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Gowling H, O'Keeffe F, Eccles FJR. Stigma, coping strategies, distress and wellbeing in individuals with cervical dystonia: a cross-sectional study. PSYCHOL HEALTH MED 2024:1-18. [PMID: 38254270 DOI: 10.1080/13548506.2024.2305172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 01/09/2024] [Indexed: 01/24/2024]
Abstract
Cervical dystonia (CD) is a movement disorder which causes sustained muscle contractions in the neck leading to abnormal postures and repetitive movements. As it is a highly visible condition, people with CD can experience stigma, which may lead to unhelpful coping strategies and increased psychological distress. This study investigated whether adaptive and maladaptive coping strategies mediate the relationship between stigma and psychological outcomes in people with CD. A total of 114 adults with CD completed measures of stigma, coping, health-related quality of life (HRQOL), psychological distress (depression, anxiety, stress), and psychological wellbeing at one time point. Participants' levels of distress were high, compared to the general population. Correlational analyses showed increased stigma and maladaptive coping (e.g. substance use, behavioural disengagement) were both significantly related to increased distress, lower wellbeing and lower HRQOL, whereas higher adaptive coping (e.g. acceptance, humour) was only related to higher wellbeing. In a parallel mediation model, maladaptive coping strategies mediated the relationship between stigma and distress, HRQOL and wellbeing, but adaptive coping strategies did not. These findings suggest that maladaptive coping may play an important role in explaining the relationship between stigma and some aspects of distress and wellbeing in CD. Interventions which focus on reducing different aspects of maladaptive coping may be helpful to improve wellbeing as well as reducing stigma.
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Affiliation(s)
- Helen Gowling
- Division of Health Research, Lancaster University, Lancaster, UK
| | - Fiadhnait O'Keeffe
- Department of Psychology, St Vincent's University Hospital, Dublin, Ireland
| | - Fiona J R Eccles
- Division of Health Research, Lancaster University, Lancaster, UK
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Effects of childhood adversity and cortisol levels on suicidal ideation and behaviour: Results from a general population study. Psychoneuroendocrinology 2022; 138:105664. [PMID: 35063686 DOI: 10.1016/j.psyneuen.2022.105664] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 12/13/2021] [Accepted: 01/07/2022] [Indexed: 11/22/2022]
Abstract
Childhood trauma is known to increase the risk of suicidal ideation and behaviours, and has also been linked to hypothalamic pituitary adrenal (HPA) axis dysregulation measured in cortisol levels. Recent evidence has shown that adverse childhood experiences are associated with lower cortisol reactivity to stress and diminished cortisol levels upon awakening in individuals vulnerable to suicide. The present study aimed to investigate whether less traumatic long term difficulties during childhood produced a similar effect on suicidal ideation/behaviour and cortisol levels in a general population sample. Participants (N = 1094; mean age 53 years, 53.7% female) from a large cohort study completed retrospective measures of long-term difficulties during childhood and adolescent years and a measure of history of suicidal thoughts, plans and actions together with a measure of current psychological distress. 24-hour urinary free cortisol samples were collected over two days. The results showed that experiencing childhood long-term difficulties were associated with 21% higher odds of reporting suicidal thoughts or plans in adulthood. Early childhood and adolescent difficulties were equally important predictors of suicide thoughts and plans. However, childhood difficulties were not found to be associated with adult urinary free cortisol, nor were adulthood suicidal thoughts, plans and behaviour associated with adult urinary free cortisol levels. Future research should explore the extent to which childhood difficulties and stressors are related to other indicators of HPA axis functioning. The current findings have implications for clinicians and for the development of future suicide prevention interventions.
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Saltzman LY. Sex Differences in the Relationship Between Child Maltreatment, Recent Bereavement, and Average Heart Rate. OMEGA-JOURNAL OF DEATH AND DYING 2021; 84:459-473. [PMID: 31865859 PMCID: PMC7306425 DOI: 10.1177/0030222819894139] [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: 11/17/2022]
Abstract
The study explores the sex differences in cardiovascular outcomes among bereaved individuals. In addition, the study differentiates the impact of child maltreatment and recent loss on the physical health of adult men and women. This study conducted a secondary analysis of data drawn from the Biomarker Subproject of the National Survey of Midlife Development in the United States (n = 1,255). Analysis included a series of regression models estimated in Stata version 15.1. A main effect for both sex and loss was observed. Both male and female respondents with loss had higher average heart rates as compared to male respondents without loss. Interestingly, being a female without loss was also associated with a higher average heart rate as compared to males without loss. The findings suggest that sex differences in cardiovascular functioning do occur and that these differences may be exacerbated by experiences of trauma and loss, and this relationship has implications for assessment and intervention.
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Affiliation(s)
- Leia Y Saltzman
- School of Social Work, Tulane University, New Orleans, LA, USA
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Hong J, Kapoor A, DaWalt LS, Maltman N, Kim B, Berry- Kravis EM, Almeida D, Coe C, Mailick M. Stress and genetics influence hair cortisol in FMR1 premutation carrier mothers of children with fragile X syndrome. Psychoneuroendocrinology 2021; 129:105266. [PMID: 34020265 PMCID: PMC8217368 DOI: 10.1016/j.psyneuen.2021.105266] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 05/02/2021] [Accepted: 05/06/2021] [Indexed: 01/20/2023]
Abstract
To investigate genetic and environmental influences on cortisol levels, mothers of children with fragile X syndrome (FXS) were studied four times over a 7.5-year period. All participants (n = 84) were carriers of the FMR1 "premutation", a genetic condition associated with impaired HPA axis functioning. Genetic variation was indicated by expansions in the number of CGG (cytosine-guanine-guanine) repeats in the FMR1 gene (67-138 repeats in the present sample). The environmental factor was cumulative exposure to adverse life events during the study period. Cortisol was measured at the beginning of the study via saliva samples and at the end of the study via hair samples; hormone values from these two specimen types were significantly correlated. The interactions between CGG repeat number and adverse life events significantly predicted hair cortisol concentration, including after accounting for the initial salivary cortisol level. For those with fewer CGG repeats, stress exposure was associated with elevated cortisol, the expected response to stress, although women with a higher number of CGGs had a reduced cortisol response to adverse events, which might be related to HPA dysfunction. These results indicate that both exogenous and endogenous factors affect HPA functioning in this population of women.
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Affiliation(s)
- Jinkuk Hong
- Waisman Center, University of Wisconsin-Madison, United States.
| | - Amita Kapoor
- Wisconsin National Primate Research Center, University of Wisconsin-Madison
| | | | | | - Bryan Kim
- Waisman Center, University of Wisconsin-Madison
| | | | - David Almeida
- Department of Human Development and Family Studies, Pennsylvania State University
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Burns RJ, Fardfini K. Prevalence and Correlates of Positive Mental Health Among Canadian Adults With Type 1 or Type 2 Diabetes: Results From the Canadian Community Health Survey---Mental Health. Can J Diabetes 2021; 45:601-606. [PMID: 33582044 DOI: 10.1016/j.jcjd.2020.12.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 11/27/2020] [Accepted: 12/01/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Current definitions of mental health are no longer limited to presence or absence of mental illness. Although dimensions of mental illness have been well studied among people with diabetes, little is known about positive mental health. Optimal positive mental health is referred to as "flourishing" and is characterized by happiness, psychological well-being and social well-being. Therefore, the purpose of this study was to examine the prevalence and correlates of flourishing mental health among Canadian adults diagnosed with diabetes. METHODS Data came from participants >19 years of age in the Canadian Community Health Survey---Mental Health 2012, a national, cross-sectional survey. Positive mental health was measured with the Mental Health Continuum---Short Form, which categorizes individuals into flourishing, moderate and languishing mental health. RESULTS Although the majority of participants with diabetes reported flourishing mental health (73.22%), flourishing mental health was more common among people without diabetes (76.56%). Among people with diabetes (n=2,024), those who were flourishing reported greater physical activity, better self-rated health, fewer comorbidities, less functional disability and were less likely to smoke compared with those who were not flourishing. Those who were flourishing were less likely to have a lifetime history of major depressive disorder or generalized anxiety disorder and were distinguished by some demographic characteristics. CONCLUSION Among people with diabetes, flourishing mental health was associated with distinct behavioural, health and sociodemographic correlates.
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Affiliation(s)
- Rachel J Burns
- Department of Psychology, Carleton University, Ottawa, Ontario, Canada.
| | - Kimia Fardfini
- Department of Psychology, Carleton University, Ottawa, Ontario, Canada
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Parra LA, Hastings PD. Challenges to Identity Integration Indirectly Link Experiences of Heterosexist and Racist Discrimination to Lower Waking Salivary Cortisol in Sexually Diverse Latinx Emerging Adults. Front Psychol 2020; 11:228. [PMID: 32161561 PMCID: PMC7053485 DOI: 10.3389/fpsyg.2020.00228] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 01/31/2020] [Indexed: 01/25/2023] Open
Abstract
Heterosexist and racist discrimination may adversely impact neurobiological processes implicated in the physical and psychosocial well-being of sexually diverse Latinx people. Yet, little is known about how experiences of both heterosexist and racist discrimination are associated with adrenocortical and psychological functioning in groups of people with multiply marginalized social group identities. Through the application of the intersectionality, minority stress, and allostatic load frameworks, it was hypothesized that experiences of heterosexist and racist discrimination would be associated with disruptions to diurnal salivary cortisol patterns and challenges to identity integration. A group of sexually diverse (self-identified lesbian, gay, bisexual, and queer) Latinx emerging adults (N = 51; ages 18-29, M = 24.06 years; SD = 2.73) provided saliva samples and completed a series of questionnaires during a four-day testing protocol. Heterosexist and racist discrimination were both positively associated with challenges to identity integration. Challenges to identity integration, in turn, were associated with lower intercepts of diurnal cortisol slopes, and heterosexist and racist discrimination were indirectly associated with lower cortisol intercepts via challenges to identity integration. These findings suggest that experiences of heterosexist and racist discrimination may interconnect by challenging sexual and ethnic/racial identity integration and disrupting adaptive adrenocortical regulation among sexually diverse Latinx emerging adults.
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Affiliation(s)
- Luis Armando Parra
- Department of Human Ecology, University of California, Davis, Davis, CA, United States
- Center for Mind and Brain, University of California, Davis, Davis, CA, United States
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, United States
| | - Paul David Hastings
- Center for Mind and Brain, University of California, Davis, Davis, CA, United States
- Department of Psychology, University of California, Davis, Davis, CA, United States
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Trudel-Fitzgerald C, Millstein RA, von Hippel C, Howe CJ, Tomasso LP, Wagner GR, VanderWeele TJ. Psychological well-being as part of the public health debate? Insight into dimensions, interventions, and policy. BMC Public Health 2019; 19:1712. [PMID: 31856772 PMCID: PMC6923969 DOI: 10.1186/s12889-019-8029-x] [Citation(s) in RCA: 85] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 12/03/2019] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Increasing evidence suggests that psychological well-being (PWB) is associated with lower disease and mortality risk, and may be enhanced with relatively low-cost interventions. Yet, dissemination of these interventions remains limited, in part because insufficient attention has been paid to distinct PWB dimensions, which may impact physical health outcomes differently. METHODS This essay first reviews the empirical evidence regarding differential relationships between all-cause mortality and multiple dimensions of PWB (e.g., life purpose, mastery, positive affect, life satisfaction, optimism). Then, individual-level positive psychology interventions aimed at increasing PWB and tested in randomized-controlled trials are reviewed as these allow for easy implementation and potentially broad outreach to improve population well-being, in concert with efforts targeting other established social determinants of health. RESULTS Several PWB dimensions relate to mortality, with varying strength of evidence. Many of positive psychology trials indicate small-to-moderate improvements in PWB; rigorous institution-level interventions are comparatively few, but preliminary results suggest benefits as well. Examples of existing health policies geared towards the improvement of population well-being are also presented. Future avenues of well-being epidemiological and intervention research, as well as policy implications, are discussed. CONCLUSIONS Although research in the fields of behavioral and psychosomatic medicine, as well as health psychology have substantially contributed to the science of PWB, this body of work has been somewhat overlooked by the public health community. Yet, the growing interest in documenting well-being, in addition to examining its determinants and consequences at a population level may provoke a shift in perspective. To cultivate optimal well-being-mental, physical, social, and spiritual-consideration of a broader set of well-being measures, rigorous studies, and interventions that can be disseminated is critically needed.
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Affiliation(s)
- Claudia Trudel-Fitzgerald
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
- Lee Kum Sheung Center for Health and Happiness, Harvard T.H, Chan School of Public Health, Boston, MA, USA.
| | - Rachel A Millstein
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Christiana von Hippel
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Wallace Center for Maternal, Child, and Adolescent Health, Berkeley School of Public Health, University of California, Berkeley, California, USA
| | - Chanelle J Howe
- Department of Epidemiology, Centers for Epidemiology and Environmental Health, Brown University School of Public Health, Providence, RI, USA
| | - Linda Powers Tomasso
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Gregory R Wagner
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Tyler J VanderWeele
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Human Flourishing Program, Harvard University, Boston, MA, USA
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