Longitudinal Assessment of Hair Cortisol as a Predictor of Psychological Symptoms During COVID-19

BACKGROUND

There is a lack of evidence regarding enduring psychoneuroendocrine changes following an initial traumatic event, particular in the presence of an ongoing stressor. The coronavirus pandemic presents an opportunity to explore this matter. Consequently, the purpose of the present study was to investigate the impact of the ongoing pandemic (2021) on individuals, who experienced a first-time motor vehicle crash (MVC) at least 6 years earlier. To this end, we hypothesized that hair cortisol concentrations (HCC) following a first-time traumatic event positively predict symptoms of depression.

METHOD

We investigated N = 69 individuals (18 - 65 yrs.), who were victims of a MVC during 2010 - 2014. Hair strands were collected 10 days (t1) and 3 months after the MVC (t2), as well during the pandemic in 2021 (t3). To assess symptoms of depression, the participants filled out the Beck Depression Inventory at t1 - t3 and were additionally interviewed (Structured Clinical Interview for DSM-IV Axis I) at t1 and t2. Exclusion criteria conveyed a lifetime or acute mental disorder (incl. past trauma exposure).

RESULTS

Elevated pre-pandemic HCC following adversity (i.e., MVC) significantly predicted symptoms of depression in adults during the coronavirus pandemic (BDI: ß =.44, p =.010, R2 =.20), even after controlling for confounders. HCC significantly decreased over time, while in average psychological symptoms remained consistent.

CONCLUSION

Cortisol dysregulation in the past presents an enduring vulnerability to ongoing stress. In this regard, vulnerable groups may benefit from preventive measures. This finding validates the predictive power of HCC and extended past evidence in this regard, at the same time reinforcing the concept of the diathesis-stress model.

Symptoms of Idiopathic Environmental Intolerance associated with chemicals (IEI-C) are positively associated with perceptual anomalies

OBJECTIVE

Idiopathic Environmental Intolerance (IEI; i.e. the experience of somatic symptoms attributed to environmental agents) represents a functional somatic syndrome of unclear aetiology. Based on previous findings that suggest an association between IEI and perceptual anomalies, this study aimed to investigate the relationship between symptoms of IEI associated with chemicals (IEI-C) and facets of the schizotypy spectrum.

METHODS

A cross-sectional study design was used with N = 410 (78.3% female) persons responding to an online survey in which chemical odor sensitivity (COS) and modern health worries (MHW) that are associated with IEI-C, as well as schizotypal personality traits (SPQ), hallucination proneness (LSHS) and delusional ideation (PDI) as core components of the schizotypy spectrum were assessed.

RESULTS

Schizotypal traits were found to be significantly positively associated with MHWs (r = 0.20, p = .01), COS (r = 0.23, p = .01), and showed significant positive associations with hallucination proneness. Magical thinking was found to exhibit a significant positive relationship with both MHW (r = 0.17, p = .01) and COS (r = 0.21, p = .01). These small associations between IEI-C and facets of the psychosis spectrum remained significant even after statistically controlling for individual levels of trait anxiety and depression.

CONCLUSION

Schizotypal personality traits, particularly magical thinking, and hallucination proneness, appear positively related to facets of IEI-C. The findings are of relevance for the advancement of theoretical models of IEI.

The latent structure of the functional dyspepsia symptom complex: a taxometric analysis

OBJECTIVES

Rome III introduced a subdivision of functional dyspepsia (FD) into postprandial distress syndrome and epigastric pain syndrome, characterized by early satiation/postprandial fullness, and epigastric pain/burning, respectively. However, evidence on their degree of overlap is mixed. We aimed to investigate the latent structure of FD to test whether distinguishable symptom-based subgroups exist.

METHODS

Consecutive tertiary care Rome II FD patients completed the dyspepsia symptom severity scale. Confirmatory factor analysis (CFA) was used to compare the fit of a single factor model, a correlated three-factor model based on Rome III subgroups and a bifactor model consisting of a general FD factor and orthogonal subgroup factors. Taxometric analyses were subsequently used to investigate the latent structure of FD.

KEY RESULTS

Nine hundred and fifty-seven FD patients (71.1% women, age 41 ± 14.8) participated. In CFA, the bifactor model yielded a significantly better fit than the two other models (χ² difference tests both p < 0.001). All symptoms had significant loadings on both the general and the subgroup-specific factors (all p < 0.05). Somatization was associated with the general (r = 0.72, p < 0.01), but not the subgroup-specific factors (all r < 0.13, p > 0.05). Taxometric analyses supported a dimensional structure of FD (all CCFI<0.38).

CONCLUSIONS AND INFERENCES

We found a dimensional rather than categorical latent structure of the FD symptom complex in tertiary care. A combination of a general dyspepsia symptom reporting factor, which was associated with somatization, and symptom-specific factors reflecting the Rome III subdivision fitted the data best. This has implications for classification, pathophysiology, and treatment of FD.

Body-related attentional biases in patients with posttraumatic stress disorder resulting from childhood sexual abuse with and without co-occurring borderline personality disorder

BACKGROUND AND OBJECTIVES

Disturbed body perception is a common characteristic of patients with posttraumatic stress disorder (PTSD) after childhood sexual abuse (CSA). We examined the extent to which biased information processing of body related stimuli was related to CSA.

METHODS

Patients with PTSD after CSA (PTSD group; n = 61) were compared to healthy controls (HC group; n = 30). The PTSD group was subdivided into patients with comorbid Borderline Personality Disorder (BPD; PTSD+ group) and patients without BPD (PTSD-group). We used an emotional Stroop task (EST) with body-related words to assess biased information processing.

RESULTS

Only patients in the PTSD+ group but not in the PTSD-group showed a significantly stronger attentional bias to body related words compared to the HC group (p = .009).

LIMITATIONS

Recruitment in in-patient setting might have led to a non-representative sample of PTSD patients. The PTSD patients were not characterized regarding anything other than the mentioned mental disorders. Potentially, the body related words may have been associated with offenders' body areas, but not with the patients.

CONCLUSION

We found that patients with PTSD and comorbid BPD had a stronger attentional bias towards body related stimuli in comparison to other groups. This suggests that the observed attentional bias is a product of CSA combined with the emotion regulation difficulties characteristic of BPD. Future studies should test whether directly targeting body-related abnormalities in information processing can improve existing treatments for patients with CSA and BPD.

[Are journalists more frequently victims of stalking? Results of first empirical examinations]

The lifetime prevalence of stalking is about 12% in the general population. The risk to become a stalking victim is increased for psychiatrists and psychologists. However, there are no studies with regard to other professions. The present study analyses the lifetime prevalence of stalking victimization for journalists, because some professional tasks may also put members of this professional group at a higher risk to become a stalking victim. 493 journalists answered an internet questionnaire. 12% of the journalists reported stalking victimization due to private or other non-professional reasons. This is nearly exactly the same lifetime prevalence that was found in a German community sample. However, 2.2% of the journalists reported stalking victimization that was related to their professional work. This is the first empirical study on this issue. Due to methodological problems no other studies have been published on this topic so far. The reported data of this study have to be interpreted cautiously, because the data are not based on a representative sample. However, comparisons with community-based epidemiological studies render our data a valid basis for starting a discussion of a so far neglected research issue. Our preliminary data suggest that journalists may be at higher risk to become a stalking victim because of their professional activities. Since stalking may cause severe psychological distress in the victims and, in some cases, puts them in severe risk of aggressive violence, preventive strategies should be considered.

The Chemical Odor Sensitivity Scale: reliability and validity of a screening instrument for idiopathic environmental intolerance

OBJECTIVE

The objective of this study was to examine the psychometric qualities of a brief screening measure for idiopathic environmental intolerance (IEI), the Chemical Odor Sensitivity Scale (COSS).

METHODOLOGY

The COSS was administered together with other measures of environmental sensitivity, IEI, and symptom scales in large samples (students, individuals with IEI, and individuals without IEI).

RESULTS

The COSS achieved high internal consistency (.88 < or = Cronbach's alpha < or = .96) and good factorial, convergent, and discriminant validity across diverse samples. In a longitudinal sample, the COSS and other IEI features were stable across time. According to receiver operating characteristic analyses, the COSS performs adequately in screening individuals likely to meet case criteria for IEI.

CONCLUSIONS

The favorable psychometric qualities of the COSS recommend the scale as a useful tool both for assessing self-reported chemical odor sensitivity as a vulnerability marker and for screening for IEI.