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Akıncı MA, Uzun N, Alp H. Evaluation of subclinical cardiovascular risk in drug-naive pediatric patients with anxiety disorders. Int J Psychiatry Med 2024; 59:153-166. [PMID: 37578806 DOI: 10.1177/00912174231196342] [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] [Indexed: 08/15/2023]
Abstract
OBJECTIVE This study examined subclinical atherosclerosis in drug-naïve children with anxiety disorders using non-invasive measures to investigate the clinical features associated with subclinical atherosclerosis. METHOD A total of 37 drug-naive children and adolescents with anxiety disorders and 37 healthy controls were included in the study. The Children's Depression Inventory (CDI) and the State-Trait Anxiety Inventory (STAI-T and STAI-S) were used to assess children's depression and anxiety levels. Carotid artery intima-media (cIMT), epicardial adipose tissue (EAT), and periaortic adipose tissue (PAT) thicknesses, which are indicators of subclinical atherosclerosis, were obtained by echocardiographic measurements. RESULTS Multivariate analysis of covariance (MANCOVA) revealed a significant main effect on cIMT, EAT thickness, and PAT thickness, independent of confounding factors such as age, sex, body mass index, mean blood pressure, and family income (Pillai's Trace V = .76, F (1, 72) = 35.60, P < .001, ηp2 = .76). Analysis of covariance (ANCOVA) showed that cIMT, EAT thickness, and PAT thickness values were significantly higher in the anxiety disorder group compared to the the control group (P < .001). In partial correlation analysis, a positive correlation was observed between STAI-T and cIMT and EAT thickness. In linear regression analyses, age and STAI-T were significantly correlated with cIMT and EAT thickness levels. CONCLUSIONS These results suggest that subclinical cardiovascular risk is significantly increased in children and adolescents with anxiety disorders.
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Affiliation(s)
- Mehmet Akif Akıncı
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Necati Uzun
- Department of Child and Adolescent Psychiatry, Meram School of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Hayrullah Alp
- Department of Pediatric Cardiology, Faculty of Medicine, Karamanoglu Mehmet Bey University, Karaman, Turkey
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2
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Mahmood A, Simon J, Cooper J, Murphy T, McCracken C, Quiroz J, Laranjo L, Aung N, Lee AM, Khanji MY, Neubauer S, Raisi-Estabragh Z, Maurovich-Horvat P, Petersen SE. Neuroticism personality traits are linked to adverse cardiovascular phenotypes in the UK Biobank. Eur Heart J Cardiovasc Imaging 2023; 24:1460-1467. [PMID: 37440761 PMCID: PMC10610755 DOI: 10.1093/ehjci/jead166] [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: 05/18/2023] [Revised: 06/26/2023] [Accepted: 06/27/2023] [Indexed: 07/15/2023] Open
Abstract
AIMS To evaluate the relationship between neuroticism personality traits and cardiovascular magnetic resonance (CMR) measures of cardiac morphology and function, considering potential differential associations in men and women. METHODS AND RESULTS The analysis includes 36 309 UK Biobank participants (average age = 63.9 ± 7.7 years; 47.8% men) with CMR available and neuroticism score assessed by the 12-item Eysenck Personality Questionnaire-Revised Short Form. CMR scans were performed on 1.5 Tesla scanners (MAGNETOM Aera, Siemens Healthcare, Erlangen, Germany) according to pre-defined protocols and analysed using automated pipelines. We considered measures of left ventricular (LV) and right ventricular (RV) structure and function, and indicators of arterial compliance. Multivariable linear regression was used to estimate association of neuroticism score with individual CMR metrics, with adjustment for age, sex, obesity, deprivation, smoking, diabetes, hypertension, hypercholesterolaemia, alcohol use, exercise, and education. Higher neuroticism scores were associated with smaller LV and RV end-diastolic volumes, lower LV mass, greater concentricity (higher LV mass to volume ratio), and higher native T1. Greater neuroticism was also linked to poorer LV and RV function (lower stroke volumes) and greater arterial stiffness. In sex-stratified analyses, the relationships between neuroticism and LV stroke volume, concentricity, and arterial stiffness were attenuated in women. In men, association (with exception of native T1) remained robust. CONCLUSION Greater tendency towards neuroticism personality traits is linked to smaller, poorer functioning ventricles with lower LV mass, higher myocardial fibrosis, and higher arterial stiffness. These relationships are independent of traditional vascular risk factors and are more robust in men than women.
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Affiliation(s)
- Adil Mahmood
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
| | - Judit Simon
- MTA-SE Cardiovascular Imaging Research Group, Department of Radiology, Medical Imaging Centre, Semmelweis University, Budapest, Hungary
| | - Jackie Cooper
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
| | - Theodore Murphy
- Department of Cardiology and Cardiovascular Imaging, Beacon Hospital, Dublin, Ireland
| | - Celeste McCracken
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, National Institute for Health Research Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 9DU, UK
| | - Juan Quiroz
- Centre for Big Data Research in Health (CBDRH), The University of New South Wales (UNSW), Sydney, Australia
| | - Liliana Laranjo
- Faculty of Medicine and Health, Westmead Applied Research Centre (WARC), University of Sydney, Australia
| | - Nay Aung
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
- Barts Heart Centre, St Bartholomew’s Hospital, Barts Health NHS Trust, West Smithfield, EC1A 7BE, London, UK
| | - Aaron Mark Lee
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
| | - Mohammed Y Khanji
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
- Barts Heart Centre, St Bartholomew’s Hospital, Barts Health NHS Trust, West Smithfield, EC1A 7BE, London, UK
| | - Stefan Neubauer
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, National Institute for Health Research Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 9DU, UK
| | - Zahra Raisi-Estabragh
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
- Barts Heart Centre, St Bartholomew’s Hospital, Barts Health NHS Trust, West Smithfield, EC1A 7BE, London, UK
| | - Pal Maurovich-Horvat
- MTA-SE Cardiovascular Imaging Research Group, Department of Radiology, Medical Imaging Centre, Semmelweis University, Budapest, Hungary
| | - Steffen E Petersen
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
- Barts Heart Centre, St Bartholomew’s Hospital, Barts Health NHS Trust, West Smithfield, EC1A 7BE, London, UK
- Health Data Research UK, London, UK
- Alan Turing Institute, London, UK
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3
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Kani AS, Çinçin A, Özercan A, Şenoğuz UD, Örnek E, Dokuz G, Topçuoğlu V, Sayar K. Exploring the role of adult attachment, major depression and childhood trauma in arterial stiffness: A preliminary study. J Psychosom Res 2023; 171:111386. [PMID: 37269643 DOI: 10.1016/j.jpsychores.2023.111386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 05/17/2023] [Accepted: 05/19/2023] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Prior research indicates a noteworthy and intricate connection between depression and subclinical atherosclerosis. Nevertheless, the biological and psychological mechanisms that underlie this association are not yet fully understood. To address this gap, this exploratory study aimed to examine the relationship between active clinical depression and arterial stiffness (AS), with a particular focus on the potential mediating roles of attachment security and childhood trauma. METHODS In this cross-sectional study, we examined 38 patients with active major depression free of dyslipidemia, diabetes mellitus, hypertension, and obesity and 32 healthy controls. All participants underwent blood tests, psychometric assessments, and AS measurements using the Mobil-O-Graph arteriograph system. AS severity was evaluated using an augmentation index (AIx) normalized to 75 beats/min. RESULTS In the absence of defined clinical cardiovascular risk factors, there was no significant difference in AIx between individuals with depression and healthy controls (p = .75). Patients with longer intervals between depressive episodes had lower AIx (r = -0.44, p < .01). Insecure attachment and childhood trauma did not significantly associate with AIx in patients. Whereas insecure attachment was positively correlated with AIx only in healthy controls (r = 0.50, p = 01). CONCLUSIONS Our analysis of established risk factors for atherosclerosis revealed that depression and childhood trauma had no significant relationship with AS. However, we did identify a novel finding: insecure attachment was significantly associated with AS severity in healthy adults without defined cardiovascular risk factors for the first time. To our knowledge, this is the first study to demonstrate this relationship.
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Affiliation(s)
- Ayşe Sakallı Kani
- Department of Psychiatry, Marmara University, School of Medicine, Istanbul, Turkey.
| | - Altuğ Çinçin
- Department of Cardiology, Marmara University, School of Medicine, Istanbul, Turkey
| | - Ahmet Özercan
- Department of Psychiatry, Marmara University, School of Medicine, Istanbul, Turkey
| | - Uzay Dural Şenoğuz
- Department of Psychology, Istanbul Medeniyet University Faculty of Arts and Humanities, Istanbul, Turkey
| | - Erdem Örnek
- Department of Psychology, Istanbul Medeniyet University Faculty of Arts and Humanities, Istanbul, Turkey
| | - Gonca Dokuz
- Department of Psychiatry, Bezmialem Vakıf University, Istanbul, Turkey
| | - Volkan Topçuoğlu
- Department of Psychiatry, Marmara University, School of Medicine, Istanbul, Turkey
| | - Kemal Sayar
- Department of Psychiatry, Marmara University, School of Medicine, Istanbul, Turkey
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Tonhajzerova I, Visnovcova Z, Ondrejka I, Funakova D, Hrtanek I, Ferencova N. Major depressive disorder at adolescent age is associated with impaired cardiovascular autonomic regulation and vasculature functioning. Int J Psychophysiol 2022; 181:14-22. [PMID: 36029918 DOI: 10.1016/j.ijpsycho.2022.08.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 08/15/2022] [Accepted: 08/18/2022] [Indexed: 11/09/2022]
Abstract
Cardiovascular adverse complications represent a risk factor for increased cardiovascular morbidity and mortality in patients with major depressive disorder (MDD). However, there is little knowledge of adolescent MDD. We aimed to study complex cardiovascular autonomic regulation and early atherosclerotic damage with a focus on an analysis of heart rate variability (HRV), blood pressure variability (BPV), systolic time intervals, and measures of early atherosclerotic changes in adolescent MDD. Ninety depressive adolescents (34 boys, age 15.8 ± 1.3 yrs.) and 90 age-/gender-matched controls were examined. Evaluated parameters: HRV - time and spectral parameters, BPV - mean, systolic, and diastolic blood pressure, spectral systolic parameters; haemodynamic indices - stroke volume, cardiac output, total peripheral resistance, systolic time intervals - left ventricular ejection time, pre-ejection period; atherosclerotic indices - ankle-brachial index (ABI), pulse wave velocity, brachial-ankle pulse wave velocity, cardio-ankle vascular index; growth factors - epidermal growth factor (EGF), vascular endothelial growth factor associated with monocyte chemoattractant protein-1. Our results showed that the MDD group had significantly reduced HRV and higher BPV measures, shortened systolic time intervals, lower ABI, and higher EGF compared to controls. Concluding, our study revealed that adolescent MDD is associated with cardiovascular dysregulation and early vasculature dysfunction as preclinical markers of higher risk for cardiovascular morbidity, thus adolescence seems to represent an important age period for early diagnosis and prevention of later MDD-linked cardiovascular diseases manifesting in adulthood.
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Affiliation(s)
- Ingrid Tonhajzerova
- Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4C, 036 01 Martin, Slovak Republic.
| | - Zuzana Visnovcova
- Biomedical Centre Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4D, 036 01 Martin, Slovak Republic.
| | - Igor Ondrejka
- Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, Kollarova 2, 036 59 Martin, Slovak Republic.
| | - Dana Funakova
- Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, Kollarova 2, 036 59 Martin, Slovak Republic.
| | - Igor Hrtanek
- Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, Kollarova 2, 036 59 Martin, Slovak Republic.
| | - Nikola Ferencova
- Biomedical Centre Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4D, 036 01 Martin, Slovak Republic.
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Santos AF, Martins MC, Fernandes C, Bost KK, Veríssimo M. Relation between Attachment and Obesity in Preschool Years: A Systematic Review of the Literature. Nutrients 2021; 13:nu13103572. [PMID: 34684573 PMCID: PMC8539151 DOI: 10.3390/nu13103572] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 10/08/2021] [Accepted: 10/11/2021] [Indexed: 01/11/2023] Open
Abstract
Increasing evidence suggests that attachment plays an important role in obesity. However, few studies examined this relationship in preschool children. This study aimed to systematically examine the empirical, peer-reviewed evidence regarding the relationship between attachment quality and obesity in the preschool years. Using established guidelines, relevant peer-reviewed literature published between 2000 and July 2021 was searched through EBSCO. This yielded a total of 1124 records for review. Established inclusion criteria comprised: empirical studies published in peer-review journals; include at least one anthropometric measure and/or food consumption measure. Exclusion criteria comprised: attachment measures not following Bowlby-Ainsworth conceptualization of the construct; children in institutionalized settings; context of severe mental illness, documented substance use disorders, or eating disorders; include only a measure of the psychological aspects of eating; intervention programs. After exclusions, eight studies with a total of 9225 participants met the inclusion criteria. Results support the role of attachment in weight-related outcomes, suggesting that considering attachment in the risk of obesity could contribute to the elaboration of effective prevention and intervention programs. Limitations included the small number of studies, predominately cross-sectional designs, the diversity of methodologies, most samples not including fathers, and lack of evidence about the developmental mechanisms underlying the association between attachment and obesity. More evidence is needed to determine how attachment and obesity are linked, and the potential underlying mechanisms accounting for this relationship.
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Affiliation(s)
- Ana F. Santos
- William James Center for Research, ISPA—Instituto Universitário, 1149-041 Lisboa, Portugal; (A.F.S.); (M.C.M.); (C.F.)
| | - Mariana C. Martins
- William James Center for Research, ISPA—Instituto Universitário, 1149-041 Lisboa, Portugal; (A.F.S.); (M.C.M.); (C.F.)
| | - Carla Fernandes
- William James Center for Research, ISPA—Instituto Universitário, 1149-041 Lisboa, Portugal; (A.F.S.); (M.C.M.); (C.F.)
| | - Kelly K. Bost
- Human Development and Family Studies, University of Illinois, Champaign, IL 61801, USA;
| | - Manuela Veríssimo
- William James Center for Research, ISPA—Instituto Universitário, 1149-041 Lisboa, Portugal; (A.F.S.); (M.C.M.); (C.F.)
- Correspondence:
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Bromfield SG, Sullivan S, Saelee R, Elon L, Lima B, Young A, Uphoff I, Li L, Quyyumi A, Bremner JD, Vaccarino V, Lewis TT. Race and Gender Differences in the Association Between Experiences of Everyday Discrimination and Arterial Stiffness Among Patients With Coronary Heart Disease. Ann Behav Med 2021; 54:761-770. [PMID: 32227162 PMCID: PMC7516092 DOI: 10.1093/abm/kaaa015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Self-reported experiences of discrimination have been linked to indices of cardiovascular disease. However, most studies have focused on healthy populations. Thus, we examined the association between experiences of everyday discrimination and arterial stiffness among patients with a history of myocardial infarction (MI). PURPOSE We hypothesized that higher reports of discrimination would be associated with greater arterial stiffness and that associations would be more pronounced among Black women, in particular, relative to other race-gender groups, using an "intersectionality" perspective. METHODS Data were from 313 participants (49.2% female, mean age: 50.8 years) who were 6 months post-MI in the Myocardial Infarction and Mental Stress 2 study. Data were collected via self-reported questionnaires, medical chart review, and a clinic visit during which arterial stiffness was measured noninvasively using pulse wave velocity. RESULTS Reports of discrimination were highest in Black men and women and arterial stiffness was greatest in Black and White women. After adjustment for demographics and relevant clinical variables, discrimination was not associated with arterial stiffness in the overall study sample. However, discrimination was associated with increased arterial stiffness among Black women but not White women, White men, or Black men. CONCLUSIONS Despite no apparent association between discrimination and arterial stiffness in the overall study sample, further stratification revealed an association among Black women but not other race-gender groups. These data not only support the utility of an intersectionality lens but also suggest the importance of implementing psychosocial interventions and coping strategies focused on discrimination into the care of clinically ill Black women.
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Affiliation(s)
- Samantha G Bromfield
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Samaah Sullivan
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Ryan Saelee
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Lisa Elon
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Bruno Lima
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.,Division of Cardiology, School of Medicine, Emory University, Atlanta, GA, USA
| | - An Young
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.,Division of Cardiology, School of Medicine, Emory University, Atlanta, GA, USA
| | - Irina Uphoff
- Division of Cardiology, School of Medicine, Emory University, Atlanta, GA, USA
| | - Lian Li
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Arshed Quyyumi
- Division of Cardiology, School of Medicine, Emory University, Atlanta, GA, USA
| | - J Douglas Bremner
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Emory University, Atlanta, GA, USA
| | - Viola Vaccarino
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Tené T Lewis
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
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7
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Goldstein BI, Korczak DJ. Links Between Child and Adolescent Psychiatric Disorders and Cardiovascular Risk. Can J Cardiol 2020; 36:1394-1405. [DOI: 10.1016/j.cjca.2020.06.023] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Revised: 06/28/2020] [Accepted: 06/29/2020] [Indexed: 12/27/2022] Open
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8
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de Keijzer C, Foraster M, Basagaña X, Tonne C, Garcia LA, Valentín A, Kivimäki M, Nieuwenhuijsen MJ, Alonso J, Antó JM, Singh-Manoux A, Sunyer J, Dadvand P. Long-Term Greenspace Exposure and Progression of Arterial Stiffness: The Whitehall II Cohort Study. ENVIRONMENTAL HEALTH PERSPECTIVES 2020; 128:67014. [PMID: 32589457 PMCID: PMC7319656 DOI: 10.1289/ehp6159] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 04/02/2020] [Accepted: 05/20/2020] [Indexed: 06/02/2023]
Abstract
BACKGROUND Arterial stiffness, and its progression with age, is an important indicator of cardiovascular aging. Greenspace exposure may protect against arterial stiffness by promoting physical activity, fostering social cohesion, and reducing stress and exposure to air pollution and noise. OBJECTIVES The aim of this study was to investigate the association of long-term exposure to outdoor greenspace with arterial stiffness and its progression over time. METHODS This prospective cohort study was based on 4,349 participants (55-83 years of age) of the Whitehall II Study, United Kingdom. Arterial stiffness was assessed in two medical examinations (2007-2009 and 2012-2013) by measuring the carotid-femoral pulse wave velocity (cf-PWV). Residential surrounding greenspace was characterized using satellite-based indices of greenspace including normalized difference vegetation index (NDVI), enhanced vegetation index (EVI), and vegetation continuous fields (VCF) across buffers of 500 and 1,000m surrounding the participants' residential locations at each follow-up. The association between the greenspace indicators and baseline cf-PWV and 4-year progression of cf-PWV was assessed using linear mixed-effects models with the participant as a random effect, controlling for demographic, lifestyle, and (individual and area) socioeconomic factors. RESULTS No statistically significant associations were observed between residential surrounding greenspace and baseline or 4-y progression of cf-PWV; interquartile range (IQR) increases in NDVI, EVI, and VCF in the 500-m buffer were associated with -0.04m/s [95% confidence interval (CI): -0.12, 0.04], -0.03m/s (95% CI: -0.10, 0.05), and -0.02m/s (95% CI: -0.08, 0.04) in baseline cf-PWV and 0.06m/s (95% CI: -0.02, 0.14), 0.05m/s (95% CI: -0.03, 0.14), and 0.00m/s (95% CI: -0.09, 0.09) in 4-y progression in cf-PWV, respectively. The associations were similar when using 1,000-m buffers. CONCLUSIONS We did not observe any consistent association between residential surrounding greenspace and arterial stiffness. https://doi.org/10.1289/EHP6159.
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Affiliation(s)
- Carmen de Keijzer
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Maria Foraster
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Xavier Basagaña
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Cathryn Tonne
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Lucia Alonso Garcia
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Antònia Valentín
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Mika Kivimäki
- Department of Epidemiology and Public Health, University College of London, London, UK
| | - Mark J Nieuwenhuijsen
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Jordi Alonso
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- IMIM-Parc Salut Mar, Barcelona, Catalonia, Spain
| | - Josep M Antó
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Archana Singh-Manoux
- Department of Epidemiology and Public Health, University College of London, London, UK
- Institut national de la santé et de la recherche médicale (Inserm), U1153, Epidemiology of Ageing and Neurodegenerative diseases, Université de Paris, France
| | - Jordi Sunyer
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Payam Dadvand
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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9
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Debeuf T, Verbeken S, Boelens E, Volkaert B, Van Malderen E, Michels N, Braet C. Emotion regulation training in the treatment of obesity in young adolescents: protocol for a randomized controlled trial. Trials 2020; 21:153. [PMID: 32039739 PMCID: PMC7011608 DOI: 10.1186/s13063-019-4020-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 12/20/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The prevalence rates of childhood obesity are increasing. The current multidisciplinary treatments for (childhood) obesity are effective but only moderately and in the short term. A possible explanation for the onset and maintenance of childhood obesity is that it reflects a maladaptive mechanism for regulating high levels of stress and emotions. Therefore, the current RCT study aims to test the effectiveness of adding an emotion regulation training to care as usual (multidisciplinary obesity treatment) in young inpatients (10-14) involved in an obesity treatment program compared to care as usual alone. The research model for this RCT study states that when high levels of stress are regulated in a maladaptive way, this can contribute to the development of obesity. METHODS The current study will recruit 140 youngsters (10-14 years) who are involved in an inpatient multidisciplinary obesity treatment (MOT) program. After giving consent to participate in the study, youngsters will be randomly assigned, during consecutive waves, to one of two conditions: care as usual (receiving MOT) or intervention (receiving MOT in addition to emotion regulation training). The training itself consists of 12 weekly sessions, followed by a booster session after 3 and 5 months. The participants will be tested pretraining, post-training, and at 6 months' follow-up. We hypothesize that, compared to the control condition, youngsters in the intervention condition will (1) use more adaptive emotion regulation strategies and (2) report less emotional eating, both primary outcome measures. Moreover, on the level of secondary outcome measures, we hypothesize that youngsters in the intervention condition, compared with the control condition, will (3) report better sleep quality, (4) undergo improved weight loss and weight loss maintenance, and (5) experience better long-term (6-months) psychological well-being. DISCUSSION This study will add to both the scientific and clinical literature on the role of emotion regulation in the development and maintenance of different psychopathologies, as emotion regulation is a transdiagnostic factor. TRIAL REGISTRATION The RCT study protocol is registered at ISRCTN Registry, with study ID "ISRCTN 83822934." Registered on 13 December 2017.
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Affiliation(s)
- Taaike Debeuf
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
| | - Sandra Verbeken
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
| | - Elisa Boelens
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
| | - Brenda Volkaert
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
| | - Eva Van Malderen
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
| | - Nathalie Michels
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
| | - Caroline Braet
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
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10
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Debeuf T, Verbeken S, Van Beveren ML, Michels N, Braet C. Stress and Eating Behavior: A Daily Diary Study in Youngsters. Front Psychol 2018; 9:2657. [PMID: 30627114 PMCID: PMC6309126 DOI: 10.3389/fpsyg.2018.02657] [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: 07/13/2018] [Accepted: 12/10/2018] [Indexed: 12/12/2022] Open
Abstract
Background: Overweight and obesity are growing problems, with more attention recently, to the role of stress in the starting and maintaining process of these clinical problems. However, the mechanisms are not yet known and well-understood; and ecological momentary analyses like the daily variations between stress and eating are far less studied. Emotional eating is highly prevalent and is assumed to be an important mechanism, as a maladaptive emotion regulation (ER) strategy, in starting and maintaining the vicious cycle of (pediatric) obesity. Objectives: The present study aims to investigate in youngsters (10 - 17 years) the daily relationship between stress and the trajectories of self-reported eating behavior (desire to eat motives; hunger eating motives and snacking) throughout 1 week; as well as the moderating role of emotion regulation and emotional eating in an average weight population. Methods: Participants were 109 average weighted youngsters between the age of 10 and 17 years (M age = 13.49; SD = 1.64). The youngsters filled in a trait-questionnaire on emotion regulation and emotional eating at home before starting the study, and answered an online diary after school time, during seven consecutive days. Desire to eat motives, hunger eating motives and snacking were assessed daily for seven consecutive days. Results: Using multilevel analyses results revealed that daily stress is significantly associated with trajectories of desire to eat motives and hunger eating motives. No evidence was found for the moderating role of maladaptive ER in these relationships; marginally significant evidence was found for the moderating role of emotional eating in the trajectories of desire to eat and snacking. Discussion: These results stress the importance of looking into the daily relationship between stress and eating behavior parameters, as both are related with change over and within days. More research is needed to draw firm conclusion on the moderating role of ER strategies and emotional eating.
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Affiliation(s)
- Taaike Debeuf
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
| | - Sandra Verbeken
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
| | - Marie-Lotte Van Beveren
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
| | | | - Caroline Braet
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
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11
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Sigfusdottir ID, Kristjansson AL, Thorlindsson T, Allegrante JP. Stress and adolescent well-being: the need for an interdisciplinary framework. Health Promot Int 2018; 32:1081-1090. [PMID: 27153917 PMCID: PMC5914452 DOI: 10.1093/heapro/daw038] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Stress and strain among adolescents have been investigated and discussed largely within three separate disciplines: mental health, where the focus has been on the negative effects of stress on emotional health; criminology, where the emphasis has been on the effects of strain on delinquency; and biology, where the focus has been to understand the effects of stress on physiology. Recently, scholars have called for increased multilevel developmental analyses of the bio-psychosocial nature of risk and protection for behaviors of individuals. This paper draws on several different but converging theoretical perspectives in an attempt to provide an overview of research relevant to stress in adolescence and puts forth a new framework that aims to provide both a common language and consilience by which future research can analyze the effects of multiple biological, social and environmental factors experienced during specific developmental periods, and cumulatively over time, on harmful behavior during adolescence. We present a framework to examine the effects of stress on diverse behavioral outcomes among adolescents, including substance use, suicidal behavior, self-inflicted harm, and delinquency.
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Affiliation(s)
- Inga Dora Sigfusdottir
- Department of Psychology, Reykjavik University, Reykjavik, Iceland.,Department of Health and Behavior Studies, Teachers College, Columbia University, New York, NY, USA
| | - Alfgeir Logi Kristjansson
- Department of Social and Behavioral Sciences, School of Public Health, West Virginia University, Morgantown, WV, USA
| | | | - John P Allegrante
- Department of Psychology, Reykjavik University, Reykjavik, Iceland.,Department of Health and Behavior Studies, Teachers College, Columbia University, New York, NY, USA.,Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
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12
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Surkan PJ, Sakyi KS, Hu A, Olinto MT, Gonçalves H, Horta BL, Gigante DP. Impact of stressful life events on central adiposity in the Pelotas Birth Cohort. Rev Saude Publica 2018; 52:61. [PMID: 29791680 PMCID: PMC5958973 DOI: 10.11606/s1518-8787.2018052000161] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Accepted: 05/08/2017] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE: To investigate how stressful life events and social support relate to central adiposity in Southern Brazil. METHODS: Data included information from 802 participants in the 1982 Pelotas Birth Cohort that was collect in 2004-2005 and 2006. Stratifying by sex, we studied self-reported stressful life events during the year before 2004-2005 in relation to change in waist circumference between 2004-2005 and 2006 and waist-to-hip ratio in 2006, using both bivariate and multivariate linear regression models. RESULTS: In adjusted models, the experience of stressful life events during the year before 2004-2005 predicted a change in waist circumference in 2006 in men and a change in both waist-to-hip ratio in 2006 and waist circumference between 2004-2005 and 2006 in women. Men who experienced two or more stressful events had on average a one centimeter increase in their waist circumference between 2004-2005 and 2006 (β = 0.97, 95%CI 0.02-1.92), compared to those reporting no stressful events. For women, those who had one and those who had two or more stressful life events had over a 1 cm increase in their waist circumference from 2004-2005 to 2006 (β = 1.37, 95%CI 0.17-2.54; β = 1.26, 95%CI 0.11-2.40, respectively), compared to those who did not experience any stressful event. For both sexes, social support level was not significantly related to either waist-to-hip ratio or change in waist circumference, and it did not modify the association between stress and central adiposity. CONCLUSIONS: The experience of more than one stressful life event was associated with distinct indicators of central adiposity for men versus women.
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Affiliation(s)
- Pamela J Surkan
- Social and Behavioral Interventions Program, Department of International Health, Johns Hopkins School of Public Health, Baltimore, Maryland, USA
| | - Kwame S Sakyi
- Social and Behavioral Interventions Program, Department of International Health, Johns Hopkins School of Public Health, Baltimore, Maryland, USA
| | - Alice Hu
- Social and Behavioral Interventions Program, Department of International Health, Johns Hopkins School of Public Health, Baltimore, Maryland, USA
| | - Maria T Olinto
- Programa de Pós-Graduação em Saúde Coletiva, Universidade do Vale do Rio dos Sinos, São Leopoldo, RS, Brasil
| | - Helen Gonçalves
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, RS, Brasil
| | - Bernardo L Horta
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, RS, Brasil
| | - Denise P Gigante
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, RS, Brasil
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13
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Abstract
Stress and negative emotions pose a major threat to public health, by increasing the risk of obesity. Since the management process for emotions (emotion regulation; ER) is developed in childhood, we present a novel conceptual framework model for the role of ER in the prevention and treatment of childhood obesity. A narrative review of the literature by electronic database search (MEDLINE, Web of Knowledge and Scopus) was conducted of observational and interventional/experimental literature on ER and obesity and the underlying concepts. We also present an overview of ER intervention techniques. Our model indicates that childhood ER is a link between stress and obesity. Stress along with ineffective ER leads to abnormal cortisol patterns, emotional eating, sedentary lifestyle, reduction of physical activity, and sleep problems. Simultaneously, a healthy lifestyle could show benefits on ER and in developing adaptive ER strategies. In the development of obesity and ER, parents also play a role. By contrast, effective ER skills decrease obesity-related unhealthy behaviour and enhance protective factors, which boost health. The literature contains some observational studies of children but very few intervention studies, most of which are pilot or on-going studies. In conclusion, encouraging effective ER could be a useful new approach for combating and treating childhood obesity. Future ER intervention studies are needed to confirm the validity of this model in children.
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14
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Nemcsik J, Vecsey-Nagy M, Szilveszter B, Kolossváry M, Karády J, László A, Kőrösi B, Nemcsik-Bencze Z, Gonda X, Merkely B, Rihmer Z, Maurovich-Horvat P. Inverse association between hyperthymic affective temperament and coronary atherosclerosis: A coronary computed tomography angiography study. J Psychosom Res 2017; 103:108-112. [PMID: 29167036 DOI: 10.1016/j.jpsychores.2017.10.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 10/15/2017] [Accepted: 10/20/2017] [Indexed: 12/21/2022]
Abstract
OBJECTIVE A bidirectional relationship exists between psychiatric disorders and cardiovascular diseases, however less is known with regards to personality traits. Accumulating data suggest that affective temperaments are both associated with psychiatric and somatic diseases. The aim of our study was to evaluate the associations between different affective temperaments and the presence of coronary atherosclerosis. METHODS 200 consecutive patients referred to coronary computed tomography angiography (CCTA) due to suspected coronary artery disease (CAD) were included in our study. Medical history and demographic parameters were recorded and all patients completed the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire (TEMPS-A) and the Beck Depression Inventory (BDI). The presence of coronary artery disease was evaluated based on the CCTA images. RESULTS 39 patients were free of any coronary atherosclerosis (CCTA-) and 161 had coronary atherosclerosis (CCTA+). Hyperthymic affective temperament score was higher in CCTA- subjects as compared to CCTA+ (13.1±3.0 vs 11.5±4.6, p=0.010, respectively). Hyperthymic affective temperament score showed a significant independent, inverse relationship with coronary atherosclerosis (OR: 0.91 CI: 0.82-0.99, p=0.04). CONCLUSION Our results suggest that hyperthymic affective temperament is independently associated with the absence of CAD. It requires further research to delineate the mechanism mediating the effect of hyperthymia on better coronary artery health and establishing potential biochemical or behavioral factors, both of which could be exploited for prevention and treatment purposes. But it is plausible, that the evaluation of affective temperaments have importance both in relation with psychiatric and cardiovascular disorders.
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Affiliation(s)
- János Nemcsik
- Department of Family Medicine, Semmelweis University, Budapest, Hungary; Health Service of Zugló (ZESZ), Budapest, Hungary.
| | - Milán Vecsey-Nagy
- MTA-SE Cardiovascular Imaging Research Group, Semmelweis University, Budapest, Hungary
| | - Bálint Szilveszter
- MTA-SE Cardiovascular Imaging Research Group, Semmelweis University, Budapest, Hungary
| | - Márton Kolossváry
- MTA-SE Cardiovascular Imaging Research Group, Semmelweis University, Budapest, Hungary
| | - Júlia Karády
- MTA-SE Cardiovascular Imaging Research Group, Semmelweis University, Budapest, Hungary
| | | | - Beáta Kőrösi
- Department of Family Medicine, Semmelweis University, Budapest, Hungary
| | - Zsófia Nemcsik-Bencze
- Magnetic Resonance Imaging Research Center, Semmelweis University, Budapest, Hungary
| | - Xénia Gonda
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary; MTA-SE Neurochemistry Research Group, Budapest, Hungary
| | - Béla Merkely
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Zoltán Rihmer
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Pál Maurovich-Horvat
- MTA-SE Cardiovascular Imaging Research Group, Semmelweis University, Budapest, Hungary
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15
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The Association Between Social Support, Body Mass Index and Increased Risk of Prediabetes: the Cardiovascular Risk in Young Finns Study. Int J Behav Med 2017; 24:161-170. [PMID: 27699627 DOI: 10.1007/s12529-016-9597-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
PURPOSE The psychosocial determinants of prediabetes are poorly understood. The aims of our study were (1) to analyse the association between perceived social support in young adulthood and fasting glucose levels and prediabetes in mid-adulthood in a cohort of healthy Finns, (2) to explore whether body mass index (BMI), inflammation or depression mediate this relationship, (3) and to examine the association between social support trajectory groups and fasting glucose. METHOD A prospective design was used with an analytic sample of 1250 participants aged 3-18 years at baseline (1980) and aged 12-39 years when social support was measured. Fasting glucose and prediabetes were assessed 32 years after baseline. Linear and logistic regression was used to examine the association between social support and the outcome measures. A bootstrapping technique was used to examine mediation effects. RESULTS Social support was associated with future glucose levels in women after adjusting for childhood socioeconomic status (SES) and youth depression (β = -0.136, p = 0.001) and also predicted prediabetes in women after adjusting for childhood SES (β = 1.31, 95 % CI 1.02 to 1.69, p = 0.031). Both associations were attenuated after adjusting for BMI in mid-adulthood. BMI was found to mediate the relationship between social support and prediabetes in women (β for indirect effect β = 0.09, SE = 0.03, CI = 0.03 to 0.16). CONCLUSION Low perceived social support in young adulthood is associated with high fasting glucose and prediabetes in mid-adulthood in women but not men. The association between social support and prediabetes in women can be partly explained by BMI.
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16
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Serlachius A, Elovainio M, Juonala M, Shea S, Sabin M, Lehtimäki T, Raitakari O, Keltikangas-Järvinen L, Pulkki-Råback L. High perceived social support protects against the intergenerational transmission of obesity: The Cardiovascular Risk in Young Finns Study. Prev Med 2016; 90:79-85. [PMID: 27394090 DOI: 10.1016/j.ypmed.2016.07.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 06/29/2016] [Accepted: 07/03/2016] [Indexed: 12/01/2022]
Abstract
AIMS Our aims were to assess whether offspring social support moderates the relationship between parental body mass index (BMI) and offspring BMI. METHODS A prospective design was used with an analytic sample of 1049 participants from Finland (the offspring) who were 35-50years old in 2012 when adulthood BMI was measured. Parental BMI was self-reported at baseline in 1980. Offspring social support was measured in 2007 when participants were 30-45years old. Linear and logistic regression was used to examine whether there was an interaction between parental BMI and offspring social support when predicting offspring BMI in adulthood. An analysis of simple slopes and multilevel growth curve modeling were used to further examine the interaction. RESULTS The interaction between maternal BMI and offspring social support was significantly and negatively related to offspring BMI in adulthood (β=-0.068, R(2) change=0.005, p=0.015) in the fully adjusted model which also adjusted for parental occupational status and offspring depressive symptoms. The logistic regression supported these results, with the interaction between maternal overweight (BMI≥25kg/m(2)) and offspring social support negatively associated with offspring overweight in adulthood (odds ratio=0.74, 95% confidence interval, 0.56 to 0.98). The growth curve analysis further demonstrated that high maternal BMI predicts more rapidly rising offspring BMI in those reporting low social support compared to high social support. CONCLUSIONS Our results suggest that social support protects against the intergenerational transmission of obesity and therefore presents an important opportunity for obesity prevention efforts.
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Affiliation(s)
- Anna Serlachius
- Institute of Behavioural Sciences, The University of Helsinki, Finland; The Department of Medicine, Division of General Medicine, Columbia University, New York, NY, USA.
| | - Marko Elovainio
- Institute of Behavioural Sciences, The University of Helsinki, Finland; Institute for Health and Welfare, Helsinki, Finland
| | - Markus Juonala
- Department of Medicine, University of Turku, Finland; The Division of Medicine, Turku University Hospital, Turku, Finland
| | - Steven Shea
- The Department of Medicine, Division of General Medicine, Columbia University, New York, NY, USA; The Department of Epidemiology, Joseph Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Matthew Sabin
- The Department of Paediatrics, University of Melbourne, Australia; Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Australia
| | - Terho Lehtimäki
- The Department of Clinical Chemistry, Fimlab Laboratories, Tampere, Finland; School of Medicine, University of Tampere, Tampere, Finland
| | - Olli Raitakari
- The Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland; Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | | | - Laura Pulkki-Råback
- Institute of Behavioural Sciences, The University of Helsinki, Finland; The Collegium for Advanced Studies, University of Helsinki, Finland
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17
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László A, Tabák Á, Kőrösi B, Eörsi D, Torzsa P, Cseprekál O, Tislér A, Reusz G, Nemcsik-Bencze Z, Gonda X, Rihmer Z, Nemcsik J. Association of affective temperaments with blood pressure and arterial stiffness in hypertensive patients: a cross-sectional study. BMC Cardiovasc Disord 2016; 16:158. [PMID: 27503108 PMCID: PMC4977892 DOI: 10.1186/s12872-016-0337-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 07/29/2016] [Indexed: 01/31/2023] Open
Abstract
Background Affective temperaments (anxious, depressive, cyclothymic, irritable and hyperthymic) measure subclinical manifestations of major mood disorders. Furthermore, cumulating evidence suggests their involvement in somatic disorders as well. We aimed to assess associations between affective temperament scores and blood pressure and arterial stiffness parameters in hypertensive patients. Methods In this cross-sectional study, 173 patients with well-controlled or grade 1 chronic hypertension, with no history of depression, completed the TEMPS-A, Beck Depression Inventory (BDI) and Hamilton Anxiety Scale (HAM-A) questionnaires in three GP practices. Arterial stiffness was measured with tonometry (PulsePen). Results According to multiple linear regression analysis, cyclothymic temperament score was positively associated with brachial systolic blood pressure independently of age, sex, total cholesterol, brachial diastolic blood pressure, BDI, HAM-A and the use of alprazolam (β = 0.529, p = 0.042), while hyperthymic temperament score was negatively related to augmentation index independent of age, sex, smoking, heart rate, BDI, HAM-A and the use of alprazolam (β = -0.612, p = 0.013). A significant interaction was found between cyclothymic temperament score and sex in predicting brachial systolic blood pressure (p = 0.025), between irritable and anxious temperament scores and sex in predicting pulse wave velocity (p = 0.021, p = 0.023, respectively) and an interaction with borderline significance between hyperthymic temperament score and sex in predicting augmentation index (p = 0.052). Conclusions The present findings highlight elevated blood pressure among subjects with high cyclothymic temperament as well as an increased level of arterial stiffening in subjects with low hyperthymic scores suggesting that affective temperaments may play a role in the development of hypertension and arterial stiffening and may thus represent markers of cardiovascular risk. Sex differences were also present in these associations.
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Affiliation(s)
- Andrea László
- Department of Family Medicine, Semmelweis University, Budapest, Hungary
| | - Ádám Tabák
- 1st Department of Medicine, Semmelweis University, Budapest, Hungary.,Department of Epidemiology and Public Health, University College, London, UK
| | - Beáta Kőrösi
- Department of Family Medicine, Semmelweis University, Budapest, Hungary
| | - Dániel Eörsi
- Department of Family Medicine, Semmelweis University, Budapest, Hungary
| | - Péter Torzsa
- Department of Family Medicine, Semmelweis University, Budapest, Hungary
| | - Orsolya Cseprekál
- 1st Department of Medicine, Semmelweis University, Budapest, Hungary
| | - András Tislér
- 1st Department of Medicine, Semmelweis University, Budapest, Hungary
| | - György Reusz
- 1st Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Zsófia Nemcsik-Bencze
- Magnetic Resonance Imaging Research Center, Semmelweis University, Budapest, Hungary
| | - Xénia Gonda
- Department of Pharmacodynamics, Semmelweis University, Budapest, Hungary. .,Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary. .,MTA-SE Neurochemistry Research Group, Budapest, Hungary.
| | - Zoltán Rihmer
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - János Nemcsik
- Department of Family Medicine, Semmelweis University, Budapest, Hungary.,Health Service of Zugló (ZESZ), Budapest, Hungary
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18
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Cook SH, Calebs B. The Integrated Attachment and Sexual Minority Stress Model: Understanding the Role of Adult Attachment in the Health and Well-Being of Sexual Minority Men. Behav Med 2016; 42:164-73. [PMID: 27337620 PMCID: PMC4969073 DOI: 10.1080/08964289.2016.1165173] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Gay and bisexual boys and men experience social stigma associated with their sexual minority status that can negatively influence health. In addition, experiencing sexual orientation stigma may be linked to a decreased capacity to effectively form and maintain secure attachment relationships with parents, peers, and romantic partners across the life-course. We proposed that utilizing a framework that integrates the process by which sexual minority men develop attachment relationships in the context of sexual minority stress can lead to a better understanding of health and well-being among sexual minority boys and men. In addition, we highlight where future research can expand upon the presented model in order to better understand the developmental processes through which attachment and sexual minority stress influences health and health behaviors among sexual minority boys and men.
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Affiliation(s)
- Stephanie H. Cook
- College of Global Public Health, New York University, 726 Broadway, New York, NY, 10010, Phone: (212) 998-5525
- School of Public Health, University of Michigan, 1415 Washington Heights, SPH I, Room 3814, Ann Arbor, MI 48109-2029
| | - Benjamin Calebs
- College of Literature, Science, and the Arts, University of Michigan, 500 S State St # 2005, Ann Arbor, MI 48109
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19
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Townsend RR, Wilkinson IB, Schiffrin EL, Avolio AP, Chirinos JA, Cockcroft JR, Heffernan KS, Lakatta EG, McEniery CM, Mitchell GF, Najjar SS, Nichols WW, Urbina EM, Weber T. Recommendations for Improving and Standardizing Vascular Research on Arterial Stiffness: A Scientific Statement From the American Heart Association. Hypertension 2015; 66:698-722. [PMID: 26160955 DOI: 10.1161/hyp.0000000000000033] [Citation(s) in RCA: 947] [Impact Index Per Article: 105.2] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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20
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Waloszek JM, Byrne ML, Woods MJ, Nicholas CL, Bei B, Murray G, Raniti M, Allen NB, Trinder J. Early physiological markers of cardiovascular risk in community based adolescents with a depressive disorder. J Affect Disord 2015; 175:403-10. [PMID: 25678173 DOI: 10.1016/j.jad.2015.01.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Revised: 01/07/2015] [Accepted: 01/08/2015] [Indexed: 01/25/2023]
Abstract
BACKGROUND Depression is recognised as an independent cardiovascular risk factor in adults. Identifying this relationship early on in life is potentially important for the prevention of cardiovascular disease (CVD). This study investigated whether clinical depression is associated with multiple physiological markers of CVD risk in adolescents from the general community. METHODS Participants aged 12-18 years were recruited from the general community and screened for depressive symptoms. Individuals with high and low depressive symptoms were administered a diagnostic interview. Fifty participants, 25 with a current depressive episode and 25 matched healthy controls, subsequently completed cardiovascular assessments. Variables assessed were automatic brachial and continuous beat-to-beat finger arterial blood pressure, heart rate, vascular functioning by pulse amplitude tonometry following reactive hyperaemia and pulse transit time (PTT) at rest. Blood samples were collected to measure cholesterol, glucose and glycohaemoglobin levels and an index of cumulative risk of traditional cardiovascular risk factors was calculated. RESULTS Depressed adolescents had a significantly lower reactive hyperaemia index and shorter PTT, suggesting deterioration in vascular integrity and structure. Higher fasting glucose and triglyceride levels were also observed in the depressed group, who also had higher cumulative risk scores indicative of increased engagement in unhealthy behaviours and higher probability of advanced atherosclerotic lesions. LIMITATIONS The sample size and number of males who completed all cardiovascular measures was small. CONCLUSIONS Clinically depressed adolescents had poorer vascular functioning and increased CVD risk compared to controls, highlighting the need for early identification and intervention for the prevention of CVD in depressed youth.
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Affiliation(s)
- Joanna M Waloszek
- Melbourne School of Psychological Sciences, The University of Melbourne, Victoria 3010, Australia.
| | - Michelle L Byrne
- Melbourne School of Psychological Sciences, The University of Melbourne, Victoria 3010, Australia.
| | - Michael J Woods
- Melbourne School of Psychological Sciences, The University of Melbourne, Victoria 3010, Australia.
| | - Christian L Nicholas
- Melbourne School of Psychological Sciences, The University of Melbourne, Victoria 3010, Australia.
| | - Bei Bei
- Melbourne School of Psychological Sciences, The University of Melbourne, Victoria 3010, Australia; School of Psychological Sciences, Monash University, Victoria 3800, Australia.
| | - Greg Murray
- Psychological Sciences and Statistics, Swinburne University of Technology, Hawthorn, Victoria 3122, Australia.
| | - Monika Raniti
- Melbourne School of Psychological Sciences, The University of Melbourne, Victoria 3010, Australia.
| | - Nicholas B Allen
- Melbourne School of Psychological Sciences, The University of Melbourne, Victoria 3010, Australia; Department of Psychology, University of Oregon, Eugene, OR 97405, USA.
| | - John Trinder
- Melbourne School of Psychological Sciences, The University of Melbourne, Victoria 3010, Australia.
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21
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Trapp M, Trapp EM, Egger JW, Domej W, Schillaci G, Avian A, Rohrer PM, Hörlesberger N, Magometschnigg D, Cervar-Zivkovic M, Komericki P, Velik R, Baulmann J. Impact of mental and physical stress on blood pressure and pulse pressure under normobaric versus hypoxic conditions. PLoS One 2014; 9:e89005. [PMID: 24817135 PMCID: PMC4015896 DOI: 10.1371/journal.pone.0089005] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Accepted: 01/13/2014] [Indexed: 11/23/2022] Open
Abstract
Objective Hypobaric hypoxia, physical and psychosocial stress may influence key cardiovascular parameters including blood pressure (BP) and pulse pressure (PP). We investigated the effects of mild hypobaric hypoxia exposure on BP and PP reactivity to mental and physical stress and to passive elevation by cable car. Methods 36 healthy volunteers participated in a defined test procedure consisting of a period of rest 1, mental stress task (KLT-R), period of rest 2, combined mental (KLT-R) and physical task (bicycle ergometry) and a last period of rest both at Graz, Austria (353 m asl) and at the top station Dachstein (2700 m asl). Beat-to-beat heart rate and BP were analysed both during the test procedures at Graz and at Dachstein and during passive 1000 m elevation by cable car (from 1702 m to 2700 m). Results A significant interaction of kind of stress (mental vs. combined mental and physical) and study location (Graz vs. Dachstein) was found in the systolic BP (p = .007) and PP (p = .002) changes indicating that during the combined mental and physical stress task sBP was significantly higher under hypoxic conditions whereas sBP and PP were similar during mental stress both under normobaric normoxia (Graz) and under hypobaric hypoxia (Dachstein). During the passive ascent in cable car less trivialization (psychological coping strategy) was associated with an increase in PP (p = .004). Conclusion Our data show that combined mental and physical stress causes a significant higher raise in sBP and PP under hypoxic conditions whereas isolated mental stress did not affect sBP and PP under hypoxic conditions. PP-reaction to ascent in healthy subjects is not uniform. BP reactions to ascent that represents an accumulation of physical (mild hypobaric hypoxia) and psychological stressors depend on predetermined psychological traits (stress coping strategies). Thus divergent cardiovascular reactions can be explained by applying the multidimensional aspects of the biopsychosocial concept.
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Affiliation(s)
- Michael Trapp
- Research Unit of Behavioural Medicine, Health Psychology and Empirical Psychosomatics, Department of Medical Psychology and Psychotherapy, Medical University of Graz, Graz, Austria
| | - Eva-Maria Trapp
- Research Unit of Behavioural Medicine, Health Psychology and Empirical Psychosomatics, Department of Medical Psychology and Psychotherapy, Medical University of Graz, Graz, Austria; University Clinic of Psychiatry. Medical University of Graz, Graz, Austria
| | - Josef W Egger
- Research Unit of Behavioural Medicine, Health Psychology and Empirical Psychosomatics, Department of Medical Psychology and Psychotherapy, Medical University of Graz, Graz, Austria
| | - Wolfgang Domej
- Department of Pneumology, Medical University of Graz, Graz, Austria
| | - Giuseppe Schillaci
- Department of Medicine, University of Perugia and Terni University Hospital, Terni, Italy
| | - Alexander Avian
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
| | - Peter M Rohrer
- Research Unit of Behavioural Medicine, Health Psychology and Empirical Psychosomatics, Department of Medical Psychology and Psychotherapy, Medical University of Graz, Graz, Austria
| | - Nina Hörlesberger
- Research Unit of Behavioural Medicine, Health Psychology and Empirical Psychosomatics, Department of Medical Psychology and Psychotherapy, Medical University of Graz, Graz, Austria
| | | | - Mila Cervar-Zivkovic
- Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria
| | - Peter Komericki
- Department of Dermatology, Medical University of Graz, Graz, Austria
| | | | - Johannes Baulmann
- UKSH Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
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22
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Seeman TE, Gruenewald TL, Cohen S, Williams DR, Matthews KA. Social relationships and their biological correlates: Coronary Artery Risk Development in Young Adults (CARDIA) study. Psychoneuroendocrinology 2014; 43:126-38. [PMID: 24703178 DOI: 10.1016/j.psyneuen.2014.02.008] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Revised: 02/14/2014] [Accepted: 02/15/2014] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Analyses test the hypothesis that aspects of social relationships (quantity of ties, social support and social strain) are associated with differences in levels of biological risk across multiple major physiological regulatory systems and consequently overall multi-systems risk (i.e., allostatic load [AL]). METHODS Data are from the Coronary Artery Risk Development in Young Adults (CARDIA) study--a bi-ethnic, prospective, multi-center epidemiological study, initiated in 1985-1986 to track the development of cardiovascular risk in young adulthood (N=5115). At the year 15 follow-up when participants were between 32 and 45 years of age, additional social and biological data were collected; biological data used to assess AL were collected at the Oakland, CA and Chicago, IL sites (N=844). RESULTS Social strains were most strongly and positively related to overall AL (Cohen's d=.79 for highest vs. lowest quartile), and to each of its component biological subsystems, independent of social ties and support as well as sociodemographics and health behaviors. Social ties and emotional support were also negatively related to AL (Cohen's d=.33 and d=.44 for lowest vs. highest quartiles of ties and support, respectively) though controls for social strains reduced these associations to non-significance. Social support and social strain were more strongly related to overall AL than to any of its component subscales while social ties were less strongly related to AL and to its component subscales. There was no evidence that effects differed by sex, age or ethnicity. CONCLUSIONS Findings focus attention on the particularly strong relationship between social strains and profiles of biological risk and support the cumulative impact of social factors on biological risks, showing larger effects for cumulative AL than for any of the individual biological systems.
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Affiliation(s)
- Teresa E Seeman
- David Geffen School of Medicine at UCLA, Los Angeles, CA, United States.
| | - Tara L Gruenewald
- Davis School of Gerontology, University of Southern California, Los Angeles, CA, United States
| | - Sheldon Cohen
- Department of Psychology, Carnegie Mellon University, Pittsburgh, PA, United States
| | - David R Williams
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Harvard University, Boston, MA, United States
| | - Karen A Matthews
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
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Abstract
Despite its pervasiveness in primary care, deficient sleep often is underappreciated as a cue to other health risks. Accordingly, this review discusses contemporary evidence-based perspectives on impaired sleep and its associations with other lifestyle medicine concerns, including obesity, cardiovascular conditions, psychological problems, and health-compromising habits. The potential clinical benefits of promoting sleep health also will be considered.
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Affiliation(s)
- Lisa Terre
- Department of Psychology, University of Missouri-Kansas City, Kansas City, Missouri
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24
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D'Antono B, Moskowitz DS, Nigam A. The metabolic costs of hostility in healthy adult men and women: cross-sectional and prospective analyses. J Psychosom Res 2013; 75:262-9. [PMID: 23972416 DOI: 10.1016/j.jpsychores.2013.05.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Revised: 05/24/2013] [Accepted: 05/25/2013] [Indexed: 12/16/2022]
Abstract
BACKGROUND Hostility is associated with altered metabolic activity but little research has examined sex and/or age differences using a global index of metabolic dysfunction or examined different aspects of hostility. METHODS The moderating effect of sex and age on the associations between three aspects of hostility (cynical attitude, angry affect, quarrelsome behavior in daily living) and metabolic burden (number of metabolic parameters in the higher quartile) were evaluated in 188 healthy men and women (M(age)=41; SD=11.34). Three years later, metabolic burden was measured again in 133 participants. RESULTS At study onset, quarrelsome behavior was associated with greater metabolic burden in men and women (Beta=.144; p<.05). After 3 yrs, cynical hostility predicted increased metabolic burden among mid-age and older individuals (b=.013 and .046 respectively; p<.001). CONCLUSION The aspect of hostility that is most closely associated with metabolic burden depends on the age of the participants and whether measures are concurrent or prospective.
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Affiliation(s)
- Bianca D'Antono
- Research Center, Montreal Heart Institute, Montreal, Quebec, Canada.
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25
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Aparicio E, Canals J, Voltas N, Hernández-Martínez C, Arija V. Emotional psychopathology and increased adiposity: follow-up study in adolescents. J Adolesc 2013; 36:319-30. [PMID: 23434271 DOI: 10.1016/j.adolescence.2012.12.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2012] [Revised: 11/06/2012] [Accepted: 12/14/2012] [Indexed: 10/27/2022]
Abstract
Based on data from a three-year longitudinal study, we assess the effect, according to gender, of emotional psychopathology in preadolescence on anthropometric and body composition parameters in adolescence (N = 229). Psychopathology was assessed using the Screen for Childhood Anxiety and Related Emotional Disorders, the Children's Depression Inventory and the MINI-International Neuropsychiatric Interview for Kids. Body fat percentage (%BF), waist circumference (WC) and body mass index (BMI) were also determined. Following analysis with adjusted multiple regression models, the results indicated that symptoms of depression and separation anxiety were significantly associated with increased WC and BMI in boys, and that somatic symptoms were associated with increased WC and %BF in girls. Diagnosis of social phobia, panic disorder or dysthymia led to significantly increased WC and/or BMI in boys and dysthymia increased WC in girls. These findings suggest that emotional psychopathology in preadolescence is associated with increased weight gain and abdominal fat in adolescence.
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Affiliation(s)
- Estefania Aparicio
- Faculty of Medicine and Health Sciences, Nutrition and Mental Health Research Group (NUTRISAM), Universitat Rovira i Virgili (URV), Reus, Spain
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26
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Jaremka LM, Glaser R, Loving TJ, Malarkey WB, Stowell JR, Kiecolt-Glaser JK. Attachment anxiety is linked to alterations in cortisol production and cellular immunity. Psychol Sci 2013; 24:272-9. [PMID: 23307944 DOI: 10.1177/0956797612452571] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Although evidence suggests that attachment anxiety may increase risk for health problems, the mechanisms underlying these effects are not well understood. In the current study, married couples (N = 85) provided saliva samples over 3 days and blood samples on two occasions. Participants with higher attachment anxiety produced more cortisol and had fewer numbers of CD3(+) T cells, CD45(+) T cells, CD3(+)CD4(+) helper T cells, and CD3(+)CD8(+) cytotoxic T cells than participants with lower attachment anxiety. Higher cortisol levels were also related to fewer numbers of CD3(+), CD45(+), CD3(+)CD4(+), and CD3(+)CD8(+) cells, which is consistent with research showing that cortisol alters the cellular immune response. These data suggest that attachment anxiety may have physiological costs, and they provide a glimpse into the pathways through which social relationships affect health. The current study also extends attachment theory in an important new direction by demonstrating the utility of a psychoneuroimmunological approach to the study of attachment anxiety, stress, and health.
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Affiliation(s)
- Lisa M Jaremka
- The Ohio State University College of Medicine, Institute for Behavioral Medicine Research, 460 Medical Center Dr., Columbus, OH 43210, USA.
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27
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Hawkins MAW, Stewart JC. Do negative emotional factors have independent associations with excess adiposity? J Psychosom Res 2012; 73:243-50. [PMID: 22980527 DOI: 10.1016/j.jpsychores.2012.07.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2012] [Revised: 07/19/2012] [Accepted: 07/24/2012] [Indexed: 10/28/2022]
Abstract
OBJECTIVE Taken in isolation, depression, anxiety, and hostility/anger have been shown to predict obesity. It is unknown whether these negative emotional factors are associated with adiposity, independently of each other. The objective of this review was to determine whether negative emotional factors have independent associations with adiposity. METHODS We searched for observational studies examining adiposity and two or more negative emotional factors. Studies which examined a negative emotional factor using analyses which controlled for other emotional factor(s) were selected for the review. RESULTS Three prospective and 11 cross-sectional studies met our inclusion/exclusion criteria. Of these investigations, 64% indicated that depression had positive associations with adiposity, independent of anxiety or hostility, and 56% indicated that anxiety had independent associations with adiposity. Only 33% of studies found independent associations for hostility and adiposity; however, far fewer studies were available. CONCLUSION Depression and anxiety have independent associations with excess adiposity when controlling for other emotional factors. Additional studies are needed to determine whether hostility/anger is independently associated with excess adiposity. These results have implications for the design of effective obesity prevention programs.
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Affiliation(s)
- Misty A W Hawkins
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN 46202, United States
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28
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Logan JG, Barksdale DJ, Carlson J, Carlson BW, Rowsey PJ. Psychological stress and arterial stiffness in Korean Americans. J Psychosom Res 2012; 73:53-8. [PMID: 22691560 PMCID: PMC3374866 DOI: 10.1016/j.jpsychores.2012.04.008] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2012] [Revised: 04/17/2012] [Accepted: 04/18/2012] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Arterial stiffness is identified as a causative factor for hypertension. The purpose of this study was to explore the relationship between psychological stress and arterial stiffness in Korean Americans. METHODS A convenience sample of 102 Korean Americans (aged 21-60 years, 60% women) was recruited from North Carolina. Psychological stress was measured by the Perceived Stress Scale, the Social, Attitudinal, Familiar, and Environmental (SAFE) Acculturative Stress Scale, and the Spielberger's State-Trait Anxiety Inventory. Arterial stiffness was measured by carotid-femoral pulse wave velocity (cfPWV) using the SphygmoCor system (AtCor Medical, Australia). RESULTS This study shows that the emotional stress response, measured by anxiety, significantly predicted arterial stiffness (β=.25, p=.008), independently of such confounding factors as age, mean arterial pressure (MAP), gender, body mass index, smoking, education, and income. Anxiety was neither related to age (r=.12, p=.212) nor MAP (r=.14, p=.151). Additionally, this sample of Korean Americans had higher levels of psychological stress when compared to previous findings from studies of other racial/ethnic groups in the U.S. CONCLUSION Findings demonstrate that anxiety is a significant and independent determinant of arterial stiffness. Given that anxiety was not related to MAP, these findings suggest that arterial stiffness may be a pathway to explain the connection between anxiety and hypertension risk. Studies that scrutinize the relationship between anxiety and arterial stiffness are an important next step for future research. Further studies are also recommended to explore cultural factors and individual characteristics that may affect anxiety in Korean Americans.
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Affiliation(s)
- Jeongok G Logan
- School of Nursing, University of North Carolina at Chapel Hill, 105 Westside Drive, Chapel Hill, NC 27516, USA.
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Versey HS, Kaplan GA. Mediation and moderation of the association between cynical hostility and systolic blood pressure in low-income women. HEALTH EDUCATION & BEHAVIOR 2011; 39:219-28. [PMID: 22167318 DOI: 10.1177/1090198111414884] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Hostility may be related to risk factors for cardiovascular disease (CVD), such as blood pressure. However, the process by which hostility affects blood pressure is not fully understood. The current study sought to evaluate abdominal obesity (waist-to-hip ratio [WHR]) as a potential mediator and modifier of the relationship between cynical hostility and systolic blood pressure (SBP) in a group of disadvantaged women. Path analysis and multiple regression models were used to identify mediating and moderating pathways in the relationship between cynical hostility and SBP. Results indicate a significant interaction between WHR and cynical hostility. WHR was a partial mediator and significant moderator of the association between hostility and blood pressure. These findings highlight the potential importance of examining abdominal obesity and psychosocial factors as conjunctive determinants of CVD and risk factors for related metabolic conditions.
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Affiliation(s)
- H Shellae Versey
- Department of Psychology, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA.
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Lahmann C, Henrich G, Henningsen P, Baessler A, Fischer M, Loew T, Tritt K, Pieh C. The impact of personality traits on the success of a multimodal obesity treatment. Behav Med 2011; 37:119-24. [PMID: 22168328 DOI: 10.1080/08964289.2011.635169] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
This prospective study investigated personality traits as predictors of the outcome in a 52-week weight-loss program for obesity. Personality traits were rated with the Inventory of Interpersonal Problems (IIP) in 54 consecutive obese outpatients when entering a multimodal weight-reduction program. The value of these variables to predict success was assessed after 12, 26, and 52 weeks of treatment. A stepwise linear regression analysis for all follow-ups was calculated to examine the impact of each IIP item subscale on weight reduction. The IIP item subscale "intrusive or needy" significantly correlated with weight reduction observed at every follow-up examination and accounts for 13.6% to 29.8% of the variance (p values < .05). Obese patients describing themselves as excessively friendly, outgoing, and sociable improved more from a weight-loss program than those with lower instances of these traits. Accordingly, personality traits deserve more attention at initial assessment and while planning treatment of obese patients.
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Affiliation(s)
- Claas Lahmann
- Department of Psychosomatic Medicine, Klinikum rechts der Isar, Technische Universitaet Muenchen, Munich, Germany.
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31
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Sutin AR, Ferrucci L, Zonderman AB, Terracciano A. Personality and obesity across the adult life span. J Pers Soc Psychol 2011; 101:579-92. [PMID: 21744974 PMCID: PMC3462003 DOI: 10.1037/a0024286] [Citation(s) in RCA: 222] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Personality traits contribute to health outcomes, in part through their association with major controllable risk factors, such as obesity. Body weight, in turn, reflects our behaviors and lifestyle and contributes to the way we perceive ourselves and others. In this study, the authors use data from a large (N = 1,988) longitudinal study that spanned more than 50 years to examine how personality traits are associated with multiple measures of adiposity and with fluctuations in body mass index (BMI). Using 14,531 anthropometric assessments, the authors modeled the trajectory of BMI across adulthood and tested whether personality predicted its rate of change. Measured concurrently, participants higher on Neuroticism or Extraversion or lower on Conscientiousness had higher BMI; these associations replicated across body fat, waist, and hip circumference. The strongest association was found for the impulsivity facet: Participants who scored in the top 10% of impulsivity weighed, on average, 11Kg more than those in the bottom 10%. Longitudinally, high Neuroticism and low Conscientiousness, and the facets of these traits related to difficulty with impulse control, were associated with weight fluctuations, measured as the variability in weight over time. Finally, low Agreeableness and impulsivity-related traits predicted a greater increase in BMI across the adult life span. BMI was mostly unrelated to change in personality traits. Personality traits are defined by cognitive, emotional, and behavioral patterns that likely contribute to unhealthy weight and difficulties with weight management. Such associations may elucidate the role of personality traits in disease progression and may help to design more effective interventions.
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Affiliation(s)
- Angelina R Sutin
- National Institute on Aging, National Institutes of Health, Department of Health and Human Services, Baltimore, MD 21224, USA.
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32
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Dietz LJ, Matthews KA. Depressive symptoms and subclinical markers of cardiovascular disease in adolescents. J Adolesc Health 2011; 48:579-84. [PMID: 21575817 PMCID: PMC3096828 DOI: 10.1016/j.jadohealth.2010.09.001] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2010] [Revised: 09/03/2010] [Accepted: 09/03/2010] [Indexed: 11/16/2022]
Abstract
PURPOSE To examine the association between depressive symptoms and subclinical markers of cardiovascular disease (CVD), specifically arterial stiffness, as indexed by pulse wave velocity (PWV), and carotid artery intima media thickening (IMT), in a sample of healthy adolescents, and to explore adolescent hostility as a potential moderator of depression on subclinical markers of CVD. METHODS One hundred fifty-seven (n = 157) black and white adolescents between the ages of 16-21 completed a follow-up study of psychosocial stress and cardiovascular risk factors that included measures of PWV and carotid IMT. Psychosocial measures included the Center for Epidemiologic Studies Depression Scale (divided into tertiles), and the Cook-Medley Hostility Inventory subscales. Linear regression models controlled for sociodemographic variables, health behaviors, blood pressure, body mass index, and heart rate. RESULTS Results show that more severe depressive symptoms were associated with higher levels of PWV (B = .17, R(2) = .30, ΔR(2) = .03, confidence interval = 2.2-47.0, p = .03) but not with higher IMT. Adolescent depression remained a significant predictor of PWV when controlling for adolescent hostility; hostility did not moderate the relationship between adolescent depression and PWV. CONCLUSION Depression may be important in the development of arterial stiffness in adolescence. Further research is needed to delineate the relationship in adolescence and young adulthood between depressive symptoms and the pathogenesis of CVD.
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Affiliation(s)
- Laura J Dietz
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15206, USA.
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Incledon E, Wake M, Hay M. Psychological predictors of adiposity: Systematic review of longitudinal studies. ACTA ACUST UNITED AC 2011; 6:e1-11. [DOI: 10.3109/17477166.2010.549491] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Midei AJ, Matthews KA. Interpersonal violence in childhood as a risk factor for obesity: a systematic review of the literature and proposed pathways. Obes Rev 2011; 12:e159-72. [PMID: 21401850 PMCID: PMC3104728 DOI: 10.1111/j.1467-789x.2010.00823.x] [Citation(s) in RCA: 115] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
We examined the associations between exposure to interpersonal violence in childhood and risk for obesity and central adiposity. Interpersonal violence is defined as behaviour that threatens, attempts or causes physical harm. In addition, we evaluated the evidence for three mechanisms that may connect interpersonal violence to obesity: negative affect, disordered eating and physical inactivity. Based on a literature search of Medline and PsycInfo databases, 36 separate studies were evaluated and ranked based on quality. Approximately 81% of the studies reported a significant positive association between some type of childhood interpersonal violence and obesity, although 83% of the studies were cross-sectional. Associations were consistent for caregiver physical and sexual abuse and peer bullying, and there was mixed evidence for community violence. Although few studies explored mechanisms, early evidence suggests that negative affect and disordered eating may be involved. More prospective studies are needed, as well as studies that examine the mechanisms connecting early childhood victimization to obesity and central adiposity.
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Affiliation(s)
- A J Midei
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
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36
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Sutin AR, Costa PT, Uda M, Ferrucci L, Schlessinger D, Terracciano A. Personality and metabolic syndrome. AGE (DORDRECHT, NETHERLANDS) 2010; 32:513-519. [PMID: 20567927 PMCID: PMC2980597 DOI: 10.1007/s11357-010-9153-9] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2010] [Accepted: 05/11/2010] [Indexed: 05/29/2023]
Abstract
The prevalence of metabolic syndrome has paralleled the sharp increase in obesity. Given its tremendous physical, emotional, and financial burden, it is of critical importance to identify who is most at risk and the potential points of intervention. Psychological traits, in addition to physiological and social risk factors, may contribute to metabolic syndrome. The objective of the present research is to test whether personality traits are associated with metabolic syndrome in a large community sample. Participants (N = 5,662) from Sardinia, Italy, completed a comprehensive personality questionnaire, the NEO-PI-R, and were assessed on all components of metabolic syndrome (waist circumference, triglycerides, high-density lipoprotein cholesterol, blood pressure, and fasting glucose). Logistic regressions were used to predict metabolic syndrome from personality traits, controlling for age, sex, education, and current smoking status. Among adults over age 45 (n = 2,419), Neuroticism and low Agreeableness were associated with metabolic syndrome, whereas high Conscientiousness was protective. Individuals who scored in the top 10% on Conscientiousness were approximately 40% less likely to have metabolic syndrome (OR = 0.61, 95% CI = 0.41-0.92), whereas those who scored in the lowest 10% on Agreeableness were 50% more likely to have it (OR = 1.53, 95% CI = 1.09-2.16). At the facet level, traits related to impulsivity and hostility were the most strongly associated with metabolic syndrome. The present research indicates that those with fewer psychological resources are more vulnerable to metabolic syndrome and suggests a psychological component to other established risk factors.
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Affiliation(s)
- Angelina R Sutin
- Laboratory of Personality and Cognition, National Institute on Aging, NIH, DHHS, 251 Bayview Blvd., Baltimore, MD 21224, USA.
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37
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Terre L. Is There a Connection Between Diabetes and Psychological Dysfunction? Am J Lifestyle Med 2010. [DOI: 10.1177/1559827610375905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This review discusses evidence-based perspectives on the relationship between diabetes and psychological distress. Future directions for inquiry and clinical management also are addressed.
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Affiliation(s)
- Lisa Terre
- Department of Psychology, University of Missouri-Kansas City,
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Sutin AR, Scuteri A, Lakatta EG, Tarasov KV, Ferrucci L, Costa PT, Schlessinger D, Uda M, Terracciano A. Trait antagonism and the progression of arterial thickening: women with antagonistic traits have similar carotid arterial thickness as men. Hypertension 2010; 56:617-22. [PMID: 20713913 DOI: 10.1161/hypertensionaha.110.155317] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
A large body of evidence links antagonism-related traits with cardiovascular outcomes, but less is known about how psychological traits are associated with intermediate markers of cardiovascular disease. Using a large, community-based sample from Sardinia, Italy (n=5614), this study examined how trait antagonism (low agreeableness) and its facets are associated with carotid artery intima-media thickness, a measure of arterial thickening. Controlling for demographic and cardiovascular risk factors, low agreeableness and, in particular, low straightforwardness and low compliance, were associated with greater carotid thickening, measured concurrently and prospectively, and with increases in intima-media thickness over 3 years. Indeed, those in the bottom 10% of agreeableness had a 40% increase in risk for elevated intima-media thickness. Although men have thicker arterial walls, women with antagonistic traits had similar carotid thickening as antagonistic men. Antagonistic individuals, especially those who are manipulative and aggressive, have greater increases in arterial thickening, independent of traditional cardiovascular risk factors.
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Affiliation(s)
- Angelina R Sutin
- National Institute on Aging, National Institutes of Health, Department of Health and HumanServices, Baltimore, MD 21224.
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Lewis TT, Sutton-Tyrrell K, Penninx BW, Vogelzangs N, Harris TB, Vaidean GD, Ayonayon HN, Kim L, Lakatta EG, Newman AB. Race, psychosocial factors, and aortic pulse wave velocity: the Health, Aging, and Body Composition Study. J Gerontol A Biol Sci Med Sci 2010; 65:1079-85. [PMID: 20522528 DOI: 10.1093/gerona/glq089] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Increasingly, researchers have begun to explore pathways through which psychosocial factors might influence cardiovascular disease, with some emphasis on early markers. The current study examined the cross-sectional association between psychosocial factors and aortic pulse wave velocity (an early marker of cardiovascular disease) in a biracial cohort of older adults. We were particularly interested in determining whether the association between psychosocial factors and aortic pulse wave velocity differed for older blacks compared with whites. METHODS Participants were 2,488 (40% black and 52% female) older adults from the Health, Aging, and Body Composition Study. Carotid-femoral aortic pulse wave velocity was assessed using standard methodologies. Depressive symptoms, anxiety symptoms, negative life events, and inadequate emotional support were assessed, and a summary psychosocial risk index was created. RESULTS In multivariable linear regression models, psychosocial risk was not associated with aortic pulse wave velocity (Estimate [Est] = .00, p = .83), but there was a significant Race × Psychosocial risk interaction (Est = .07, p = .01), after adjusting for age, race, sex, and education. Further analyses revealed that this association was driven by the inadequate emotional support component of psychosocial risk (Race × Inadequate emotional support, p = .005). In race-stratified analyses, inadequate emotional support was associated with higher levels of arterial stiffness in older blacks (Est = .05, p = .04) but not whites (Est = -.04, p = .13). This association persisted after adjusting for demographics, cardiovascular risk factors, and social network characteristics. CONCLUSIONS Findings suggest that older blacks may be particularly vulnerable to the effects of inadequate emotional support on vascular health. Interventions aimed at increasing social support among this population might be beneficial in reducing cardiovascular disease risk.
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Affiliation(s)
- Tené T Lewis
- Department of Epidemiology and Public Health, Yale University, New Haven, Connecticut, USA.
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Sharma M, Branscum P. Novel and emerging approaches to combat adolescent obesity. ADOLESCENT HEALTH MEDICINE AND THERAPEUTICS 2010; 1:9-19. [PMID: 24600257 PMCID: PMC3915788 DOI: 10.2147/ahmt.s7579] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Overweight and obesity continue to be health concerns facing today’s adolescent population. Along with metabolic and physical problems associated with obesity, today’s obese adolescents also face many psychological issues such as high rates of depression, anxiety, and social discrimination. Obesity is commonly recognized as having many causes, such as genetic, lifestyle and environmental. There are four major modalities for management of overweight and obesity in adolescents: dietary management, increasing physical activity, pharmacological therapy, and bariatric surgery. The purpose of this study was to conduct a review of novel and emerging approaches for preventing and managing adolescent obesity. It was found that while not always the case, theory driven approaches are being better utilized in newer interventions especially by those directed toward prevention. New theories that are being used are the theories of reasoned action, planned behavior, intervention mapping, and social marketing. Schools are found to be the most common place for such interventions, which is appropriate since virtually all children attend some form of private or public school. Limitations found in many studies include the underuse of process evaluations, the low number of studies attempted, environmental or policy changes, and that not all studies used a similar control group for comparison.
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Affiliation(s)
- Manoj Sharma
- Health Promotion and Education and Public Health Sciences, University of Cincinnati, Cincinnati, OH, USA
| | - Paul Branscum
- Health Promotion and Education and Public Health Sciences, University of Cincinnati, Cincinnati, OH, USA
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Childhood abuse is associated with adiposity in midlife women: possible pathways through trait anger and reproductive hormones. Psychosom Med 2010; 72:215-23. [PMID: 20064904 PMCID: PMC2832915 DOI: 10.1097/psy.0b013e3181cb5c24] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To examine the association between childhood abuse/neglect and central adiposity and obesity in a sample of 311 women (n = 106 black, 205 white) from the Pittsburgh site of the Study of Women's Health Across the Nation (SWAN). METHODS SWAN included a baseline measurement of women in midlife (mean age = 45.7 years) and eight follow-up visits during which waist circumference (WC) and body mass index (BMI) were measured. The Childhood Trauma Questionnaire retrospectively assessed emotional, physical, and sexual abuse, and emotional and physical neglect in childhood. RESULTS Analyses of covariance showed that women with a history of any abuse/neglect, and specifically physical and sexual abuse, had significantly higher WC and BMI at baseline than women with no abuse history. A significant interaction between abuse and BMI showed that among women with BMI of <30, any abuse/neglect and certain subtypes of abuse predicted greater increases in WC over time. Additional analyses showed that Trait Anger scores and sex hormone-binding globulin (SHBG) attenuated cross-sectional relationships between abuse/neglect and WC and BMI. CONCLUSION This study suggests that abused/neglected women seem to have greater anger and lower levels of SHBG, which are associated with adiposity in midlife.
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Abstract
Hypertension is on a worrisome public health trajectory. This review discusses some key contributing dynamics as well as considerations for progress toward the prevention and control of hypertension and its comorbidities.
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Affiliation(s)
- Lisa Terre
- Department of Psychology, University of Missouri-Kansas City,
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