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Campos JADB, Campos LA, Martins BG, Marôco J. Coping Strategies and Their Relationship With Subjective Distress due to the COVID-19 Pandemic in Brazil. Psychol Rep 2024; 127:40-63. [PMID: 35767592 PMCID: PMC9243966 DOI: 10.1177/00332941221110538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To identify the strategies used by Brazilian adults for coping with the COVID-19 pandemic and to verify the effect of these strategies on subjective distress. METHODS This was a cross-sectional observational study with online data collection in May/June 2020, November/December 2020, and May/June 2021. The BriefCOPE Inventory and the Impact of Event Scale (IES-R) were used. The prevalence of strategies used at different time points was estimated with a 95% confidence interval and compared with a z-test. A multiple logistic regression model was constructed and the odds ratio (OR, 95%CI) was calculated to verify the probability of subjective distress according to the coping strategy used. RESULTS Younger individuals had a lower prevalence of adaptive strategies, which increased significantly with age. Participants with higher income levels had a higher prevalence of adaptive strategies, as did those who were never diagnosed with a mental health disorder. The prevalence of using only maladaptive strategies ranged from 6.1% to 5.4% (p > 0.05). The use of problem-centered strategies (Active Coping and Planning), venting of emotions, and substance use increased with time, while acceptance and behavioral disengagement decreased. In general, the population used problem-centered strategies, but the high prevalence of problem avoidance was striking. Positive reinterpretation and acceptance were protective factors for subjective distress, whereas maladaptive strategies increased the chance of distress. The presence of a negative valence component (problem- or emotion-centered) increased the chance of subjective distress, whereas strategies based on Problem Solving acted as a protective factor. CONCLUSION Coping strategies were significantly associated to subjective distress and have changed since the beginning of the pandemic. Strategies focused on emotion regulation may be relevant to minimize distress.
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Affiliation(s)
| | - Lucas Arrais Campos
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Tampere University Hospital, Tampere, Finland
- School of Dentistry, Campus Araraquara, São Paulo State University (UNESP), São Paulo, Brazil
| | | | - João Marôco
- William James Center for Research (WJCR), University Institute of Psychological, Social, and Life Sciences (ISPA), Lisbon, Portugal
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Simjanoski M, de Azevedo Cardoso T, Frey BN, Minuzzi L, De Boni RB, Balanzá-Martínez V, Kapczinski F. Lifestyle in bipolar disorder: A cross-sectional study. SPANISH JOURNAL OF PSYCHIATRY AND MENTAL HEALTH 2023; 16:244-250. [PMID: 37839960 DOI: 10.1016/j.rpsm.2023.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 04/14/2023] [Accepted: 04/27/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND Modifiable lifestyle behaviors are important factors for improving mental health, yet there has been a lack of research studying lifestyle as a multidimensional construct in bipolar disorder (BD). The aim of this cross-sectional study was to compare the lifestyle patterns of individuals with BD in a current mood episode with healthy controls (HCs) using the Short Multidimensional Inventory Lifestyle Evaluation (SMILE). MATERIALS AND METHODS The sample consisted of 46 individuals with BD currently experiencing a depressive or manic episode and 50 HC, assessed using the MINI International Neuropsychiatric Interview, Montgomery-Åsberg Depression Rating Scale (MADRS), and the Young Mania Rating Scale (YMRS). The SMILE scale assesses lifestyle across seven domains: diet and nutrition, substance abuse, physical activity, stress management, restorative sleep, social support, and environmental exposures. Between-groups comparisons were performed based on the presence of a psychiatric diagnosis and the type of BD episode. RESULTS We found significant differences in the total SMILE score (r=0.75, p<0.001) and in scores from each domain of the scale between BD and HC (p<0.05), where individuals with BD in a depressive or manic episode with or without mixed features reported worse lifestyle across all domains. Differences between individuals with BD in different mood episodes across domains on the SMILE scale were non-significant. CONCLUSION Findings from this study highlight the presence of unhealthy lifestyle patterns in people with BD regardless of the polarity of their mood episode. Implementation of multidimensional lifestyle assessments is an essential step toward detecting the clustering of unhealthy lifestyle patterns in BD.
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Affiliation(s)
- Mario Simjanoski
- Neuroscience Graduate Program, McMaster University, 1280 Main St. West, Hamilton, ON, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main St. West, Hamilton, ON, Canada.
| | - Taiane de Azevedo Cardoso
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main St. West, Hamilton, ON, Canada
| | - Benicio N Frey
- Neuroscience Graduate Program, McMaster University, 1280 Main St. West, Hamilton, ON, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main St. West, Hamilton, ON, Canada; Women's Health Concerns Clinic and Mood Disorders Program, St. Joseph's Healthcare, 100 West 5th Street, Hamilton, ON, Canada
| | - Luciano Minuzzi
- Neuroscience Graduate Program, McMaster University, 1280 Main St. West, Hamilton, ON, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main St. West, Hamilton, ON, Canada; Women's Health Concerns Clinic and Mood Disorders Program, St. Joseph's Healthcare, 100 West 5th Street, Hamilton, ON, Canada
| | - Raquel B De Boni
- Institute of Scientific and Technological Communication and Information in Health (ICICT), Oswaldo Cruz Foundation (FIOCRUZ), 4365 Manguinhos, Rio de Janeiro, Brazil
| | - Vicent Balanzá-Martínez
- Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, CIBERSAM, Av. de Blasco Ibáñez, 13, Valencia, Spain
| | - Flavio Kapczinski
- Neuroscience Graduate Program, McMaster University, 1280 Main St. West, Hamilton, ON, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main St. West, Hamilton, ON, Canada; Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, Brazil; Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Av. Paulo Gama, 110, Porto Alegre, Brazil
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Simjanoski M, Patel S, Boni RD, Balanzá-Martínez V, Frey BN, Minuzzi L, Kapczinski F, Cardoso TDA. Lifestyle interventions for bipolar disorders: A systematic review and meta-analysis. Neurosci Biobehav Rev 2023; 152:105257. [PMID: 37263531 DOI: 10.1016/j.neubiorev.2023.105257] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 05/05/2023] [Accepted: 05/29/2023] [Indexed: 06/03/2023]
Abstract
This review and meta-analysis aimed to describe the existing literature on interventions for bipolar disorder (BD) targeting the 6 pillars of Lifestyle Psychiatry: diet, physical activity (PA), substance use (SU), sleep, stress management, and social relationships (SR). Randomized Controlled Trials that examined the efficacy of lifestyle interventions targeting improvement in depressive/(hypo)manic symptom severity, lifestyle patterns, functioning, quality of life, and/or circadian rhythms were included. The systematic review included 18 studies, while the meta-analysis included studies targeting the same lifestyle domains and outcomes. Sleep (n = 10), PA (n = 9), and diet (n = 8) were the most targeted domains, while SU, SM and SR were least targeted (n = 4 each). Combined diet and PA interventions led to significant improvements in depressive symptoms (SMD: -0.46; 95%CI: -0.88, -0.04; p = 0.03), and functioning (SMD: -0.47; 95%CI: -0.89, -0.05; p = 0.03). Sleep interventions also led to significant improvements in depressive symptoms (SMD: -0.80; 95%CI: -1.21, -0.39; p < 0.01). Future research should focus on developing more multidimensional lifestyle interventions for a potentially greater impact on clinical and functional outcomes of BD.
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Affiliation(s)
- Mario Simjanoski
- Neuroscience Graduate Program, McMaster University, 1280 Main St. West, Hamilton, ON, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main St. West, Hamilton, ON, Canada.
| | - Swara Patel
- Life Sciences Program, School of Interdisciplinary Science, McMaster University, 1280 Main St. West, Hamilton, ON, Canada
| | - Raquel De Boni
- Institute of Scientific and Technological Communication and Information in Health (ICICT), Oswaldo Cruz Foundation (FIOCRUZ), 4365 Manguinhos, Rio de Janeiro, Brazil
| | - Vicent Balanzá-Martínez
- Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, CIBERSAM, Av. de Blasco Ibáñez, 13, Valencia, Spain
| | - Benicio N Frey
- Neuroscience Graduate Program, McMaster University, 1280 Main St. West, Hamilton, ON, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main St. West, Hamilton, ON, Canada; Women's Health Concerns Clinic and Mood Disorders Program, St. Joseph's Healthcare, 100 West 5th Street, Hamilton, ON, Canada
| | - Luciano Minuzzi
- Neuroscience Graduate Program, McMaster University, 1280 Main St. West, Hamilton, ON, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main St. West, Hamilton, ON, Canada; Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, CIBERSAM, Av. de Blasco Ibáñez, 13, Valencia, Spain
| | - Flavio Kapczinski
- Neuroscience Graduate Program, McMaster University, 1280 Main St. West, Hamilton, ON, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main St. West, Hamilton, ON, Canada; Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, Brazil
| | - Taiane de Azevedo Cardoso
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main St. West, Hamilton, ON, Canada; Life Sciences Program, School of Interdisciplinary Science, McMaster University, 1280 Main St. West, Hamilton, ON, Canada
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Van Rheenen TE, Miskowiak K, Karantonis J, Furlong LS, Murray G, Rossell SL. Understanding familial liability for emotion regulation difficulties in bipolar disorder. Psychol Med 2022; 52:2614-2621. [PMID: 33327971 DOI: 10.1017/s0033291720004626] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND There has been relatively limited work focused on understanding whether relatives of individuals with bipolar disorder (BD) have difficulties in the regulation of emotion, particularly in relation to perceptions about whether emotions can be effectively regulated, or trait behaviours that acknowledge emotions as self-regulators themselves. In this study, we assessed the presence and extent of difficulties in these dimensions of emotion regulation in individuals with BD compared to unaffected first-degree biological relatives (FDR) for the first time. METHODS In total, 161 participants, including euthymic individuals with BD, unaffected FDRs, and healthy controls, were compared on the Difficulties in Emotion Regulation Scale (DERS) - a multi-dimensional measure of habitual emotion regulation. Clinical data were also collected and examined in relation to DERS scores in a secondary analysis. RESULTS In the BD group, difficulties were evident for most dimensions of emotion regulation as measured by the DERS; and correlated with an earlier onset of illness and more mood episodes. FDRs displayed generally normal emotion regulation, except in terms of their beliefs that emotions can be effectively regulated; on this dimension, their reported difficulty was intermediate to the BD group and controls. CONCLUSION Habitual emotion regulation difficulties in BD persist irrespective of mood state, are related to the course of illness, and should be targeted in psychological interventions. Further, the perception that emotions cannot be effectively regulated during times of distress seems to represent an endophenotype for BD.
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Affiliation(s)
- Tamsyn E Van Rheenen
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne, Melbourne, Australia
- Centre for Mental Health, Faculty of Health, Arts and Design, School of Health Sciences, Swinburne University, Melbourne, Australia
| | - Kamilla Miskowiak
- Neurocognition and Emotion in Affective Disorders Group, Copenhagen Affective Disorder Research Centre, Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - James Karantonis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne, Melbourne, Australia
- Centre for Mental Health, Faculty of Health, Arts and Design, School of Health Sciences, Swinburne University, Melbourne, Australia
| | - Lisa S Furlong
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne, Melbourne, Australia
| | - Greg Murray
- Centre for Mental Health, Faculty of Health, Arts and Design, School of Health Sciences, Swinburne University, Melbourne, Australia
| | - Susan L Rossell
- Centre for Mental Health, Faculty of Health, Arts and Design, School of Health Sciences, Swinburne University, Melbourne, Australia
- Department of Psychiatry, St Vincent's Hospital, VIC, Australia
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Carruthers SP, Rossell SL, Murray G, Karantonis J, Furlong LS, Van Rheenen TE. Mindfulness, mood symptom tendencies and quality of life in bipolar disorder: An examination of the mediating influence of emotion regulation difficulties. J Affect Disord 2022; 298:166-172. [PMID: 34715199 DOI: 10.1016/j.jad.2021.10.107] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 08/02/2021] [Accepted: 10/23/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND The aim of this cross-sectional study was to investigate dispositional mindfulness and its association with depression and manic tendencies, and subjective life quality in bipolar disorder (BD). Furthermore, this study sought to examine the potential mediating effects of emotion regulation difficulties on these relationships. METHOD Twenty-eight healthy controls (HC) and 66 clinically stable outpatients with a DSM-IV-TR diagnosis of BD completed the Mindfulness Attention Awareness Scale (MAAS), Difficulties in Emotion Regulation Scale (DERS), Seven Up (7 Up) Seven Down (7 Down) and the Quality of Life in Bipolar Disorder Questionnaire (QoL.BD). These variables were compared between groups and entered into a series of mediation analyzes using PROCESS in the BD group only. RESULTS Lower MAAS scores were detected amongst the BD patients compared to HCs. Lower MAAS scores in BD patients predicted higher 7 Up, 7 Down and lower QoL.BD scores. For the 7 Down and QoL.BD, the associations were completely mediated by DERS scores, with difficulties in strategy use and emotional clarity mediating the association between mindfulness and depressive tendencies and quality of life, respectively. No significant direct or indirect effects were detected for the 7 Up model. LIMITATIONS The cross-sectional design precludes causal inference. The MAAS conceptualises mindfulness as unidimensional. Self-report scales of depressive and manic tendencies utilised. CONCLUSIONS This study detected a significant association between dispositional mindfulness and depressive tendencies and life quality in BD, and found that these associations were influenced by emotion regulation difficulties. These findings encourage further investigation of mindfulness-based interventions in BD.
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Affiliation(s)
- Sean P Carruthers
- Centre for Mental Health, Faculty of Health, Arts and Design, School of Health Sciences, Swinburne University, Melbourne, Australia
| | - Susan L Rossell
- Centre for Mental Health, Faculty of Health, Arts and Design, School of Health Sciences, Swinburne University, Melbourne, Australia; Department of Psychiatry, St Vincent's Hospital, VIC, Australia
| | - Greg Murray
- Centre for Mental Health, Faculty of Health, Arts and Design, School of Health Sciences, Swinburne University, Melbourne, Australia
| | - James Karantonis
- Centre for Mental Health, Faculty of Health, Arts and Design, School of Health Sciences, Swinburne University, Melbourne, Australia; Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne, Melbourne, Australia
| | - Lisa S Furlong
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne, Melbourne, Australia
| | - Tamsyn E Van Rheenen
- Centre for Mental Health, Faculty of Health, Arts and Design, School of Health Sciences, Swinburne University, Melbourne, Australia; Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne, Melbourne, Australia.
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Cabib S, Campus P, Conversi D, Orsini C, Puglisi-Allegra S. Functional and Dysfunctional Neuroplasticity in Learning to Cope with Stress. Brain Sci 2020; 10:E127. [PMID: 32102272 PMCID: PMC7071431 DOI: 10.3390/brainsci10020127] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 02/15/2020] [Accepted: 02/20/2020] [Indexed: 12/20/2022] Open
Abstract
In this brief review, we present evidence of the primary role of learning-associated plasticity in the development of either adaptive or maladaptive coping strategies. Successful interactions with novel stressors foster plasticity within the neural circuits supporting acquisition, consolidation, retrieval, and extinction of instrumental learning leading to development of a rich repertoire of flexible and context-specific adaptive coping responses, whereas prolonged or repeated exposure to inescapable/uncontrollable stressors fosters dysfunctional plasticity within the learning circuits leading to perseverant and inflexible maladaptive coping strategies. Finally, the results collected using an animal model of genotype-specific coping styles indicate the engagement of different molecular networks and the opposite direction of stress effects (reduced vs. enhanced gene expression) in stressed animals, as well as different behavioral alterations, in line with differences in the symptoms profile associated with post-traumatic stress disorder.
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Affiliation(s)
- Simona Cabib
- Department of Psychology, University of Rome ‘La Sapienza’, 00185 Rome, Italy; (D.C.); (C.O.); (S.P.-A.)
- Department of Experimental Neurosciences, IRCCS Fondazione Santa Lucia, 00143 Rome, Italy
| | - Paolo Campus
- Department of Psychiatry and Molecular and Behavioral Neuroscience Institute, University of Michigan, Ann Arbor, MI 48109, USA;
| | - David Conversi
- Department of Psychology, University of Rome ‘La Sapienza’, 00185 Rome, Italy; (D.C.); (C.O.); (S.P.-A.)
| | - Cristina Orsini
- Department of Psychology, University of Rome ‘La Sapienza’, 00185 Rome, Italy; (D.C.); (C.O.); (S.P.-A.)
- Department of Experimental Neurosciences, IRCCS Fondazione Santa Lucia, 00143 Rome, Italy
| | - Stefano Puglisi-Allegra
- Department of Psychology, University of Rome ‘La Sapienza’, 00185 Rome, Italy; (D.C.); (C.O.); (S.P.-A.)
- IRCCS Neuromed, via Atinense 18, 86077 Pozzilli (IS), Italy
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