From serendipity to clinical relevance: How clinical psychology and neuroscience converged to illuminate psychoneuroendocrinology

Residential segregation and prenatal depression in a non-Hispanic Black and Hispanic cohort in North Carolina

PURPOSE

Investigate residential segregation and prenatal depression in a non-Hispanic (NH) Black and Hispanic North Carolina pregnancy cohort.

METHODS

Demographics, prenatal depression (Center for Epidemiological Studies Depression scale ≥16), and residence from the 2006-2009 Newborn Epigenetic Survey were linked to Census-tract levels of racial and economic segregation (Index of Concentration at the Extremes) from the American Community Survey 2005-2009 5-year estimates. Adjusted prevalence ratios (aPR) for prenatal depression compared living in Index of Concentration at the Extremes tertiles 1 and 2 (higher proportion NH Black or Hispanic and/or low income) to 3 (higher proportion NH white and/or high-income), accounting for neighborhood clustering, age, education, employment, parity, and marital status.

RESULTS

Among the 773 survey participants (482 NH Black and 291 Hispanic), 35.7% and 27.2% of NH Black and Hispanic participants had prenatal depression, respectively. For NH Black participants, depression prevalence was 17% lower for tertile 1 versus 3 for the NH Black/white (aPR=0.83; 95% CI=0.62-1.10), low/high income (aPR=0.83; 95% CI=0.62-1.11), and low-income NH Black/high-income NH white (aPR=0.82; 95% CI=0.61-1.09) measures. For Hispanic participants, estimates were weaker in the opposite direction for the Hispanic/NH white (aPR=1.02; 95% CI=0.71-1.47), low/high income (aPr=1.14; (95% CI=0.76-1.69), and low-income Hispanic/high-income NH white (aPR=1.12; 95% CI=0.78-1.60) measures.

CONCLUSIONS

Residential segregation's impact on prenatal depression may differ by race/ethnicity and level of segregation, but findings are imprecise due to small sample sizes. Longitudinal research spanning greater geographic areas is needed.

Antepartum Depression and Preterm Birth: Pathophysiology, Epidemiology, and Disparities due to structural racism

PURPOSE OF REVIEW

Informed by the evidence of links between physiology of stress and parturition, we review recent epidemiologic evidence (2015-2020) of antenatal depression as a risk factor for preterm birth (PTB). We also explain racial/ethnic disparities in depression and preterm birth as a consequence of structural racism.

RECENT FINDINGS

Epidemiologic evidence is consistent in linking antepartum depression with an elevated risk of PTB. Antidepressant usage has been linked with an elevated risk of PTB. However, recent evidence suggests that severity of depression is the underlying driver of the elevated risk attributed to antidepressant usage. The number of depressive symptoms, as a proxy for severity of maternal stress, may be a more informative predictor of PTB than criterion based predictors. Across various study designs, measurement modalities, and populations, antenatal depression predicts an elevated risk of delivering preterm. The physiology of stress provides a plausible explanation for this observation. Excessive stress-induced elevations in maternal and then fetal HPA hormones can alter maternal and fetal homeostasis and hasten the timing of parturition. Antenatal depression and exposure to structural racism are two stressors that can trigger the maternal stress response. Chronically elevated levels of stress hormones among women of color in the USA provide a likely physiologic explanation for Black-White disparities in the risk of PTB. Focusing on the number of depressive symptoms as the more informative predictor of PTB raises several questions. We consider these questions as well as directions for future research in the context of recent advances in the field.

The Relationship between Eco-Innovation and Smart Working as Support for Sustainable Management

Nowadays, firms have to face challenging economical cirses, like the one caused by the COVID-19 pandemic, where volatility, uncertainty, complexity, and ambiguity are manifested. Strategic management is seen as one of the key approaches that firms can choose to implement sustainable smart working (on the support of Internet of Things and smart technologies) and to face global competition. In this article, as a response to the current crisis, we study the influence of Smart Working on Eco-innovation within EU 28 countries. Specifically, we evaluate the relationship between Eco-innovation index for EU 28 countries and Smart Working, by using a clustering analysis. The results show that the increased labor productivity and employees’ eco-innovation are associated, to a higher extent, with the companies agreeing to a flexible and comfortable environment. These companies agree with the introduction of special programs such as working from home. We also prove that Smart Working is implemented by innovative leaders gaining economic sustainability. This study also provides several theoretical and practical contributions. We provide (i) an overview of sustainable management, including the diverse theoretical and methodological perspectives; and (ii) the recommendation of an innovation model through the bilateral collaboration for the constructs of performant sustainable strategies.

A scoping review of interventions targeting allostatic load

Allostatic load (AL) is the manifestation of cumulative responses to chronic stress exposure. Numerous studies have shown the importance of AL in understanding disease risks. Yet little is known about existing interventions that target AL specifically. We aimed to address this gap by identifying interventions targeting AL and determining the success of these interventions in improving biological functioning. We searched five electronic databases using variations of two concepts: AL and programs or interventions. We included original research reports that focused on AL as an outcome. We excluded work that focused on a single indicator, not written in English or did not implement an intervention. The Template for Intervention Description and Replication checklist guided our intervention critique and synthesis. Six articles were included, with sample size across the interventions ranging between 2 and 733. Despite inconsistencies in the selection of AL indicators and scoring of AL, all four body systems were represented in all the studies. Four interventions showed significant improvement in Al (as indicated by a decrease in AL score) as early as 7 weeks. More interventions targeting Al are needed. The reduction in AL scores among four of the six interventions suggests that Al could be a biological outcome measure that is sensitive to change in response to interventions. This has significant clinical and research implications. Future studies are needed to examine whether AL serves as a mediator in the effects of the intervention on improving clinical manifestations of diseases.

Using consumer-wearable technology for remote assessment of physiological response to stress in the naturalistic environment

Psychosocial stress is a major risk factor for morbidity and mortality related to a wide range of health conditions and has a significant negative impact on public health. Quantifying exposure to stress in the naturalistic environment can help to better understand its health effects and identify strategies for timely intervention. The objective of the current project was to develop and test the infrastructure and methods necessary for using wearable technology to quantify individual response to stressful situations and to determine if popular and accessible fitness trackers such as Fitbit® equipped with an optical heart rate (HR) monitor could be used to detect physiological response to psychosocial stress in everyday life. The participants in this study were University of Minnesota students (n = 18) that owned a Fitbit® tracker and had at least one upcoming examination. Continuous HR and activity measurements were obtained during a 7-day observation period containing examinations self-reported by the participants. Participants responded to six ecological momentary assessment surveys per day (~ 2 hour intervals) to indicate occurrence of stressful events. We compared HR during stressful events (e.g., exams) to baseline HR during periods indicated as non-stressful using mixed effects modeling. Our results show that HR was elevated by 8.9 beats per minute during exams and by 3.2 beats per minute during non-exam stressors. These results are consistent with prior laboratory findings and indicate that consumer wearable fitness trackers could serve as a valuable source of information on exposure to psychosocial stressors encountered in the naturalistic environment.

Mitochondrial Psychobiology: Foundations and Applications

Mitochondrial psychobiology is the study of the interactions between psychological states and the biological processes that take place within mitochondria. It also examines how mitochondrial behavior influence neural, endocrine, and immune systems known to transduce psychological experiences into health outcomes. Unlike traditional biological outcomes and mediators, mitochondria are dynamic and multifunctional living organisms. By leveraging a variety of laboratory tools including omics, scientists can now map mitochondrial behavior at multiple levels of complexity - from isolated molecular markers to dynamic functional and signaling outcomes. Here we discuss current efforts to develop relevant measures of mitochondrial behavior in accessible human tissues, increase their biological specificity by applying precise measurements in defined cell populations, create composite indices reflecting mitochondrial health, and integrate these approaches with psycho-neuro-endocrino-immune outcomes. This systematic inter-disciplinary effort will help move the field of mitochondrial psychobiology towards a predictive science explaining how, and to what extent, mitochondria contribute to the biological embedding of stress and other psychological states.