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Misiak B, Frydecka D, Piotrowski P, Rembacz K, Bielawski T, Samochowiec J, Tyburski E, Łaczmański Ł, Pawlak E. Coping styles do not interact with the association between childhood trauma history and the immune-inflammatory phenotype of schizophrenia: Findings from a cross-sectional study. Psychoneuroendocrinology 2024; 166:107062. [PMID: 38678733 DOI: 10.1016/j.psyneuen.2024.107062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 04/19/2024] [Accepted: 04/21/2024] [Indexed: 05/01/2024]
Abstract
Adverse childhood experiences (ACEs) are a well-known risk factor of schizophrenia. Moreover, individuals with schizophrenia are likely to use maladaptive stress coping strategies. Although it has been reported that a history of ACEs might be associated with a pro-inflammatory phenotype in patients with schizophrenia, the interacting effect of coping styles on this association has not been tested so far. In the present study, we aimed to investigate the levels of immune-inflammatory markers in patients with schizophrenia and healthy controls (HCs), taking into consideration a history of ACEs and coping strategies. Participants included 119 patients with schizophrenia and 120 HCs. Serum levels of 26 immune-inflammatory markers were determined. A history of any categories of ACEs was significantly more frequent in patients with schizophrenia. Moreover, patients with schizophrenia were significantly more likely to use emotion-focused coping and less likely to use active coping strategies compared to HCs. The levels of interleukin(IL)-6, RANTES, and tumor necrosis factor-α (TNF-α), appeared to be elevated in patients with schizophrenia after adjustment for potential confounding factors in all tested models. Participants reporting a history of any ACEs had significantly higher levels of TNF-α and IL-6. No significant main and interactive effects of active strategies as the predominant coping on immune-inflammatory markers with altered levels in patients with schizophrenia were found. Findings from the present study indicate that ACEs are associated with elevated TNF-α and IL-6 levels regardless of schizophrenia diagnosis and predominant coping styles.
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Affiliation(s)
- Błażej Misiak
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland.
| | - Dorota Frydecka
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | - Patryk Piotrowski
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | - Krzysztof Rembacz
- Laboratory of Immunopathology, Department of Experimental Therapy, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wroclaw, Poland
| | - Tomasz Bielawski
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | - Jerzy Samochowiec
- Department of Psychiatry, Pomeranian Medical University, Szczecin, Poland
| | - Ernest Tyburski
- Department of Psychiatry, Pomeranian Medical University, Szczecin, Poland
| | - Łukasz Łaczmański
- Laboratory of Genomics & Bioinformatics, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wroclaw, Poland
| | - Edyta Pawlak
- Laboratory of Immunopathology, Department of Experimental Therapy, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wroclaw, Poland
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Koga K, Hara M, Shimanoe C, Nishida Y, Furukawa T, Iwasaka C, Tanaka K, Otonari J, Ikezaki H, Kubo Y, Kato Y, Tamura T, Hishida A, Matsuo K, Ito H, Nakamura Y, Kusakabe M, Nishimoto D, Shibuya K, Suzuki S, Watanabe M, Ozaki E, Matsui D, Kuriki K, Takashima N, Kadota A, Arisawa K, Katsuura-Kamano S, Takeuchi K, Wakai K. Association of perceived stress and coping strategies with the renal function in middle-aged and older Japanese men and women. Sci Rep 2022; 12:291. [PMID: 34997128 PMCID: PMC8742036 DOI: 10.1038/s41598-021-04324-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 12/20/2021] [Indexed: 11/10/2022] Open
Abstract
Elucidating the risk factors for chronic kidney disease is important for preventing end-stage renal disease and reducing mortality. However, little is known about the roles of psychosocial stress and stress coping behaviors in deterioration of the renal function, as measured by the estimated glomerular filtration rate (eGFR). This cross-sectional study of middle-aged and older Japanese men (n = 31,703) and women (n = 38,939) investigated whether perceived stress and coping strategies (emotional expression, emotional support seeking, positive reappraisal, problem solving, and disengagement) were related to the eGFR, with mutual interactions. In multiple linear regression analyses adjusted for age, area, lifestyle factors, and psychosocial variables, we found a significant inverse association between perceived stress and the eGFR in men (Ptrend = 0.02), but not women. This male-specific inverse association was slightly attenuated after adjustment for the history of hypertension and diabetes and was more evident in lower levels of emotional expression (Pinteraction = 0.003). Unexpectedly, problem solving in men (Ptrend < 0.001) and positive reappraisal in women (Ptrend = 0.002) also showed an inverse association with the eGFR. Perceived stress may affect the eGFR, partly through the development of hypertension and diabetes. The unexpected findings regarding coping strategies require the clarification of the underlying mechanisms, including the hormonal and immunological aspects.
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Affiliation(s)
- Kayoko Koga
- Department of Preventive Medicine, Faculty of Medicine, Saga University, Saga, Japan. .,Department of Nursing, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
| | - Megumi Hara
- Department of Preventive Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Chisato Shimanoe
- Department of Preventive Medicine, Faculty of Medicine, Saga University, Saga, Japan.,Department of Pharmacy, Saga University Hospital, Saga, Japan
| | - Yuichiro Nishida
- Department of Preventive Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Takuma Furukawa
- Department of Preventive Medicine, Faculty of Medicine, Saga University, Saga, Japan.,Advanced Comprehensive Functional Recovery Center, Saga University Hospital, Saga, Japan
| | - Chiharu Iwasaka
- Department of Preventive Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Keitaro Tanaka
- Department of Preventive Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Jun Otonari
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Psychosomatic Medicine, International University of Health and Welfare Narita Hospital, Chiba, Japan
| | - Hiroaki Ikezaki
- Department of Comprehensive General Internal Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Yoko Kubo
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yasufumi Kato
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Takashi Tamura
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Asahi Hishida
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Keitaro Matsuo
- Division of Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan.,Division of Cancer Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hidemi Ito
- Division of Cancer Information and Control, Aichi Cancer Center Research Institute, Nagoya, Japan.,Division of Descriptive Cancer Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yohko Nakamura
- Cancer Prevention Center, Chiba Cancer Center Research Institute, Chiba, Japan
| | - Miho Kusakabe
- Cancer Prevention Center, Chiba Cancer Center Research Institute, Chiba, Japan
| | - Daisaku Nishimoto
- Department of International Island and Community Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.,School of Health Sciences, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Keiichi Shibuya
- Department of International Island and Community Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.,Department of Intensive Care Medicine, Kagoshima University Hospital, Kagoshima, Japan
| | - Sadao Suzuki
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Miki Watanabe
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Etsuko Ozaki
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Daisuke Matsui
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Kiyonori Kuriki
- Laboratory of Public Health, Division of Nutritional Sciences, School of Food and Nutritional Sciences, University of Shizuoka, Shizuoka, Japan
| | - Naoyuki Takashima
- Department of Public Health, Kindai University Faculty of Medicine, Osaka-Sayama, Japan.,Department of Public Health, Shiga University of Medical Science, Otsu, Japan
| | - Aya Kadota
- Department of Public Health, Shiga University of Medical Science, Otsu, Japan
| | - Kokichi Arisawa
- Department of Preventive Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Sakurako Katsuura-Kamano
- Department of Preventive Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Kenji Takeuchi
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kenji Wakai
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
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3
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Salomon RE, Tan KR, Vaughan A, Adynski H, Muscatell KA. Minimally-invasive methods for examining biological changes in response to chronic stress: A scoping review. Int J Nurs Stud 2020; 103:103419. [PMID: 31945603 DOI: 10.1016/j.ijnurstu.2019.103419] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 09/05/2019] [Accepted: 09/06/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Nurse researchers are increasingly interested in incorporating biological indicators related to chronic stress, or repeated or constant exposure to psychological stressors. Minimally invasive collection methods may improve access to vulnerable populations. OBJECTIVE To map biological indicators measured through minimally invasive methods investigating biological changes in response to chronic stress. DESIGN, DATA SOURCES, AND METHODS The paper seeks to answer two questions: What are the characteristics of the minimally-invasive methods used to measure the biological correlates of chronic stress? What are the limitations regarding the use of the minimally-invasive methods and/or biological indicators identified above? Authors completed a scoping review following guidelines from the Joanna Briggs Institute Manual and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for Scoping Reviews. A literature search was completed in PubMed, PsycINFO, and Scopus. 2518 articles were screened and 145 studies were included. Data were extracted using a standardized extraction tool, compiled, and coded. RESULTS Studies included minimally-invasive methods to measure the hypothalamic-adrenal-pituitary axis (N = 173), immune and inflammatory markers (N = 118), and adult neurogenesis (N = 6). Cortisol was most frequently measured (N = 136), usually in saliva (N = 86). Studies included a variety of limitations for the methods and indicators, including concerns about timing and accuracy of collection, frequency of sampling, and controlling for acute stressors. CONCLUSIONS Nurse researchers have access to many minimally-invasive methods to measure altered biological processes related to chronic stress. A gap identified by this review is the paucity of minimally-invasive methods for investigating neurogenesis; the measurement of brain derived neurotrophic factor in plasma is a distal proxy and further research is needed to test the response of peripheral levels to psychosocial stress interventions. Additionally, while this scoping review allows nurse researchers to consider possible biological indicators to include in their research, future research is still needed on some of the basic premises of stress research, including agreement on the conceptualization of chronic stress.
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Affiliation(s)
- Rebecca E Salomon
- School of Nursing, University of California San Francisco, 2 Koret Way, UCSF Box 0608, San Francisco, CA 94143-0608, USA.
| | - Kelly R Tan
- School of Nursing, University of California San Francisco, 2 Koret Way, UCSF Box 0608, San Francisco, CA 94143-0608, USA.
| | - Ashley Vaughan
- School of Nursing, University of California San Francisco, 2 Koret Way, UCSF Box 0608, San Francisco, CA 94143-0608, USA.
| | - Harry Adynski
- School of Nursing, University of California San Francisco, 2 Koret Way, UCSF Box 0608, San Francisco, CA 94143-0608, USA.
| | - Keely A Muscatell
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Campus Box #3270, 235 E. Cameron Avenue, Chapel Hill, NC 27599-3270, USA; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Campus Box #7295, 450 West Drive, Chapel Hill, NC 27599-7295, USA.
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4
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Assaf AM, Al-Abbassi R, Al-Binni M. Academic stress-induced changes in Th1- and Th2-cytokine response. Saudi Pharm J 2017; 25:1237-1247. [PMID: 29204074 PMCID: PMC5688230 DOI: 10.1016/j.jsps.2017.09.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 09/23/2017] [Indexed: 11/30/2022] Open
Abstract
Psychological stress stimulates physiological responses releasing catecholamines and corticoids, which act via corresponding receptors on immune cells, producing a shift in the cytokine balance. These responses are variable depending on the nature of stressors. The effect of the academic stress on the production of the Th1-cytokines (TNF-α, IFN-γ, IL-1β, IL-2, IL-6 and IL-8) and Th2-cytokines (IL-1ra, IL-4, IL-5 and IL-10) on 35 medical/health sciences students after completing their questionnaires was investigated. Blood samples were taken at three stages; baseline stage at the beginning, midterm and final academic examination stages. Plasma cortisol and cytokines were measured during the three stages. The last two stages were compared with the baseline non-stress period. Results of the stress induced during the final examination stage were the highest with a significant increase in cortisol release, IL-4, IL-5 and IL-1ra release with a shift in Th1:Th2 cytokines balance towards Th2. Whereby, the midterm stage did not show significant reduction in Th1-cytokines except for TNF-α, with an increase in IFN-γ level that was reduced in the third stage. Th2 cytokine, IL-1ra, had positive correlations with Th1 cytokines; IL-2 and IFN-γ in the second stage and IL-6 cytokine in the third stage. Cortisol was positively correlated with IL-8 in the last stage and heart rates had negative correlation with IL-10 in the first and last stages. Findings of this study indicate that exam stress down-regulates Th1 with a selective up-regulation of Th2-cytokines. In conclusion, Cortisol might have a role in suppressing the release of Th1- mediated cellular immune response which could increase the vulnerability among the students to infectious diseases.
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Affiliation(s)
- Areej M Assaf
- Department of Biopharmaceutics and Clinical Pharmacy, Faculty of Pharmacy, The University of Jordan, Amman, Jordan
| | - Reem Al-Abbassi
- Department of Biopharmaceutics and Clinical Pharmacy, Faculty of Pharmacy, The University of Jordan, Amman, Jordan
| | - Maysaa Al-Binni
- Department of Biopharmaceutics and Clinical Pharmacy, Faculty of Pharmacy, The University of Jordan, Amman, Jordan
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5
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Admission Exam at a Medical School: Correlation Between Symptoms of Somatization and Performance. ZEITSCHRIFT FUR PSYCHOSOMATISCHE MEDIZIN UND PSYCHOTHERAPIE 2017; 63:213-218. [PMID: 28585503 DOI: 10.13109/zptm.2017.63.2.213] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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6
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Gilbert K, Mineka S, Zinbarg RE, Craske MG, Adam EK. Emotion Regulation Regulates More than Emotion: Associations of Momentary Emotion Regulation with Diurnal Cortisol in Current and Past Depression and Anxiety. Clin Psychol Sci 2016; 5:37-51. [PMID: 28944106 DOI: 10.1177/2167702616654437] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Maladaptive emotion regulation and dysregulated hypothalamic-pituitary-adrenal (HPA) axis functioning are characteristic of depression and anxiety. However, little research examines whether and how emotion regulation affects HPA axis functioning. We utilized an experience sampling methodology to examine associations between three emotion regulation strategies (problem solving, disengagement, and emotional expression/support seeking) and diurnal cortisol rhythms and reactivity in everyday life. Participants were young adults with current, past, or no history of internalizing disorders (depression or anxiety; N = 182). Across participants, problem solving was associated with an elevated cortisol awakening response (CAR) while disengagement was associated with a steeper cortisol slope. Only for individuals with internalizing disorders was momentary problem solving and emotional expression/support seeking associated with higher cortisol reactivity and emotional expression/support seeking associated with a flatter diurnal slope and blunted CAR. Results provide insight into associations between emotion regulation and day-to-day HPA-axis functioning.
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Affiliation(s)
- Kirsten Gilbert
- Department of Psychiatry, Washington University in St. Louis
| | - Susan Mineka
- Department of Psychology, Northwestern University
| | | | - Michelle G Craske
- Department of Psychology, University of California Los Angeles.,Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles
| | - Emma K Adam
- School of Education and Social Policy, Northwestern University.,Cells to Society Center, Institute of Policy Research, Northwestern University
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7
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Ogłodek EA, Szota AM, Just MJ, Araszkiewicz A, Szromek AR. Sense of alexithymia in patients with anxiety disorders comorbid with recurrent urticaria. Neuropsychiatr Dis Treat 2016; 12:995-1004. [PMID: 27143899 PMCID: PMC4844460 DOI: 10.2147/ndt.s94600] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
AIM Alexithymia is associated with limited cognitive processing of emotions by an individual suffering from recurrent urticaria and alexithymia and makes them focus on somatic manifestations of emotional arousal and on poorly controlled compulsive reactions to negative stimulation. Alexithymia is considered to be a personality trait, which, along with other factors, predisposes individuals toward developing somatic diseases. The aim of the study was to assess the measurement of alexithymic features in patients with recurrent urticaria and to assess the types of concurrent anxiety disorders and overall anxiety level. METHODS In order to diagnose clinical anxiety symptoms in patients, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition and the Hamilton Anxiety Rating Scale were applied. Alexithymic features were measured by means of a shortened version of the Toronto Alexithymia Scale, characterized by high discrimination power, internal coherence, and reliability. RESULTS According to the Toronto Alexithymia Scale results, the greatest contributing factor was "inability to differentiate between feelings and bodily sensations". This was observed in both males and females. Most frequently, the patients were found to suffer from generalized anxiety disorder and social phobia. CONCLUSION Alexithymia may result from the difficulty associated with expressing emotions caused by anxiety disorders. Undergoing treatment for anxiety disorders may contribute to reduced exacerbation of urticaria.
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Affiliation(s)
- Ewa A Ogłodek
- Department of Psychiatry, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Toruń Poland
| | - Anna M Szota
- Department of Psychiatry, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Toruń Poland
| | - Marek J Just
- Department of General and Endocrine Surgery, Municipal Hospital, Piekary Śląskie Poland
| | - Aleksander Araszkiewicz
- Department of Psychiatry, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Toruń Poland
| | - Adam R Szromek
- Department of Organization and Management, Silesian University of Technology, Gliwice, Poland
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8
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Woo JM, Kim TS. Gender Plays Significant Role in Short-Term Heart Rate Variability. Appl Psychophysiol Biofeedback 2015; 40:297-303. [DOI: 10.1007/s10484-015-9295-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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9
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Denson TF, Creswell JD, Terides MD, Blundell K. Cognitive reappraisal increases neuroendocrine reactivity to acute social stress and physical pain. Psychoneuroendocrinology 2014; 49:69-78. [PMID: 25063879 DOI: 10.1016/j.psyneuen.2014.07.003] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Revised: 06/17/2014] [Accepted: 07/04/2014] [Indexed: 12/15/2022]
Abstract
Cognitive reappraisal can foster emotion regulation, yet less is known about whether cognitive reappraisal alters neuroendocrine stress reactivity. Some initial evidence suggests that although long-term training in cognitive behavioral therapy techniques (which include reappraisal as a primary training component) can reduce cortisol reactivity to stress, some studies also suggest that reappraisal is associated with heightened cortisol stress reactivity. To address this mixed evidence, the present report describes two experimental studies that randomly assigned young adult volunteers to use cognitive reappraisal while undergoing laboratory stressors. Relative to the control condition, participants in the reappraisal conditions showed greater peak cortisol reactivity in response to a socially evaluative speech task (Experiment 1, N=90) and to a physical pain cold pressor task (Experiment 2, N=94). Participants in the cognitive reappraisal group also reported enhanced anticipatory psychological appraisals of self-efficacy and control in Experiment 2 and greater post-stressor self-efficacy. There were no effects of the reappraisal manipulation on positive and negative subjective affect, pain, or heart rate in either experiment. These findings suggest that although cognitive reappraisal fosters psychological perceptions of self-efficacy and control under stress, this effortful emotion regulation strategy in the short-term may increase cortisol reactivity. Discussion focuses on promising psychological mechanisms for these cognitive reappraisal effects.
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Affiliation(s)
- Thomas F Denson
- School of Psychology, UNSW Australia, Sydney, New South Wales 2052, Australia.
| | - J David Creswell
- Department of Psychology, Carnegie Mellon University, Baker Hall 342c, Pittsburgh, PA 15213, USA
| | - Matthew D Terides
- School of Psychology, UNSW Australia, Sydney, New South Wales 2052, Australia
| | - Kate Blundell
- School of Psychology, UNSW Australia, Sydney, New South Wales 2052, Australia
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10
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Zunhammer M, Eberle H, Eichhammer P, Busch V. Somatic symptoms evoked by exam stress in university students: the role of alexithymia, neuroticism, anxiety and depression. PLoS One 2013; 8:e84911. [PMID: 24367700 PMCID: PMC3867544 DOI: 10.1371/journal.pone.0084911] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Accepted: 11/28/2013] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVE The etiology of somatization is incompletely understood, but could be elucidated by models of psychosocial stress. Academic exam stress has effectively been applied as a naturalistic stress model, however its effect on somatization symptoms according to ICD-10 and DSM-IV criteria has not been reported so far. Baseline associations between somatization and personality traits, such as alexithymia, have been studied exhaustively. Nevertheless, it is largely unknown if personality traits have an explanatory value for stress induced somatization. METHODS This longitudinal, quasi-experimental study assessed the effects of university exams on somatization - and the reversal of effects after an exam-free period. Repeated-observations were obtained within 150 students, measuring symptom intensity before, during and after an exam period, according to the Screening for Somatoform Symptoms 7-day (SOMS-7d). Additionally, self-reports on health status were used to differentiate between medically explained and medically unexplained symptoms. Alexithymia, neuroticism, trait-anxiety and baseline depression were surveyed using the Toronto-Alexithymia Scale (TAS-20), the Big-Five Personality Interview (NEO-FFI), the State Trait Anxiety Inventory (STAI) and Beck's Depression Inventory (BDI-II). These traits were competitively tested for their ability to explain somatization increases under exam stress. RESULTS Somatization significantly increased across a wide range of symptoms under exam stress, while health reports pointed towards a reduction in acute infections and injuries. Neuroticism, alexithymia, trait anxiety and depression explained variance in somatization at baseline, but only neuroticism was associated with symptom increases under exam stress. CONCLUSION Exam stress is an effective psychosocial stress model inducing somatization. A comprehensive quantitative description of bodily symptoms under exam stress is supplied. The results do not support the stress-alexithymia hypothesis, but favor neuroticism as a personality trait of importance for somatization.
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Affiliation(s)
- Matthias Zunhammer
- Department of Experimental Psychology, University of Regensburg, Regensburg, Germany
- Department of Psychiatry, University of Regensburg, Regensburg, Germany
| | - Hanna Eberle
- Department of Experimental Psychology, University of Regensburg, Regensburg, Germany
| | - Peter Eichhammer
- Department of Psychiatry, University of Regensburg, Regensburg, Germany
| | - Volker Busch
- Department of Psychiatry, University of Regensburg, Regensburg, Germany
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11
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Ways of coping and biomarkers of an increased atherothrombotic cardiovascular disease risk in elderly individuals. Cardiovasc Psychiatry Neurol 2012; 2012:875876. [PMID: 22848795 PMCID: PMC3405559 DOI: 10.1155/2012/875876] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2012] [Accepted: 05/22/2012] [Indexed: 11/17/2022] Open
Abstract
Objective. To investigate the relationship between coping and atherothrombotic biomarkers of an increased cardiovascular disease (CVD) risk in the elderly. Methods. We studied 136 elderly caregiving and noncaregiving men and women who completed the Ways of Coping Checklist to assess problem-focused coping, seeking social support (SSS), blamed self, wishful thinking, and avoidance coping. They had circulating levels of 12 biomarkers measured. We also probed for potential mediator and moderator variables (chronic stress, affect, health behavior, autonomic activity) for the relation between coping and biomarkers. Results. After controlling for demographic and CVD risk factors, greater use of SSS was associated with elevated levels of serum amyloid A (P = 0.001), C-reactive protein (CRP) (P = 0.002), vascular cellular adhesion molecule (VCAM)-1 (P = 0.021), and D-dimer (P = 0.032). There were several moderator effects. For instance, greater use of SSS was associated with elevated VCAM-1 (P < 0.001) and CRP (P = 0.001) levels in subjects with low levels of perceived social support and positive affect, respectively. The other coping styles were not significantly associated with any biomarker. Conclusions. Greater use of SSS might compromise cardiovascular health through atherothrombotic mechanisms, including elevated inflammation (i.e., serum amyloid A, CRP, VCAM-1) and coagulation (i.e., D-dimer) activity. Moderating variables need to be considered in this relationship.
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12
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Koh KB, Lee YJ, Beyn KM, Chu SH, Kim DM, Seo WY. Effects of high and low stress on proinflammatory and antiinflammatory cytokines. Psychophysiology 2012; 49:1290-7. [PMID: 22803590 DOI: 10.1111/j.1469-8986.2012.01409.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2011] [Accepted: 05/22/2012] [Indexed: 11/27/2022]
Abstract
The effects of stress, which varies throughout an academic year, on proinflammatory and antiinflammatory cytokines were examined in 44 medical students. This was tested by comparing stimulated cytokines during a baseline period, stress period, and poststress vacation period. During the stress period, compared with the baseline period, levels of IL-6 were reduced, while levels of IL-10 were elevated. During the poststress vacation period, compared with the stress period, levels of IL-6 and TNF-α were increased. However, the changes in stress-related psychological and physiological variables were not significantly associated with changes in levels of proinflammatory and antiinflammatory cytokines. These results suggest that vacation is more likely to have a counterstress effect on proinflammatory cytokines than on an antiinflammatory cytokine and that a stressor may affect changes in immune function independently of self-reported stress.
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Affiliation(s)
- Kyung Bong Koh
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Korea.
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13
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Troy AS, Wilhelm FH, Shallcross AJ, Mauss IB. Seeing the silver lining: cognitive reappraisal ability moderates the relationship between stress and depressive symptoms. ACTA ACUST UNITED AC 2011; 10:783-95. [PMID: 21058843 DOI: 10.1037/a0020262] [Citation(s) in RCA: 227] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Individuals differ in their adjustment to stressful life events, with some exhibiting impaired functioning, including depression, while others exhibit impressive resilience. The present study examined the hypothesis that the ability to deploy a particularly adaptive type of emotion regulation-cognitive reappraisal-may be a protective factor. It expands upon existing research in three ways. First, participants' ability to use reappraisal (cognitive reappraisal ability: CRA) was measured by using a behavioral challenge that assessed changes in experiential and physiological domains, rather than questionnaires. Second, all participants had been exposed to one or more recent stressful life events, a context in which emotion regulation may be particularly important. Third, a community sample of 78 women aged 20 to 60 was recruited, as opposed to undergraduates. Results indicate that, at low levels of stress, participants' CRA was not associated with depressive symptoms. However, at high levels of stress, women with high CRA exhibited less depressive symptoms than those with low CRA, suggesting that CRA may be an important moderator of the link between stress and depressive symptoms.
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Affiliation(s)
- Allison S Troy
- Department of Psychology, University of Denver, Denver, CO 80208, USA.
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Sprehn GC, Chambers JE, Saykin AJ, Konski A, Johnstone PAS. Decreased cancer survival in individuals separated at time of diagnosis: critical period for cancer pathophysiology? Cancer 2009; 115:5108-16. [PMID: 19705348 DOI: 10.1002/cncr.24547] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND : It long has been recognized that married patients have improved cancer survival when compared with unmarried patients. This has been postulated as being due to increased support, potentially leading to better compliance with therapy. Conversely, some data exist pointing to a relationship between marital discord and decreased immunity. We examined whether unmarried patients have a different prognosis by whether they are 1) never married, 2) divorced, 3) widowed, or 4) separated at time of diagnosis. METHODS : The public access data of the Surveillance, Epidemiology and End Results (SEER) registry were queried for cancer survival across all 17 registries between 1973 and 2004. SEER last updated data in April 2007. Records of 3.79 million patients were included in the analysis. We specifically analyzed 5-year and 10-year relative survival (RS; 5yRS, 10yRS), defined as observed survival divided by observed survival of an age-matched, race-matched, and gender-matched population without disease, for all cancer patients by marital status, with specific subset analyses as indicated. RESULTS : Among unmarried patients, those separated at time of diagnosis had the lowest survival, followed by widowed, divorced, and never married patients. 5-year and 10-year RS of separated patients was 72% and 64% than that of married patients, respectively. This relationship persists when data are analyzed by gender. CONCLUSIONS : Separated marital status is associated with a significant decrement in cancer survival, even in comparison with other unmarried groups. While other socioeconomic variables could contribute to this phenomenon, further research into the immunologic correlates of the acutely stressful condition of marital separation should be conducted. Cancer 2009. (c) 2009 American Cancer Society.
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Affiliation(s)
- Gwen C Sprehn
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, USA.
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Koh KB, Lee Y, Beyn KM, Chu SH, Kim DM. Counter-stress effects of relaxation on proinflammatory and anti-inflammatory cytokines. Brain Behav Immun 2008; 22:1130-7. [PMID: 18639628 DOI: 10.1016/j.bbi.2008.06.009] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2008] [Revised: 06/18/2008] [Accepted: 06/20/2008] [Indexed: 11/30/2022] Open
Abstract
The counter-stress effects of relaxation on proinflammatory and anti-inflammatory cytokines were examined. From 36 medical students, 18 were randomly assigned to the relaxation group, and 18 were randomly assigned to the non-relaxation group. Relaxation lasted for four weeks. The levels of stimulated production of IL-6, TNF-alpha, and IL-10, and blood pressure were measured during the non-examination period (baseline period) and the pre-examination period (stress period). The levels of perceived stress were assessed by the Global Assessment of Recent Stress (GARS) scale, the Stress Response Inventory (SRI) and the Symptom Checklist-90-Revised (SCL-90-R) anxiety subscale. Repeat measure ANOVA revealed that the SRI total score, scores of the SCL-90-R anxiety subscale and diastolic blood pressure were significantly higher during the stress period than during the baseline period regardless of groups. The level of IL-6 production was significantly lower but the level of IL-10 production was significantly higher during the stress period than during the baseline period. Significant reduction in the delta (stress period value minus baseline period value) in the total GARS score, systolic and diastolic blood pressure, the levels of IL-6 and TNF-alpha production but significant enhancement in the delta in the level of the IL-10 production were found in the relaxation group compared with the non-relaxation group. These results suggest that relaxation is associated with reduction in stress-induced psychological or physiological responses and proinflammatory cytokine alterations but with enhancement in stress-induced anti-inflammatory cytokine alteration. Therefore, relaxation is more likely to have counter-stress effect on proinflammatory cytokines than on anti-inflammatory cytokine.
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Affiliation(s)
- Kyung Bong Koh
- Department of Psychiatry, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-gu, Seoul 120-752, Republic of Korea.
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