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Rojas DL, Torres FC, Torres-Soto NY, Martín-Estal I, Rosas VM, Tapia BM, Rodríguez-de-Ita J. Implications of adverse and benevolent childhood experiences on the physical and mental health of Mexican adults: a population-based study. LANCET REGIONAL HEALTH. AMERICAS 2025; 46:101092. [PMID: 40290134 PMCID: PMC12033956 DOI: 10.1016/j.lana.2025.101092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2024] [Revised: 10/07/2024] [Accepted: 03/27/2025] [Indexed: 04/30/2025]
Abstract
Background Adverse childhood experiences (ACEs) are linked to negative physical and mental health outcomes. Limited information on their influence exists in Latin America and middle-income countries like Mexico. This study aimed to determine the prevalence and impact of ACEs and benevolent childhood experiences (BCEs) on Mexican population health. Methods From September to November 2023, this cross-sectional study recruited a nationally representative sample of adults aged 18-65, randomly selected from urban and rural areas. Sociodemographic data, ACEs, BCEs, physical and mental health history, and clinical assessments for depression, anxiety, post-traumatic stress disorder, and eating disorders were collected. Findings Of 1448 participants recruited, 1115 (77%) were women, 1278 (88·2%) reported at least one ACE, while 328 (22·6%) had four or more. Physical (840; 58·6%) and emotional neglect (518; 35·7%) were the most frequent. Four or more ACEs increased the odds of obesity (OR 1·8, 95% CI 1·2-2·8), hypertension (OR 1·6, 95% CI 1·1-2·2), depression (OR 4·7, 95% CI 3·6-6·1) and anxiety (OR 4·1, 95% CI 3·2-5·3) among others. Common BCEs included having at least one supportive caregiver (1298; 89·6%) and feeling comfortable with oneself (1272; 87·8%). BCEs decreased the odds of physical and mental health diagnoses. Interpretation ACEs are highly prevalent and significantly impact the health of Mexican population. BCEs protect against these effects. Considering ACEs in public policies can help establish interventions to prevent adversity and promote positive childhood experiences. Funding Fundación FEMSA, Centro de Primera Infancia from Tecnológico de Monterrey and Fundación FEMSA and Tecnologico de Monterrey Challenge-Based Research Funding Program 2022.
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Affiliation(s)
- Daniela León Rojas
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Ave. Morones Prieto 3000, Monterrey, N.L, Mexico
| | - Fabiola Castorena Torres
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Ave. Morones Prieto 3000, Monterrey, N.L, Mexico
| | - Nissa Yaing Torres-Soto
- División de Ciencias de la Salud, Universidad Autónoma del Estado de Quintana Roo, Chetumal, Quintana Roo, Mexico
| | - Irene Martín-Estal
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Ave. Morones Prieto 3000, Monterrey, N.L, Mexico
| | - Veronica Mundo Rosas
- Center for Evaluation and Survey Research, National Institute of Public Health, Mexico
| | - Brenda Martinez Tapia
- Center for Evaluation and Survey Research, National Institute of Public Health, Mexico
| | - Julieta Rodríguez-de-Ita
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Ave. Morones Prieto 3000, Monterrey, N.L, Mexico
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Hospital San José, TecSalud, N.L, Mexico
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Jansen van Vuren E, van den Heuvel LL, Hemmings SM, Seedat S. Cardiovascular risk and allostatic load in PTSD: The role of cumulative trauma and resilience in affected and trauma-exposed adults. J Psychiatr Res 2025; 182:338-346. [PMID: 39848101 DOI: 10.1016/j.jpsychires.2025.01.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2024] [Revised: 01/15/2025] [Accepted: 01/16/2025] [Indexed: 01/25/2025]
Abstract
BACKGROUND The pathophysiology of posttraumatic stress disorder (PTSD) involves dysregulation of stress-sensitive biological systems due to repeated trauma exposure, predisposing individuals to the development of cardiovascular disease (CVD). Allostatic load (AL), an indicator of maladaptive stress responses, could shed light on the underlying biological mechanisms. We determined whether CVD risk and AL were associated with trauma load and resilience in women with PTSD and trauma-exposed controls (TEC). METHODS Adults with PTSD N = 114 and TEC N = 95 were administered the Clinician Administered Posttraumatic Stress Disorder Scale for DSM-5, to assess for current PTSD diagnosis and severity, the Life Events Checklist for DSM-5 for lifetime exposure to potentially traumatic events (cumulative trauma) and the Connor-Davidson Resilience Scale. An AL score was calculated as a sum of dichotomous variables from four physiological systems (neuroendocrine, metabolic, cardiovascular, and inflammatory). CVD risk was assessed with the South African Framingham risk score. RESULTS In patients with PTSD, cumulative trauma was associated with higher AL (p = 0.04) and CVD risk (p = 0.02). In TEC, AL was inversely associated with resilience (p = 0.04). There was a significant interaction between cumulative trauma and resilience on AL (p = 0.009) in PTSD cases, with a stronger association between cumulative trauma and AL in those with higher resilience. CONCLUSIONS Resilience may have differential detrimental and protective effects on AL in individuals with PTSD and TEC. Cumulative trauma exposure may, independently, increase the likelihood of high AL and CVD risk in PTSD, with resilience moderating this effect. Remaining resilient while experiencing PTSD symptoms may impose a biological strain that could have long-term harmful effects.
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Affiliation(s)
- Esmé Jansen van Vuren
- Hypertension in Africa Research Team (HART), North-West University, Private Bag X1290, Potchefstroom, South Africa; South African Medical Research Council Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa.
| | - Leigh L van den Heuvel
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; South African Medical Research Council Genomics of Brain Disorders Unit, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa
| | - Sian Mj Hemmings
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; South African Medical Research Council Genomics of Brain Disorders Unit, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa
| | - Soraya Seedat
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; South African Medical Research Council Genomics of Brain Disorders Unit, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa
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Chapman TM, McAlister KL, Moore KN, Wang WL, Belcher BR. Screen time and allostatic load among youth: findings from the National Health and Nutrition Examination Survey, 2015-2018. Ann Behav Med 2025; 59:kaaf031. [PMID: 40387912 DOI: 10.1093/abm/kaaf031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2025] Open
Abstract
BACKGROUND More screen time (ST) is associated with dysregulation of the individual biological systems (cardiovascular, immune, metabolic, and neuroendocrine) involved in the stress response in youth. However, its relationship with allostatic load (AL), a measure of the cumulative physiological stress response, is unclear in youth. PURPOSE To investigate the associations between ST types and AL outcomes in youth and to explore sociodemographic and behavioral moderators of these relationships. METHODS Cross-sectional data were from 1053 US youth aged 12-17 years (Mage = 14.20; 54% male; 21% Hispanic) in the 2015-2018 National Health and Nutrition Examination Survey (NHANES). ST was assessed as watching TV/videos and computer use/playing computer games. AL was measured using 7 biomarkers across 3 systems: cardiovascular (systolic and diastolic blood pressure, heart rate), immune (C-reactive protein), and metabolic (body mass index, glycohemoglobin, and high-density lipoprotein). Weighted multivariable regression models assessed whether ST predicted AL composite and subsystem (cardiovascular, immune, and metabolic) scores. Moderation by age, sex, income, race/ethnicity, and physical activity was explored. RESULTS A 1-hour/day increase in watching TV/videos was associated with a 4% increase in mean AL composite score (incident rate ratio = 1.040; 95% CI = 1.008, 1.073; P = .015), while computer use/gaming showed no significant associations (P's > .05). Age moderated the TV/videos-AL cardiovascular association (P = .009), with older youth having higher AL cardiovascular scores. CONCLUSIONS More time spent watching TV/videos was associated with higher cumulative physiological stress in youth. Prospective studies are needed to determine causal pathways and potential intervention targets in youth.
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Affiliation(s)
- Tiffany M Chapman
- Department of Population and Public Health Sciences, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA 90032, United States
| | - Kelsey L McAlister
- Department of Population and Public Health Sciences, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA 90032, United States
| | - Kristen N Moore
- Department of Population and Public Health Sciences, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA 90032, United States
| | - Wei-Lin Wang
- Department of Population and Public Health Sciences, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA 90032, United States
| | - Britni R Belcher
- Department of Population and Public Health Sciences, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA 90032, United States
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Pividori I, Peric T, Comin A, Cotticelli A, Corazzin M, Prandi A, Mascolo MD. Hair Cortisol/DHEA-S Ratios in Healthcare Workers and Their Patients During the COVID-19 Pandemic: A Case Study. Life (Basel) 2024; 14:1582. [PMID: 39768290 PMCID: PMC11676202 DOI: 10.3390/life14121582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2024] [Revised: 11/25/2024] [Accepted: 11/29/2024] [Indexed: 01/11/2025] Open
Abstract
BACKGROUND Unlike psychological distress, which has been extensively studied during the COVID-19 pandemic, the impact of the pandemic on stress hormones has been overlooked. The aim of this study is to examine the hair cortisol/dehydroepiandrosterone sulfate (DHEA-S) ratios as markers of HPA axis dysregulation in healthcare workers and their patients. METHODS A total of 200 healthcare workers and 161 "patients" patients with special healthcare needs due to chronic illness or motor disabilities were included in this study. The hormone concentrations were measured using a radioimmunoassay. RESULTS Our results show that the patients had significantly higher cortisol/DHEA-S ratios than the workers. A high cortisol/DHEA-S ratio in the patients reflects higher cortisol concentrations (p < 0.001) and lower DHEA-S (p < 0.05) concentrations compared to those of the healthcare workers, suggesting that they may be exposed to a greater degree of stress and a decrease in their ability to cope with their disease. The cut-off value of the hair cortisol/DHEA-S ratio in our study for detecting people with needs that require special consideration and attention was 1.46 (p ≤ 0.01). CONCLUSIONS Assessing the hair cortisol/DHEA-S ratios in both healthcare workers and the patients allowed us to identify a non-homeostatic condition that could lead to disease and to understand psychophysical well-being during the COVID-19 pandemic. They also play a crucial role in preventive and personalized medicine.
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Affiliation(s)
- Isabella Pividori
- Department of Agricultural, Food, Environmental and Animal Sciences, University of Udine, 33100 Udine, Italy; (I.P.); (T.P.); (A.C.); (A.P.)
| | - Tanja Peric
- Department of Agricultural, Food, Environmental and Animal Sciences, University of Udine, 33100 Udine, Italy; (I.P.); (T.P.); (A.C.); (A.P.)
| | - Antonella Comin
- Department of Agricultural, Food, Environmental and Animal Sciences, University of Udine, 33100 Udine, Italy; (I.P.); (T.P.); (A.C.); (A.P.)
| | - Alessio Cotticelli
- Department of Veterinary Medicine and Animal Production, Federico II University, 80137 Naples, Italy;
| | - Mirco Corazzin
- Department of Agricultural, Food, Environmental and Animal Sciences, University of Udine, 33100 Udine, Italy; (I.P.); (T.P.); (A.C.); (A.P.)
| | - Alberto Prandi
- Department of Agricultural, Food, Environmental and Animal Sciences, University of Udine, 33100 Udine, Italy; (I.P.); (T.P.); (A.C.); (A.P.)
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Yi W, Chen W, Lan B, Yan L, Hu X, Wu J. A U-shaped relationship between chronic academic stress and the dynamics of reward processing. Neuroimage 2024; 300:120849. [PMID: 39265955 DOI: 10.1016/j.neuroimage.2024.120849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 08/29/2024] [Accepted: 09/09/2024] [Indexed: 09/14/2024] Open
Abstract
Despite the potential link between stress-induced reward dysfunctions and the development of mental problems, limited human research has investigated the specific impacts of chronic stress on the dynamics of reward processing. Here we aimed to investigate the relationship between chronic academic stress and the dynamics of reward processing (i.e., reward anticipation and reward consumption) using event-related potential (ERP) technology. Ninety healthy undergraduates who were preparing for the National Postgraduate Entrance Examination (NPEE) participated in the study and completed a two-door reward task, their chronic stress levels were assessed via the Perceived Stress Scale (PSS). The results showed that a lower magnitude of reward elicited more negative amplitudes of cue-N2 during the anticipatory phase, and reward omission elicited more negative amplitudes of FRN compared to reward delivery especially in high reward conditions during the consummatory phase. More importantly, the PSS score exhibited a U-shaped relationship with cue-N2 amplitudes regardless of reward magnitude during the anticipatory phase; and FRN amplitudes toward reward omission in high reward condition during the consummatory phase. These findings suggest that individuals exposed to either low or high levels of chronic stress, as opposed to moderate stress levels, exhibited a heightened reward anticipation, and an augmented violation of expectations or affective response when faced with relatively more negative outcomes.
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Affiliation(s)
- Wei Yi
- School of Psychology, Shenzhen University, 3688#, Nanhai Avenue, Nanshan District, Shenzhen 518060, China
| | - Wangxiao Chen
- School of Psychology, Shenzhen University, 3688#, Nanhai Avenue, Nanshan District, Shenzhen 518060, China
| | - Biqi Lan
- School of Psychology, Shenzhen University, 3688#, Nanhai Avenue, Nanshan District, Shenzhen 518060, China
| | - Linlin Yan
- Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Xiaoqing Hu
- Department of Psychology, The University of Hong Kong, Room 6.62, Jocky Club Tower, Pokfulam, Hong Kong, China
| | - Jianhui Wu
- School of Psychology, Shenzhen University, 3688#, Nanhai Avenue, Nanshan District, Shenzhen 518060, China.
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Doan SN, Aringer AS, Vicman JM, Fuller-Rowell T. Chronic Physiological Dysregulation and Changes in Depressive Symptoms: Testing Sex and Race as Vulnerability Factors. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-02189-5. [PMID: 39388078 DOI: 10.1007/s40615-024-02189-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 09/19/2024] [Accepted: 09/21/2024] [Indexed: 10/12/2024]
Abstract
Depression is a growing public health concern that affects approximately 5% of adults in their lifetime (WHO in Depression, 2021). Understanding the biological correlates of depression is imperative for advancing treatment. Of particular interest is allostatic load, a multisystem indicator of chronic physiological dysregulation (McEwen and Seeman in, Ann N Y Acad Sci, 1999). The current longitudinal study examined the association between allostatic load, depressive symptoms, and the moderating roles of sex and race. Participants consisted of 150 young adults (Mage = 18.81) who reported their demographics and depressive symptoms at T1 and T2, a year and a half later. Allostatic load was computed using indicators of metabolic, cardiovascular, and neuroendocrine functioning. Allostatic load was found to predict changes in depressive symptoms. Moreover, interaction effects models revealed that the associations between allostatic load and depressive symptoms at follow-up were further influenced by sex, such that the relationship was significant for males, with pronounced effects for Black males in particular. Black males may be particularly vulnerable to the mental health consequences of biological dysregulation.
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Affiliation(s)
- Stacey N Doan
- Department of Psychological Science, Claremont McKenna College, 850 Columbia Avenue, Claremont, CA, 91711, USA.
| | - Alexandra S Aringer
- Department of Psychological Science, Claremont McKenna College, 850 Columbia Avenue, Claremont, CA, 91711, USA
| | - Jessica M Vicman
- Department of Psychological Science, Claremont McKenna College, 850 Columbia Avenue, Claremont, CA, 91711, USA
| | - Thomas Fuller-Rowell
- Department of Human Development and Family Studies, Auburn University, Auburn, USA
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Ferro MA, Chan CKY, Lipman EL, Lieshout RJV, Shanahan L, Gorter JW. Continuity of mental disorders in children with chronic physical illness. Eur Child Adolesc Psychiatry 2024; 33:3593-3602. [PMID: 38519608 DOI: 10.1007/s00787-024-02420-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 03/15/2024] [Indexed: 03/25/2024]
Abstract
Data on the chronicity of mental disorder in children with chronic physical illness (CPI) are limited. We examined the prevalence and predictors of homotypic and heterotypic continuity of mental disorder in children with CPI. A sample of 263 children aged 2-16 years with physician-diagnosed CPI were recruited from outpatient clinics (e.g., dermatology, respiratory) at a Canadian pediatric academic hospital and followed for 24 months. Parent and child-reported mental disorders (mood, anxiety, behavioral, attention-deficit hyperactivity disorder [ADHD]) were assessed using the Mini International Neuropsychiatric Interview for Children and Adolescents at baseline, 6, 12, and 24 months. Marginal regression models were computed to identify clinical, parent, and demographic factors associated with mental comorbidity over time. Mental disorder was observed in 24-27% of children with CPI based on child reports and 35-39% based on parent reports. Parent-reported models revealed significant homotypic continuity for all mental disorders (ORs = 4.2-9.5), and heterotypic continuity between mood and anxiety disorders (OR = 2.2), ADHD and behavioral disorders (OR = 5.1), and behavioral and each mental disorder (ORs = 6.7-8.4). Child-reported models revealed significant homotypic continuity for mood (OR = 8.8) and anxiety disorder (OR = 6.0), and heterotypic continuity between anxiety and mood disorders (OR = 12.4). Child disability (ORs = 1.3-1.5) and parent psychopathology (ORs = 1.2-1.8) were the most consistent predictors of both child- and parent-reported mental disorder over time. Mental comorbidity was prevalent and persistent in children with CPI with homotypic and heterotypic continuity common across informants. Child disability and parent psychopathology may be priority targets within integrated family-centered models of care to prevent mental comorbidity in children with CPI.
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Affiliation(s)
- Mark A Ferro
- School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada.
| | - Christy K Y Chan
- School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
| | - Ellen L Lipman
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Ryan J Van Lieshout
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Lilly Shanahan
- Jacobs Center for Productive Youth Development, Zurich, Switzerland
| | - Jan Willem Gorter
- Pediatric Rehabilitation Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
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Premji SS, Lalani S, Ghani F, Nausheen S, Forcheh N, Omuse G, Letourneau N, Babar N, Sulaiman S, Wangira M, Ali SS, Islam N, Dosani A, Yim IS. Allostatic Load as a Mediator and Perceived Chronic Stress as a Moderator in the Association between Maternal Mental Health and Preterm Birth: A Prospective Cohort Study of Pregnant Women in Pakistan. Psychopathology 2024; 58:13-32. [PMID: 39342939 DOI: 10.1159/000540579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 07/22/2024] [Indexed: 10/01/2024]
Abstract
INTRODUCTION The complex biopsychosocial pathways linking maternal mental health with preterm birth (PTB) are not well understood. This study aimed to explore allostatic load (AL) as a mediator and perceived chronic stress as a moderator in the pathway linking maternal mental health and PTB. METHODS A cohort study of pregnant women (n = 1,567) recruited at clinic visits within 10-19 weeks of gestation was assessed for maternal mental health (i.e., pregnancy-related anxiety, state anxiety, depressive symptoms) and perceived chronic stress. Blood pressure and levels of cortisol, total cholesterol, C-reactive protein, and glycosylated hemoglobin were used to create a composite measure of AL. RESULTS AL had the most significant effect on PTB (odds ratio (OR) = 1.84, 95% CI = 1.26-12.67, p = 0.001), while systolic blood pressure emerged as the only significant individual marker using variable selection (OR = 22%, 95% CI = 1.06-1.40, p < 0.001) in multiple logistic regression analysis. A mediation analysis revealed that maternal mental health did not have a significant direct effect on PTB (p = 0.824), but its indirect effect mediated by AL was significant (z = 2.33, p < 0.020). Low and high levels of perceived chronic stress, relative to the mean, moderated this indirect effect (z = 3.66, p < 0.001). CONCLUSIONS AL has a significant direct influence on PTB and mediates the effect of maternal mental health on PTB; however, the indirect effect of AL is indistinguishable between women with higher or lower levels of perceived chronic stress than normal.
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Affiliation(s)
| | - Sharifa Lalani
- School of Nursing and Midwifery, Aga Khan University, Karachi, Pakistan
| | - Farooq Ghani
- Department of Pathology and Microbiology, Aga Khan University, Karachi, Pakistan
| | - Sidrah Nausheen
- Department of Obstetrics and Gynecology, Aga Khan University, Karachi, Pakistan
| | - Ntonghanwah Forcheh
- School of Nursing, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Geoffrey Omuse
- Department of Pathology, Aga Khan University, Nairobi, Kenya
| | | | - Neelofur Babar
- Department of Obstetrics and Gynecology, Aga Khan University, Karachi, Pakistan
| | - Salima Sulaiman
- Department of Nursing, Faculty of Applied Health Sciences, Brock University, St. Catherines, Ontario, Canada
| | - Musana Wangira
- Department of Obstetrics and Gynaecology, Aga Khan University Hospital, Nairobi, Kenya
| | - Shahnaz Shahid Ali
- Arthur Labatt Family School of Nursing, University of Western Ontario, London, Ontario, Canada
| | - Nazneen Islam
- Molecular Pathology, Clinical Laboratory Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Aliyah Dosani
- School of Nursing and Midwifery, Faculty of Health, Community and Education, Mount Royal University, Calgary, Alberta, Canada
| | - Ilona S Yim
- Department of Psychological Science, University of California, Irvine, California, USA
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Gordon REF, Kosty D, Khurana A. The mediating role of child delay of gratification in the link between early and prolonged poverty exposure and adolescent allostatic load. Psychoneuroendocrinology 2024; 163:106990. [PMID: 38412742 PMCID: PMC10954378 DOI: 10.1016/j.psyneuen.2024.106990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 02/01/2024] [Accepted: 02/12/2024] [Indexed: 02/29/2024]
Abstract
Early and prolonged exposure to poverty disrupts biological processes associated with the body's stress response system, leading to long-term negative health outcomes, including obesity, autoimmune disorders, and cardiovascular disease. Allostatic load (AL), a composite measure of chronic stress on the body, is a robust predictor of subsequent health outcomes. However, developmental research examining the associations of early poverty exposure with AL in adolescence, as well as the underlying mechanisms of influence is limited. Early poverty exposure also impedes healthy development of child self-regulation, which may increase risk for high AL in adolescence, but this mechanistic pathway has not yet been tested. We used data from the national Study of Early Child Care and Youth Development (SECCYD) to examine the longitudinal associations between prolonged poverty exposure in early childhood (0-3 years) and AL in adolescence (age 15). We also tested the mediating role of child delay of gratification, a behavioral measure of self-regulation (at age 54 months), in the potential association between early poverty exposure and adolescent AL. Accounting for model covariates (i.e., child biological sex and race-ethnicity) and individual differences in child delay of gratification, early and prolonged poverty exposure was significantly associated with higher AL at age 15. The indirect effect through child delay of gratification was not significant, but the individual pathways of the indirect effect were significant, and the overall direct association of early poverty exposure with adolescent AL was significant. Our findings show that prolonged exposure to poverty in early childhood (0-3 years) can have significant negative associations with both child delay of gratification (at 54 months) and AL (at age 15). Given that the detrimental impacts of poverty exposure can be detected at an early age, targeted prevention efforts (e.g., anti-poverty programs such as cash assistance programs) may be able to offset some of the risks of early poverty exposure on self-regulation and AL.
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Affiliation(s)
- Rebecca E F Gordon
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene, OR, USA.
| | - Derek Kosty
- Prevention Science Institute, University of Oregon, Eugene, OR, USA
| | - Atika Khurana
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene, OR, USA
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Holochwost SJ, Volpe VV, Collins AN, Propper CB, Mills-Koonce WR, Brown ED, Jaffee SR. Allostatic Load in Childhood, Adolescence, and Young Adulthood: Are Assumptions of Measurement Invariance Warranted? Psychosom Med 2024; 86:169-180. [PMID: 38588495 DOI: 10.1097/psy.0000000000001292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
OVERVIEW Allostatic load represents the cumulative toll of chronic mobilization of the body's stress response systems, as indexed by biomarkers. Higher levels of stress and disadvantage predict higher levels of allostatic load, which, in turn, predict poorer physical and mental health outcomes. To maximize the efficacy of prevention efforts, screening for stress- and disadvantage-associated health conditions must occur before middle age-that is, during childhood, adolescence, and young adulthood. However, this requires that models of allostatic load display properties of measurement invariance across age groups. Because most research on allostatic load has featured older adults, it is unclear if these requirements can be met. METHODS To address this question, we fit a series of exploratory and confirmatory analytic models to data on eight biomarkers using a nationally representative sample of N = 4260 children, adolescents, and young adults drawn from the National Health and Nutrition Examination Survey dataset. RESULTS Exploratory and confirmatory models indicated that, consistent with allostatic load theory, a unidimensional model was a good fit to the data. However, this model did not display properties of measurement invariance; post-hoc analyses suggested that the biomarkers included in the final confirmatory model were most strongly intercorrelated among young adults and most weakly intercorrelated among adolescents. CONCLUSIONS These results underscore the importance of testing assumptions about measurement invariance in allostatic load before drawing substantive conclusions about stress, disadvantage, and health by directly comparing levels of allostatic load across different stages of development, while underscoring the need to expand investigations of measurement invariance to samples of longitudinal data.
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Affiliation(s)
- Steven J Holochwost
- From the Department of Psychology (Holochwost), Lehman College, The City University of New York, Bronx, New York; Department of Psychology (Volpe, Collins), North Carolina State University, Raleigh; School of Nursing (Propper) and School of Education (Mills-Koonce), University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Psychology (Brown), West Chester University, West Chester; and Department of Psychology (Jaffee), University of Pennsylvania, Philadelphia, Pennsylvania
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Cassiani-Miranda CA, Díaz Rincón M, Arroyo-Gamero LA, Giraldo-Barrios LG, Carmona-Meza Z. Weight stigma and allostatic load in adults: protocol for a scoping review. BMJ Open 2024; 14:e076629. [PMID: 38367970 PMCID: PMC10875553 DOI: 10.1136/bmjopen-2023-076629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 12/19/2023] [Indexed: 02/19/2024] Open
Abstract
INTRODUCTION Weight-related stigma (WS) has been associated with adverse psychosocial and physical health effects. Despite the relationship between WS and allostatic load, there are no integrative reviews of this association. This scoping review aims to provide a comprehensive overview of the relationship between allostatic load biomarkers associated with WS by identifying gaps in this topic and proposing recommendations for future research. METHODS AND ANALYSIS This protocol was guided by the methodological framework of Arksey and O'Malley and the Joanna Briggs Institute (JBI). The research questions were based on the population-concept-context framework. Studies in adults diagnosed as overweight or obese, exposed to WS and assessing the association between WS and biomarkers of allostatic load will be included. A search will be conducted in Medline (Ovid), PsycINFO (Ovid), Scopus (Elsevier), Cochrane Library (Wiley) and Google Scholar. The search strategy will be conducted in three stages, based on the JBI recommendation with the MESH terms "Social Stigma," "Weight Prejudice," "Biomarkers," "Allostasis," "Adults" and related terms. Data extraction will be done with a template adapted from JBI. The search strategy and selection process results will be presented in a flow chart and summarised in the text. The main results will be presented in a descriptive synthesis. ETHICS AND DISSEMINATION Ethics review and approval are not required. The results will be disseminated through peer-reviewed publications, conferences, congresses or symposia.
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Affiliation(s)
| | | | | | | | - Zenen Carmona-Meza
- Universidad de Cartagena Facultad de Medicina, Cartagena de Indias, Bolívar, Colombia
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Hoffman KW, Tran KT, Moore TM, Gataviņš MM, Visoki E, DiDomenico GE, Schultz LM, Almasy L, Hayes MR, Daskalakis NP, Barzilay R. Allostatic load in early adolescence: gene / environment contributions and relevance for mental health. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.10.27.23297674. [PMID: 37961462 PMCID: PMC10635214 DOI: 10.1101/2023.10.27.23297674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
Background Allostatic load is the cumulative "wear and tear" on the body due to chronic adversity. We aimed to test poly-environmental (exposomic) and polygenic contributions to allostatic load and their combined contribution to early adolescent mental health. Methods We analyzed data on N = 5,035 diverse youth (mean age 12) from the Adolescent Brain Cognitive Development Study (ABCD). Using dimensionality reduction method, we calculated and overall allostatic load score (AL) using body mass index [BMI], waist circumference, blood pressure, blood glycemia, blood cholesterol, and salivary DHEA. Childhood exposomic risk was quantified using multi-level environmental exposures before age 11. Genetic risk was quantified using polygenic risk scores (PRS) for metabolic system susceptibility (type 2 diabetes [T2D]) and stress-related psychiatric disease (major depressive disorder [MDD]). We used linear mixed effects models to test main, additive, and interactive effects of exposomic and polygenic risk (independent variables) on AL (dependent variable). Mediation models tested the mediating role of AL on the pathway from exposomic and polygenic risk to youth mental health. Models adjusted for demographics and genetic principal components. Results We observed disparities in AL with non-Hispanic White youth having significantly lower AL compared to Hispanic and Non-Hispanic Black youth. In the diverse sample, childhood exposomic burden was associated with AL in adolescence (beta=0.25, 95%CI 0.22-0.29, P<.001). In European ancestry participants (n=2,928), polygenic risk of both T2D and depression was associated with AL (T2D-PRS beta=0.11, 95%CI 0.07-0.14, P<.001; MDD-PRS beta=0.05, 95%CI 0.02-0.09, P=.003). Both polygenic scores showed significant interaction with exposomic risk such that, with greater polygenic risk, the association between exposome and AL was stronger. AL partly mediated the pathway to youth mental health from exposomic risk and from MDD-PRS, and fully mediated the pathway from T2D-PRS. Conclusions AL can be quantified in youth using anthropometric and biological measures and is mapped to exposomic and polygenic risk. Main and interactive environmental and genetic effects support a diathesis-stress model. Findings suggest that both environmental and genetic risk be considered when modeling stress-related health conditions.
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Affiliation(s)
- Kevin W. Hoffman
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, US
- Department of Child and Adolescent Psychiatry and Behavioral Science, Children’s Hospital of Philadelphia, Philadelphia, US
| | - Kate T. Tran
- Lifespan Brain Institute of Children’s Hospital of Philadelphia and Penn Medicine, Philadelphia, US
| | - Tyler M. Moore
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, US
- Lifespan Brain Institute of Children’s Hospital of Philadelphia and Penn Medicine, Philadelphia, US
| | - Mārtiņš M. Gataviņš
- Lifespan Brain Institute of Children’s Hospital of Philadelphia and Penn Medicine, Philadelphia, US
| | - Elina Visoki
- Lifespan Brain Institute of Children’s Hospital of Philadelphia and Penn Medicine, Philadelphia, US
| | - Grace E. DiDomenico
- Lifespan Brain Institute of Children’s Hospital of Philadelphia and Penn Medicine, Philadelphia, US
| | - Laura M. Schultz
- Lifespan Brain Institute of Children’s Hospital of Philadelphia and Penn Medicine, Philadelphia, US
- Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, US
| | - Laura Almasy
- Lifespan Brain Institute of Children’s Hospital of Philadelphia and Penn Medicine, Philadelphia, US
- Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, US
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, US
| | - Matthew R. Hayes
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, US
| | - Nikolaos P. Daskalakis
- Department of Psychiatry, McLean Hospital, Harvard Medical School, Belmont, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Ran Barzilay
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, US
- Department of Child and Adolescent Psychiatry and Behavioral Science, Children’s Hospital of Philadelphia, Philadelphia, US
- Lifespan Brain Institute of Children’s Hospital of Philadelphia and Penn Medicine, Philadelphia, US
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Lucente M, Guidi J. Allostatic Load in Children and Adolescents: A Systematic Review. PSYCHOTHERAPY AND PSYCHOSOMATICS 2023; 92:295-303. [PMID: 37666236 PMCID: PMC10716875 DOI: 10.1159/000533424] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 08/02/2023] [Indexed: 09/06/2023]
Abstract
INTRODUCTION The concept of allostatic load encompasses the cumulative effects of both ordinary daily life events as well as major challenges, and also includes related health-damaging behavior. Allostatic overload ensues when environmental challenges exceed the individual's ability to cope. Identification of allostatic load is carried out through the use of biomarkers and clinimetric criteria. Studies are increasingly reported on allostatic load in younger populations, yet a systematic review is missing. OBJECTIVE The aim of the present systematic review was to summarize the current knowledge on allostatic load/overload among children and adolescents. METHODS PubMed, PsycINFO, Web of Science, and the Cochrane Library were searched from inception to April 2023. A manual search of the literature was also performed. We considered only studies in which allostatic load or overload were adequately described and assessed in either clinical or non-clinical populations younger than 18 years. RESULTS A total of 38 original investigations were included in this systematic review. Studies reported an association between allostatic load and sociodemographic characteristics (e.g., poverty, ethnicity, perceived discrimination, adverse childhood experiences) and environmental factors, as well as consequences of allostatic load on both physical and mental health among children and adolescents. CONCLUSIONS The findings indicate that greater allostatic load is associated with poorer health outcomes in both clinical and non-clinical pediatric populations, with possible enduring effects. The results support the clinical utility of the transdiagnostic identification of allostatic load and overload in children and adolescents across a variety of settings, with a number of potential clinical implications.
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Affiliation(s)
- Marcella Lucente
- Department of Psychology "Renzo Canestrari", University of Bologna, Bologna, Italy
| | - Jenny Guidi
- Department of Psychology "Renzo Canestrari", University of Bologna, Bologna, Italy
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14
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Querdasi FR, Enders C, Karnani N, Broekman B, Yap Seng C, Gluckman PD, Mary Daniel L, Yap F, Eriksson JG, Cai S, Chong MFF, Toh JY, Godfrey K, Meaney MJ, Callaghan BL. Multigenerational adversity impacts on human gut microbiome composition and socioemotional functioning in early childhood. Proc Natl Acad Sci U S A 2023; 120:e2213768120. [PMID: 37463211 PMCID: PMC10372691 DOI: 10.1073/pnas.2213768120] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 05/25/2023] [Indexed: 07/20/2023] Open
Abstract
Adversity exposures in the prenatal and postnatal period are associated with an increased risk for psychopathology, which can be perpetuated across generations. Nonhuman animal research highlights the gut microbiome as a putative biological mechanism underlying such generational risks. In a sample of 450 mother-child dyads living in Singapore, we examined associations between three distinct adversity exposures experienced across two generations-maternal childhood maltreatment, maternal prenatal anxiety, and second-generation children's exposure to stressful life events-and the gut microbiome composition of second-generation children at 2 y of age. We found distinct differences in gut microbiome profiles linked to each adversity exposure, as well as some nonaffected microbiome features (e.g., beta diversity). Remarkably, some of the microbial taxa associated with concurrent and prospective child socioemotional functioning shared overlapping putative functions with those affected by adversity, suggesting that the intergenerational transmission of adversity may have a lasting impact on children's mental health via alterations to gut microbiome functions. Our findings open up a new avenue of research into the underlying mechanisms of intergenerational transmission of mental health risks and the potential of the gut microbiome as a target for intervention.
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Affiliation(s)
- Francesca R. Querdasi
- Department of Psychology, University of California Los Angeles, Los Angeles, CA90095
| | - Craig Enders
- Department of Psychology, University of California Los Angeles, Los Angeles, CA90095
| | - Neerja Karnani
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore138632, Singapore
| | - Birit Broekman
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore138632, Singapore
| | - Chong Yap Seng
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore138632, Singapore
- Department of Obstetrics and Gynaecology, Yong Loo School of Medicine, National University of Singapore, Singapore117597, Singapore
| | - Peter D. Gluckman
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore138632, Singapore
- Liggins Institute, University of Auckland, Auckland1023, New Zealand
| | - Lourdes Mary Daniel
- Duke-National University of Singapore Medical School, Singapore169857, Singapore
- Department of Child Development, KK Women’s and Children’s Hospital, Singapore229899, Singapore
| | - Fabian Yap
- Department of Paediatrics, KK Women’s and Children’s Hopsital, Singapore229899, Singapore
- Department of Pediatrics, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore636921, Singapore
- Department of Maternal Fetal Medicine, KK Women’s and Children’s Hospital, Singapore229899, Singapore
| | - Johan G. Eriksson
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore138632, Singapore
- Department of Obstetrics and Gynaecology, Yong Loo School of Medicine, National University of Singapore, Singapore117597, Singapore
- Department of General Practice and Primary Health, University of Helsinki and Helsinki University Hospital, 00100Helsinki, Finland
- Program of Public Health Research, Folkhälsan Research Center, 00250Helsinki, Finland
| | - Shirong Cai
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore138632, Singapore
| | - Mary Foong-Fong Chong
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore117561, Singapore
| | - Jia Ying Toh
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore138632, Singapore
| | - Keith Godfrey
- Department of Epidemiology, University of Southampton, SouthamptonSO16 6YD, United Kingdom
- Department of Human Development, University of Southampton, SouthamptonSO16 6YD, United Kingdom
| | - Michael J. Meaney
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore138632, Singapore
- Department of Psychiatry, McGill University, Montreal, QuebecH3A 0G4, Canada
- Brain–Body Initiative, Agency for Science, Technology, and Research, Singapore138632, Singapore
| | - Bridget L. Callaghan
- Department of Psychology, University of California Los Angeles, Los Angeles, CA90095
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Bu S, Li Y. Physical activity is associated with allostatic load: Evidence from the National Health and Nutrition Examination Survey. Psychoneuroendocrinology 2023; 154:106294. [PMID: 37216739 DOI: 10.1016/j.psyneuen.2023.106294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 05/14/2023] [Accepted: 05/16/2023] [Indexed: 05/24/2023]
Abstract
We determined the associations between physical activity and allostatic load, and whether it is a modifiable factor related to allostatic load. We obtained data from the National Health and Nutrition Examination Survey (NHANES) database collected between 2017 and March 2020. The relationship between physical activity and allostatic load was examined using a logistic regression model. In the unadjusted model, physical activity level was associated with allostatic load index (odds ratio [OR] = 0.664, 95% confidence interval [CI]: 0.550, 0.802, P<0.001), with this relationship being retained in the adjusted model (OR = 0.739, 95%CI: 0.603, 0.907; P = 0.004). Sedentary behaviour was also related to allostatic load index (OR = 1.236, 95%CI: 1.005, 1.520; P = 0.044). Our findings indicated that sufficient physical activity is associated with a lower allostatic load index, and sedentary behaviour is associated with a higher allostatic load index. Physical activity is a modifiable factor related to allostatic load.
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Affiliation(s)
- Sisi Bu
- School of Nursing, Anhui Medical University, Hefei 230032, Anhui, China
| | - Yuhong Li
- School of Nursing, Anhui Medical University, Hefei 230032, Anhui, China.
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Stam JV, Kallen VL, Westenberg PM. Associations between Autonomic and Endocrine Reactivity to Stress in Adolescence: Related to the Development of Anxiety? Healthcare (Basel) 2023; 11:healthcare11060869. [PMID: 36981526 PMCID: PMC10048500 DOI: 10.3390/healthcare11060869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 03/09/2023] [Accepted: 03/14/2023] [Indexed: 03/19/2023] Open
Abstract
Internalizing disorders in adolescence have been associated with disturbances in autonomic and endocrine functioning. Because the prefrontal cortex and the limbic system play a central role in regulating both the autonomic and the endocrine systems, their joint functioning is hypothesized to provide information about the potential development of internalizing symptoms throughout adolescence, notably in the preclinical stage. This hypothesis was tested in a sample of 198 adolescents from the general population. Heart rate variability (HRV) and skin conductance levels (SCLs) were measured before, during, and after a public speaking task. These autonomic parameters were associated with cortisol response to the task in the complete sample as well as in low- and high-anxiety adolescents separately. Self-reported social anxiety, low HRV, and high SCL recovery values were predictive of cortisol response. Importantly, in low-anxiety adolescents, only HRV during the task predicted the cortisol response, whereas, in their highly anxious peers, both HRV and SCL were strongly associated with this response. In the latter finding, age was a prominent factor. Additional analyses supported the idea that the interaction of autonomic and endocrine reactivity is subject to natural development. These findings provide evidence that adolescence might be a period of highly interactive emotional–neurobiological development, particularly with respect to the development of stress management skills.
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Affiliation(s)
- Jacqueline V. Stam
- The Netherlands Organization for Applied Sciences (TNO), Department of Human Behavior & Training, Kampweg 55, 3769 DE Soesterberg, The Netherlands
- Unit Developmental and Educational Psychology, Institute of Psychology, Leiden University, Wassenaarseweg 52, 2333 AK Leiden, The Netherlands
- Correspondence: ; Tel.: +31-6-27622113
| | - Victor L. Kallen
- The Netherlands Organization for Applied Sciences (TNO), Department of Human Behavior & Training, Kampweg 55, 3769 DE Soesterberg, The Netherlands
- Unit Developmental and Educational Psychology, Institute of Psychology, Leiden University, Wassenaarseweg 52, 2333 AK Leiden, The Netherlands
| | - P. Michiel Westenberg
- Unit Developmental and Educational Psychology, Institute of Psychology, Leiden University, Wassenaarseweg 52, 2333 AK Leiden, The Netherlands
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Solomonian L, Blesoff J, Garofalo L, Lucas S, Picardo A, Garber A, Wilson M, Leach M. Naturopathic Management of Acute Pediatric Respiratory Infections: A Modified Delphi Study. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2023; 29:181-195. [PMID: 36827416 DOI: 10.1089/jicm.2022.0669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
Objective: Both the United Nations and the World Health Organization have identified antimicrobial resistance as a significant threat to global health. The Centers for Disease Control and Prevention identified five pediatric respiratory conditions as requiring particular scrutiny in terms of antibiotic stewardship. This study sought to identify strategies used by experienced naturopathic practitioners to treat acute respiratory infections in children. The authors theorize that naturopathic strategies safely fill the gap between watchful waiting and antibiotic prescription, thus reducing the use of antibiotics. Methods: Naturopathic practitioners in Canada, the United States, and Australia with a minimum of 5 years of experience in clinical naturopathic care of children were recruited for a modified Delphi study. A 14-person panel of practitioners was selected to complete a series of four iterative surveys assessing agreement to statements in five domains of knowledge/attitudes, assessment/diagnosis, management, monitoring, and education. Items were deemed to have reached consensus if they reached a predetermined threshold of 70% agreement, or failed to reach a threshold of 40% agreement. Items between these boundaries were modified and retested until either consensus was reached or the four surveys had been completed. Results: Results yielded a large degree of agreement on core naturopathic approaches to the management of acute pediatric respiratory infections, especially lifestyle strategies, including adequate rest and dietary recommendations. The use of vitamins C and D was strongly supported, as were herbs, particularly echinacea and elderberry. Some hydrotherapy and topical applications specific to the individual focus on infection also reached consensus. Results suggested that most respondents, even if they have the authority to prescribe antibiotics, rarely deem it necessary to do so. Conclusion: Findings of this study provide (1) clarity on the role of naturopathic doctors in the management of pediatric health concerns and the stewardship of antibiotics; and (2) initial guidance to less experienced naturopathic practitioners. The findings also identify key priorities for research into the safety and effectiveness of naturopathic interventions to reduce the unnecessary prescribing of antibiotics.
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Affiliation(s)
| | - Jamine Blesoff
- National University of Health Sciences, Lombard, IL, USA
| | | | - Sandra Lucas
- School of Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Andrea Picardo
- Canadian College of Naturopathic Medicine, Toronto, ON, Canada
| | - Anna Garber
- Canadian College of Naturopathic Medicine, Toronto, ON, Canada
| | - Mariah Wilson
- Canadian College of Naturopathic Medicine, Toronto, ON, Canada
| | - Matthew Leach
- National Centre for Naturopathic Medicine, Southern Cross University, Lismore, NSW, Australia
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de la Rosa R, Zablotny D, Ye M, Bush NR, Hessler D, Koita K, Bucci M, Long D, Thakur N. Biological Burden of Adverse Childhood Experiences in Children. Psychosom Med 2023; 85:108-117. [PMID: 36728584 PMCID: PMC9930178 DOI: 10.1097/psy.0000000000001167] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE This study aimed to examine relationships between adverse childhood experiences (ACEs) and related life events and allostatic load (AL)-"wear and tear" from chronic stress-in a pediatric population. METHODS Children were screened with the PEdiatric ACEs and Related Life Event Screener (PEARLS) tool, a 17-item questionnaire capturing experiences of abuse, neglect, household challenges, and related life events. Biological data were available for 207 participants, and AL was operationalized using clinical or empirical cutoff points across 4 physiological systems (i.e., cardiac, metabolic, inflammatory, neurologic). Covariate-adjusted multivariable regression models were used to examine associations between AL with adversity and health. RESULTS Children (mean age = 6.5 years, range = 1-11 years) had an average AL score of 1.9 (standard deviation = 1.7), and a U-shaped relationship was observed with child's age. Continuous PEARLS and original ACE scores were not associated with AL. However, children with a reported PEARLS score of 1 to 2 or original ACEs score of 1 to 3 had 1.5 (incidence rate ratio [IRR] = 1.50, 95% confidence interval [CI] = 1.09-2.08) and 1.4 (IRR = 1.41, 95% CI = 1.08-1.84) times greater AL, respectively, compared with participants with none reported. In secondary analyses, caregiver mental illness was associated with higher child AL (adjusted IRR = 1.27, 95% CI = 1.01-1.58). AL was also associated with poorer perceived child general health (adjusted β = -0.87, 95% CI = -1.58 to -0.15) and greater odds of child obesity (adjusted odds ratio = 1.51, 95% CI = 1.23-1.89). CONCLUSIONS Measuring AL in a pediatric population requires careful consideration of age. Higher AL was associated with a greater number of reported adversities and worse child health.
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Affiliation(s)
- Rosemarie de la Rosa
- From the Department of Medicine (de la Rosa, Zablotny, Ye, Thakur), University of California San Francisco, San Francisco; School of Public Health (de la Rosa), University of California Berkeley, Berkeley; Departments of Psychiatry and Behavioral Science (Bush) and Pediatrics (Bush and Long) and Family and Community Medicine (Hessler), University of California San Francisco, San Francisco; UCSF Benioff Children's Hospital Oakland (Long), Oakland; Center for Youth Wellness (Koita, Bucci), San Francisco, California
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Longitudinal associations between allostatic load, pet ownership, and socioeconomic position among U.S. adults aged 50. SSM Popul Health 2023; 21:101344. [PMID: 36684398 PMCID: PMC9853381 DOI: 10.1016/j.ssmph.2023.101344] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 12/15/2022] [Accepted: 01/13/2023] [Indexed: 01/15/2023] Open
Abstract
It is hypothesized that pets provide benefits to human health by buffering the deleterious effects of stress, but varying exposure to chronic stress via social position is rarely considered in these conceptual and empirical models. Allostatic load is an index of biological and physical measures that represents cumulative wear and tear on the body via chronic stress exposure. In this study, we use the 2006-2016 waves of the Health and Retirement Study, a nationally representative, longitudinal panel survey of adults aged 50+ in the United States, to test whether and to what extent pet ownership has an impact on allostatic load, and whether pet ownership moderates the effects of socioeconomic position on allostatic load. Linear mixed effects regression models revealed that pet owners had significantly lower allostatic load scores than those who do not own pets; however, after adjusting for socioeconomic position (i.e., wealth, education, race, ethnicity, gender, marital status), the effect of pet ownership was no longer significant. We estimated a series of models stratified by sociodemographic groups to test moderation effects. Among those who had a high school education, pet owners had lower allostatic load scores, whereas among those who had attended some college, pet owners had higher scores. Among those who were aged 80+, pet owners had higher scores than those who did not own pets. These findings suggest that the magnitude of the effect of pet ownership on allostatic load may not be sufficient to counteract experiences of high chronic stress as experienced by lower-status groups. Supporting the human-animal bond may contribute to improving older adult population health if paired with efforts to address the underlying causes of population health disparities.
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Provenzi L, Roberti E, Capelli E. Envisioning translational hyperscanning: how applied neuroscience might improve family-centered care. Soc Cogn Affect Neurosci 2022; 18:6953329. [PMID: 36542821 PMCID: PMC9910277 DOI: 10.1093/scan/nsac061] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 11/17/2022] [Accepted: 12/20/2022] [Indexed: 12/24/2022] Open
Abstract
From the very beginning of their life, human beings are immersed in a social and interactive environment that contributes to shaping their social and cognitive development under typical and at-risk conditions. In order to understand human development in its bidirectional relationship with the social environment, we need to develop a 'complexity-sensitive' approach in neuroscience. Recent advances have started to do so with the application of hyperscanning techniques which involve recording adult and child neural activity simultaneously and highlighting the presence of similar patterns of brain activity in the dyad. Numerous studies focused on typically developing children have been published in recent years with the application of this technique to different fields of developmental research. However, hyperscanning techniques could also be extremely beneficial and effective in studying development in atypical and clinical populations. Such application, namely translational hyperscanning, should foster the transition toward a two-brain translational neuroscience. In this paper, we envision how the application of hyperscanning to atypical and clinical child populations can inform family-centered care for children and their parents.
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Affiliation(s)
- Livio Provenzi
- Correspondence should be addressed to Livio Provenzi, Department of Brain and Behavioral Sciences, University of Pavia, via Mondino 2, Pavia 27100, Italy. E-mail:
| | - Elisa Roberti
- Developmental Psychobiology Lab, IRCCS Mondino Foundation, Pavia 27100, Italy
| | - Elena Capelli
- Developmental Psychobiology Lab, IRCCS Mondino Foundation, Pavia 27100, Italy
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The association between allostatic load and brain: A systematic review. Psychoneuroendocrinology 2022; 145:105917. [PMID: 36113380 DOI: 10.1016/j.psyneuen.2022.105917] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 08/29/2022] [Accepted: 09/03/2022] [Indexed: 11/22/2022]
Abstract
Allostatic load (AL) refers to prolonged dysregulation related to chronic stress that affects brain regions such as the hippocampus, amygdala, and prefrontal cortex (PFC). Higher levels of AL have been associated with poor health outcomes, including psychiatric disorders, cognitive decline, and chronic somatic conditions. However, still little is known about the relationship between AL and the brain, and the mechanisms explaining the damaging effects of stress-related biological dysregulations. Therefore, we aimed to perform a systematic review of studies investigating the association of the AL index with brain structure and functioning in adult populations. PubMed/MEDLINE, CINAHL, Academic Search Complete and Web of Science were searched from their inception until August, 9th 2021. A total of 13 studies were included in the qualitative synthesis. There was a high between-study heterogeneity with respect to the methods used to calculate the AL index and brain parameters. All studies confirmed the associations between a higher AL index and alterations in various brain areas, especially: 1) the hippocampus, white matter volume, gray matter volume, and density in the older adults; 2) the cortex, fornix, hippocampus and choroid plexus in patients with schizophrenia spectrum disorders; and 3) whole-brain white matter tracts, cortical gray matter volume, and cortical thickness in overweight subjects. Overall, the findings of this systematic review imply that an elevated AL index might be associated with various neurostructural and neurofunctional alterations. Some of these associations may appear regardless of clinical or non-clinical populations being investigated (e.g., white matter tracts), whereas others may appear in specific populations (e.g., cortical thinning in overweight/obesity and schizophrenia spectrum disorders). However, additional studies utilizing a consistent approach to calculating the AL index are needed to extend these findings and indicate populations that are most vulnerable to the damaging effects of AL.
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Manczak EM, Watamura SE. Introduction to the SEED Science special issue. Dev Psychobiol 2022; 64:e22312. [DOI: 10.1002/dev.22312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 06/17/2022] [Indexed: 11/11/2022]
Affiliation(s)
- Erika M. Manczak
- Department of Psychology University of Denver Denver Colorado USA
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23
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Premji SS, Pana GS, Cuncannon A, Ronksley PE, Dosani A, Hayden KA, Lalani S, Musana JW, Shaikh K, Yim IS, Maternal-infant Global Health Team (MiGHT) Collaborators in Research. Prenatal allostatic load and preterm birth: A systematic review. Front Psychol 2022; 13:1004073. [PMID: 36267082 PMCID: PMC9577361 DOI: 10.3389/fpsyg.2022.1004073] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 09/05/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveAllostatic load refers to cumulative neuroendocrine burden and has been postulated to mediate and moderate physiological and psychological stress-related responses. This may have important implications for the risk of preterm birth. This systematic review examines the evidence on the association between prenatal allostatic load and preterm birth.Data sourcesA comprehensive search of seven electronic databases was conducted from inception to August 23, 2022 to identify all English-language observational and mixed methods studies examining allostatic load and preterm birth with no year or geographic restrictions.Study eligibility criteriaStudies were included if they measured allostatic load, evaluated as the cumulative effect of any combination of more than one allostatic load biomarker, during pregnancy. Studies must have observed preterm birth, defined as < 37 weeks' gestational age, as a primary or secondary outcome of interest.Study appraisal and synthesis methodsThe Quality In Prognosis Studies tool was used to evaluate risk of bias within included studies. A narrative synthesis was conducted to explore potential associations between allostatic load and preterm birth, and sources of heterogeneity.ResultsThree prospective cohort studies were identified and revealed mixed evidence for an association between allostatic load and preterm birth. One study reported a statistically significant association while the other two studies reported little to no evidence for an association. Heterogeneity in when and how allostatic load was measured, limitations in study design and cohort socio-demographics may have contributed to the mixed evidence.ConclusionsThis review provides insight into key individual-, community-, and study-level characteristics that may influence the association between allostatic load and preterm birth. Knowledge gaps are identified as foci for future research, including heterogeneity in allostatic load biomarkers and allostatic load index algorithms as well as pregnancy-specific considerations for allostatic load measurement. Further investigation of the allostatic load framework in the context of perinatal mental health is needed to advance understandings of maternal, infant, and child health.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020208990, PROSPERO, identifier: CRD42020208990.
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Affiliation(s)
- Shahirose Sadrudin Premji
- School of Nursing, Faculty of Health, York University, Toronto, ON, Canada
- *Correspondence: Shahirose Sadrudin Premji
| | - Gianella Santos Pana
- School of Nursing and Midwifery, Faculty of Health, Community and Education, Mount Royal University, Calgary, AB, Canada
| | | | - Paul E. Ronksley
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Aliyah Dosani
- School of Nursing and Midwifery, Faculty of Health, Community and Education, Mount Royal University, Calgary, AB, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - K. Alix Hayden
- Libraries and Cultural Resources, University of Calgary, Calgary, AB, Canada
| | - Sharifa Lalani
- School of Nursing and Midwifery, Aga Khan University, Karachi, Pakistan
| | - Joseph Wangira Musana
- Department of Obstetrics and Gynecology, Aga Khan University Hospital, Nairobi, Kenya
| | - Kiran Shaikh
- School of Nursing and Midwifery, Aga Khan University, Karachi, Pakistan
| | - Ilona S. Yim
- Department of Psychological Science, University of California, Irvine, Irvine, CA, United States
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Kent N, Alhowaymel F, Kalmakis K, Troy L, Chiodo L. Development of the College Student Acute Stress Scale (CSASS). Perspect Psychiatr Care 2022; 58:2998-3008. [PMID: 35191032 PMCID: PMC9392815 DOI: 10.1111/ppc.13053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 01/14/2022] [Accepted: 02/03/2022] [Indexed: 11/27/2022] Open
Abstract
PURPOSE The purpose of this study is to develop and validate the College Student Acute Stress Scale, a measure of acute stress specific to college students. DESIGN AND METHODS A total sample of 440 young adults from a university in the northeast United States were surveyed across three separate research studies. Exploratory principal component analysis, internal consistency reliability, convergent and divergent validity, and test-retest reliability analyses were performed. FINDINGS Evidence of convergent and divergent validity were obtained, and adequate internal consistency and test-retest reliability were identified. PRACTICE IMPLICATIONS This study provides evidence for the validity and reliability of a self-report measure of college students' acute stress experiences.
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Affiliation(s)
- Nicole Kent
- College of Nursing, University of Massachusetts Amherst, USA
| | - Fahad Alhowaymel
- College of Nursing, University of Massachusetts Amherst, USA
- Department of Nursing, College of Applied Medical Sciences, Shaqra University, Shaqra, Saudi Arabia
| | - Karen Kalmakis
- College of Nursing, University of Massachusetts Amherst, USA
| | - Lisa Troy
- School of Public Health & Health Sciences and Commonwealth Honors College, University of Massachusetts Amherst, USA
| | - Lisa Chiodo
- College of Nursing, University of Massachusetts Amherst, USA
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25
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Cost of resilience: Childhood poverty, mental health, and chronic physiological stress. Psychoneuroendocrinology 2022; 144:105872. [PMID: 35879139 DOI: 10.1016/j.psyneuen.2022.105872] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 07/09/2022] [Accepted: 07/18/2022] [Indexed: 12/23/2022]
Abstract
Childhood poverty is associated with elevated internalizing symptoms. Nevertheless, some children exposed to poverty evince remarkable resilience, demonstrating lower than expected levels of psychological distress. However, recent work suggests that coping with adversity can lead to undesirable physical health consequences. Specifically, successful adaptation in the context of early adversity, including socioeconomic disadvantage, appears to be associated with elevated chronic physiological stress and ill health. The current study adds to this emerging literature by examining in a longitudinal context whether low levels of internalizing symptoms in the face of childhood poverty is accompanied by elevated chronic physiological stress (allostatic load) during childhood, as well as over time from childhood to adulthood. Results (n = 341; M=9.2 years, 49 % female; 94 % Caucasian) show that childhood poverty was prospectively associated with higher allostatic load during adolescence, controlling for baseline allostatic load. Furthermore, greater duration of childhood poverty led to steeper, more elevated allostatic load trajectories from childhood to adulthood, for youth with lower levels of internalizing symptoms. Efforts to manage adverse sequelae of early adversity likely yield a complex array of benefits and costs.
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26
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The Impact of Chronic Unpredictable Mild Stress-Induced Depression on Spatial, Recognition and Reference Memory Tasks in Mice: Behavioral and Histological Study. Behav Sci (Basel) 2022; 12:bs12060166. [PMID: 35735376 PMCID: PMC9219659 DOI: 10.3390/bs12060166] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 05/23/2022] [Accepted: 05/26/2022] [Indexed: 02/05/2023] Open
Abstract
Depression-induced cognitive impairment has recently been given more attention in research. However, the relationship between depression and different types of memory is still not clear. Chronic unpredictable mild stress (CUMS) is a commonly used animal model of depression in which animals are exposed to chronic unpredictable environmental and psychological stressors, which mimics daily human life stressors. This study investigated the impact of different durations of CUMS on various types of memory (short- and long-term spatial memory and recognition memory) and investigated CUMS’ impact on the ultrastructural level by histological assessment of the hippocampus and prefrontal cortex. Twenty male C57BL/J6 mice (6 weeks old, 21.8 ± 2 g) were randomly divided into two groups (n = 10): control and CUMS (8 weeks). A series of behavioral tasks were conducted twice at weeks 5–6 (early CUMS) and weeks 7–8 (late CUMS). A tail-suspension test (TST), forced swimming test (FST), elevated zero maze (EZM), elevated plus maze (EPM), open field test (OFT), and sucrose-preference test (SPT) were used to assess anxiety and depressive symptoms. The cognitive function was assessed by the novel object recognition test (NORT; for recognition memory), Y-maze (for short-term spatial memory), and Morris water maze (MWM: for long-term spatial memory) with a probe test (for reference memory). Our data showed that 8 weeks of CUMS increased the anxiety level, reported by a significant increase in anxiety index in both EPM and EZM and a significant decrease in central preference in OFT, and depression was reported by a significant increase in immobility in the TST and FST and sucrose preference in the SPT. Investigating the impact of CUMS on various types of memory, we found that reference memory is the first memory to be affected in early CUMS. In late CUMS, all types of memory were impaired, and this was consistent with the abnormal histological features of the memory-related areas in the brain (hippocampus and prefrontal cortex).
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27
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Liu S, Fisher PA. Early experience unpredictability in child development as a model for understanding the impact of the COVID-19 pandemic: A translational neuroscience perspective. Dev Cogn Neurosci 2022; 54:101091. [PMID: 35217299 PMCID: PMC8860470 DOI: 10.1016/j.dcn.2022.101091] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 02/13/2022] [Accepted: 02/19/2022] [Indexed: 01/11/2023] Open
Abstract
Extensive evidence links adverse experiences during childhood to a wide range of negative consequences in biological, socioemotional, and cognitive development. Unpredictability is a core element underlying most forms of early adversity; it has been a focus of developmental research for many years and has been receiving increasing attention recently. In this article, we propose a conceptual model to describe how unpredictable and adverse early experiences affect children's neurobiological, behavioral, and psychological development in the context of the COVID-19 pandemic. We first highlight the critical role of unpredictability in child development by reviewing existing conceptual models of early adversity as they relate to subsequent development across the lifespan. Then, we employ a translational neuroscience framework to summarize the current animal- and human-based evidence on the neurobiological alterations induced by early experience unpredictability. We further argue that the COVID-19 pandemic serves as a global "natural experiment" that provides rare insight to the investigation of the negative developmental consequences of widespread, clustered, and unpredictable adverse events among children. We discuss how the pandemic helps advance the science of unpredictable early adverse experiences. As unpredictability research continues to grow, we highlight several directions for future studies and implications for policymaking and intervention practices.
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Affiliation(s)
- Sihong Liu
- Center for Translational Neuroscience, Department of Psychology, University of Oregon, Eugene, OR, United States.
| | - Philip A Fisher
- Center for Translational Neuroscience, Department of Psychology, University of Oregon, Eugene, OR, United States
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Fry CM, Ram N, Gatzke-Kopp LM. Integrating dynamic and developmental time scales: Emotion-specific autonomic coordination predicts baseline functioning over time. Int J Psychophysiol 2021; 171:29-37. [PMID: 34906622 DOI: 10.1016/j.ijpsycho.2021.12.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 10/25/2021] [Accepted: 12/01/2021] [Indexed: 11/27/2022]
Abstract
Autonomic nervous system activity flexibly shifts and modulates behavior at multiple time scales, with some work suggesting that patterns of short-term reactivity contribute to long-term developmental change. However, previous work has largely considered sympathetic and parasympathetic systems independently, even though both systems contribute dynamically to the regulation of physiological arousal. Using physiological data obtained from 313 children in kindergarten, 1st, and 2nd grade we examined whether within-person autonomic coordination during an emotion-inducing film task in kindergarten was associated with developmental change in resting autonomic activity. On average, these kindergarteners exhibited reciprocal coordination during the approach-oriented emotion (angry, happy) condition and a lack of coordination during the avoidance-oriented emotion (fear, sad) condition. Alignment with these patterns was associated with more typical autonomic development, specifically an increase in resting respiratory sinus arrhythmia (RSA) and a decrease in resting skin conductance (SCR) from kindergarten to 2nd grade; while lack of coordination during the approach condition was associated with a relatively delayed increase in resting RSA and a steeper decline in SCR, and reciprocal coordination during the avoidance condition was associated with a lack of RSA increase. Findings highlight the need for additional consideration of how moment-to-moment dynamics of autonomic coordination influence longer-term development, and suggest that early patterns of atypical arousal may portend dysregulation of developing physiological systems.
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Affiliation(s)
- Cassidy M Fry
- Department of Human Development and Family Studies, Pennsylvania State University, 115 Health & Human Development Building, University Park, PA 16802, USA.
| | - Nilam Ram
- Departments of Psychology and Communication, Stanford University, 450 Jane Stanford Way, Building 120, Stanford, CA 94305, USA.
| | - Lisa M Gatzke-Kopp
- Department of Human Development and Family Studies, Pennsylvania State University, 115 Health & Human Development Building, University Park, PA 16802, USA.
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The contribution of racism-related stress and adversity to disparities in birth outcomes: evidence and research recommendations. F S Rep 2021; 3:5-13. [PMID: 35937456 PMCID: PMC9349247 DOI: 10.1016/j.xfre.2021.10.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 10/27/2021] [Accepted: 10/29/2021] [Indexed: 12/14/2022] Open
Abstract
Currently, racial and ethnic differences in adverse birth outcomes and infant mortality are some of the largest and most persistent health disparities in the United States. This narrative review article synthesizes existing literature to present a conceptual model of how racism-related stress and adversity are critical determinants of such disparities. We describe how historical and ongoing racism has created conditions wherein women of color are disproportionately exposed to chronic, multilayered stress and adversity and how the biological consequences of exposure to these stressors confers risk for adverse birth outcomes. Next, we identify important priorities and considerations for future research, including the heterogeneity of racism-related stressors, biomarkers and mechanisms, chronicity and sensitive periods of exposure, developmental programming of lifespan health, resilience, and community-engaged research methodologies. Historical and ongoing racism has created conditions wherein women of color are disproportionately exposed to stress and adversity. The consequences of exposure to racism-related stress and adversity can confer risk for health conditions implicated in adverse birth outcomes and alter maternal physiology associated with fetal development and timing of parturition. Conjointly studying racism-related stress, biologic profiles, and birth outcomes is a priority for future research. It is important to identify factors that mitigate the impact of racism-related stress and adversity on birth outcomes.
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30
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Affiliation(s)
- Pam Factor-Litvak
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
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