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Slezackova A, Malatincova T, Millova K, Svetlak M, Krafft AM. The moderating effect of perceived hope in the relationship between anxiety and posttraumatic growth during the Russian-Ukrainian war. Front Psychol 2024; 15:1440021. [PMID: 39156809 PMCID: PMC11327115 DOI: 10.3389/fpsyg.2024.1440021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Accepted: 07/22/2024] [Indexed: 08/20/2024] Open
Abstract
Introduction This study examines the relationships between perceived hope, posttraumatic growth, well-being, anxiety, and perceived threat of the Russian-Ukrainian War (RUW) in the Czech adult population. Drawing on the evidence of posttraumatic growth (PTG) amidst crisis, we hypothesized that perceived hope moderates the effects of perceived threat of war and anxiety on PTG. Methods Data were obtained from 1,000 Czech respondents via an online questionnaire ten months post-invasion. The form included measures of posttraumatic growth, perceived hope, well-being, anxiety and depression, and perceived threat of war. Results Our findings reveal that perceived hope acted as a moderator enhancing the positive effects of perceived threat and anxiety on PTG. However, perceived hope did not significantly moderate the direct effects of perceived threats and anxiety on well-being. Discussion This study highlights the significant role of hope amidst adversity and underscores its potential as a target for interventions aiming to foster PTG in populations who navigate traumatic experiences. Furthermore, it advocates for continued exploration of the factors interacting to enhance well-being and facilitate PTG in affected communities.
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Affiliation(s)
- Alena Slezackova
- Department of Medical Psychology and Psychosomatics, Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Tatiana Malatincova
- Department of Medical Psychology and Psychosomatics, Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Katarina Millova
- Department of Psychology, Faculty of Arts, University of Ostrava, Ostrava, Czechia
| | - Miroslav Svetlak
- Department of Medical Psychology and Psychosomatics, Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Andreas M. Krafft
- Institute of Systemic Management and Public Governance, University of St. Gallen, St. Gallen, Switzerland
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Negri A, Barazzetti A, Rinzivillo A, Mariani R, Di Monte C. Cognitive and Relational Processes Associated to Mental Health in Italian High School Students during COVID-19 and Russian-Ukrainian War Outbreaks. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:508. [PMID: 38673420 PMCID: PMC11050012 DOI: 10.3390/ijerph21040508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 03/26/2024] [Accepted: 04/14/2024] [Indexed: 04/28/2024]
Abstract
The negative impact of the COVID-19 pandemic on mental health has been widely demonstrated; however, few studies have investigated the psychological processes involved in this impact, including core beliefs violation, meaning-making disruption, interpersonal support, or one's relational functioning. This study explored the mental health of 215 Italian adolescents during the COVID-19 pandemic and the subsequent outbreak of the Russian-Ukrainian war. By administering a set of questionnaires, several cognitive and emotional variables were investigated, including core belief violation, meaning attribution to the pandemic and war, attachment, and emotion regulation, social media addiction, and relationships with significant others and teachers. We conducted some descriptive, mean difference, correlational, and predictive analyses that revealed a significant association between core belief violation caused by war and pandemic, ability to integrate war and pandemic within personal meaning universe, the relational support received, and mental health. The relationship with teachers during these challenging periods improved significantly according to the respondents' opinion, becoming both more authoritative and empathic. This study offers insights into what cognitive and relational processes are useful to intervene on to reduce the distress of adolescents who are facing significant moments of crisis due to events that challenge their cognitive and emotional balance.
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Affiliation(s)
- Attà Negri
- Department of Human and Social Sciences, University of Bergamo, 24129 Bergamo, Italy;
| | - Arianna Barazzetti
- Department of Human and Social Sciences, University of Bergamo, 24129 Bergamo, Italy;
| | | | - Rachele Mariani
- Department of Dynamic and Clinical Psychology and Health Studies “Sapienza”, University of Rome, 00185 Rome, Italy; (R.M.); (C.D.M.)
| | - Cinzia Di Monte
- Department of Dynamic and Clinical Psychology and Health Studies “Sapienza”, University of Rome, 00185 Rome, Italy; (R.M.); (C.D.M.)
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3
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Vargová L, Jozefiaková B, Lačný M, Adamkovič M. War-related stress scale. BMC Psychol 2024; 12:208. [PMID: 38622687 PMCID: PMC11020644 DOI: 10.1186/s40359-024-01687-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 03/26/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND The current war in Ukraine has affected the well-being of people worldwide. In order to understand how difficult the situation is, specific stressors associated with war need to be measured. In response, an inventory of war-related stressors including its short form, has been developed. METHODS A list of potential war-related stressors was created, and the content validity of each item assessed. The list, along with other validated scales, was administered to a representative sample of the Slovak population (effective N = 1851). Exploratory factor analysis, confirmatory factor analysis, convergent validity analysis and network analysis were carried out to determine the optimal scale (long and short form) focused on war-related stressors. RESULTS The full version of the scale consists of 21 items, further divided into three factors: society-related stressors, person-related stressors, and security-related stressors. The short version of the scale comprises nine items loaded onto one factor. These items cover concerns for one's safety and future, access to necessities, potential worsening of the economic situation, and the risk of conflict escalation, including a nuclear threat. The results of the network analysis indicate that concern about escalation and fear of an economic crisis play a central role. CONCLUSIONS The scale attempts to encompass a wide spectrum of areas that are affected by war and its potential consequences on individuals who reside outside the conflict zone. Given the complexity of the issue, researchers are invited to modify the scale, tailoring it to specific cultural, geographical, and temporal contexts.
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Affiliation(s)
- Lenka Vargová
- Faculty of Education, University of Presov, Prešov, Slovakia
- Institute of Social Sciences, Centre of Social and Psychological Sciences, Slovak Academy of Sciences, Košice, Slovakia
| | - Bibiána Jozefiaková
- Olomouc University Social Health Institute, Palacky University, Olomouc, Czechia
| | - Martin Lačný
- Institute of Political Science, Faculty of Arts, University of Presov, Prešov, Slovakia
| | - Matúš Adamkovič
- Institute of Social Sciences, Centre of Social and Psychological Sciences, Slovak Academy of Sciences, Košice, Slovakia.
- Faculty of Humanities and Social Sciences, University of Jyväskylä, Jyväskylä, Finland.
- Faculty of Education, Charles University, Prague, Czechia.
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Raccanello D, Burro R, Aristovnik A, Ravšelj D, Umek L, Vicentini G, Hall R, Buizza C, Buzdar MA, Chatterjee S, Cucari N, Dobrowolska B, Ferreira-Oliveira AT, França T, Ghilardi A, Inasius F, Kar SK, Karampelas K, Kuzyshyn A, Lazăr F, Machin-Mastromatteo JD, Malliarou M, Marques BP, Méndez-Prado SM, Mollica C, Obadić A, Olaniyan OF, Rodrigues AS, Sbravati G, Vasić A, Zamfir AM, Tomaževič N. Coping and emotions of global higher education students to the Ukraine war worldwide. Sci Rep 2024; 14:8561. [PMID: 38609468 PMCID: PMC11014932 DOI: 10.1038/s41598-024-59009-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 04/05/2024] [Indexed: 04/14/2024] Open
Abstract
Trauma scientists have raised the alarm about the devastating consequences of the Ukraine war on mental health. We examined how higher education students-as indirect victims-coped with this conflict and how they emotionally reacted during 2022. We involved 2314 students from 16 countries through an online survey. A structural equation model indicated significant relations between war-related worry about military and macroeconomics domains and two coping strategies (opposition, support giving), in turn significantly linked with six emotions. The model was strongly invariant across gender, study field, and geographic area. The most frequent emotions were anger and anxiety, followed by two future-centred emotions (hopelessness and hope). Emotions were more frequent for females and students of the countries geographically close to the war region. Our findings call for evidence-based policy recommendations to be implemented by institutions to combat the negative short and long-term psychological sequelae of being witnesses of armed conflicts.
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Affiliation(s)
| | - Roberto Burro
- Department of Human Sciences, University of Verona, Verona, Italy
| | | | - Dejan Ravšelj
- Faculty of Public Administration, University of Ljubljana, Ljubljana, Slovenia.
| | - Lan Umek
- Faculty of Public Administration, University of Ljubljana, Ljubljana, Slovenia.
| | - Giada Vicentini
- Department of Human Sciences, University of Verona, Verona, Italy
| | - Rob Hall
- Department of Psychology, Macquarie University, Sydney, Australia
- Environmetrics, Killara, Australia
| | - Chiara Buizza
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Muhammad Ayub Buzdar
- Department of Secondary Teacher Education, Allama Iqbal Open University Islamabad, Islamabad, Pakistan
| | - Surobhi Chatterjee
- Department of Psychiatry, King George's Medical University, Lucknow, India
| | - Nicola Cucari
- Department of Management, Sapienza University of Rome, Rome, Italy
| | - Beata Dobrowolska
- Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland
| | | | - Thais França
- Centre for Research and Studies in Sociology, Cies-Iscte, Lisbon, Portugal
| | - Alberto Ghilardi
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Fany Inasius
- School of Accounting, Bina Nusantara University, Jakarta, Indonesia
| | - Sujita Kumar Kar
- Department of Psychiatry, King George's Medical University, Lucknow, India
| | | | - Andrii Kuzyshyn
- Ternopil Volodymyr Hnatiuk National Pedagogical University, Ternopil, Ukraine
| | - Florin Lazăr
- Faculty of Sociology and Social Work, University of Bucharest, Bucharest, Romania
| | | | - Maria Malliarou
- Department of Nursing, University of Thessaly, Vólos, Greece
| | - Bertil P Marques
- Institute of Engineering of Porto, P.PORTO-Polytechnic of Porto, Porto, Portugal
| | | | - Cristina Mollica
- Department of Statistical Sciences, Sapienza University of Rome, Rome, Italy
| | - Alka Obadić
- Faculty of Economics and Business, University of Zagreb, Zagreb, Croatia
| | - Olawale Festus Olaniyan
- School of Agriculture and Environmental Sciences, University of The Gambia, Serrekunda, Gambia
| | - Ana Sofia Rodrigues
- CISAS, Polytechnic Institute of Viana Do Castelo, Viana do Castelo, Portugal
| | - Giulio Sbravati
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | | | - Ana-Maria Zamfir
- National Scientific Research Institute for Labour and Social Protection, Bucharest, Romania
| | - Nina Tomaževič
- Faculty of Public Administration, University of Ljubljana, Ljubljana, Slovenia.
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Pavlova I, Rogowska AM, Zhang SX. Mental Health and well-being During the COVID-19 Pandemic and After the Russian Invasion of Ukraine. J Community Health 2024; 49:173-182. [PMID: 37620707 PMCID: PMC10881779 DOI: 10.1007/s10900-023-01273-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2023] [Indexed: 08/26/2023]
Abstract
The study compared the mental health of university students during the COVID-19 pandemic and the Russian invasion of Ukraine. A repeated online cross-sectional study was performed twice among university students in Ukraine: in November 2020 (Pre-war sample, n = 752) and September-October 2022 (During-war sample, n = 862). The survey measured life satisfaction (SWLS), perceived stress (PSS-10), anxiety (GAD-7), and depression (PHQ-9). Stress, anxiety, and life satisfaction levels were similar during the war and pandemic, while symptoms of depression decreased during the war, compared to the pandemic. Network analysis showed that anxiety has a crucial effect on depression and stress, and stress is most closely related to life satisfaction. The association of life satisfaction with anxiety and depression disappeared in wartime, in contrast to the pandemic. The priority of prevention and intervention programs in wartime Ukraine should focus on anxiety as the most influential factor in other mental health and well-being problems. The results showed high resistance and adaptation to war conditions among university students in Ukraine.
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Affiliation(s)
- Iuliia Pavlova
- Theory and Methods of Physical Culture Department, Lviv State University of Physical Culture, Lviv, Ukraine
| | | | - Stephen X Zhang
- Faculty of Arts, Law and Economics, Adelaide Business School, University of Adelaide, Business, Adelaide, Australia
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Pavlova I, Rogowska AM. Exposure to war, war nightmares, insomnia, and war-related posttraumatic stress disorder: A network analysis among university students during the war in Ukraine. J Affect Disord 2023; 342:148-156. [PMID: 37690539 DOI: 10.1016/j.jad.2023.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 08/18/2023] [Accepted: 09/05/2023] [Indexed: 09/12/2023]
Abstract
INTRODUCTION Little is known about the prevalence and associations between war-related variables among Ukrainians during the Russian invasion. The present study assesses the prevalence and associations between exposure to war (EW), nightmares of war (NW), insomnia, and war-related post-traumatic stress disorder (WPTSD) among university students from Ukraine. METHODS During the war, an online cross-sectional study was performed among university students (N = 1072) from western Ukraine. Newly developed questions evaluated EW and NW, while insomnia was measured using Athens Insomnia Scale (AIS), and for assessing war-related PTSD symptoms, we adopted an abbreviated six-item PTSD checklist (PCL-6). The associations between exposure to war, nightmares of war, and symptoms of insomnia and PTSD were examined using network analysis (NA). RESULTS Among university students, 98 % declared exposure to war, 86 % dreamed nightmares of war, 49 % experienced insomnia symptoms, and 27 % presented symptoms of PTSD. A network analysis found that war-related PTSD has a central and the greatest impact on the frequency of war nightmares and the severity of insomnia symptoms. LIMITATIONS Self-report measurements were applied to a gender-unbalanced sample of university students from the western regions of Ukraine, so it would be inappropriate to generalize to the population directly affected by the war. CONCLUSIONS War-related PTSD symptoms had the most significant impact on the other variables. Therefore, war-related PTSD should be a priority in treatment among university students in Ukraine. However, multidisciplinary integrative intervention programs that treat nightmares, insomnia, and PTSD, can be the most effective.
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Affiliation(s)
- Iuliia Pavlova
- Theory and Methods of Physical Culture Department, Lviv State University of Physical Culture, Lviv, Ukraine
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Rogowska AM, Pavlova I. A path model of associations between war-related exposure to trauma, nightmares, fear, insomnia, and posttraumatic stress among Ukrainian students during the Russian invasion. Psychiatry Res 2023; 328:115431. [PMID: 37688837 DOI: 10.1016/j.psychres.2023.115431] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 08/21/2023] [Accepted: 08/24/2023] [Indexed: 09/11/2023]
Abstract
The present study examined the associations between war-related exposure, nightmares, fear, insomnia, and PTSD symptoms among university students from Western Ukraine. An online cross-sectional study was performed among 1,072 university students (80% of whom were women) during the war. Eight questions were developed to assess exposure to war, and seven items were designed regarding nightmares of war. War-related PTSD symptoms were assessed using an abbreviated six-item PTSD checklist (PCL-6), insomnia was measured using the Athens Insomnia Scale (AIS), and to examine fear of war, the Fear of COVID-19 Scale (FoCV-19S) was adopted. Positive correlations were found between exposure to war, nightmares of war, fear of war, insomnia, and war-related PTSD. The path model using structural equation modelling (SEM) analysis showed that the chain mediation partially explains the relationship between war exposure and war-related PTSD symptoms via nightmares of war, fear of war, and insomnia among university students during the Russian invasion of Ukraine. Women scored significantly higher than men in fear of war and symptoms of insomnia and PTSD, but the path model was invariant across genders. Young adults require treatment focused primarily on nightmares, insomnia, and fear of war to prevent PTSD symptoms.
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Affiliation(s)
| | - Iuliia Pavlova
- Theory and Methods of Physical Culture Department, Lviv State University of Physical Culture, Lviv, Ukraine
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Wiederhold BK. A Legacy of Trauma: How Local Conflicts Can Have Global Implications for Mental Health. CYBERPSYCHOLOGY, BEHAVIOR AND SOCIAL NETWORKING 2023. [PMID: 37751187 DOI: 10.1089/cyber.2023.29296.editorial] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/27/2023]
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Mottola F, Gnisci A, Kalaitzaki A, Vintilă M, Sergi I. The impact of the Russian-Ukrainian war on the mental health of Italian people after 2 years of the pandemic: risk and protective factors as moderators. Front Psychol 2023; 14:1154502. [PMID: 37303912 PMCID: PMC10250742 DOI: 10.3389/fpsyg.2023.1154502] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 05/08/2023] [Indexed: 06/13/2023] Open
Abstract
Objective This contribution aimed at investigating the moderating role of risk (e.g., the negative influence of COVID-19 on mental health) and protective (e.g., post-traumatic growth) factors on the relationship between the concern for war and stress and anxiety/depression levels among Italian people. Methods A questionnaire that included sociodemographic characteristics, the Perceived Stress Scale (PSS-4), the Patient Health Questionnaire (PHQ-4), the Brief Resilience Scale (BRS), the Post-Traumatic Growth Inventory (PTGI), and questions formulated ad hoc about concern for war was administered online. A sample of 755 participants (65.4% females, mean age = 32.39, SD = 12.64, range = 18-75) was recruited by convenience and snowball sampling. The researchers spread the link to the questionnaire to their acquaintances asking them to fill it out and to recruit other people. Results Results showed that concern for war significantly augmented the levels of stress and anxiety/depression in Italian people. Being a healthcare professional or having a chronic illness negatively moderated the effect of concern for war on stress and anxiety/depression. Instead, the negative influence of COVID-19 on mental health positively moderated the effect of concern for war on stress. Moreover, the overall positive changes after trauma and four of its five scales (i.e., Relating to Others, New Possibilities, Personal Strength, and Spiritual Change), negatively moderated the effect of concern for war on anxiety/depression. Conclusions In conclusion, concern about the Russian-Ukrainian war affects the mental health of the Italian population even if they are not directly involved in the conflict.
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Affiliation(s)
- Francesca Mottola
- Department of Psychology, University of Campania “Luigi Vanvitelli”, Caserta, Italy
| | - Augusto Gnisci
- Department of Psychology, University of Campania “Luigi Vanvitelli”, Caserta, Italy
| | - Argyroula Kalaitzaki
- Department of Social Work, Hellenic Mediterranean University, Heraklion, Crete, Greece
| | - Mona Vintilă
- Department of Psychology, West University of Timișoara, Timisoara, Romania
| | - Ida Sergi
- Department of Psychology, University of Campania “Luigi Vanvitelli”, Caserta, Italy
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Tei S, Fujino J. Adverse effects of empathy and cognitive inflexibility on social trauma. Front Psychol 2023; 14:1090297. [PMID: 37303915 PMCID: PMC10250643 DOI: 10.3389/fpsyg.2023.1090297] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 05/10/2023] [Indexed: 06/13/2023] Open
Affiliation(s)
- Shisei Tei
- Department of Psychiatry, Kyoto University, Kyoto, Japan
- Institute of Applied Brain Sciences, Waseda University, Saitama, Japan
- School of Human and Social Sciences, Tokyo International University, Saitama, Japan
| | - Junya Fujino
- Department of Psychiatry, Kyoto University, Kyoto, Japan
- Medical Institute of Developmental Disabilities Research, Showa University, Tokyo, Japan
- Department of Psychiatry and Behavioral Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Gellisch M, Bablok M, Morosan-Puopolo G, Schäfer T, Brand-Saberi B. Dynamically Changing Mental Stress Parameters of First-Year Medical Students over the Three-Year Course of the COVID-19 Pandemic: A Repeated Cross-Sectional Study. Healthcare (Basel) 2023; 11:healthcare11111558. [PMID: 37297698 DOI: 10.3390/healthcare11111558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 05/22/2023] [Accepted: 05/23/2023] [Indexed: 06/12/2023] Open
Abstract
Numerous research results have already pointed towards the negative influence of increased mental stress on educational processes and motivational criteria. It has also been shown that the global public health crisis induced by COVID-19 was related to anxiety symptoms and elevated levels of distress. To holistically elucidate the dynamics of the pandemic-related mental stress of first-year medical students, the associated parameters of three different cohorts were measured at the beginning of the pandemic-related restrictions on university life in Germany (20/21), at the peak of the COVID-19-related restrictions (21/22) and during the easing of the restrictions in the winter term 22/23. In a repeated cross-sectional study design, the constructs of worries, tension, demands and joy were collected from first-year medical students (n = 578) using the Perceived Stress Questionnaire. The results demonstrate significantly increased values of the constructs worries (p < 0.001), tension (p < 0.001) and demands (p < 0.001) at the peak of the pandemic related restrictions compared to the previous and following year as well as significantly decreasing values of general joy of life during the observed period of 3 years (all p-values < 0.001). A confirmatory factor analysis was performed to verify the questionnaire's factor structure regarding the addressed target group during the pandemic (CFI: 0.908, RMSEA: 0.071, SRMR: 0.052). These data, collected over a period of three years, provide information regarding dynamically manifesting mental stress during the COVID-19 pandemic, and refer to new areas of responsibility for the faculties to adequately counteract future crisis situations.
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Affiliation(s)
- Morris Gellisch
- Department of Anatomy and Molecular Embryology, Institute of Anatomy, Medical Faculty, Ruhr University Bochum, 44801 Bochum, Germany
| | - Martin Bablok
- Department of Anatomy and Molecular Embryology, Institute of Anatomy, Medical Faculty, Ruhr University Bochum, 44801 Bochum, Germany
| | - Gabriela Morosan-Puopolo
- Department of Anatomy and Molecular Embryology, Institute of Anatomy, Medical Faculty, Ruhr University Bochum, 44801 Bochum, Germany
| | - Thorsten Schäfer
- Center for Medical Education, Ruhr-University Bochum, 44801 Bochum, Germany
| | - Beate Brand-Saberi
- Department of Anatomy and Molecular Embryology, Institute of Anatomy, Medical Faculty, Ruhr University Bochum, 44801 Bochum, Germany
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Crișan CA, Milhem Z, Stretea R, Hossu RM, Florean IS, Cherecheș RM. Coping Mechanisms during the War in Ukraine: A Cross-Sectional Assessment among Romanian Population. Healthcare (Basel) 2023; 11:healthcare11101412. [PMID: 37239702 DOI: 10.3390/healthcare11101412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 05/07/2023] [Accepted: 05/11/2023] [Indexed: 05/28/2023] Open
Abstract
On 24 February 2022, the Russian Federation invaded Ukraine, starting a military conflict that soon turned into a full-scale war. The Romanians have been actively involved in helping their neighbors, causing the accumulation of emotional and mental pressure upon the Romanian population exposed to such a close military conflict. This cross-sectional study assessed, through an online survey (1586 adult Romanian residents), the primary coping mechanisms, quality of life and anxiety levels in response to the psychological trauma associated with the Russo-Ukrainian war. Based on the results, focusing on and venting emotions along with behavioral disengagement were the coping strategies that had the strongest negative impact on anxiety and well-being. On the other hand, positive reinterpretation and growth were associated with less anxiety, a higher degree of overall health and better quality of life. To the best of our knowledge, this study is the first of its kind to be performed among the Romanian population so far. Thus, we equip mental health practitioners with the tools (real-life evidence data) that will allow them to establish a more meaningful doctor-patient relationship, maximizing therapy results.
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Affiliation(s)
- Cătălina Angela Crișan
- Department of Neurosciences, Psychiatry and Pediatric Psychiatry, Faculty of Medicine, Iuliu Hațieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania
| | - Zaki Milhem
- Department of Neurosciences, Psychiatry and Pediatric Psychiatry, Faculty of Medicine, Iuliu Hațieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania
| | - Roland Stretea
- Clinical Hospital of Infectious Diseases, 400347 Cluj-Napoca, Romania
| | | | - Ionuț Stelian Florean
- Department of Clinical Psychology and Psychotherapy, Babeş-Bolyai University, 400084 Cluj-Napoca, Romania
| | - Răzvan Mircea Cherecheș
- RoNeuro Institute, Center for Research and Diagnosis of Neurological Diseases, 400012 Cluj-Napoca, Romania
- Department of Public Health, College of Political, Administrative and Communication Sciences, Babeș-Bolyai University, 400591 Cluj-Napoca, Romania
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Ting A, McLachlan C. Dr. Smartphone, can you support my trauma? An informatics analysis study of App Store apps for trauma- and stressor-related disorders. PeerJ 2023; 11:e15366. [PMID: 37187512 PMCID: PMC10178213 DOI: 10.7717/peerj.15366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 04/16/2023] [Indexed: 05/17/2023] Open
Abstract
Background Psychological trauma is prevalent in developed countries, with prevalence rates and treatment needs exceeding health system capacity. As telemedicine and out-of-patient care are promoted, there has been an expansion of digital apps to compliment therapeutic stages in psychological trauma. To date there are no reviews that have compared these apps and their clinical utility. This study aims to identify the availability of trauma- and stressor-related mhealth apps, assess their functionality, and review their therapeutic abilities. Methodology The authors conducted a systematic search using an iPhone 13 Pro in the Australian IOS App Store to extract trauma- and stressor-related apps that resulted from the search criteria. A cross-adaptation of the Mobile App Rating Scale (MARS) and the Comprehensive App Evaluation Model (CAEM) were used as a framework to produce the mTrauma App Evaluation Conceptual Model and Informatics Framework. App content descriptors were analysed based on their general characteristics, usability, therapeutic focus, clinical utility, data integration. Following an applicability in concordance with psychological trauma-informed delivery. Results A total of 234 apps resulting from the search strategy were screened, with 81 apps that met the inclusion criteria. The majority of apps were marketed to 4+ to 17+ years of age, categorised as 'health and fitness', with the highest target markets observed for adolescents, children, parents, clinicians, and clients. A total of 43 apps (53.1%) contained a trauma-informed specified section, and 37 (45.7%) incorporated a section useful to support trauma-related symptoms. A significant number of apps there was an absence of therapeutic utility (in 32 apps (39.5%)). Most apps were supporting post-traumatic stress disorder-informed, cognitive behavioural therapy and eye movement desensitisation and reprocessing. Provision of psychoeducation, courses, guided sessions, trainings, self-reflection/journaling, symptom management and progress tracking were highly present. Conclusions Trauma-informed mobile apps are available in the App Store, expanding in its target market reach and usability, with an increase of creative psychotherapies being introduced alongside conventional modalities. However, based on the app descriptors, the scarcity of evidenced-based testimonials and therapeutic applicability remains questionable for clinical validity. Although mhealth tools are marketed as trauma-related, current available apps employ a multifunctional approach to general psychological symptomatology, through to associated comorbid conditions and emphasizes on passive activity. For higher uptake on user engagement, clinical application and validity, trauma-apps require curated specification to fulfil its role as complimentary psychological treatment.
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Affiliation(s)
- Amanda Ting
- Centre for Healthy Futures, Torrens University Australia, Surry Hills, New South Wales, Australia
| | - Craig McLachlan
- Centre for Healthy Futures, Torrens University Australia, Surry Hills, New South Wales, Australia
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Mofaz M, Yechezkel M, Einat H, Kronfeld-Schor N, Yamin D, Shmueli E. Real-time sensing of war's effects on wellbeing with smartphones and smartwatches. COMMUNICATIONS MEDICINE 2023; 3:55. [PMID: 37069232 PMCID: PMC10109229 DOI: 10.1038/s43856-023-00284-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 03/31/2023] [Indexed: 04/19/2023] Open
Abstract
BACKGROUND Modern wars have a catastrophic effect on the wellbeing of civilians. However, the nature of this effect remains unclear, with most insights gleaned from subjective, retrospective studies. METHODS We prospectively monitored 954 Israelis (>40 years) from two weeks before the May 2021 Israel-Gaza war until four weeks after the ceasefire using smartwatches and a dedicated mobile application with daily questionnaires on wellbeing. This war severely affected civilians on both sides, where over 4300 rockets and missiles were launched towards Israeli cities, and 1500 aerial, land, and sea strikes were launched towards 16,500 targets in the Gaza Strip. RESULTS We identify considerable changes in all the examined wellbeing indicators during missile attacks and throughout the war, including spikes in heart rate levels, excessive screen-on time, and a reduction in sleep duration and quality. These changes, however, fade shortly after the war, with all affected measures returning to baseline in nearly all the participants. Greater changes are observed in individuals living closer to the battlefield, women, and younger individuals. CONCLUSIONS The demonstrated ability to monitor objective and subjective wellbeing indicators during crises in real-time is pivotal for the early detection of and prompt assistance to populations in need.
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Affiliation(s)
- Merav Mofaz
- Department of Industrial Engineering, Tel-Aviv University, Tel-Aviv, Israel
| | - Matan Yechezkel
- Department of Industrial Engineering, Tel-Aviv University, Tel-Aviv, Israel
| | - Haim Einat
- School of Behavioral Sciences, The Academic College of Tel Aviv-Yafo, Tel-Aviv, Israel
| | - Noga Kronfeld-Schor
- School of Zoology and Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel
| | - Dan Yamin
- Department of Industrial Engineering, Tel-Aviv University, Tel-Aviv, Israel
- Center for Combating Pandemics, Tel-Aviv University, Tel-Aviv, Israel
| | - Erez Shmueli
- Department of Industrial Engineering, Tel-Aviv University, Tel-Aviv, Israel.
- MIT Media Lab, Cambridge, MA, USA.
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15
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Mauz E, Walther L, Junker S, Kersjes C, Damerow S, Eicher S, Hölling H, Müters S, Peitz D, Schnitzer S, Thom J. Time trends in mental health indicators in Germany's adult population before and during the COVID-19 pandemic. Front Public Health 2023; 11:1065938. [PMID: 36908429 PMCID: PMC9995751 DOI: 10.3389/fpubh.2023.1065938] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 01/26/2023] [Indexed: 02/25/2023] Open
Abstract
Background Times of crisis such as the COVID-19 pandemic are expected to compromise mental health. Despite a large number of studies, evidence on the development of mental health in general populations during the pandemic is inconclusive. One reason may be that representative data spanning the whole pandemic and allowing for comparisons to pre-pandemic data are scarce. Methods We analyzed representative data from telephone surveys of Germany's adults. Three mental health indicators were observed in ~1,000 and later up to 3,000 randomly sampled participants monthly until June 2022: symptoms of depression (observed since April 2019, PHQ-2), symptoms of anxiety (GAD-2), and self-rated mental health (latter two observed since March 2021). We produced time series graphs including estimated three-month moving means and proportions of positive screens (PHQ/GAD-2 score ≥ 3) and reports of very good/excellent mental health, as well as smoothing curves. We also compared time periods between years. Analyses were stratified by sex, age, and level of education. Results While mean depressive symptom scores declined from the first wave of the pandemic to summer 2020, they increased from October 2020 and remained consistently elevated throughout 2021 with another increase between 2021 and 2022. Correspondingly, the proportion of positive screens first decreased from 11.1% in spring/summer 2019 to 9.3% in the same period in 2020 and then rose to 13.1% in 2021 and to 16.9% in 2022. While depressive symptoms increased in all subgroups at different times, developments among women (earlier increase), the youngest (notable increase in 2021) and eldest adults, as well as the high level of education group (both latter groups: early, continuous increases) stand out. However, the social gradient in symptom levels between education groups remained unchanged. Symptoms of anxiety also increased while self-rated mental health decreased between 2021 and 2022. Conclusion Elevated symptom levels and reduced self-rated mental health at the end of our observation period in June 2022 call for further continuous mental health surveillance. Mental healthcare needs of the population should be monitored closely. Findings should serve to inform policymakers and clinicians of ongoing dynamics to guide health promotion, prevention, and care.
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Affiliation(s)
- Elvira Mauz
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Lena Walther
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Stephan Junker
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Christina Kersjes
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Stefan Damerow
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Sophie Eicher
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Heike Hölling
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Stephan Müters
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Diana Peitz
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Susanne Schnitzer
- Institute of Medical Sociology and Rehabilitation Science, Charité-Universitätsmedizin, Berlin, Germany
| | - Julia Thom
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
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16
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Maftei A, Dănilă O, Măirean C. The war next-door-A pilot study on Romanian adolescents' psychological reactions to potentially traumatic experiences generated by the Russian invasion of Ukraine. Front Psychol 2022; 13:1051152. [PMID: 36544444 PMCID: PMC9762354 DOI: 10.3389/fpsyg.2022.1051152] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 11/08/2022] [Indexed: 12/12/2022] Open
Abstract
Introduction Romania shares the longest UE border with Ukraine, and since the Russian invasion of Ukraine began, many have been involved in helping the refugees. Consequently, children and adolescents might be directly and indirectly exposed to war-related trauma. In the present exploratory research, we investigated Romanian adolescents' potential risk and protective factors related to the psychological outcomes of war exposure. Our cross-sectional study was conducted shortly after February 24th (i.e., the first invasion day). Methods The sample included 90 Romanian adolescents aged 11 to 15 (M = 12.90, SD = 1.17), residents in Iași, Romania (i.e., 205,7 km from the Ukrainian border). Participants completed self-reported measures of peritraumatic dissociative experiences, knowledge about the conflict in Ukraine, personal, school, and family implications in volunteering/helping behavior, discussions about the conflict, threat perception (self and perceived parental threat), anxiety, social media engagement, resilience, and moral elevation. Results The main findings suggested that participants involved in helping behaviors toward Ukrainian refugees present higher peritraumatic dissociative experiences, anxiety symptoms, and higher moral elevation than boys and participants not involved in these behaviors. Moreover, anxiety symptoms were positively associated with threat perception, peritraumatic dissociation, and social media engagement and negatively related to resilience. Discussions Finally, we discuss the implications of our findings concerning their practical utility in managing peritraumatic exposure to war by using interventions designed to increase adolescents' resilience during difficult times.
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17
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Tei S, Fujino J. The educational value of sense of coherence for grief care. Front Psychol 2022; 13:1037637. [PMID: 36420379 PMCID: PMC9676356 DOI: 10.3389/fpsyg.2022.1037637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 10/24/2022] [Indexed: 11/09/2022] Open
Affiliation(s)
- Shisei Tei
- Department of Psychiatry, Kyoto University, Kyoto, Japan
- Institute of Applied Brain Sciences, Waseda University, Saitama, Japan
- School of Human and Social Sciences, Tokyo International University, Saitama, Japan
| | - Junya Fujino
- Department of Psychiatry, Kyoto University, Kyoto, Japan
- Medical Institute of Developmental Disabilities Research, Showa University, Tokyo, Japan
- Department of Psychiatry and Behavioral Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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18
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Hamama-Raz Y, Goodwin R, Leshem E, Ben-Ezra M. Can patriotism be a protective factor for symptoms of post-traumatic stress disorder? The case of the Russia - Ukraine 2022 war. J Psychiatr Res 2022; 155:100-103. [PMID: 36027645 DOI: 10.1016/j.jpsychires.2022.08.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 08/01/2022] [Accepted: 08/16/2022] [Indexed: 11/17/2022]
Abstract
The 2022 Russian invasion of the Ukraine created a large-scale humanitarian crisis that has intensified as the conflict persists. The impact of armed conflict, such as forced migration, exposure to violence, supply shortages, destruction of infrastructure, and interruption of essential services, can have serious negative consequences for the mental health and wellbeing of Ukrainians living through the invasion and its aftermath. At the same time threat to a nation can trigger a wave of patriotism. Such feelings of patriotic belonging, love, pride and caring for a country can help maintain national group cohesion and respect for civic authorities. We studied demographic and war related factors associated with patriotic attitudes and posttraumatic stress disorder (PTSD) symptoms in a national Ukraine sample of 2000 respondents six weeks into this crisis. Respondents completed an online inventory assessing patriotic attitudes, PTSD symptoms, having relatives wounded or killed, having relatives who left Ukraine due to the war, alongside key demographics. Hierarchical regressions found that having relatives that were wounded or that left Ukraine because of the war and those coming from a Ukrainian speaking region were associated with patriotic attitudes. Patriotic attitudes were positively associated with elevated risk for PTSD symptoms. Mental health professionals should consider the potential mental health burden of existential national conflicts amongst civilian populations with strongly patriotic attitudes.
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Affiliation(s)
| | | | - Elazar Leshem
- Ariel University, School of Social Work, Ariel, Israel
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Barchielli B, Cricenti C, Gallè F, Sabella EA, Liguori F, Da Molin G, Liguori G, Orsi GB, Giannini AM, Ferracuti S, Napoli C. Climate Changes, Natural Resources Depletion, COVID-19 Pandemic, and Russian-Ukrainian War: What Is the Impact on Habits Change and Mental Health? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11929. [PMID: 36231229 PMCID: PMC9565033 DOI: 10.3390/ijerph191911929] [Citation(s) in RCA: 65] [Impact Index Per Article: 32.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 09/17/2022] [Accepted: 09/18/2022] [Indexed: 05/17/2023]
Abstract
Climate Change, Natural Resources Depletion, COVID-19, and Wars are some of the great challenges of our time. The consequences will affect psychological well-being and could have a harmful impact on mental health. This study aimed to assess the level of preoccupation and fears surrounding issues of the 21st-century and the implication for psychological well-being of the general population from Central/Southern Italy among different age groups. A questionnaire that included sociodemographic characteristics, topics formulated ad-hoc about preoccupation, fears, habits, and willingness to change habits in the future related to the 21st-century challenges, and the Depression Anxiety Stress Scales 21 (DASS-21) was administered online. A sample of 1831 participants (61% F; mean age 47.71 ± 17.30) was obtained. Results showed that young adults and older adults, respectively, reported greater and less psychological well-being. Young adults reported higher scores for preoccupation, changing habits, and willingness to change habits in the future, while older adults reported the lowest scores except for changing habits, also controlling for gender. Results for this variable, as well as correlations between the many variables described, rely on the specificity of age, and 21st-century challenges. Moreover, the main fears related to the 21st-century concerns were different based on both age and gender. In conclusion, the various stresses of the 21st-century discussed in this study have a relationship with personal well-being, and it is important to consider potential global mental health issues resulting from these stressors.
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Affiliation(s)
- Benedetta Barchielli
- Department of Dynamic, Clinical Psychology and Health, “Sapienza” University of Rome, Via degli Apuli 1, 00185 Rome, Italy
| | - Clarissa Cricenti
- Department of Psychology, “Sapienza” University of Rome, Via dei Marsi 78, 00185 Rome, Italy
| | - Francesca Gallè
- Department of Movement Sciences and Wellbeing, University of Naples “Parthenope”, Via Medina 40, 80133 Naples, Italy
| | - Elita Anna Sabella
- Inter-University Research Centre “Population, Environment and Health”, University of Bari Aldo Moro, Piazza Cesare Battisti 1, 70122 Bari, Italy
| | - Fabrizio Liguori
- Family Psychotherapy Academy, Via Raffaele Morghen 181, 80129 Naples, Italy
| | - Giovanna Da Molin
- Inter-University Research Centre “Population, Environment and Health”, University of Bari Aldo Moro, Piazza Cesare Battisti 1, 70122 Bari, Italy
| | - Giorgio Liguori
- Department of Movement Sciences and Wellbeing, University of Naples “Parthenope”, Via Medina 40, 80133 Naples, Italy
| | - Giovanni Battista Orsi
- Department of Public Health and Infectious Diseases, “Sapienza” University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy
| | - Anna Maria Giannini
- Department of Psychology, “Sapienza” University of Rome, Via dei Marsi 78, 00185 Rome, Italy
| | - Stefano Ferracuti
- Department of Human Neuroscience, “Sapienza” University of Rome, Piazzale Aldo Moro, 5, 00185 Rome, Italy
| | - Christian Napoli
- Department of Medical Surgical Sciences and Translational Medicine, “Sapienza” University of Rome, Via di Grottarossa 1035/1039, 00189 Rome, Italy
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Al Jowf GI, Ahmed ZT, An N, Reijnders RA, Ambrosino E, Rutten BPF, de Nijs L, Eijssen LMT. A Public Health Perspective of Post-Traumatic Stress Disorder. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:6474. [PMID: 35682057 PMCID: PMC9180718 DOI: 10.3390/ijerph19116474] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 05/20/2022] [Accepted: 05/23/2022] [Indexed: 11/25/2022]
Abstract
Trauma exposure is one of the most important and prevalent risk factors for mental and physical ill-health. Prolonged or excessive stress exposure increases the risk of a wide variety of mental and physical symptoms, resulting in a condition known as post-traumatic stress disorder (PTSD). The diagnosis might be challenging due to the complex pathophysiology and co-existence with other mental disorders. The prime factor for PTSD development is exposure to a stressor, which variably, along with peritraumatic conditions, affects disease progression and severity. Additionally, many factors are thought to influence the response to the stressor, and hence reshape the natural history and course of the disease. With sufficient knowledge about the disease, preventive and intervenient methods can be implemented to improve the quality of life of the patients and to limit both the medical and economic burden of the disease. This literature review provides a highlight of up-to-date literature on traumatic stress, with a focus on causes or triggers of stress, factors that influence response to stress, disease burden, and the application of the social-ecological public health model of disease prevention. In addition, it addresses therapeutic aspects, ethnic differences in traumatic stress, and future perspectives, including potential biomarkers.
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Affiliation(s)
- Ghazi I. Al Jowf
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Centre, 6200 MD Maastricht, The Netherlands; (N.A.); (R.A.R.); (B.P.F.R.); (L.d.N.)
- Department of Public Health, College of Applied Medical Sciences, King Faisal University, Al-Ahsa 31982, Saudi Arabia
- European Graduate School of Neuroscience, Maastricht University, 6200 MD Maastricht, The Netherlands
| | - Ziyad T. Ahmed
- College of Medicine, Sulaiman Al Rajhi University, Al-Bukairyah 52726, Saudi Arabia;
| | - Ning An
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Centre, 6200 MD Maastricht, The Netherlands; (N.A.); (R.A.R.); (B.P.F.R.); (L.d.N.)
- European Graduate School of Neuroscience, Maastricht University, 6200 MD Maastricht, The Netherlands
| | - Rick A. Reijnders
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Centre, 6200 MD Maastricht, The Netherlands; (N.A.); (R.A.R.); (B.P.F.R.); (L.d.N.)
- European Graduate School of Neuroscience, Maastricht University, 6200 MD Maastricht, The Netherlands
| | - Elena Ambrosino
- Institute for Public Health Genomics, Department of Genetics and Cell Biology, Research School GROW (School for Oncology and Reproduction), Faculty of Health, Medicine and Life Sciences, Maastricht University, 6200 MD Maastricht, The Netherlands;
| | - Bart P. F. Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Centre, 6200 MD Maastricht, The Netherlands; (N.A.); (R.A.R.); (B.P.F.R.); (L.d.N.)
- European Graduate School of Neuroscience, Maastricht University, 6200 MD Maastricht, The Netherlands
| | - Laurence de Nijs
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Centre, 6200 MD Maastricht, The Netherlands; (N.A.); (R.A.R.); (B.P.F.R.); (L.d.N.)
- European Graduate School of Neuroscience, Maastricht University, 6200 MD Maastricht, The Netherlands
| | - Lars M. T. Eijssen
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Centre, 6200 MD Maastricht, The Netherlands; (N.A.); (R.A.R.); (B.P.F.R.); (L.d.N.)
- European Graduate School of Neuroscience, Maastricht University, 6200 MD Maastricht, The Netherlands
- Department of Bioinformatics—BiGCaT, School of Nutrition and Translational Research in Metabolism (NUTRIM), Faculty of Health, Medicine and Life Sciences, Maastricht University, 6200 MD Maastricht, The Netherlands
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