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Mann FD, Cuevas AG, Clouston SAP, Freilich CD, Krizan Z, Zuber S, Wänström L, Muniz-Terrera G, O'Keefe P, Voll S, Hofer S, Rodgers JL, Krueger RF. A novel approach to model cumulative stress: Area under the s-factor curve. Soc Sci Med 2024; 348:116787. [PMID: 38547807 DOI: 10.1016/j.socscimed.2024.116787] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 02/06/2024] [Accepted: 03/12/2024] [Indexed: 04/26/2024]
Abstract
OBJECTIVE Using a large longitudinal sample of adults from the Midlife in the United States (MIDUS) study, the present study extended a recently developed hierarchical model to determine how best to model the accumulation of stressors, and to determine whether the rate of change in stressors or traditional composite scores of stressors are stronger predictors of health outcomes. METHOD We used factor analysis to estimate a stress-factor score and then, to operationalize the accumulation of stressors we examined five approaches to aggregating information about repeated exposures to multiple stressors. The predictive validity of these approaches was then assessed in relation to different health outcomes. RESULTS The prediction of chronic conditions, body mass index, difficulty with activities of daily living, executive function, and episodic memory later in life was strongest when the accumulation of stressors was modeled using total area under the curve (AUC) of estimated factor scores, compared to composite scores that have traditionally been used in studies of cumulative stress, as well as linear rates of change. CONCLUSIONS Like endogenous, biological markers of stress reactivity, AUC for individual trajectories of self-reported stressors shows promise as a data reduction technique to model the accumulation of stressors in longitudinal studies. Overall, our results indicate that considering different quantitative models is critical to understanding the sequelae and predictive power of psychosocial stressors from midlife to late adulthood.
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Affiliation(s)
- Frank D Mann
- Program in Public Health, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA; Family, Population, and Preventive Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA.
| | - Adolfo G Cuevas
- Department of Social and Behavioral Sciences Department, School of Global Public Health at New York University, Manhattan, NY, USA
| | - Sean A P Clouston
- Program in Public Health, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA; Family, Population, and Preventive Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Colin D Freilich
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Zlatan Krizan
- Department of Psychology, Iowa State University, Ames, IA, USA
| | - Sascha Zuber
- Institute of Aging and Lifelong Health, University of Victoria, Victoria, BC, V8N 1V8, Canada; Geneva Aging Research Center at University of Geneva, Geneva, Switzerland
| | - Linda Wänström
- Department of Computer and Information Science, Linköping University, 581 83, Linköping, Sweden
| | - Graciela Muniz-Terrera
- Ohio University Heritage College of Osteopathic Medicine (OUHCOM), Dublin, OH, 43016, USA; Edinburgh Dementia Prevention, University of Edinburgh, Edinburgh, EH4 2XU, UK
| | - Patrick O'Keefe
- Department of Neurology, Oregon Health and Science University, Portland, OR, 97239, USA
| | - Stacey Voll
- Institute of Aging and Lifelong Health, University of Victoria, Victoria, BC, V8N 1V8, Canada
| | - Scott Hofer
- Institute of Aging and Lifelong Health, University of Victoria, Victoria, BC, V8N 1V8, Canada; Department of Neurology, Oregon Health and Science University, Portland, OR, 97239, USA
| | - Joseph L Rodgers
- Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, 37232, USA
| | - Robert F Krueger
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
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Kałwak W, Weziak-Bialowolska D, Wendołowska A, Bonarska K, Sitnik-Warchulska K, Bańbura A, Czyżowska D, Gruszka A, Opoczyńska-Morasiewicz M, Izydorczyk B. Young adults from disadvantaged groups experience more stress and deterioration in mental health associated with polycrisis. Sci Rep 2024; 14:8757. [PMID: 38627525 PMCID: PMC11021532 DOI: 10.1038/s41598-024-59325-8] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 04/09/2024] [Indexed: 04/19/2024] Open
Abstract
The recent polycrisis (COVID-19, Ukraine war, climate change, economic crisis) has been associated with mental health through cumulative stress, with young people being particularly vulnerable. We surveyed 403 college students from Poland to examine their psychological responses to the experienced crises. The results showed that polycrisis was associated with worse mental health of college students from disadvantaged groups (based on gender, sexual orientation, and financial situation) compared to other college students, in four areas: sense of proximity to the crises, stress caused by the crises, sense of responsibility for mitigating the crises, and experiencing everyday moral dilemmas regarding the crises. These young adults also suffered more in terms of negative affectivity, depressive symptoms, and subjective physical and mental health. Our findings suggest that when discussing public mental health perspectives, it is important to consider consequences of cumulative stress and its greater impact on young people from disadvantaged groups.
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Affiliation(s)
- Weronika Kałwak
- Institute of Psychology, Faculty of Philosophy, Jagiellonian University, ul. Romana Ingardena 6, 30-060, Kraków, Poland.
| | - Dorota Weziak-Bialowolska
- Department of Quantitative Methods and Information Technology, Kozminski University, ul. Jagiellonska 57/59, 03-301, Warsaw, Poland
- Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, 12 Arrow St, Cambridge, MA, 02138, USA
| | - Anna Wendołowska
- Institute of Psychology, Faculty of Philosophy, Jagiellonian University, ul. Romana Ingardena 6, 30-060, Kraków, Poland
| | - Karolina Bonarska
- Institute of Psychology, Faculty of Philosophy, Jagiellonian University, ul. Romana Ingardena 6, 30-060, Kraków, Poland
| | - Katarzyna Sitnik-Warchulska
- Institute of Applied Psychology, Faculty of Management and Social Communication, Jagiellonian University, ul. Prof. Stefana Łojasiewicza 4, 30-348, Kraków, Poland
| | - Anna Bańbura
- Institute of Psychology, Faculty of Philosophy, Jagiellonian University, ul. Romana Ingardena 6, 30-060, Kraków, Poland
| | - Dorota Czyżowska
- Institute of Psychology, Faculty of Philosophy, Jagiellonian University, ul. Romana Ingardena 6, 30-060, Kraków, Poland
| | - Aleksandra Gruszka
- Institute of Psychology, Faculty of Philosophy, Jagiellonian University, ul. Romana Ingardena 6, 30-060, Kraków, Poland
| | | | - Bernadetta Izydorczyk
- Institute of Psychology, Faculty of Philosophy, Jagiellonian University, ul. Romana Ingardena 6, 30-060, Kraków, Poland
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Portillo C, Adinoff B, Spencer CT, Field CA. The association of allostasis with alcohol use: A case-control study in males with and without alcohol use disorder. Alcohol 2023; 112:9-16. [PMID: 37454744 DOI: 10.1016/j.alcohol.2023.07.001] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 07/06/2023] [Accepted: 07/06/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND Allostatic load (AL) is associated with a heightened predisposition to disease due to prolonged activation of biological stress-response systems. Alcohol use disorder (AUD) is known to activate these systems. The primary aim of the current study was to examine the relationship between AL and AUD. METHODS Participants were males (100%) with DSM-IV Alcohol Dependence (n = 48) and healthy participants with no history of substance use disorder (n = 17). Participants with AUD were 4-6 weeks abstinent. The AL index used cortisol, interleukin-6 (IL-6), fibrinogen, tumor necrosis factor-alpha (TNFα), C-reactive protein (CRP), glucose, insulin, leptin, pulse, systolic blood pressure readings, diastolic blood pressure readings, and body mass index (BMI). Physiological dysregulation for each biological measure was determined based on values within the 25th or 75th percentiles; AL was calculated as the total number of physiologically dysregulated biological measures. RESULTS No differences in mean AL scores between the cases and controls [t(63) = .48, p = .633] were observed. Among cases, AL was not associated with lifetime drinks per drinking day (F(2,42) = .42, p = .662), lifetime total drinks (F(2,42) = 0.48, p = .620), total drinks 6 months prior to participating in the study (F(2,43) = 0.58, p = .563), or drinks per drinking day at 3-month follow-up (F(2,35) = 1.93, p = .161). AL was negatively associated with drinks per drinking day 6 months prior to study participation (F(2,42) = 3.71, p = .033). CONCLUSIONS The hypotheses were not supported. Given that alcohol is likely to lead to physiological dysregulation, the apparent absence of a relationship between biomarkers of cumulative stress as indicated by AL and drinking status was both unanticipated and remarkable. Based on the results, AL in the context of drinking status or drinking among males with AUD may not be applicable.
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Affiliation(s)
- Carlos Portillo
- The Latino Alcohol and Health Disparities Research and Training Center at The University of Texas at El Paso, El Paso, TX, United States.
| | - Bryon Adinoff
- The University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Charles T Spencer
- The University of Texas at El Paso, Department of Biological Sciences, El Paso, TX, United States
| | - Craig A Field
- The Latino Alcohol and Health Disparities Research and Training Center at The University of Texas at El Paso, El Paso, TX, United States; The University of Texas at El Paso, Department of Psychology, El Paso, TX, United States
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Li C, Andrzejak SE, Jones SR, Williams BM, Moore JX. Investigating the association between educational attainment and allostatic load with risk of cancer mortality among African American women. BMC Womens Health 2023; 23:448. [PMID: 37620873 PMCID: PMC10463695 DOI: 10.1186/s12905-023-02529-3] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 07/05/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND African American (AA) women navigate the world with multiple intersecting marginalized identities. Accordingly, AA women have higher cumulative stress burden or allostatic load (AL) compared to other women. Studies suggest that AA women with a college degree or higher have lower AL than AA women with less than a high school diploma. We examined the joint effect of educational attainment and AL status with long-term risk of cancer mortality, and whether education moderated the association between AL and cancer mortality. METHODS We performed a retrospective analysis among 4,677 AA women within the National Health and Nutrition Examination Survey (NHANES) from 1988 to 2010 with follow-up data through December 31, 2019. We fit weighted Cox proportional hazards models to estimate adjusted hazard ratios (aHRs) of cancer death between educational attainment/AL (adjusted for age, income, and smoking status). RESULTS AA women with less than a high school diploma living with high AL had nearly a 3-fold increased risk (unadjusted HR: 2.98; 95%C CI: 1.24-7.15) of cancer death compared to AA college graduates living with low AL. However, after adjusting for age, this effect attenuated (age-adjusted HR: 1.11; 95% CI: 0.45-2.74). AA women with high AL had 2.3-fold increased risk of cancer death (fully adjusted HR: 2.26; 95% CI: 1.10-4.57) when compared to AA with low AL, specifically among women with high school diploma or equivalent and without history of cancer. CONCLUSIONS Our findings suggest that high allostatic load is associated with a higher risk of cancer mortality among AA women with lower educational attainment, while no such association was observed among AA women with higher educational attainment. Thus, educational attainment plays a modifying role in the relationship between allostatic load and the risk of cancer death for AA women. Higher education can bring several benefits, including improved access to medical care and enhanced medical literacy, which in turn may help mitigate the adverse impact of AL and the heightened risk of cancer mortality among AA women.
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Affiliation(s)
- Cynthia Li
- Georgia Cancer Center, Augusta University, 1410 Laney Walker Blvd, 30912, Augusta, GA, USA
| | | | - Samantha R Jones
- Department of Family and Community Medicine, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | | | - Justin Xavier Moore
- Center for Health Equity Transformation, Department of Behavioral Science, University of Kentucky, Lexington, KY, USA.
- Community Impact Office, Markey Cancer Center, University of Kentucky, Lexington, KY, USA.
- Department of Internal Medicine, University of Kentucky, Lexington, KY, USA.
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Carcone D, Gardhouse K, Goghari VM, Lee ACH, Ruocco AC. The transdiagnostic relationship of cumulative lifetime stress with memory, the hippocampus, and personality psychopathology. J Psychiatr Res 2022; 155:483-492. [PMID: 36183602 DOI: 10.1016/j.jpsychires.2022.09.005] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 07/19/2022] [Accepted: 09/12/2022] [Indexed: 10/31/2022]
Abstract
Stress has a detrimental impact on memory, the hippocampus, and psychological health. Psychopathology research on stress has centered mainly on psychiatric diagnoses rather than symptom dimensions, and less attention has been given to the neurobiological factors through which stress might be translated into psychopathology. The present work investigates the transdiagnostic relationship of cumulative stress with episodic memory and the hippocampus (both structure and function) and explores the extent to which stress mediates the relationship between personality psychopathology and hippocampal size and activation. Cumulative lifetime stress was assessed in a sample of females recruited to vary in stress exposure and severity of personality psychopathology. Fifty-six participants completed subjective and objective tests of episodic memory, a T2-weighted high-resolution magnetic resonance imaging (MRI) scan of the medial-temporal lobe, and functional MRI (fMRI) scanning during a learning and recognition memory task. Higher cumulative stress was significantly related to memory complaints (but not episodic memory performance), lower bilateral hippocampal volume, and greater encoding-related hippocampal activation during the presentation of novel stimuli. Furthermore, cumulative stress significantly mediated the relationship between personality psychopathology and both hippocampal volume and activation, whereas alternative mediation models were not supported. The findings suggest that structural and functional activation differences in the hippocampus observed in case-control studies of psychiatric diagnoses may share cumulative stress as a common factor, which may mediate broadly reported relationships between psychopathology and hippocampal structure and function.
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Affiliation(s)
- Dean Carcone
- Department of Psychological Clinical Science, University of Toronto, 1265 Military Trail, Toronto, Ontario, M1C 1A4, Canada.
| | - Katherine Gardhouse
- Department of Psychological Clinical Science, University of Toronto, 1265 Military Trail, Toronto, Ontario, M1C 1A4, Canada; Centre for Addiction and Mental Health (CAMH), 60 White Squirrel Way, Toronto, Ontario, M6J 1H4, Canada
| | - Vina M Goghari
- Department of Psychological Clinical Science, University of Toronto, 1265 Military Trail, Toronto, Ontario, M1C 1A4, Canada; Department of Psychology, University of Toronto Scarborough, 1265 Military Trail, Toronto, Ontario, M1C 1A4, Canada
| | - Andy C H Lee
- Department of Psychological Clinical Science, University of Toronto, 1265 Military Trail, Toronto, Ontario, M1C 1A4, Canada; Department of Psychology, University of Toronto Scarborough, 1265 Military Trail, Toronto, Ontario, M1C 1A4, Canada; Rotman Research Institute, Baycrest Hospital, 3560 Bathurst St, Toronto, ON, M6A 2E1, Canada
| | - Anthony C Ruocco
- Department of Psychological Clinical Science, University of Toronto, 1265 Military Trail, Toronto, Ontario, M1C 1A4, Canada; Department of Psychology, University of Toronto Scarborough, 1265 Military Trail, Toronto, Ontario, M1C 1A4, Canada
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Rao WW, Li M, Su Y, Caron J, Xiang YT, Meng X. How psychosocial stress profile influences the subsequent occurrence of neuropsychiatric comorbidities: A longitudinal population-based cohort study. J Affect Disord 2022; 311:294-302. [PMID: 35588911 DOI: 10.1016/j.jad.2022.05.066] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/31/2022] [Accepted: 05/12/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND The role of psychosocial stressors in psychiatric disorders and executive dysfunction has been reported, separately. The literature has also suggested the involvement of social support and coping strategies in these relationships. However, there is a lack of research conducted to examine the relationships among multiple stressors and neuropsychiatric comorbidities while considering the presence of social support and coping strategies. This study aims to articulate the roles of multiple psychosocial stressors, social support, and coping strategies in the subsequent occurrence of neuropsychiatric comorbidities. METHODS Data analyzed were from the 6th data collection of a large-scale, longitudinal population-based cohort from Southwest Montreal in Canada. The cumulative effects of multiple stressors were separately examined by a composite score and latent profile analysis. Multinomial logistic regression models were used to test the relationship between cumulative stressors and neuropsychiatric comorbidities. RESULTS A total of 210 participants were included in the analyses. The LPA identified a 2-class model for psychosocial stressors (low and high) and executive function (executive dysfunction and no executive dysfunction), respectively. There were 11.8% of participants with neuropsychiatric comorbidities. Both the composite stress score (RR = 1.08, 95%CI = 1.01-1.15) and latent stress groups (RR = 3.65, 95%CI = 1.15-11.57) were associated with neuropsychiatric comorbidities after adjusting for social support and coping strategies. The risk of developing neuropsychiatric comorbidities decreased when the level of social support was high (P < 0.05). CONCLUSIONS Exposures to multiple stressors increased the risk of subsequent neuropsychiatric comorbidities, but the risk can be modified by a higher level of social support.
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Affiliation(s)
- Wen-Wang Rao
- Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada; Douglas Research Centre, Montreal, Quebec, Canada
| | - Muzi Li
- Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada; Douglas Research Centre, Montreal, Quebec, Canada
| | - Yingying Su
- Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada; Douglas Research Centre, Montreal, Quebec, Canada
| | - Jean Caron
- Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada; Douglas Research Centre, Montreal, Quebec, Canada
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China; Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao SAR, China
| | - Xiangfei Meng
- Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada; Douglas Research Centre, Montreal, Quebec, Canada.
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Williams BM, Laurent C, Chawla R, Moore JX. Examining educational attainment and allostatic load in non-Hispanic Black women. BMC Womens Health 2022; 22:75. [PMID: 35300673 PMCID: PMC8928016 DOI: 10.1186/s12905-022-01641-0] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 02/22/2022] [Indexed: 11/30/2022] Open
Abstract
Background Research suggests that non-Hispanic Black (henceforth, Black) women and people with lower educational attainment have higher levels of allostatic load (AL). This study sought to determine the association between educational attainment and AL among a large sample of Black women.
Methods We analyzed data among 4177 Black women from the National Health and Nutrition Examination Survey years 1999–2018. AL score was defined as the total for abnormal measures of eight biomarkers. We further categorized participants with AL score greater than or equal to 4 as having high AL. We calculated mean estimates of total allostatic load scores using generalized linear models. We performed modified Poisson Regression models with robust variance estimation to estimate prevalence ratios (PRs) of high allostatic load and their associated 95% confidence intervals (CIs) by educational attainment.
Results Black women with a college degree or higher had the lowest prevalence of high allostatic load (31.8% vs. 42.7%, 36.3%, 36.6%), and age adjusted mean allostatic load scores (mean = 1.90 vs. mean = 2.34, mean = 1.99, mean = 2.05) when compared to Black women with less than a high school diploma, high school diploma or GED, and some college or associates degree respectively. Even after accounting for age, poverty-to-income ratio, smoking, congestive heart failure, and heart attack, Black college graduates had an 14.3% lower prevalence of high allostatic load (PR = 0.857, 95% CI 0.839–0.876) when compared to Black women with lower educational attainment. Conclusions Black women with a baccalaureate degree or higher educational attainment had lower allostatic load compared to Black women with less than a high school education. This finding further confirms higher education is a social determinant of health. Future research should explore differences in AL by more granular degree types. Supplementary Information The online version contains supplementary material available at 10.1186/s12905-022-01641-0.
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Affiliation(s)
- Brittany Marie Williams
- Department of Educational Leadership and Higher Education, St. Cloud State University, St. Cloud, MN, USA
| | - Christian Laurent
- Cancer Prevention, Control, and Population Health Program, Department of Medicine, Georgia Cancer Center, Augusta University, 1410 Laney Walker Blvd CN-2135, Augusta, GA, 30912, USA
| | - Rishab Chawla
- Cancer Prevention, Control, and Population Health Program, Department of Medicine, Georgia Cancer Center, Augusta University, 1410 Laney Walker Blvd CN-2135, Augusta, GA, 30912, USA
| | - Justin Xavier Moore
- Cancer Prevention, Control, and Population Health Program, Department of Medicine, Georgia Cancer Center, Augusta University, 1410 Laney Walker Blvd CN-2135, Augusta, GA, 30912, USA. .,Institute of Preventive and Public Health, Medical College of Georgia, Augusta University, Augusta, GA, USA.
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Sokołowski A, Folkierska-Żukowska M, Jednoróg K, Wypych M, Dragan WŁ. It is Not (Always) the Mismatch That Beats You-On the Relationship Between Interaction of Early and Recent Life Stress and Emotion Regulation, an fMRI Study. Brain Topogr 2021. [PMID: 34775569 DOI: 10.1007/s10548-021-00880-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Accepted: 11/03/2021] [Indexed: 01/05/2023]
Abstract
Stress may impact the ability to effectively regulate emotions. To study the impact of stressful experiences in early and recent life on emotion regulation, we examined the relationship between early life stress, recent stress, and brain activation during cognitive reappraisal. We investigated two regulation goals: the decrease and increase of emotional response to both negative and positive stimuli. Furthermore, two models of stress consequences were examined: the cumulative and match/mismatch models. A total of 83 participants (Mage = 21.66) took part in the study. There was an interaction between cumulative stress and stimuli valence in the cuneus, superior lateral occipital cortex, superior parietal lobule, supramarginal gyrus extending to superior temporal gyrus, and precentral gyrus extending to supplementary motor area. Interaction between mismatched stress index and stimuli valence was found in the left hippocampus, left insula extending to the orbitofrontal cortex and amygdala, and in a cluster including the anterior cingulate cortex, superior frontal gyrus, and frontal pole. Furthermore, there were differences between the effects of cumulative and mismatched stress indices on brain activation during reappraisal of positive but not negative stimuli. Results indicate that cumulative stress and match/mismatch approaches are both useful for explaining brain activation during reappraisal. This finding is important for our understanding of the multifaceted impact of stress on emotion regulation.
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Mann FD, Cuevas AG, Krueger RF. Cumulative stress: A general "s" factor in the structure of stress. Soc Sci Med 2021; 289:114405. [PMID: 34563869 PMCID: PMC8906193 DOI: 10.1016/j.socscimed.2021.114405] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 10/01/2020] [Revised: 09/01/2021] [Accepted: 09/13/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The present study tested a hierarchical model of cumulative stress in a large probability sample of adults from the United States. METHODS Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) models were used to develop and test a hierarchical model of cumulative stress. Structural equation models were used to estimate concurrent associations with demographic factors, polygenic risk scores, and physical health outcomes, as well as prospective associations with physical health outcomes. RESULTS A hierarchical model of cumulative stress was the best-fitting model, with a general "s-factor" capturing the tendency for subordinate dimensions of stress to correlate. Associations with demographic factors and polygenic risk scores for physical and psychological phenotypes provide evidence for the convergent validity of a general s-factor of cumulative stress. The general s-factor and subordinate factors of cumulative stress were also associated with physical health outcomes, concurrently and prospectively, including number of chronic conditions, body mass index, and difficulty with activities of daily living. CONCLUSIONS Like other human individual differences, the co-occurrence of social stressors can be understood using a hierarchical model.
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Affiliation(s)
- Frank D Mann
- Department of Family, Population, and Preventative Medicine, Stony Brook University, 101 Nicolls Road, Health Sciences Center, Level 3, Room 071, Stony Brook, NY, 11794, USA.
| | - Adolfo G Cuevas
- Department of Community Health, Tufts University, 574 Boston Avenue, Suite 208, Medford, MA, 02155, USA
| | - Robert F Krueger
- Department of Psychology, University of Minnesota, 7 E River Road, Minneapolis, MN, 55455, USA
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Sokołowski A, Folkierska-Żukowska M, Jednoróg K, Moodie CA, Dragan WŁ. The relationship between early and recent life stress and emotional expression processing: A functional connectivity study. Cogn Affect Behav Neurosci 2020; 20:588-603. [PMID: 32342272 DOI: 10.3758/s13415-020-00789-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The aim of this study was to characterize neural activation during the processing of negative facial expressions in a non-clinical group of individuals characterized by two factors: the levels of stress experienced in early life and in adulthood. Two models of stress consequences were investigated: the match/mismatch and cumulative stress models. The match/mismatch model assumes that early adversities may promote optimal coping with similar events in the future through fostering the development of coping strategies. The cumulative stress model assumes that effects of stress are additive, regardless of the timing of the stressors. Previous studies suggested that stress can have both cumulative and match/mismatch effects on brain structure and functioning and, consequently, we hypothesized that effects on brain circuitry would be found for both models. We anticipated effects on the neural circuitry of structures engaged in face perception and emotional processing. Hence, the amygdala, fusiform face area, occipital face area, and posterior superior temporal sulcus were selected as seeds for seed-based functional connectivity analyses. The interaction between early and recent stress was related to alterations during the processing of emotional expressions mainly in to the cerebellum, middle temporal gyrus, and supramarginal gyrus. For cumulative stress levels, such alterations were observed in functional connectivity to the middle temporal gyrus, lateral occipital cortex, precuneus, precentral and postcentral gyri, anterior and posterior cingulate gyri, and Heschl's gyrus. This study adds to the growing body of literature suggesting that both the cumulative and the match/mismatch hypotheses are useful in explaining the effects of stress.
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Moore JX, Bevel MS, Aslibekyan S, Akinyemiju T. Temporal changes in allostatic load patterns by age, race/ethnicity, and gender among the US adult population; 1988-2018. Prev Med 2021; 147:106483. [PMID: 33640399 PMCID: PMC8826516 DOI: 10.1016/j.ypmed.2021.106483] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [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: 09/15/2020] [Revised: 02/08/2021] [Accepted: 02/22/2021] [Indexed: 12/21/2022]
Abstract
The objective of this study is to provide an assessment of allostatic load (AL) burden among US adults across race/ethnicity, gender, and age groups over a 30-year time period. We analyzed data from 50,671 participants of the National Health and Nutrition Examination Survey (NHANES) years 1988 through 2018. AL score was defined as the sum total for abnormal measures of the following components: serum albumin, body mass index, serum C - reactive protein, serum creatinine, diastolic blood pressure, glycated hemoglobin, systolic blood pressure, total cholesterol, and serum triglycerides. We performed modified Poisson regression to estimate the adjusted Relative Risks (aRRs) of allostatic load, and generalized linear models to determine adjusted mean differences accounting for NHANES sampling weights. Among US adults aged 18 or older, the prevalence of high AL increased by more than 45% from 1988 to 1991 to 2015-2018, from 33.5% to 48.6%. By the latest period, 2015-2018, Non-Hispanic Black women (aRR: 1.292; 95% CI: 1.290-1.293) and Latina women (aRR: 1.266; 95% CI: 1.265-1.267) had higher risks of AL than non-Hispanic White women. Similar trends were observed among men. Age-adjusted mean AL score among NH-Black and Latinx adults was higher than for NH-Whites of up to a decade older regardless of gender. From 1988 through 2018, Adults aged 40 years old and older had over 2-fold increased risks of high AL when compared to adults 18-29 years old. After 30-years of collective data, racial disparities in allostatic load persist for NH-Black and Latinx adults.
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Affiliation(s)
- Justin Xavier Moore
- Division of Epidemiology, Department of Population Health Sciences, Augusta University, Augusta, GA, USA; Institute of Preventive and Public Health, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Malcolm S Bevel
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Stella Aslibekyan
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Tomi Akinyemiju
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA.
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Bednaršek N, Newton JA, Beck MW, Alin SR, Feely RA, Christman NR, Klinger T. Severe biological effects under present-day estuarine acidification in the seasonally variable Salish Sea. Sci Total Environ 2021; 765:142689. [PMID: 33077233 DOI: 10.1016/j.scitotenv.2020.142689] [Citation(s) in RCA: 3] [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] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 07/15/2020] [Accepted: 09/26/2020] [Indexed: 05/27/2023]
Abstract
Estuaries are recognized as one of the habitats most vulnerable to coastal ocean acidification due to seasonal extremes and prolonged duration of acidified conditions. This is combined with co-occurring environmental stressors such as increased temperature and low dissolved oxygen. Despite this, evidence of biological impacts of ocean acidification in estuarine habitats is largely lacking. By combining physical, biogeochemical, and biological time-series observations over relevant seasonal-to-interannual time scales, this study is the first to describe both the spatial and temporal variation of biological response in the pteropod Limacina helicina to estuarine acidification in association with other stressors. Using clustering and principal component analyses, sampling sites were grouped according to their distribution of physical and biogeochemical variables over space and time. This identified the most exposed habitats and time intervals corresponding to the most severe negative biological impacts across three seasons and three years. We developed a cumulative stress index as a means of integrating spatial-temporal OA variation over the organismal life history. Our findings show that over the 2014-2016 study period, the severity of low aragonite saturation state combined with the duration of exposure contributed to overall cumulative stress and resulted in severe shell dissolution. Seasonally-variable estuaries such as the Salish Sea (Washington, U.S.A.) predispose sensitive organisms to more severe acidified conditions than those of coastal and open-ocean habitats, yet the sensitive organisms persist. We suggest potential environmental factors and compensatory mechanisms that allow pelagic calcifiers to inhabit less favorable habitats and partially offset associated stressors, for instance through food supply, increased temperature, and adaptation of their life history. The novel metric of cumulative stress developed here can be applied to other estuarine environments with similar physical and chemical dynamics, providing a new tool for monitoring biological response in estuaries under pressure from accelerating global change.
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Affiliation(s)
- Nina Bednaršek
- Southern California Coastal Water Research Project, Costa Mesa, CA, United States of America.
| | - Jan A Newton
- Applied Physics Laboratory and School of Oceanography, University of Washington, Seattle, WA, United States of America
| | - Marcus W Beck
- Tampa Bay Estuary Program, 263 13th Ave S, St. Petersburg, FL, United States of America
| | - Simone R Alin
- NOAA Pacific Marine Environmental Laboratory, Seattle, WA, United States of America
| | - Richard A Feely
- NOAA Pacific Marine Environmental Laboratory, Seattle, WA, United States of America
| | - Natasha R Christman
- College of Earth, Ocean, and Atmospheric Sciences, Oregon State University, Corvallis, OR, United States of America
| | - Terrie Klinger
- University of Washington, School of Marine and Environmental Affairs, Seattle, WA, United States of America
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Mayer SE, Prather AA, Puterman E, Lin J, Arenander J, Coccia M, Shields GS, Slavich GM, Epel ES. Cumulative lifetime stress exposure and leukocyte telomere length attrition: The unique role of stressor duration and exposure timing. Psychoneuroendocrinology 2019; 104:210-8. [PMID: 30884304 DOI: 10.1016/j.psyneuen.2019.03.002] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 01/22/2019] [Accepted: 03/04/2019] [Indexed: 01/08/2023]
Abstract
BACKGROUND Stress exposure occurring across the lifespan increases risk for disease, potentially involving telomere length shortening. Stress exposure during childhood and adulthood has been cross-sectionally linked with shorter telomere length. However, few longitudinal studies have examined telomere length attrition over time, and none have investigated how stressor duration (acute life events vs. chronic difficulties), timing (childhood vs. adulthood), and perceived severity may be uniquely related to telomere length shortening. METHODS To address these issues, we administered a standardized instrument for assessing cumulative lifetime stress exposure (Stress and Adversity Inventory; STRAIN) to 175 mothers of children with Autism Spectrum Disorder or neurotypical children and measured their leukocyte telomere length (LTL) at baseline and 2 years later. RESULTS Greater count of lifetime stressors was associated with shorter LTL at baseline and greater LTL attrition over time. When separating lifetime stressors into acute life events and chronic difficulties, only greater count of chronic difficulties significantly predicted shorter baseline LTL and greater LTL attrition. Similarly, when examining timing of stressor exposure, only greater count of chronic childhood difficulties (age < 18) significantly predicted shorter baseline LTL and greater LTL attrition over the 2-year period in mid-life. Importantly, these results were robust while controlling for stressors occurring during the interim 2-year period. Post-hoc analyses suggested that chronic difficulties occurring during earlier childhood (0-12 years) were associated with greater LTL attrition. Cumulative stressor severity predicted LTL attrition in a parallel manner, but was less consistently associated with baseline LTL. CONCLUSIONS These data are the first to examine the effects of different aspects of cumulative lifetime stress exposure on LTL attrition over time, suggesting that accumulated chronic difficulties during childhood may play a unique role in shaping telomere shortening in midlife.
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Marshall AC, Cooper N, Rosu L, Kennett S. Stress-related deficits of older adults' spatial working memory: an EEG investigation of occipital alpha and frontal-midline theta activities. Neurobiol Aging 2018; 69:239-248. [PMID: 29909181 PMCID: PMC6689422 DOI: 10.1016/j.neurobiolaging.2018.05.025] [Citation(s) in RCA: 2] [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: 01/18/2018] [Revised: 05/14/2018] [Accepted: 05/21/2018] [Indexed: 12/09/2022]
Abstract
Studies highlight cumulative life stress as a significant predictor of accelerated cognitive aging. This study paired electrophysiological with behavioral measures to explore how cumulative stress affects attentional and maintenance processes underpinning working memory retention. We collected electroencephalographic recordings from 60 individuals (30 older, 30 younger) reporting high or low levels of cumulative stress during the performance of a spatial Sternberg task. We measured mid-occipital alpha (8-12 Hz) and frontal-midline theta (4-6 Hz) as indicators of attentional and maintenance processes. Older, high-stress participants' behavioral performance lay significantly below than that of younger adults and low-stress older individuals. Impaired task performance coincided with reduced event-related synchronization in alpha and theta frequency ranges during memory maintenance. Electrophysiological findings suggest that older adults' reduced performance results from a stress-related impact on their ability to retain a stimulus in working memory and inhibit extraneous information from interfering with maintenance. Our results demonstrate the wide-ranging impact of cumulative stress on cognitive health and provide insight into the functional mechanisms disrupted by its influence.
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Affiliation(s)
- Amanda C Marshall
- Department of Psychology, General and Experimental Psychology unit, Ludwig-Maximilians University, Munich, Germany.
| | - Nicholas Cooper
- Centre for Brain Science, University of Essex, Colchester, UK
| | - Livia Rosu
- Centre for Brain Science, University of Essex, Colchester, UK
| | - Steffan Kennett
- Centre for Brain Science, University of Essex, Colchester, UK
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van Netten JJ, van Baal JG, Bril A, Wissink M, Bus SA. An exploratory study on differences in cumulative plantar tissue stress between healing and non-healing plantar neuropathic diabetic foot ulcers. Clin Biomech (Bristol, Avon) 2018; 53:86-92. [PMID: 29477099 DOI: 10.1016/j.clinbiomech.2018.02.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 01/12/2018] [Accepted: 02/14/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Mechanical stress is important in causing and healing plantar diabetic foot ulcers, but almost always studied as peak pressure only. Measuring cumulative plantar tissue stress combines plantar pressure and ambulatory activity, and better defines the load on ulcers. Our aim was to explore differences in cumulative plantar tissue stress between people with healing and non-healing plantar diabetic foot ulcers. METHODS We analyzed a subgroup of 31 patients from a randomized clinical trial, treated with a removable offloading device for their plantar diabetic forefoot ulcer. We measured in-device dynamic plantar pressure and daily stride count to calculate cumulative plantar tissue stress at the ulcer location and associated this with ulcer healing and ulcer surface area reduction at four weeks (Student's t and chi-square test for significance, Cohen's d for effect size). FINDINGS In 12 weeks, 68% (n = 21) of the ulcers healed and 32% (n = 10) did not. No statistically significant differences were found for cumulative plantar tissue stress, plantar pressure or ambulatory activity between people with healed and not-healed ulcers. Cumulative plantar tissue stress was 25% lower for people with healed ulcers (155 vs. 207 MPa·s/day; P = 0.71; Effect size: d = 0.29). Post-hoc analyses in the 27 patients who self-reported to be adherent to wearing the device showed that cumulative plantar tissue stress was 49% lower for those who reached ≥75% ulcer surface area reduction at four weeks (140 vs. 275 MPa·s/day; P = 0.09; d = 0.76); smaller differences and effect sizes were found for peak pressure (24%), peak pressure-time integral (30%) and ambulatory activity (26%); (P-value range: 0.14-0.97; Cohen's d range: 0.14-0.70). INTERPRETATION Measuring cumulative plantar tissue stress may provide insight beyond that obtained from plantar pressure or ambulatory activity alone, with regard to diabetic foot ulcer healing using removable offloading devices. These explorative findings provide baseline data for further studies on this relevant topic.
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Bøe T, Serlachius AS, Sivertsen B, Petrie KJ, Hysing M. Cumulative effects of negative life events and family stress on children's mental health: the Bergen Child Study. Soc Psychiatry Psychiatr Epidemiol 2018; 53:1-9. [PMID: 29090324 DOI: 10.1007/s00127-017-1451-4] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [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: 02/20/2017] [Accepted: 10/22/2017] [Indexed: 01/14/2023]
Abstract
PURPOSE Numerous studies have documented that lower socioeconomic status (SES) is associated with increased mental health problems in children. One proposed pathway for this association has been differential exposure to accumulated risk factors in children of lower SES. The aim of the current study was to investigate the socioeconomic distribution of exposure to negative life events and family stress and to examine the direct and interactive association between lower SES and exposure to life events and family stress in relation with mental health problems. METHODS Using cross-sectional data from the second wave of the Bergen Child Study (conducted in 2006), the current study investigated the association between lower SES and exposure to negative life events, family life stressors, and mental health problems in a sample of 2043 Norwegian 11-13 years and their parents. Information about mental health was self-reported by the children using the Strengths and Difficulties Questionnaire, whereas information about SES and exposure to negative life events and family stressors were provided by their parents. RESULTS The findings showed that lower SES was associated with more symptoms of emotional-, conduct-, hyperactivity/inattention-, and peer problems and that exposure to life events and family stress explained some of this association (10-29% of the total effects). CONCLUSIONS Low SES and higher prevalence of negative life events and family stressors were associated with more symptoms of mental health problems. Overall, the effect sizes were smaller than previous investigations (f 2s = 0.015-0.031), perhaps suggesting a buffering effect of the social safety net in place in Norway.
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Affiliation(s)
- Tormod Bøe
- Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health, Bergen, Mailbox 7810, 5020, Norway.
| | | | - Børge Sivertsen
- Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health, Bergen, Mailbox 7810, 5020, Norway.,Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway.,Department of Research and Innovation, Helse Fonna HF, Haugesund, Norway
| | - Keith J Petrie
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | - Mari Hysing
- Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health, Bergen, Mailbox 7810, 5020, Norway
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Xu K, Zhang X, Wang Z, Hu Y, Sinha R. Epigenome-wide association analysis revealed that SOCS3 methylation influences the effect of cumulative stress on obesity. Biol Psychol 2018; 131:63-71. [PMID: 27826092 PMCID: PMC5419875 DOI: 10.1016/j.biopsycho.2016.11.001] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 10/03/2016] [Accepted: 11/03/2016] [Indexed: 12/20/2022]
Abstract
Chronic stress has a significant impact on obesity. However, how stress influences obesity remains unclear. We conducted an epigenome-wide DNA methylation association analysis of obesity (N=510) and examined whether cumulative stress influenced the DNA methylation on body weight. We identified 20 CpG sites associated with body mass index at the false discovery rate q<0.05, including a novel site, cg18181703, in suppressor of cytokine signaling 3 (SOCS3) gene (coefficient β=-0.0022, FDR q=4.94×10-5). The interaction between cg18181703 and cumulative adverse life stress contributed to variations in body weight (p=0.002). Individuals with at least five major life events and lower methylation of cg1818703 showed a 1.38-fold higher risk of being obese (95%CI: 1.17-1.76). Our findings suggest that aberrant in DNA methylation is associated with body weight and that methylation of SOCS3 moderates the effect of cumulative stress on obesity.
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Affiliation(s)
- Ke Xu
- Department of Psychiatry, Yale School of Medicine, 300 George street, Suite 901, New Haven, CT 06511, United States; Connecticut Veteran Health System, 950 Campbell Ave, Building 35, Room #43, West Haven, 06516, United States.
| | - Xinyu Zhang
- Department of Psychiatry, Yale School of Medicine, 300 George street, Suite 901, New Haven, CT 06511, United States; Connecticut Veteran Health System, 950 Campbell Ave, Building 35, Room #43, West Haven, 06516, United States
| | - Zuoheng Wang
- Department of Biostatistics, Yale School of Public Health, New Haven, CT 06511, United States
| | - Ying Hu
- Yale Stress Center, Yale University, 2 Church St S #209, New Haven, CT 06519, United States
| | - Rajita Sinha
- Department of Psychiatry, Yale School of Medicine, 300 George street, Suite 901, New Haven, CT 06511, United States; Center for Biomedical Informatics and Information Technology, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20850, United States
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Hernandez DC, Pressler E. Gender disparities among the association between cumulative family-level stress & adolescent weight status. Prev Med 2015; 73:60-6. [PMID: 25622888 DOI: 10.1016/j.ypmed.2015.01.013] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Revised: 01/10/2015] [Accepted: 01/18/2015] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To investigate precursors to gender-related obesity disparities by examining multiple family-level stress indices. METHODS Analyses was based on adolescents born between 1975 and 1991 to women from the 1979 National Longitudinal Study of Youth data set (N=4762). Three types of family-level stressors were captured from birth to age 15: family disruption and conflict, financial strain, and maternal risky health behaviors, along with a total cumulative risk index. Body mass index was constructed on reference criteria for children outlined by the Centers for Disease Control. Multivariate logistic regressions were conducted for the three types of family stressors and for the total cumulative index. RESULTS The accumulation of family disruption and conflict and financial stress was positively related to female adolescents being overweight/obese. Childhood exposure to maternal risky health behaviors was positively associated with higher weight status for male adolescents. Total cumulative stress was related to overweight/obesity for females, but not males. CONCLUSION Different family-level stress indices are associated with the weight status of female and male adolescents. Combining types of family-level stress into one cumulative index appears to mask these differences.
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Abravanel BT, Sinha R. Emotion dysregulation mediates the relationship between lifetime cumulative adversity and depressive symptomatology. J Psychiatr Res 2015; 61:89-96. [PMID: 25528603 PMCID: PMC4308421 DOI: 10.1016/j.jpsychires.2014.11.012] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [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: 06/26/2014] [Revised: 10/07/2014] [Accepted: 11/20/2014] [Indexed: 10/24/2022]
Abstract
Repeated exposure to stressful events across the lifespan, referred to as cumulative adversity, is a potent risk factor for depression. Research indicates that cumulative adversity detrimentally affects emotion regulation processes, which may represent a pathway linking cumulative adversity to vulnerability to depression. However, empirical evidence that emotion dysregulation mediates the relationship between cumulative adversity and depression is limited, particularly in adult populations. We examined the direct and indirect effects of cumulative adversity on depressive symptomatology in a large community sample of adults (n = 745) who were further characterized by risk status: never-depressed (n = 638) and "at-risk" remitted mood-disordered (n = 107). All participants completed the Cumulative Adversity Inventory (CAI), the Difficulties in Emotion Regulation Scale (DERS), and the Center for Epidemiologic Studies Depression Scale (CES-D). Bootstrapped confidence intervals were computed to estimate the indirect effect of emotion dysregulation on the relationship between cumulative adversity and depressive symptomatology and to test whether this indirect effect was moderated by risk status. Emotion dysregulation partially and significantly mediated the relationship between cumulative adversity and depressive symptomatology independent of risk status. Overall, cumulative adversity and emotion dysregulation accounted for 50% of the variance in depressive symptomatology. These findings support the hypothesis that disruption of adaptive emotion regulation processes associated with repeated exposure to stressful life events represents an intrapersonal mechanism linking the experience of adverse events to depression. Our results support the utility of interventions that simultaneously emphasize stress reduction and emotion regulation to treat and prevent depressive vulnerability and pathology.
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Affiliation(s)
| | - Rajita Sinha
- Department of Psychiatry, Yale School of Medicine, Yale University, New Haven, CT, USA.
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Hamilton KR, Sinha R, Potenza MN. Self-reported impulsivity, but not behavioral approach or inhibition, mediates the relationship between stress and self-control. Addict Behav 2014; 39:1557-1564. [PMID: 24508183 DOI: 10.1016/j.addbeh.2014.01.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [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: 07/15/2013] [Revised: 01/10/2014] [Accepted: 01/14/2014] [Indexed: 11/27/2022]
Abstract
Stress has been associated with poor self-control. Individual differences in impulsivity and other behavioral tendencies may influence the relationship of stress with self-control, although this possibility has not been examined to date. The present research investigated whether cumulative stress is associated with poor self-control, and whether this relationship is mediated by impulsivity, behavioral approach, and behavioral inhibition in men and women. A community sample of 566 adults (319 women and 247 men) was assessed on the Cumulative Adversity Interview, Brief Self-control Scale, Barratt Impulsivity Scale, and Behavioral Activation System and Behavioral Inhibition System Scale (BIS/BAS). Data were analyzed using regression and bootstrapping techniques. In the total sample, the effects of cumulative stress on self-control were mediated by impulsivity. Neither behavioral inhibition nor behavioral approach mediated the association between cumulative stress and self-control in the total sample. Results were similar when men and women were considered separately, with impulsivity, but not behavioral inhibition or approach, mediating the association between cumulative stress and self-control. Impulsive individuals might benefit preferentially from interventions focusing on stress management and strategies for improving self-control.
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Affiliation(s)
- Kristen R Hamilton
- Center for Addictions, Personality, and Emotion Research, Department of Psychology, University of Maryland, 2103 Cole Field House, College Park, MD 20742, United States.
| | - Rajita Sinha
- Department of Psychiatry, Yale University School of Medicine, 1 Church Street, New Haven, CT 06511, United States; Child Study Center, Yale University School of Medicine, 230 S. Frontage Road, New Haven, CT 06520, United States; Department of Neurobiology, Yale University School of Medicine, 1 Church Street, New Haven, CT 06511, United States
| | - Marc N Potenza
- Department of Psychiatry, Yale University School of Medicine, 1 Church Street, New Haven, CT 06511, United States; Child Study Center, Yale University School of Medicine, 230 S. Frontage Road, New Haven, CT 06520, United States; Department of Neurobiology, Yale University School of Medicine, 1 Church Street, New Haven, CT 06511, United States
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