important than physical injury to understand PTSD. In addition, forgiveness of other in a traumatic situation needs to be considered as one of coping strategies.
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Affiliation(s)
| | - Sung-Man Bae
- Department of Counseling Psychology, The Cyber Universit y of Korea, Seoul, Republic of Korea
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28
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Abstract
The reactions of human organism to changes of internal or external environment termed as stress response have been at the center of interest during recent decades. Several theories were designed to describe the regulatory mechanisms which maintain the stability of vital physiological functions under conditions of threat or other environmental challenges. However, most of the models of stress reactivity were focused on specific aspects of the regulatory outcomes – physiological (e.g. neuroendocrine), psychological or behavioral regulation. Recently, a novel complex theory based on evolutionary and developmental biology has been introduced. The Adaptive Calibration Model of stress response employs a broad range of the findings from previous theories of stress and analyzes the responsivity to stress with respect to interindividual differences as a consequence of conditional adaptation – the ability to modify developmental trajectory to match the conditions of the social and physical environment. This review summarizes the contributions of the most important models in the field of stress response and emphasizes the importance of complex analysis of the psycho-physiological mechanisms. Moreover, it outlines the implications for nonpharmacological treatment of stress-related disorders with the application of biofeedback training as a promising tool based on voluntary modification of neurophysiological functions.
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Affiliation(s)
| | - M. MESTANIK
- Biomedical Center Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovakia
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29
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Jovanovic T, Rauch SAM, Rothbaum AO, Rothbaum BO. Using experimental methodologies to assess posttraumatic stress. Curr Opin Psychol 2017; 14:23-28. [DOI: 10.1016/j.copsyc.2016.10.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 10/02/2016] [Accepted: 10/04/2016] [Indexed: 10/20/2022]
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30
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Sippel LM, Allington CE, Pietrzak RH, Harpaz-Rotem I, Mayes LC, Olff M. Oxytocin and Stress-related Disorders: Neurobiological Mechanisms and Treatment Opportunities. CHRONIC STRESS (THOUSAND OAKS, CALIF.) 2017; 1:2470547016687996. [PMID: 28649672 PMCID: PMC5482285 DOI: 10.1177/2470547016687996] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2016] [Revised: 12/14/2016] [Accepted: 12/15/2016] [Indexed: 11/16/2022]
Abstract
Novel pharmacotherapies that improve outcomes for individuals with stress-related psychiatric disorders are needed. The neurohormone oxytocin (OT) is a promising candidate given its influence on the social-emotional brain. In this review, we present an overview of evidence supporting OT's utility for treating major depressive disorder and posttraumatic stress disorder. We first discuss endogenous OT, which research suggests is not yet a reliable biomarker of stress-related disorders. Second, we review effects of intranasal (IN) OT on processes relevant to stress-related disorders in healthy populations (anhedonia, reward processing, psychosocial stress reactivity, fear/anxiety, and social behavior) and their neurobiological mechanisms (e.g., the salience network and hypothalamic-pituitary-adrenal axis). Third, we present the sparse but promising findings from clinical populations, followed by discussion of critical moderating variables to consider in the service of maximizing the therapeutic potential of OT (e.g., patient sex and child maltreatment). We also identify heterogeneous findings and limitations of existing research, including reliance on single-dose studies in psychiatrically healthy samples and unanswered questions regarding the effectiveness of IN drug delivery and dosing schedules. Well-controlled multidose studies including women and measures of potentially moderating variables are sorely needed and would inform our understanding of the utility of OT for preventing and treating stress-related psychiatric disorders.
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Affiliation(s)
- Lauren M. Sippel
- U.S. Department of Veterans Affairs
National Center for Posttraumatic Stress Disorder, Clinical Neurosciences Division,
VA Connecticut Healthcare System, West Haven, CT, USA
- Department of Psychiatry, Yale
University School of Medicine, New Haven, CT, USA
| | | | - Robert H. Pietrzak
- U.S. Department of Veterans Affairs
National Center for Posttraumatic Stress Disorder, Clinical Neurosciences Division,
VA Connecticut Healthcare System, West Haven, CT, USA
- Department of Psychiatry, Yale
University School of Medicine, New Haven, CT, USA
| | - Ilan Harpaz-Rotem
- U.S. Department of Veterans Affairs
National Center for Posttraumatic Stress Disorder, Clinical Neurosciences Division,
VA Connecticut Healthcare System, West Haven, CT, USA
- Department of Psychiatry, Yale
University School of Medicine, New Haven, CT, USA
| | | | - Miranda Olff
- Department of Psychiatry, Academic
Medical Center, University of Amsterdam, The Netherlands
- Arq Psychotrauma Expert Group, Diemen,
The Netherlands
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31
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Costs and benefits of self-efficacy: Differences of the stress response and clinical implications. Neurosci Biobehav Rev 2017; 75:40-52. [PMID: 28143761 DOI: 10.1016/j.neubiorev.2017.01.031] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Revised: 12/22/2016] [Accepted: 01/23/2017] [Indexed: 01/17/2023]
Abstract
Encounters with stressors induce diverse idiosyncratic neuroendocrine, behavioral and psychological reactions across people. Perceived self-efficacy can alter autonomic responses and their effects on mental health. The beneficial effects of self-efficacy in buffering physiological arousal, enhancing performance, and diminishing psychopathological symptoms have been observed in diverse contexts. We show that the role of self-efficacy is not uniformly beneficial, and that higher levels of self-efficacy can sometimes lead to increases in neuroendocrine and psychological stress responses and decreases in performance, a phenomenon that has been widely neglected. We discuss specific conditions under which self-efficacy effects do not uniformly ameliorate or prevent the consequences of stress. These conditions suggest that therapeutic interventions need not always promote self-efficacy in principal. Simultaneously, they to do suggest that keeping self-efficacy high might be disadvantageous or detrimental.
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32
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Olff M, van Zuiden M. Neuroendocrine and neuroimmune markers in PTSD: pre-, peri- and post-trauma glucocorticoid and inflammatory dysregulation. Curr Opin Psychol 2017; 14:132-137. [PMID: 28813312 DOI: 10.1016/j.copsyc.2017.01.001] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 01/03/2017] [Accepted: 01/03/2017] [Indexed: 01/04/2023]
Abstract
We review current knowledge on how posttraumatic stress disorder (PTSD) is associated with dysregulation of the most commonly studied markers of the endocrine and immune systems pre-, peri- and post-trauma. Lower basal cortisol output, enhanced glucocorticoid receptor function, and a proinflammatory state have been most consistently found in PTSD, with considerable variability among studies and participants. Longitudinal research is scarce, but there is converging evidence that biological dysregulation is present before PTSD onset. Biological dysregulation may become more apparent with increasing time since trauma, and may be reversible with and predict effective treatment. However, considering the variability of findings and the complex interplay of these systems with other factors, the current clinical application of these findings remains limited.
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Affiliation(s)
- Miranda Olff
- Department of Psychiatry, Academic Medical Center at the University of Amsterdam, The Netherlands; Arq Psychotrauma Expert Group, Diemen, The Netherlands.
| | - Mirjam van Zuiden
- Department of Psychiatry, Academic Medical Center at the University of Amsterdam, The Netherlands
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33
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Hatherall L, Sánchez C, Morilak DA. Chronic Vortioxetine Treatment Reduces Exaggerated Expression of Conditioned Fear Memory and Restores Active Coping Behavior in Chronically Stressed Rats. Int J Neuropsychopharmacol 2016; 20:316-323. [PMID: 27927740 PMCID: PMC5409129 DOI: 10.1093/ijnp/pyw105] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Accepted: 11/17/2016] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Stress is a risk factor for depression and anxiety disorders, disrupting neuronal processes leading to exaggerated fear and compromised coping behaviors. Current antidepressants are only partially effective. Vortioxetine, a novel multimodal antidepressant, is a serotonin transporter inhibitor; 5-HT3, 5-HT7, and 5-HT1D receptor antagonist; 5-HT1B partial agonist; and 5-HT1A agonist. We have shown that chronic dietary vortioxetine administration reversed stress-induced deficits in cognitive flexibility. In the present studies, we investigated the generality of vortioxetine's effects on other stress-related behavioral changes after different types of chronic stress. METHODS In experiment 1, rats were fear-conditioned by pairing a tone with footshock, then exposed to chronic plus acute prolonged stress. In experiment 2, rats were exposed to chronic unpredictable stress. In both experiments, beginning on day 4 of chronic stress, vortioxetine was given in the diet (24 mg/kg/d). In experiment 1, effects of vortioxetine were tested on stress-induced changes in retention and extinction of cue-conditioned fear, and in experiment 2, on coping behavior on the shock probe defensive burying test after chronic stress. RESULTS Chronic stress exaggerated the expression of conditioned fear memory. Vortioxetine restored fear memory to control levels and rendered extinction in stressed rats comparable with that in controls. In experiment 2, chronic unpredictable stress caused a shift from active to passive coping behavior, and vortioxetine restored active coping. CONCLUSIONS Vortioxetine reduced exaggerated expression of conditioned fear and restored adaptive coping behavior following 2 different types of chronic stress, adding to the evidence of its therapeutic potential in the management of depression and anxiety disorders.
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Affiliation(s)
- Lauren Hatherall
- Department of Pharmacology and Center for Biomedical Neuroscience, University of Texas Health Science Center at San Antonio, San Antonio, Texas (Ms Hatherall and Dr Morilak); Translational Neuropsychiatry Unit, Aarhus University, Aarhus, Denmark (Dr Sánchez)
| | - Connie Sánchez
- Department of Pharmacology and Center for Biomedical Neuroscience, University of Texas Health Science Center at San Antonio, San Antonio, Texas (Ms Hatherall and Dr Morilak); Translational Neuropsychiatry Unit, Aarhus University, Aarhus, Denmark (Dr Sánchez)
| | - David A. Morilak
- Department of Pharmacology and Center for Biomedical Neuroscience, University of Texas Health Science Center at San Antonio, San Antonio, Texas (Ms Hatherall and Dr Morilak); Translational Neuropsychiatry Unit, Aarhus University, Aarhus, Denmark (Dr Sánchez)
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34
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Egle UT, Franz M, Joraschky P, Lampe A, Seiffge-Krenke I, Cierpka M. [Health-related long-term effects of adverse childhood experiences - an update]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2016; 59:1247-54. [PMID: 27580599 DOI: 10.1007/s00103-016-2421-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
In the last decade strong empirical evidence from several long-term studies supports the conclusion that physical and sexual abuse as well as emotional deprivation in childhood make people significantly more vulnerable to mental and functional disorders across their lifetime. Additionally, an increased vulnerability to several somatic disorders (cardiovascular disorders, type-2-diabetes, hepatitis, chronic obstructive pulmonary disease (COPD), immunological and pain disorders, pharynx and lung cancer) was demonstrated - most of them with a reduced life expectancy. A review of the current research will be presented that outlines the underlying developmental neurobiological and psychological mechanisms mediating these long-term effects. There is now sufficient evidence about familial risk constellations that demonstrates the well-documented impact of specific prevention strategies by several model projects. Only by establishing these strategies, future enormous health-related burdens and high economic costs (unfitness to work, early retirement) can presumably be limited.
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Affiliation(s)
- Ulrich T Egle
- Klinik Barmelweid, Aarau, Schweiz. .,, Wiesentalstr. 48, 79111, Freiburg, Deutschland.
| | - Matthias Franz
- Klinisches Institut für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland
| | - Peter Joraschky
- Klinik für Psychotherapie und Psychosomatik, Universitätsklinikums Dresden, Dresden, Deutschland
| | - Astrid Lampe
- Klinik für Medizinische Psychologie, Universitätsklinikum Innsbruck, Innsbruck, Österreich
| | - Inge Seiffge-Krenke
- Abt. Entwicklungspsychologie, Psychologisches Institut, Johannes Gutenberg-Universität Mainz, Mainz, Deutschland
| | - Manfred Cierpka
- Institut für Psychosoziale Prävention, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
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Chiang JJ, Tsai KM, Park H, Bower JE, Almeida DM, Dahl RE, Irwin MR, Seeman TE, Fuligni AJ. Daily family stress and HPA axis functioning during adolescence: The moderating role of sleep. Psychoneuroendocrinology 2016; 71:43-53. [PMID: 27235639 PMCID: PMC5718343 DOI: 10.1016/j.psyneuen.2016.05.009] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Revised: 05/05/2016] [Accepted: 05/06/2016] [Indexed: 01/09/2023]
Abstract
The present study examined the moderating role of sleep in the association between family demands and conflict and hypothalamic-pituitary-adrenal (HPA) axis functioning in a sample of ethnically diverse adolescents (n=316). Adolescents completed daily diary reports of family demands and conflict for 15 days, and wore actigraph watches during the first 8 nights to assess sleep. Participants also provided five saliva samples for 3 consecutive days to assess diurnal cortisol rhythms. Regression analyses indicated that sleep latency and efficiency moderated the link between family demands and the cortisol awakening response. Specifically, family demands were related to a smaller cortisol awakening response only among adolescents with longer sleep latency and lower sleep efficiency. These results suggest that certain aspects of HPA axis functioning may be sensitive to family demands primarily in the context of longer sleep latency and lower sleep efficiency.
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Affiliation(s)
- Jessica J. Chiang
- University of California, Los Angeles, Department of Psychology, Los Angeles, CA 90095, USA,Corresponding author at: Department of Psychology, University of California, Los Angeles, 1285 Franz Hall, Los Angeles, CA 90095, USA. (J.J. Chiang)
| | - Kim M. Tsai
- California State San Marcos, Department of Psychology, San Marcos, CA 92096, USA
| | - Heejung Park
- Bryn Mawr College, Department of Psychology, Bryn Mawr, PA 19010, USA
| | - Julienne E. Bower
- University of California, Los Angeles, Department of Psychology, Los Angeles, CA 90095, USA,University of California, Los Angeles, Department of Psychiatry and Biobehavioral Sciences, Los Angeles, CA 90095, USA
| | - David M. Almeida
- Pennsylvania State University, Department of Human Development and Family Studies, University Park, PA 16802, USA
| | - Ronald E. Dahl
- University of California, Berkeley, Institute of Human Development, Berkeley, CA 94720, USA
| | - Michael R. Irwin
- University of California, Los Angeles, Department of Psychology, Los Angeles, CA 90095, USA,University of California, Los Angeles, Department of Psychiatry and Biobehavioral Sciences, Los Angeles, CA 90095, USA,University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, CA 90095, USA
| | - Teresa E. Seeman
- University of California, Los Angeles, Division of Geriatrics, Los Angeles, CA 90095, USA
| | - Andrew J. Fuligni
- University of California, Los Angeles, Department of Psychology, Los Angeles, CA 90095, USA,University of California, Los Angeles, Department of Psychiatry and Biobehavioral Sciences, Los Angeles, CA 90095, USA
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Leinweber J, Creedy DK, Rowe H, Gamble J. Responses to birth trauma and prevalence of posttraumatic stress among Australian midwives. Women Birth 2016; 30:40-45. [PMID: 27425165 DOI: 10.1016/j.wombi.2016.06.006] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 06/15/2016] [Accepted: 06/24/2016] [Indexed: 11/17/2022]
Abstract
BACKGROUND Midwives frequently witness traumatic birth events. Little is known about responses to birth trauma and prevalence of posttraumatic stress among Australian midwives. AIM To assess exposure to different types of birth trauma, peritraumatic reactions and prevalence of posttraumatic stress. METHODS Members of the Australian College of Midwives completed an online survey. A standardised measure assessed posttraumatic stress symptoms. FINDINGS More than two-thirds of midwives (67.2%) reported having witnessed a traumatic birth event that included interpersonal care-related trauma features. Midwives recalled strong emotions during or shortly after witnessing the traumatic birth event, such as feelings of horror (74.8%) and guilt (65.3%) about what happened to the woman. Midwives who witnessed birth trauma that included care-related features were significantly more likely to recall peritraumatic distress including feelings of horror (OR=3.89, 95% CI [2.71, 5.59]) and guilt (OR=1.90, 95% CI [1.36, 2.65]) than midwives who witnessed non-interpersonal birth trauma. 17% of midwives met criteria for probable posttraumatic stress disorder (95% CI [14.2, 20.0]). Witnessing abusive care was associated with more severe posttraumatic stress than other types of trauma. DISCUSSION Witnessing care-related birth trauma was common. Midwives experience strong emotional reactions in response to witnessing birth trauma, in particular, care-related birth trauma. Almost one-fifth of midwives met criteria for probable posttraumatic stress disorder. CONCLUSION Midwives carry a high psychological burden related to witnessing birth trauma. Posttraumatic stress should be acknowledged as an occupational stress for midwives. The incidence of traumatic birth events experienced by women and witnessed by midwives needs to be reduced.
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Affiliation(s)
- Julia Leinweber
- Menzies Health Institute Queensland, Griffith University, Logan Campus, University Drive, Meadowbrook, QLD 4131, Australia.
| | - Debra K Creedy
- Menzies Health Institute Queensland, Griffith University, Logan Campus, University Drive, Meadowbrook, QLD 4131, Australia.
| | - Heather Rowe
- School of Public Health and Preventive Medicine, Monash University, The Alfred Campus, Level 1 549 St Kilda Road, Melbourne, VIC 3004, Australia.
| | - Jenny Gamble
- Menzies Health Institute Queensland, Griffith University, Logan Campus, University Drive, Meadowbrook, QLD 4131, Australia.
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Challenges in the retrospective assessment of trauma: comparing a checklist approach to a single item trauma experience screening question. BMC Psychiatry 2016; 16:20. [PMID: 26830818 PMCID: PMC4736664 DOI: 10.1186/s12888-016-0720-1] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Accepted: 01/18/2016] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Research on trauma and its impact on mental health typically relies on self-reports which can be influenced by recall bias and an individual's subjective interpretation of events. This study aims to compare responses on a checklist of life events with a trauma experience screening question, both of which assessed trauma experience retrospectively. METHODS A community sample of adults were asked about life events from a checklist before asking them whether they ever had a trauma experience, i.e. "an event that either puts them or someone close to them at risk of serious harm or death". RESULTS Less than half of the sample who reported at least one life event on the checklist that qualified as a trauma reported a trauma experience that they perceived put them or close others at risk of serious harm. Women responders, those reporting early life traumas, and a greater number of lifetime trauma events were more likely to report a trauma experience. Current symptoms of Common Mental Disorder did not account for differences in reporting of trauma experiences. CONCLUSIONS Epidemiological approaches which require participants to make subjective judgement on the severity of the trauma experience will capture individual differences that we have shown are influenced by gender and previous trauma experience.
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Salivary biomarkers of neural hypervigilance in trauma-exposed women. Psychoneuroendocrinology 2016; 63:17-25. [PMID: 26398002 PMCID: PMC4695293 DOI: 10.1016/j.psyneuen.2015.09.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Revised: 09/06/2015] [Accepted: 09/07/2015] [Indexed: 01/26/2023]
Abstract
OBJECTIVES More than half of all adults will be exposed to a traumatic event at some point in their lives, yet we do not yet have reliable biomarkers to help predict who experiences trauma-related symptoms in response to exposure. We tested the utility of salivary cortisol and salivary alpha amylase as markers of (1) neural reactivity to negative affective information and (2) neural hypervigilance in the absence of threat. PARTICIPANTS 20 women (mean age 23.6 +/- 5.8 years) with a history of trauma exposure. MEASURES Salivary cortisol and alpha amylase reactivity were measured in response to a trauma reminder during a clinical interview. Neural reactivity to novel and familiar affective scenes was measured in a later session using functional magnetic resonance imaging. RESULTS Salivary alpha amylase, but not cortisol, increased in response to the trauma reminder. Salivary alpha amylase reactivity was associated with neural reactivity in the salience network in response to novel negative scenes and neural hypervigilance as indexed by reactivity to novel neutral scenes. CONCLUSIONS Salivary alpha amylase might serve as a more reliable marker of trauma-related reactivity to negative affective information, and also as a marker of hypervigilance in the absence of threatening information.
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Jett JD, Boley AM, Girotti M, Shah A, Lodge DJ, Morilak DA. Antidepressant-like cognitive and behavioral effects of acute ketamine administration associated with plasticity in the ventral hippocampus to medial prefrontal cortex pathway. Psychopharmacology (Berl) 2015; 232:3123-33. [PMID: 25986748 PMCID: PMC4536154 DOI: 10.1007/s00213-015-3957-3] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 05/05/2015] [Indexed: 12/14/2022]
Abstract
RATIONALE Acute low-dose administration of the N-methyl-D-aspartate (NMDA) receptor antagonist, ketamine, produces rapid and sustained antidepressant-like effects in humans and rodents. Recently, we found that the long-lasting effect of ketamine on the forced swim test requires ventral hippocampal (vHipp) activity at the time of drug administration. The medial prefrontal cortex (mPFC), a target of the vHipp dysregulated in depression, is important for cognitive flexibility and response strategy selection. Deficits in cognitive flexibility, the ability to modify thoughts and behaviors in response to changes in the environment, are associated with depression. We have shown that chronic stress impairs cognitive flexibility on the attentional set-shifting test (AST) and induces a shift from active to passive response strategies on the shock-probe defensive burying test (SPDB). OBJECTIVE In this study, we tested the effects of ketamine on chronic stress-induced changes in cognitive flexibility and coping behavior on the AST and SPDB, respectively. Subsequently, we investigated vHipp-mPFC plasticity as a potential mechanism of ketamine's therapeutic action. RESULTS Ketamine reversed deficits in cognitive flexibility and restored active coping behavior in chronically stressed rats. Further, high frequency stimulation in the vHipp replicated ketamine's antidepressant-like effects on the forced swim test and AST, but not on the SPDB. CONCLUSION These results show that ketamine restores cognitive flexibility and coping response strategy compromised by stress. Activity in the vHipp-mPFC pathway may represent a neural substrate for some of the antidepressant-like behavioral effects of ketamine, including cognitive flexibility, but other circuits may mediate the effects of ketamine on coping response strategy.
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Affiliation(s)
- Julianne D Jett
- Department of Pharmacology and Center for Biomedical Neuroscience, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, MC 7764, San Antonio, TX, 78229-3900, USA
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Becker C, Roos V, Coetzee H. Disaster recovery experiences of a South African rural farming community. JOURNAL OF PSYCHOLOGY IN AFRICA 2015. [DOI: 10.1080/14330237.2015.1065051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Christiaan Becker
- Africa Unit for Transdisciplinary Health Research, North-West University, South Africa
| | - Vera Roos
- Africa Unit for Transdisciplinary Health Research, North-West University, South Africa
| | - Hendri Coetzee
- Africa Unit for Transdisciplinary Health Research, North-West University, South Africa
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Bae SM, Hyun MH, Ra YS. Mediating effects of forgiveness and emotion-focused coping on post-traumatic stress disorder symptoms caused by physical injury and perceived threat. Asia Pac Psychiatry 2015; 7:164-72. [PMID: 24898771 DOI: 10.1111/appy.12142] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Accepted: 04/24/2014] [Indexed: 01/08/2023]
Abstract
INTRODUCTION The purpose of this study was to develop and test a model (including cognitive appraisal, coping strategy, and forgiveness variables) predicting post-traumatic stress disorder (PTSD) in 127 adults who were involved in traffic accidents. METHODS Participants were recruited from the inpatient and outpatient departments of three urban hospitals in South Korea. We utilized the path analysis to identify the best fitting model to our data. RESULTS Path analysis showed that the baseline model compared with an alternative model was more appropriate for our data. Our results indicated that the severity of physical injury was directly related to the participants' perceived threat. The perceived threat had direct and indirect effects on PTSD symptoms through forgiveness and emotion-focused coping strategies. One of the significant findings was that victims' forgiveness of the person at fault for the accident reduced their PTSD symptoms. The severity of physical injury was not related directly to PTSD symptoms. DISCUSSION Our study demonstrates that victim's forgiveness of the person at fault in a traumatic situation can be useful in helping their recovery after trauma and the forgiveness process may be applied to traffic accident situations as well as other types of interpersonal trauma.
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Affiliation(s)
- Sung-Man Bae
- Department of Psychiatry, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, South Korea; Department of Psychology, Chung-Ang University, Seoul, South Korea
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Payne P, Crane-Godreau MA. The preparatory set: a novel approach to understanding stress, trauma, and the bodymind therapies. Front Hum Neurosci 2015; 9:178. [PMID: 25883565 PMCID: PMC4381623 DOI: 10.3389/fnhum.2015.00178] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Accepted: 03/17/2015] [Indexed: 01/09/2023] Open
Abstract
Basic to all motile life is a differential approach/avoid response to perceived features of environment. The stages of response are initial reflexive noticing and orienting to the stimulus, preparation, and execution of response. Preparation involves a coordination of many aspects of the organism: muscle tone, posture, breathing, autonomic functions, motivational/emotional state, attentional orientation, and expectations. The organism organizes itself in relation to the challenge. We propose to call this the "preparatory set" (PS). We suggest that the concept of the PS can offer a more nuanced and flexible perspective on the stress response than do current theories. We also hypothesize that the mechanisms of body-mind therapeutic and educational systems (BTES) can be understood through the PS framework. We suggest that the BTES, including meditative movement, meditation, somatic education, and the body-oriented psychotherapies, are approaches that use interventions on the PS to remedy stress and trauma. We discuss how the PS can be adaptive or maladaptive, how BTES interventions may restore adaptive PS, and how these concepts offer a broader and more flexible view of the phenomena of stress and trauma. We offer supportive evidence for our hypotheses, and suggest directions for future research. We believe that the PS framework will point to ways of improving the management of stress and trauma, and that it will suggest directions of research into the mechanisms of action of BTES.
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Rauch SAM, King AP, Abelson J, Tuerk PW, Smith E, Rothbaum BO, Clifton E, Defever A, Liberzon I. Biological and symptom changes in posttraumatic stress disorder treatment: a randomized clinical trial. Depress Anxiety 2015; 32:204-12. [PMID: 25639570 DOI: 10.1002/da.22331] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Revised: 09/30/2014] [Accepted: 10/10/2014] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Understanding cognitive and biological mechanisms of PTSD treatment can help refine treatments and increase rates of response. METHODS Thirty-six veterans with PTSD were randomly assigned to receive Prolonged exposure therapy (PE) or Present-Centered therapy (PCT). We examined symptoms, trauma-related cognitions, and two indices of HPA axis function (cortisol awakening response and cortisol response to a script-driven imagery task). RESULTS Thirty veterans started treatment and 26 completed. PE resulted in significantly more symptom reduction than PCT (P = .008). High treatment responders collapsed across treatments showed nominally higher cortisol levels measured at pretreatment 30 min after trauma script exposure compared to low responders (P = .08). At midtreatment, high treatment responders showed higher cortisol levels throughout the imagery task (Ps = .03-.04). There were no differences between high and low treatment responders at posttreatment. Thoughts of incompetence (F (1.6, 35.8) = 16.8, P = .000) and a dangerous world (F (1.3, 29.9) = 8.2, P = .004) significantly improved over time in high treatment responders but showed no change in low responders. Script-associated cortisol response prior to treatment and reductions in thoughts of incompetence accounted for 83% of the variance in reductions in PTSD severity with PE. CONCLUSIONS Both increased cortisol response to personal trauma script prior to PTSD therapy and reductions in cognitive symptoms of PTSD were significantly and uniquely related to reductions in the core symptoms of PTSD in PE. However, contrary to our hypotheses, cortisol measures were not related to cognitive changes.
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Affiliation(s)
- Sheila A M Rauch
- PTSD Clinical Team, VA Ann Arbor Healthcare System, Ann Arbor, Michigan; Department of Psychiatry, University of Michigan Medical School, Ann Arbor, Michigan
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Abstract
Posttraumatic stress disorder (PTSD) now sits within the newly created "Trauma- and Stressor-Related Disorders" section of the Diagnostic and Statistical Manual of Mental Disorders (fifth edition; DSM-5). Through the refinement and expansion of diagnostic criteria, the DSM-5 version better clarifies the broad and pervasive effects of trauma on functioning, as well as the impact of development on trauma reactions. Aggressive and dissociative symptoms are more thoroughly characterized, reflecting increasing evidence that reactions to trauma often reach beyond the domains of fear and anxiety (these latter domains were emphasized in DSM-IV). These revised criteria are supported by decades of preclinical and clinical research quantifying traumatic stress-induced changes in neurobiological and behavioral function. Several features of the DSM-5 PTSD criteria are similarly and consistently represented in preclinical animal models and humans following exposure to extreme stress. In rodent models, for example, increases in anxiety-like, helplessness, or aggressive behavior, along with disruptions in circadian/neurovegetative function, are typically induced by severe, inescapable, and uncontrollable stress. These abnormalities are prominent features of PTSD and can help us in understanding the pathophysiology of this and other stress-associated psychiatric disorders. In this article we examine some of the changes to the diagnostic criteria of PTSD in the context of trauma-related neurobiological dysfunction, and discuss implications for how preclinical data can be useful in current and future clinical conceptualizations of trauma and trauma-related psychiatric disorders.
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Strahler J, Ziegert T. Psychobiological stress response to a simulated school shooting in police officers. Psychoneuroendocrinology 2015; 51:80-91. [PMID: 25290348 DOI: 10.1016/j.psyneuen.2014.09.016] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Revised: 09/02/2014] [Accepted: 09/17/2014] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Police work is one of the most demanding professions with various sources of high occupational stress. Among the most demanding tasks are amok situations, such as school shootings. Hardly anything is known about endocrine and cardiovascular markers in safety professionals during emergency situations in real life and how this relates to stress perception and management. This study will therefore explore police officers' stress responses to a reality-based school shooting simulation assessing neuroendocrine, cardiovascular, and psychological stress markers. METHODS A convenience sample of 50 police officers (39.5 ± 8.7 yrs, 9 women) participating in a basic or refresher amok training session for the German uniformed and criminal police were recruited. Saliva samples were collected shortly before the simulation task (school shooting), immediately after, 20 and 45 min after finishing the task for the assessment of cortisol and alpha-amylase (sAA), as markers of the hypothalamic-pituitary-adrenal axis and the autonomic nervous system, respectively. Heart rate (variability) was assessed continuously. Officers rated their actual mood right before and 10 min after the simulation. Subjective experience of task stressfulness was assessed minutes after finishing the simulation. RESULTS Overall, the simulated school shooting did not result in changes of mood, tiredness, or calmness but higher restlessness was experienced during the basic training, which was also experienced as more controllable. Female officers reported to experience more strain and anxiety. Cortisol showed highest levels at the beginning of the training and steadily decreasing values thereafter. In contrast, sAA increased substantially right after the simulation with officers on the front position showing most pronounced changes. Cardiovascular reactivity was highest in officers acting on the side positions while advancing to find the suspect. Furthermore higher self-efficacy as well as, by trend, controllability and relevance of results correlated with cardiovascular measures. DISCUSSION Autonomic but not endocrine stress markers increased to a simulated school shooting, which were further related to the subjective experience of the simulation. Our results provide a more in-depth picture of stress responses in such situations, which will in the long run raise the possibility to refine training programs, design more effective stress-management strategies for these critical incidents, and improve performance but also coping with work-related stress.
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Affiliation(s)
- Jana Strahler
- Clinical Biopsychology, University of Marburg, Marburg, Germany.
| | - Thomas Ziegert
- University of Applied Police Science, Rothenburg/O.L., Germany
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Christiansen DM, Olff M, Elklit A. Parents bereaved by infant death: sex differences and moderation in PTSD, attachment, coping and social support. Gen Hosp Psychiatry 2014; 36:655-61. [PMID: 25218784 DOI: 10.1016/j.genhosppsych.2014.07.012] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2014] [Revised: 07/25/2014] [Accepted: 07/29/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Parents bereaved by infant death experience a wide range of symptomatology, including posttraumatic stress disorder (PTSD) that may persist for years after the loss. Little research has been conducted on PTSD in fathers who have lost an infant. Mothers report most symptoms to a greater extent than fathers, but not much is known about other sex differences following infant death. METHOD The present cross-sectional study examined sex differences in PTSD and sex differences in the relationship between PTSD severity and related variables. Subjects were 361 mothers and 273 fathers who had lost an infant either late in pregnancy, during birth or in the first year of life. Participants filled out questionnaires between 1.2 months and 18 years after the loss (M = 3.4 years). RESULTS Mothers reported significantly more PTSD symptoms, attachment anxiety, emotion-focused coping and feeling let down, but significantly lower levels of attachment avoidance than fathers. Attachment anxiety, attachment avoidance and emotion-focused coping were significantly more strongly associated with PTSD severity in mothers than fathers, but only when examined alone. When all variables and time since the loss were examined together, there were no longer any significant moderation effects of sex. CONCLUSIONS Persistent posttraumatic symptomatology exists in both mothers and fathers long after the loss. There are several sex differences in severity and correlates of PTSD, and a few moderation effects were identified for attachment and emotion-focused coping. Overall, more similarities than differences were found between mothers and fathers in the associations between PTSD and covariates.
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Affiliation(s)
- Dorte M Christiansen
- Department of Psychology, University of Aarhus, Bartholins Allé 9, 8000 Aarhus C, Denmark; National Centre for Psychotraumatology, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark.
| | - Miranda Olff
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Meibergdreef 5, 1105 AZ, Amsterdam, The Netherlands; Arq Psychotrauma Expert Group, Nienoord 5, 1112 XE Diemen, the Netherlands.
| | - Ask Elklit
- National Centre for Psychotraumatology, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark; Psychology Research Institute, School of Psychology, Faculty of Life and Health Sciences, University of Ulster, Londonderry, United Kingdom.
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Saliva pH as a biomarker of exam stress and a predictor of exam performance. J Psychosom Res 2014; 77:420-5. [PMID: 25439341 DOI: 10.1016/j.jpsychores.2014.07.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Revised: 07/01/2014] [Accepted: 07/04/2014] [Indexed: 11/20/2022]
Abstract
BACKGROUND Salivary pH is regulated by the sympathetic and parasympathetic nervous system; therefore, it may serve as a biomarker of stress. AIMS To assess the associations between the cognitive and emotional dimensions of exam stress and pH levels, and the predictability of salivary pH in relation to test performance. METHODS A prospective study. Eighty-three nursing students answered a questionnaire on stress appraisals, experienced stress, test anxiety (including worry and emotionality subscales) and health behaviors, and gave a saliva sample for measuring pH on the morning of their first term exam and three months later. Their performance on the test (grades) was also recorded. RESULTS Levels of pH in saliva were higher (levels of acidity were lower) in the post exam compared to the exam period, in parallel to lower threat appraisal, experienced stress, and test anxiety levels post exam. Controlling for smoking, physical activity and working hours per week, pH levels at both time points were predicted by appraised threat regarding the exam situation, experienced stress, and the emotionality dimension of test anxiety. pH at Time 1 predicted performance on the exams and mediated the associations of experienced stress and emotionality subscale with test performance. CONCLUSIONS the present study indicates that pH levels may serve as a reliable, accessible and inexpensive means by which to assess the degree of physiological reactions to exams and other naturalistic stressors.
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Andreotti C, Root JC, Ahles TA, McEwen BS, Compas BE. Cancer, coping, and cognition: a model for the role of stress reactivity in cancer-related cognitive decline. Psychooncology 2014; 24:617-23. [PMID: 25286084 DOI: 10.1002/pon.3683] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2014] [Revised: 07/15/2014] [Accepted: 08/20/2014] [Indexed: 12/29/2022]
Abstract
BACKGROUND Cognitive decline and accompanying neurological changes associated with non-CNS cancer diagnosis and treatment have been increasingly identified in a subset of patients. Initially believed to be because of neurotoxic effects of chemotherapy exposure, observation of cognitive decline in patients not treated with chemotherapy, cancer-diagnosed individuals prior to treatment, and patients receiving alternative treatment modalities (surgery, endocrine therapy, and radiation) has led to the investigation of additional potential etiologies and moderating factors. Stressful experiences have long been posited as a contributor to these cognitive changes. Through reciprocal connectivity with peripheral systems, the brain maintains a dynamic circuitry to adapt to stress (allostasis). However, overuse of this system leads to dysregulation and contributes to pathophysiology (allostatic load). At this time, little research has been conducted to systematically examine the role of allostatic load in cancer-related cognitive dysfunction. METHODS AND RESULTS Here, we integrate theories of stress biology, neuropsychology, and coping and propose a model through which individuals with a high level of allostatic load at diagnosis may be particularly vulnerable to the neurocognitive effects of cancer. CONCLUSIONS Opportunities for future research to test and extend proposed mechanisms are discussed in addition to points of prevention and intervention based on individual variation in stress reactivity and coping skills.
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Affiliation(s)
- Charissa Andreotti
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - James C Root
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Tim A Ahles
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | | | - Bruce E Compas
- Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, USA
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49
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McGuire TM, Lee CW, Drummond PD. Potential of eye movement desensitization and reprocessing therapy in the treatment of post-traumatic stress disorder. Psychol Res Behav Manag 2014; 7:273-83. [PMID: 25302027 PMCID: PMC4189702 DOI: 10.2147/prbm.s52268] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Post-traumatic stress disorder (PTSD) continues to attract both empirical and clinical interest due to its complex symptom profile and the underlying processes involved. Recently, research attention has been focused on the types of memory processes involved in PTSD and hypothesized neurobiological processes. Complicating this exploration, and the treatment of PTSD, are underlying comorbid disorders, such as depression, anxiety, and substance use disorders. Treatment of PTSD has undergone further reviews with the introduction of eye movement desensitization and reprocessing (EMDR). EMDR has been empirically demonstrated to be as efficacious as other specific PTSD treatments, such as trauma-focused cognitive behavioral therapy. There is emerging evidence that there are different processes underlying these two types of trauma treatment and some evidence that EMDR might have an efficiency advantage. Current research and understanding regarding the processes of EMDR and the future direction of EMDR is presented.
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Affiliation(s)
- Tracy M McGuire
- School of Psychology, Murdoch University, Perth, WA, Australia
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50
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Donlon K, Jones RT. Applying a traumatic stress approach to understanding PCS following pediatric mild TBI. Child Neuropsychol 2014; 21:803-22. [PMID: 25103672 DOI: 10.1080/09297049.2014.944491] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Pediatric traumatic brain injury is a significant public health concern affecting hundreds of thousands of children each year. The majority of children who sustain traumatic brain injuries are classified as having a mild traumatic brain injury, and a subset of these children go on to experience persistent physical, cognitive, and emotional symptoms. These symptoms, known as postconcussive symptoms, can endure for months and even years after injury. The outcomes of mild traumatic brain injury are variable and not well understood for a small percentage of children who experience persistent symptoms. The current article explores the potential influence of children's posttraumatic stress symptoms on persistent postconcussive symptoms. Despite the high incidence of posttraumatic stress symptoms after pediatric accidental injury, they have not yet been identified as an important factor for consideration in the understanding of pediatric postconcussive outcomes. The article will review the literature on posttraumatic stress and postconcussive symptoms after pediatric injury and consider neurobiological and cognitive factors to propose a model explaining a pathway through which posttraumatic stress reactions may serve as the mechanism for the expression and maintenance of postconcussive symptoms after mild traumatic brain injury. The clinical implications for the proposed relationship between posttraumatic stress symptoms and postconcussive symptoms are considered prior to the conclusion of the article, which acknowledges limitations in the current literature and provides suggestions for future research.
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Affiliation(s)
- Katharine Donlon
- a Department of Psychology , Virginia Polytechnic Institute and State University , Blacksburg , VA , USA
| | - Russell T Jones
- a Department of Psychology , Virginia Polytechnic Institute and State University , Blacksburg , VA , USA
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