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Schwandt ML, Cullins E, Ramchandani VA. The role of resilience in the relationship between stress and alcohol. Neurobiol Stress 2024; 31:100644. [PMID: 38827175 PMCID: PMC11140813 DOI: 10.1016/j.ynstr.2024.100644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 04/12/2024] [Accepted: 05/15/2024] [Indexed: 06/04/2024] Open
Abstract
Stress plays a well-documented role in alcohol consumption and the risk for developing alcohol use disorder. The concept of resilience - coping with and successfully adapting to stressful life experiences - has received increasing attention in the field of addiction research in recent decades, and there has been an accumulation of evidence for resilience as a protective factor against problematic alcohol consumption, risk for alcohol use disorder, disorder severity, and relapse. The conceptual and methodological approaches used in the generation of this evidence vary considerably across investigations, however. In light of this, we carried out this review in order to provide a more thorough understanding of the meaning and scope of resilience, what factors contribute to resilience, how it is measured, and how it relates to alcohol-associated phenotypes. Implications for treatment through the use of resilience-building interventions are likewise discussed, as well as implications for future research on the role of resilience in the etiology and clinical outcomes of alcohol use disorder.
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Affiliation(s)
- Melanie L. Schwandt
- Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA
| | - Eva Cullins
- Human Psychopharmacology Laboratory, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA
| | - Vijay A. Ramchandani
- Human Psychopharmacology Laboratory, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA
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Sreenivasulu M., Prathyusha V, Ezhumalai S, Narayanan G, Murthy P. Adverse Childhood Experiences, Coping and Resilience in Persons with Alcohol Use Disorder and Their Non-drinking Siblings in High-density Families: A Case-control Study. Indian J Psychol Med 2024; 46:139-146. [PMID: 38725730 PMCID: PMC11076933 DOI: 10.1177/02537176231219769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/12/2024] Open
Abstract
Background Adverse childhood experiences (ACEs) increase the odds of alcohol use disorder (AUD). Aim To study the ACEs, coping, and resilience in persons with AUD and their non-drinking siblings from high-density families. Methods The study used a case-control study design. Using purposive sampling, 135 participants were selected; the sample consists of persons with AUD (n = 45), non-drinking siblings (n = 45), and healthy controls (n = 45), selected from out-patient and in-patient services from a government-run de-addiction centre in Bengaluru. Individuals were administered an ACEs questionnaire, Brief-COPE, and Connor-Davison Resilience scale. Descriptive statistics, Friedman's test, and Bonferroni's post-hoc test, Binary Logistic Regression were used for analysis. Results ACEs, coping, and resilience significantly differ across the three groups. Persons with AUD and their non-drinking siblings are comparable in terms of ACEs and having dysfunctional family members. Non-drinking siblings and healthy controls have similar coping and resilience. None of the healthy controls had dysfunctional family members. Conclusion ACEs are more prevalent and more frequent in persons with AUD. Individuals with AUD showed higher avoidant coping and lower resilience than their non-drinking siblings and healthy controls. Early identification of ACEs and interventions to build resilience and coping strategies could prevent individuals from developing AUD in high-density families.
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Affiliation(s)
- Sreenivasulu M.
- Dept. of Psychiatric Social Work, NIMHANS, Bangalore, Karnataka, India
| | - Vasuki Prathyusha
- Dept of Bio-Statistics, National Institute of Mental Health and Neuro Sciences, Bangalore, Karnataka, India
| | - Sinu Ezhumalai
- Dept. of Psychiatric Social Work, NIMHANS, Bangalore, Karnataka, India
| | | | - Pratima Murthy
- Dept of Psychiatry, NIMHANS, Bangalore, Karnataka, India
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Khadse VJ, Dhillon HS, Sasidharan S. Psychological hardiness, personality factors and coping styles in male patients of alcohol dependence syndrome. Med J Armed Forces India 2024; 80:172-177. [PMID: 38525456 PMCID: PMC10954500 DOI: 10.1016/j.mjafi.2022.07.007] [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: 08/23/2021] [Accepted: 07/22/2022] [Indexed: 03/26/2024] Open
Abstract
Background Alcohol dependence syndrome (ADS) is a result of complex interplay between biological, psychological, and sociocultural factors. While the biological (genetic) factors remain non-modifiable, better understanding of individual hardiness, personality variables, and coping mechanisms can help us in better understanding and comprehensive management of the illness. Methods A cross-sectional comparative study was conducted at a tertiary care hospital. A total of 112 patients with ADS (test group) and 124 healthy age matched male controls were recruited from the same social milieu. They were assessed for hardiness, personality factors, and coping mechanisms using Hardiness scale, 16 Personality factors (5th Edition), and Brief COPE scale, respectively. The data were analyzed with Chi square, Student t tests (two tailed, unpaired), Mann Whitney U test, and Kruskal Waal analysis. Results The test group had less hardy personality compared to control group (25% vs 43.54%) (p = 0.002). The level of Hardiness had an inverse relationship with alcohol dependence (p = 0.886). The majority of patients with ADS had high score on extraversion (p < 0.001), anxiety (p < 0.001), and tough-mindedness (p < 0.001), and the severity of alcohol dependence had an inverse relationship with extraversion (p = 0.004) and self-control (p = 0.002). The severity of ADS was directly related to the use of emotional support (p = 0.007) and substance use (p = 0.005) as coping mechanisms while the use of instrumental support (p = 0.001) and humor (p < 0.001) had inverse relationship with the severity of ADS. Conclusions ADS had less hardy personality and the level of hardiness had inverse relationship with alcohol dependence. The severity of alcohol dependence had an inverse relationship with extraversion and self-control. In terms of coping styles, substance use and use of emotional support was found to be directly related with the severity of alcohol dependence while the use of instrumental support and humor were found to be protective against severe dependence.
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Affiliation(s)
| | | | - Shibu Sasidharan
- Assistant Professor (Psychiatry), Level III Hospital, Goma, Congo
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Schmid F, Henry A, Benzerouk F, Barrière S, Gondrexon J, Kaladjian A, Gierski F. Patterns of executive functions and theory of mind in adults with a family history of alcohol use disorder: Combined group and single-case analyses. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2024; 48:362-374. [PMID: 38243915 DOI: 10.1111/acer.15238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 11/24/2023] [Accepted: 11/26/2023] [Indexed: 01/22/2024]
Abstract
BACKGROUND Impairments in executive function and social cognition are highly prevalent in individuals with an alcohol use disorder (AUD). Some studies show that similar difficulties are displayed by individuals with a positive family history of AUD (FH+) compared with individuals with a negative family history (FH-). Yet, no studies have jointly investigated cognitive and affective theory of mind at the behavioral level. Moreover, some studies show preserved executive and socioemotional functioning in FH+ participants. One possible explanation for these divergent results is that FH+ individuals are cognitively heterogeneous. In this study, we examined the frequency and co-occurrence of difficulties in executive function and social cognition among FH+ individuals at the individual level. METHODS Sixty FH+ and 60 FH- participants matched on age, sex, and education level were included. They completed tasks assessing executive functions (Stroop, Trail Making Test) and affective and cognitive theory of mind (Movie for the Assessment of Social Cognition). They also completed self-report questionnaires measuring impulsivity, alexithymia, and empathy. Single-case analyses assessed the proportion of FH+ participants with difficulties in executive function and/or theory of mind. RESULTS FH+ individuals exhibited difficulties in response inhibition and made more errors during theory of mind processing, indicating an absence of mental state representation, compared with FH- individuals. In the FH+ sample, 53.33% had executive function and/or theory of mind difficulties. Those with lower theory of mind scores reported higher alexithymia and lower empathy on self-report measures. CONCLUSIONS FH+ individuals display heterogeneous executive function and theory of mind abilities. Given that they mostly occur independently of one another, executive function and theory of mind difficulties may be distinct vulnerability markers in AUD.
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Affiliation(s)
- F Schmid
- Laboratoire Cognition, Santé, Société (C2S - EA 6291), University of Reims Champagne-Ardenne, Reims, France
| | - A Henry
- Laboratoire Cognition, Santé, Société (C2S - EA 6291), University of Reims Champagne-Ardenne, Reims, France
- Psychiatry Department, Marne Public Mental Health Institute & Reims University Hospital, Reims, France
| | - F Benzerouk
- Laboratoire Cognition, Santé, Société (C2S - EA 6291), University of Reims Champagne-Ardenne, Reims, France
- Psychiatry Department, Marne Public Mental Health Institute & Reims University Hospital, Reims, France
- INSERM U1247, Research Group on Alcohol and Dependences, University of Picardy Jules Verne, Amiens, France
| | - S Barrière
- Psychiatry Department, Marne Public Mental Health Institute & Reims University Hospital, Reims, France
| | - J Gondrexon
- Psychiatry Department, Marne Public Mental Health Institute & Reims University Hospital, Reims, France
| | - A Kaladjian
- Laboratoire Cognition, Santé, Société (C2S - EA 6291), University of Reims Champagne-Ardenne, Reims, France
- Psychiatry Department, Marne Public Mental Health Institute & Reims University Hospital, Reims, France
| | - F Gierski
- Laboratoire Cognition, Santé, Société (C2S - EA 6291), University of Reims Champagne-Ardenne, Reims, France
- Psychiatry Department, Marne Public Mental Health Institute & Reims University Hospital, Reims, France
- INSERM U1247, Research Group on Alcohol and Dependences, University of Picardy Jules Verne, Amiens, France
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Johnson EC, Salvatore JE, Lai D, Merikangas AK, Nurnberger JI, Tischfield JA, Xuei X, Kamarajan C, Wetherill L, Rice JP, Kramer JR, Kuperman S, Foroud T, Slesinger PA, Goate AM, Porjesz B, Dick DM, Edenberg HJ, Agrawal A. The collaborative study on the genetics of alcoholism: Genetics. GENES, BRAIN, AND BEHAVIOR 2023; 22:e12856. [PMID: 37387240 PMCID: PMC10550788 DOI: 10.1111/gbb.12856] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 06/02/2023] [Accepted: 06/17/2023] [Indexed: 07/01/2023]
Abstract
This review describes the genetic approaches and results from the family-based Collaborative Study on the Genetics of Alcoholism (COGA). COGA was designed during the linkage era to identify genes affecting the risk for alcohol use disorder (AUD) and related problems, and was among the first AUD-focused studies to subsequently adopt a genome-wide association (GWAS) approach. COGA's family-based structure, multimodal assessment with gold-standard clinical and neurophysiological data, and the availability of prospective longitudinal phenotyping continues to provide insights into the etiology of AUD and related disorders. These include investigations of genetic risk and trajectories of substance use and use disorders, phenome-wide association studies of loci of interest, and investigations of pleiotropy, social genomics, genetic nurture, and within-family comparisons. COGA is one of the few AUD genetics projects that includes a substantial number of participants of African ancestry. The sharing of data and biospecimens has been a cornerstone of the COGA project, and COGA is a key contributor to large-scale GWAS consortia. COGA's wealth of publicly available genetic and extensive phenotyping data continues to provide a unique and adaptable resource for our understanding of the genetic etiology of AUD and related traits.
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Affiliation(s)
- Emma C. Johnson
- Department of PsychiatryWashington University School of MedicineSt. LouisMissouriUSA
| | - Jessica E. Salvatore
- Department of Psychiatry, Robert Wood Johnson Medical SchoolRutgers UniversityPiscatawayNew JerseyUSA
| | - Dongbing Lai
- Department of Medical & Molecular GeneticsIndiana University School of MedicineIndianapolisIndianaUSA
| | - Alison K. Merikangas
- Department of Biomedical and Health InformaticsChildren's Hospital of PhiladelphiaPhiladelphiaPennsylvaniaUSA
- Department of Genetics, Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
- Lifespan Brain Institute, Children's Hospital of Philadelphia and Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - John I. Nurnberger
- Department of Medical & Molecular GeneticsIndiana University School of MedicineIndianapolisIndianaUSA
- Department of PsychiatryIndiana University School of MedicineIndianapolisIndianaUSA
| | | | - Xiaoling Xuei
- Department of Medical & Molecular GeneticsIndiana University School of MedicineIndianapolisIndianaUSA
| | - Chella Kamarajan
- Department of Psychiatry and Behavioral SciencesState University of New York Health Sciences UniversityBrooklynNew YorkUSA
| | - Leah Wetherill
- Department of Medical & Molecular GeneticsIndiana University School of MedicineIndianapolisIndianaUSA
| | | | - John P. Rice
- Department of PsychiatryWashington University School of MedicineSt. LouisMissouriUSA
| | - John R. Kramer
- Department of Psychiatry, Carver College of MedicineUniversity of IowaIowa CityIowaUSA
| | - Samuel Kuperman
- Department of Psychiatry, Carver College of MedicineUniversity of IowaIowa CityIowaUSA
| | - Tatiana Foroud
- Department of Medical & Molecular GeneticsIndiana University School of MedicineIndianapolisIndianaUSA
| | - Paul A. Slesinger
- Departments of Neuroscience and Pharmacological SciencesIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Alison M. Goate
- Departments of Genetics and Genomic Sciences, Neuroscience, and NeurologyIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Bernice Porjesz
- Department of Psychiatry and Behavioral SciencesState University of New York Health Sciences UniversityBrooklynNew YorkUSA
| | - Danielle M. Dick
- Department of Psychiatry, Robert Wood Johnson Medical SchoolRutgers UniversityPiscatawayNew JerseyUSA
| | - Howard J. Edenberg
- Department of Medical & Molecular GeneticsIndiana University School of MedicineIndianapolisIndianaUSA
- Department of Biochemistry and Molecular BiologyIndiana UniversityIndianapolisIndianaUSA
| | - Arpana Agrawal
- Department of PsychiatryWashington University School of MedicineSt. LouisMissouriUSA
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Ueno M. Relationships between drinking habits, psychological resilience, and salivary cortisol responses on the Trier Social Stress Test-Online among Japanese people. BMC Psychol 2023; 11:250. [PMID: 37641113 PMCID: PMC10464479 DOI: 10.1186/s40359-023-01297-x] [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: 10/12/2022] [Accepted: 08/22/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND This study aimed to determine whether individual differences in resilience interacted with those in alcohol consumption habits in situations involving exposure to psychosocial stressors (Trier Social Stress Test-Online; TSST-OL). Additionally, we investigated whether individuals exhibiting resilience in their psychological scale scores showed biological responses that could be interpreted as resilience in stressful situations, such as the TSST-OL. We hypothesized that there would be no association between drinking habits and stress responses in the high-resilience group. Furthermore, high drinking habits would be associated with high stress responses in the low-resilience group. METHODS We recruited 22 and 20 individuals from the high and low-resilience groups, respectively, from among those who completed the online survey comprising the Alcohol Use Disorders Identification Test (AUDIT) and resilience scales; we excluded individuals with AUDIT scores of 15 or higher, and divided them by the median total resilience scale score. During the TSST-OL, self-rated stress measurement and saliva sample collection were performed seven times. Frozen samples were collected at the Tokyo site, and salivary hormonal (cortisol and dehydroepiandrosterone) levels were measured after transport in frozen state. Finally, 36 participants were included in the analysis of self-rated stress and cortisol levels. RESULTS We observed the typical subjective stress responses to the TSST-OL. People with higher psychological scale scores for resilience traits showed significantly higher salivary cortisol levels than those with lower scores. Due to deficiencies in the survey and experimental design, the classification criteria were changed and an exploratory analysis was performed to investigate the interaction of individual differences in resilience and drinking habits. In contrast to our expectation, those with low resilience scores showed stress responses, regardless of their drinking habits. Furthermore, those with high resilience and drinking habits showed a specific insensitivity to salivary cortisol levels. Their self-rated stress scores were similar to those of other groups. CONCLUSIONS Our study showed the applicability of the TSST-OL in the Japanese population, the individual relationship between psychological resilience measures and biological stress responses, and a specific insensitivity in the salivary cortisol response as a result of individual differences in high resilience and drinking habits.
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Affiliation(s)
- Masaharu Ueno
- Tobacco Academic Studies Center, 1-16-3, Yokokawa, Sumida-ku, Tokyo, 130-0003, Japan.
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Sassoon SA, Fama R, Le Berre AP, Müller-Oehring EM, Zahr NM, Pfefferbaum A, Sullivan EV. Influence of childhood trauma, HIV infection, alcohol use disorder, and resilience on health-related quality of life in adulthood. J Psychiatr Res 2023; 163:230-239. [PMID: 37230007 PMCID: PMC11376962 DOI: 10.1016/j.jpsychires.2023.05.033] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 04/26/2023] [Accepted: 05/03/2023] [Indexed: 05/27/2023]
Abstract
Experience of childhood trauma, especially physical, emotional, and sexual abuse, carries a risk for developing alcohol use disorder (AUD) and engaging in risky behaviors that can result in HIV infection. AUD and HIV are associated with compromised self-reported health-related quality of life (HRQoL) possibly intersecting with childhood trauma. To determine whether poor HRQoL is heightened by AUD, HIV, their comorbidity (AUD + HIV), number of trauma events, or poor resilience, 108 AUD, 45 HIV, 52 AUD + HIV, and 67 controls completed the SF-21 HRQoL, Brief Resilience Scale (BRS), Ego Resiliency Scale (ER-89), and an interview about childhood trauma. Of the 272 participants, 116 reported a trauma history before age 18. Participants had a blood draw, AUDIT questionnaire, and interview about lifetime alcohol consumption. AUD, HIV, and AUD + HIV had lower scores on HRQoL and resilience composite comprising the BRS and ER-89 than controls. Greater resilience was a significant predictor of better quality of life in all groups. HRQoL was differentially moderated in AUD and HIV: more childhood traumas predicted poorer quality of life in AUD and controls, whereas higher T-lymphocyte count contributed to better quality of life in HIV. This study is novel in revealing a detrimental impact on HRQoL from AUD, HIV, and their comorbidity, with differential negative contribution from trauma and beneficial effect of resilience to quality of life. Channeling positive effects of resilience and reducing the incidence and negative impact of childhood trauma may have beneficial effects on health-related quality of life in adulthood independent of diagnosis.
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Affiliation(s)
| | - Rosemary Fama
- SRI International, Biosciences Division, Menlo Park, CA, 94025, USA; Stanford University School of Medicine, Department of Psychiatry and Behavioral Sciences, Stanford, CA, 94305, USA
| | - Anne-Pascale Le Berre
- Stanford University School of Medicine, Department of Psychiatry and Behavioral Sciences, Stanford, CA, 94305, USA
| | - Eva M Müller-Oehring
- SRI International, Biosciences Division, Menlo Park, CA, 94025, USA; Stanford University School of Medicine, Department of Psychiatry and Behavioral Sciences, Stanford, CA, 94305, USA
| | - Natalie M Zahr
- Stanford University School of Medicine, Department of Psychiatry and Behavioral Sciences, Stanford, CA, 94305, USA
| | - Adolf Pfefferbaum
- SRI International, Biosciences Division, Menlo Park, CA, 94025, USA; Stanford University School of Medicine, Department of Psychiatry and Behavioral Sciences, Stanford, CA, 94305, USA
| | - Edith V Sullivan
- Stanford University School of Medicine, Department of Psychiatry and Behavioral Sciences, Stanford, CA, 94305, USA
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Cusack SE, Aliev F, Bustamante D, Dick DM, Amstadter AB. A statistical genetic investigation of psychiatric resilience. Eur J Psychotraumatol 2023; 14:2178762. [PMID: 37052082 PMCID: PMC9987782 DOI: 10.1080/20008066.2023.2178762] [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: 09/20/2022] [Accepted: 01/28/2023] [Indexed: 03/06/2023] Open
Abstract
Background: Although trauma exposure (TE) is a transdiagnostic risk factor for many psychiatric disorders, not everyone who experiences TE develops a psychiatric disorder. Resilience may explain this heterogeneity; thus, it is critical to understand the etiologic underpinnings of resilience.Objective: The present study sought to examine the genetic underpinnings of psychiatric resilience using genome-wide association studies (GWAS), genome-wide complex trait analysis (GCTA), and polygenic risk score (PRS) analyses.Method: Participants were 6,634 trauma exposed college students attending a diverse, public university in the Mid Atlantic. GWAS and GCTA analyses were conducted, and using GWAS summary statistics from large genetic consortia, PRS analyses examined the shared genetic risk between resilience and various phenotypes.Results: Results demonstrate that nine single-nucleotide polymorphisms (SNPs) met the suggestive of significance threshold, heritability estimates for resilience were non-significant, and that there is genetic overlap between resilience and AD, as well as resilience and PTSD.Conclusion: Mixed findings from the present study suggest additional research to elucidate the etiological underpinnings of resilience, ideally with larger samples less biased by variables such as heterogeneity (i.e. clinical vs. population based) and population stratification. Genetic investigations of resilience have the potential to elucidate the molecular bases of stress-related psychopathology, suggesting new avenues for prevention and intervention efforts.
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Affiliation(s)
- Shannon E. Cusack
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Richmond, VA, USA
| | - Fazil Aliev
- Department of African American Studies, Virginia Commonwealth University, Richmond, VA, USA
| | - Daniel Bustamante
- Department of Human and Molecular Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | | | - Danielle M. Dick
- Brain Health Institute, Rutgers Biomedical and Health Sciences, Rutgers University, Piscataway, NJ, USA
| | - Ananda B. Amstadter
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Richmond, VA, USA
- Department of Human and Molecular Genetics, Virginia Commonwealth University, Richmond, VA, USA
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
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Ueda P, Pasternak B, Svanström H, Lim CE, Neovius M, Forssblad M, Ludvigsson JF, Kader M. Alcohol related disorders among elite male football players in Sweden: nationwide cohort study. BMJ 2022; 379:e074093. [PMID: 36543350 PMCID: PMC9768814 DOI: 10.1136/bmj-2022-074093] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To assess whether male elite football players are at increased risk of alcohol related disorders compared with men from the general population, and whether such an increased risk would vary on the basis of calendar year of the first playing season in the top tier of competition, age, career length, and goal scoring abilities. DESIGN Nationwide cohort study. SETTING Sweden, 1924-2020. PARTICIPANTS 6007 male football players who had played in the Swedish top division, Allsvenskan, from 1924 to 2019 and 56 168 men from the general population matched to players based on age and region of residence. MAIN OUTCOME MEASURES Primary outcome was alcohol related disorders (diagnoses recorded in death certificates, during hospital admissions and outpatient visits, or use of prescription drugs for alcohol addiction); secondary outcome was disorders related to misuse of other drugs. RESULTS During follow-up up to 31 December 2020, 257 (4.3%) football players and 3528 (6.3%) men from the general population received diagnoses of alcohol related disorders. In analyses accounting for age, region of residence, and calendar time, risk of alcohol related disorders was lower among football players than among men from the general population (hazard ratio 0.71, 95% confidence interval 0.62 to 0.81). A reduced risk of alcohol related disorders was observed for football players who played their first season in the top tier in the early 1960s and later, while no significant difference versus men from the general population was seen in the risk for football players from earlier eras. The hazard ratio was lowest at around age 35 years, and then increased with age; at around age 75 years, football players had a higher risk of alcohol related disorders than men from the general population. No significant association was seen between goal scoring, number of games, and seasons played in the top tier and the risk of alcohol related disorders. Risk of disorders related to other drug misuse was significantly lower among football players than the general population (hazard ratio 0.22, 95% confidence interval 0.15 to 0.34). CONCLUSIONS In this nationwide cohort study, male football players who had played in the Swedish top tier of competition had a significantly lower risk of alcohol related disorders than men from the general population.
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Affiliation(s)
- Peter Ueda
- Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
| | - Björn Pasternak
- Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | - Henrik Svanström
- Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | - Carl-Emil Lim
- Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
| | - Martin Neovius
- Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
| | - Magnus Forssblad
- Department of Molecular Medicine and Surgery, Stockholm Sports Trauma Research Center, Karolinska Institutet, Stockholm, Sweden
- Ortopedi Stockholm, Stockholm, Sweden
| | - Jonas F Ludvigsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden
- Department of Paediatrics, Örebro University Hospital, Örebro, Sweden
| | - Manzur Kader
- Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
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Cusack SE, Bountress KE, Denckla CA, Vassileva J, Dick DM, Amstadter AB. A Longitudinal Investigation of Resilience as a Protective Factor During the COVID-19 Pandemic. TRAUMATOLOGY 2022; 28:403-410. [PMID: 36504730 PMCID: PMC9731141 DOI: 10.1037/trm0000397] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
COVID-19 is a global stressor that has been shown to impact mental health outcomes. Given that COVID-19 is a unique stressor that has been shown to have mental health consequences, identifying protective factors is imperative. The protective influences of resilience are demonstrated through the extant literature, though less is known about resilience and COVID-19 impact. The current study seeks to expand the existing literature on resilience, and on mental health outcomes influenced by COVID-19, by longitudinally investigating relative resilience as a buffer against posttraumatic stress disorder (PTSD) symptoms and alcohol consumption, in the wake of a global pandemic. Participants included 549 undergraduates with a history of lifetime trauma exposure. Using a longitudinal path model, we tested the interaction between relative resilience (i.e., an individual's deviation from distress levels predicted by prior trauma exposure relative to other individuals in the same cohort) and COVID-19 impact domains (i.e., social media use, worry, exposure, change in substance use, and housing/food insecurity) on PTSD symptoms and alcohol consumption. Findings demonstrate a significant interaction between the COVID-19 worry impact domain and baseline resilience on later PTSD symptoms, whereby COVID-19 worry impacts PTSD symptoms at low levels of resilience (β = .26, p < .001), marginally impacts PTSD symptoms at mean levels of resilience (β = .09, p = .05), and does not impact PTSD symptoms at high levels of resilience (β = -.08, p = .16). There were no significant main effects nor interaction effects of resilience on alcohol consumption. This article adds to the literature on resilience and COVID-19 through examining both internalizing (i.e., PTSD) and substance use outcomes, using longitudinal data, and using a quantitative measure of resilience.
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Affiliation(s)
| | | | - Christy A. Denckla
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health
| | | | - Jasmin Vassileva
- Department of Psychology, Virginia Commonwealth University
- Department of Psychiatry, Virginia Commonwealth University
| | - Danielle M. Dick
- Department of Psychology, Virginia Commonwealth University
- Department of Human and Molecular Genetics, Virginia Commonwealth University
| | - Ananda B. Amstadter
- Department of Psychology, Virginia Commonwealth University
- Department of Psychiatry, Virginia Commonwealth University
- Department of Human and Molecular Genetics, Virginia Commonwealth University
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Lannoy S, Ohlsson H, Sundquist J, Sundquist K, Edwards AC. Roles of alcohol use disorder and resilience in risk of suicide attempt in men: A Swedish population-based cohort. Suicide Life Threat Behav 2022; 52:341-351. [PMID: 34981559 PMCID: PMC8995358 DOI: 10.1111/sltb.12825] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 09/27/2021] [Accepted: 11/08/2021] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Alcohol use disorder (AUD) has been identified as a strong risk factor for suicide attempt. However, few studies have considered protective factors that may moderate this association, such as resilience. METHODS We used longitudinal nationwide Swedish data of 903,333 males born 1960-1980 and 48,285 males born 1949-1951. We performed Cox proportional hazards models to test the role of AUD, resilience, and their interaction on risk for suicide attempt. We used co-relative models to account for familial factors. RESULTS Alcohol use disorder was strongly associated with increased risk of suicide attempt [hazard ratio (HR) = 12.22], while resilience was associated with reduced risk (HR = 0.73). Multiplicative interaction (HR = 1.21) showed that, in the context of AUD, the protective role of resilience on risk of suicide attempt was somewhat attenuated. Co-relative analyses supported both familial liability and a possible causal pathway between AUD, resilience, and suicide attempt. In the cohort born 1949-1951, resilience subcomponents-social maturity, interests, psychological energy, home conditions, and emotional control-were all associated with reduced suicide attempt risk (HRs between 0.63 and 0.74). CONCLUSION While resilience is associated with reduced risk of suicide attempt, this effect is less pronounced in the context of AUD. These associations are potentially causal.
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Affiliation(s)
- Séverine Lannoy
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Henrik Ohlsson
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Jan Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden,Department of Family Medicine and Community Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA,Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Kristina Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden,Department of Family Medicine and Community Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA,Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Alexis C. Edwards
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
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Neppala GK, Terkuhle I, Wagner A, Lepow L, Shaik RB, Freed R, Kimhy D, Pietrzak RH, Velthorst E, Feder A, Ivanov I, Parvaz MA. Social Isolation-Mediated Exacerbation of Negative Affect in Young Drinkers during the COVID-19 Pandemic. Brain Sci 2022; 12:brainsci12020214. [PMID: 35203977 PMCID: PMC8870361 DOI: 10.3390/brainsci12020214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 01/26/2022] [Accepted: 02/02/2022] [Indexed: 02/04/2023] Open
Abstract
Emerging research on psychological adjustment during the COVID-19 outbreak has suggested that young people may be particularly vulnerable to increases in negative affect during the pandemic. However, the association between alcohol use in youth and change in negative affect during this unprecedented time is not clear. Using an online survey, this study obtained scores on negative affect (before and during the COVID-19 pandemic), pandemic-related stress, change in drinking frequency, and traits including resilience, impulsivity and anhedonia, from a sample of drinkers and non-drinkers, up to the age of 21. Young drinkers experienced a greater increase in negative affect during the pandemic compared to non-drinkers, and this differential rise in negative affect was mediated by the pandemic-related stress of social isolation. Young drinkers also experienced a decrease in alcohol use during the pandemic, but this was not associated with a change in negative affect. Interestingly, young drinkers with greater resilience and lower anhedonia reported less increase in negative affect during the COVID-19 pandemic. Taken together, these results show that the greater increase in negative affect that young drinkers experienced during the COVID-19 pandemic, compared to their non-drinking counterparts, was mediated by pandemic-related social isolation. Moreover, greater resilience and lower anhedonia may have served as protective factors for mitigating the social isolation-induced worsening of negative affect in young drinkers during the pandemic. These findings may inform future studies investigating potential indicators of maladaptive affective responses to public health crises in vulnerable adolescent populations.
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Affiliation(s)
- Gopi K. Neppala
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (G.K.N.); (I.T.); (A.W.); (L.L.); (R.B.S.); (R.F.); (D.K.); (E.V.); (A.F.); (I.I.)
| | - Isabel Terkuhle
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (G.K.N.); (I.T.); (A.W.); (L.L.); (R.B.S.); (R.F.); (D.K.); (E.V.); (A.F.); (I.I.)
| | - Ariella Wagner
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (G.K.N.); (I.T.); (A.W.); (L.L.); (R.B.S.); (R.F.); (D.K.); (E.V.); (A.F.); (I.I.)
| | - Lauren Lepow
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (G.K.N.); (I.T.); (A.W.); (L.L.); (R.B.S.); (R.F.); (D.K.); (E.V.); (A.F.); (I.I.)
| | - Riaz B. Shaik
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (G.K.N.); (I.T.); (A.W.); (L.L.); (R.B.S.); (R.F.); (D.K.); (E.V.); (A.F.); (I.I.)
| | - Rachel Freed
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (G.K.N.); (I.T.); (A.W.); (L.L.); (R.B.S.); (R.F.); (D.K.); (E.V.); (A.F.); (I.I.)
| | - David Kimhy
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (G.K.N.); (I.T.); (A.W.); (L.L.); (R.B.S.); (R.F.); (D.K.); (E.V.); (A.F.); (I.I.)
| | - Robert H. Pietrzak
- U.S. Department of Veterans Affairs, National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT 06516, USA;
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06511, USA
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT 06520, USA
| | - Eva Velthorst
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (G.K.N.); (I.T.); (A.W.); (L.L.); (R.B.S.); (R.F.); (D.K.); (E.V.); (A.F.); (I.I.)
| | - Adriana Feder
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (G.K.N.); (I.T.); (A.W.); (L.L.); (R.B.S.); (R.F.); (D.K.); (E.V.); (A.F.); (I.I.)
| | - Iliyan Ivanov
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (G.K.N.); (I.T.); (A.W.); (L.L.); (R.B.S.); (R.F.); (D.K.); (E.V.); (A.F.); (I.I.)
| | - Muhammad A. Parvaz
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (G.K.N.); (I.T.); (A.W.); (L.L.); (R.B.S.); (R.F.); (D.K.); (E.V.); (A.F.); (I.I.)
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Correspondence:
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13
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Calpe-López C, Martínez-Caballero MA, García-Pardo MP, Aguilar MA. Resilience to the effects of social stress on vulnerability to developing drug addiction. World J Psychiatry 2022; 12:24-58. [PMID: 35111578 PMCID: PMC8783163 DOI: 10.5498/wjp.v12.i1.24] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 08/01/2021] [Accepted: 12/23/2021] [Indexed: 02/06/2023] Open
Abstract
We review the still scarce but growing literature on resilience to the effects of social stress on the rewarding properties of drugs of abuse. We define the concept of resilience and how it is applied to the field of drug addiction research. We also describe the internal and external protective factors associated with resilience, such as individual behavioral traits and social support. We then explain the physiological response to stress and how it is modulated by resilience factors. In the subsequent section, we describe the animal models commonly used in the study of resilience to social stress, and we focus on the effects of chronic social defeat (SD), a kind of stress induced by repeated experience of defeat in an agonistic encounter, on different animal behaviors (depression- and anxiety-like behavior, cognitive impairment and addiction-like symptoms). We then summarize the current knowledge on the neurobiological substrates of resilience derived from studies of resilience to the effects of chronic SD stress on depression- and anxiety-related behaviors in rodents. Finally, we focus on the limited studies carried out to explore resilience to the effects of SD stress on the rewarding properties of drugs of abuse, describing the current state of knowledge and suggesting future research directions.
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Affiliation(s)
| | | | - Maria P García-Pardo
- Faculty of Social and Human Sciences, University of Zaragoza, Teruel 44003, Spain
| | - Maria A Aguilar
- Department of Psychobiology, University of Valencia, Valencia 46010, Spain
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Lommer K, Schurr T, Frajo-Apor B, Plattner B, Chernova A, Conca A, Fronthaler M, Haring C, Holzner B, Macina C, Marksteiner J, Miller C, Pardeller S, Perwanger V, Pycha R, Schmidt M, Sperner-Unterweger B, Tutzer F, Hofer A. Addiction in the time of COVID-19: Longitudinal course of substance use, psychological distress, and loneliness among a transnational Tyrolean sample with substance use disorders. Front Psychiatry 2022; 13:918465. [PMID: 35982932 PMCID: PMC9380400 DOI: 10.3389/fpsyt.2022.918465] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 07/01/2022] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Next to an increased use of alcohol, the current pandemic has been associated with increased psychological distress among the general population. Research on its effects on individuals suffering from substance use disorders (SUD) is scarce. This study aimed at expanding the existing literature on this topic with a focus on the impact of loneliness and perceived social support. METHODS Sixty-eight people diagnosed with SUD according to ICD-10 from the Austrian state of Tyrol and from the Italian Province of South Tyrol who had been treated in a psychiatric hospital in 2019 and one hundred and thirty-six matched reference subjects of the same regional background participated in an online survey. Sociodemographic variables and scores on the Brief Symptom Checklist, the Three-Item Loneliness Scale, and the Multidimensional Scale of Perceived Social Support were collected at baseline and 5 months thereafter. Baseline took place after the first wave, while follow-up largely coincided with the second wave of the pandemic. RESULTS Among both patients and the matched reference group, substance use as a means to feel better facing the pandemic rose and predicted higher levels of psychological distress. Patients were less likely to receive specific care at follow-up than at baseline and presented with a significantly higher prevalence of clinically relevant psychological distress and loneliness than the matched reference group at both assessment times. Among both groups, psychological burden remained unchanged over time. Perceived social support was generally significantly higher in the matched reference group than in patients. Loneliness and, to a lesser degree, low perceived social support predicted psychological distress. CONCLUSION These findings emphasize the need of preventive and educational measures regarding substance use behavior for both individuals suffering from SUD and those without mental health disorders.
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Affiliation(s)
- Kilian Lommer
- Division of Psychiatry I, Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Medical University Innsbruck, Innsbruck, Austria
| | - Timo Schurr
- Division of Psychiatry I, Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Medical University Innsbruck, Innsbruck, Austria
| | - Beatrice Frajo-Apor
- Division of Psychiatry I, Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Medical University Innsbruck, Innsbruck, Austria
| | - Barbara Plattner
- Department of Psychiatry, General Hospital of Bolzano, Sanitary Agency of South Tyrol, Bolzano, Italy
| | - Anna Chernova
- Division of Psychiatry I, Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Medical University Innsbruck, Innsbruck, Austria
| | - Andreas Conca
- Department of Psychiatry, General Hospital of Bolzano, Sanitary Agency of South Tyrol, Bolzano, Italy
| | - Martin Fronthaler
- Therapy Center Bad Bachgart, Sanitary Agency of South Tyrol, Rodengo, Italy
| | - Christian Haring
- Department of Psychiatry and Psychotherapy B, State Hospital Hall in Tyrol, Hall in Tyrol, Austria
| | - Bernhard Holzner
- Division of Psychiatry I, Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Medical University Innsbruck, Innsbruck, Austria
| | - Christian Macina
- Department of Psychiatry, General Hospital of Brunico, Sanitary Agency of South Tyrol, Brunico, Italy
| | - Josef Marksteiner
- Department of Psychiatry and Psychotherapy A, State Hospital Hall in Tyrol, Hall in Tyrol, Austria
| | - Carl Miller
- Department of Psychiatry, County Hospital Kufstein, Kufstein, Austria
| | - Silvia Pardeller
- Division of Psychiatry I, Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Medical University Innsbruck, Innsbruck, Austria
| | - Verena Perwanger
- Department of Psychiatry, General Hospital of Merano, Sanitary Agency of South Tyrol, Merano, Italy
| | - Roger Pycha
- Department of Psychiatry, General Hospital of Bressanone, Sanitary Agency of South Tyrol, Bressanone, Italy
| | - Martin Schmidt
- Department of Psychiatry, County Hospital Lienz, Lienz, Austria
| | - Barbara Sperner-Unterweger
- Division of Psychiatry II, Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Medical University Innsbruck, Innsbruck, Austria
| | - Franziska Tutzer
- Division of Psychiatry I, Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Medical University Innsbruck, Innsbruck, Austria
| | - Alex Hofer
- Division of Psychiatry I, Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Medical University Innsbruck, Innsbruck, Austria
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15
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Ciydem E, Bilgin H. The moderating role of resilience in the relationship between peer pressure and risky behaviors among nursing students. Perspect Psychiatr Care 2022; 58:355-363. [PMID: 33861479 DOI: 10.1111/ppc.12797] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 03/13/2021] [Accepted: 03/27/2021] [Indexed: 10/21/2022] Open
Abstract
PURPOSE To examine the moderating role of resilience in the relationship between peer pressure and risky behaviors among nursing students. DESIGN AND METHODS A cross-sectional correlational study carried out with 512 students. FINDINGS The mean age was 20.90 ± 1.66. Of the students, 82.4% were females 99.0% were single, 71.5% had moderate socioeconomic status. While peer pressure directly made an effect on whole subdimensions for risky behaviors (p < 0.001), resilience had an effect on antisocial behavior, dropout, eating habits, and suicidal tendency (p < 0.001). Moderation was supported as the relationship between peer pressure and substance use varied by resilience level (p < 0.001). PRACTICAL IMPLICATIONS: Students with high levels of resilience are less prone to exhibit some risky behaviors based on peer pressure. Resilience-building strategies should be incorporated into the curriculum.
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Affiliation(s)
- Emre Ciydem
- Department of Mental Health and Psychiatric Nursing, Florence Nightingale Nursing Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Hulya Bilgin
- Department of Mental Health and Psychiatric Nursing, Florence Nightingale Nursing Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
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16
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Lannoy S, Sullivan EV. Trajectories of brain development reveal times of risk and factors promoting resilience to alcohol use during adolescence. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2021; 160:85-116. [PMID: 34696880 PMCID: PMC10657639 DOI: 10.1016/bs.irn.2021.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Alcohol use disorder (AUD) is recognized as harmful for the developing brain. Numerous studies have sought environmental and genetic risk factors that predict the development of AUD, but recently identified resilience factors have emerged as protective. This chapter reviews normal processes of brain development in adolescence and emerging adulthood, delineates disturbed growth neurotrajectories related to heavy drinking, and identifies potential endogenous, experiential, and time-linked brain markers of resilience. For example, concurrent high dorsolateral prefrontal activation serving inhibitory control and low nucleus accumbens activation serving reward functions engender positive adaptation and low alcohol use. Also discussed is the role that moderating factors have in promoting risk for or resilience to AUD. Longitudinal research on the effects of all levels of alcohol drinking on the developing brain remains crucial and should be pursued in the context of resilience, which is a promising direction for identifying protective biomarkers against developing AUDs.
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Affiliation(s)
- S Lannoy
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States; Department of Psychiatry, Virginia Commonwealth University, Virginia Institute for Psychiatric and Behavioral Genetics, Richmond, VA, United States
| | - E V Sullivan
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States.
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Genetic association of FKBP5 with trait resilience in Korean male patients with alcohol use disorder. Sci Rep 2021; 11:18454. [PMID: 34531492 PMCID: PMC8445975 DOI: 10.1038/s41598-021-98032-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 09/02/2021] [Indexed: 11/19/2022] Open
Abstract
The FKBP5 gene is known to have an important role in alcohol use disorder (AUD) in response to stress and has been reported to affect stress responses by interacting with childhood trauma. This study investigated the effects of the FKBP5 polymorphism rs1360780 and childhood trauma on trait resilience in male patients with AUD. In addition, allele-specific associations between FKBP5 DNA methylation and resilience were examined. In total, 297 men with AUD were assessed for alcohol use severity, childhood trauma, resilience, and impulsivity. Genotyping for FKBP5 rs1360780 and DNA methylation were analyzed. The effects of the rs1360780 single nucleotide polymorphism (SNP) and clinical variables on resilience were tested using linear regression analysis. Possible associations between FKBP5 DNA methylation and resilience were tested with partial correlation analysis. The rs1360780 risk allele, a low education level, and high impulsivity were associated with diminished resilience, whereas no significant main or interaction effect of childhood trauma with the SNP rs1360780 genotype on resilience was shown. No significant association between FKBP5 DNA methylation and resilience was found. The present study demonstrated the involvement of the rs1360780 risk allele in trait resilience in men with AUD, suggesting that the genetic vulnerability of FKBP5 may influence resilience related to AUD.
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de Vries LP, Baselmans BM, Luykx JJ, de Zeeuw EL, Minică CC, de Geus EJ, Vinkers CH, Bartels M. Genetic evidence for a large overlap and potential bidirectional causal effects between resilience and well-being. Neurobiol Stress 2021; 14:100315. [PMID: 33816719 PMCID: PMC8010858 DOI: 10.1016/j.ynstr.2021.100315] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 03/03/2021] [Accepted: 03/03/2021] [Indexed: 01/07/2023] Open
Abstract
Resilience and well-being are strongly related. People with higher levels of well-being are more resilient after stressful life events or trauma and vice versa. Less is known about the underlying sources of overlap and causality between the constructs. In a sample of 11.304 twins and 2.572 siblings from the Netherlands Twin Register, we investigated the overlap and possible direction of causation between resilience (i.e. the absence of psychiatric symptoms despite negative life events) and well-being (i.e. satisfaction with life) using polygenic score (PGS) prediction, twin-sibling modelling, and the Mendelian Randomization Direction of Causality (MR-DoC) model. Longitudinal twin-sibling models showed significant phenotypic correlations between resilience and well-being (.41/.51 at time 1 and 2). Well-being PGS were predictive for both well-being and resilience, indicating that genetic factors influencing well-being also predict resilience. Twin-sibling modeling confirmed this genetic correlation (0.71) and showed a strong environmental correlation (0.93). In line with causality, both genetic (51%) and environmental (49%) factors contributed significantly to the covariance between resilience and well-being. Furthermore, the results of within-subject and MZ twin differences analyses were in line with bidirectional causality. Additionally, we used the MR-DoC model combining both molecular and twin data to test causality, while correcting for pleiotropy. We confirmed the causal effect from well-being to resilience, with the direct effect of well-being explaining 11% (T1) and 20% (T2) of the variance in resilience. Data limitations prevented us to test the directional effect from resilience to well-being with the MR-DoC model. To conclude, we showed a strong relation between well-being and resilience. A first attempt to quantify the direction of this relationship points towards a bidirectional causal effect. If replicated, the potential mutual effects can have implications for interventions to lower psychopathology vulnerability, as resilience and well-being are both negatively related to psychopathology.
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Affiliation(s)
- Lianne P. de Vries
- Department of Biological Psychology, Vrije Universiteit Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Amsterdam University Medical Centres, Amsterdam, the Netherlands
| | - Bart M.L. Baselmans
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia
| | - Jurjen J. Luykx
- Department of Psychiatry, UMC Utrecht, Brain Center, University Medical Center Utrecht, Utrecht, the Netherlands
- Department of Translational Neuroscience, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
- Outpatient Second Opinion Clinic, GGNet Mental Health, Warnsveld, the Netherlands
| | - Eveline L. de Zeeuw
- Department of Biological Psychology, Vrije Universiteit Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Amsterdam University Medical Centres, Amsterdam, the Netherlands
| | - Camelia C. Minică
- Department of Biological Psychology, Vrije Universiteit Amsterdam, the Netherlands
- Stanley Center for Psychiatric Disease, Broad Institute of MIT and Harvard, Cambridge, MA, 02142, USA
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - Eco J.C. de Geus
- Department of Biological Psychology, Vrije Universiteit Amsterdam, the Netherlands
| | - Christiaan H. Vinkers
- Department of Psychiatry, Amsterdam UMC, Location VUmc, the Netherlands
- Department of Anatomy and Neurosciences, Amsterdam UMC, Location VUmc, the Netherlands
| | - Meike Bartels
- Department of Biological Psychology, Vrije Universiteit Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Amsterdam University Medical Centres, Amsterdam, the Netherlands
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Berg V, Kuja-Halkola R, D'Onofrio BM, Lichtenstein P, Latvala A. Parental substance misuse and reproductive timing in offspring: A genetically informed study. EVOL HUM BEHAV 2021. [DOI: 10.1016/j.evolhumbehav.2020.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Karriker-Jaffe KJ, Lönn SL, Cook WK, Kendler KS, Sundquist K. Young men's behavioral competencies and risk of alcohol use disorder in emerging adulthood: Early protective effects of parental education. Dev Psychopathol 2021; 33:135-148. [PMID: 32124710 PMCID: PMC8018800 DOI: 10.1017/s0954579419001640] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
We investigate how early exposure to parental externalizing behaviors (EB) may contribute to development of alcohol use disorders (AUD) in young adulthood, testing a developmental cascade model focused on competencies in three domains (academic, conduct, and work) in adolescence and emerging adulthood, and examining whether high parental education can buffer negative effects of parental EB and other early risk factors. We use data from 451,054 Swedish-born men included in the national conscript register. Structural equation models showed parental EB was associated with academic and behavioral problems during adolescence, as well as with lower resilience, more criminal behavior, and reduced social integration during emerging adulthood. These pathways led to elevated rates of AUD in emerging and young adulthood. Multiple groups analysis showed most of the indirect pathways from parental EB to AUD were present but buffered by higher parental education, suggesting early life experiences and competencies matter more for young men from lower socioeconomic status (SES) families than from higher SES families. Developmental competencies in school, conduct, and work are important precursors to the development of AUD by young adulthood that are predicted by parental EB. Occupational success may be an overlooked source of resilience for young men from low-SES families.
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Affiliation(s)
| | - Sara L. Lönn
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Won K. Cook
- Alcohol Research Group, Public Health Institute, Emeryville, CA, USA
| | - Kenneth S. Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics and Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
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Kassim S. The impact of protective psychosocial factors on khat chewing among male medical and dental future health-care providers in Yemen. J Dent Sci 2020; 15:451-456. [PMID: 33505616 PMCID: PMC7816017 DOI: 10.1016/j.jds.2019.08.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 08/15/2019] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND/PURPOSE Khat chewing, a green leaf with amphetamine effects, is a public health concern. Yet, it is prevalent and evident, in the khat belt region, among male students in health faculties. This study aimed to examine whether psychosocial factors have a protective impact on khat chewing among male dental and medical students. MATERIALS AND METHODS A cross-sectional study included all students (1457) in second year and above at a Yemeni university. A self-administered questionnaire was used to obtain sociodemographic data and to assess students' psychosocial characteristics namely, depression, resilience and social support (perceived or received [living with or away from family]). Data analysis included descriptive statistics and multivariable logistic regression modelling. RESULTS The response rate was 61% (male = 334, female = 547) and the responding students' mean ± SD age was 22.95 ± 1.56 years. Of the respondents 185 (21% [95%CI = 18%-24%]) were current khat chewers (7 [4%] females and 178 [96%] males respectively). In the adjusted model, among male students living away from family was significantly associated with khat chewing (adjusted odd ratio [AOR] = 3.15,95%CI = 1.96-5.07, p < 0.001) and perceived social support was inversely significantly related to khat chewing (AOR = 0.98; 95%CI = 0.96-1.00; p = 0.019). CONCLUSION Within the limitation of the study of a single institute, social support whether received (living with family) or perceived appeared to be a protective factor from khat chewing among male medical and dental students. Social support should be enhanced and targeted to discourage khat chewing during the preparation of this future health care force.
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Affiliation(s)
- Saba Kassim
- Department of Preventive Dental Sciences, Taibah University Dental College & Hospital, Naif Ibn Abdulaziz Road, Al-Madinah Al-Munawwarah, 42353, Saudi Arabia
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Al-Khawaldeh SA, Hamdan-Mansour AM, Shehadeh JH, Thultheen IN. Socio-Demographics and Psychological Correlates of Anger Among Individuals Diagnosed with Alcohol Use Disorder In Jordan. Open Nurs J 2020. [DOI: 10.2174/1874434602014010135] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective:
Psychological disturbances such as anger, impulsivity and resilience among individuals with alcohol use disorder are considered barriers to successful treatment and contribute to poor prognosis and early relapse. The purpose of this study is to investigate the socio-demographic and psychological factors associated with anger among individuals diagnosed with alcohol use disorder in Jordan.
Methods:
A descriptive correlational design was used to collect data using self-reported questionnaire from 54 hospitalized patients with alcohol use disorder admitted for treatment over 4 months period. Data collected in relation to anger, impulsivity, and resilience.
Results:
The results showed that 64% of the patients in this study had severe clinical anger, 70% had moderate to high impulsivity level, and about 48% had high level of resilience. The findings also showed a significant positive correlation between patients’ anger and impulsivity (r = .36, p <0.05), while a significant negative correlation was observed between patients’ anger and resilience (r = - 0.60, p < .001).
Conclusion:
The link between anger, impulsivity and resilience is alarming mental health professionals toward the need for an integrated model of care during and after interventions to prevent relapse and sustain sobriety.
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Straus E, Norman SB, Pietrzak RH. Determinants of new-onset alcohol use disorder in U.S. military veterans: Results from the National Health and Resilience in Veterans Study. Addict Behav 2020; 105:106313. [PMID: 32058235 DOI: 10.1016/j.addbeh.2020.106313] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 01/09/2020] [Accepted: 01/09/2020] [Indexed: 10/25/2022]
Abstract
BACKGROUND Although veterans are at increased risk of alcohol use disorder (AUD) relative to civilians, few longitudinal studies have examined both risk and protective factors that influence the development of AUD. This study aimed to identify risk and protective factors that contribute to incident AUD. METHODS Data were analyzed from the National Health and Resilience in Veterans Study (NHRVS), a nationally representative, prospective cohort study of U.S. veterans. The sample included 1,770 veterans who did not meet criteria for lifetime AUD at Wave 1 and completed at least one follow-up assessment over a 7-year period. Veterans completed self-report measures to assess for risk and protective factors. A multivariable binary logistic regression analysis was conducted to examine baseline factors associated with incident AUD. RESULTS A total of 5.9% of veterans without AUD at Wave 1 developed AUD in the 7-year follow-up period. Adult sexual trauma, greater severity of anxious arousal symptoms of PTSD, lifetime history of drug and nicotine use disorders, and higher alcohol consumption at Wave 1 were independently associated with incident AUD. Lifetime drug use disorder (75.9%) and higher alcohol consumption (22.1%) explained the most variance in incident AUD. CONCLUSION Approximately 6% of veterans without AUD at Wave 1 developed AUD over a 7-year period. Lifetime drug use disorder and greater alcohol consumption at baseline, as well as trauma-related characteristics (i.e., adult sexual trauma, anxious arousal symptoms), were associated with increased risk of developing AUD. Future research should examine whether treatment of drug use disorder and PTSD symptoms in at-risk veterans may help mitigate risk of developing AUD in this population.
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Lee IS, Lee M, Kim HK, Lee EJ. Effectiveness of a drinking-reduction program on drinking behavior, stages of change, drinking refusal self-efficacy, and resilience in Koreans with moderate alcohol use disorder. Arch Psychiatr Nurs 2019; 33:189-195. [PMID: 30927989 DOI: 10.1016/j.apnu.2018.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 11/22/2018] [Accepted: 12/09/2018] [Indexed: 10/27/2022]
Abstract
The purpose of this study was to examine the effects of a drinking-reduction program on drinking behavior, stages of change, drinking refusal self-efficacy, and resilience in Koreans with moderate alcohol use disorder. This study used a quasi-experimental nonequivalent control design. This study was performed from March 2015 to July 2015. The drinking-reduction program was conducted once per week for 11 weeks. This program improved drinking behavior, stages of change, drinking refusal self-efficacy, and resilience in the experimental group compared to the control group (p < .05, n = 34). The drinking-reduction program can be used as a nursing intervention for people with moderate alcohol use disorder.
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25
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Kennedy B, Chen R, Fang F, Valdimarsdottir U, Montgomery S, Larsson H, Fall K. Low stress resilience in late adolescence and risk of smoking, high alcohol consumption and drug use later in life. J Epidemiol Community Health 2019; 73:496-501. [PMID: 30718261 DOI: 10.1136/jech-2018-211815] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 01/16/2019] [Accepted: 01/22/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND While compromised stress resilience constitutes a recognised risk factor for somatic and psychiatric disease development in general, the knowledge about how individual variation in vulnerability to stress may specifically influence the long-term risks of disadvantageous health behaviours is limited. METHODS In this Swedish cohort study, we aimed to investigate the association between stress resilience in late adolescence and adult use of addictive substances. We included 9381 men with information on psychological stress resilience measured during military conscription examinations, who later responded to an extensive health survey (mean age 34.0±7.2 years) including detailed information on substance use. We modelled continuous outcomes using linear regression, binary outcomes with logistic regression and other categorical outcomes with multinomial logistic regression. RESULTS We found that low stress resilience in adolescence conferred increased risks of all studied measures of addictive behaviour. After adjusting for childhood socioeconomic information, low stress resilience was associated with adult current regular smoking (relative risk ratio: 5.85, 95% CI 4.32 to 7.93), higher nicotine dependence scores (beta: 0.76, 95% CI 0.29 to 1.23), hazardous use of alcohol (>14 alcoholic drink-equivalents per week, OR: 1.72, 95% CI 1.37 to 2.16), DSM-IV criteria for alcohol dependence (OR: 1.74, 95% CI 1.35 to 2.25), and drug use (OR: 1.77, 95% CI 1.51 to 2.08). The results remained largely unchanged after further adjustments for adult educational attainment and occupation as well as for additional conscription covariates. CONCLUSION Low stress resilience in late adolescence appears to be associated with an increased risk of disadvantageous and addictive health behaviours in adulthood.
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Affiliation(s)
- Beatrice Kennedy
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden .,Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Ruoqing Chen
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Fang Fang
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Unnur Valdimarsdottir
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Centre of Public Health Sciences, Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavík, Iceland.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Scott Montgomery
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden.,Department of Epidemiology and Public Health, University College London, London, UK.,Clinical Epidemiology Unit, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Henrik Larsson
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Katja Fall
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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26
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The role of parent and offspring sex on risk for externalizing psychopathology in offspring with parental alcohol use disorder: a national Swedish study. Soc Psychiatry Psychiatr Epidemiol 2018; 53:1381-1389. [PMID: 30019183 PMCID: PMC6252126 DOI: 10.1007/s00127-018-1563-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 07/04/2018] [Indexed: 12/15/2022]
Abstract
PURPOSE The substantial literature showing that offspring of parents with alcohol use disorder (AUD) is at increased risk for externalizing psychopathology rarely examines the differential effects of parental and offspring sex. This literature also has other important limitations, such as modest sample sizes and use of unrepresentative samples. Using a large, nationwide Swedish sample, we aim to investigate the roles of parental and offspring sex in externalizing psychopathology among offspring with parental AUD. METHODS AUD diagnosis and externalizing measures were obtained from national registries. Associations between outcomes and parental AUD were examined using logistic regressions. Parental and offspring sex effects were examined with interaction terms. RESULTS Risks for externalizing disorders were increased in sons and daughters with parental AUD, with significant differences between sons and daughters for criminal behavior; maternal AUD had a greater impact than paternal AUD (regardless of offspring sex), but having two parents with AUD increased risk for all outcomes substantially more than having one parent; and maternal AUD increased risk of drug abuse for daughters more than sons, while paternal AUD increased risk of AUD and criminal behavior for sons more than daughters. CONCLUSIONS Offspring of parents with AUD are at increased risk for externalizing psychopathology. Maternal and paternal AUD differentially affected sons' vs. daughters' risks for AUD, drug abuse, and criminal behavior. The transmission of psychopathology within the externalizing spectrum appears to have sex-specific elements.
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Kennedy B, Chen R, Valdimarsdóttir U, Montgomery S, Fang F, Fall K. Childhood Bereavement and Lower Stress Resilience in Late Adolescence. J Adolesc Health 2018; 63:108-114. [PMID: 29724669 DOI: 10.1016/j.jadohealth.2018.02.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 01/17/2018] [Accepted: 02/14/2018] [Indexed: 12/31/2022]
Abstract
PURPOSE Although childhood traumatic experiences are recognized as important determinants for adolescent psychiatric health in general, our objective was to explore the specific influence of childhood bereavement on the stress resilience development trajectory. METHODS In this national register-based cohort study, we identified 407,639 men born in Sweden between 1973 and 1983, who underwent compulsory military enlistment examinations in late adolescence, including measures of psychological stress resilience. We defined exposure as loss of a first-degree family member in childhood, and estimated relative risk ratios (RRRs) for reduced (moderate or low), compared with high, stress resilience with 95% confidence intervals (CIs) using multinomial logistic regression. RESULTS Loss of a parent or sibling in childhood conferred a 49% increased risk of subsequent low stress resilience (RRR, 1.49, 95% CI, 1.41-1.57) and an 8% increased risk of moderate stress resilience (RRR, 1.08, 95% CI, 1.03-1.13) in late adolescence. There was also a graded increase in risk with increasing age at loss; teenagers were at higher risk for low resilience (RRR, 1.64, 95% CI, 1.52-1.77) than children aged 7-12 (RRR, 1.47, 95% CI, 1.34-1.61) and ≤6 years (RRR, 1.16 95% CI, 1.02-1.32). The excess risk was observed for all causes of death, including suicide and unexpected deaths as well as deaths due to other illnesses. The associations remained after exclusion of parents with a history of hospitalization for psychiatric diagnoses. CONCLUSIONS The long-term consequences of childhood bereavement may include lower stress resilience in late adolescence.
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Affiliation(s)
- Beatrice Kennedy
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden; Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden.
| | - Ruoqing Chen
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Unnur Valdimarsdóttir
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Centre of Public Health Sciences, Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavík, Iceland; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Scott Montgomery
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden; Department of Epidemiology and Public Health, University College London, London, UK; Clinical Epidemiology Unit, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Fang Fang
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Katja Fall
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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28
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Flotte TR. Gene Therapy for Alcoholism and Other Substance Use Disorders. Hum Gene Ther 2017; 28:701-702. [DOI: 10.1089/hum.2017.29048.trf] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Kennedy B, Fang F, Valdimarsdóttir U, Udumyan R, Montgomery S, Fall K. Stress resilience and cancer risk: a nationwide cohort study. J Epidemiol Community Health 2017; 71:947-953. [DOI: 10.1136/jech-2016-208706] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Revised: 05/10/2017] [Accepted: 06/19/2017] [Indexed: 11/03/2022]
Abstract
BackgroundStress resilience is recognised as a determinant of both psychiatric and somatic health, but the potential link between stress resilience and cancer development has not been explored.MethodsIn this nationwide cohort study, we examined the association between stress resilience in adolescence and subsequent cancer risk. We identified a cohort of 284 257 Swedish men, born 1952–1956, who underwent compulsory military enlistment examinations including measures of psychological stress resilience (median age 18 years). The resulting score was categorised as low, moderate and high stress resilience. Individuals diagnosed with cancer during the follow-up time were identified through data linkage to the Swedish Cancer Register.ResultsLowest stress resilience, compared with the highest, was associated with increased risks of liver (HR: 4.73, 95% CI 2.73 to 8.19) and lung (HR: 2.75, 95% CI 2.02 to 3.74) cancer after adjusting for markers of socioeconomic circumstances in childhood (p for trend <0.001 for both cancer types). Further adjustment for cognitive and physical fitness at conscription assessment had a marginal influence. In contrast, men with low stress resilience had a decreased risk of being diagnosed with prostate cancer (HR: 0.65, 95% CI 0.56 to 0.76) and malignant melanoma (HR: 0.65, 95% CI 0.55 to 0.76).ConclusionWe conclude that adolescent stress resilience, plausibly by influencing behavioural choices and social patterns, constitutes an important determinant of adult cancer occurrence. Increased awareness of long-term consequences in susceptible individuals may help direct future efforts to reduce cancer burden in adults.
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