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Pujo JM, Fitriani DY, Ben Saad H, Ghariani M, Dghim A, Mellouli M, Burin A, Mutricy R, Houcke S, Roujansky A, Mansyur M, Nkontcho F, de Toffol B, Ben Amara I, Kallel H. The effects of prolonged stress exposure on the brain of rats and insights to understand the impact of work-related stress on caregivers. Front Behav Neurosci 2023; 17:1288814. [PMID: 38098499 PMCID: PMC10720043 DOI: 10.3389/fnbeh.2023.1288814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 10/20/2023] [Indexed: 12/17/2023] Open
Abstract
Introduction Stress exposure is a significant concern in the healthcare sector. This animal model study aims to reproduce caregivers' working conditions and determine their impact on the brain. Method Twenty-four healthy male rats of the Wistar strain were divided into four groups. Three groups were submitted each to one stressor for 21 days, while the fourth group was used as a control. Stressors were food and water deprivation (FW), permanent illumination (PI), and forced swimming (FS). At the end of the experiment, rats were euthanized, and stress biomarkers, biological parameters, and DNA damage were measured. Results Prooxidant biomarker rates increased in the different groups (+50 to +75%) compared to the control (p < 0.0001). Urinary corticosterone rates increased in all stressed animals, mainly in the PI group, with changes of up to +50% compared to the control group. Acetylcholinesterase levels decreased to -50% (p < 0.0001 for the three exposed groups). Total ATPase, (Na+/K+)-ATPase, and Mg2+-ATPase activities decreased in all stressed groups. The percentage of brain cell congestion and apoptosis was 3% for the FW group (p < 0.0001), 2% for the PI group (p < 0.0001), and 4% for the FS group (p < 0.0001) compared to the control (0.8%). DNA damage was observed in all exposed groups. Finally, we noticed behavioral changes and a depression-like syndrome in all stressed rats. Conclusion Stressful conditions such as the working environment of caregivers can trigger several pathophysiological processes leading to oxidative, neurochemical, and hypothalamic-pituitary-adrenal disorders. These changes can progress to cell damage and apoptosis in the brain and trigger psychological and physical disorders.
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Affiliation(s)
- Jean Marc Pujo
- Emergency Department, Cayenne General Hospital, Cayenne, French Guiana
| | - Dewi Yunia Fitriani
- Community Medicine Department, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
- Occupational Medicine Specialist Program, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
- Occupational and Environmental Health Research Center, IMERI, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Hajer Ben Saad
- Laboratory of Medicinal and Environment Chemistry, Higher Institute of Biotechnology, University of Sfax, Sfax, Tunisia
| | - Marwa Ghariani
- Laboratory of Medicinal and Environment Chemistry, Higher Institute of Biotechnology, University of Sfax, Sfax, Tunisia
- Laboratory of Molecular and Cellular Screening Processes (LPCMC), LR15CBS07, Center of Biotechnology of Sfax, University of Sfax, Sfax, Tunisia
| | - Amel Dghim
- Laboratory of Medicinal and Environment Chemistry, Higher Institute of Biotechnology, University of Sfax, Sfax, Tunisia
| | - Manel Mellouli
- Laboratory of Anatomopathology, CHU Habib Bourguiba, University of Sfax, Sfax, Tunisia
| | - Antoine Burin
- Emergency Department, Cayenne General Hospital, Cayenne, French Guiana
| | - Remi Mutricy
- Emergency Department, Cayenne General Hospital, Cayenne, French Guiana
| | - Stephanie Houcke
- Intensive Care Unit, Cayenne General Hospital, Cayenne, French Guiana
| | - Ariane Roujansky
- Intensive Care Unit, Cayenne General Hospital, Cayenne, French Guiana
| | - Muchtaruddin Mansyur
- Community Medicine Department, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
- Occupational Medicine Specialist Program, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
- Occupational and Environmental Health Research Center, IMERI, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Flaubert Nkontcho
- Pharmacy Department, Cayenne General Hospital, Cayenne, French Guiana
| | | | - Ibtissem Ben Amara
- Laboratory of Medicinal and Environment Chemistry, Higher Institute of Biotechnology, University of Sfax, Sfax, Tunisia
| | - Hatem Kallel
- Intensive Care Unit, Cayenne General Hospital, Cayenne, French Guiana
- Tropical Biome and Immunopathology CNRS UMR-9017, Inserm U 1019, Université de Guyane, Cayenne, French Guiana
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2
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Alloqi Tahirbegolli I, Tahirbegolli B, Şen S, Sayın B, Kaşkal M, Üresin AY. Evaluation of Stress Response in Middle-Aged Male Diabetic Hypertensive Patients. J Clin Endocrinol Metab 2023; 108:2307-2314. [PMID: 36880261 PMCID: PMC10438877 DOI: 10.1210/clinem/dgad122] [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: 01/03/2023] [Revised: 02/14/2023] [Accepted: 02/28/2023] [Indexed: 03/08/2023]
Abstract
CONTEXT Stress triggers a cascade of reactions that alter the organism's dynamic steady state. There is a scarcity of interventional studies that show cortisol variability upon stress over time in groups of patients with chronic noncommunicable diseases and comorbidities. OBJECTIVE We aimed to examine salivary cortisol changes in the cognitive stress response of patients with hypertension and diabetes mellitus (HT&DM) and patients with hypertension (HT) and to determine differences between them. METHODS The study was conducted using a stress test of solving an arithmetic task in 62 patients with HT&DM and HT who were being treated in the outpatient clinic of the Medical Pharmacology and Clinical Pharmacology Department in Istanbul University, Istanbul Medical Faculty Hospital. RESULTS There was no statistically significant difference between the HT&DM and HT groups for systolic blood pressure (SBP) and diastolic blood pressure (DBP) values (P = .331 and P = .058). When measured by repeated ANOVA, salivary cortisol level [F (1.842, 60) = 8.771, P < .0001], SBP [F (2.185, 60) = 12.080, P < .0001], DBP [F (2.793, 60) = 6.043, P = .001], and heart rate [F (2.073, 60) = 13.259, P < .0001] were statistically significant for the main effect (time), while the effect of the group × time interaction factor was statistically not significant (P = .773; P = .751; P = .713 and P = .506, respectively). CONCLUSION The arithmetic problem-solving task used with the HT&DM and HT patients was useful as an acute stress test in the laboratory environment. There was no statistically significant difference for group × time interaction factor between the HT&DM and HT groups; however, the salivary cortisol and BP values increased significantly after acute stress within each group.
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Affiliation(s)
- Iliriana Alloqi Tahirbegolli
- Clinical Pharmacology Division, Department of Medical Pharmacology, Institute of Medical Sciences, Istanbul University, 34126 Istanbul, Turkey
- Laboratory Technician Department, Heimerer College, 10000 Prishtina, Kosovo
| | - Bernard Tahirbegolli
- Public Health Department, Institute of Medical Sciences, Istanbul University, 34126 Istanbul, Turkey
- Management of Health Institutions and Services Department, Heimerer College, 10000 Prishtina, Kosovo
- National Sports Medicine Center, 10000 Prishtina, Kosovo
| | - Selçuk Şen
- Division of Clinical Pharmacology, Department of Medical Pharmacology, Istanbul Faculty of Medicine, Istanbul University, 34093 Istanbul, Turkey
| | - Betül Sayın
- Division of Clinical Pharmacology, Department of Medical Pharmacology, Istanbul Faculty of Medicine, Istanbul University, 34093 Istanbul, Turkey
| | - Mert Kaşkal
- Department of Pharmacology, Marmara University School of Medicine, 34854 Istanbul, Turkey
| | - Ali Yağız Üresin
- Division of Clinical Pharmacology, Department of Medical Pharmacology, Istanbul Faculty of Medicine, Istanbul University, 34093 Istanbul, Turkey
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3
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Kühnel A, Czisch M, Sämann PG, Binder EB, Kroemer NB. Spatiotemporal Dynamics of Stress-Induced Network Reconfigurations Reflect Negative Affectivity. Biol Psychiatry 2022; 92:158-169. [PMID: 35260225 DOI: 10.1016/j.biopsych.2022.01.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 01/09/2022] [Accepted: 01/13/2022] [Indexed: 02/08/2023]
Abstract
BACKGROUND Maladaptive stress responses are important risk factors in the etiology of mood and anxiety disorders, but exact pathomechanisms remain to be understood. Mapping individual differences of acute stress-induced neurophysiological changes, especially on the level of neural activation and functional connectivity (FC), could provide important insights in how variation in the individual stress response is linked to disease risk. METHODS Using an established psychosocial stress task flanked by two resting states, we measured subjective, physiological, and brain responses to acute stress and recovery in 217 participants with and without mood and anxiety disorders. To estimate blockwise changes in stress-induced activation and FC, we used hierarchical mixed-effects models based on denoised time series within predefined stress-related regions. We predicted inter- and intraindividual differences in stress phases (anticipation vs. stress vs. recovery) and transdiagnostic dimensions of stress reactivity using elastic net and support vector machines. RESULTS We identified four subnetworks showing distinct changes in FC over time. FC but not activation trajectories predicted the stress phase (accuracy = 70%, pperm < .001) and increases in heart rate (R2 = 0.075, pperm < .001). Critically, individual spatiotemporal trajectories of changes across networks also predicted negative affectivity (ΔR2 = 0.075, pperm = .030) but not the presence or absence of a mood and anxiety disorder. CONCLUSIONS Spatiotemporal dynamics of brain network reconfiguration induced by stress reflect individual differences in the psychopathology dimension of negative affectivity. These results support the idea that vulnerability for mood and anxiety disorders can be conceptualized best at the level of network dynamics, which may pave the way for improved prediction of individual risk.
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Affiliation(s)
- Anne Kühnel
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany; International Max Planck Research School for Translational Psychiatry, Munich, Germany.
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- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
| | - Elisabeth B Binder
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany.
| | - Nils B Kroemer
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health, University of Tübingen, Tübingen, Germany
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4
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Stanley B, Dixon L. Health System-Based Low-Intensity Interventions to Prevent Self-harm Among Patients With Suicidal Ideation: Disentangling the Effects of Implementation Strategies and Interventions. JAMA 2022; 327:626-628. [PMID: 35166818 DOI: 10.1001/jama.2022.0770] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Barbara Stanley
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, New York
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York
- Center for Practice Innovations, New York State Psychiatric Institute, New York
| | - Lisa Dixon
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, New York
- Center for Practice Innovations, New York State Psychiatric Institute, New York
- Division of Behavioral Health Services and Policy Research, New York State Psychiatric Institute, New York
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5
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Flores-Kanter PE, Moretti L, Medrano LA. A narrative review of emotion regulation process in stress and recovery phases. Heliyon 2021; 7:e07218. [PMID: 34179528 PMCID: PMC8213899 DOI: 10.1016/j.heliyon.2021.e07218] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 03/13/2020] [Accepted: 06/02/2021] [Indexed: 12/02/2022] Open
Abstract
The difficulty in studying the relationship between stress and emotional regulation is due to the need to contemplate a dynamic perspective that analyzes the moderating role of stress. In fact, stress involves different phases or stages, and the neurocognitive processes involved in emotion regulation differ significantly between these phases. The period of anticipation of stressful events can be fundamental to understand the process of stress regulation; however, surprisingly few works have analyzed the differential activation of brain networks involved in cognitive regulation during the phases of stress and recovery. Taking this into consideration, within this study we propose to analyze in an integrated way the psychological and neurobiological processes during the phase of stress and recovery, with the aim of improving our understanding of the mechanisms that underlie successful and unsuccessful stress regulation. We consider that from the present review we contribute to achieve a better understanding of the mechanisms underlying successful and unsuccessful stress regulation would contribute to the improvement of prevention and treatment interventions for mental disorders.
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Affiliation(s)
- Pablo Ezequiel Flores-Kanter
- Universidad Siglo 21, Argentina.,Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina
| | - Luciana Moretti
- Universidad Siglo 21, Argentina.,Pontificia Universidad Católica Madre y Maestra, República Dominicana
| | - Leonardo Adrián Medrano
- Universidad Siglo 21, Argentina.,Pontificia Universidad Católica Madre y Maestra, República Dominicana
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6
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Mikkelsen MB, Tramm G, Zachariae R, Gravholt CH, O’Toole MS. A systematic review and meta-analysis of the effect of emotion regulation on cortisol. COMPREHENSIVE PSYCHONEUROENDOCRINOLOGY 2021; 5:100020. [PMID: 35754452 PMCID: PMC9216322 DOI: 10.1016/j.cpnec.2020.100020] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Accepted: 12/07/2020] [Indexed: 12/28/2022] Open
Abstract
It is generally acknowledged that hormones are implicated in socioemotional behavior, yet little is known about the role of hormones in the context of emotion regulation. The aims of the present review and meta-analysis were to review and synthesize the available evidence pertaining to the effect of emotion regulation instructions on hormones, and to investigate whether this effect varies according to: type of hormone, context (e.g., emotion-induction procedure), emotion regulation characteristics (e.g., emotion regulation strategy), and presence and type of psychiatric disorder. PubMed, PsycINFO, and CINAHL were searched for experimental studies assessing the effect of instructed emotion regulation on levels of hormones (i.e., testosterone, cortisol, oxytocin, estradiol, and vasopressin) in physically healthy adults. The literature search yielded 17 relevant studies, 16 investigating cortisol and one investigating testosterone. Of these, 12 cortisol studies had eligible data for the meta-analysis. The results of the meta-analysis indicated no statistically significant effect of receiving an emotion regulation instruction compared with receiving no instruction on the cortisol response to subsequent emotion induction (g = −0.05, p = .48). However, within-person comparisons of change from an unregulated response to a regulated response indicated a significant change in cortisol levels (g = 0.18, p = .03) consistent with the specified regulation goal (i.e., either up- or downregulation). No statistically significant effects were found in subgroup meta-analyses conducted according to context, emotion regulation characteristics or psychiatric disorders. Taken together, the findings indicate that emotion-induction procedures are associated with increases in cortisol that may subsequently return to equilibrium regardless of emotion-regulation instructions. Based on the large gaps in research (e.g., few studies investigated other hormones than cortisol, few studies included self-report measures of emotions) identified in the present review, we conclude that the effect of emotion regulation on hormones remains poorly understood. Prospero registration CRD42020157336. Research on the effect of emotion regulation on hormones has focused on cortisol. Emotion regulation does not influence cortisol responses to emotion induction. Psychological confounders have received little attention in the reviewed research. The effect of emotion regulation on hormones remains poorly understood.
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7
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Emotional Comprehension Is Not Related to Duration of Distress from Daily Life Events. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020459. [PMID: 33430055 PMCID: PMC7827275 DOI: 10.3390/ijerph18020459] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 12/04/2020] [Accepted: 12/30/2020] [Indexed: 11/21/2022]
Abstract
The main aim of this paper is to analyze to what extent insight (i.e., mentalization referring to one’s own mental state) moderates recovering from daily life events. A total of 110 participants (84.5% women; mean age: M = 21.5; SD = 3.2) filled in the Trait Meta-Mood Scale (TMMS-24) and the Eysenck Personality Questionnaire (EPQ-R), and were interviewed about impairment derived from daily life events (everyday life stresses) during the past year. Multivariate regression models were adjusted for neuroticism, sex, and socioeconomic status to analyze whether different degrees of insight moderated the relationship between the intensity and the duration of emotional distress. Results showed that the global measure of insight did not moderate recovering from daily-life distress. Regarding the subdimensions, attention to emotional reactions was related to an increased duration of distress. Results showed that, against our hypothesis, deeper comprehension of emotional reactions, operationalized here as “true insight”, was not associated to faster recovery. Limitations and recommendations for further studies are discussed considering these results.
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8
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Laferton JAC, Oeltjen L, Neubauer K, Ebert DD, Munder T. The effects of patients' expectations on surgery outcome in total hip and knee arthroplasty: a prognostic factor meta-analysis. Health Psychol Rev 2020; 16:50-66. [PMID: 33228474 DOI: 10.1080/17437199.2020.1854051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Patients' expectations are among the most frequently studied psychological prognostic factors in total knee and hip arthroplasty (TKA/THA). So far, however, evidence on the effect of patients' preoperative expectations on surgery outcome is inconclusive. Heterogeneity of expectation constructs and the use of psychometrically not evaluated measurement instruments have constituted major obstacles for the integration of the current literature. Using a theory-based model of expectation constructs , this meta-analysis set out to disentangle the conflicting results in the current literature. Systematic literature searches yielded k = 46 studies (N = 10,465) that reported associations of preoperative expectations with postoperative pain, functioning and disability, and satisfaction. Random effects meta-analysis revealed a robust small association (r = .16; 95% CI .13, .19) between patients' positive preoperative expectations and better postoperative outcomes. This effect did not differ between THA and TKA, different outcome categories and different follow-up periods. Studies using psychometrically evaluated expectation measures reported significantly higher effects (r = .19; 95% CI .16, .22). Whether this effect varies among different expectation constructs remains unclear. High-quality studies using validated, multidimensional expectation measures are needed to further understand the role of different expectation constructs in THA and TKA surgery.
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Affiliation(s)
- Johannes A C Laferton
- Division of Clinical Psychology and Psychotherapy, Psychologische Hochschule Berlin, Berlin, Germany.,Division of Clinical Psychology and Psychotherapy, Department of Psychology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.,Division of Psychological Medicine, Department of Medicine, Health and Medical University Potsdam, Potsdam, Germany
| | - Lara Oeltjen
- Department of Psychological Methods, Institute of Psychology, Friedrich-Schiller-Universität Jena, Jena, Germany
| | | | - David D Ebert
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Thomas Munder
- Department of Psychology, University of Zurich, Zurich, Switzerland
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9
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Post-Encoding Stress Does Not Enhance Memory Consolidation: The Role of Cortisol and Testosterone Reactivity. Brain Sci 2020; 10:brainsci10120995. [PMID: 33339431 PMCID: PMC7766306 DOI: 10.3390/brainsci10120995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 11/27/2020] [Accepted: 12/15/2020] [Indexed: 11/17/2022] Open
Abstract
In contrast to the large body of research on the effects of stress-induced cortisol on memory consolidation in young people, far less attention has been devoted to understanding the effects of stress-induced testosterone on this memory phase. This study examined the psychobiological (i.e., anxiety, cortisol, and testosterone) response to the Maastricht Acute Stress Test and its impact on free recall and recognition for emotional and neutral material. Thirty-seven healthy young men and women were exposed to a stress (MAST) or control task post-encoding, and 24 h later, they had to recall the material previously learned. Results indicated that the MAST increased anxiety and cortisol levels, but it did not significantly change the testosterone levels. Post-encoding MAST did not affect memory consolidation for emotional and neutral pictures. Interestingly, however, cortisol reactivity was negatively related to free recall for negative low-arousal pictures, whereas testosterone reactivity was positively related to free recall for negative-high arousal and total pictures. This study provides preliminary evidence about a different reactivity of testosterone and cortisol to the MAST as well as on their effects on consolidation. Our results suggest a different pattern of relationships between these steroid hormones and the arousal of the negative images.
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10
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Kühnel A, Kroemer NB, Elbau IG, Czisch M, Sämann PG, Walter M, Binder EB. Psychosocial stress reactivity habituates following acute physiological stress. Hum Brain Mapp 2020; 41:4010-4023. [PMID: 32597537 PMCID: PMC7469805 DOI: 10.1002/hbm.25106] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 05/13/2020] [Accepted: 06/12/2020] [Indexed: 11/08/2022] Open
Abstract
Acute and chronic stress are important factors in the development of mental disorders. Reliable measurement of stress reactivity is therefore pivotal. Critically, experimental induction of stress often involves multiple “hits” and it is an open question whether individual differences in responses to an earlier stressor lead to habituation, sensitization, or simple additive effects on following events. Here, we investigated the effect of the individual cortisol response to intravenous catheter placement (IVP) on subsequent neural, psychological, endocrine, and autonomous stress reactivity. We used an established psychosocial stress paradigm to measure the acute stress response (Stress) and recovery (PostStress) in 65 participants. Higher IVP‐induced cortisol responses were associated with lower pulse rate increases during stress recovery (b = −4.8 bpm, p = .0008) and lower increases in negative affect after the task (b = −4.2, p = .040). While the cortisol response to IVP was not associated with subsequent specific stress‐induced neural activation patterns, the similarity of brain responses Pre‐ and PostStress was higher IVP‐cortisol responders (t[64] = 2.35, p = .022) indicating faster recovery. In conclusion, preparatory stress induced by IVP reduced reactivity in a subsequent stress task by modulating the latency of stress recovery. Thus, an individually stronger preceding release of cortisol may attenuate a second physiological response and perceived stress suggesting that relative changes, not absolute levels are crucial for stress attribution. Our study highlights that considering the entire trajectory of stress induction during an experiment is important to develop reliable individual biomarkers.
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Affiliation(s)
- Anne Kühnel
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany.,International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Munich, Germany
| | - Nils B Kroemer
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Immanuel G Elbau
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
| | | | | | - Martin Walter
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany.,Leibniz Institute for Neurobiology, Magdeburg, Germany.,Department of Psychiatry and Psychotherapy, Otto-von-Guericke University Magdeburg, Magdeburg, Germany.,Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
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- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany.,Max Planck Institute of Psychiatry, Munich, Germany
| | - Elisabeth B Binder
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
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11
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Simms M, Arnold R, Turner JE, Hays K. A repeated-measures examination of organizational stressors, perceived psychological and physical health, and perceived performance in semi-elite athletes. J Sports Sci 2020; 39:64-77. [PMID: 32851916 DOI: 10.1080/02640414.2020.1804801] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Organizational stressors can undermine the psychological well-being and performance of athletes. Less is known, however, about how these relationships unfold over time and whether organizational stressors can impact upon perceived physical health. The current study, therefore, used a repeated-measures design to examine relationships between organizational stressors with components of perceived psychological (anxiety and depression) and physical (illness symptoms and missed training days via illness) ill-health, and perceived performance at the within-person level. Twenty-three semi-elite female rowers completed monthly measures of study variables for six-months. Multilevel models indicated that selection-related stressors positively predicted symptoms of perceived psychological and physical ill-health, and negatively predicted perceived performance. Conversely, coaching stressors negatively predicted symptoms of perceived psychological ill-health. Logistics and operations stressors positively predicted perceived performance, whereas goals and development stressors negatively predicted perceived performance. These findings demonstrate for the first time that, with a repeated-measures design, organizational stressors can predict components of perceived physical and psychological ill-health, and perceived performance at the within-person level in athletes. From a practical perspective, practitioners should incorporate these findings when diagnosing the need for, developing, and optimally implementing primary and secondary stress management interventions.
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Affiliation(s)
- Max Simms
- Department for Health, University of Bath Bath UK
| | | | | | - Kate Hays
- English Institute of Sport Manchester UK
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12
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Kube T, Rozenkrantz L. When Beliefs Face Reality: An Integrative Review of Belief Updating in Mental Health and Illness. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2020; 16:247-274. [DOI: 10.1177/1745691620931496] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Belief updating is a relatively nascent field of research that examines how people adjust their beliefs in light of new evidence. So far, belief updating has been investigated in partly unrelated lines of research from different psychological disciplines. In this article, we aim to integrate these disparate lines of research. After presenting some prominent theoretical frameworks and experimental designs that have been used for the study of belief updating, we review how healthy people and people with mental disorders update their beliefs after receiving new information that supports or challenges their views. Available evidence suggests that both healthy people and people with particular mental disorders are prone to certain biases when updating their beliefs, although the nature of the respective biases varies considerably and depends on several factors. Anomalies in belief updating are discussed in terms of both new insights into the psychopathology of various mental disorders and societal implications, such as irreconcilable political and societal controversies due to the failure to take information into account that disconfirms one’s own view. We conclude by proposing a novel integrative model of belief updating and derive directions for future research.
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Affiliation(s)
- Tobias Kube
- Program in Placebo Studies, Harvard Medical School/Beth Israel Deaconess Medical Center, Boston, Massachusetts
- Department of Psychology, Clinical Psychology and Psychotherapy, University of Koblenz-Landau
| | - Liron Rozenkrantz
- Program in Placebo Studies, Harvard Medical School/Beth Israel Deaconess Medical Center, Boston, Massachusetts
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology
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13
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Boggiss AL, Consedine NS, Brenton-Peters JM, Hofman PL, Serlachius AS. A systematic review of gratitude interventions: Effects on physical health and health behaviors. J Psychosom Res 2020; 135:110165. [PMID: 32590219 DOI: 10.1016/j.jpsychores.2020.110165] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 05/12/2020] [Accepted: 05/31/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Gratitude interventions are easy-to-deliver, offering promise for use in clinical-care. Although gratitude interventions have consistently shown benefits to psychological wellbeing, the effects on physical health outcomes are mixed. This systematic review aims to synthesize gratitude intervention studies which assessed physical health and health behavior outcomes, as well as evaluate study quality, comment on their efficacy, and provide directions for future research. METHODS Relevant studies were identified through searches conducted in PsycINFO, MedLine, Embase and Cochrane Library databases, up until August 2019. Only studies that evaluated a gratitude intervention, randomly assigned participants to gratitude and control conditions, and assessed objective and subjective measures of physical health and health behaviors were included. The Revised Cochrane risk-of-bias (RoB2) tool was used to assess risk of bias. RESULTS Of the 1433 articles found, 19 were included in the review. Subjective sleep quality was improved in 5/8 studies. Improvements in blood pressure, glycemic control, asthma control and eating behavior were understudied yet demonstrated improvements (all 1/1). Other outcome categories remain understudied and mixed, such as inflammation markers (1/2) and self-reported physical symptoms (2/8). The majority of studies showed some risk of bias concerns. CONCLUSIONS Although it was suggested gratitude interventions may improve subjective sleep quality, more research is still needed to make firm conclusions on the efficacy of gratitude interventions on improving health outcomes. Further research focusing on gratitude's link with sleep and causal mechanisms is needed, especially in patient populations where more 'clinically-usable' psychosocial interventions are urgently needed.
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Affiliation(s)
- Anna L Boggiss
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
| | - Nathan S Consedine
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
| | - Jennifer M Brenton-Peters
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
| | - Paul L Hofman
- Liggins Institute, University of Auckland, Auckland, New Zealand.
| | - Anna S Serlachius
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
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14
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Roque A, Craske MG, Treanor M, Rosenfield D, Ritz T, Meuret AE. Stress-induced cortisol reactivity as a predictor of success in treatment for affective dimensions. Psychoneuroendocrinology 2020; 116:104646. [PMID: 32200225 PMCID: PMC8978549 DOI: 10.1016/j.psyneuen.2020.104646] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 01/31/2020] [Accepted: 03/03/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Response rates to first-line treatments for depression and anxiety remain unsatisfactory. Identification of predictors or moderators that can optimize treatment matching is of scientific and clinical interest. This study examined the role of prolonged laboratory-induced stress cortisol reactivity as a predictor of outcome for a treatment of affective dimensions (TAD). Patients received 15-sessions of a treatment targeting reductions in negative affect or increases in positive affect (Craske et al., 2019). A second aim was to examine whether treatment type would moderate the association between cortisol reactivity and treatment outcome. METHODS Thirty-five participants underwent a 36-minute intermittent stress induction task composed of a mental arithmetic task and a fear-potentiated startle task one week before treatment initiation. Cortisol was collected at five-time points with reactivity being quantified as peak during the task minus basal level of cortisol the evening before the assessment. Using multilevel modeling, we examined the associations between cortisol reactivity and slopes of symptom improvement. RESULTS Cortisol reactivity was related to treatment outcome, with average and higher levels of stress-induced cortisol response predicting greater decreases in symptoms throughout treatment and 6-month follow-up. Treatment condition differences (moderation) were not observed in the effect of cortisol reactivity on symptoms. CONCLUSION Our findings demonstrate the impact of greater cortisol stress reactivity on treatment outcome. Future studies should investigate how to enhance this therapeutic benefit through capitalizing on endogenous diurnal fluctuations or exogenous cortisol manipulation.
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Affiliation(s)
- Andres Roque
- Department of Psychology, Southern Methodist University
| | | | - Michael Treanor
- Department of Psychology, University of California Los Angeles
| | | | - Thomas Ritz
- Department of Psychology, Southern Methodist University
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15
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Nicolson NA, Peters ML, In den Bosch-Meevissen YMC. Imagining a positive future reduces cortisol response to awakening and reactivity to acute stress. Psychoneuroendocrinology 2020; 116:104677. [PMID: 32344176 DOI: 10.1016/j.psyneuen.2020.104677] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 03/23/2020] [Accepted: 03/24/2020] [Indexed: 11/27/2022]
Abstract
The positive influence of optimism on health is thought to be due in part to a reduced physiological response to stress, as manifested for instance in activity of hypothalamic-pituitary-adrenal (HPA) systems. Results of previous studies support the notion that dispositional optimism can influence diurnal cortisol secretion as well as cortisol reactivity. The aim of the present study was to examine whether induced optimism can similarly affect HPA activity and thereby potentially have beneficial health effects. We assigned 66 university students to either the Best Possible Self (BPS) or an active control condition, respectively entailing two weeks of daily visualization of a positive future or time management exercises. Before and after the intervention, we assessed diurnal cortisol levels, response to awakening (CAR), and reactivity to the Trier Social Stress Task (TSST), as well as optimism, affect, negative cognitions, perceived stress, and threat appraisal. Effects of the BPS intervention were tested with repeated measures ANOVA (psychological outcomes) and multilevel regression (cortisol outcomes). The BPS intervention was associated with decreases in both the CAR and cortisol responses to acute stress. Compared to controls, BPS participants showed decreased worrying and increased positive affect post-intervention; however, they did not show the expected greater increase in optimism. Within-person decreases in worrying were associated with decreased CARs, whereas both decreased worrying and increased PA were linked to attenuated stress reactivity. Results suggest that the BPS intervention can influence HPA axis reactivity, with effects on well-being variables likely mediating the process. More research is needed to determine longer-term neuroendocrine and health effects of such interventions in at-risk as well as healthy populations.
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Affiliation(s)
- Nancy A Nicolson
- Department of Psychiatry & Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Universiteitssingel 40, 6229ER Maastricht, the Netherlands.
| | - Madelon L Peters
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Universiteitssingel 40, 6229ER Maastricht, the Netherlands.
| | - Yvo M C In den Bosch-Meevissen
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Universiteitssingel 40, 6229ER Maastricht, the Netherlands
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16
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Pulopulos MM, Baeken C, De Raedt R. Cortisol response to stress: The role of expectancy and anticipatory stress regulation. Horm Behav 2020; 117:104587. [PMID: 31639385 DOI: 10.1016/j.yhbeh.2019.104587] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 09/02/2019] [Accepted: 09/11/2019] [Indexed: 11/22/2022]
Abstract
An exacerbated physiological response to stress is associated with the development of stress-related disorders (e.g., depression and anxiety disorders). Recently, it has been proposed that individuals with high expectancies of being able to deal with stressful situations will activate regulatory mechanisms during the anticipation of the stressful event that would improve stress regulation. To test this hypothesis, 52 women in young adulthood (M = 21.06; SD = 2.58) anticipated and performed a laboratory-based stress task after receiving positive or negative bogus feedback on their abilities to deal with stressful events. Heart rate variability and salivary cortisol were assessed throughout the experimental protocol. Participants receiving positive bogus feedback (i.e., High Expectancy group) showed a more positive anticipatory cognitive stress appraisal (i.e., they anticipated the stress task as less threatening/challenging, and they perceived that they were more able to deal with it), and they showed a lower cortisol response to stress. Moreover, a more positive anticipatory cognitive stress appraisal was associated with better anticipatory stress regulation (indexed as less decrease in heart rate variability), leading to a lower cortisol response. Our results indicate that people with positive expectancy initiate mechanisms of anticipatory stress regulation that enhance the regulation of the physiological stress response. Expectancy and anticipatory stress regulation may be key mechanisms in the development and treatment of stress-related disorders.
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Affiliation(s)
- Matias M Pulopulos
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium.
| | - Chris Baeken
- Department of Psychiatry and Medical Psychology, Ghent University, Ghent, Belgium; Ghent Experimental Psychiatry (GHEP) Lab, Ghent, Belgium; Department of Psychiatry, University Hospital (UZBrussel), Brussels, Belgium; Eindhoven University of Technology, Department of Electrical Engineering, Eindhoven, The Netherlands
| | - Rudi De Raedt
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
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Bertrams A, Minkley N. Preliminary Indications That First Semester Students From Academic Households Exhibit Higher Hair Cortisol Concentrations Than Their Peers From Nonacademic Households. Front Psychiatry 2020; 11:580. [PMID: 32670110 PMCID: PMC7327536 DOI: 10.3389/fpsyt.2020.00580] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Accepted: 06/05/2020] [Indexed: 11/20/2022] Open
Abstract
Previous research has extensively addressed social disparity in education using certain aspects, including the stress differences between students from nonacademic families and those from academic families during the transition from secondary school to a university. However, this issue has not yet been fully understood; the current literature suggests contradictory predictions, and physiological indicators of stress have never been assessed. Therefore, we tested whether hair cortisol concentrations (HCCs) in first semester students from nonacademic families are different from those of first semester students from academic families during their first six weeks at university. We analyzed hair samples and parental educational background reports from 71 female first semester students at a university in Switzerland in two waves (n = 34 in the autumn of 2016 and n = 37 in the autumn of 2017). The HCCs were extracted from the hair using a well-established protocol. The analyses revealed higher HCCs in the students from the academic families across the two cohorts. This difference could not be attributed to different control variables (e.g., age, migration background). These preliminary findings were in line with the sociological theory that an academic parental background is associated with pressure to avoid a drop in one's social status.
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Affiliation(s)
- Alex Bertrams
- Educational Psychology Lab, Institute of Educational Science, University of Bern, Bern, Switzerland
| | - Nina Minkley
- Faculty of Biology and Biotechnology, Behavioral Biology and Biology Education, Ruhr-Universität Bochum, Bochum, Germany
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18
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Amiri P, Mirghafourvand M, Esmaeilpour K, Kamalifard M, Ivanbagha R. The effect of distraction techniques on pain and stress during labor: a randomized controlled clinical trial. BMC Pregnancy Childbirth 2019; 19:534. [PMID: 31888543 PMCID: PMC6938000 DOI: 10.1186/s12884-019-2683-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Accepted: 12/17/2019] [Indexed: 12/28/2022] Open
Abstract
Background Pain control and the stress associated with labor and delivery are among the most important issues of health care system. Use of distraction techniques during childbirth is reported to reduce pain and stress of labor. However, there is a limited publication that looked on the effect of distraction techniques on labor pain and stress. Thus, the aim of this study was to determine the effect of distraction techniques on labor pain and stress (primary outcomes), fear of childbirth, length of delivery stages, first minute Apgar score and oxytocin consumption (secondary outcomes). Methods A randomized controlled clinical trial was conducted on 68 pregnant women. Participants were allocated into two groups (intervention and control groups) by blocked randomization. Participants in the intervention group received distraction techniques in four sessions. Questionnaires of Fear of Childbirth (W-DEQ version A) and PSS once were completed before intervention and again at the 36th week for the W-DEQ and in the active phase for the PSS through interviews. The pain was assessed through VAS during active phase per hour. The length of delivery stages was recorded in the partograph chart. Data were analyzed by independent t-test and ANCOVA. Results The mean of perceived stress during labor in the intervention group was significantly less than that of the control group (AMD: -3.2; 95% CI: − 0.8 to − 6.0; P = 0.01). The mean (SD) of pain intensity during labor was less than in the intervention and control groups compare to the control group (6.2 vs 7.5; P < 0.001). There was no significant difference between the two groups in terms of fear of childbirth score (AMD: 5.3; 95% CI: 13.0 to − 6.0; P = − 2.3). Moreover, there was no statistically significant difference between the two groups in terms of the active phase of labor (P = 0.504), second stage of delivery (P = 0.928), total length of delivery (P = 0.520), Apgar score (P = 1.000) and frequency of oxytocin consumption (P = 0.622). Conclusion According to the results, distraction techniques can reduce the pain and stress of labor, but further studies by using the distraction techniques are needed to reach a decisive conclusion. Trial registration IRCT2017042910324N39; Name of registry: Iranian Registry of Clinical Trials; Registered 11 September 2017. URL of registry: https://fa.irct.ir/user/trial/10814/view. Date of enrolment of the first participant to the trial: September 2017.
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Affiliation(s)
- Paria Amiri
- Department of Midwifery, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mojgan Mirghafourvand
- Social Determinants of Health Research Centre, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran. .,Nursing and Midwifery Faculty, Midwifery Department, Tabriz University of Medical sciences, Tabriz, Iran.
| | | | - Mahin Kamalifard
- Department of Midwifery, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Reyhaneh Ivanbagha
- Department of Midwifery, Faculty of Nursing and Midwifery, Khlkhal University of Medical Sciences, Khalkhal, Iran
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