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Wang Y, Huang J, Zheng H, Tao L, Gu K, Xie C, Cha L, Chen H, Hu H. Resting-state activity and functional connectivity of insula and postcentral gyrus related to psychological resilience in female depressed patients: A preliminary study. J Affect Disord 2024; 352:509-516. [PMID: 38412929 DOI: 10.1016/j.jad.2024.02.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 02/04/2024] [Accepted: 02/19/2024] [Indexed: 02/29/2024]
Abstract
BACKGROUND Psychological resilience is a protective factor of depression. However, the neuroimaging characteristics of the relationship between psychological resilience and brain imaging in depression are not very clear. Our objectives were to explore the brain functional imaging characteristics of different levels of resilience in female patients with depression. METHODS Resting-state functional magnetic resonance imaging (rs-fMRI) was performed on 58 female depressed patients. According to the resilience score, participants were divided into three groups: Low resilience (Low-res), Medium resilience (Med-res) and High resilience (High-res). We compared the differences in the amplitude of low-frequency fluctuations (ALFF) and functional connectivity (FC) among the three groups and correlated psychological resilience with ALFF and FC. RESULTS According to ALFF, there was a higher activation in RI and RPG in the High-res compared with Med-res and Low-res, but no significant differences between Med-res and Low-res. The FC between the RPG and supramarginal gyrus (SG) in the High-res was significantly stronger than that in the Med-res and the Low-res, and the FC of the Med-res is stronger than that of the Low-res. Both ALFF and FC were positively correlated with the score of resilience. LIMITATIONS The sample size of this study was relatively small and it lacked healthy controls. The results of this study could be considered preliminary. CONCLUSIONS Among female patients with depression, patients with higher psychological resilience had higher resting state activation in the RI and RPG and had a stronger interaction between the RPG and the SG.
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Affiliation(s)
- Yuhan Wang
- Department of Psychiatry, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Jie Huang
- Department of Psychiatry, Chongqing Eleventh People's Hospital, Chongqing 400038, China
| | - Hanhan Zheng
- Department of Psychiatry, the Fourth People's Hospital of Chengdu, Chengdu, Sichuan 610000, China
| | - Li Tao
- Department of Radiology, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Kaiqi Gu
- Department of Psychiatry, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Caihong Xie
- Chongqing Technology and Business Institute, Chongqing 400000, China
| | - Lijun Cha
- Department of Psychiatry, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Hong Chen
- Department of Psychiatry, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Hua Hu
- Department of Psychiatry, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.
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Srivastava AV, Brown R, Newport DJ, Rousseau JF, Wagner KD, Guzick A, Devargas C, Claassen C, Ugalde IT, Garrett A, Gushanas K, Liberzon I, Cisler JM, Nemeroff CB. The role of resilience in the development of depression, anxiety, and post-traumatic stress disorder after trauma in children and adolescents. Psychiatry Res 2024; 334:115772. [PMID: 38442477 DOI: 10.1016/j.psychres.2024.115772] [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: 07/25/2023] [Revised: 01/30/2024] [Accepted: 02/02/2024] [Indexed: 03/07/2024]
Abstract
This investigation, conducted within the Texas Childhood Trauma Research Network, investigated the prospective relationships between resiliency and emergent internalizing symptoms among trauma-exposed youth. The cohort encompassed 1262 youth, aged 8-20, from twelve health-related institutions across Texas, who completed assessments at baseline and one- and six-month follow-ups for resiliency, symptoms of depression, generalized anxiety, posttraumatic stress disorder (PTSD), and other demographic and clinical characteristics. At baseline, greater resilience was positively associated with older age, male (vs female) sex assigned at birth, and history of mental health treatment. Unadjusted for covariates, higher baseline resilience was associated with greater prospective depression and PTSD symptoms but not anxiety symptoms. Upon adjusting for demographic and clinical factors, higher baseline resilience was no longer associated with depression, PTSD, or anxiety symptoms. Our analyses demonstrate that the predictive value of resilience on psychopathology is relatively small compared to more readily observable clinical and demographic factors. These data suggest a relatively minor prospective role of resilience in protecting against internalizing symptoms among trauma-exposed youth and highlight the importance of controlling for relevant youth characteristics when investigating a protective effect of resilience on internalizing symptoms.
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Affiliation(s)
- Arjun V Srivastava
- Department of Psychiatry and Behavioral Sciences, University of Texas at Austin Dell Medical School, Health Discovery Building, 1601 Trinity Blvd, Austin, TX 78701, USA
| | - Ryan Brown
- Department of Psychiatry and Behavioral Sciences, University of Texas at Austin Dell Medical School, Health Discovery Building, 1601 Trinity Blvd, Austin, TX 78701, USA
| | - D Jeffrey Newport
- Department of Psychiatry and Behavioral Sciences, University of Texas at Austin Dell Medical School, Health Discovery Building, 1601 Trinity Blvd, Austin, TX 78701, USA; Department of Women's Health, University of Texas at Austin Dell Medical School, Austin, TX, USA
| | - Justin F Rousseau
- Department of Population Health, University of Texas at Austin Dell Medical School, Austin, TX, USA; Department of Neurology, University of Texas at Austin Dell Medical School, Austin, TX, USA
| | - Karen D Wagner
- Department of Psychiatry and Behavioral Sciences, University of Texas Medical Branch, Galveston, TX, USA
| | - Andrew Guzick
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA; Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Cecilia Devargas
- Department of Psychiatry, Texas Tech University Health Sciences Center - El Paso Paul L. Foster School of Medicine, El Paso, TX, USA
| | - Cynthia Claassen
- Department of Psychiatry, JPS Health Network / University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Irma T Ugalde
- Department of Emergency Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Amy Garrett
- Department of Psychiatry, University of Texas Health Science Center San Antonio, San Antonio, TX, USA
| | - Kim Gushanas
- Department of Psychiatry and Behavioral Sciences, University of Texas Medical Branch, Galveston, TX, USA
| | - Israel Liberzon
- Department of Psychiatry and Behavioral Sciences, Texas A&M University School of Medicine, Bryan, TX, USA
| | - Josh M Cisler
- Department of Psychiatry and Behavioral Sciences, University of Texas at Austin Dell Medical School, Health Discovery Building, 1601 Trinity Blvd, Austin, TX 78701, USA.
| | - Charles B Nemeroff
- Department of Psychiatry and Behavioral Sciences, University of Texas at Austin Dell Medical School, Health Discovery Building, 1601 Trinity Blvd, Austin, TX 78701, USA
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Gao Y, Wang Y, Wang Z, Ma M, Li H, Wang J, Liu J, Qian H, Zhu P, Xu X. Family intimacy and adaptability and non-suicidal self-injury: a mediation analysis. BMC Psychiatry 2024; 24:210. [PMID: 38500067 PMCID: PMC10946147 DOI: 10.1186/s12888-024-05642-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 02/27/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND Current research has been focusing on non-suicidal self-injury (NSSI) behaviors among adolescents with depression. Although family intimacy and adaptability are considered protective factors for NSSI, evidence supporting this relationship is lacking. OBJECTIVE This study aims to examine the mechanisms operating in the relationship between family intimacy and adaptability and NSSI behaviors among adolescents. METHODS A self-administered general demographic information questionnaire, the Behavioral Functional Assessment Scale for Non-Suicidal Self-Injury, the Family Intimacy and Adaptability Scale, the Connor-Davidson Resilience Scale, and the Self-Assessment of Depression Scale were distributed among adolescents with depression in three tertiary hospitals in Jiangsu Province. RESULTS The relationship between family intimacy and adaptability and NSSI was assessed among 596 adolescents with depression. The results revealed the following: (1) Family intimacy and adaptability were negatively correlated with NSSI behavior. (2) Psychological resilience and depression levels acted as chain mediators in the relationship between family intimacy and adaptability and NSSI behavior. CONCLUSIONS Enhancing psychological resilience, controlling depressive symptoms, and reducing depression severity among adolescents by improving their family intimacy and adaptability are conducive to preventing and mitigating their NSSI behaviors.
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Affiliation(s)
- Yuehong Gao
- The Fourth People's Hospital of Nantong, Nantong, China
| | - Yanchi Wang
- The Sixth People's Hospital of Nantong, Nantong, China
| | - Zhiping Wang
- The Fourth People's Hospital of Nantong, Nantong, China
| | - Mingzhen Ma
- The Fourth People's Hospital of Nantong, Nantong, China
| | | | - Jinhong Wang
- The Fourth People's Hospital of Nantong, Nantong, China
| | - Jianan Liu
- The Fourth People's Hospital of Nantong, Nantong, China
| | | | - Ping Zhu
- Suzhou Guangji Hospital, Su Zhou Shi, China
| | - Xujuan Xu
- Affiliated Hospital of Nantong University, Nantong, China.
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Maddah Z, Negarandeh R, Rahimi S, Pashaeypoor S. Challenges of living with veterans with post-traumatic stress disorder from the perspective of spouses: a qualitative content analysis study. BMC Psychiatry 2024; 24:151. [PMID: 38383353 PMCID: PMC10882771 DOI: 10.1186/s12888-024-05572-y] [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: 07/14/2023] [Accepted: 01/30/2024] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND AND OBJECTIVE The needs and characteristics of veterans with post-traumatic stress disorder (PTSD) create significant challenges in family life, particularly for spouses. Identifying the nature of these challenges from the perspective of spouses leads to a more comprehensive and profound understanding of their existing problems and can be used for targeted interventions. Therefore, this research was conducted to explore the challenges of living with veterans suffering from PTSD from the perspective of their spouses. METHODS This qualitative study used conventional content analysis to explore Challenges of spouses of veterans with post-traumatic stress disorder. Fifteen spouses of veterans with PTSD from the Veterans Affairs Center in Iran between June 2022 and January 2023, were purposively selected to participate in the study. Semi-structured in-depth interviews were conducted to collect data. The interviews were audio-recorded and transcribed verbatim. The data were analyzed using the method proposed by Graneheim and Lundman content analysis method with the support of MAXQDA 2020 software. RESULTS The mean age of the participants was 56.74 ± 6.43 years. Through data analysis, seven main categories and sixteen subcategories were identified. These categories included burnout (sleep disturbances, feelings of exhaustion), apathy towards self-care and caring for the veteran (neglecting self-care, lack of interest in continuing care), depression (feelings of hopelessness and being at the end of the line, decreased self-confidence ( Crushed and ignored (being mistreated, having multiple roles), relationship disturbances (Dissatisfaction with marital relationship,isolation and limited social interactions, disconnection from God), financial burden (heavy costs of care, lack of insurance support), and declining social status (negative attitude of the society, suffering from discrimination and inequality). CONCLUSION The consequences of PTSD-related injuries in veterans directly and indirectly affect the overall living conditions of their spouses. These spouses experience emotional detachment and constant rejection, leading to a decrease in their resilience against existing stressors and exposing them to disruptive and challenging issues in individual, family, and social dimensions of life that affect their physical and mental well-being. Therefore, these spouses require empowerment and access to social support in dimensions of educational, caregiving, therapeutic, and supportive. It is recommended that health policymakers pay special attention to designing up-to-date interventions to enhance the health of these spouses in physical, mental, spiritual, and social dimensions.
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Affiliation(s)
- Zahra Maddah
- Department of Psychiatric Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Negarandeh
- Nursing & Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Soheil Rahimi
- Department of Psychiatric Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahzad Pashaeypoor
- Department of Community Health and Geriatric Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
- Community Based Participatory Research Center, Tehran University of Medical Sciences, Tehran, Iran.
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A statistical genetic investigation of psychiatric resilience. Eur J Psychotraumatol 2023; 14:2178762. [PMID: 37052082 PMCID: PMC9987782 DOI: 10.1080/20008066.2023.2178762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023] Open
Abstract
Background: Although trauma exposure (TE) is a transdiagnostic risk factor for many psychiatric disorders, not everyone who experiences TE develops a psychiatric disorder. Resilience may explain this heterogeneity; thus, it is critical to understand the etiologic underpinnings of resilience.Objective: The present study sought to examine the genetic underpinnings of psychiatric resilience using genome-wide association studies (GWAS), genome-wide complex trait analysis (GCTA), and polygenic risk score (PRS) analyses.Method: Participants were 6,634 trauma exposed college students attending a diverse, public university in the Mid Atlantic. GWAS and GCTA analyses were conducted, and using GWAS summary statistics from large genetic consortia, PRS analyses examined the shared genetic risk between resilience and various phenotypes.Results: Results demonstrate that nine single-nucleotide polymorphisms (SNPs) met the suggestive of significance threshold, heritability estimates for resilience were non-significant, and that there is genetic overlap between resilience and AD, as well as resilience and PTSD.Conclusion: Mixed findings from the present study suggest additional research to elucidate the etiological underpinnings of resilience, ideally with larger samples less biased by variables such as heterogeneity (i.e. clinical vs. population based) and population stratification. Genetic investigations of resilience have the potential to elucidate the molecular bases of stress-related psychopathology, suggesting new avenues for prevention and intervention efforts.
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Barton BB, Ehring T, Reinhard MA, Goerigk S, Wüstenberg T, Musil R, Amann BL, Jobst A, Dewald-Kaufmann J, Padberg F. Effects of resilience and timing of adverse and adaptive experiences on interpersonal behavior: a transdiagnostic study in a clinical sample. Sci Rep 2023; 13:18131. [PMID: 37875505 PMCID: PMC10598007 DOI: 10.1038/s41598-023-44555-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 10/10/2023] [Indexed: 10/26/2023] Open
Abstract
Adverse childhood experiences (ACE) have been linked to less prosocial behavior during social exclusion in vulnerable groups. However, little is known about the impact of the timing of ACE and the roles of protective factors. Therefore, this study investigated the association of the behavioral response to experimental partial social exclusion with adverse and adaptive experiences across age groups and resilience in clinical groups with persistent depressive disorder and borderline personality disorder, i.e., groups with high ACE, and in healthy controls (HC) (N = 140). Adverse and adaptive experiences during childhood, youth, and adulthood were assessed with the Traumatic Antecedents Questionnaire, and resilience was measured with the Connor Davidson Resilience Scale. A modified version of the Cyberball paradigm was used to assess the direct behavioral response to partial social exclusion. In patients, adverse events during youth (B = - 0.12, p = 0.016) and adulthood (B = - 0.14, p = 0.013) were negatively associated with prosocial behavior, whereas in the HC sample, adaptive experiences during youth were positively associated with prosocial behavior (B = 0.25, p = 0.041). Resilience did not mediate these effects. The findings indicate that critical events during youth may be particularly relevant for interpersonal dysfunction in adulthood.
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Affiliation(s)
- Barbara B Barton
- Department of Psychiatry and Psychotherapy, LMU University Hospital, Munich, Germany.
| | - Thomas Ehring
- Department of Psychology, LMU Munich, Munich, Germany
| | - Matthias A Reinhard
- Department of Psychiatry and Psychotherapy, LMU University Hospital, Munich, Germany
| | - Stephan Goerigk
- Department of Psychiatry and Psychotherapy, LMU University Hospital, Munich, Germany
- Charlotte Fresenius Hochschule, Infanteriestrasse 11A, 80797, Munich, Germany
- Department of Psychological Methodology and Assessment, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Torsten Wüstenberg
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Richard Musil
- Department of Psychiatry and Psychotherapy, LMU University Hospital, Munich, Germany
| | - Benedikt L Amann
- Department of Psychiatry and Psychotherapy, LMU University Hospital, Munich, Germany
- Centre Fòrum Research Unit, Hospital Del Mar Research Institute, Barcelona, Spain
- Mental Health Institute, Hospital Del Mar, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Andrea Jobst
- Department of Psychiatry and Psychotherapy, LMU University Hospital, Munich, Germany
| | - Julia Dewald-Kaufmann
- Department of Psychiatry and Psychotherapy, LMU University Hospital, Munich, Germany
| | - Frank Padberg
- Department of Psychiatry and Psychotherapy, LMU University Hospital, Munich, Germany
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Tu Z, He J, Wang Z, Song M, Tian J, Wang C, Ba J, Shen X. Psychometric properties of the 10-item Connor-Davidson Resilience Scale in Chinese military personnel. Front Psychol 2023; 14:1163382. [PMID: 37599761 PMCID: PMC10437071 DOI: 10.3389/fpsyg.2023.1163382] [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: 02/10/2023] [Accepted: 05/26/2023] [Indexed: 08/22/2023] Open
Abstract
Background The 10-item Connor-Davidson Resilience Scale (CD-RISC-10) is a widely used assessment of resilience. However, psychometric properties of the Chinese version of CD-RISC-10 have not been well investigated in a Chinese military personnel sample. Methods A total of 3,129 Chinese military personnel completed the CD-RISC-10, Self-rating Anxiety Scale (SAS), and Self-rating Depression Scale (SDS). Among them, 528 recruits completed the CD-RISC-10, SAS, and SDS again after 3-month basic military training (BMT). Meanwhile, the commanding officers were asked to rate recruits' training performance on the training performance rating scale for recruits (TPRS). Confirmatory factor analysis (CFA) was implemented to examine the single-factor model of the CD-RISC-10, and multigroup CFA was conducted to test measurement invariance across military rank (officers vs. enlisted), gender (male vs. female), and time (before and after 3-month BMT). Internal consistency was evaluated using Cronbach's α and McDonald's ω, and test-retest reliability was tested using the intra-class correlation coefficient (ICC). The criterion-related validity of CD-RISC was evaluated using Pearson's correlation analysis between the CD-RISC-10 total score and SAS scores, SDS scores, and training performance ratings. Results The single-factor model of the CD-RISC-10 showed adequate fit (CFI = 0.955-0.970, TLI = 0.943-0.962, RMSEA = 0.059-0.072) in all examined subsamples (male, female, officer, and enlisted), and strict invariance was also supported across military rank, gender, and time (ΔCFI ≤ 0.001, ΔTLI ≤ 0.005, ΔRMSEA ≤ 0.006). The CD-RISC-10 showed good internal consistency in all subsamples (Cronbach's α of > 0.93 and McDonald's ω of > 0.93) and good test-retest reliability (ICC = 0.88). Moreover, concurrent and predictive validity with the SAS and SDS scores were good (r = -0.68 to -0.49, p < 0.001). The resilience level of recruits at the beginning of BMT was significantly associated with training performance rated by supervisors after training (r = 0.29, p < 0.001). Conclusion The psychometric evidence reported in this study suggests that the CD-RISC-10 is a reliable and valid assessment of resilience and a potential predictor for mental health and military performance in Chinese military personnel.
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Affiliation(s)
- Zhihao Tu
- Navy Special Medical Center, Naval Medical University, Shanghai, China
- Qingdao Special Servicemen Recuperation Center of PLA Navy, Qingdao, Shandong, China
| | - Jingwen He
- Department of Medical Psychology, No. 96110 Hospital, Yinchuan, Ningxia, China
- Second Military Medical University, Shanghai, China
| | - Ziying Wang
- Navy Special Medical Center, Naval Medical University, Shanghai, China
| | - Mingfang Song
- Navy Special Medical Center, Naval Medical University, Shanghai, China
| | - Jianquan Tian
- Navy Special Medical Center, Naval Medical University, Shanghai, China
| | - Chuan Wang
- Navy Special Medical Center, Naval Medical University, Shanghai, China
| | - Jianbo Ba
- Navy Special Medical Center, Naval Medical University, Shanghai, China
| | - Xinghua Shen
- Navy Special Medical Center, Naval Medical University, Shanghai, China
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Wang W, Zhang J, Zheng X, Li G, Zhou Y. Heterogeneity of resilience and the curvilinear relationship between childhood trauma and resilience among people with schizophrenia. Front Psychiatry 2023; 14:1082000. [PMID: 37255684 PMCID: PMC10225606 DOI: 10.3389/fpsyt.2023.1082000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 04/24/2023] [Indexed: 06/01/2023] Open
Abstract
Background As a group with a high incidence of childhood trauma, the differential characteristics of resilience in schizophrenia and its relationship with childhood trauma are still unclear. Methods A total of 626 individuals diagnosed with schizophrenia were selected from four psychiatric hospitals in northern China. Childhood trauma and resilience were measured using the Childhood Trauma Questionnaire-short form (CTQ-SF) and Connor-Davidson Resilience Scale (CD-RISC), respectively. Latent profile analysis (LPA) was used to identify the potential classes of resilience. A generalized additive mixed model (GAMM) and restricted cubic spline (RCS) was used to explore and determine the shape of the relationship between childhood trauma and resilience. Results Model fits of LPA showed three heterogeneous classes of resilience: moderate resilience levels (n = 312; 49.06%); high resilience levels (n = 171; 26.89%) and low resilience levels (n = 153; 24.06%). Resilience scores fluctuated depending on amount of exposure to childhood trauma. The GAMM results verified the non-linear relationship between resilience and childhood trauma, with an estimated degree of freedom higher than 1 (4.573) and p = 0.003. RCS fitted for ordinary least square (OLS) regression models determined a smooth continuous cubic curve of resilience across childhood trauma levels, and the two turning points of the curve line were 41.04 and 54.74 for childhood trauma. Discussion Our findings confirm the people-specific differences in the level of resilience in schizophrenia and describe the cubic curvilinear relationship between childhood trauma and resilience, which provides data support for mechanistic research and intervention in related fields.
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Affiliation(s)
- Weiliang Wang
- School of Nursing, Xuzhou Medical University, Xuzhou, Jiangsu, China
- School of Nursing, Harbin Medical University, Harbin, Heilongjiang, China
| | - Jun Zhang
- School of Nursing, Harbin Medical University, Harbin, Heilongjiang, China
- Heilongjiang Sengong Red Cross General Hospital, Harbin, Heilongjiang, China
| | - Xinzhu Zheng
- School of Nursing, Harbin Medical University, Harbin, Heilongjiang, China
- The First Psychiatric Hospital of Harbin, Harbin, Heilongjiang, China
| | - Guohua Li
- Chifeng Anding Hospital, Chifeng, China
| | - Yuqiu Zhou
- School of Nursing, Harbin Medical University, Harbin, Heilongjiang, China
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Watters ER, Aloe AM, Wojciak AS. Examining the Associations Between Childhood Trauma, Resilience, and Depression: A Multivariate Meta-Analysis. TRAUMA, VIOLENCE & ABUSE 2023; 24:231-244. [PMID: 34313169 DOI: 10.1177/15248380211029397] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
TOPIC OF REVIEW Childhood trauma has been associated with increased depression; however, resilience has been found to reduce this association. METHOD OF REVIEW Present analyses were based on multivariate meta-analytical techniques, an extension of univariate meta-analysis. All computations were performed using the metafor package and the metaRmat package from R. Bivariate associations (r) between trauma, resilience, and depression were utilized as the pooled effect sizes. CRITERIA FOR INCLUSION Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, articles were coded based on the following inclusion criteria: (a) sample participants had a history of childhood trauma; (b) studies included one of the four instruments of trait resilience; (c) studies included measures of individual outcomes of depression; (d) studies were published in peer-reviewed journals, dissertations, book chapters since 2009, or provided by leading scholars who had yet to publish their data; (e) all manuscripts were written in English; and (f) studies included the Pearson Product Moment Correlation Coefficient (r) for the effect size. CRITERIA FOR REVIEW We systematically coded for the following items for each study: year of publication, type of report, peer-reviewed, funding, sampling strategy, sample size, gender, mean age, country of study, measure of resilience, measure depression, and measure of childhood trauma. MAJOR FINDINGS The pooled correlations indicate that trauma, resilience, and depression are significantly associated. There were no significant differences in symptoms of depression for high versus low reports of resilience for individuals with a history of trauma. Year of publication was a significant moderator for the associations between trauma, resilience, and depression. Resilience significantly mediated the association between trauma and depression.
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Affiliation(s)
- Elizabeth R Watters
- Department of Psychological and Quantitative Foundations, University of Iowa, IA, USA
| | - Ariel M Aloe
- Department of Psychological and Quantitative Foundations, University of Iowa, IA, USA
| | - Armeda S Wojciak
- Department of Family Social Sciences, University of Minnesota, MN, USA
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Reyes AT, Cross CL, Manzano ERM. The Moderating Role of Resilience on Mindfulness, Experiential Avoidance, and Posttraumatic Stress Disorder (PTSD) Symptoms of College Student Veterans: A Cross-Sectional Study. Issues Ment Health Nurs 2022; 43:721-729. [PMID: 35285759 DOI: 10.1080/01612840.2022.2051104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The purpose of the study was to investigate the moderating effect of resilience on the relationship between mindfulness, experiential avoidance, and posttraumatic stress disorder (PTSD) symptom severity. A cross-sectional study design was used on a sample of 133 college student military veterans. We found a direct effect of mindfulness on PTSD and a significant mediating effect of experiential avoidance on the relationship between mindfulness and PTSD. Resilience also had a significant moderating effect on the relationship between mindfulness and PTSD. This study provides preliminary evidence on the usefulness of integrating resilience development in mindfulness-based interventions for trauma-related disorders.
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Affiliation(s)
| | - Chad L Cross
- School of Public Health, University of Nevada Las Vegas, Las Vegas, Nevada, USA
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Scoglio AAJ, Reilly ED, Girouard C, Quigley KS, Carnes S, Kelly MM. Social Functioning in Individuals With Post-Traumatic Stress Disorder: A Systematic Review. TRAUMA, VIOLENCE & ABUSE 2022; 23:356-371. [PMID: 32812513 DOI: 10.1177/1524838020946800] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Post-traumatic stress disorder (PTSD) can lead to multiple deleterious outcomes and has negative, sometimes debilitating, impacts on general functioning of those affected. This systematic review of 26 articles evaluates the existing literature on social functioning outcomes used in PTSD research, the association between PTSD and social functioning, and the impact of interventions for PTSD on social functioning. A review of 26 articles using the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines for systematic reviews showed that PTSD was associated with significant impairment in global social functioning. This review also reveals the need for both standardized definitions and better assessment methods to operationalize social functioning and improve our ability to compare findings across studies. The literature also suggests that some evidence-based treatments for PTSD improve social functioning despite not explicitly targeting social functioning in the treatment. The findings of this review suggest that there are ample opportunities for improving both research and interventions to improve global social functioning in PTSD.
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Affiliation(s)
- Arielle A J Scoglio
- Social and Community Reintegration Research Program, ENRM VA Medical Center, Bedford, MA, USA
- Institute of Health Equity and Social Justice Research, Northeastern University, Boston, MA, USA
| | - Erin D Reilly
- Social and Community Reintegration Research Program, ENRM VA Medical Center, Bedford, MA, USA
- Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, USA
| | - Caitlin Girouard
- Social and Community Reintegration Research Program, ENRM VA Medical Center, Bedford, MA, USA
| | - Karen S Quigley
- Social and Community Reintegration Research Program, ENRM VA Medical Center, Bedford, MA, USA
- Center for Healthcare Organizational and Implementation Research, ENRM VA Medical Center, Bedford, MA, USA
- Department of Psychology, Northeastern University, Boston, MA, USA
| | | | - Megan M Kelly
- Social and Community Reintegration Research Program, ENRM VA Medical Center, Bedford, MA, USA
- Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, USA
- VISN 1 New England Mental Illness Research, Education, and Clinical Center, ENRM VA Medical Center, Bedford, MA, USA
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12
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McDaniel JT, Hascup ER, Hascup KN, Trivedi M, Henson H, Rados R, York M, Albright DL, Weatherly T, Frick K. Psychological Resilience and Cognitive Function Among Older Military Veterans. Gerontol Geriatr Med 2022; 8:23337214221081363. [PMID: 35252475 PMCID: PMC8891840 DOI: 10.1177/23337214221081363] [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: 11/26/2021] [Revised: 01/06/2022] [Accepted: 02/01/2022] [Indexed: 11/22/2022] Open
Abstract
The purpose of this study was to explore the association between psychological resilience and cognitive function in military veterans. We obtained public-use data from the Health and Retirement Study (HRS) for this cross-sectional study of military veterans aged 52 to 101 years (n = 150). We estimated a multivariable linear regression model in which cognitive function served as the dependent variable and psychological resilience served as the independent variable. After controlling for demographics, health conditions, and health behaviors, veterans who had higher psychological resilience scores had better cognitive function (b = 0.22, p = 0.03). Our findings suggest that psychological resilience may be associated with cognitive function among veterans. These findings highlight the importance of assessing psychological resilience in gerontological social work practice.
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Affiliation(s)
- Justin T. McDaniel
- School of Human Sciences, Southern Illinois University Carbondale, Carbondale, IL, USA
| | - Erin R. Hascup
- Dale and Deborah Smith Center for Alzheimer’s Research and trEatment (CARE), Southern Illinois University School of Medicine, Springfield, IL, USA
| | - Kevin N. Hascup
- Department of Psychiatry, Southern Illinois University School of Medicine, Springfield, IL USA
| | - Mehul Trivedi
- Department of Psychiatry, Southern Illinois University School of Medicine, Springfield, IL USA
| | - Harvey Henson
- School of Education, Southern Illinois University Carbondale, Carbondale, IL, USA
| | - Robert Rados
- School of Health Sciences, Southern Illinois University Carbondale, Carbondale, IL, USA
| | - Mary York
- School of Human Sciences, Southern Illinois University Carbondale, Carbondale, IL, USA
| | | | - Taryn Weatherly
- School of Human Sciences, Southern Illinois University Carbondale, Carbondale, IL, USA
| | - Kaitlyn Frick
- School of Human Sciences, Southern Illinois University Carbondale, Carbondale, IL, USA
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13
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Graziani G, Aylward BS, Kunkle S, Shih E. Changes in Resilience Following Engagement with A Virtual Mental Health System: A Real World Observational Study (Preprint). JMIR Form Res 2022; 6:e37169. [PMID: 35904875 PMCID: PMC9377433 DOI: 10.2196/37169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 04/21/2022] [Accepted: 05/09/2022] [Indexed: 11/13/2022] Open
Abstract
Background Objective Methods Results Conclusions
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Affiliation(s)
| | | | | | - Emily Shih
- Ginger, San Francisco, CA, United States
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14
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Matsumoto N, Sugimoto T, Kuroda Y, Uchida K, Kishino Y, Arai H, Sakurai T. Psychological Resilience Among Older Japanese Adults With Mild Cognitive Impairment During the COVID-19 Pandemic. Front Psychiatry 2022; 13:898990. [PMID: 35757230 PMCID: PMC9226331 DOI: 10.3389/fpsyt.2022.898990] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 05/19/2022] [Indexed: 11/13/2022] Open
Abstract
Psychological resilience refers to the ability to cope with adversities, and deficits in resilience might lead to mental illness. The COVID-19 pandemic has had impact on psychological resilience for older adults, but there are as yet no data on its impacts on the mental health of older adults who were living with mild cognitive impairment (MCI). Therefore, the aim of this study was to investigate the impact of the COVID-19 pandemic on psychological resilience in older adults with MCI and to explore associated physical and psychosocial factors. In this cross-sectional study of 268 older adults aged 65-85, we defined MCI as age- and education-adjusted cognitive decline with a standard deviation of 1.0 or more from the reference threshold. During December 2020 to April 2021, we carried out to all participants the 10-item version of the Connor-Davidson Resilience Scale (CD-RISC-10) to measure psychological resilience. We also conducted a comprehensive geriatric assessment including sleep quality and depressive symptoms (Pittsburgh Sleep Quality Index and 15-item Geriatric Depression Scale, respectively). To identify factors associated with CD-RISC-10 scores (mean: 23.3 ± 0.4), multiple regression analysis revealed that older age [coefficient = 0.23, 95% confidence interval (CI) = 0.06-0.39] was significantly correlated with higher scores, whereas poor sleep quality (coefficient = -2.06, 95% CI = -3.93 to -0.19) and depressive symptoms (coefficient = -2.95, 95% CI = -5.70 to -0.21) were significantly correlated with lower scores. In this study, older adults with MCI showed low psychological resilience during the COVID-19 pandemic, and people with low psychological resilience indicated poor sleep quality and depressive symptoms. Our findings suggest directions for devising interventions to maintain mental health and psychological resilience among the vulnerable population of older adults with MCI living under the socially isolated conditions of COVID-19 pandemic restrictions. Our recommendation includes continuous assessment of this population and appropriate care for poor sleep quality and depressive symptoms.
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Affiliation(s)
- Nanae Matsumoto
- Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Taiki Sugimoto
- Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, Obu, Japan.,Department of Prevention and Care Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Yujiro Kuroda
- Department of Prevention and Care Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Kazuaki Uchida
- Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, Obu, Japan.,Department of Public Health, Graduate School of Health Sciences, Kobe University, Kobe, Japan
| | - Yoshinobu Kishino
- Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, Obu, Japan.,Department of Cognitive and Behavioral Science, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology, Obu, Japan
| | - Takashi Sakurai
- Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, Obu, Japan.,Department of Prevention and Care Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan.,Department of Cognitive and Behavioral Science, Graduate School of Medicine, Nagoya University, Nagoya, Japan
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15
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Troyanskaya M, Pastorek NJ, Walder A, Wilde EA, Kennedy JE, Levin HS, Scheibel RS. Role of deployment-related mTBI and resilience in perceived participation limitations among Veterans. MILITARY PSYCHOLOGY 2021. [DOI: 10.1080/08995605.2021.1962191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Maya Troyanskaya
- Michael E. DeBakey Veterans Affairs Medical Center Houston, Houston, Texas, USA
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine Houston, Houston, Texas, USA
| | - Nicholas J. Pastorek
- Michael E. DeBakey Veterans Affairs Medical Center Houston, Houston, Texas, USA
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine Houston, Houston, Texas, USA
| | - Annette Walder
- Michael E. DeBakey Veterans Affairs Medical Center Houston, Houston, Texas, USA
- Department of Medicine, Baylor College of Medicine Houston, Houston, Texas, USA
| | - Elisabeth A. Wilde
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine Houston, Houston, Texas, USA
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, Utah, USA
- George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, Utah, USA
| | - Jan E. Kennedy
- DefenseTX And Veterans Brain Injury Center, Brooke Army Medical Center Ft Sam Houston, San Antonio, Texas, USA
- General Dynamics Information Technology Falls Church, Falls Church, Virginia, USA
| | - Harvey S. Levin
- Michael E. DeBakey Veterans Affairs Medical Center Houston, Houston, Texas, USA
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine Houston, Houston, Texas, USA
- Department of Neurology, Baylor College of Medicine Houston, Houston, Texas, USA
- Department of Neurosurgery, Baylor College of Medicine Houston, Houston, Texas, USA
- Department of Pediatrics, Baylor College of Medicine Houston, Houston, Texas, USA
| | - Randall S. Scheibel
- Michael E. DeBakey Veterans Affairs Medical Center Houston, Houston, Texas, USA
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine Houston, Houston, Texas, USA
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16
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Graziani G, Kunkle S, Shih E. Resilience in 2021: Descriptive analysis of individuals accessing virtual mental health services (Preprint). JMIR Form Res 2021; 6:e34283. [PMID: 35357309 PMCID: PMC9015774 DOI: 10.2196/34283] [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: 10/14/2021] [Revised: 12/03/2021] [Accepted: 01/25/2022] [Indexed: 11/15/2022] Open
Abstract
Background Psychological resilience has been extensively studied by developmental researchers, and there is a growing body of literature regarding its role in psychiatry and psychopathology research and practice. This study contributes to this growing literature by providing real-world evidence on the relationship between resilience and clinical symptoms among a large sample of employed Americans. Objective This study aimed to describe resilience levels in individuals accessing Ginger, a virtual mental health system, in addition to the association of resilience with demographic characteristics, baseline depression, and anxiety symptoms. Methods We conducted a retrospective observational study of 9165 members who signed up for Ginger and completed a baseline survey between January 1 and August 5, 2021. We used multivariate regression models to test for associations between baseline resilience and other member characteristics. Results Baseline resilience scores centered on a mean of 23.84 (SD 6.56) and median of 24 (IQR 8) out of 40, with 81.0% (7424/9165) of the sample having low resilience at baseline. Despite having relatively higher resilience scores, members with no or mild depression or anxiety still had low resilience scores on average. Self-reported suicidal ideation was associated with lower resilience. Conclusions Overall, members had low baseline resilience, similar to resilience levels observed in trauma survivors in prior studies. Younger members and those with higher levels of depression and anxiety at intake reported lower levels of resilience at baseline. Notably, members with no or mild depression or anxiety still had low resilience scores on average, suggesting a need for mental health support among individuals who might not typically be recommended for treatment based on traditional clinical assessments, such as the 9-item Patient Health Questionnaire (PHQ-9) and the 7-item Generalized Anxiety Disorder scale (GAD-7). Two suggestions for topics of future research are to develop treatment recommendations based on the Connor-Davidson Resilience Scale and to understand the interaction between resilience levels and symptom-based outcome measures, such as the PHQ-9 and the GAD-7.
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Affiliation(s)
| | | | - Emily Shih
- Ginger, San Francisco, CA, United States
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17
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Avanci JQ, Serpeloni F, de Oliveira TP, de Assis SG. Posttraumatic stress disorder among adolescents in Brazil: a cross-sectional study. BMC Psychiatry 2021; 21:75. [PMID: 33546640 PMCID: PMC7866458 DOI: 10.1186/s12888-021-03062-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 01/19/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The frequency of trauma and different types of violence exposure in urban areas and their effects on the mental health of adolescents in developing countries are poorly investigated. Most information about traumatized young people comes from war scenarios or disasters. This study aimed to determine the prevalence of PTSD in trauma-exposed students in a low-resource city of the state of Rio de Janeiro, Brazil. The effects of sociodemographic and individual and family factors in the development of PTSD were also investigated. METHODS Through multi-stage cluster sampling, 862 adolescents (Mage = 15 years old, 65% female) from public and private schools in the city of São Gonçalo were selected for the study. Self-rating structured questionnaires were applied to assess sociodemographic profile, exposure to physical and psychological violence (family, school, community), sexual abuse, social support, social functional impairment, resilience, and posttraumatic stress disorder. The data were grouped in blocks regarding sociodemographic, individual, family, and community variables. For statistical analysis, chi-square, Fisher's exact test, and logistic regression were performed. RESULTS The PTSD prevalence was 7.8% among adolescents. Boys were exposed to significantly higher number of events of community violence, while girls to family violence. The adjusted odds ratio (OR) for PTSD were statistically significant for age (OR, 1.45, [95% CI, 1.043-2.007]), social functional impairment (OR, 4.82, [95% CI, 1.77-13.10]), severe maternal physical violence (OR, 2.79, [95% CI, 0.79-9.93]), psychological violence by significant people (OR, 3.96, [95% CI, 1.89-8.31]) and a high number of episodes of community violence (OR, 3.52, [95% CI, 1.47-8.40). CONCLUSIONS There was a high prevalence of PTSD within this population associated with exposure to violence. Not only physical, but also psychological violence contributed to PTSD. The results also raise awareness to the differences in life trajectories between boys and girls regarding violence. These differences need to be better understood in order to enable the development of effective preventative interventions. Treating and preventing mental health disorders presents a challenge for countries, especially those with a lower degree of social and economic development and high community violence.
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Affiliation(s)
- Joviana Quintes Avanci
- Department of Studies on Violence and Health Jorge Careli, National School of Public Health, Oswaldo Cruz Foundation, Avenida Brasil 4036, 700 Manguinhos, Rio de Janeiro, 21040-361, Brazil.
| | - Fernanda Serpeloni
- Department of Studies on Violence and Health Jorge Careli, National School of Public Health, Oswaldo Cruz Foundation, Avenida Brasil 4036, 700 Manguinhos, Rio de Janeiro, 21040-361, Brazil
| | - Thiago Pires de Oliveira
- Department of Studies on Violence and Health Jorge Careli, National School of Public Health, Oswaldo Cruz Foundation, Avenida Brasil 4036, 700 Manguinhos, Rio de Janeiro, 21040-361, Brazil
- International Business Machines Corporation, Rio de Janeiro, Brazil
| | - Simone Gonçalves de Assis
- Department of Studies on Violence and Health Jorge Careli, National School of Public Health, Oswaldo Cruz Foundation, Avenida Brasil 4036, 700 Manguinhos, Rio de Janeiro, 21040-361, Brazil
- Neurology Post-Graduate Program, Federal University of the State of Rio de Janeiro, Mariz e Barros 775, Rio de Janeiro, 20270-901, Brazil
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18
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Bauer A, Amspoker AB, Fletcher TL, Jackson C, Jacobs A, Hogan J, Shammet R, Speicher S, Lindsay JA, Cloitre M. A Resource Building Virtual Care Programme: improving symptoms and social functioning among female and male rural veterans. Eur J Psychotraumatol 2021; 12:1860357. [PMID: 34025913 PMCID: PMC8128123 DOI: 10.1080/20008198.2020.1860357] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Background: Veterans have higher rates of PTSD and depression compared to the general population and experience substantial functional impairment. Impairment in social functioning has been a significant concern among Veterans, particularly rural Veterans, who have limited access to mental health care and are at risk for social isolation. Objective: A mixed-method study was implemented to evaluate the feasibility and effectiveness of webSTAIR, a web-based skills training programme, paired with home-based telehealth sessions. It was hypothesized that the programme would lead not only to reductions in PTSD and depression but also to improvements in social functioning. Method: Participants were 80 trauma-exposed Veterans enrolled in rural-serving VHA facilities with clinically elevated symptoms of either PTSD or depression. The study directed substantial outreach efforts to rural women Veterans and those who have experienced military sexual trauma (MST). Results: Significant improvements were obtained with PTSD and depression symptoms as well as in social functioning, emotion regulation, and interpersonal problems at post-treatment and 3-month follow-up. Ratings of therapeutic alliance were high as were reports of overall satisfaction in the programme. There were no differences by gender or MST status in symptom outcomes or satisfaction. Conclusions: The results support the feasibility and effectiveness of this integrated telehealth web-based skills training programme for both male and female Veterans as well as for those with and without MST. The focus on resource building and improved functioning make this programme of particular interest. Further testing is warranted.
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Affiliation(s)
- Ashley Bauer
- National Center for PTSD Dissemination and Training Division, VA Palo Alto Health Care System, Palo Alto, CA, USA
| | - Amber B Amspoker
- VA HSR&D Houston Center of Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX, USA.,Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Terri L Fletcher
- VA HSR&D Houston Center of Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX, USA.,Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.,VA South Central Mental Illness Research, Education and Clinical Center, Houston, TX, USA
| | | | - Adam Jacobs
- National Center for PTSD Dissemination and Training Division, VA Palo Alto Health Care System, Palo Alto, CA, USA
| | - Julianna Hogan
- VA HSR&D Houston Center of Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX, USA.,Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.,VA South Central Mental Illness Research, Education and Clinical Center, Houston, TX, USA
| | - Rayan Shammet
- National Center for PTSD Dissemination and Training Division, VA Palo Alto Health Care System, Palo Alto, CA, USA
| | - Sarah Speicher
- National Center for PTSD Dissemination and Training Division, VA Palo Alto Health Care System, Palo Alto, CA, USA
| | - Jan A Lindsay
- VA HSR&D Houston Center of Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX, USA.,Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.,VA South Central Mental Illness Research, Education and Clinical Center, Houston, TX, USA
| | - Marylène Cloitre
- National Center for PTSD Dissemination and Training Division, VA Palo Alto Health Care System, Palo Alto, CA, USA.,Department of Psychiatry and Behavioural Sciences, Stanford University, Stanford, CA, USA
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19
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Antelo E, Saldaña O, Rodríguez-Carballeira Á. The impact of group psychological abuse on distress: the mediating role of social functioning and resilience. Eur J Psychotraumatol 2021; 12:1954776. [PMID: 34408819 PMCID: PMC8366645 DOI: 10.1080/20008198.2021.1954776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND Previous studies indicate that social functioning and resilience can mitigate the adverse psychological effects of interpersonal violence. Unfortunately, the role of these variables has not been studied in survivors of groups, organizations, and communities in which psychological abusive strategies are inflicted to recruit and dominate their members. OBJECTIVE To examine the mediating role of social functioning and resilience in the relationship between psychological abuse experienced in the past while in a group and current psychosocial distress and psychopathological symptoms. METHOD In this cross-sectional study, an online questionnaire was administered to 794 English-speaking former members of different kinds of groups, such as religious, pseudo therapeutic, pyramid scheme groups, and others. Among them, 499 were victims of group psychological abuse and 295 were non-victims. RESULTS Victims of group psychological abuse reported lower levels of social functioning and resilience than non-victims, and higher levels of psychosocial difficulties and psychopathological symptoms. Serial mediation analyses revealed that social functioning and resilience mediated part of the impact of group psychological abuse on psychosocial difficulties and psychopathological symptoms. Sex and age joining the group were included as covariates. Participants who had experienced higher levels of group psychological abuse tend to have poorer social functioning, which is related to lower resilience. In turn, lower levels of social functioning and resilience are related with higher distress. CONCLUSIONS This research sheds light on the underlying mechanisms involved in the relationship between group psychological abuse and distress suffered following this kind of traumatic experiences. Findings highlight the protective role of social adjustment, which can help promote and enhance resilience and mitigate psychosocial difficulties and psychopathological symptoms in survivors of group psychological abuse.
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Affiliation(s)
- Emma Antelo
- Department of Social Psychology and Quantitative Psychology, Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - Omar Saldaña
- Department of Social Psychology and Quantitative Psychology, Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - Álvaro Rodríguez-Carballeira
- Department of Social Psychology and Quantitative Psychology, Institute of Neurosciences, University of Barcelona, Barcelona, Spain
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20
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Chesnut RP, Richardson CB, Morgan NR, Bleser JA, Perkins DF, Vogt D, Copeland LA, Finley E. Moral Injury and Social Well-Being: A Growth Curve Analysis. J Trauma Stress 2020; 33:587-597. [PMID: 32662166 DOI: 10.1002/jts.22567] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 04/28/2020] [Accepted: 05/10/2020] [Indexed: 11/11/2022]
Abstract
Moral injury (MI) may occur in the context of committing transgressions (i.e., self-directed MI reactions), witnessing transgressions, or being the victims of others' transgressions (i.e., other-directed MI reactions) that violate an individual's moral principles. Veterans with MI may experience impaired social well-being (SWB). Studies on MI and veterans' SWB have focused almost exclusively on social support and used cross-sectional data. The present study used growth curve analyses to examine the associations between self- and other-directed MI reactions and veterans' levels of social support, social functioning, social activities, and social satisfaction over the first 18 to 21 months of their transition to civilian life (N = 9,566). The results demonstrated declines in all SWB outcomes, with self- and other-directed MI reactions having differential effects. Higher versus lower levels of other-directed MI reactions were related to lower baseline scores on all SWB outcomes, βs = -.06 to -.20, and steeper declines over time in social functioning, β = -.09, and social satisfaction, β = -.10. Higher versus lower levels of self-directed MI reactions were related to lower baseline levels of social functioning, β = -.07, but higher baseline levels of social activity, β = .04. Higher versus lower levels of self-directed MI reactions were related to a steeper decline in social activity over time, β = -.10. These findings present a more nuanced picture than that depicted by current MI theoretical frameworks and support further research to uncover moderators of the associations between self- and other-directed MI reactions and SWB outcomes.
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Affiliation(s)
- Ryan P Chesnut
- Clearinghouse for Military Family Readiness at Penn State, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Cameron B Richardson
- Clearinghouse for Military Family Readiness at Penn State, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Nicole R Morgan
- Clearinghouse for Military Family Readiness at Penn State, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Julia A Bleser
- Clearinghouse for Military Family Readiness at Penn State, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Daniel F Perkins
- Clearinghouse for Military Family Readiness at Penn State, The Pennsylvania State University, University Park, Pennsylvania, USA.,Social Science Research Institute, The Pennsylvania State University, University Park, Pennsylvania, USA.,Department of Agricultural Economics, Sociology, and Education, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Dawne Vogt
- Women's Health Sciences Division, VA Boston Healthcare System, Boston, Massachusetts, USA.,Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts, USA
| | | | - Erin Finley
- Veterans Evidence-Based Research Dissemination and Implementation Center, South Texas Veterans Health Care System, San Antonio, Texas, USA
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21
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Clement E, Yoon J, Sutherland T, Tsang B, Fawcett V, Kim M, Widder S. Effect of a mindfulness intervention on patients admitted after multisystem trauma. TRAUMA-ENGLAND 2020. [DOI: 10.1177/1460408619872593] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background The incidence of depression, anxiety, and post-traumatic stress disorders is reported to be as high as 50% in trauma patients. The perpetual negative emotions and state of mind in these disorders predisposes patients to negative mental health outcomes. Mindfulness, on the other hand, helps people to process their experience and emotions in a non-judgmental manner, and recently, there has been increased utilization of mindfulness-based therapies for the treatment of mental health conditions. This proof-of-concept study evaluates the use of a mindfulness-based online application in patients admitted to the trauma service at a Level 1 Trauma Centre. Methods Trauma patients who were English speaking, over the age of 18, and without brain injury or pre-existing neurocognitive disorder were included. Participants completed the Depression Anxiety Stress Scale (DASS)-21 to assess level of depression, anxiety, and stress, and the Connor-Davidson Resilience Scale (CD-RISC) to assess level of resiliency. Then, after 28 consecutive days of practicing mindfulness using the app ‘Stop, Breathe, and Think,’ the questionnaires were repeated and an exit survey conducted. Results For this study, 13 participants were enrolled, 2 withdrew, and 5 were lost to follow-up. The mean DASS-21 score at time enrollment was 16.4 and was 11.2 at follow-up ( p = 0.10). There were no differences between the level of depression and stress from enrollment to follow-up, but there was significant decrease in anxiety symptoms from 7.2 to 3.0 (<0.05). CD-RISC scores at enrollment and follow-up were 77.8 and 81 ( p = 0.23), respectively. At the time of exit interview, 67% of patients continued to use the application three to four times a week and 67% responded they plan to continue using the application. In addition, 83% of patients always or often felt better after practicing mindfulness and stated they would recommend the application to others. Conclusions Mindfulness shows promising potential to decrease psychological distress in trauma patients.
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Affiliation(s)
- Elizabeth Clement
- Department of Surgery, University of Alberta Hospital, Edmonton, AB, Canada
| | - Jenny Yoon
- Department of Surgery, University of Alberta Hospital, Edmonton, AB, Canada
| | - Tala Sutherland
- Department of Surgery, University of Alberta Hospital, Edmonton, AB, Canada
| | - Bonnie Tsang
- Department of Surgery, University of Alberta Hospital, Edmonton, AB, Canada
| | - Vanessa Fawcett
- Department of Surgery, University of Alberta Hospital, Edmonton, AB, Canada
| | - Michael Kim
- Department of Surgery, University of Alberta Hospital, Edmonton, AB, Canada
| | - Sandy Widder
- Department of Surgery, University of Alberta Hospital, Edmonton, AB, Canada
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22
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Hamrick LA, Owens GP. Exploring the potential moderating role of self-compassion on the relationships between event centrality and post-assault psychological outcomes. J Clin Psychol 2020; 77:156-172. [PMID: 32589806 DOI: 10.1002/jclp.23018] [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: 02/27/2020] [Revised: 06/01/2020] [Accepted: 06/11/2020] [Indexed: 11/10/2022]
Abstract
OBJECTIVE The present study examined whether post-assault internal processes (i.e., present control, event centrality, and compassionate and uncompassionate self-responding) were associated with distress and resilience among women who have experienced adult sexual assault. The authors also tested whether compassionate and uncompassionate self-responses would moderate the relationships between event centrality and outcomes. METHOD A convenience sample of women who had experienced sexual assault during adulthood (N = 253) completed an anonymous online survey. RESULTS Regression analyses showed that lower present control, higher event centrality, and higher uncompassionate responses to the self were associated with posttraumatic stress disorder. Additionally, higher present control and higher compassionate responses to the self were associated with resilience. Moderation analyses were not significant. CONCLUSIONS Endorsing greater levels of uncompassionate responses was associated with greater distress while engaging in greater compassionate responses was associated with greater resilience, even when accounting for levels of present control and event centrality.
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Affiliation(s)
- Lauren A Hamrick
- Department of Psychology, University of Tennessee, Knoxville, Tennessee, USA
| | - Gina P Owens
- Department of Psychology, University of Tennessee, Knoxville, Tennessee, USA
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23
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Aziz IA, Yıldırım M. Investigating relationship between psychological trait resilience and forgiveness among internally displaced persons. PSYCHOLOGY, COMMUNITY & HEALTH 2020. [DOI: 10.5964/pch.v8i1.313] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Aim
In general, conflict has many adverse effects on individuals’ lives. The purpose of this study was to examine the relationship between psychological trait resilience and forgiveness among internally displaced persons (IDPs).
Method
The sample consisted of 244 IDPs (111 males and 133 females) who have been exposed to various stressful situations. Age of participants ranged between 18 and 60 years (M = 32.63 years, SD = 8.18). Psychological Trait Resilience Scale and Enright Forgiveness Inventory were used through a cross-sectional study to collect data.
Results
The results showed that IDPs reported low levels of resilience and forgiveness. The results also indicated that ecological resilience was positively related with emotional, behavioral, and cognitive forgiveness, while engineering resilience was positively related with emotional and cognitive forgiveness. Adaptive resilience was found to be positively related with emotional forgiveness. Regression analysis indicated that ecological resilience uniquely predicted emotional, behavioral, and cognitive forgiveness after controlling for demographic characteristics.
Conclusion
These results suggest that higher levels of resilience are important for forgiveness among IDPs. Interventions aiming to enhance IDPs’ forgiveness should account for psychological trait resilience.
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24
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Dong Y, Li H. The relationship between social support and depressive symptoms among the college students of Liaoning, China: a moderated mediated analysis. PSYCHOL HEALTH MED 2019; 25:368-378. [DOI: 10.1080/13548506.2019.1679844] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Yuanyuan Dong
- College of Nursing, Jinzhou Medical University, Jinzhou, China
| | - Hongyu Li
- Institute of Medical Education, Jinzhou Medical University, Jinzhou, China
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25
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Szafranski DD, Gros DF, Acierno R, Brady KT, Killeen TK, Back SE. Heterogeneity of treatment dropout: PTSD, depression, and alcohol use disorder reductions in PTSD and AUD/SUD treatment noncompleters. Clin Psychol Psychother 2018; 26:218-226. [DOI: 10.1002/cpp.2344] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 10/11/2018] [Accepted: 10/11/2018] [Indexed: 11/06/2022]
Affiliation(s)
- Derek D. Szafranski
- Ralph H. Johnson Veterans Affairs Medical CenterMental Health Service 116, General Mental Health 109 Bee Street Charleston SC 29401 USA
- Department of Psychiatry and Behavioral SciencesMedical University of South Carolina Charleston South Carolina USA
| | - Daniel F. Gros
- Ralph H. Johnson Veterans Affairs Medical CenterMental Health Service 116, General Mental Health 109 Bee Street Charleston SC 29401 USA
- Department of Psychiatry and Behavioral SciencesMedical University of South Carolina Charleston South Carolina USA
| | - Ron Acierno
- Ralph H. Johnson Veterans Affairs Medical CenterMental Health Service 116, General Mental Health 109 Bee Street Charleston SC 29401 USA
- College of NursingMedical University of South Carolina Charleston South Carolina USA
| | - Kathleen T. Brady
- Ralph H. Johnson Veterans Affairs Medical CenterMental Health Service 116, General Mental Health 109 Bee Street Charleston SC 29401 USA
- Department of Psychiatry and Behavioral SciencesMedical University of South Carolina Charleston South Carolina USA
| | - Therese K. Killeen
- Department of Psychiatry and Behavioral SciencesMedical University of South Carolina Charleston South Carolina USA
| | - Sudie E. Back
- Ralph H. Johnson Veterans Affairs Medical CenterMental Health Service 116, General Mental Health 109 Bee Street Charleston SC 29401 USA
- Department of Psychiatry and Behavioral SciencesMedical University of South Carolina Charleston South Carolina USA
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26
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Herbert MS, Leung DW, Pittman JOE, Floto E, Afari N. Race/ethnicity, psychological resilience, and social support among OEF/OIF combat veterans. Psychiatry Res 2018; 265:265-270. [PMID: 29763847 DOI: 10.1016/j.psychres.2018.04.052] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 03/12/2018] [Accepted: 04/28/2018] [Indexed: 11/19/2022]
Abstract
This study examined the relationship between race/ethnicity and psychological resilience, and the moderating role of social support in this relationship among non-Hispanic White (n = 605), Hispanic (n = 107), African American (n = 141), and Asian American (n = 97) Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) combat veterans. Veterans were primarily male (88%) with a mean age of 31.4 years (SD = 8.35). An analysis of covariance showed that Asian American veterans reported significantly lower psychological resilience than non-Hispanic White veterans. The interaction of race/ethnicity and social support with psychological resilience was examined via linear regression. We found that the relationship between psychological resilience and social support significantly differed by race/ethnicity such that social support was positively associated with psychological resilience among non-Hispanic White veterans, but not among other racial/ethnic groups. Our findings are consistent with previous studies that show Asian American veterans report lower psychological resilience than non-Hispanic White veterans. Cultural differences in how and why individuals use social support may underlie racial/ethnic differences in the relationship between social support and psychological resilience. Future qualitative and quantitative research is encouraged to better understand how social support relates to psychological resilience among minority OEF/OIF combat veterans.
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Affiliation(s)
- Matthew S Herbert
- Center of Excellence for Stress and Mental Health (CESAMH) San Diego, CA USA; VA San Diego Healthcare System, University of California, San Diego, CA, USA; Department of Psychiatry, University of California, San Diego, CA USA
| | - Desmond W Leung
- Baruch College & The Graduate Center, City University of New York, NY USA
| | - James O E Pittman
- Center of Excellence for Stress and Mental Health (CESAMH) San Diego, CA USA; VA San Diego Healthcare System, University of California, San Diego, CA, USA; Department of Psychiatry, University of California, San Diego, CA USA
| | - Elizabeth Floto
- Center of Excellence for Stress and Mental Health (CESAMH) San Diego, CA USA; VA San Diego Healthcare System, University of California, San Diego, CA, USA; Department of Psychiatry, University of California, San Diego, CA USA
| | - Niloofar Afari
- Center of Excellence for Stress and Mental Health (CESAMH) San Diego, CA USA; VA San Diego Healthcare System, University of California, San Diego, CA, USA; Department of Psychiatry, University of California, San Diego, CA USA.
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27
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Mehta D, Bruenig D, Lawford B, Harvey W, Carrillo-Roa T, Morris CP, Jovanovic T, Young RM, Binder EB, Voisey J. Accelerated DNA methylation aging and increased resilience in veterans: The biological cost for soldiering on. Neurobiol Stress 2018; 8:112-119. [PMID: 29888306 PMCID: PMC5991315 DOI: 10.1016/j.ynstr.2018.04.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Revised: 04/04/2018] [Accepted: 04/05/2018] [Indexed: 11/29/2022] Open
Abstract
Accelerated epigenetic aging, the difference between the DNA methylation-predicted age (DNAm age) and the chronological age, is associated with a myriad of diseases. This study investigates the relationship between epigenetic aging and risk and protective factors of PTSD. Genome-wide DNA methylation analysis was performed in 211 individuals including combat-exposed Australian veterans (discovery cohort, n = 96 males) and trauma-exposed civilian males from the Grady Trauma Project (replication cohort, n = 115 males). Primary measures included the Clinician Administered PTSD Scale for DSM-5 and the Connor-Davidson Resilience Scale (CD-RISC). DNAm age prediction was performed using the validated epigenetic clock calculator. Veterans with PTSD had increased PTSD symptom severity (P-value = 3.75 × 10-34) and lower CD-RISC scores (P-value = 7.5 × 10-8) than veterans without PTSD. DNAm age was significantly correlated with the chronological age (P-value = 3.3 × 10-6), but DNAm age acceleration was not different between the PTSD and non-PTSD groups (P-value = 0.24). Evaluating potential protective factors, we found that DNAm age acceleration was significantly associated with CD-RISC resilience scores in veterans with PTSD, these results remained significant after multiple testing correction (P-value = 0.023; r = 0.32). This finding was also replicated in an independent trauma-exposed civilian cohort (P-value = 0.02; r = 0.23). Post-hoc factor analyses revealed that this association was likely driven by "self-efficacy" items within the CD-RISC (P-value = 0.015; r = 0.35). These results suggest that among individuals already suffering from PTSD, some aspects of increased resilience might come at a biological cost.
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Affiliation(s)
- Divya Mehta
- School of Psychology and Counselling, Faculty of Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland 4059, Australia
| | - Dagmar Bruenig
- School of Biomedical Sciences, Faculty of Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland 4059, Australia
- Gallipoli Medical Research Institute, Greenslopes Private Hospital, Newdegate Street, Greenslopes, QLD 4120, Australia
| | - Bruce Lawford
- School of Biomedical Sciences, Faculty of Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland 4059, Australia
| | - Wendy Harvey
- Gallipoli Medical Research Institute, Greenslopes Private Hospital, Newdegate Street, Greenslopes, QLD 4120, Australia
| | - Tania Carrillo-Roa
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, 80804, Germany
| | - Charles P. Morris
- School of Biomedical Sciences, Faculty of Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland 4059, Australia
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Ross McD. Young
- School of Psychology and Counselling, Faculty of Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland 4059, Australia
- Gallipoli Medical Research Institute, Greenslopes Private Hospital, Newdegate Street, Greenslopes, QLD 4120, Australia
| | - Elisabeth B. Binder
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, 80804, Germany
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Joanne Voisey
- School of Biomedical Sciences, Faculty of Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland 4059, Australia
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Lee EE, Martin AS, Tu X, Palmer BW, Jeste DV. Childhood Adversity and Schizophrenia: The Protective Role of Resilience in Mental and Physical Health and Metabolic Markers. J Clin Psychiatry 2018; 79:17m11776. [PMID: 29701938 PMCID: PMC6464641 DOI: 10.4088/jcp.17m11776] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 01/08/2018] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To determine the impact of childhood adversity and current (adulthood) resilience on mental and physical health and markers of metabolic function among adults with schizophrenia and nonpsychiatric comparison participants (NCs). METHODS We conducted a cross-sectional study of 114 participants with schizophrenia (DSM-IV-TR criteria) and 101 NCs aged 26-65 years during 2012-2017. Sociodemographic, clinical, and laboratory measures were examined. Childhood Trauma Questionnaire was used to retrospectively assess emotional abuse/neglect, physical abuse/neglect, and sexual abuse experienced during childhood. Connor-Davidson Resilience Scale was employed to measure resilience. RESULTS Persons with schizophrenia reported more severe childhood trauma, lower resilience, and worse mental and physical health and had worse metabolic biomarker levels than NCs. Trauma severity correlated with worse depression in the NCs (r = 0.34), but not in the schizophrenia group (r = 0.02). In both groups, trauma severity was associated with worse physical well-being, higher fasting insulin levels, and greater insulin resistance (P ≤ .02). Notably, resilience appeared to counteract effects of trauma and diagnosis on mental and physical health. The schizophrenia subgroup with high resilience and severe trauma reported mental and physical well-being and had glycosylated hemoglobin levels and insulin resistance scores that were comparable to those of NCs with low resilience and severe trauma. CONCLUSIONS To our knowledge, this is the first study to quantitatively assess effects of both childhood trauma and resilience in schizophrenia on health, notably metabolic function. Interventions to bolster resilience in the general population and in people with schizophrenia may improve outcomes for those with a history of childhood adversity.
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Affiliation(s)
- Ellen E. Lee
- Department of Psychiatry, University of California San Diego, La Jolla, CA, United States.,Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA, United States
| | - Averria Sirkin Martin
- Department of Psychiatry, University of California San Diego, La Jolla, CA, United States.,Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA, United States
| | - Xin Tu
- Department of Psychiatry, University of California San Diego, La Jolla, CA, United States.,Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, United States
| | - Barton W. Palmer
- Department of Psychiatry, University of California San Diego, La Jolla, CA, United States.,Veterans Affairs San Diego Healthcare System, San Diego, CA, United States
| | - Dilip V. Jeste
- Department of Psychiatry, University of California San Diego, La Jolla, CA, United States.,Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA, United States.,Department of Neurosciences, University of California, San Diego, CA, United States
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29
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Denckla CA, Consedine NS, Spies G, Cherner M, Henderson DC, Koenen KC, Seedat S. Associations between neurocognitive functioning and social and occupational resilience among South African women exposed to childhood trauma. Eur J Psychotraumatol 2017; 8:1394146. [PMID: 29163865 PMCID: PMC5687801 DOI: 10.1080/20008198.2017.1394146] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 10/12/2017] [Indexed: 12/21/2022] Open
Abstract
Background: Prior research on adaptation after early trauma among black South African women typically assessed resilience in ways that lacked contextual specificity. In addition, the neurocognitive correlates of social and occupational resilience have not been investigated. Objective: The primary aim of this exploratory study was to identify domains of neurocognitive functioning associated with social and occupational resilience, defined as functioning at a level beyond what would be expected given exposure to childhood trauma. Methods: A sample of black South African women, N = 314, completed a neuropsychological battery, a questionnaire assessing exposure to childhood trauma, and self-report measures of functional status. We generated indices of social and occupational resilience by regressing childhood trauma exposure on social and occupational functioning, saving the residuals as indices of social and occupational functioning beyond what would be expected given exposure to childhood trauma. Results: Women with lower non-verbal memory evidenced greater social and occupational resilience above and beyond the effects attributable to age, education, HIV status, and depressive and posttraumatic stress symptoms. In addition, women with greater occupational resilience exhibited lower semantic language fluency and processing speed. Conclusion: Results are somewhat consistent with prior studies implicating memory effects in impairment following trauma, though our findings suggest that reduced abilities in these domains may be associated with greater resilience. Studies that use prospective designs and objective assessment of functional status are needed to determine whether non-verbal memory, semantic fluency, and processing speed are implicated in the neural circuitry of post-traumatic exposure resilience.
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Affiliation(s)
- C A Denckla
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Cambridge, MA, USA
| | - N S Consedine
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | - G Spies
- Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| | - M Cherner
- HIV Neurobehavioral Research Center, University of California, San Diego, CA, USA
| | - D C Henderson
- Boston Medical Center, Boston University, Boston, MA, USA
| | - K C Koenen
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Cambridge, MA, USA
| | - S Seedat
- Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
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