Uncontrollable and unpredictable stress interacts with subclinical depression and anxiety scores in determining anxiety response

Effects of prolonged escitalopram administration on long-term potentiation within the hippocampal CA1 area in rats under predictable and unpredictable chronic mild stress

Exposure to chronic stress impairs memory. Also, escitalopram's impact on memory remains paradoxical. Therefore, this study examined how prolonged escitalopram administration affects input-output (I/O) functions, paired-pulse ratio (PPR), and long-term potentiation (LTP) in the hippocampal CA1 area in rats that underwent predictable and unpredictable chronic mild stress (PCMS and UCMS, respectively). Male rats were randomly assigned to different groups of control (Co), sham (Sh), PCMS and UCMS (PSt and USt, respectively; 2 h/day, for 21 consecutive days), escitalopram (Esc; 10 mg/kg, i.p., for 21 days), as well as PCMS and UCMS with escitalopram (PSt-Esc and USt-Esc, respectively). The fEPSP slope, amplitude, and area under the curve (AUC) were assessed in the hippocampal CA1 area using I/O functions, PP responses, and LTP. Serum corticosterone (CORT) levels were quantified in all experimental animals. The slope, amplitude, and AUC of fEPSP in the I/O functions, and all three PP phases prior and subsequent to LTP induction significantly declined in the USt and PSt groups. Escitalopram significantly enhanced these parameters in the PSt-Esc, but not in the USt-Esc group. Serum CORT levels corroborated the electrophysiological findings among experimental groups. Both PCMS and UCMS impaired neural excitability, neurotransmission, and memory within the hippocampal CA1 area. Escitalopram improved memory impairment only under PCMS, potentially attributed to reduced serum CORT levels. However, no influence on neural excitability, neurotransmission, and memory was observed under UCMS. This suggests different escitalopram doses might be required to ameliorate simultaneous mechanisms in response to various types of chronic mild stress.

Vilazodone Alleviates Neurogenesis-Induced Anxiety in the Chronic Unpredictable Mild Stress Female Rat Model: Role of Wnt/β-Catenin Signaling

Defective β-catenin signaling is accompanied with compensatory neurogenesis process that may pave to anxiety. β-Catenin has a distinct role in alleviating anxiety in adolescence; however, it undergoes degradation by the degradation complex Axin and APC. Vilazodone (VZ) is a fast, effective antidepressant with SSRI activity and 5-HT1A partial agonism that amends somatic and/or psychic symptoms of anxiety. Yet, there is no data about anxiolytic effect of VZ on anxiety-related neurogenesis provoked by stress-reduced β-catenin signaling. Furthermore, females have specific susceptibility toward psychopathology. The aim of the present study is to uncover the molecular mechanism of VZ relative to Wnt/β-catenin signaling in female rats. Stress-induced anxiety was conducted by subjecting the rats to different stressful stimuli for 21 days. On the 15th day, stressed rats were treated with VZ(10 mg/kg, p.o.) alone or concomitant with the Wnt inhibitor: XAV939 (0.1 mg/kg, i.p.). Anxious rats showed low β-catenin level turned over by Axin-1 with unanticipated reduction of APC pursued with elevated protein levels of neurogenesis-stimulating proteins: c-Myc and pThr183-Erk likewise gene expressions of miR-17-5p and miR-18. Two weeks of VZ treatment showed anxiolytic effect figured by alleviation of hippocampal histological examination. VZ protected β-catenin signal via reduction in Axin-1 and elevation of APC conjugated with modulation of β-catenin downstream targets. The cytoplasmic β-catenin turnover by Axin-1 was restored by XAV939. Herein, VZ showed anti-anxiety effect, which may be in part through regaining the balance of the reduced β-catenin and its subsequent exaggerated response of p-Erk, c-Myc, Dicer-1, miR-17-5p, and miR-18.

Stress in Huntington's Disease: Characteristics and Correlates in Patients and At-Risk Individuals

Background

Huntington's disease (HD) is a neurodegenerative disease that presents families with significant numbers of stressful events. However, relatively little empirical research has characterized the stressors encountered by members of HD-affected families and their correlations with psychological symptoms.

Objective

This study examined frequencies of specific stressors in HD patients and at-risk individuals and the correlates of these stressors with demographics, disease characteristics, and symptoms of depression and anxiety.

Methods

HD patients (n = 57) and at-risk individuals (n = 81) completed the Responses to Stress Questionnaire -Huntington's Disease Version to assess HD-related stressors. Participants completed measures of depression and anxiety symptoms. Patient health records were accessed to obtain information related to disease characteristics.

Results

Patients endorsed a mean number of 5.05 stressors (SD = 2.74) out of the 10-item list. Demographics were not related to total stressors, but disease characteristics were significantly related to specific stressors. At-risk individuals endorsed a mean number of 3.20 stressors (SD = 2.65) out of the 11-item list. Age and sex were significantly related to specific stressors. Total number of stressors was significantly related to depression (β=0.67, p < 0.001) and anxiety symptoms (β=0.58, p < 0.001) in patients and at-risk individuals (β=0.35, p = 0.003 and β=0.32, p = 0.006, respectively).

Conclusions

hese findings emphasize the significant burden of stress experienced by HD patients and at-risk individuals. We highlight a need for more specific stress-based measures and psychosocial support interventions for HD-affected families.

A nervous wait: Instagram's sensitive-content screens cause anticipatory anxiety but do not mitigate reactions to negative content

Online platforms like Instagram cover potentially distressing imagery with a sensitive-content screen (blurred imagery plus a content warning). Previous research suggests people typically choose to "uncover" and view screened content. In three studies, we investigated whether the presence of screens mitigates the negative emotional impact of viewing content. In Study 1, participants viewed positive and neutral images, and screens (with an option to view the negative images beneath) for a 5-minute period. In Study 2, half the participants saw a grey mask in place of the typical sensitive-content screen. In addition, each image appeared for a fixed period (5 s) and participants had no option to uncover it. Study 3 was like Study 2 except half the participants saw negative images preceded by a sensitive-content screen and half saw negative images without screens. Overall, participants reported a significant increase in state anxiety and negative affect from pre-to post task when they were exposed to sensitive-content screens, whether or not they were also exposed to the negative imagery beneath. Our data suggest sensitive-content screens cause negative responses - state anxiety and negative affect - that do not translate to an emotional benefit when people view negative content.

Resilience as a predictor of habituation

Habituation refers to the physiological adaptation to recurrent stressors, which can be measured by cortisol levels, and is considered a central mechanism in reducing allostatic load. Resilience, a potential factor influencing stress reduction, is the focus of this study. Specifically, the study aims to investigate the impact of resilience, as assessed by the Brief Resilience Scale (BRS), on habituation. The Trier Social Stress Test (TSST) was used as the recurrent stressor, and it was administered to each of the 56 subjects at 4 consecutive measurements. To assess habituation, various physiological parameters including the area under the curve with respect to the ground (AUCg) and with respect to the increase (AUCi), cortisol peak, slope from baseline to peak, and recovery were calculated. Mixed linear models were employed to examine the differences in the influence of resilience on habituation across the different time points. The findings indicate that the influence of resilience significantly varies from the first to the fourth measurement time point for AUCg (p = .048), while no significant differences were observed for the other cortisol parameters. The effects plot suggests that individuals with higher levels of resilience exhibit lower AUCg values throughout the measurements. These findings provide initial evidence supporting resilience as a predictor of cortisol habituation. However, future studies should also consider dynamic resilience models, utilizing longitudinally assessed resilience as a predictor for habituation, to explore whether resilience acts as a determinant of habituation or if habituation itself constitutes a resilience mechanism.

COVID-19 pandemic fatigue and its sociodemographic and psycho-behavioral correlates: a population-based cross-sectional study in Hong Kong

Pandemic fatigue is a growing public health concern of the lingering COVID-19 pandemic. Despite its widespread mass media coverage, systematic empirical investigations are scarce. Under the Hong Kong Jockey Club SMART Family-Link Project, we conducted online and telephone surveys amid the pandemic in February to March 2021 to assess self-reported pandemic fatigue (range 0-10) in Hong Kong adults (N = 4726) and its associations with sociodemographic and psycho-behavioral (high vs low to moderate) variables. Data were weighted by sex, age, and education of the general population. Binary logistic regression models yielded adjusted odds ratios (aORs) for high pandemic fatigue (score ≥ 7) for sociodemographic and psycho-behavioral variables. 43.7% reported high pandemic fatigue. It was less common in older people (55-64 years: aOR 0.56, 95% CI 0.39-0.82; 65 + years: 0.33, 0.21-0.52) versus age group 18-24 years, but more common in those with tertiary education (1.36, 1.15-1.62) versus secondary or below. High pandemic fatigue was positively associated with depressive symptoms (aOR 1.83, 95% CI 1.55-2.17), anxiety symptoms (1.87, 1.58-2.20), loneliness (1.75, 1.32-2.31), personal fear of COVID-19 (2.61, 2.12-3.23), family fear of COVID-19 (2.03, 1.67-2.47), and current alcohol use (1.16, 1.00-1.33), but negatively associated with self-rated health (0.79, 0.68-0.92), personal happiness (0.63, 0.55-0.72), personal adversity coping capability (0.71, 0.63-0.81), family adversity coping capability (0.79, 0.69-0.90), family well-being (0.84, 0.73-0.97), family communication quality (0.86, 0.75-0.98), and frequent home exercise (0.82, 0.69-0.96; versus less frequent). We first used a single-item tool to measure COVID-19 pandemic fatigue, showing that it was common and associated with worse mental health, lower levels of personal and family well-being and alcohol use.

Alcohol's effects during uncertain and uncontrollable stressors in the laboratory

Alcohol's effects on reactivity to stressors depends on the nature of the stressor and the reactivity being assessed. Research identifying characteristics of stressors that modulate reactivity and clarifies the neurobehavioral, cognitive, and affective components of this reactivity may help prevent, reduce or treat the negative impacts of acute and chronic alcohol use with implications for other psychopathology involving maladaptive reactivity to stressors. We used a novel, multi-measure, cued electric shock stressor paradigm in a greater university community sample of adult recreational drinkers to test how alcohol (N=64), compared to No-alcohol (N=64), effects reactivity to stressors that vary in both their perceived certainty and controllability. Preregistered analyses suggested alcohol significantly dampened subjective anxiety (self-report) and defensive reactivity (startle potentiation) more during uncertain than during certain stressors regardless of controllability, suggesting that stressor uncertainty -but not uncontrollability- may be sufficient to enhance alcohol's stress reactivity dampening and thus negative reinforcement potential.

Tactile Interaction with a Humanoid Robot: Effects on Physiology and Subjective Impressions

This study investigated how touching and being touched by a humanoid robot affects human physiology, impressions of the interaction, and attitudes towards humanoid robots. 21 healthy adult participants completed a 3 (touch style: touching, being touched, pointing) × 2 (body part: hand vs buttock) within-subject design using a Pepper robot. Skin conductance response (SCR) was measured during each interaction. Perceived impressions of the interaction (i.e., friendliness, comfort, arousal) were measured per questionnaire after each interaction. Participants’ demographics and their attitude towards robots were also considered. We found shorter SCR rise times in the being touched compared to the touching condition, possibly reflecting psychological alertness to the unpredictability of robot-initiated contacts. The hand condition had shorter rise times than the buttock condition. Most participants evaluated the hand condition as most friendly and comfortable and the robot-initiated interactions as most arousing. Interacting with Pepper improved attitudes towards robots. Our findings require future studies with larger samples and improved procedures. They have implications for robot design in all domains involving tactile interactions, such as caring and intimacy.

Socioeconomic Status and Individual Personal Responsibility Beliefs Towards Food Access

Despite worldwide attention given to food access, very little progress has been made under the current model. Recognizing that individual engagement is likely based on individual experiences and perceptions, this research study investigated whether or not a correlation exists between one's socioeconomic status (SES) and perceived personal responsibility for food access. Discussion of results and implications provide fresh insight into the ongoing global debate surrounding food access. Outcomes also provide insight into willing and able participants and point to least-cost solutions which may be better suited to implement and initiate change. Results indicate that the issue of food access is more complex than simply lobbying for better decision-making among individuals and populations, highlighting the importance of unit of analysis considerations.

Experiences of family caregivers of patients with COVID-19

Background

Family caregivers of patients with COVID-19 face many challenges that affect their physical and mental health.

Aim

The aim of the present study was to explore experiences of family caregivers of patients with COVID-19.

Methods

This phenomenological study was performed based on 13 family caregivers who had experience in home caring for patients with COVID-19. Data were collected through purposive sampling with in-depth semi-structured interviews. The Colaizzi's 7-step method was used to determine themes. The MAXQDA10 software was used to manage qualitative data analysis.

Results

Thirteen family caregivers participated. Five main themes describe family caregivers' experiences of caring for patients with COVID-19: nature of the disease; unmet needs; unpleasant physical, psychological, and social experiences; care facilitators and positive experiences.

Conclusion

Information and financial support for COVID-19 should be provided to family caregivers. Also, community members should embrace patients and family caregivers and reinforce the positive experiences of caregivers.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12875-021-01489-7.

A Case Study on the Behavioural Effect of Positive Reinforcement Training in a Novel Task Participation Test in Göttingen Mini Pigs

In laboratory animal research, many procedures will be stressful for the animals, as they are forced to participate. Training animals to cooperate using clicker training (CT) or luring (LU) may reduce stress levels, and thereby increase animal welfare. In zoo animals, aquarium animals, and pets, CT is used to train animals to cooperate during medical procedures, whereas in experimental research, LU seem to be the preferred training method. This descriptive case study aims to present the behaviour of CT and LU pigs in a potentially fear-evoking behavioural test-the novel task participation test-in which the pigs walked a short runway on a novel walking surface. All eight pigs voluntarily participated, and only one LU pig showed body stretching combined with lack of tail wagging indicating reduced welfare. All CT pigs and one LU pig displayed tail wagging during the test, indicating a positive mental state. Hence, training pigs to cooperate during experimental procedures resulted in a smooth completion of the task with no signs of fear or anxiety in seven out of eight animals. We suggest that training laboratory pigs prior to experimental procedures or tests should be done to ensure low stress levels.

COVID-19-Related Changes to Pregnant People's Work-Plans Increase Prenatal Depression

The COVID-19 pandemic has caused unprecedented rates of unemployment in the United States. Pregnant workers may be especially affected as they are over-represented in low-wage service and hospitality industries impacted by the pandemic. We surveyed an online convenience sample of currently working pregnant people living in the U.S. (n = 1,417) to determine whether COVID-19-related changes to how long individuals planned to work during their pregnancy, and uncertainty about these changes, were associated with prenatal depression. As hypothesized, both COVID-19-related work-plan changes (OR = 1.81, 95% CI 1.36-2.42, p < 0.001) and uncertainty about the precise nature of these changes (OR = 2.62, 95% CI 1.14-6.0, p = 0.022) were associated with significantly higher odds of a clinically-significant depression score. These effects appeared to be even greater among individuals who continued working outside the home during the pandemic. Since the U.S. is one of the few countries in the world that does not guarantee paid parental leave, pregnant people may be forced to choose between keeping their jobs and risking infection during the COVID-19 pandemic. Our results demonstrate a need for immediate suspension of the eligibility requirements for the Family and Medical Leave Act and/or universal access to both paid family leave and prenatal depression screening. This would help to alleviate these concerns and provide pregnant people with more options while preserving their employment status and financial security.

Transnasal endoscopic skull base surgery in the COVID-19 era: Recommendations for increasing the safety of the method

Transnasal endoscopic skull base surgery (eSBS) has been adopted in recent years, in great part to replace the extended procedures required by external approaches. Though sometimes perceived as "minimally invasive", eSBS still necessitates extensive manipulations within the nose/paranasal sinuses. Furthermore, exposure of susceptible cerebral structures to light and heat emanated by the telescope should be considered to comprehensively evaluate the safety of the method. While the number of studies specifically targeting eSBS safety still remains scarce, the problem has recently expanded with the SARS-CoV-2 pandemic, which also has implications for the safety of the surgical personnel. It must be stressed that eSBS may directly expose the surgeon to potentially high volumes of virus-contaminated aerosol. Thus, the anxiety of both the patient and the surgeon must be taken into account. Consequently, safety requirements must follow the highest standards. This paper summarizes current knowledge on SARS-CoV-2 biology and the peculiarities of human immunology in respect of the host-virus relationship, taking into account the latest information concerning the SARS-CoV-2 worrisome affinity for the nervous system. Based on this information, a workflow proposal is offered for consideration. This could be useful not only for the duration of the pandemic, but also during the unpredictable timeline involving our coexistence with the virus. Recommendations include technical modifications to the operating theatre, personal protective equipment, standards of testing for SARS-CoV-2 infection, prophylactic pretreatment with interferon, anti-IL6 treatment and, last but not least, psychological support for the patient.

Hair Cortisol and Self-Injurious Behavior Among Children With Autism Spectrum Disorder

Elevated salivary cortisol levels have been documented in individuals who engage in self-injurious behavior (SIB), indicating acute physiological stress. Less is known about the chronicity of stress and SIB. We analyzed the relationship between parent ratings of problem behavior and hair cortisol concentrations (an index of chronic adrenocortical activity) in 23 children with autism spectrum disorder (ASD). Parent ratings of problem behavior were not significantly correlated with hair cortisol concentrations. When children were categorized into groups based on the frequency and severity of SIB, participants with the greatest frequency and severity of SIB had higher hair cortisol concentrations compared to children without SIB. Frequent and severe SIB may be associated with altered hypothalamic-pituitary-adrenal (HPA) axis activity in children with ASD.

Burden, quality of life, anxiety, and depressive symptoms among caregivers of hemodialysis patients: The role of social support

OBJECTIVE

The purpose of this study was to determine how burden and quality of life predict anxiety and depressive symptoms among caregivers of hemodialysis patients. Social support was included in the model as a proposed moderator in the above relationships.

METHODS

This cross-sectional study involved 340 caregivers of chronic kidney patients undergoing hemodialysis. The setting was in Terengganu, Malaysia. The caregivers completed the measures of caregiving burden, quality of life, social support, and symptoms of anxiety and depression.

RESULTS

About 28.8% and 52.4% of caregivers showed clinically moderate levels of anxiety and depressive symptoms, respectively. Furthermore, 35.9% and 3.8% of them showed clinically high levels of anxiety and depressive symptoms, respectively. Analyses showed that general quality of life was a significant predictor of both anxiety and depressive symptoms. Burden and psychological domains of quality of life significantly predicted anxiety. In addition, a lack of social support was a determinant of depressive symptoms. Evidence suggested that social support moderated the burden-anxiety relationship. Specifically, caregivers with low levels of social support showed more elevated levels of anxiety symptoms when their burden was higher.

CONCLUSION

There is an urgent need for early detection to initiate prompt treatment in this population. The study provides some important insights into offering comprehensive intervention to help caregivers cope more effectively through the provision of sufficient social support to buffer the effects of caregiving burden and improve mental health.

A Translational Paradigm to Study the Effects of Uncontrollable Stress in Humans

Theories on the aetiology of depression in humans are intimately linked to animal research on stressor controllability effects. However, explicit translations of established animal designs are lacking. In two consecutive studies, we developed a translational paradigm to study stressor controllability effects in humans. In the first study, we compared three groups of participants, one exposed to escapable stress, one yoked inescapable stress group, and a control group not exposed to stress. Although group differences indicated successful stress induction, the manipulation failed to differentiate groups according to controllability. In the second study, we employed an improved paradigm and contrasted only an escapable stress group to a yoked inescapable stress group. The final design successfully induced differential effects on self-reported perceived control, exhaustion, helplessness, and behavioural indices of adaptation to stress. The latter were examined in a new escape behaviour test which was modelled after the classic shuttle box animal paradigm. Contrary to the learned helplessness literature, exposure to uncontrollable stress led to more activity and exploration; however, these behaviours were ultimately not adaptive. We discuss the results and possible applications in light of the findings on learning and agency beliefs, inter-individual differences, and interventions aimed at improving resilience to stress-induced mental dysfunction.

Brain moderators supporting the relationship between depressive mood and pain

Pain and depressive mood commonly exhibit a comorbid relationship. Yet, the brain mechanisms that moderate the relationship between dysphoric mood and pain remain unknown. An exploratory analysis of functional magnetic resonance imaging, behavioral, and psychophysical data was collected from a previous study in 76 healthy, nondepressed, and pain-free individuals. Participants completed the Beck Depression Inventory-II (BDI), a measure of negative mood/depressive symptomology, and provided pain intensity and pain unpleasantness ratings in response to noxious heat (49°C) during perfusion-based, arterial spin-labeled functional magnetic resonance imaging. Moderation analyses were conducted to determine neural mechanisms involved in facilitating the hypothesized relationship between depressive mood and pain sensitivity. Higher BDI-II scores were positively associated with pain intensity (R = 0.10; P = 0.006) and pain unpleasantness (R = 0.12; P = 0.003) ratings. There was a high correlation between pain intensity and unpleasantness ratings (r = 0.94; P < 0.001); thus, brain moderation analyses were focused on pain intensity ratings. Individuals with higher levels of depressive mood exhibited heightened sensitivity to experimental pain. Greater activation in regions supporting the evaluation of pain (ventrolateral prefrontal cortex; anterior insula) and sensory-discrimination (secondary somatosensory cortex; posterior insula) moderated the relationship between higher BDI-II scores and pain intensity ratings. This study demonstrates that executive-level and sensory-discriminative brain mechanisms play a multimodal role in facilitating the bidirectional relationship between negative mood and pain.

Racial discrimination trajectories predicting psychological well-being: From emerging adulthood to adulthood

Perceived racial discrimination (PRD) has been documented as a risk factor for worse psychological well-being among African Americans. Yet, most researchers have not examined how trajectories of PRD during emerging adulthood shape psychological well-being in adulthood. Moreover, less is known about whether demographic factors and components of racial identity shape PRD over time. We identified trajectories of PRD among 605 African American emerging adults and examined whether PRD trajectories were associated with depressive symptoms, anxiety symptoms, and perceived lack of control in adulthood. Four trajectories of PRD were identified (i.e., high-stable, moderate-declining, low-rising, and low-stable), and demographic factors and racial identity indicators influenced the likelihood of trajectory classification. In addition, members of the moderate-declining trajectory exhibited higher levels of depressive symptoms, anxiety symptoms, and perceived lack of control than members in the low-stable trajectory. Our findings suggest that changes in PRD in emerging adulthood can extend our understanding of psychological well-being in adulthood. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

The role of stressful life events appraisal in major depressive disorder

INTRODUCTION

Major depressive disorder (MDD) is a multifactorial disease in which, due to the interaction of several variables, the vulnerability of suffering from it increases. Several models, such as the diathesis-stress model, have explained these interactions. However, experiencing stressful events does not always lead to the development of MDD, and the attribution and appraisal of stressful events contributing to further development of depression symptoms has been considered as a possible explanation.

OBJECTIVE

To determinate the association and the predictive power of the frequency and appraisal of stressful life events to predict MDD symptomatology.

METHODS

Case-control study with 120 psychiatric patients and 120 people from the general population. A structured clinical interview and the life events questionnaire (Sandín and Chorcot) were used to evaluate the sample. The data were analysed with non-parametric tests and binary logistic regression.

RESULTS

The psychiatric patients reported significantly higher levels of negative affect, frequency of stressful life events, perceived stress, negative appraisal of the situation and lack of perceived control. The binary logistic regression model indicated that poor perception of control of the stressful event is the most determining factor, followed by negative evaluation of the situation.

CONCLUSIONS

The attributions that are made regarding a stressful event are variables that predict MDD, specifically the assessment of the perceived control over the situation. These results concur with the aetiological models of MDD, such as the cognitive diathesis-stress model.

Amygdala and prefrontal cortex activity varies with individual differences in the emotional response to psychosocial stress

Stress elicits a variety of psychophysiological responses that show large interindividual variability. Determining the neural mechanisms that mediate individual differences in the emotional response to stress would provide new insight that would have important implications for understanding stress-related disorders. Therefore, the present study examined individual differences in the relationship between brain activity and the emotional response to stress. In the largest stress study to date, 239 participants completed the Montreal Imaging Stress Task (MIST) while heart rate, skin conductance response (SCR), cortisol, self-reported stress, and blood oxygen level dependent (BOLD) functional MRI (fMRI) signal responses were measured. The relationship between differential responses (heart rate, SCR, cortisol, and self-reported stress) and differential BOLD fMRI data was analyzed. Dorsolateral prefrontal cortex (PFC), dorsomedial PFC, ventromedial PFC, and amygdala activity varied with the behavioral response (i.e., SCR and self-reported stress). These results suggest the PFC and amygdala support processes that are important for the expression and regulation of the emotional response to stress, and that stress-related PFC and amygdala activity underlie interindividual variability in peripheral physiologic measures of the stress response. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Suicidal ideation in patients with coronary heart disease and hypertension: Baseline results from the DEPSCREEN-INFO clinical trial

BACKGROUND

A high proportion of cardiac patients suffers from depression, which is an antecedent for suicidal ideation. This study identifies clinical vulnerabilities for suicidal ideation in cardiac patients.

METHODS

The primary outcome of the study was severity of suicidal ideation as measured with the Patient Health Questionnaire (PHQ-9) item No. 9. Covariates were demographics, cardiac characteristics (i.e., Canadian Cardiovascular Society angina rating of chest pain and New York Heart Association rating of shortness of breath), depression (PHQ-8,i.e., PHQ-9 minus item No. 9), anxiety (Generalized Anxiety Disorder-7, GAD-7), somatic symptoms (PHQ-15), illness perception (Brief-Illness Perception Questionnaire), and health-related quality of life (EuroQol-5D, EQ 5D).

RESULTS

Data from 1,976 patients were analysed. At least 14% (95% CI [12%, 16%]) of patients indicated suicidal ideations within the last 2 weeks. Bivariate analyses yielded associations between suicidal ideation and higher levels of depression severity, anxiety severity, somatic symptom burden, chest pain, shortness of breath, negative illness perceptions, reduced health-related quality of life, and a higher probability of living alone (all p < 0.001). A multivariable ordinal regression revealed depression severity and anxiety severity to show the highest associations with suicidal ideation (OR_PHQ-8  = 1.22, p < 0.001; OR_GAD-7  = 1.09, p < 0.001). Having a defibrillator implant was associated with a lower probability of suicidal ideation (OR = 0.27, p = 0.017).

CONCLUSIONS

This study identified several clinical vulnerabilities of suicidal ideation. The results stress the importance of screening for suicidal ideation in clinical practice.

A Meaningful Life is a Healthy Life: A Conceptual Model Linking Meaning and Meaning Salience to Health

Accumulating evidence suggests that a global sense of meaning in life is related to physical health, including increased longevity and reduced morbidity. However, the mechanisms responsible for these relationships remain largely unknown and uninvestigated. Moreover, there is no unifying conceptual framework linking meaning in life to physical health. Our aims are to (a) review the literature linking meaning in life to potential mechanisms associated with better physical health; (b) offer a comprehensive conceptual framework associating meaning in life with physical health; and (c) introduce a new construct, meaning salience, as a potentially important intermediary mechanism. Specifically, we review the evidence suggesting that meaning in life is associated with reduced stress, more adaptive coping, and greater engagement in health-promoting behaviors. Our model proposes that effects of global sense of meaning are potentiated through increased meaning salience, or daily awareness of meaning in the moment, which enhances self-regulation. Suggestions are proposed for empirically examining this new model.

Modeling consequences of prolonged strong unpredictable stress in zebrafish: Complex effects on behavior and physiology

Chronic stress is the major pathogenetic factor of human anxiety and depression. Zebrafish (Danio rerio) have become a novel popular model species for neuroscience research and CNS drug discovery. The utility of zebrafish for mimicking human affective disorders is also rapidly growing. Here, we present a new zebrafish model of clinically relevant, prolonged unpredictable strong chronic stress (PUCS). The 5-week PUCS induced overt anxiety-like and motor retardation-like behaviors in adult zebrafish, also elevating whole-body cortisol and proinflammatory cytokines - interleukins IL-1β and IL-6. PUCS also elevated whole-body levels of the anti-inflammatory cytokine IL-10 and increased the density of dendritic spines in zebrafish telencephalic neurons. Chronic treatment of fish with an antidepressant fluoxetine (0.1mg/L for 8days) normalized their behavioral and endocrine phenotypes, as well as corrected stress-elevated IL-1β and IL-6 levels, similar to clinical and rodent data. The CNS expression of the bdnf gene, the two genes of its receptors (trkB, p75), and the gfap gene of glia biomarker, the glial fibrillary acidic protein, was unaltered in all three groups. However, PUCS elevated whole-body BDNF levels and the telencephalic dendritic spine density (which were corrected by fluoxetine), thereby somewhat differing from the effects of chronic stress in rodents. Together, these findings support zebrafish as a useful in-vivo model of chronic stress, also calling for further cross-species studies of both shared/overlapping and distinct neurobiological responses to chronic stress.

What is stressful for females? Differential effects of unpredictable environmental or social stress in CD1 female mice

Stressful life events are a major factor in the etiology of several diseases, such as cardiovascular, inflammatory and psychiatric disorders (i.e., depression and anxiety), with the two sexes greatly differing in vulnerability. In humans and other animals, physiological and behavioral responses to stress are strongly dependent on gender, and conditions that are stressful for males are not necessarily stressful for females. Hence the need of an animal model of social chronic stress specifically designed for females. In the present study we aimed to compare the effects of two different chronic stress procedures in female mice, by investigating the impact of 4weeks of nonsocial unpredictable, physical stress by the Chronic Mild Stress paradigm (CMS; Exp.1) or of Social Instability Stress (SIS; Exp.2) on physiological, endocrine and behavioral parameters in adult female mice. CMS had a pronounced effect on females' response to novelty (i.e., either novel environment or novel social stimulus), body weight growth and hormonal profile. Conversely, 4weeks of social instability did not alter females' response to novelty nor hormonal levels but induced anhedonia. Our findings thus showed that female mice were more sensitive to nonsocial stress due to unpredictable physical environment than to social instability stressors. Neither of these stress paradigms, however, induced a consistent behavioral and physiological stress response in female mice comparable to that induced by chronic stress procedures in male mice, thus confirming the difficulties of developing a robust and validated model of chronic psychosocial stress in female mice.

Are carriers of CYP21A2 mutations less vulnerable to psychological stress? A population-based national cohort study

BACKGROUND

Congenital adrenal hyperplasia (CAH) is one of the most common monogenic autosomal recessive disorders with an incidence of one in 15 000. About one in 70 individuals in the general population are carriers of a severe CYP21A2 mutation. It has been suggested that this confers a survival advantage, perhaps as a result of increased activity in the hypothalamic-pituitary-adrenal axis. We investigated vulnerability to psychological stress in obligate carriers.

METHOD

The Swedish CAH Registry encompasses more than 600 patients. Parents, that is obligate carriers of the CYP21A2 mutation, were identified through the Multigeneration Register. The diagnosis of the child was used as the psychological stressor. Psychiatric diagnoses before and after the birth of a child with CAH were compared to those of controls derived from (i) the general population, (ii) parents of children with hypospadias and (iii) parents of children with diabetes mellitus type 1 (T1DM).

RESULTS

Parents of children with CAH had less risk of being diagnosed with any psychiatric disorder (OR, 0·6), an affective disorder (OR, 0·5) or substance misuse (OR, 0·5) after the diagnosis of the child, compared to the general population. Their risk was also decreased compared to parents of a child with hypospadias (OR, 0·6, 0·4 and 0·2, respectively) and parents of a child with T1DM (OR 0·7, 0·6 and 0·2, respectively). The CYP21A2 carriers had a lower risk of developing mood and stress-related disorders after the diagnosis of the child.

CONCLUSION

Obligate CYP21A2 carriers had a reduced risk of a psychiatric diagnosis and were less vulnerable to a psychologically stressful situation, at least with respect to receiving a psychiatric diagnosis. This indicates a better ability to cope with psychological stress among heterozygous carriers of severe CYP21A2 mutations, which may contribute to the apparent survival advantage.