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Danyluck C, Blair IV, Manson SM, Laudenslager ML, Daugherty SL, Brondolo E. Discrimination and Sleep Impairment in American Indians and Alaska Natives. Ann Behav Med 2022; 56:969-976. [PMID: 34864832 DOI: 10.1093/abm/kaab097] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Sleep impairment may be a key pathway through which discrimination undermines health. Links between discrimination and sleep in American Indians and Alaska Natives (AI/AN) have not been established. Further, it is unclear if such links might depend on the timing of discrimination or if socioeconomic status (SES) might buffer the impact of discrimination. PURPOSE To investigate associations between interpersonal discrimination and sleep impairment in urban AI/AN, for both lifetime and recent discrimination, and controlling for other life stressors. Education and income, indices of SES, were tested as potential moderators. METHODS A community sample of urban AI/AN (N = 303, 18-78 years old, 63% female) completed self-report measures of sleep impairment, lifetime and recent discrimination, depressive symptoms, perceived stress, other life stressors (childhood adversity and past year major events), and socio-demographic characteristics. RESULTS Lifetime discrimination was associated with impaired sleep in AI/AN after adjustment for socio-demographic characteristics, recent depressive symptoms, perceived stress, and other life stressors. Past-week discrimination was associated with sleep in unadjusted but not adjusted models. Education, but not income, was found to buffer the effects of both lifetime and past-week discrimination on sleep in adjusted models. CONCLUSION Lifetime discrimination uniquely accounts for sleep impairment and may be especially harmful in those with less education. These findings suggest targeting interventions to those most in need. Limitations include the cross-sectional nature of the data. Longitudinal and qualitative work is needed to understand how education may buffer the effects of discrimination on sleep and perhaps other health problems in AI/AN.
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Affiliation(s)
| | | | - Spero M Manson
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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2
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Wagner RE, Jonson-Reid M, Drake B, Kohl PL, Pons L, Zhang Y, Fitzgerald RT, Laudenslager ML, Constantino JN. Parameterizing Toxic Stress in Early Childhood: Maternal Depression, Maltreatment, and HPA-Axis Variation in a Pilot Intervention Study. Prev Sci 2022:10.1007/s11121-022-01366-4. [PMID: 35606570 DOI: 10.1007/s11121-022-01366-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2022] [Indexed: 12/22/2022]
Abstract
Adverse experiences superseding a child's capacity to sustain regulation of emotion and adaptive function are theorized to constitute "toxic stressors" when they induce a deleterious biological response within an individual. We ascertained presumptive parameters of toxic stress among 164 low-income infants and toddlers (ages 4-48 months) from 132 families enrolled in Early Head Start (EHS). We randomized a subset of these families into a pilot intervention arm of parenting education (the Incredible Years, TIY), which supplemented the EHS curriculum. Official report child abuse and neglect (CAN) and child behavior were serially ascertained over the course of the study. We observed relatively low associations among maternal depression, CAN, caregiver-child relationship quality, hair cortisol, and adverse child behavioral outcomes. Moreover, despite poverty and the high prevalence (51%) of CAN in this sample, the frequency of clinical-level internalizing and externalizing behavior among the children did not exceed that of the general population, by their parents' report. The pilot supplementation of EHS with TIY improved attendance in group meetings but did not significantly reduce adverse behavioral outcomes or CAN. This study revealed marked independence of standard indices of toxic stress (child maltreatment, maternal depression, caregiver emotional unavailability) which have been presumed to be risk factors for the development of psychopathology. That they were weakly inter-correlated, and only modestly predictive of child behavioral outcomes in this EHS sample, caution against presumptions about the toxicity of individual stressors, highlight the importance of ascertaining risk (and compensatory influences) comprehensively, suggest buffering effects of programs like EHS, and demonstrate the need for greater understanding of what parameterizes resilience in early childhood.
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Affiliation(s)
- Rachael E Wagner
- Department of Psychiatry, Division of Child and Adolescent Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Melissa Jonson-Reid
- School of Social Work, Washington University in St. Louis, St. Louis, MO, USA
| | - Brett Drake
- School of Social Work, Washington University in St. Louis, St. Louis, MO, USA
| | - Patricia L Kohl
- School of Social Work, Washington University in St. Louis, St. Louis, MO, USA
| | - Laura Pons
- Department of Psychiatry, Division of Child and Adolescent Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Yi Zhang
- Department of Psychiatry, Division of Child and Adolescent Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Robert T Fitzgerald
- Department of Psychiatry, Division of Child and Adolescent Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | | | - John N Constantino
- Department of Psychiatry, Division of Child and Adolescent Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA.
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3
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Sannes TS, Ranby KW, Yusufov M, Brewer BW, Jacobs JM, Callan S, Ulrich GR, Pensak NA, Natvig C, Laudenslager ML. More often than not, we're in sync: patient and caregiver well-being over time in stem cell transplantation. Health Qual Life Outcomes 2022; 20:6. [PMID: 35012566 PMCID: PMC8744240 DOI: 10.1186/s12955-021-01909-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Accepted: 12/13/2021] [Indexed: 11/10/2022] Open
Abstract
Background Hematopoietic stem cell transplantation (HSCT) is an aggressive medical procedure which significantly impacts the shared emotional well-being of patients and family caregivers (FC). Prior work has highlighted the significant overlap in well-being among patients and FCs; however, how this interdependence may change over the course of HSCT has received less attention. Methods We conducted secondary analyses of a supportive intervention delivered to 154 FCs of HSCT patients and examined relationships at baseline, 6 weeks, 3 and 6 months post-HSCT. Actor Partner Interdependence Modeling examined patient quality of life (QOL) and FC anxiety/depression. Results The data did not fit a multigroup approach limiting our ability to test intervention effects; however, bivariate analyses indicated FC depression significantly correlated to patient QOL at baseline (r = − .32), 6 weeks (r = − .22) and 6 months post-HSCT (r = − .34; p’s < .05); whereas FC anxiety was only correlated with patient QOL at the first two timepoints (p’s < .05). There was an unexpected, partner effect such that worse patient QOL at 6-weeks significantly related to lower FC depression at 3-months (B = .193; p = .026) and changed direction with patient QOL at 3-months being related to more FC depression at 6-months (B = − .187; p = .001). Conclusions These findings highlight the significant, yet nuanced, interdependence of patient QOL and FC well-being during HSCT. Specifically, greater interdependence was observed between patient QOL and FC depression compared to FC anxiety, suggesting potential treatment targets for patients and their families. Trial was registered at ClinicalTrials.gov Identifier: NCT02037568; first registered: January 16, 2014; https://clinicaltrials.gov/ct2/show/NCT02037568
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Affiliation(s)
- Timothy S Sannes
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, USA. .,Division of Adult Psychosocial Oncology and Palliative Care, Dana Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.
| | - Krista W Ranby
- Department of Psychology, The University of Colorado Denver, Denver, USA
| | - Miryam Yusufov
- Division of Adult Psychosocial Oncology and Palliative Care, Dana Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Benjamin W Brewer
- School of Medicine Anschutz Medical Campus, Division of Hematology, The University of Colorado, Aurora, USA
| | - Jamie M Jacobs
- Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, USA
| | - Stephanie Callan
- Department of Psychology, The University of Colorado Denver, Denver, USA
| | - Gillian R Ulrich
- Department of Psychology, The University of Colorado Denver, Denver, USA
| | | | - Crystal Natvig
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, USA
| | - Mark L Laudenslager
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, USA
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4
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Senehi N, Flykt M, Biringen Z, Laudenslager ML, Watamura SE, Garrett BA, Kominsky TK, Wurster HE, Sarche M. Emotional Availability as a Moderator of Stress for Young Children and Parents in Two Diverse Early Head Start Samples. Prev Sci 2021:10.1007/s11121-021-01307-7. [PMID: 34773574 DOI: 10.1007/s11121-021-01307-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2021] [Indexed: 10/19/2022]
Abstract
Positive parent-child relationship quality is critical for buffering children from the effects of stress on development. It is thus vital to develop interventions that target parent-child relationship quality for families experiencing stress. We examined the moderating role of parent-child relationship quality (as measured by parental emotional availability [EA]) in the intergenerational association between parental adverse childhood experiences (ACEs) and their young children's hair cortisol concentrations (HCCs)-a physiological marker of cumulative hypothalamic pituitary adrenal (HPA)-axis activity. Using data from 127 parent-child dyads collected by two of six ACF-funded Buffering Toxic Stress consortium sites, we tested interaction effects of parental ACEs with parental EA on young children's (Mage = 18.38, SDage = 7.10) HCC. Results revealed curvilinear main effects such that higher parental ACEs were significantly associated with greater HCC and stronger associations occurred at higher levels of parental ACEs. However, this association was moderated by parental EA. Thus, among children with higher parental history of ACEs, children of parents with higher EA had lower HCC compared to children of parents with lower EA. These findings provide support for the risk-buffering and risk-exacerbating role of parent-child relationship quality (e.g., EA) for the transmission of parents' early life adversity on their children's HPA-axis activity, documented here in a racially and ethnically diverse sample of children and parents served by Early Head Start. Findings suggest that intervention and prevention efforts targeting stress response in children of mothers with childhood adversity should also support parents in building an emotionally available relationship with their children.
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Affiliation(s)
- Neda Senehi
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, 31001 E 17th Place, Aurora, CO, USA.
| | - Marjo Flykt
- Faculty of Social Sciences/Psychology, Tampere University, Tampere, Finland
- Faculty of Medicine/Psychology, University of Helsinki, Helsinki, Finland
| | - Zeynep Biringen
- Department of Human Development and Family Services, Colorado State University, Fort Collins, USA
| | - Mark L Laudenslager
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, 31001 E 17th Place, Aurora, CO, USA
| | | | | | | | - Hannah E Wurster
- Department of Human Development and Family Services, Colorado State University, Fort Collins, USA
| | - Michelle Sarche
- Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, USA
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5
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Cunningham K, Hinton TG, Luxton JJ, Bordman A, Okuda K, Taylor LE, Hayes J, Gerke HC, Chinn SM, Anderson D, Laudenslager ML, Takase T, Nemoto Y, Ishiniwa H, Beasley JC, Bailey SM. Evaluation of DNA damage and stress in wildlife chronically exposed to low-dose, low-dose rate radiation from the Fukushima Dai-ichi Nuclear Power Plant accident. Environ Int 2021; 155:106675. [PMID: 34120002 DOI: 10.1016/j.envint.2021.106675] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 05/24/2021] [Accepted: 05/25/2021] [Indexed: 06/12/2023]
Abstract
The health effects associated with chronic low-dose, low-dose rate (LD-LDR) exposures to environmental radiation are uncertain. All dose-effect studies conducted outside controlled laboratory conditions are challenged by inherent complexities of ecological systems and difficulties quantifying dose to free-ranging organisms in natural environments. Consequently, the effects of chronic LD-LDR radiation exposures on wildlife health remain poorly understood and much debated. Here, samples from wild boar (Sus scrofa leucomystax) and rat snakes (Elaphe spp.) were collected between 2016 and 2018 across a gradient of radiation exposures in Fukushima, Japan. In vivo biomarkers of DNA damage and stress were evaluated as a function of multiple measurements of radiation dose. Specifically, we assessed frequencies of dicentric chromosomes (Telomere-Centromere Fluorescence in situ Hybridization: TC-FISH), telomere length (Telo-FISH, qPCR), and cortisol hormone levels (Enzyme Immunoassay: EIA) in wild boar, and telomere length (qPCR) in snakes. These biological parameters were then correlated to robust calculations of radiation dose rate at the time of capture and plausible upper bound lifetime dose, both of which incorporated internal and external dose. No significant relationships were observed between dicentric chromosome frequencies or telomere length and dose rate at capture or lifetime dose (p value range: 0.20-0.97). Radiation exposure significantly associated only with cortisol, where lower concentrations were associated with higher dose rates (r2 = 0.58; p < 0.0001), a relationship that was likely due to other (unmeasured) factors. Our results suggest that wild boar and snakes chronically exposed to LD-LDR radiation sufficient to prohibit human occupancy were not experiencing significant adverse health effects as assessed by biomarkers of DNA damage and stress.
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Affiliation(s)
- Kelly Cunningham
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO 80523-1618, USA
| | - Thomas G Hinton
- Centre for Environmental Radioactivity, Faculty of Environmental Sciences and Natural Resource Management, Norwegian University of Life Sciences (NMBU), P.O. Box 5003, N-1433 Ås, Norway; Institute of Environmental Radioactivity, 1 Kanayagawa, Fukushima City, Fukushima 960-1296, Japan.
| | - Jared J Luxton
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO 80523-1618, USA
| | - Aryn Bordman
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO 80523-1618, USA
| | - Kei Okuda
- Faculty of Human Environmental Studies, Hiroshima Shudo University, Hiroshima 731-3195, Japan
| | - Lynn E Taylor
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO 80523-1618, USA
| | - Josh Hayes
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO 80523-1618, USA
| | - Hannah C Gerke
- Savannah River Ecology Laboratory, Warnell School of Forestry and Natural Resources, University of Georgia, Aiken, SC 29808, USA
| | - Sarah M Chinn
- Savannah River Ecology Laboratory, Warnell School of Forestry and Natural Resources, University of Georgia, Aiken, SC 29808, USA
| | - Donovan Anderson
- Symbiotic Systems Science and Technology, Fukushima University, Fukushima, Fukushima City, Kanayagawa 960-1248, Japan
| | - Mark L Laudenslager
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Tsugiko Takase
- Institute of Environmental Radioactivity, 1 Kanayagawa, Fukushima City, Fukushima 960-1296, Japan
| | - Yui Nemoto
- Fukushima Prefectural Centre for Environmental Creation, 2-10 Fukasaku, Miharu, Fukushima 963-7799, Japan
| | - Hiroko Ishiniwa
- Institute of Environmental Radioactivity, 1 Kanayagawa, Fukushima City, Fukushima 960-1296, Japan
| | - James C Beasley
- Savannah River Ecology Laboratory, Warnell School of Forestry and Natural Resources, University of Georgia, Aiken, SC 29808, USA
| | - Susan M Bailey
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO 80523-1618, USA
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6
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Natvig C, Mikulich-Gilbertson SK, Laudenslager ML, Bradley CJ. Association between employment status change and depression and anxiety in allogeneic stem cell transplant caregivers. J Cancer Surviv 2021; 16:1090-1095. [PMID: 34417708 DOI: 10.1007/s11764-021-01099-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 08/11/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Allogeneic hematopoietic stem cell transplantation (Allo-HSCT) is a demanding treatment that requires caregiver support during the first 100 days post-transplant. Little is known about the association between caregivers' employment changes and their well-being during this lengthy and challenging time when caregivers may be balancing work with caregiving responsibilities. METHODS We used data from employed caregivers of Allo-HSCT patients who participated in two randomized clinical trials (N = 187) of an intervention for caregivers. Caregiver depression and anxiety were assessed using the Center for Epidemiologic Studies Depression and the Spielberger State-Trait Anxiety Inventory. ANCOVA was used to measure the associations between reducing work with depression and anxiety. Caregiver's demographics and baseline employment status were controlled in the analysis along with the patient's transplant conditioning intensity. RESULTS Approximately 45% of caregivers reduced hours worked following the resumption of their caregiving duties. These caregivers, on average, had 3.49 points higher depression scores than caregivers who did not report a reduction in work (p < 0.01). Similarly, these caregivers also reported, on average, 3.56 higher anxiety scores (p < 0.10). CONCLUSIONS Caregivers who reduced hours worked while caregiving reported greater distress. The underlying cause of this distress deserves further investigation. IMPLICATIONS FOR CANCER SURVIVORS Caregivers of patients diagnosed with cancer may experience considerable stress related to work discontinuation and caregiving. Interventions are needed to support caregivers who are trying to balance work and caregiving responsibilities.
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Affiliation(s)
- Crystal Natvig
- Department of Psychiatry, School of Medicine, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA.
| | - Susan K Mikulich-Gilbertson
- Department of Psychiatry, School of Medicine, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA
| | - Mark L Laudenslager
- Department of Psychiatry, School of Medicine, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA
| | - Cathy J Bradley
- Department of Health Systems, Management, and Policy, School of Public Health, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA
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7
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Danyluck C, Blair IV, Manson SM, Laudenslager ML, Daugherty SL, Jiang L, Brondolo E. Older and Wiser? Age Moderates the Association Between Discrimination and Depressive Symptoms in American Indians and Alaska Natives. J Aging Health 2021; 33:10S-17S. [PMID: 34167343 PMCID: PMC9087640 DOI: 10.1177/08982643211013699] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Objectives: To examine age differences in the association between discrimination and depressive symptoms among urban American Indians and Alaska Natives (AI/AN). Methods: A sample of 303 urban AI/AN (18-78 years old) reported on lifetime and past-week experiences of racial discrimination and depressive symptoms. Depressive symptoms were regressed on racial discrimination, age, and their interaction, adjusting for demographic factors and other life stressors. Results: Lifetime and past-week discrimination were significantly associated with depressive symptoms, and these associations were stronger among younger than older adult AI/AN. Discussion: The results are consistent with prior reports in other populations, but this is the first such study to focus on AI/AN, and it highlights the importance of considering life course perspectives. Conclusions are limited by the cross-sectional nature of the data. Longitudinal and qualitative work is needed to understand why discrimination may have a stronger effect on mental health for younger than older AI/AN.
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Affiliation(s)
| | | | - Spero M. Manson
- University of Colorado Anschutz Medical Campus, Aurora, CO,
USA
| | | | | | - Luohua Jiang
- School of Medicine, University of California Irvine,
Irvine, CA, USA
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8
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Ravyts SG, Sannes TS, Dzierzewski JM, Zhou ES, Brewer BW, Natvig C, Laudenslager ML. Check your sleep before you start: A secondary analysis of a stress management intervention for caregivers of stem cell transplant patients. Psychooncology 2021; 30:936-945. [PMID: 33749066 DOI: 10.1002/pon.5680] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 02/26/2021] [Accepted: 03/08/2021] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Caregiving for hematopoietic stem cell transplant (HSCT) patients is associated with significant physical and psychological sequelae. While psychosocial interventions may reduce caregiver burden, knowledge regarding which caregivers may benefit the most from such interventions is limited. The purpose of this secondary analysis was to examine whether HSCT caregivers' peritransplant sleep moderated the effect of a psychosocial intervention on depression and anxiety posttransplant. METHODS Participants included 135 caregivers (mean age = 54.23) who participated in randomized controlled trial and were assigned to receive either 8 weeks of Psychoeducation, Paced Respiration, and Relaxation (PEPRR) or treatment as usual (TAU). Sleep, depression, and anxiety were assessed using the Pittsburg Sleep Quality Index, the Center for Epidemiologic Studies Depression Scale, and the State-Trait Anxiety Inventory, respectively. Caregiver symptoms were assessed at baseline (e.g., peritransplant period) and 6-month posttransplant. RESULTS Baseline sleep quality (∆R2 = 0.04, p = 0.002), sleep efficiency (∆R2 = 0.03, p = 0.02), and sleep onset latency (∆R2 = 0.07, p < 0.001) independently moderated the effect of group assignment on depression outcomes at the 6-month follow-up. Specifically, caregivers with poor sleep at baseline who received PEPRR reported significantly lower depression scores at follow-up compared to caregivers with poor sleep who received TAU. By contrast, only sleep quality (∆R2 = 0.02, p = 0.01) and sleep onset latency (∆R2 = 0.02, p = 0.005) moderated the effect of the group assignment on anxiety. CONCLUSIONS Psychosocial interventions for HSCT caregivers may buffer against psychological morbidity, particularly among caregivers with poor sleep quality.
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Affiliation(s)
- Scott G Ravyts
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Timothy S Sannes
- Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Department of Psychosocial Oncology and Palliative Care, Harvard Medical School, Boston, Massachusetts, USA
| | - Joseph M Dzierzewski
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Eric S Zhou
- Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Department of Psychosocial Oncology and Palliative Care, Harvard Medical School, Boston, Massachusetts, USA
| | - Benjamin W Brewer
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Crystal Natvig
- University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
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Blair IV, Danyluck C, Judd CM, Manson SM, Laudenslager ML, Daugherty SL, Ratliff EL, Gardner JA, Brondolo E. Validation of the Brief Perceived Ethnic Discrimination Questionnaire–Community Version in American Indians. ACTA ACUST UNITED AC 2021; 27:47-59. [DOI: 10.1037/cdp0000419] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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10
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Pensak NA, Carr AL, Jones J, Mikulich-Gilbertson SK, Kutner JS, Kilbourn K, Sannes TS, Brewer BB, Kolva E, Joshi T, Laudenslager ML. A pilot study of mobilized intervention to help caregivers of oncology patients manage distress. Psychooncology 2020; 30:520-528. [PMID: 33217070 DOI: 10.1002/pon.5597] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 11/02/2020] [Accepted: 11/09/2020] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Caregivers of patients with advanced cancer experience significant anxiety, depression, and distress. Caregivers have barriers to accessing in-person treatment to manage stress. Technology allows for the dissemination of evidence-based interventions in a convenient way. This study examined usage rates of Pep-Pal (an evidence-based mobilized intervention to help caregivers of patients with advanced cancer manage distress) and estimates of efficacy on anxiety, depression, stress, and sexual dysfunction. METHODS Fifty-six primary caregivers of patients with advanced cancer were recruited through oncology clinics and randomized to either Pep-Pal (a mobilized psychoeducation and skills-based intervention for caregivers, n = 26) or treatment as usual (TAU; n = 30). All were screened for moderate anxiety on the Hospital Anxiety and Depression Scale-Anxiety screening assessment (A ≥ 8) at baseline. RESULTS Participants randomized to Pep-Pal experienced greater reductions in perceived stress (PSS; F = 3.91, p = .05), greater increases in ability to learn and use stress management skills (F = 6.16, p = 0.01), and greater increases in sexual function (women only; F = 5.07, p = 0.03) compared to participants in TAU. Of Pep-Pal participants, only 10 (38.5%) watched at least 7/9 full-length sessions. The a priori hypothesis and criterion that participants would watch at least 75% full-length sessions were not met. CONCLUSIONS A brief, easily disseminated mobile intervention showed poor adherence, but had limited estimates of efficacy for secondary outcomes; perceived stress, learning stress management skills, and sexual functioning (women only). Future directions are discussed.
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Affiliation(s)
| | - Alaina L Carr
- University of Colorado-Denver, Denver, Colorado, USA
| | - Jacqueline Jones
- College of Nursing, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | | | - Jean S Kutner
- Division of General Internal Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | | | - Timothy S Sannes
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Benjamin B Brewer
- Division of Hematology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Elissa Kolva
- Division of Medical Oncology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Tanisha Joshi
- Division of Hematology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Mark L Laudenslager
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
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11
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Oaks BM, Adu-Afarwuah S, Kumordzie S, Laudenslager ML, Smith DL, Lin J, Young RR, Arnold CD, Bentil H, Okronipa H, Ocansey M, Dewey KG. Impact of a nutritional supplement during gestation and early childhood on child salivary cortisol, hair cortisol, and telomere length at 4-6 years of age: a follow-up of a randomized controlled trial. Stress 2020; 23:597-606. [PMID: 32063089 PMCID: PMC7497284 DOI: 10.1080/10253890.2020.1728528] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Dysregulation of the stress response can occur early in life and may be affected by nutrition. Our objective was to evaluate the long-term effect of nutritional supplementation during gestation and early childhood on child cortisol and buccal telomere length (a marker of cellular aging) at 4-6 years of age. We conducted a follow-up study of children born to women who participated in a nutritional supplementation trial in Ghana. In one group, a lipid-based nutrient supplement (LNS) was provided to women during gestation and the first 6 months postpartum and to their infants from age 6 to 18 months. The control groups received either iron and folic acid (IFA) during gestation or multiple micronutrients during gestation and the first 6 months postpartum, with no infant supplementation. At age 4-6 years, we measured hair cortisol, buccal telomere length, and salivary cortisol before and after a stressor. Salivary cortisol was available for 364 children across all three trial arms and hair cortisol and telomere length were available for a subset of children (n = 275 and 278, respectively) from the LNS and IFA groups. Telomere length, salivary cortisol, and hair cortisol did not differ by supplementation group. Overall, these findings suggest that nutritional supplementation given during gestation and early childhood does not have an effect on child stress response or chronic stress in children at 4-6 years. Trial registration: ClinicalTrials.gov Identifier NCT00970866.Lay SummaryThis study addressed a research gap about whether improved nutrition during pregnancy and early childhood impacts telomere length and cortisol in preschool children. There was no difference in child telomere length or cortisol between two trial arms of a nutritional supplementation trial that began during pregnancy. The research outcomes indicate lipid-based nutrient supplements, a relatively new form of supplementation, do not have an effect on markers of stress or cellular aging measured in later childhood.
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Affiliation(s)
- Brietta M Oaks
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI, USA
| | - Seth Adu-Afarwuah
- Department of Nutrition and Food Science, University of Ghana, Legon, Ghana
| | - Sika Kumordzie
- Department of Nutrition, University of California, Davis, CA, USA
| | - Mark L Laudenslager
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Dana L Smith
- Department of Biochemistry and Biophysics, University of California, San Francisco, CA, USA
| | - Jue Lin
- Department of Biochemistry and Biophysics, University of California, San Francisco, CA, USA
| | - Rebecca R Young
- Department of Nutrition, University of California, Davis, CA, USA
| | - Charles D Arnold
- Department of Nutrition, University of California, Davis, CA, USA
| | - Helena Bentil
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI, USA
| | - Harriet Okronipa
- Department of Nutrition, University of California, Davis, CA, USA
| | - Maku Ocansey
- Department of Nutrition, University of California, Davis, CA, USA
| | - Kathryn G Dewey
- Department of Nutrition, University of California, Davis, CA, USA
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12
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Lehrer HM, Goosby BJ, Dubois SK, Laudenslager ML, Steinhardt MA. Race moderates the association of perceived everyday discrimination and hair cortisol concentration. Stress 2020; 23:529-537. [PMID: 31888404 PMCID: PMC7769195 DOI: 10.1080/10253890.2019.1710487] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 12/19/2019] [Indexed: 12/22/2022] Open
Abstract
The influence of discrimination on hypothalamic-pituitary-adrenal (HPA) axis function is considered to be more pronounced for racial minority versus majority groups, although empirical support for this argument is not strong. This study examined whether the association of perceived discrimination was more strongly associated with long-term, retrospective cortisol output (as measured by hair cortisol concentration [HCC]) among African American compared to White adults. Participants included 141 community-dwelling adults (72 White, 69 African American; mean age 45.8 years; 67% females). The Everyday Discrimination Scale assessed perceived discrimination. The first 3 cm of proximal scalp hair was analyzed for HCC using enzyme-linked immunoassay. Associations between race, perceived discrimination and HCC were examined using hierarchical multiple regression. African Americans had higher HCC than Whites, but both groups reported perceived discrimination with similar frequency. Race moderated the association between perceived discrimination and HCC (R2 interaction = 0.03, p = 0.007) such that perceived discrimination was positively associated with HCC among African Americans (β = 0.28, p = 0.007), but not Whites (β = -0.11, p = 0.274). Perceived discrimination did not mediate the association between race and HCC (β for indirect effect = 0.025, 95% CI [-.003, 0.087]). Although perceived discrimination did not differ between races, perceived discrimination was positively associated with retrospective levels of cortisol in scalp hair among African Americans but not Whites. This may suggest that characteristics of discrimination other than frequency are particularly salient to HPA axis function among African Americans (e.g. attribution, severity, historical context).LAY SUMMARYThis study found that greater perceived discrimination frequency was associated with greater long-term cortisol secretion (i.e. hair cortisol concentration) among African American compared to White adults. Both groups reported similar discrimination frequency, so the uniqueness of African Americans' experience with discrimination may be salient to HPA axis upregulation for this population.
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Affiliation(s)
- H. Matthew Lehrer
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, USA
| | - Bridget J. Goosby
- Department of Sociology, The University of Texas at Austin, Austin, TX, USA
| | - Susan K. Dubois
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, USA
- Department of Internal Medicine, Dell Medical School, The University of Texas at Austin, Austin, TX, USA
| | - Mark L. Laudenslager
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Mary A. Steinhardt
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, USA
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13
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Lehrer HM, Steinhardt MA, Dubois SK, Laudenslager ML. Perceived stress, psychological resilience, hair cortisol concentration, and metabolic syndrome severity: A moderated mediation model. Psychoneuroendocrinology 2020; 113:104510. [PMID: 31911349 PMCID: PMC7769194 DOI: 10.1016/j.psyneuen.2019.104510] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Revised: 09/22/2019] [Accepted: 11/07/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND Psychological resilience is considered to protect against detrimental effects of perceived stress on cardiovascular and metabolic health, but few studies have tested biological mechanisms underlying these relationships. PURPOSE This study examined whether psychological resilience moderated the indirect association of perceived stress with Metabolic Syndrome (MetS) severity via hair cortisol concentration (HCC), a retrospective index of hypothalamic pituitary adrenal (HPA) axis activity. METHOD Participants included 228 adults (73 White, 86 Hispanic, 69 African American; mean age 45.29 years; 68% females). Participants completed questionnaires assessing perceived stress (Perceived Stress Scale) and resilience (Brief Resilience Scale). The first 3 cm of scalp-near hair were analyzed for cortisol concentration using enzyme-linked immunoassay analysis. Cardiometabolic risk factors including blood glucose, lipids, blood pressure, and waist circumference were assessed, from which a sex- and race/ethnicity-specific continuous MetS severity score was calculated. A moderated mediation model was tested using path analysis. RESULTS Psychological resilience moderated the association of perceived stress with HCC (R2 change for interaction = 0.014, p = 0.043), such that the association of perceived stress and HCC decreased as resilience scores increased. Resilience also moderated the indirect association of perceived stress with MetS severity via HCC (b = -0.039, 95% CI [-0.001; -0.100]), such that HCC mediated the association of greater perceived stress with greater MetS severity only for individuals reporting Brief Resilience Scale scores 3 or below (range: 1.17-5.00). Psychological resilience was also associated with lower MetS severity (β = -0.227, p = 0.014) independent of perceived stress and HCC. CONCLUSION Findings suggest that psychological resilience may serve as both a stress buffer and as a direct determinant of cardiometabolic health. These results extend literature on psychological resilience to measures of retrospective HPA axis function and MetS severity in a diverse sample.
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Affiliation(s)
- H. Matthew Lehrer
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, USA
| | - Mary A. Steinhardt
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, USA
| | - Susan K. Dubois
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, USA,Department of Internal Medicine, Dell Medical School, The University of Texas at Austin, Austin, TX, USA
| | - Mark L. Laudenslager
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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14
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Laudenslager ML, Simoneau TL, Mikulich-Gilbertson SK, Natvig C, Brewer BW, Sannes TS, Kilbourn K, Gutman J, McSweeney P. A randomized control trial of stress management for caregivers of stem cell transplant patients: Effect on patient quality of life and caregiver distress. Psychooncology 2019; 28:1614-1623. [PMID: 31127974 DOI: 10.1002/pon.5126] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 04/27/2019] [Accepted: 05/13/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Psychological interventions reduce caregiver distress (CG-distress). Less distress in caregivers may contribute to improved patient quality of life (QoL), but empirical evidence is lacking. Will a caregiver stress management intervention improve patient QoL? METHODS In this replication study, we randomized 155 allogeneic hematopoietic stem cell transplant (Allo-HSCT) patients and caregivers to PsychoEducation, Paced Respiration, and Relaxation (PEPRR) or enhanced treatment as usual (eTAU). We provided PEPRR over 3 months following transplant. Functional Assessment of Cancer Therapy-Bone Marrow Transplant (FACT-BMT) evaluated patient QoL, and CG-distress was based on depressive, anxious, and stress symptoms. Hierarchical linear models tested intervention, time, and interactions as fixed effects with participant as random effects. RESULTS Patients whose caregivers received PEPRR did not differ on FACT-BMT between baseline and 6 months (mean = +3.74; 95% CI, -3.54 to 11.02) compared with patients of caregivers in eTAU (mean = +3.16; 95% CI, -2.88 to 9.20) even though CG-distress was decreased by PEPRR (mean = -0.23; 95% CI, -0.448 to -0.010) compared with those receiving eTAU (mean = +0.27; 95% CI, 0.033-0.504) at 6 months. CONCLUSIONS PEPRR reduced CG-distress without affecting their patient's FACT-BMT score. The FACT-BMT may not have distinguished unique psychological changes associated with their caregiver receiving PEPRR.
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Affiliation(s)
- Mark L Laudenslager
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Teresa L Simoneau
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | | | - Crystal Natvig
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Benjamin W Brewer
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Timothy S Sannes
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Kristin Kilbourn
- Department of Psychology, University of Colorado Denver, Denver, Colorado
| | - Jon Gutman
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, Colorado
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15
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Radin RM, Mason AE, Laudenslager ML, Epel ES. Maternal caregivers have confluence of altered cortisol, high reward-driven eating, and worse metabolic health. PLoS One 2019; 14:e0216541. [PMID: 31075126 PMCID: PMC6510426 DOI: 10.1371/journal.pone.0216541] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 04/23/2019] [Indexed: 01/01/2023] Open
Abstract
Animal models have shown that chronic stress increases cortisol, which contributes to overeating of highly palatable food, increased abdominal fat and lower cortisol reactivity. Few studies in humans have simultaneously examined these trajectories. We examined premenopausal women, either mothers of children with a diagnosis of an autism spectrum disorder (n = 92) or mothers of neurotypical children (n = 91). At baseline and 2-years, we assessed hair cortisol, metabolic health, and reward-based eating. We compared groups cross-sectionally and prospectively, accounting for BMI change. Caregivers, relative to controls, had lower cumulative hair cortisol at each time point, with no decreases over time. Caregivers also had stable levels of poor metabolic functioning and greater reward-based eating across both time points, and evidenced increased abdominal fat prospectively (all ps ≤.05), independent of change in BMI. This pattern of findings suggest that individuals under chronic stress, such as caregivers, would benefit from tailored interventions focusing on better regulation of stress and eating in tandem to prevent early onset of metabolic disease, regardless of weight status.
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Affiliation(s)
- Rachel M. Radin
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, United States of America
- Osher Center for Integrative Medicine, University of California, San Francisco, San Francisco, CA, United States of America
- * E-mail:
| | - Ashley E. Mason
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, United States of America
- Osher Center for Integrative Medicine, University of California, San Francisco, San Francisco, CA, United States of America
| | - Mark L. Laudenslager
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, United States of America
| | - Elissa S. Epel
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, United States of America
- Osher Center for Integrative Medicine, University of California, San Francisco, San Francisco, CA, United States of America
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16
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Carr AL, Jones J, Mikulich Gilbertson S, Laudenslager ML, Kutner JS, Kilbourn K, Sannes TS, Brewer BW, Kolva E, Joshi T, Amoyal Pensak N. Impact of a Mobilized Stress Management Program (Pep-Pal) for Caregivers of Oncology Patients: Mixed-Methods Study. JMIR Cancer 2019; 5:e11406. [PMID: 31066678 PMCID: PMC6524452 DOI: 10.2196/11406] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 10/02/2018] [Accepted: 12/29/2018] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Caregivers of patients with advanced diseases are known to have high levels of distress, including depression and anxiety. Recent research has focused on recognizing caregivers in need of psychosocial support to help them manage their distress. Evidenced-based technological interventions have the potential to aid caregivers in managing distress. OBJECTIVE The objective of our study was to describe caregiver perceptions of the usability and acceptability, and their suggestions for future adaptations, of a mobilized psychoeducation and skills-based intervention. METHODS This study was a part of a larger trial of a mobilized psychoeducation and skills-based intervention (Psychoeducation and Skills-Based Mobilized Intervention [Pep-Pal]) for caregivers of patients with advanced illness. This substudy used a mixed-methods analysis of quantitative data from all 26 intervention participants and qualitative data from 14 intervention caregivers who completed the Pep-Pal intervention. The qualitative semistructured individual interviews, which we conducted within the first 4 weeks after participants completed the intervention, assessed the acceptability and usability of Pep-Pal. Additionally, the qualitative interviews provided contextual evidence of how the intervention was helpful to interviewees in unanticipated ways. We conducted applied thematic analysis via independent review of transcripts to extract salient themes. RESULTS Overall, caregivers of patients with advanced cancer deemed Pep-Pal to be acceptable in all Web-based sessions except for Improving Intimacy. Caregivers perceived the program to be of use across the areas they needed and in others that they had not anticipated. Caregiver recommendations of key changes for the program were to include more variety in caregiver actors in sessions, change the title of Improving Intimacy to Improving Relationships, provide an audio-only option in addition to video, and change the format of the mobilized website program to a stand-alone mobile app. CONCLUSIONS The valuable feedback in key areas from individual interviews will be integrated into the final version of Pep-Pal that will be tested in a fully powered randomized clinical trial. TRIAL REGISTRATION ClinicalTrials.gov NCT03002896; https://clinicaltrials.gov/ct2/show/NCT03002896 (Archived by WebCite at http://www.webcitation.org/76eThwaei).
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Affiliation(s)
- Alaina L Carr
- Department of Psychology, University of Colorado-Denver, Denver, CO, United States
| | - Jacqueline Jones
- College of Nursing, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | | | - Mark L Laudenslager
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Jean S Kutner
- Division of General Internal Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, United States
| | - Kristin Kilbourn
- Department of Psychology, University of Colorado-Denver, Denver, CO, United States
| | - Timothy S Sannes
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Benjamin W Brewer
- Division of Hematology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Elissa Kolva
- Division of Medical Oncology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Tanisha Joshi
- Division of Hematology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Nicole Amoyal Pensak
- Jersey Shore University Medical Center, Hackensack Meridian Health, Neptune, NJ, United States.,Georgetown University Medical Center, Washington, DC, United States
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17
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Rooney BV, Crucian BE, Pierson DL, Laudenslager ML, Mehta SK. Herpes Virus Reactivation in Astronauts During Spaceflight and Its Application on Earth. Front Microbiol 2019; 10:16. [PMID: 30792698 PMCID: PMC6374706 DOI: 10.3389/fmicb.2019.00016] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 01/09/2019] [Indexed: 12/30/2022] Open
Abstract
Latent herpes virus reactivation has been demonstrated in astronauts during shuttle (10–16 days) and International Space Station (≥180 days) flights. Following reactivation, viruses are shed in the body fluids of astronauts. Typically, shedding of viral DNA is asymptomatic in astronauts regardless of mission duration; however, in some cases, live/infectious virus was recovered by tissue culture that was associated with atopic-dermatitis or skin lesions during and after spaceflight. Hypothalamic-pituitary-adrenal (HPA) and sympathetic-adrenal-medullary (SAM) axes activation during spaceflight occurs as indicated by increased levels of stress hormones including cortisol, dehydroepiandrosterone, epinephrine, and norepinephrine. These changes, along with a decreased cell mediated immunity, contribute to the reactivation of latent herpes viruses in astronauts. Currently, 47/89 (53%) astronauts from shuttle-flights and 14/23 (61%) astronauts from ISS missions shed one or more herpes viruses in saliva/urine samples. Astronauts shed Epstein–Barr virus (EBV), varicella-zoster virus (VZV), and herpes-simplex-1 (HSV-1) in saliva and cytomegalovirus (CMV) in urine. Larger quantities and increased frequencies for these viruses were found during spaceflight as compared to before or after flight samples and their matched healthy controls. The shedding did not abate during the longer ISS missions, but rather increased in frequency and amplitude. These findings coincided with the immune system dysregulation observed in astronauts from shuttle and ISS missions. VZV shedding increased from 41% in space shuttle to 65% in ISS missions, EBV increased 82 to 96%, and CMV increased 47 to 61%. In addition, VZV/CMV shed ≤30 days after ISS in contrast to shuttle where VZV/CMV shed up to 5 and 3 days after flight respectively. Continued shedding of infectious-virus post-flight may pose a potential risk for crew who may encounter newborn infants, sero-negative adults or any immunocompromised individuals on Earth. Therefore, developing spaceflight countermeasures to prevent viral reactivation is essential. Our spaceflight-developed technologies for saliva collection/rapid viral detection have been extended to include clinical applications including zoster patients, chicken pox, post-herpetic neuralgia, multiple sclerosis, and various neurological disorders. These protocols are employed in various clinics and hospitals including the CDC and Columbia University in New York, as well as overseas in Switzerland and Israel.
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Affiliation(s)
| | | | | | - Mark L Laudenslager
- Anschutz Medical Campus, University of Colorado Denver, Aurora, CO, United States
| | - Satish K Mehta
- Jes Tech, KBR Wyle Laboratories Houston, Houston, TX, United States
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18
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Sannes TS, Simoneau TL, Mikulich-Gilbertson SK, Natvig CL, Brewer BW, Kilbourn K, Laudenslager ML. Distress and quality of life in patient and caregiver dyads facing stem cell transplant: identifying overlap and unique contributions. Support Care Cancer 2018; 27:2329-2337. [PMID: 30353229 DOI: 10.1007/s00520-018-4496-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 10/03/2018] [Indexed: 12/11/2022]
Abstract
PURPOSE Allogeneic hematopoietic stem cell transplantation (Allo-HSCT) is a demanding treatment requiring caregiver support. The pre-transplant period is particularly stressful. How patient and caregiver dyads respond to these stressors can impact post-transplant outcomes. The purpose of this cross-sectional study was to assess pre-transplant patient and caregiver distress, patient quality of life (pQoL), and simultaneously investigate relationship between caregiver distress, patient distress, and patient QoL. METHODS We measured caregiver anxiety, depressive symptoms, perceived stress, sleep quality, caregiver burden, and pQoL in148 dyads compared to clinical thresholds or population norms. To reduce comparisons, we created a composite distress score from affective measures. Associations within dyads were examined via correlation and path analysis. RESULTS Most dyads scored above norms for psychological measures. Patient distress was positively associated with caregiver distress. Higher caregiver distress significantly predicted poorer pQoL after accounting for the interdependence of patient and caregiver distress. Specifically, patients' physical functioning was the primary driver of this interrelationship. CONCLUSIONS Allo-HSCT patients and their caregivers reported elevated distress pre-transplant. Both patient and caregiver distress contributed to pQoL, with patients' physical functioning accounting significantly for caregiver well-being. Supporting the patient-caregiver dyad before transplantation is a priority for supportive services.
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Affiliation(s)
- Timothy S Sannes
- University of Colorado Anschutz Medical Campus, Blood Cancer and Bone Marrow Transplant Program, Aurora, CO, USA.
| | | | | | - Crystal L Natvig
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Benjamin W Brewer
- University of Colorado Anschutz Medical Campus, Blood Cancer and Bone Marrow Transplant Program, Aurora, CO, USA
| | - Kristin Kilbourn
- Department of Psychology, University of Colorado Denver, Denver, CO, USA
| | - Mark L Laudenslager
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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19
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Frank GKW, DeGuzman MC, Shott ME, Laudenslager ML, Rossi B, Pryor T. Association of Brain Reward Learning Response With Harm Avoidance, Weight Gain, and Hypothalamic Effective Connectivity in Adolescent Anorexia Nervosa. JAMA Psychiatry 2018; 75:1071-1080. [PMID: 30027213 PMCID: PMC6233809 DOI: 10.1001/jamapsychiatry.2018.2151] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
IMPORTANCE Anorexia nervosa (AN) is associated with adolescent onset, severe low body weight, and high mortality as well as high harm avoidance. The brain reward system could have an important role in the perplexing drive for thinness and food avoidance in AN. OBJECTIVE To test whether brain reward learning response to taste in adolescent AN is altered and associated with treatment response, striatal-hypothalamic connectivity, and elevated harm avoidance. DESIGN, SETTING, AND PARTICIPANTS In this cross-sectional multimodal brain imaging study, adolescents and young adults with AN were matched with healthy controls at a university brain imaging facility and eating disorder treatment program. During a sucrose taste classical conditioning paradigm, violations of learned associations between conditioned visual and unconditioned taste stimuli evoked the dopamine-related prediction error (PE). Dynamic effective connectivity during sweet taste receipt was studied to investigate hierarchical brain activation across the brain network that regulates eating. The study was conducted from July 2012 to May 2017, and data were analyzed from June 2017 to December 2017. MAIN OUTCOMES AND MEASURES Prediction error brain reward response across the insula, caudate, and orbitofrontal cortex; dynamic effective connectivity between hypothalamus and ventral striatum; and treatment weight gain, harm avoidance scores, and salivary cortisol levels and their correlations with PE brain response. RESULTS Of 56 female participants with AN included in the study, the mean (SD) age was 16.6 (2.5) years, and the mean (SD) body mass index (BMI; calculated as weight in kilograms divided by height in meters squared) was 15.9 (0.9); of 52 matched female controls, the mean (SD) age was 16.0 (2.8) years, and the mean (SD) BMI was 20.9 (2.1). Prediction error response was elevated in participants with AN in the caudate head, nucleus accumbens, and insula (multivariate analysis of covariance: Wilks λ, 0.707; P = .02; partial η2 = 0.296), which correlated negatively with sucrose taste pleasantness. Bilateral AN orbitofrontal gyrus rectus PE response was positively correlated with harm avoidance (right ρ, 0.317; 95% CI, 0.091 to 0.539; P < .02; left ρ, 0.336; 95% CI, 0.112 to 0.550; P < .01) but negatively correlated with treatment BMI change (right ρ, -0.282; 95% CI, -0.534 to -0.014; P < .04; left ρ, -0.268; 95% CI, -0.509 to -0.018; P < .045). Participants with AN showed effective connectivity from ventral striatum to hypothalamus, and connectivity strength was positively correlated with insula and orbitofrontal PE response. Right frontal cortex PE response was associated with cortisol, which correlated with body dissatisfaction. CONCLUSIONS AND RELEVANCE These results further support elevated PE signal in AN and suggest a link between PE and elevated harm avoidance, brain connectivity, and weight gain in AN. Prediction error may have a central role in adolescent AN in driving anxiety and ventral striatal-hypothalamus circuit-controlled food avoidance.
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Affiliation(s)
- Guido K. W. Frank
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, School of Medicine, Aurora,Neuroscience Program, University of Colorado Anschutz Medical Campus, Aurora
| | - Marisa C. DeGuzman
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, School of Medicine, Aurora,Neuroscience Program, University of Colorado Anschutz Medical Campus, Aurora
| | - Megan E. Shott
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, School of Medicine, Aurora
| | - Mark L. Laudenslager
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, School of Medicine, Aurora
| | - Brogan Rossi
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, School of Medicine, Aurora
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20
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Wright KD, Ford JL, Perazzo J, Jones LM, Mahari S, Sullenbarger BA, Laudenslager ML. Collecting Hair Samples for Hair Cortisol Analysis in African Americans. J Vis Exp 2018. [PMID: 29939172 DOI: 10.3791/57288] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
The hormone cortisol is typically assessed in saliva, serum, or urine samples. More recently, cortisol has been successfully extracted from hair, including humans. The advantage of hair cortisol concentration is that it reflects a retrospective representation of hypothalamic-pituitary-adrenal (HPA) axis function over time, much like hemoglobin A1C represents glycemic control. However, obtaining hair samples can be challenging, due to the cultural beliefs and hair care practices of minority participants. For example, African Americans may be reluctant to provide samples. Additionally, few researchers are trained to collect hair samples from African Americans. The purpose of this paper is to present a culturally informed protocol to help researchers obtain hair samples from African Americans. To illustrate the representative results of this protocol implementation, de-identified data from African Americans that participated in a community-based study on chronic stress are provided. Hair practice preferences are assessed. The participants are made comfortable by showing pictures of hair samples prior to cutting their hair. The single strain twist and gently pull method is used to collect approximately 30 - 50 strands of hair from the posterior vertex region of the scalp. This protocol will significantly improve collection of hair samples from African Americans.
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Affiliation(s)
| | - Jodi L Ford
- College of Nursing, The Ohio State University
| | | | | | | | - Brent A Sullenbarger
- Clinical Research Manager, The Ohio State University; Biomedical Core Research Coordinator, The Ohio State University; College of Nursing Biomedical Core Research Laboratory, The Ohio State University
| | - Mark L Laudenslager
- Department of Psychiatry, Behavioral Immunology & Endocrinology Laboratory, University of Colorado Denver Anschutz Medical Campus
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Goldman SE, Alder ML, Burgess HJ, Corbett BA, Hundley R, Wofford D, Fawkes DB, Wang L, Laudenslager ML, Malow BA. Characterizing Sleep in Adolescents and Adults with Autism Spectrum Disorders. J Autism Dev Disord 2017; 47:1682-1695. [PMID: 28286917 DOI: 10.1007/s10803-017-3089-1] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
We studied 28 adolescents/young adults with autism spectrum disorders (ASD) and 13 age/sex matched individuals of typical development (TD). Structured sleep histories, validated questionnaires, actigraphy (4 weeks), and salivary cortisol and melatonin (4 days each) were collected. Compared to those with TD, adolescents/young adults with ASD had longer sleep latencies and more difficulty going to bed and falling asleep. Morning cortisol, evening cortisol, and the morning-evening difference in cortisol did not differ by diagnosis (ASD vs. TD). Dim light melatonin onsets (DLMOs) averaged across participants were not different for the ASD and TD participants. Average participant scores indicated aspects of poor sleep hygiene in both groups. Insomnia in ASD is multifactorial and not solely related to physiological factors.
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Affiliation(s)
- S E Goldman
- Sleep Disorders Division, Department of Neurology, Vanderbilt University School of Medicine, 1161 21st Avenue South, Room A-0116, Nashville, TN, 37232-2551, USA
| | - M L Alder
- Sleep Disorders Division, Department of Neurology, Vanderbilt University School of Medicine, 1161 21st Avenue South, Room A-0116, Nashville, TN, 37232-2551, USA
| | - H J Burgess
- Departments of Behavioral Sciences & Internal Medicine, Rush University Medical Center, Chicago, USA
| | - B A Corbett
- Department of Psychiatry and Kennedy Center, Vanderbilt University School of Medicine, Nashville, USA
| | - R Hundley
- Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, USA
| | - D Wofford
- Sleep Disorders Division, Department of Neurology, Vanderbilt University School of Medicine, 1161 21st Avenue South, Room A-0116, Nashville, TN, 37232-2551, USA
| | - D B Fawkes
- Sleep Disorders Division, Department of Neurology, Vanderbilt University School of Medicine, 1161 21st Avenue South, Room A-0116, Nashville, TN, 37232-2551, USA
| | - L Wang
- Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, USA
| | - M L Laudenslager
- Behavioral Immunology and Endocrinology Laboratory, Department of Psychiatry, University of Colorado Anschutz Medical Campus, Denver, CO, USA
| | - B A Malow
- Sleep Disorders Division, Department of Neurology, Vanderbilt University School of Medicine, 1161 21st Avenue South, Room A-0116, Nashville, TN, 37232-2551, USA.
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Pensak NA, Joshi T, Simoneau T, Kilbourn K, Carr A, Kutner J, Laudenslager ML. Correction of: Development of a Web-Based Intervention for Addressing Distress in Caregivers of Patients Receiving Stem Cell Transplants: Formative Evaluation With Qualitative Interviews and Focus Groups. JMIR Res Protoc 2017; 6:e130. [PMID: 30578231 PMCID: PMC6305070 DOI: 10.2196/resprot.8322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 06/30/2017] [Indexed: 11/21/2022] Open
Affiliation(s)
- Nicole Amoyal Pensak
- Hackensack University Medical Center, Department of Research, Cancer Prevention and Control, John Theurer Cancer Center, Hackensack, NJ, United States
| | - Tanisha Joshi
- University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Teresa Simoneau
- VA Eastern Colorado Healthcare System, Golden, CO, United States
| | | | - Alaina Carr
- University of Colorado-Denver, Denver, CO, United States
| | - Jean Kutner
- University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Mark L Laudenslager
- University of Colorado Anschutz Medical Campus, Department of Psychiatry, Aurora, CO, United States
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Pensak NA, Joshi T, Simoneau T, Kilbourn K, Carr A, Kutner J, Laudenslager ML. Development of a Web-Based Intervention for Addressing Distress in Caregivers of Patients Receiving Stem Cell Transplants: Formative Evaluation With Qualitative Interviews and Focus Groups. JMIR Res Protoc 2017. [PMID: 28642213 PMCID: PMC5500777 DOI: 10.2196/resprot.7075] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background Caregivers of cancer patients experience significant burden and distress including depression and anxiety. We previously demonstrated the efficacy of an eight session, in-person, one-on-one stress management intervention to reduce distress in caregivers of patients receiving allogeneic hematopoietic stem cell transplants (allo-HSCT). Objective The objective of this study was to adapt and enhance the in-person caregiver stress management intervention to a mobilized website (eg, tablet, smartphone, or computer-based) for self-delivery in order to enhance dissemination to caregiver populations most in need. Methods We used an established approach for development of a mhealth intervention, completing the first two research and evaluation steps: Step One: Formative Research (eg, expert and stakeholder review from patients, caregivers, and palliative care experts) and Step Two: Pretesting (eg, Focus Groups and Individual Interviews with caregivers of patients with autologous HSCT (auto-HSCT). Step one included feedback elicited for a mock-up version of Pep-Pal session one from caregiver, patients and clinician stakeholders from a multidisciplinary palliative care team (N=9 caregivers and patient stakeholders and N=20 palliative care experts). Step two included two focus groups (N=6 caregivers) and individual interviews (N=9 caregivers) regarding Pep-Pal’s look and feel, content, acceptability, and potential usability/feasibility. Focus groups and individual interviews were audio-recorded. In addition, individual interviews were transcribed, and applied thematic analysis was conducted in order to gain an in-depth understanding to inform the development and refinement of the mobilized caregiver stress management intervention, Pep-Pal (PsychoEducation and skills for Patient caregivers). Results Overall, results were favorable. Pep-Pal was deemed acceptable for caregivers of patients receiving an auto-HSCT. The refined Pep-Pal program consisted of 9 sessions (Introduction to Stress, Stress and the Mind Body Connection, How Thoughts Can Lead to Stress, Coping with Stress, Strategies for Maintaining Energy and Stamina, Coping with Uncertainty, Managing Changing Relationships and Communicating Needs, Getting the Support You Need, and Improving Intimacy) delivered via video instruction through a mobilized website. Conclusions Feedback from stakeholder groups, focus groups, and individual interviews provided valuable feedback in key areas that was integrated into the development of Pep-Pal with the goal of enhancing dissemination, engagement, acceptability, and usability.
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Affiliation(s)
- Nicole Amoyal Pensak
- Hackensack University Medical Center, Department of Research, Cancer Prevention and Control, John Theurer Cancer Center, Hackensack, NJ, United States
| | - Tanisha Joshi
- University of Colorado Anschutz Medical Campus, Department of Medicine, Aurora, CO, United States
| | - Teresa Simoneau
- VA Eastern Colorado Healthcare System, Golden, CO, United States
| | | | - Alaina Carr
- University of Colorado-Denver, Denver, CO, United States
| | - Jean Kutner
- University of Colorado Anschutz Medical Campus, Department of Medicine, Aurora, CO, United States
| | - Mark L Laudenslager
- University of Colorado Anschutz Medical Campus, Department of Psychiatry, Aurora, CO, United States
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Mehta SK, Laudenslager ML, Stowe RP, Crucian BE, Feiveson AH, Sams CF, Pierson DL. Latent virus reactivation in astronauts on the international space station. NPJ Microgravity 2017. [PMID: 28649633 PMCID: PMC5445581 DOI: 10.1038/s41526-017-0015-y] [Citation(s) in RCA: 85] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Reactivation of latent herpes viruses was measured in 23 astronauts (18 male and 5 female) before, during, and after long-duration (up to 180 days) spaceflight onboard the international space station . Twenty age-matched and sex-matched healthy ground-based subjects were included as a control group. Blood, urine, and saliva samples were collected before, during, and after spaceflight. Saliva was analyzed for Epstein-Barr virus, varicella-zoster virus, and herpes simplex virus type 1. Urine was analyzed for cytomegalovirus. One astronaut did not shed any targeted virus in samples collected during the three mission phases. Shedding of Epstein-Barr virus, varicella-zoster virus, and cytomegalovirus was detected in 8 of the 23 astronauts. These viruses reactivated independently of each other. Reactivation of Epstein-Barr virus, varicella-zoster virus, and cytomegalovirus increased in frequency, duration, and amplitude (viral copy numbers) when compared to short duration (10 to 16 days) space shuttle missions. No evidence of reactivation of herpes simplex virus type 1, herpes simplex virus type 2, or human herpes virus 6 was found. The mean diurnal trajectory of salivary cortisol changed significantly during flight as compared to before flight (P = 0.010). There was no statistically significant difference in levels of plasma cortisol or dehydoepiandosterone concentrations among time points before, during, and after flight for these international space station crew members, although observed cortisol levels were lower at the mid and late-flight time points. The data confirm that astronauts undertaking long-duration spaceflight experience both increased latent viral reactivation and changes in diurnal trajectory of salivary cortisol concentrations.
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Affiliation(s)
- Satish K Mehta
- Jestech, Johnson Space Center, NASA, Houston, TX 77058 USA
| | - Mark L Laudenslager
- University of Colorado Denver, Anschutz Medical Campus, 12700 E. 19th Ave, Aurora, CO 80045 USA
| | - Raymond P Stowe
- Microgen Laboratories, 903 Texas Ave, La Marque, TX 77568 USA
| | - Brian E Crucian
- NASA Johnson Space Center, Mail code SK, 2101 NASA Parkway, Houston, TX 77058 USA
| | - Alan H Feiveson
- NASA Johnson Space Center, Mail code SK, 2101 NASA Parkway, Houston, TX 77058 USA
| | - Clarence F Sams
- NASA Johnson Space Center, Mail code SK, 2101 NASA Parkway, Houston, TX 77058 USA
| | - Duane L Pierson
- NASA Johnson Space Center, Mail code SK, 2101 NASA Parkway, Houston, TX 77058 USA
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Simoneau TL, Kilbourn K, Spradley J, Laudenslager ML. An evidence-based stress management intervention for allogeneic hematopoietic stem cell transplant caregivers: development, feasibility and acceptability. Support Care Cancer 2017; 25:2515-2523. [PMID: 28283805 DOI: 10.1007/s00520-017-3660-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 03/06/2017] [Indexed: 01/05/2023]
Abstract
PURPOSE Caregivers of cancer patients face challenges impacting their physical, psychological and social well-being that need attention in the form of well-designed and tested interventions. We created an eight-session individual stress management intervention for caregivers of allogeneic hematopoietic stem cell transplant (Allo-HSCT) recipients. This intervention, tested by randomized control trial, proved effective in decreasing distress. Herein, we describe the intervention including theoretical framework, development, and elements of fidelity. Implementation challenges along with recommendations for refinement in future studies are discussed with the goal of replication and dissemination. METHODS Seventy-four of 148 caregivers received stress management training following randomization. The intervention occurred during the 100-day post-transplant period when caregivers are required. The training provided integrated cognitive behavioral strategies, psychoeducation, and problem-solving skills building as well as use of a biofeedback device. RESULTS Seventy percent of caregivers completed all eight sessions indicating good acceptability for the in-person intervention; however, most caregivers did not reliably use the biofeedback device. The most common reason for drop-out was their patient becoming gravely ill or patient death. Few caregivers dropped out because of study demands. The need for flexibility in providing intervention sessions was key to retention. CONCLUSION Our evidence-based stress management intervention for Allo-HSCT caregivers was feasible. Variability in acceptability and challenges in implementation are discussed and suggestions for refinement of the intervention are outlined. Dissemination efforts could improve by using alternative methods for providing caregiver support such as telephone or video chat to accommodate caregivers who are unable to attend in-person sessions.
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Affiliation(s)
- Teresa L Simoneau
- VA Eastern Colorado Healthcare System, 1020 Johnson Rd., Golden, CO, 80401, USA.
| | - Kristin Kilbourn
- Department of Psychology, University of Colorado Denver, Denver, CO, USA
| | - Janet Spradley
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Mark L Laudenslager
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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Melhem NM, Munroe S, Marsland A, Gray K, Brent D, Porta G, Douaihy A, Laudenslager ML, DiPietro F, Diler R, Driscoll H, Gopalan P. Blunted HPA axis activity prior to suicide attempt and increased inflammation in attempters. Psychoneuroendocrinology 2017; 77:284-294. [PMID: 28135675 PMCID: PMC5336407 DOI: 10.1016/j.psyneuen.2017.01.001] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 11/15/2016] [Accepted: 01/03/2017] [Indexed: 11/25/2022]
Abstract
BACKGROUND Hypothalamic-Pituitary-Adrenal (HPA) axis dysregulation is associated with increased risk for suicidal behavior. However, it is not clear whether such dysregulation exists prior to or is a consequence of attempt. Studies also show an activation of inflammatory responses in suicidal behavior but often combine attempters with those with ideation. METHODS The sample consisted of psychiatric inpatients, aged 15-30 years, admitted for suicide attempt (SA, n=38), inpatients admitted for suicidal ideation with no prior history of attempts (SI, n=40), and healthy controls (n=37). We compared SA, SI, and controls on hair cortisol concentrations (HCC), which provides retrospective levels of cortisol and thus prior to the attempt in SA. We also compared them on the expression of genes in the HPA axis and inflammatory pathways previously implicated in suicidal behavior (GR or NR3C1, SKA2, FKBP5, IL-1β, TNF-α); plasma C-Reactive Protein (CRP); and cellular measures of glucocorticoid receptor (GR) sensitivity and stimulated production of IL-6. RESULTS We found lower HCC [β=-0.55, 95% CI (-0.96, -0.13), p=0.01, ES=-0.54] in first-time SA compared to SI and controls. In addition, SA showed lower GR or NR3C1 (α isoform) mRNA [β=-5.11, 95% CI (-10.9, 0.73), p=0.09, ES=-0.46], higher CRP [β=0.94, 95% CI (-0.004, 1.9), p=0.05, ES=0.60], and higher TNF-α mRNA [β=26.4, 95% CI (7.7, 45.2), p=0.006, ES=0.73]. CONCLUSIONS This is the first study to differentiate youth who attempt suicide from those with suicidal ideation on HCC and to show that low HCC precedes suicide attempt. Suicide attempters also showed a distinct biological profile on several markers in both the HPA axis and inflammatory pathways. Future longitudinal studies are needed to examine the ability of these biomarkers to predict suicidal behavior.
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Affiliation(s)
- Nadine M. Melhem
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Sara Munroe
- University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Anna Marsland
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Katarina Gray
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - David Brent
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Giovanna Porta
- University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Antoine Douaihy
- University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Mark L. Laudenslager
- Department of Pscyhiatry, University of Colorado Denver Anschutz Medical Campus, Denver, Colorado, USA
| | - Frank DiPietro
- University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Rasim Diler
- University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Henry Driscoll
- University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Priya Gopalan
- University of Pittsburgh Medical Center, Pittsburgh, PA, USA
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Lehrer HM, Dubois SK, Maslowsky J, Laudenslager ML, Steinhardt MA. Hair cortisol concentration and glycated hemoglobin in African American adults. Psychoneuroendocrinology 2016; 72:212-8. [PMID: 27500952 DOI: 10.1016/j.psyneuen.2016.06.018] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 06/27/2016] [Accepted: 06/28/2016] [Indexed: 01/26/2023]
Abstract
BACKGROUND African Americans have higher diabetes prevalence compared to Whites. They also have elevated cortisol levels - indicating possible HPA axis dysregulation - which may raise blood glucose as part of the biological response to physiological and psychosocial stress. Little is known about chronic cortisol levels in African Americans, and even less about the role of chronically elevated cortisol in type 2 diabetes development in this racial group. PURPOSE We used analysis of cortisol in hair to examine associations of long-term (∼3months) cortisol levels with glycated hemoglobin (HbA1c) in a group of African American adults. In exploratory analyses, we also studied the relationship of hair dehydroepiandrosterone (DHEA) with HbA1c. METHOD Participants were 61 community-dwelling African American adults (85% female; mean age 54.30 years). The first 3cm of scalp-near hair were analyzed for cortisol and DHEA concentration using enzyme-linked immunoassay analysis. Glycated hemoglobin was assessed, and regression analyses predicting HbA1c from hair cortisol and DHEA were performed in the full sample and in a subsample of participants (n=20) meeting the National Institute of Diabetes and Digestive Kidney Disease (NIDDK) criteria for type 2 diabetes (HbA1c≥6.5%). RESULTS In the full sample, HbA1c increased with hair cortisol level (β=0.22, p=0.04, f(2)=0.10), independent of age, sex, chronic health conditions, diabetes medication use, exercise, and depressive symptoms. In the subsample of participants with an HbA1c≥6.5%, hair cortisol was also positively related to HbA1c (β=0.45, p=0.04, f(2)=0.32), independent of diabetes medication use. Glycated hemoglobin was unrelated to hair DHEA in both the full sample and HbA1c≥6.5% subsample. CONCLUSION Long-term HPA axis dysregulation in the form of elevated hair cortisol is associated with elevated HbA1c in African American adults.
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Affiliation(s)
- H Matthew Lehrer
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, USA
| | - Susan K Dubois
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, USA
| | - Julie Maslowsky
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, USA
| | - Mark L Laudenslager
- Department of Psychiatry, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA
| | - Mary A Steinhardt
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, USA.
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Hoffman MC, D'Anna-Hernandez K, Benitez P, Ross RG, Laudenslager ML. Cortisol during human fetal life: Characterization of a method for processing small quantities of newborn hair from 26 to 42 weeks gestation. Dev Psychobiol 2016; 59:123-127. [PMID: 27255609 DOI: 10.1002/dev.21433] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2015] [Accepted: 05/10/2016] [Indexed: 01/24/2023]
Abstract
OBJECTIVE Fetal cortisol may be reflected in hair collected shortly after birth. The objective of this study was to determine the range of human fetal hair cortisol concentrations (HCC) in live-born neonates using an approach for processing small quantities of hair. MATERIALS AND METHODS Hair was cut on the day of birth from neonates and their mothers, born between 26 and 42 weeks gestational age (GA). HCC was determined by enzyme immunoassay. Maternal sociodemographics and birth data were collected. T-tests, ANOVA, Pearson correlation, and Wilcoxon Signed Rank test were used as appropriate. RESULTS Ninety maternal and neonatal hair samples were cut from 79 term (T) and 11 preterm (PT) delivered pregnancies. All samples weighed ≥2.5 mg. Fetal HCC correlated with GA (r = .25, p = .02) and birth weight (r = .25, p = .03) and was lower in PT (4.3 ± .3 LN pg/mg) than T (5.3 ± .1, LN pg/mg, p < .001) neonates. No significant relationships were seen between fetal HCC and maternal characteristics or maternal HCC. Fetal HCC was significantly higher than maternal HCC. CONCLUSION Fetal cortisol exposure was determined using this approach for processing small amounts of hair. Preterm neonates have significantly lower HCC than term neonates and fetal HCC is associated with GA at delivery and birth weight. Fetal HCC is significantly higher than maternal HCC cut on the same day. These data provide novel information on the intrauterine fetal cortisol environment.
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Affiliation(s)
- M Camille Hoffman
- Departments of Obstetrics and Gynecology and Psychiatry, University of Colorado School of Medicine, Denver Health and Hospital Authority, Denver, Colorado
| | | | - Patrick Benitez
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Randal G Ross
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Mark L Laudenslager
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, Colorado
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Abstract
Psychoneuroimmunology (PNI) emerged in the neurosciences in the late 1970s to early 1980s and has extended to influence the fields of psychology, psychiatry, endocrinology, physiology, and the biomedical research community. This review documents the journey of PNI from the early 1980s to the present. Today, we recognize that the highly complex immune system interacts with an equally complex nervous system in a bidirectional manner. Evolutionarily old signals continue to play a role in these communications, as do mechanisms for protection of the host. The disparity between physical and psychological stressors is only an illusion. Host defense mechanisms respond in adaptive and meaningful ways to both. The present review will describe a new way of thinking about evolutionarily old molecules, heat shock proteins, adding to a body of evidence suggesting that activation of the acute stress response is a double-edged sword that can both benefit and derail optimal immunity.
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Crucian B, Johnston S, Mehta S, Stowe R, Uchakin P, Quiriarte H, Pierson D, Laudenslager ML, Sams C. A case of persistent skin rash and rhinitis with immune system dysregulation onboard the International Space Station. J Allergy Clin Immunol Pract 2016; 4:759-762.e8. [PMID: 27036643 DOI: 10.1016/j.jaip.2015.12.021] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Revised: 12/08/2015] [Accepted: 12/21/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Brian Crucian
- Biomedical Research and Environmental Sciences, NASA Johnson Space Center, Houston, Texas.
| | - Smith Johnston
- Space and Clinical Operations, NASA Johnson Space Center, Houston, Texas
| | - Satish Mehta
- Biomedical Research and Environmental Sciences, JES Tech, Houston, Texas
| | - Raymond Stowe
- Immunology Research, Microgen Laboratories, La Marque, Texas
| | - Peter Uchakin
- Department of Internal Medicine, Mercer University, Macon, Ga
| | - Heather Quiriarte
- Biomedical Research and Environmental Sciences, JES Tech, Houston, Texas
| | - Duane Pierson
- Biomedical Research and Environmental Sciences, NASA Johnson Space Center, Houston, Texas
| | - Mark L Laudenslager
- Behavioral Immunology and Endocrinology Laboratory, Denver Anschutz Medical Campus, University of Colorado, Denver, Colo
| | - Clarence Sams
- Space and Clinical Operations, NASA Johnson Space Center, Houston, Texas
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Hoffman MC, Vanlandingham LA, Wagner BD, Laudenslager ML, Ross RG. 601: Gestational age at delivery is mediated by second trimester hypothalamic-pituitary-adrenocorticol axis function in relation to early pregnancy maternal stress and mood. Am J Obstet Gynecol 2016. [DOI: 10.1016/j.ajog.2015.10.646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Lafferty DJR, Laudenslager ML, Mowat G, Heard D, Belant JL. Sex, Diet, and the Social Environment: Factors Influencing Hair Cortisol Concentration in Free-Ranging Black Bears (Ursus americanus). PLoS One 2015; 10:e0141489. [PMID: 26529405 PMCID: PMC4631324 DOI: 10.1371/journal.pone.0141489] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 10/07/2015] [Indexed: 12/01/2022] Open
Abstract
Increasingly, measures of glucocorticoid levels (e.g., cortisol), key components of the neuroendocrine stress axis, are being used to measure past hypothalamic-pituitary-adrenal (HPA) activity to index psychological and physiological stress exhibited by wildlife for assessing individual and population-level well-being. However, many intrinsic and extrinsic factors affect HPA activity in animals. Using American black bears (Ursus americanus; n = 116) as an ecological model and hair cortisol concentration (HCC) as an integrative measure of past HPA activity, we evaluated the influence of diet, sex and the social environment on black bear HCC in a free-ranging population that spanned adjoining ecoregions with differing densities of potential conspecific and heterospecific competitors. HCC varied by sex, with female HCC ranging from 0.6 to 10.7 pg/mg (median = 4.5 ± 1.2 mean absolute deviation [MAD]) and male HCC ranging from 0.5 to 35.1 pg/mg (median = 6.2 ± 2.6 MAD). We also observed a three-way interaction among sex, δ14C and ecoregion, which may indicate that some differences in HCC between female and male black bears results from variability in the nutritional needs of larger-bodied males relative to smaller-bodied females, slight differences in food resources use between ecoregions as well as sex-based differences regarding the social environment. Once we understand what drives sex-specific differences in HCC, HCC may aid our understanding of the physiological responses by bears and other wildlife to diverse environmental challenges.
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Affiliation(s)
- Diana J. R. Lafferty
- Department of Wildlife, Fisheries and Aquaculture, Carnivore Ecology Laboratory, Mississippi State University, Mississippi State, Mississippi, United States of America
- Department of Forestry and Environmental Resources, Fisheries, Wildlife and Conservation Biology Program, North Carolina State University, Raleigh, North Carolina, United States of America
- * E-mail:
| | - Mark L. Laudenslager
- Department of Psychiatry, Behavioural Immunology and Endocrinology Laboratory, University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado, United States of America
| | - Garth Mowat
- British Columbia Ministry of Forests, Lands, and Natural Resource Operations, Nelson, British Columbia, Canada
| | - Doug Heard
- British Columbia Ministry of Forests, Lands, and Natural Resource Operations, Prince George, British Columbia, Canada
| | - Jerrold L. Belant
- Department of Wildlife, Fisheries and Aquaculture, Carnivore Ecology Laboratory, Mississippi State University, Mississippi State, Mississippi, United States of America
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Sannes TS, Mikulich-Gilbertson SK, Simoneau TL, Laudenslager ML. Patient and caregiver well-being: Observation of changing dyad over time. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.29_suppl.89] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
89 Background: Allogeneic hematopoietic stem cell transplant (Allo-HSCT) is a particularly stressful time for patient and caregivers alike. As such, well-being within patient-caregivers dyads is highly correlated in previous studies. It is less clear how this dyadic relationship changes over the course of treatment and recovery. Methods: In these secondary analyses of a randomized clinical trial of psychoeducational support (5 time points across 12 months), partial correlations, adjusting for group assignment and age, tested the relationship between individual mental and physical summary scores of patients and caregivers. 117 Allo-HSCT patient and caregivers provided baseline data, with available data used at each subsequent timepoint. Quality of life was measured with the Short-Form Health Survey; divided into mental (MCS) and physical summary (PCS) scores. Results: Patients were primarily men (69.6% male; Mage=49.36; SD=13.04); caregivers were primarily female (78%;Mage=53.26;SD=12.34). Patient and caregivers’ MCS were significantly correlated at baseline (r=.23;p<.05) and 4 weeks after consenting to study participation, (r=.26;p<.01), whereas patients’ PCS scores were significantly correlated with caregivers’ MCS at 3 months (r=.26;p<.05). At 6 months, the relationship between patient PCS and caregiver MCS was no longer significant (p=.51), whereas the relationship between patient and caregiver MCS re-emerged at 6 months (r=.32; p<.05). In evaluating 6 month completers (N=84), the trend between patient-caregivers well-being displayed the same significant pattern at each timepoint. Conclusions: These data replicate significant relationships of mental well-being within patient-caregiver dyads in Allo-HSCT. This relationship shifts over time, in which caregiver mental well-being becomes related to patients’ physical functioning. These data underscore the importance of this dyadic relationship and deserve follow-up statistical approaches (e.g., covariation). Extending these relationships to clinical endpoints remains an area for future investigation. Funding: NIHCA126971(MLL); T32AG044296(TS): DA034604(SMG) and PCORI CE-1304-6208(MLL). Clinical trial information: NCT00833898.
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Genther DJ, Laudenslager ML, Sung YK, Blake CR, Chen DS, Lin FR. Assessing Systemic Stress in Otolaryngology: Methodology and Feasibility of Hair and Salivary Cortisol Testing. J Nat Sci 2015; 1:e152. [PMID: 26436139 PMCID: PMC4592142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Elevated systemic stress is a predictor of adverse health outcomes, and stress can be objectively quantified by cortisol concentration. Despite its utility, such testing is rarely performed in otolaryngology. This manuscript provides details on the principles, methodology, and feasibility of performing laboratory assessments of hair and salivary cortisol to inform researchers wishing to incorporate these novel tests in future otolaryngologic studies. METHODS Participants were older adults with hearing impairment. One hair sample and eight saliva samples were collected. Feasibility of study design was assessed through rates of participation in hair and saliva sampling and protocol adherence for saliva collection. Area under the curve (AUC) was used to evaluate overall secretion, and cortisol awakening response (CAR) was used to evaluate the dynamic secretion response. RESULTS From 9/1/2013 to 12/31/2013, 26/30 (86.7%) eligible participants agreed to hair sampling. All 30 subjects agreed to collect saliva, with 29 (96.7%) adhering to the collection protocol. Mean AUC was 401.2 nmol/L per hour, and CAR was 4.5 nmol/L. CONCLUSIONS Evaluating systemic stress in an otolaryngologic population using hair and saliva is feasible with acceptable participation and adherence. Repeat measurements over time will allow for evaluation of changes in systemic stress in relation to treatment.
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Affiliation(s)
- Dane J. Genther
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, 601 N. Caroline St., Suite 6210, Baltimore, Maryland 21287, USA
- Center on Aging and Health, Johns Hopkins University, 2024 E. Monument St. Suite 2-700, Baltimore, Maryland 21205, USA
| | - Mark L. Laudenslager
- Department of Psychiatry, University of Colorado School of Medicine, 12700 E. 19 Ave., Building RC2, Aurora, Colorado 80045, USA
| | - Yoon-kyu Sung
- Center on Aging and Health, Johns Hopkins University, 2024 E. Monument St. Suite 2-700, Baltimore, Maryland 21205, USA
| | - Caitlin R. Blake
- Center on Aging and Health, Johns Hopkins University, 2024 E. Monument St. Suite 2-700, Baltimore, Maryland 21205, USA
| | - David S. Chen
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, 601 N. Caroline St., Suite 6210, Baltimore, Maryland 21287, USA
- Center on Aging and Health, Johns Hopkins University, 2024 E. Monument St. Suite 2-700, Baltimore, Maryland 21205, USA
| | - Frank R. Lin
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, 601 N. Caroline St., Suite 6210, Baltimore, Maryland 21287, USA
- Center on Aging and Health, Johns Hopkins University, 2024 E. Monument St. Suite 2-700, Baltimore, Maryland 21205, USA
- Department of Medicine, Division of Geriatric Medicine and Gerontology, Johns Hopkins University School of Medicine, 5505 Hopkins Bayview Cr., John R. Burton Pavilion, Room 163, Baltimore, Maryland 21224, USA
- Departments of Epidemiology and Mental Health, Johns Hopkins University Bloomberg School of Public Health, 615 Wolfe St., Baltimore, Maryland 21205, USA
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Wright KD, Hickman R, Laudenslager ML. Hair Cortisol Analysis: A Promising Biomarker of HPA Activation in Older Adults. Gerontologist 2015; 55 Suppl 1:S140-5. [PMID: 26055775 PMCID: PMC4566915 DOI: 10.1093/geront/gnu174] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Accepted: 12/19/2014] [Indexed: 02/07/2023] Open
Abstract
Prolonged stress is a potentially harmful and often undetected risk factor for chronic illness in older adults. Cortisol, one indicator of the body's hormonal responses to stress, is regulated by the hypothalamic-pituitary-adrenal (HPA) axis and is commonly measured in saliva, urine, or blood samples. Cortisol possesses a diurnal pattern and thus collection timing is critical. Hair cortisol is a proxy measure to the total retrospective activity of the HPA axis over the preceding months, much like hemoglobin A1c is a proxy measure of glucose control over the past 3 months. The aim of this review is to examine a novel biomarker, hair cortisol, as a practical measure of long-term retrospective cortisol activity associated with chronic stress in older adults. Hair cortisol analysis advances the science of aging by better characterizing chronic stress as a risk factor for chronic illness progression and as a biomarker of the effectiveness of stress reduction interventions.
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Affiliation(s)
- Kathy D Wright
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio.
| | - Ronald Hickman
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio
| | - Mark L Laudenslager
- Department of Psychiatry, Behavioral Immunology & Endocrinology Laboratory, School of Medicine, University of Colorado Denver Anschutz Medical Campus, Aurora
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Laudenslager ML, Simoneau TL, Kilbourn K, Natvig C, Philips S, Spradley J, Benitez P, McSweeney P, Mikulich-Gilbertson SK. A randomized control trial of a psychosocial intervention for caregivers of allogeneic hematopoietic stem cell transplant patients: effects on distress. Bone Marrow Transplant 2015; 50:1110-8. [PMID: 25961767 PMCID: PMC4527944 DOI: 10.1038/bmt.2015.104] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Revised: 03/13/2015] [Accepted: 03/18/2015] [Indexed: 01/20/2023]
Abstract
Caregivers of patients receiving allogeneic hematopoietic stem cell transplants (Allo-HSCT) serve a pivotal role in patient care but experience high stress, anxiety, and depression as a result. We theorized that a stress management adapted for Allo-HSCT caregivers would reduce distress compared to treatment as usual (TAU). From 267 consecutive caregivers of Allo-HSCT patients approached, 148 (mean=53.5 years, 75.7% female) were randomized to either psychosocial intervention (n=74) or TAU (n=74). Eight 1-on-1 stress management sessions delivered across the 100 day post-transplant period focused on understanding stress, changing role(s) as caregiver, cognitive behavioral stress management, pacing respiration, and identifying social support. Primary outcomes included perceived stress (psychological) and salivary cortisol awakening response (CAR) (physiological). Randomized groups were not statistically different at baseline. Mixed models analysis of covariance (intent-to-treat) showed that intervention was associated with significantly lower caregiver stress 3 months post-transplant (Mean=20.0, CI95=17.9-22.0) compared to TAU (Mean=23.0, CI95=21.0-25.0) with an effect size (ES) of 0.39 (p=0.039). Secondary psychological outcomes, including depression and anxiety, were significantly reduced with ESs of 0.46 and 0.66 respectively. Caregiver CAR did not differ from non-caregiving controls at baseline and was unchanged by intervention. Despite significant caregiving burden, this psychosocial intervention significantly mitigated distress in Allo-HSCT caregivers.
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Affiliation(s)
- M L Laudenslager
- Department of Psychiatry, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA
| | - T L Simoneau
- Department of Psychiatry, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA
| | - K Kilbourn
- Department of Psychology, Univerity of Colorado Denver, Denver, CO, USA
| | - C Natvig
- Department of Psychiatry, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA
| | - S Philips
- Department of Psychiatry, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA
| | - J Spradley
- 1] Presbyterian/St Luke's Medical Center, Denver, CO, USA [2] Colorado Blood Cancer Institute, Denver, CO, USA
| | - P Benitez
- Department of Psychiatry, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA
| | - P McSweeney
- 1] Presbyterian/St Luke's Medical Center, Denver, CO, USA [2] Colorado Blood Cancer Institute, Denver, CO, USA
| | - S K Mikulich-Gilbertson
- Department of Psychiatry, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA
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Neu M, Matthews E, King NA, Cook PF, Laudenslager ML. Anxiety, depression, stress, and cortisol levels in mothers of children undergoing maintenance therapy for childhood acute lymphoblastic leukemia. J Pediatr Oncol Nurs 2015; 31:104-13. [PMID: 24608702 DOI: 10.1177/1043454213520346] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
The purpose of this study was to compare anxiety, depression, and stress between mothers of children during maintenance treatment for acute lymphoblastic leukemia (ALL) and matched controls. Twenty-six mothers were recruited from the hematology unit at a children's hospital, and 26 mothers were recruited from the community. Participants were matched to their child's age and gender. Mothers completed the Hospital Anxiety and Depression Scale, the Perceived Stress Sale, and collected salivary cortisol 4 times a day for 3 consecutive days. Compared with mothers of healthy children, anxiety scores did not differ (P=.10), but depression scores were higher (P=.003) in mothers of children with ALL. More mothers in the ALL group scored above the cutoff of 7 indicating clinical anxiety (46%) and depressive symptoms (27%). A trend toward increased stress was found in mothers in the ALL group. No difference was found in overall daily cortisol (area under the curve), daily decrease in cortisol (slope), and cortisol awakening response. Mothers of children with ALL experienced emotional symptoms many months after the initial diagnosis.
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Affiliation(s)
- Madalynn Neu
- 1University of Colorado Anschutz Medical Campus, Aurora CO, USA
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Mehta SK, Laudenslager ML, Stowe RP, Crucian BE, Sams CF, Pierson DL. Multiple latent viruses reactivate in astronauts during Space Shuttle missions. Brain Behav Immun 2014; 41:210-7. [PMID: 24886968 DOI: 10.1016/j.bbi.2014.05.014] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2013] [Revised: 05/20/2014] [Accepted: 05/22/2014] [Indexed: 01/26/2023] Open
Abstract
Latent virus reactivation and diurnal salivary cortisol and dehydroepiandrosterone were measured prospectively in 17 astronauts (16 male and 1 female) before, during, and after short-duration (12-16 days) Space Shuttle missions. Blood, urine, and saliva samples were collected during each of these phases. Antiviral antibodies and viral load (DNA) were measured for Epstein-Barr virus (EBV), varicella-zoster virus (VZV), and cytomegalovirus (CMV). Three astronauts did not shed any virus in any of their samples collected before, during, or after flight. EBV was shed in the saliva in all of the remaining 14 astronauts during all 3 phases of flight. Seven of the 14 EBV-shedding subjects also shed VZV during and after the flight in their saliva samples, and 8 of 14 EBV-shedders also shed CMV in their urine samples before, during, and after flight. In 6 of 14 crewmembers, all 3 target viruses were shed during one or more flight phases. Both EBV and VZV DNA copies were elevated during the flight phase relative to preflight or post-flight levels. EBV DNA in peripheral blood was increased preflight relative to post-flight. Eighteen healthy controls were also included in the study. Approximately 2-5% of controls shed EBV while none shed VZV or CMV. Salivary cortisol measured preflight and during flight were elevated relative to post-flight. In contrast DHEA decreased during the flight phase relative to both preflight and post-flight. As a consequence, the molar ratio of the area under the diurnal curve of cortisol to DHEA with respect to ground (AUCg) increased significantly during flight. This ratio was unrelated to viral shedding. In summary, three herpes viruses can reactivate individually or in combination during spaceflight.
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Affiliation(s)
- S K Mehta
- Enterprise Advisory Services, Inc., 1290 Hercules, Houston, TX 77058, USA.
| | - M L Laudenslager
- University of Colorado Denver, Anschutz Medical Campus, 12700 E. 19(th) Ave, Aurora, CO 80045, USA.
| | - R P Stowe
- Microgen Laboratories, 903 Texas Ave, La Marque, TX 77568, USA.
| | - B E Crucian
- NASA Johnson Space Center, Mail code SK, 2101 NASA Parkway, Houston, TX 77058, USA.
| | - C F Sams
- NASA Johnson Space Center, Mail code SK, 2101 NASA Parkway, Houston, TX 77058, USA.
| | - D L Pierson
- NASA Johnson Space Center, Mail code SK, 2101 NASA Parkway, Houston, TX 77058, USA.
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Hoffman MC, Karban LV, Benitez P, Goodteacher A, Laudenslager ML. Chemical processing and shampooing impact cortisol measured in human hair. ACTA ACUST UNITED AC 2014; 37:E252-7. [PMID: 25090265 DOI: 10.25011/cim.v37i4.21731] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Indexed: 01/10/2023]
Abstract
PURPOSE The assessment of cortisol in hair has gained popularity as a means to measure retrospective hypothalamic-pituitary-adrenal activity in a number of species; however, cortisol levels from human hair subjected to typical chemicals for cosmetic or hygienic purposes may be altered by the chemicals used. The purposed of this study was to determine if exposure of hair to chemical processing or shampooing impacts cortisol values. METHODS Human hair not exposed to prior chemical processing was cut from the posterior vertex region of the head of 106 human subjects as close to the scalp as possible. The hair sample was divided into 4-6 full-length clusters depending on quantity of hair available. Each hair sample was processed for baseline (native) cortisol and remaining clusters were exposed to five standard chemical hair treatments (Experiment 1) or were shampooed 15 or 30 times (Experiment 2). Hair was ground and cortisol levels were determined by enzyme immunoassay (EIA). Comparisons were made between native hair and processed hair using paired t-tests and Pearson correlation. RESULTS Hair cortisol as assessed by EIA was significantly altered by chemical processing but in somewhat different ways. Exposure to bleach (harshest exposure), demi-perm (least exposure) or 15-30 shampoos resulted in a significant decrease in cortisol level while exposure to varying percentages of peroxides increased cortisol measured. There were no differences in cortisol levels associated with sex, age or tobacco use in the native hair for this particular group. CONCLUSION Chemical processing and frequent shampooing affect cortisol levels measured in hair. Chemically processed or excessively shampooed hair should be avoided when recruiting subjects for hair cortisol studies.
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Ouseph R, Croy C, Natvig C, Simoneau T, Laudenslager ML. Decreased mental health care utilization following a psychosocial intervention in caregivers of hematopoietic stem cell transplant patients. Ment Illn 2014; 6:5120. [PMID: 25478136 PMCID: PMC4253397 DOI: 10.4081/mi.2014.5120] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Revised: 01/04/2014] [Accepted: 01/08/2014] [Indexed: 11/22/2022] Open
Abstract
Caregivers are known to experience increased morbidity when compared to noncaregivers. Does an intervention targeting caregiver distress affect their health care utilization? One hundred forty-eight caregivers of allogeneic hematopoietic stem cell transplant patients were randomized to treatment as usual (TAU) or a psychoeducation, paced respiration, and relaxation (PEPRR) intervention. Assessments of caregivers’ service utilization were collected at baseline and 1, 3, and 6 months post-transplant. During the first 30 days after patient transplant, caregiver medical and mental health professional service use decreased while support group attendance peaked. Mixed model regressions showed a significant decrease in mental health service use by the PEPRR group (P=0.001). At six months caregivers in TAU had predicted marginal probabilities of mental health services utilization over 10 times as high as caregivers in PEPRR (18.1% vs 1.5%). Groups failed to differ in medical service (P=0.861) or support group (P=0.067) use. We can conclude that participation in PEPRR compared to TAU was associated with reduced mental health service utilization. Caregiver psychosocial support services are critical to improve caregiver outcomes.
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Affiliation(s)
- Rita Ouseph
- Duke University , Durham, NC ; Anschutz Medical Campus, University of Colorado , Denver, CO
| | - Calvin Croy
- Anschutz Medical Campus, University of Colorado , Denver, CO
| | - Crystal Natvig
- Anschutz Medical Campus, University of Colorado , Denver, CO
| | - Teresa Simoneau
- Anschutz Medical Campus, University of Colorado , Denver, CO
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Ouseph R, Croy C, Natvig C, Simoneau T, Laudenslager ML. Decreased mental health care utilization following a psychosocial intervention in caregivers of hematopoietic stem cell transplant patients. Ment Illn 2014. [DOI: 10.1108/mi.2014.5120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Caregivers are known to experience increased morbidity when compared to noncaregivers. Does an intervention targeting caregiver distress affect their health care utilization? One hundred forty-eight caregivers of allogeneic hematopoietic stem cell transplant patients were randomized to treatment as usual (TAU) or a psychoeducation, paced respiration, and relaxation (PEPRR) intervention. Assessments of caregivers' service utilization were collected at baseline and 1, 3, and 6 months post-transplant. During the first 30 days after patient transplant, caregiver medical and mental health professional service use decreased while support group attendance peaked. Mixed model regressions showed a significant decrease in mental health service use by the PEPRR group (P=0.001). At six months caregivers in TAU had predicted marginal probabilities of mental health services utilization over 10 times as high as caregivers in PEPRR (18.1% vs 1.5%). Groups failed to differ in medical service (P=0.861) or support group (P=0.067) use. We can conclude that participation in PEPRR compared to TAU was associated with reduced mental health service utilization. Caregiver psychosocial support services are critical to improve caregiver outcomes.
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Abstract
Caregivers of loved ones with chronic illnesses experience an uncontrollable challenge with potentially negative behavioral and medical consequences. Extensive research has demonstrated immune and endocrine regulation can be significantly disrupted by negative behavioral factors based on both animal models and human studies. However, fewer studies have focused on how psychosocial interventions might reverse the negative consequences of stressors such as caregiving. The distress of caring for individuals with cancer has only recently begun to receive attention. These interventions addressing caregiver distress are rare overall and caregivers of patients receiving hematopoietic stem cell transplants (HSCT) have received even less attention. HSCT caregivers report feelings of loss of control. Animal studies suggest that control over aversive events can mitigate the negative consequences of stressors. Caregivers of allogeneic HSCT patients for blood cancers must be available 24/7 for three months or longer following stem cell infusion to closely monitor the recipients' health and well-being. Does establishing a greater sense of control have positive impacts on caregivers? A randomized control trial of a cognitive behavioral stress management intervention for allogeneic HSCT caregivers is briefly described. A model of caregiver mental health which may potentially impact the patient's quality of life is proposed. These relationships exist in a complex system that includes genetic influences, sex, social environment, and prior experience. This system fits well within recent formulations of a "complexity science" approach to health and well-being.
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Affiliation(s)
- Mark L Laudenslager
- University of Colorado Denver Anschutz Medical Campus, Department of Psychiatry, Aurora, CO 80045, United States.
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Neu M, Pan Z, Workman R, Marcheggiani-Howard C, Furuta G, Laudenslager ML. Benefits of massage therapy for infants with symptoms of gastroesophageal reflux disease. Biol Res Nurs 2013; 16:387-97. [PMID: 24379449 DOI: 10.1177/1099800413516187] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES This randomized controlled pilot trial was conducted to evaluate the clinical efficacy of massage therapy (MT) for relief of symptoms of gastroesophageal reflux disease (GERD). The hypothesis was that, when compared to infants who received nonmassage therapy, infants who received MT would display fewer GERD symptoms, greater weight gain, greater amount of sleep, lower cortisol levels before and after treatment, and lower daily (area under the curve [AUC]) cortisol secretion. METHODS Participants were 36 infants born at term, 4-10 weeks of age at enrollment, healthy except for a diagnosis of GERD by their pediatrician, and with a score of at least 16 on the Infant Gastroesophageal Reflux Questionnaire-Revised (I-GERQ-R). Infants were randomized to receive either MT or a nonmassage sham treatment in their homes for 30 min twice a week for 6 weeks. Data collectors and parents were blind to study condition. RESULTS GERD symptoms decreased in both groups and weight increased. Pretreatment salivary cortisol levels decreased significantly over time in the massage group while increasing in the nonmassage group. Daily cortisol level also decreased in the massage group and increased in the nonmassage group, but the difference was not significant. CONCLUSIONS MT administered by a professional therapist did not affect symptoms of GERD differently than a sham treatment but did decrease infant stress as measured by cortisol. Research focusing on stress reduction in infants with GERD and multimodal treatments addressing GERD symptoms may yield the most effective treatment.
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Affiliation(s)
- Madalynn Neu
- University of Colorado Anschutz Medical Campus, College of Nursing, Denver, CO, USA
| | - Zhaoxing Pan
- Department of Pediatrics, University of Colorado, School of Medicine, Anschutz Medical Campus, Denver, CO, USA
| | | | | | - Glenn Furuta
- Department of Pediatrics, University of Colorado, School of Medicine, Anschutz Medical Campus, Denver, CO, USA Gastrointestinal Eosinophilic Diseases Program, Children's Hospital Colorado, Aurora Colorado
| | - Mark L Laudenslager
- Department of Pediatrics, University of Colorado, School of Medicine, Anschutz Medical Campus, Denver, CO, USA
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Gabriels RL, Agnew JA, Pan Z, Holt KD, Reynolds A, Laudenslager ML. Elevated repetitive behaviors are associated with lower diurnal salivary cortisol levels in autism spectrum disorder. Biol Psychol 2013; 93:262-8. [DOI: 10.1016/j.biopsycho.2013.02.017] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2012] [Revised: 02/19/2013] [Accepted: 02/22/2013] [Indexed: 10/27/2022]
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Laudenslager ML, Natvig C, Corcoran CA, Blevins MW, Pierre PJ, Bennett AJ. The influences of perinatal challenge persist into the adolescent period in socially housed bonnet macaques (Macaca radiata). Dev Psychobiol 2013; 55:316-22. [PMID: 22488164 PMCID: PMC3404189 DOI: 10.1002/dev.21030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2011] [Accepted: 03/02/2012] [Indexed: 02/03/2023]
Abstract
Social challenges during the perinatal period influence the mother-infant relationship in nonhuman primates and may affect the offspring's response to later social challenge(s). Relocation of a breeding colony of monkeys (Macaca radiata) created two groups of infants: one group experienced social group relocation to a new housing facility during the perinatal period (ATYPICAL) and the second group developed within a constant environment (TYPICAL). At a mean age of 25 months, all animals were removed from their natal group and placed in same sex adolescent social groups. Behavioral observations were collected after group formation or introduction to a new group. ATYPICAL subjects showed increased aggression and reduced affiliation compared to TYPICAL subjects. Hair cortisol in male subjects collected 6 months after introduction was elevated in the ATYPICAL subjects compared to TYPICAL subjects. These findings demonstrate that early life challenges affect behavior as well as stress hormone responses to social challenge in adolescence.
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Affiliation(s)
- Mark L Laudenslager
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, East 19th Ave., Room 3001, Aurora, CO 80045, USA.
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Simoneau TL, Mikulich-Gilbertson SK, Natvig C, Kilbourn K, Spradley J, Grzywa-Cobb R, Philips S, McSweeney P, Laudenslager ML. Elevated peri-transplant distress in caregivers of allogeneic blood or marrow transplant patients. Psychooncology 2013; 22:2064-70. [PMID: 23440998 DOI: 10.1002/pon.3259] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2012] [Revised: 01/08/2013] [Accepted: 01/21/2013] [Indexed: 01/22/2023]
Abstract
PURPOSE A full-time 24/7 caregiver is required for 100 days or longer following an allogeneic blood or marrow transplant during which time caregivers have multiple demands. Although distress in caregivers is documented, generalization is limited by small sample sizes, restricted range of assessments, and lack of information as to which caregivers may be more vulnerable to distress. The purpose of this study was to describe the peri-transplant psychological status of a sample of caregivers of allogeneic transplant patients. METHODS We assessed caregiver mood, stress, burden, and sleep using valid self-report measures in 109 caregivers of allogeneic transplant patients prior to stem cell transplantation. Caregivers' scores were compared with norms or established cutoff scores for behavioral measures. Additionally, demographic characteristics such as age and sex were tested as predictors of distress. RESULTS Caregivers showed significant levels of anxiety, stress, intrusion and avoidance behaviors, and poor sleep at the start of transplant compared with established norms. Younger caregivers were more distressed than older caregivers. There were no differences in levels of distress between male and female caregivers. CONCLUSION The peri-transplant period is a time of heightened anxiety and distress for caregivers of allogeneic transplant patients. This study indicates that caregivers would benefit from support programs in the peri-transplant period. Recommendations for types of support that may be helpful to caregivers are provided, but additional research is needed to validate that these programs would help caregivers providing care to patients receiving an allogeneic transplant in the peri-transplant period.
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Irwin MR, Levin MJ, Laudenslager ML, Olmstead R, Lucko A, Lang N, Carrillo C, Stanley HA, Caulfield MJ, Weinberg A, Chan ISF, Clair J, Smith JG, Marchese RD, Williams HM, Beck DJ, McCook PT, Zhang JH, Johnson G, Oxman MN. Varicella zoster virus-specific immune responses to a herpes zoster vaccine in elderly recipients with major depression and the impact of antidepressant medications. Clin Infect Dis 2013; 56:1085-93. [PMID: 23413415 DOI: 10.1093/cid/cis1208] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The Depression Substudy of the Shingles Prevention Study (SPS) was designed to evaluate the association between major depression and immune responses to a high-titer live attenuated varicella zoster virus (VZV) vaccine (zoster vaccine), which boosts cell-mediated immunity (CMI) to VZV and decreases the incidence and severity of herpes zoster (HZ). The Depression Substudy was a 2-year longitudinal cohort study in 92 community-dwelling adults≥60 years of age who were enrolled in the SPS, a large, double-blind, placebo-controlled Veterans Affairs Cooperative zoster vaccine efficacy study. METHODS Forty subjects with major depressive disorder, stratified by use of antidepressant medications, and 52 age- and sex-matched controls with no history of depression or other mental illness had their VZV-CMI measured prior to vaccination with zoster vaccine or placebo and at 6 weeks, 1 year, and 2 years postvaccination. RESULTS Depressed subjects who were not treated with antidepressant medications had lower levels of VZV-CMI following administration of zoster vaccine than nondepressed controls or depressed subjects receiving antidepressants even when antidepressant medications failed to alter depressive symptom severity (P<.005). Similar results were obtained taking into account the time-varying status of depression and use of antidepressant medications, as well as changes in depressive symptoms, during the postvaccination period. CONCLUSIONS Depressed patients have diminished VZV-CMI responses to zoster vaccine, and treatment with antidepressant medication is associated with normalization of these responses. Because higher levels of VZV-CMI correlate with lower risk and severity of HZ, untreated depression may increase the risk and severity of HZ and reduce the efficacy of zoster vaccine.
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Affiliation(s)
- Michael R Irwin
- Cousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience, University of California, Los Angeles, Los Angeles, CA 90095-7057, USA.
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Grand AP, Kuhar CW, Leighty KA, Bettinger TL, Laudenslager ML. Using personality ratings and cortisol to characterize individual differences in African Elephants (Loxodonta africana). Appl Anim Behav Sci 2012. [DOI: 10.1016/j.applanim.2012.09.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Laudenslager ML, Jorgensen MJ, Fairbanks LA. Developmental patterns of hair cortisol in male and female nonhuman primates: lower hair cortisol levels in vervet males emerge at puberty. Psychoneuroendocrinology 2012; 37:1736-9. [PMID: 22497987 PMCID: PMC3398229 DOI: 10.1016/j.psyneuen.2012.03.015] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2012] [Revised: 03/09/2012] [Accepted: 03/20/2012] [Indexed: 11/17/2022]
Abstract
Studies have yielded inconsistent results with regard to effects of age and sex on short-term markers of hypothalamic pituitary adrenal (HPA) activity. Hair cortisol provides a retrospective proxy measure of the cumulative activity of the HPA axis over the preceding 3- to 4-month period. In order to describe potential developmental trends in this biomarker, we assessed hair cortisol levels between 1 and 12 years of age in a cross-sectional study of 350 vervets (222 females and 128 males). Monkeys were grouped according to age as 1 (young juvenile), 2 (juvenile), 3 (early adolescent), 4 (late adolescent-young adult), and 5-12 (adult) years of age such that fully mature animals were included in the 5-12 year old age group. We observed that hair cortisol level was higher among the younger monkeys and declined with age (p<.001). More importantly the effect of age significantly interacted with sex (p=.02), such that hair cortisol was consistently lower in males than females beginning at age 3 (p<.05 or better). The developmental decline began one year earlier in females than males suggesting an influence of the earlier maturational processes typical in both human and nonhuman primates. The advantage of lower cortisol levels in the males may be related to social group patterns of male emigration during adolescence in many nonhuman primate species.
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Affiliation(s)
- Mark L Laudenslager
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA.
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