A pilot study on perceived stress and PTSD symptomatology in relation to four dimensions of older women's physical health

Self-Perceptions of Aging Moderate Associations of Within- and Between-Persons Perceived Stress and Physical Health Symptoms

OBJECTIVES

To examine how self-perceptions of aging (SPA) moderated within- and between-persons perceived stress associations with physical health symptoms.

METHODS

A community-dwelling sample of 103 adults (Meanage = 63, range = 52-88) participated in an online microlongitudinal study for 100 days (Noccasions = 7,064). Participants completed baseline surveys consisting of SPA, social connections, and demographics followed by 100 daily surveys including information about daily stress perceptions and physical health. Utilizing generalized multilevel models, we examined whether daily fluctuations and average levels of perceived stress over 100 days affected physical health symptoms and whether these associations varied by SPA.

RESULTS

Adults who had higher perceived stress, on average across 100 days, reported significantly more physical health symptoms compared to individuals with lower perceived stress on average (p < .05). On days when individuals reported higher perceived stress than their own average, they had a higher likelihood of reporting more physical health symptoms compared to days when their perceived stress was lower than their own average (p < .05). Further, SPA significantly moderated associations between both within- and between-persons perceived stress and physical health symptoms (ps < .05). Individuals with more positive SPA were less affected by high levels of perceived stress-both on average and on days when perceived stress was higher than their own average.

DISCUSSION

More positive SPA significantly dampened the impact of perceived stress, suggesting the importance of SPA as an individual characteristic within stress processes. Future work should examine how daily changes in SPA may exacerbate or mitigate the impacts of daily stress processes and health outcomes.

Daily associations among aging perceptions, perceived health, and perceived stress in older adults

OBJECTIVES

Daily perceived stress is a key indicator of well-being across adulthood, but particularly for those experiencing age-linked challenges. Understanding how day-level factors most salient to the aging process are associated with daily stress levels can further elucidate the mechanisms involved. Here, we investigate two such age-salient factors-daily perceived health and day-level aging perceptions-on daily perceived stress in later life, with a particular interest in the potential role of aging perceptions as an emotion-focused coping resource.

METHOD

127 older adults (mean age 79) completed daily surveys reporting aging perceptions, perceived health, and perceived stress for 14 days, along with a global questionnaire. Multilevel models assessed the between-person and within-person influences of both daily aging perceptions and daily perceived health on day-level perceived stress.

RESULTS

Key findings: (a) days of worse perceived health are also days of higher perceived stress; (b) days of more negative aging perceptions are days of higher perceived stress; (c) these individual effects maintain significance when the other is controlled, and (d) these effects interact, so that perceived health is more strongly associated with perceived stress on days when aging perceptions are below a person's mean.

CONCLUSION

The moderating effect identifies aging perceptions as a potentially important resource for emotion-focused coping in later life, particularly for older adults experiencing stress associated with poorer perceived health.

Online yoga to reduce post traumatic stress in women who have experienced stillbirth: a randomized control feasibility trial

BACKGROUND

About 1 in every 150 pregnancies end in stillbirth. Consequences include symptoms of post traumatic stress disorder (PTSD), depression, and anxiety. Yoga has been used to treat PTSD in other populations and may improve health outcomes for stillbirth mothers. The purpose of this study was to determine: (a) feasibility of a 12-week home-based, online yoga intervention with varying doses; (b) acceptability of a "stretch and tone" control group; and (c) preliminary efficacy of the intervention on reducing symptoms of PTSD, anxiety, depression, perinatal grief, self-compassion, emotional regulation, mindfulness, sleep quality, and subjective health.

METHODS

Participants (N = 90) were recruited nationally and randomized into one of three groups for yoga or exercise (low dose (LD), 60 min per week; moderate dose (MD), 150 min per week; and stretch-and-tone control group (STC)). Baseline and post-intervention surveys measured main outcomes (listed above). Frequency analyses were used to determine feasibility. Repeated measures ANCOVA were used to determine preliminary efficacy. Multiple regression analyses were used to determine a dose-response relationship between minutes of yoga and each outcome variable.

RESULTS

Over half of participants completed the intervention (n = 48/90). Benchmarks (≥70% reported > 75% satisfaction) were met in each group for satisfaction and enjoyment. Participants meeting benchmarks (completing > 90% of prescribed minutes 9/12 weeks) for LD and MD groups were 44% (n = 8/18) and 6% (n = 1/16), respectively. LD and MD groups averaged 44.0 and 77.3 min per week of yoga, respectively. The MD group reported that 150 prescribed minutes per week of yoga was too much. There were significant decreases in PTSD and depression, and improvements in self-rated health at post-intervention for both intervention groups. There was a significant difference in depression scores (p = .036) and grief intensity (p = .009) between the MD and STC groups. PTSD showed non-significant decreases of 43% and 56% at post-intervention in LD and MD groups, respectively (22% decrease in control).

CONCLUSIONS

This was the first study to determine the feasibility and preliminary efficacy of an online yoga intervention for women after stillbirth. Future research warrants a randomized controlled trial.

TRIAL REGISTRATION

ClinicalTrials.gov. NCT02925481. Registered 10-04-16.

Neurodevelopmental changes in the relationship between stress perception and prefrontal-amygdala functional circuitry

Our brain during distinct developmental phases may show differential responses to perceived psychological stress, yet existing research specifically examining neurodevelopmental changes in stress processing is scarce. To fill in this research gap, this functional magnetic resonance imaging (fMRI) study examined the relationship between perceived stress and resting-state neural connectivity patterns among 67 healthy volunteers belonging to three age groups (adolescents, young adults and adults), who were supposed to be at separate neurodevelopmental phases and exhibit different affect regulatory processes in the brain. While the groups showed no significant difference in self-reported general perceived stress levels, the functional connectivity between amygdala and ventromedial prefrontal cortex (vmPFC) was positively and negatively correlated with perceived stress in adolescents and young adults respectively, while no significant correlations were observed in adults. Furthermore, among adolescents, the causal functional interaction between amygdala and vmPFC exhibited bottom-up connectivity, and that between amygdala and subgenual anterior cingulate cortex exhibited top-down connectivity, both of which changed to bilateral directions, i.e. both bottom-up and top-down connections, in both young adults and adults, supporting the notion that the amygdala and prefrontal cortical circuitries undergo functional reorganizations during brain development. These novel findings have important clinical implications in treating stress-related affective disorders in young individuals.

•

Age moderates the relationship between prefrontal-amygdala circuitry and perceived stress.

•

The VMPFC-amygdala connectivity were distinct in different age groups.

•

The VMPFC-amygdala connectivity was positively related to stress in adolescents.

•

The VMPFC-amygdala connectivity was negatively related to stress in young adults.

•

The Ventral PFC-amygdala connectivity was bi-directional in adults.

Long-term health outcomes of childhood sexual abuse and peer sexual contact among an urban sample of behaviourally bisexual Latino men

While previous research indicates high rates of childhood sexual abuse among Latino men who have sex with men, few studies have examined the long-term health outcomes of childhood sexual abuse specifically among behaviourally bisexual Latino men. In a sample of 148 behaviourally bisexual Latino men in New York City, we examined associations between childhood sexual abuse and multiple dimensions of adult health: sexual risk behaviours; sexually transmitted infections incidence; polydrug use; depressive symptoms; and perceived stress. We compared outcomes between those with histories of childhood sexual abuse, those reporting peer sexual contact prior to age 13 and those with no sexual contact prior to age 13. Over one-fifth (22.3%) reported a history of childhood sexual abuse, which was significantly associated with engaging in receptive condomless anal intercourse (aOR = 3.59, p < .01, SE = 2.0), high perceived stress (aOR = 2.48, p < .06, SE = 1.13) and clinically significant depressive symptoms (aOR = 2.7, p < .05, SE = 1.25). Across all variables, peer sexual contact did not impact these outcomes, underscoring a key distinction between abusive and non-abusive early sexual experiences. We recommend that sexual abuse prevention policies and programmes better engage Latino youth, and that practitioners serving this population across diverse areas of practice incorporate childhood sexual abuse screening and culturally appropriate treatment and care into practice.

A Pilot Psychometric Study on the Validation of the Older Women's Non-Medical Stress Scale (OWN-MSS) on an Ethnically Diverse Sample

INTRODUCTION

Older women often experience various types of stressors, including the death of a spouse and associated financial stress (often with a lack of social support), emotional stress due to factors such as caregiving and being single, and the challenges of the aging process. These circumstances could produce or aggravate anxious symptomatology that can in turn compound the negative effects of aging. A brief scale of perceived stress that is not confounded with health status and covers multiple culturally relevant potential stressors is needed for quick use in busy medical settings.

AIM

To assess the reliability and the validity of an original stress scale designed to measure perceptions of stress beyond health status in a non-clinical convenience sample of community-dwelling older women.

METHOD

In this cross-sectional pilot investigation, via conducting item-total correlations and correlational tests of validity, we studied the psychometric properties of our measure using data from volunteer older subjects (mainly low-income and from non-Caucasian backgrounds). The domains covered by the nine items of the tool were selected based on a literature review of common stressors experienced by older adults, especially by older women. Data were collected face-to-face using a demographic list, a well-established depression measure, a brief posttraumatic stress disorder (PTSD) screener, and our 9-item stress tool. Primary outcomes: reliability and validity of the scale of older women's non-medical stress. Secondary outcomes: demographic characteristics of the sample and correlations between stress items.

RESULTS

Based on our sample of older women (N=40, mean age 71 years), good internal consistency between the items of the stress scale was found (Cronbach's a=.66). The findings of the data analyses also revealed that our psychometric tool has good convergent validity with the PTSD screener (r=.53). Moreover, in contrast with most other stress tools, it has strong discriminant validity (r=.11) with a well-validated depression scale.

CONCLUSION

Our results suggest that this new measure is psychometrically strong. Future research directions encompass using larger samples, ideally including older men with the modification of the scale's name, as well as validating this tool against more measures. Clinical implications of our findings are briefly discussed.

What contributes to perceived stress in later life? A recursive partitioning approach

One possible explanation for the individual differences in outcomes of stress is the diversity of inputs that produce perceptions of being stressed. The current study examines how combinations of contextual features (e.g., social isolation, neighborhood quality, health problems, age discrimination, financial concerns, and recent life events) of later life contribute to overall feelings of stress. Recursive partitioning techniques (regression trees and random forests) were used to examine unique interrelations between predictors of perceived stress in a sample of 282 community-dwelling adults. Trees provided possible examples of equifinality (i.e., subsets of people with similar levels of perceived stress but different predictors) as well as identification both of contextual combinations that separated participants with very high and very low perceived stress. Random forest analyses aggregated across many trees based on permuted versions of the data and predictors; loneliness, financial strain, neighborhood strain, ageism, and to some extent life events emerged as important predictors. Interviews with a subsample of participants provided both thick description of the complex relationships identified in the trees, as well as additional risks not appearing in the survey results. Together, the analyses highlight what may be missed when stress is used as a simple unidimensional construct and can guide differential intervention efforts.