Screening for Comorbidity of Sleep Disorders in Career Firefighters

BACKGROUND

The purpose of this study was to assess the prevalence and sequelae of insomnia, obstructive sleep apnea (OSA), and comorbid OSA and insomnia (COMISA).

METHOD

In the morning, after a shift end, Midwest career firefighters ( N = 89) in a midsized city completed an electronic battery of questionnaire to screen for OSA, daytime sleepiness, insomnia, presleep arousal, nightmares, mental and physical health symptoms, and a one-night sleep diary.

RESULTS

Prevalence of firefighters exceeding screening thresholds: OSA: 54%; insomnia: 30%; COMISA: 17%; four or more nightmares per month: 15%. Firefighters who met criteria for COMISA had shorter total sleep time, less restful and worse sleep quality, higher depression and anxiety symptoms, and presleep arousal symptoms than firefighters without self-reported sleep problems.

CONCLUSIONS

Many firefighters are at elevated risk of individual behavioral sleep disorders, COMISA, and daytime dysfunction.

Cognitive behavioral therapy for insomnia treatment attrition in patients with weekly nightmares

STUDY OBJECTIVES

This study's objective was to evaluate the effect of nightmares (NMs) on attrition and symptom change following cognitive behavioral therapy for insomnia (CBT-I) treatment using data from a successful CBT-I randomized controlled trial delivered to participants with recent interpersonal violence exposure.

METHODS

The study randomized 110 participants (107 women; mean age: 35.5 years) to CBT-I or to an attention-control group. Participants were assessed at 3 time periods: baseline, post-CBT-I (or attention control), and at time 3 (T3) post-cognitive processing therapy received by all participants. NM reports were extracted from the Fear of Sleep Inventory. Participants with weekly NMs were compared with those with fewer than weekly NMs on outcomes including attrition, insomnia, posttraumatic stress disorder, and depression. Change in NM frequency was examined.

RESULTS

Participants with weekly NMs (55%) were significantly more likely to be lost to follow-up post-CBT-I (37%) compared with participants with infrequent NMs (15.6%) and were less likely to complete T3 (43%) than patients with less frequent NMs (62.5%). NMs were unrelated to differential treatment response in insomnia, depression, or posttraumatic stress disorder. Treatment with CBT-I was not associated with reduced NM frequency; however, change in sleep-onset latency from post-CBT-I to T3 predicted fewer NMs at T3.

CONCLUSIONS

Weekly NMs were associated with attrition but not a reduced change in insomnia symptoms following CBT-I. NM symptoms did not change as a function of CBT-I, but change in sleep-onset latency predicted lower NM frequency. CBT-I trials should screen for NMs and consider augmenting CBT-I to specifically address NMs.

CITATION

Hamilton NA, Russell JA, Youngren WA, et al. Cognitive behavioral therapy for insomnia treatment attrition in patients with weekly nightmares. J Clin Sleep Med. 2023;19(11):1913-1921.

Testing the nightmare cognitive arousal processing model

OBJECTIVE

Posttrauma nightmares are recurring nightmares that begin after a traumatic experience. Research has only recently begun to identify variables that predict posttrauma nightmare occurrences. Research has identified presleep arousal-cognitive (PSA-C) and presleep arousal physiological (PSA-PHYS), sleep onset latency (SOL), and sleep-disordered breathing (SDB) as potential predictors of posttrauma nightmares. However, previous research includes methodological limitations, such as a lack of physiological measures and a homogeneous sample. To replicate previous findings and increase generalizability, the current study investigated predictors of nightmare occurrences in a sample of male inpatient veterans with mixed-trauma history.

METHOD

Participants (n = 15) completed an initial assessment battery and seven consecutive days of pre and postsleep diaries, including measures of posttrauma nightmare triggers and posttrauma nightmare occurrences. Portable objective measurements of sleep and presleep states were used to examine sleep quality and physical arousal.

RESULTS

Analyses revealed that PSA-C and SOL both predicted posttrauma nightmare occurrences and that PSA-PHYS was significantly higher on nights when nightmares occurred.

CONCLUSION

Results replicate earlier research which posits that PSA and SOL play a role in triggering the occurrence of posttrauma nightmares. It should be noted that the sample was relatively small, warranting cautious interpretation of results. However, when taken together with the findings of the replicated study, results could suggest the plausibility of therapies targeting presleep cognitions, SOL, and presleep arousal in the treatment of posttrauma nightmares. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Characterization of tissue types in basal cell carcinoma images via generative modeling and concept vectors

The promise of machine learning methods to act as decision support systems for pathologists continues to grow. However, central to their successful adoption must be interpretable implementations so that people can trust and learn from them effectively. Generative modeling, most notable in the form of adversarial generative models, is a naturally interpretable technique because the quality of the model is explicit from the quality of images it generates. Such a model can be further assessed by exploring its latent space, using human-meaningful concepts by defining concept vectors. Motivated by these ideas, we apply for the first time generative methods to histological images of basal cell carcinoma (BCC). By simultaneously learning to generate and encode realistic image patches, we extract feature rich latent vectors that correspond to various tissue morphologies, namely BCC, epidermis, keratin, papillary dermis and inflammation. We show that a logistic regression model trained on these latent vectors can achieve high classification accuracies across 6 binary tasks (86-98%). Further, by projecting the latent vectors onto learned concept vectors we can generate a score for the absence or degree of presence for a given concept, providing semantically accurate "conceptual summaries" of the various tissues types within a patch. This can be extended to generate multi-dimensional heat maps for whole-image specimens, which characterizes the tissue in a similar way to a pathologist. We additionally find that accurate concept vectors can be defined using a small labeled dataset.

Assessing Triggers of Posttrauma Nightmares

Posttrauma nightmares are recurring nightmares that begin after a traumatic experience and can occur as often as multiple times per week, often in a seemingly random pattern. Although these nightmares are prevalent in trauma survivors, little is known about the mechanisms underlying their sporadic occurrence. The present study aimed to investigate predictors of posttrauma nightmares. The sample included 146 observations nested within 27 female college students who reported frequent nightmares related to sexual trauma. Participants were recruited from an undergraduate student subject pool (n = 71) or were clinical referrals (n = 75). Participants completed an initial assessment battery and six consecutive days of pre- and postsleep diaries, which included measures of potential posttrauma nightmare triggers and measures intended to assess sleep quality and posttrauma nightmare occurrence. Descriptive statistics, mean comparisons, and multilevel modeling were used to examine the data. The results showed that both presleep cognitive arousal, γ₁₀ SL_ij = 0.58, p = .006, z(1, N = 146) = -2.61; and sleep latency (SL), γ₂₀ PCA_ij = 0.76, p < .001, z(1, N = 146) = -2.69, predicted posttrauma nightmare occurrence. Further investigation suggested that presleep cognitive arousal moderated the relation between SL and posttrauma nightmare occurrence, γ₃₀ PCA x SL_ij = 0.67, p = .048 z(1, N = 146) = 1.98. The present results are the first to show that the co-occurrence of presleep arousal and delayed sleep onset latency may influence posttrauma nightmare occurrence, suggesting that the time immediately before sleep is crucial to the production of the posttrauma nightmares.

Factors associated with women's desire for control of healthcare during childbirth: Psychometric analysis and construct validation

The desire for control of healthcare is a significant moderator of outcomes related to childbirth. Researchers have shown that a sense of control of healthcare during childbirth is strongly correlated with postpartum maternal well-being. The aims of this study were to examine (a) the psychometric characteristics of an instrument to assess women's desire for control of healthcare during childbirth, and (b) examine desire for control in relation to parity, medical complications of pregnancy, and women's choices of childbirth providers and setting. The study design was cross-sectional using two different samples totaling 385 pregnant women. In Sample 1, (n = 193) we conducted an exploratory factor analysis to reduce the initial item pool. In Sample 2, (n = 192) we conducted a confirmatory factor analysis (CFA) of the final 12-item instrument and examined factors related to the desire for control. Results of the analysis in Sample 1 were supportive of a single-factor structure reflecting women's desire to influence the childbirth healthcare environment and decision-making. The final 12-item instrument had high internal consistency reliability (Cronbach's alpha = 0.93). CFA in Sample 2 was supportive of the single-factor structure with good model fit. The desire for control was directly correlated with an internal locus of control. Nulliparous women reported a lower desire for control compared with multiparous women. The desire for control among women with self-reported medical complications of pregnancy was comparable to that among women without pregnancy complications. The desire for control was a predictor of choosing midwives (vs. obstetricians), home or birth center (vs. hospitals), and professional labor support (e.g., doulas). Implications for future research on the impact of desire for control on maternal health outcomes are discussed.

The Association of Daytime Maternal Napping and Exercise With Nighttime Sleep in First-Time Mothers Between 3 and 6 Months Postpartum

OBJECTIVE

This study investigated the relationship of daytime maternal napping, exercise, caffeine, and alcohol intake to objective and subjective sleep indices.

PARTICIPANTS

Sixty healthy, nondepressed, first-time mothers between 3 and 6 months postpartum.

METHODS

Seven consecutive days of online behavior diaries, sleep diaries, and wrist actigraphy, collecting Total Sleep Time (TST), Sleep Onset Latency (SOL), and Wake After Sleep Onset (WASO).

RESULTS

After controlling for infant age, employment status, infant feeding method, and infant sleeping location, mixed linear models showed that longer average exercise durations were associated with longer average TST, and longer average nap durations were associated with longer average WASO durations. Significant within-person differences in TST and SOL were also observed, such that, on days when participants exercised and napped longer than average, their respective TST and SOL durations that night were longer.

CONCLUSION

Shorter nap durations and longer exercise durations were associated with longer TST, shorter SOL, and reduced WASO. Even small changes in daily exercise and napping behaviors could lead to reliable improvements in postpartum maternal sleep.

Sleep quality buffers the effects of negative social interactions on maternal mood in the 3-6 month postpartum period: a daily diary study

Sleep and social relationships are two key determinants of psychosocial health that undergo considerable change across the transition to motherhood. The current study investigated the bidirectional relationship between daytime Positive and Negative Social Interactions (PSIs & NSIs) and nighttime sleep quality on maternal mood across 1 week in the 3-6 month postpartum period. Sixty healthy, non-depressed first-time mothers completed 7-consecutive days of daily social interaction and sleep diaries. Results indicated that higher than average sleep quality buffered the effect of higher than average NSIs on maternal mood (i.e., buffered mood reactivity) and appeared to promote mood recovery following a particularly "bad day" (i.e., higher than average NSIs). In addition, although PSIs were more common than NSIs overall, the most frequent and positively rated PSIs were with baby as were the most frequent and negatively rated NSIs. To our knowledge, our results are the first to characterize the impact of PSIs on postpartum maternal mood, assess maternal-infant social interactions in daily diary study of postpartum social relationships, and demonstrate the role that maternal sleep quality plays in social discord-related mood reactivity and mood recovery processes in the 3-6 month postpartum period.

Percentage of REM sleep is associated with overnight change in leptin

Sleep contributes importantly to energy homeostasis, and may impact hormones regulating appetite, such as leptin, an adipocyte-derived hormone. There is increasing evidence that sleep duration, and reduced rapid eye movement sleep, are linked to obesity. Leptin has central neural effects beyond modulation of appetite alone. As sleep is not a unifrom process, interactions between leptin and sleep stages including rapid eye movement sleep may play a role in the relationship between sleep and obesity. This study examined the relationship between serum leptin and rapid eye movement sleep in a sample of healthy adults. Participants were 58 healthy adults who underwent polysomnography. Leptin was measured before and after sleep. It was hypothesized that a lower percentage of rapid eye movement sleep would be related to lower leptin levels during sleep. The relationship between percentage of rapid eye movement sleep and leptin was analysed using hierarchical linear regression. An increased percentage of rapid eye movement sleep was related to a greater reduction in leptin during sleep even when controlling for age, gender, percent body fat and total sleep time. A greater percentage of rapid eye movement sleep was accompanied by more marked reductions in leptin. Studies examining the effects of selective rapid eye movement sleep deprivation on leptin levels, and hence on energy homeostasis in humans, are needed.

Performance selection for Thoroughbreds racing in Hong Kong

REASONS FOR PERFORMING STUDY

Different indicators of racing performance are commonly used in the racing industry to assess the genetic superiority of racing Thoroughbreds. However, how well these indicators predict the performance of future progeny or siblings varies depending on the population and circumstances in which the indicators were recorded or achieved.

OBJECTIVES

To identify heritable indicators of racing performance for horses racing in Hong Kong.

STUDY DESIGN

Heritability analysis of racing performance traits.

METHODS

Performance data on the population of Thoroughbreds racing in Hong Kong between 3 September 2000 and 12 March 2011 (n = 4947) were acquired and used to estimate the heritabilities and probability values of fixed effects and covariates for a range of racing performance traits. Heritabilities for all performance traits were estimated using a single trait animal model. Each model included, as a minimum, the effects of sex, region of origin and trainer.

RESULTS

Heritability estimates for traits relating to finish position ranged from 0.01 to 0.06. Average handicap weight had a heritability of 0.07 ± 0.03. The effects of sex (fixed) and trainer (random) were significant (P<0.05) for all performance traits relating to earnings measures, handicap weights and finish positions. The heritability of win time at 1600 m was 0.52 ± 0.06 and was the only significant estimate of heritability for win time in the current study.

CONCLUSIONS

Although significantly affected by multiple environmental factors, certain indicators of Hong Kong racing performance can be reliably used to predict the performance of the individual's progeny or siblings. However, despite Hong Kong's controlled racing environment, these indicators appear to be no more heritable than in other less controlled racing environments.

Modelling cell turnover in a complex tissue during development

The growth of organs results from proliferation within distinct cellular compartments. Organ development also involves transitions between cell types and variations in cell cycle duration as development progresses, and is regulated by a balance between entry into the compartment, proliferation of cells within the compartment, acquisition of quiescence and exit from that cell state via differentiation or death. While it is important to understand how environmental or genetic alterations can perturb such development, most approaches employed to date are descriptive rather than quantitative. This is because the identification and quantification of such parameters, while tractable in vitro, is challenging in the context of a complex tissue in vivo. Here we present a new framework for determining cell turnover in developing organs in vivo that combines cumulative cell-labelling and quantification of distinct cell-cycle phases without assuming homogeneity of behaviour within that compartment. A mathematical model is given that allows the calculation of cell cycle length in the context of a specific biological example and assesses the uncertainty of this calculation due to incomplete knowledge of cell cycle dynamics. This includes the development of a two population model to quantify possible heterogeneity of cell cycle length within a compartment and estimate the aggregate proliferation rate. These models are demonstrated on data collected from a progenitor cell compartment within the developing mouse kidney, the cap mesenchyme. This tissue was labelled by cumulative infusion, volumetrically quantified across time, and temporally analysed for the proportion of cells undergoing proliferation. By combining the cell cycle length predicted by the model with measurements of total cell population and mitotic rate, this approach facilitates the quantification of exit from this compartment without the need for a direct marker of that event. As a method specifically designed with assumptions appropriate to developing organs we believe this approach will be applicable to a range of developmental systems, facilitating estimations of cell cycle length and compartment behaviour that extend beyond simple comparisons of mitotic rates between normal and perturbed states.

Massage on experimental pain in healthy females: A randomized controlled trial

This randomized controlled study evaluated the effect of massage on affect, relaxation, and experimental pain induced by electrical stimulation. Participants were 96 healthy women ( M age = 20.13 ± 5.93 years; 84.4% White) randomly assigned to a 15-minute no-treatment control, guided imagery, massage or massage plus guided imagery condition. Multilevel piecewise modeling revealed no group differences in pain intensity, threshold, or tolerance. The two massage conditions generally reported decreased pain unpleasantness, lower unpleasant affect, maintenance of pleasant affect, and increased relaxation compared to the no-treatment condition. The results suggest that massage may alter immediate affective qualities in the context of pain.

Recycling endosome-dependent and -independent mechanisms for IL-10 secretion in LPS-activated macrophages

IL-10 is a key anti-inflammatory cytokine secreted by activated macrophages as a feedback control mechanism to prevent excessive inflammatory responses. Here, we define multiple intracellular trafficking pathways involved in the secretion of newly synthesized IL-10 from macrophages following TLR4 activation with LPS, and show how this relates to the previously defined trafficking pathways for IL-6 and TNF in macrophages simultaneously producing these proinflammatory cytokines. IL-10 exits the Golgi in multiple tubular carriers, including those dependent on p230GRIP. Some of the IL-10 is then delivered to recycling endosomes, where cytokine sorting may occur prior to its release. Another portion of the IL-10 is delivered to the cell surface in distinct vesicles colabeled for apoE. Thus, we show at least two post-Golgi pathways via which IL-10 is trafficked, ensuring its secretion from activated macrophages under different physiological conditions.

Insomnia symptoms and well-being: Longitudinal follow-up

OBJECTIVE

Most Americans have occasional problems with symptoms of insomnia. Insomnia symptoms have been linked to psychological distress, but few studies have examined the relationship between insomnia symptoms and well-being. The purpose of the present study was to assess the relationship between insomnia symptoms reported in a 10-year longitudinal study and the dimensions of subjective well-being and eudaimonic well-being, adjusting for the potential confounds of age, gender, and comorbid physical illness.

METHOD

The data for the present study came from the National Survey of Midlife Development in the United States. Participants were 4,014 community dwelling adults (M age = 56.27 years, SD = 12.4; 55.4% female; 91.6% White).

RESULTS

After adjusting for demographic characteristics and a wide range of chronic physical health conditions, we found that insomnia symptoms had a significant relationship with both subjective and eudaimonic well-being. Furthermore, the report of insomnia symptoms at 2 time points 10 years apart was found to have an additional impact on subjective and eudaimonic well-being.

CONCLUSIONS

Results of this study suggest that insomnia symptoms have a strong relationship to individuals enjoying life and perceiving that one has a meaningful life. In addition, these data suggest that the experience of recurrent insomnia symptoms at 2 time points is particularly detrimental to one's well-being.

Perceived control and maternal satisfaction with childbirth: a measure development study

The purpose of this study was to develop and validate two instruments: one to assess patient perceptions of control of the childbirth environment and the other, global satisfaction with the childbirth experience. Participants were 187 women recruited from obstetric clinics, breast-feeding support groups and online who had given birth in the past 4 months. Scale development involved item construction, exploratory factor analysis (EFA) of the Perceived Control in Childbirth Scale (PCCh), confirmatory factor analysis (CFA) of the Satisfaction with Childbirth Scale (SWCh), reliability analysis and construct validity analyses. EFA identified a single factor underlying a set of items reflecting the patient's belief that her actions influenced the birth environment (i.e. perceived control). CFAs supported a single-factor model reflecting the degree to which the birth experience met the patient's ideal (i.e. satisfaction). Perceived control was associated with childbirth self-efficacy. Childbirth satisfaction was associated with both affective reactions to birth and childbirth-related posttraumatic stress disorder (PTSD) symptoms. Results support the validity and reliability of two new scales that assess perceived control of the birth environment and global satisfaction with childbirth.

Evaluating Evidence for the Role of Sleep in Fibromyalgia: A Test of the Sleep and Pain Diathesis Model

The Sleep and Pain Diathesis (SAPD) Model predicts that sleep quality is related to Fibromylagia (FM) outcomes such as disability and depression and that these relationships are mediated by both pain and impaired emotional dysregulation. The purpose of this paper is to provide a preliminary test of this model using cross-sectional data. 35 adult women, who had been living with FM for an average of 13 years, completed a battery of questionnaires that included reports of pain, sleep, affect, and disability. Consistent with this model, FM patients who reported more disrupted sleep also reported higher levels of psychological disability (i.e., BDI depression symptoms) and physical disability. Moreover, the trajectory of the relationship between sleep and pain appears to be mediated by cognitive processes such as increased pain helplessness and, thus, the relationship between sleep and disability appears to be mediated via pain. These data are consistent with the SAPD model, and lend support for the need to include sleep related factors as a critical contributor to our understanding of FM.

Validation of the multidimensional health locus of control scales for labor and delivery

No current instrument assesses women's health locus of control beliefs in relation to childbirth. Form C of the Multidimensional Health Locus of Control Scales was used to develop items for a new instrument specific to labor and delivery (MHLC-LD). Psychometric analyses conducted with two independent samples of pregnant women supported a three-factor model of the new instrument, consisting of Internal, Powerful Others, and Chance subscales. Results revealed modest coefficient alphas (>.70) for the subscales and demonstrated construct validity in known group analyses. Future validation research will focus on improving the internal consistency reliability of the MHLC-LD, testing factorial invariance across demographic groups, and examining the relationships between obstetric risk, previous birth experiences, and beliefs about control over childbirth outcomes.

Early biocompatibility of crosslinked and non-crosslinked biologic meshes in a porcine model of ventral hernia repair

PURPOSE

Biologic meshes have unique physical properties as a result of manufacturing techniques such as decellularization, crosslinking, and sterilization. The purpose of this study is to directly compare the biocompatibility profiles of five different biologic meshes, AlloDerm(®) (non-crosslinked human dermal matrix), PeriGuard(®) (crosslinked bovine pericardium), Permacol(®) (crosslinked porcine dermal matrix), Strattice(®) (non-crosslinked porcine dermal matrix), and Veritas(®) (non-crosslinked bovine pericardium), using a porcine model of ventral hernia repair.

METHODS

Full-thickness fascial defects were created in 20 Yucatan minipigs and repaired with the retromuscular placement of biologic mesh 3 weeks later. Animals were euthanized at 1 month and the repair sites were subjected to tensile testing and histologic analysis. Samples of unimplanted (de novo) meshes and native porcine abdominal wall were also analyzed for their mechanical properties.

RESULTS

There were no significant differences in the biomechanical characteristics between any of the mesh-repaired sites at 1 month postimplantation or between the native porcine abdominal wall without implanted mesh and the mesh-repaired sites (P > 0.05 for all comparisons). Histologically, non-crosslinked materials exhibited greater cellular infiltration, extracellular matrix (ECM) deposition, and neovascularization compared to crosslinked meshes.

CONCLUSIONS

While crosslinking differentiates biologic meshes with regard to cellular infiltration, ECM deposition, scaffold degradation, and neovascularization, the integrity and strength of the repair site at 1 month is not significantly impacted by crosslinking or by the de novo strength/stiffness of the mesh.

Insomnia and well-being

Most Americans have occasional problems with insomnia. The relationship of insomnia to illness is well known. However, insomnia may also relate to lower levels of well-being. Although there are various definitions of well-being, one of the most clearly articulated and comprehensive models identifies 2 overarching constructs, psychological well-being and subjective well-being. The purpose in the present study was to assess the relationship between insomnia symptoms and the dimensions of psychological and subjective well-being, adjusting for the potential confound of comorbid physical and psychological illness. The data for the present study came from the National Survey of Midlife Development in the United States, a survey of community-dwelling adults. After adjustment for demographic characteristics and a wide range of chronic mental and physical health conditions, insomnia symptoms were found to have a significant relationship with both psychological and subjective well-being but a stronger relationship to subjective well-being. These data suggest that insomnia symptoms have a stronger relationship to enjoying life than to the perception that one has a meaningful life.

Sleep and the affective response to stress and pain

OBJECTIVE

The current study examined sleep disturbance (i.e., sleep duration, sleep quality) as a correlate of stress reactivity and pain reactivity.

DESIGN AND OUTCOME MEASURES

An ecological momentary assessment design was used to evaluate the psychosocial functioning of men and women with fibromyalgia or rheumatoid arthritis (N=49). Participants recorded numeric ratings of pain, the occurrence of a stressful event, as well as positive and negative affect 7 times throughout the day for 2 consecutive days. In addition, participants reported on their sleep duration and sleep quality each morning.

RESULTS

Sleep disruption was not found to be an independent predictor of affect. However, sleep was found to buffer the relationship between stress and negative affect and the relationship between pain and both positive and negative affect.

CONCLUSION

These results are consistent with a model in which good-quality sleep acts as a biobehavioral resource that minimizes allostatic load.

Individual differences in emotional processing and reactivity to pain among older women with rheumatoid arthritis

The purpose of the current study was to determine whether the relationship between pain and emotion may be better understood by identifying people who are more vulnerable to emotional dysregulation and those who are able to regulate emotion. Data were collected from 81 women diagnosed with rheumatoid arthritis. We assessed affect intensity, emotion regulation, active coping, neuroticism as well as weekly reports of pain, positive affect, and negative affect. Results indicated that the joint effects of emotion regulation and emotional intensity predicted emotional responses to pain. The current study suggests that the emotional impact of pain is related to emotional intensity which can be tempered by the ability to regulate emotion.

Enhancing Health and Emotion: Mindfulness as a Missing Link Between Cognitive Therapy and Positive Psychology

Mindfulness meditation is an increasingly popular intervention for the treatment of physical illnesses and psychological difficulties. Using intervention strategies with mechanisms familiar to cognitive behavioral therapists, the principles and practice of mindfulness meditation offer promise for promoting many of the most basic elements of positive psychology. It is proposed that mindfulness meditation promotes positive adjustment by strengthening metacognitive skills and by changing schemas related to emotion, health, and illness. Additionally, the benefits of yoga as a mindfulness practice are explored. Even though much empirical work is needed to determine the parameters of mindfulness meditation’s benefits, and the mechanisms by which it may achieve these benefits, theory and data thus far clearly suggest the promise of mindfulness as a link between positive psychology and cognitive behavioral therapies.

Health Goal Cognition and Adjustment in Women with Fibromyalgia

The purpose of this study was to identify individual differences in symptom-specific goal for persons diagnosed with fibromyalgia syndrome (FMS) and to determine whether those differences are related to adjustment outcomes. Women with FMS (N=71) rank ordered 12 FMS-specific goals and completed a packet of psychosocial outcome measures. Cluster analysis suggested that there were three relatively homogeneous subgroups defined. Cluster 1 ranked goals related to seeking professional care higher than all other groups. Cluster 2 ranked self-sufficiency goals higher than the other two groups. Cluster 3 ranked social-validation goals higher than the other two clusters. Multivariate analyses of variance (MANOVAs) and post-hoc tests showed that goal profiles covaried with differences in pain, negative affect, goal-specific social support, general social support, goal-related interference, and negative life events. Differences between groups are discussed in the context of proposed relations between goals and environmental support.

Impact of two types of expectancy on recovery from total knee replacement surgery (TKR) in adults with osteoarthritis

This study examines the impact of 2 classes of psychological variables--expectancies for the future and self-efficacy--on recovery of function and reduction in symptomatology among individuals seeking total knee replacement surgery (TKR). The authors collected outcome measures (SF-36, WOMAC, Clinician assessments) prior to surgery, 4-6 weeks after surgery, and 6 months postsurgery for surgery patients and controls. Linear trend analyses by group gauged the impact of the surgical intervention on recovery, revealing significant improvements over time on physical health outcomes for the surgery patients not attained by controls. In addition, two classes of psychosocial variables--expectancies and efficacy beliefs--predicted the extent of gains in physical and mental health outcomes among those patients who elected to have surgery. When initial status was controlled, between 9 and 13 percent of the variance in TKR outcomes was due to expectations and efficacy. These results point to the importance of psychosocial variables in recovery of function and reduced symptoms after knee surgery.

Affect and pain in rheumatoid arthritis: Do individual differences in affective regulation and affective intensity predict emotional recovery from pain?

BACKGROUND

Individual differences in adaptation to rheumatoid arthritis are not fully accounted for by illness severity or duration of symptoms.

PURPOSE

In this study, we assessed differences in affect regulation and affect intensity as variables that might be important for identifying women with rheumatoid arthritis who are resilient versus those who have disrupted moods following pain exacerbations.

METHOD

Specifically, affective regulation, affect intensity, active coping, neuroticism and weekly reports of pain, positive affect, and negative affect were assessed in a sample of 81 women diagnosed with rheumatoid arthritis.

RESULTS

Our results indicated that affective regulation, affect intensity, and active coping played important but distinct roles in the ebb and flow of negative and positive affect. In particular, active coping was related to positive affect, whereas affective regulation and affect intensity showed interactive effects, moderating the prospective relationship between pain and negative affect and pain and positive affect.

CONCLUSION

Overall, this study suggests that recovery from rheumatoid arthritis pain can be swift, except for those women who have difficulty regulating strong unpleasant affect.

Correlates of distress in children at risk for affective disorder: exploring predictors in the offspring of depressed and nondepressed mothers

BACKGROUND

Efforts to understand the correlates of psychological distress in children frequently examine possible correlates in samples of children who are selected for high levels of distress. The propose of this study was to compare distress correlates in a sample with depressed mothers, and thus at high-risk for distress, to a low-risk sample.

METHODS

Examining data from part of a larger project, the association of children's depressive symptoms and internalizing and externalizing problems to maternal depression level, life stress, verbal ability, and the experience of a traumatic event were examined in a series of regression equations.

RESULTS

Results indicated that children's depressive symptoms, rather than internalizing and externalizing problems, tended to be most consistently related to maternal variables, and also suggested that any experience of maternal depressive symptoms was associated with child problems. It was also found that child depressive symptoms were correlated with life events, but only for nondepressed mothers, and that at-risk children with higher levels of verbal ability were significantly less likely to report experiencing depressive symptoms and internalizing problems than were those with lower levels of verbal ability.

LIMITATIONS

Because these data are preliminary, further research examining a broader array of variables is important.

CONCLUSIONS

These results suggest the need for different models of these processes in different populations of children.

Body fat distribution and hemodynamic stress responses in premenopausal obese women: a preliminary study

To examine the relationship between body fat distribution and hemodynamic stress responses, cardiovascular responses to a speech task and a forehead cold pressor task were evaluated with 24 premenopausal women classified a priori as either centrally or peripherally obese. Results showed that women with central adiposity exhibited greater stress-related increases in diastolic blood pressure and total peripheral resistance, whereas women with peripheral adiposity exhibited greater stress-related increases in cardiac output. Depression, self-consciousness, hostility, and mood scores did not explain significant variance in the stress response differences between regional adiposity groups. The findings suggest that central adiposity may increase the risk of cardiovascular disease in women at least in part by enhancing vascular responses to stress.

Body fat distribution and hemodynamic stress responses in premenopausal obese women: a preliminary study

To examine the relationship between body fat distribution and hemodynamic stress responses, cardiovascular responses to a speech task and a forehead cold pressor task were evaluated with 24 premenopausal women classified a priori as either centrally or peripherally obese. Results showed that women with central adiposity exhibited greater stress-related increases in diastolic blood pressure and total peripheral resistance, whereas women with peripheral adiposity exhibited greater stress-related increases in cardiac output. Depression, self-consciousness, hostility, and mood scores did not explain significant variance in the stress response differences between regional adiposity groups. The findings suggest that central adiposity may increase the risk of cardiovascular disease in women at least in part by enhancing vascular responses to stress.

Field research on the relationship between stress and disease activity in rheumatoid arthritis

We review empirical evidence from two field studies for the role of stressful life events in disease flare-ups among patients with rheumatoid arthritis (RA). RA patients were expected to be more vulnerable psychologically, and physiologically, to stressful events in their everyday lives than other arthritis patients without an autoimmune disease. Findings from two studies are reviewed both for their substantive contribution, but also to provide guidance on measurement issues in future field research of this kind. One study included 41 patients with RA, who were interviewed weekly and called to a clinic for blood work and joint examinations when their levels of interpersonal stress increased significantly. A second study used a similar design but included comparison samples of patients with osteoarthritis (OA) and healthy controls of similar age and the same gender as the RA sample. The findings provided support for the proposition that interpersonal stressors are predictive of increases in disease activity. Not all RA patients, however, showed these relationships, and there was evidence that some participants with OA who were depressed also showed higher disease activity following interpersonal stressors. Significant individual differences in the stress-disease relationship were uncovered that deserve greater attention in future studies. Important improvements in the assessment of stressful events and refinements in panel study design are also presented as guides to research on the role of stress in disease processes.

Development of ultrasonic vocalization responses in genetically heterogeneous National Institute of Health (N:NIH) rats. I. Influence of age, testing experience, and associated factors

The N:NIH strain of rats was developed by the National Institutes of Health to provide a maximally heterogeneous population as a base for selective breeding (Hansen & Spuhler, 1984). Using the N:NIH strain, this laboratory will selectively breed adult animals that exhibited extremes of high or low ultrasonic vocalization (USV) rates as infants. Because nothing was known about USV in N:NIH rats, we characterized the development of isolation-induced USV in the first generation of this strain born in our laboratory. In a longitudinal/cross-sectional study of pups tested at 3, 10, 15, and 18 days postnatally, N:NIH pups emitted their highest rates of USV at 3-4 days postnatally and calling remained high for 10 days before declining. USV rates were found to be a relatively environmentally stable behavioral trait in that repeated testing did not significantly affect the calling rates of either individuals or litters, and only at 3 days postnatal age did naturally occurring ambient temperature variations (6 degrees C range) significantly affect USV responses. Individual differences in USV responses emerged by 10 days of age that were not simply correlations of body weight or rectal temperature, and pups at that age showed isolation calling rates that were highly predictive of their response levels 5 days later.