1
|
Schäfer SK, Supke M, Kausmann C, Schaubruch LM, Lieb K, Cohrdes C. A systematic review of individual, social, and societal resilience factors in response to societal challenges and crises. COMMUNICATIONS PSYCHOLOGY 2024; 2:92. [PMID: 39369098 PMCID: PMC11455977 DOI: 10.1038/s44271-024-00138-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 09/11/2024] [Indexed: 10/07/2024]
Abstract
Societal challenges put public mental health at risk and result in a growing interest in resilience as trajectories of good mental health during stressor exposure. Resilience factors represent multilevel psychosocial resources that increase the likelihood of resilient responses. This preregistered systematic review aims at summarizing evidence on the predictive value of individual, social and societal resilience factors for resilient responses to societal challenges and crises. Eligible studies examined the predictive value of resilience factors in stressor-exposed populations in high-income countries by means of multinomial regression models based on growth mixture modeling. Five databases were searched until August 2, 2023. Data synthesis employed a rating scheme to assess the incremental predictive value of resilience factors beyond sociodemographic variables and other resilience factors. An adapted version of the Newcastle-Ottawa Scale was used for risk of bias assessment. Fifty studies (sample sizes: 360-65,818 participants) with moderate study quality reported on various stressors (e.g., pandemics, natural disasters, terrorist attacks). Higher income, socioeconomic status and perceived social support, better emotion regulation and psychological flexibility were related to more resilient responses. The association between resilience factors and resilient responses was stronger in samples with younger mean age and a larger proportion of women. Most studies used non-representative convenience samples and effects were smaller when accounting for sociodemographic variables and other resilience factors. For many factors, findings were mixed, supporting the importance of the fit between resilience factors and situational demands. Research into social and societal resilience factors and multilevel resilience interventions is needed. Preregistration-ID: 10.17605/OSF.IO/GWJVA. Funding source: Robert Koch Institute (ID: LIR_2023_01).
Collapse
Affiliation(s)
- Sarah K Schäfer
- Leibniz Institute for Resilience Research, Mainz, Germany.
- Department of Clinical Psychology, Psychotherapy and Psychodiagnostics, Technische Universität, Braunschweig, Braunschweig, Germany.
| | - Max Supke
- Leibniz Institute for Resilience Research, Mainz, Germany
- Department of Clinical Psychology, Psychotherapy and Psychodiagnostics, Technische Universität, Braunschweig, Braunschweig, Germany
| | - Corinna Kausmann
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | | | - Klaus Lieb
- Leibniz Institute for Resilience Research, Mainz, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center of Johannes Gutenberg University, Mainz, Germany
| | - Caroline Cohrdes
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| |
Collapse
|
2
|
Rösner C, Tüscher O, Petrowski K. Resilience as a predictor of habituation. Eur Arch Psychiatry Clin Neurosci 2024; 274:1615-1623. [PMID: 37526676 PMCID: PMC11422439 DOI: 10.1007/s00406-023-01658-y] [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: 01/11/2023] [Accepted: 07/17/2023] [Indexed: 08/02/2023]
Abstract
Habituation refers to the physiological adaptation to recurrent stressors, which can be measured by cortisol levels, and is considered a central mechanism in reducing allostatic load. Resilience, a potential factor influencing stress reduction, is the focus of this study. Specifically, the study aims to investigate the impact of resilience, as assessed by the Brief Resilience Scale (BRS), on habituation. The Trier Social Stress Test (TSST) was used as the recurrent stressor, and it was administered to each of the 56 subjects at 4 consecutive measurements. To assess habituation, various physiological parameters including the area under the curve with respect to the ground (AUCg) and with respect to the increase (AUCi), cortisol peak, slope from baseline to peak, and recovery were calculated. Mixed linear models were employed to examine the differences in the influence of resilience on habituation across the different time points. The findings indicate that the influence of resilience significantly varies from the first to the fourth measurement time point for AUCg (p = .048), while no significant differences were observed for the other cortisol parameters. The effects plot suggests that individuals with higher levels of resilience exhibit lower AUCg values throughout the measurements. These findings provide initial evidence supporting resilience as a predictor of cortisol habituation. However, future studies should also consider dynamic resilience models, utilizing longitudinally assessed resilience as a predictor for habituation, to explore whether resilience acts as a determinant of habituation or if habituation itself constitutes a resilience mechanism.
Collapse
Affiliation(s)
- Christoph Rösner
- Medical Psychology & Medical Sociology, University Medical Center of the Johannes Gutenberg, University Mainz, Duesbergweg 6, 55128, Mainz, Germany.
| | - Oliver Tüscher
- Leibniz Institute for Resilience Research (LIR) gGmbH Mainz, Wallstr. 7, 55122, Mainz, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg, University Mainz, Untere Zahlbacher Str. 8, 55131, Mainz, Germany
- Institute of Molecular Biology gGmbH Mainz, Ackermannweg 4, 55128, Mainz, Germany
| | - Katja Petrowski
- Medical Psychology & Medical Sociology, University Medical Center of the Johannes Gutenberg, University Mainz, Duesbergweg 6, 55128, Mainz, Germany
| |
Collapse
|
3
|
Schellekens MPJ, Zwanenburg LC, van der Lee ML. Resilience in the Face of Cancer: On the Importance of Defining and Studying Resilience as a Dynamic Process of Adaptation. Curr Oncol 2024; 31:4003-4014. [PMID: 39057169 PMCID: PMC11276221 DOI: 10.3390/curroncol31070297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Revised: 07/02/2024] [Accepted: 07/12/2024] [Indexed: 07/28/2024] Open
Abstract
Resilience is defined as the maintenance or relatively quick recovery of mental health during and after adversity. Rather than focusing on psychopathology and its causes, resilience research aims to understand what protective mechanisms shield individuals against developing such disorders and translate these insights to improve psychosocial care. This resilience approach seems especially promising for the field of oncology because patients face stressor after stressor from diagnosis to survivorship. Helping patients to learn how they can best use the resources and abilities available to them can empower patients to handle subsequent stressors. In the past few decades, resilience has increasingly been considered as a dynamic process of adaptation. While researchers use this definition, resilience has not yet been studied as a dynamic process in the field of oncology. As a result, the potential of resilience research to gain insight into what helps protect cancer patients from developing psychopathology is limited. We discuss conceptual and methodological proposals to advance resilience research in oncology. Most importantly, we propose applying prospective longitudinal designs to capture the dynamic resilience process. By gaining insight in how cancer patients engage in protective factors, resilience research can come to its full potential and help prevent psychopathology.
Collapse
Affiliation(s)
- Melanie P. J. Schellekens
- Scientific Research Department, Helen Dowling Institute, Expert Centre for Psycho-Oncology, 3720 AB Bilthoven, The Netherlands; (L.C.Z.); (M.L.v.d.L.)
- Department of Medical and Clinical Psychology, Tilburg University School of Social and Behavioral Sciences, 5037 AB Tilburg, The Netherlands
| | - Laura C. Zwanenburg
- Scientific Research Department, Helen Dowling Institute, Expert Centre for Psycho-Oncology, 3720 AB Bilthoven, The Netherlands; (L.C.Z.); (M.L.v.d.L.)
- Department of Medical and Clinical Psychology, Tilburg University School of Social and Behavioral Sciences, 5037 AB Tilburg, The Netherlands
| | - Marije L. van der Lee
- Scientific Research Department, Helen Dowling Institute, Expert Centre for Psycho-Oncology, 3720 AB Bilthoven, The Netherlands; (L.C.Z.); (M.L.v.d.L.)
- Department of Medical and Clinical Psychology, Tilburg University School of Social and Behavioral Sciences, 5037 AB Tilburg, The Netherlands
| |
Collapse
|
4
|
Petri-Romão P, Engen H, Rupanova A, Puhlmann L, Zerban M, Neumann RJ, Malyshau A, Ahrens KF, Schick A, Kollmann B, Wessa M, Walker H, Plichta MM, Reif A, Chmitorz A, Tuescher O, Basten U, Kalisch R. Self-report assessment of Positive Appraisal Style (PAS): Development of a process-focused and a content-focused questionnaire for use in mental health and resilience research. PLoS One 2024; 19:e0295562. [PMID: 38306328 PMCID: PMC10836662 DOI: 10.1371/journal.pone.0295562] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 11/23/2023] [Indexed: 02/04/2024] Open
Abstract
Positive Appraisal Style Theory of Resilience posits that a person's general style of evaluating stressors plays a central role in mental health and resilience. Specifically, a tendency to appraise stressors positively (positive appraisal style; PAS) is theorized to be protective of mental health and thus a key resilience factor. To this date no measures of PAS exist. Here, we present two scales that measure perceived positive appraisal style, one focusing on cognitive processes that lead to positive appraisals in stressful situations (PASS-process), and the other focusing on the appraisal contents (PASS-content). For PASS-process, the items of the existing questionnaires Brief COPE and CERQ-short were analyzed in exploratory and confirmatory factor analyses (EFA, CFA) in independent samples (N = 1157 and N = 1704). The resulting 10-item questionnaire was internally consistent (α = .78, 95% CI [.86, .87]) and showed good convergent and discriminant validity in comparisons with self-report measures of trait optimism, neuroticism, urgency, and spontaneity. For PASS-content, a newly generated item pool of 29 items across stressor appraisal content dimensions (probability, magnitude, and coping potential) were subjected to EFA and CFA in two independent samples (N = 1174 and N = 1611). The resulting 14-item scale showed good internal consistency (α = .87, 95% CI [.86, .87]), as well as good convergent and discriminant validity within the nomological network. The two scales are a new and reliable way to assess self-perceived positive appraisal style in large-scale studies, which could offer key insights into mechanisms of resilience.
Collapse
Affiliation(s)
| | - Haakon Engen
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Anna Rupanova
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Lara Puhlmann
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
| | - Matthias Zerban
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Rebecca J Neumann
- Department of Psychiatry, University Hospital, Psychosomatic Medicine and Psychotherapy, Goethe University Frankfurt, Frankfurt, Germany
| | - Aliaksandr Malyshau
- Department of Psychiatry, University Hospital, Psychosomatic Medicine and Psychotherapy, Goethe University Frankfurt, Frankfurt, Germany
| | - Kira F Ahrens
- Department of Psychiatry, University Hospital, Psychosomatic Medicine and Psychotherapy, Goethe University Frankfurt, Frankfurt, Germany
| | - Anita Schick
- Medical Faculty Mannheim, Department of Public Mental Health, Central Institute of Mental Health (CIMH), Heidelberg University, Mannheim, Germany
| | - Bianca Kollmann
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Department of Psychiatry and Psychotherapy, Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Michèle Wessa
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Department of Clinical Psychology and Neuropsychology, Institute of Psychology, Johannes Gutenberg University, Mainz, Germany
| | - Henrik Walker
- Department of Psychiatry & Psychotherapy, Division of Mind and Brain Research, Campus Charité Mitte, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Michael M Plichta
- Department of Psychiatry, University Hospital, Psychosomatic Medicine and Psychotherapy, Goethe University Frankfurt, Frankfurt, Germany
| | - Andreas Reif
- Department of Psychiatry, University Hospital, Psychosomatic Medicine and Psychotherapy, Goethe University Frankfurt, Frankfurt, Germany
| | - Andrea Chmitorz
- Faculty of Social Work, Health Care and Nursing, Esslingen University of Applied Sciences, Esslingen, Germany
| | - Oliver Tuescher
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Department of Psychiatry and Psychotherapy, Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Ulrike Basten
- Department of Psychology, University of Kaiserslautern-Landau, Landau, Germany
| | - Raffael Kalisch
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
| |
Collapse
|
5
|
von Werthern NM, Ahrens KF, Neumann RJ, Kollmann B, Kranz TM, Lieb K, Tüscher O, Reif A, Fiebach CJ, Plichta MM. Loneliness during the Covid-19 pandemic in Germany: Impact of social factors and polygenic risk scores on interpersonal differences in loneliness and mental health. World J Biol Psychiatry 2023; 24:838-848. [PMID: 37334645 DOI: 10.1080/15622975.2023.2226201] [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: 02/04/2023] [Revised: 06/11/2023] [Accepted: 06/13/2023] [Indexed: 06/20/2023]
Abstract
OBJECTIVES The outbreak of Covid-19 negatively affected mental health and increased loneliness. The subjective feeling of loneliness is influenced by genetic and social factors and has a negative impact on mental health. METHODS From March 2020 to June 2021 loneliness was investigated in N = 517 individuals using monthly acquired questionnaire data and Latent Growth Curve Analysis. Associations of social factors and polygenic risk scores (PRSs, n = 361) with class membership were investigated. RESULTS Three classes ("average", 40%; "not lonely", 38%; "elevated loneliness", 22%) were identified, that differ significantly regarding loneliness, mental dysfunction, and response to the lockdown phases. Individuals with a high PRS for neuroticism are more likely to belong to the "elevated loneliness" class, living with another person is a protective factor. CONCLUSION As the "elevated loneliness" class was at the highest risk of mental dysfunction, our findings underscore the importance of identifying those individuals to implement counteractive measures.
Collapse
Affiliation(s)
- N M von Werthern
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University Frankfurt, University Hospital, Frankfurt, Germany
| | - K F Ahrens
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University Frankfurt, University Hospital, Frankfurt, Germany
| | - R J Neumann
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University Frankfurt, University Hospital, Frankfurt, Germany
| | - B Kollmann
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
| | - T M Kranz
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University Frankfurt, University Hospital, Frankfurt, Germany
| | - K Lieb
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
| | - O Tüscher
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
| | - A Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University Frankfurt, University Hospital, Frankfurt, Germany
| | - C J Fiebach
- Department of Psychology, Goethe University Frankfurt, Frankfurt, Germany
- Brain Imaging Center, Goethe University Frankfurt, Frankfurt, Germany
| | - M M Plichta
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University Frankfurt, University Hospital, Frankfurt, Germany
| |
Collapse
|
6
|
Kegelaers J. Are we really studying resilience in sport? A critical review of adopted methodologies. Front Psychol 2023; 14:1270887. [PMID: 37954183 PMCID: PMC10637379 DOI: 10.3389/fpsyg.2023.1270887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 10/11/2023] [Indexed: 11/14/2023] Open
Abstract
Psychological resilience has gained considerable attention in sport. Nevertheless, the construct often remains poorly understood and multiple conceptual and methodological issues pervade the literature. The purpose of the present article is to provide a critical review of the commonly adopted methodologies to study resilience in sport. This review is divided into four sections. The first section will briefly discuss opposing conceptualizations of resilience as a static trait or a dynamic process. The second section will then discuss key methodological implications relating to the conceptualization of resilience as a dynamic process. In the third section, common methodologies to study resilience in sport are presented and critically reviewed. These methodologies are broadly divided into: (i) self-report resilience measures, (ii) qualitative research, and (iii) direct assessment of functioning in relation to observed adversity. In the final section, some avenues for future research are offered.
Collapse
Affiliation(s)
- Jolan Kegelaers
- Brussels University Consultation Center, Department of Psychology, Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium
- Sport Psychology and Mental Support, Department of Movement and Sport Sciences, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| |
Collapse
|
7
|
Schäfer SK, Fritz J, Sopp MR, Kunzler AM, von Boros L, Tüscher O, Göritz AS, Lieb K, Michael T. Interrelations of resilience factors and their incremental impact for mental health: insights from network modeling using a prospective study across seven timepoints. Transl Psychiatry 2023; 13:328. [PMID: 37872216 PMCID: PMC10593776 DOI: 10.1038/s41398-023-02603-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 09/15/2023] [Accepted: 09/20/2023] [Indexed: 10/25/2023] Open
Abstract
Resilience can be viewed as trajectory of stable good mental health or the quick recovery of mental health during or after stressor exposure. Resilience factors (RFs) are psychological resources that buffer the potentially negative effects of stress on mental health. A problem of resilience research is the large number of conceptually overlapping RFs complicating their understanding. The current study sheds light on the interrelations of RFs in the face of the COVID-19 pandemic as a use case for major disruptions. The non-preregistered prospective study assessed a sample of 1275 German-speaking people from February 2020 to March 2021 at seven timepoints. We measured coping, hardiness, control beliefs, optimism, self-efficacy, sense of coherence (SOC), sense of mastery, social support and dispositional resilience as RFs in February 2020, and mental health (i.e., psychopathological symptoms, COVID-19-related rumination, stress-related growth) at all timepoints. Analyses used partial correlation network models and latent growth mixture modeling (LGMM). Pre-pandemic RFs were strongly interrelated, with SOC being the most central node. The strongest associations emerged between coping using emotional support and social support, SOC and sense of mastery, and dispositional resilience and self-efficacy. SOC and active coping were negatively linked. When we examined RFs as predictors of mental health trajectories, SOC was the strongest predictor of psychopathological symptoms and rumination, while trajectories of stress-related growth were predicted by optimism. Subsequent network analyses, including individual intercepts and slopes from LGMM, showed that RFs had small to moderate associations with intercepts but were unrelated to slopes. Our findings provide evidence for SOC playing an important role in mental distress and suggest further examining SOC's incremental validity. However, our results also propose that RFs might be more important for stable levels of mental health than for adaptation processes over time. The differential associations for negative and positive outcomes support the use of multidimensional outcomes in resilience research.
Collapse
Affiliation(s)
- Sarah K Schäfer
- Leibniz Institute for Resilience Research, Mainz, Germany
- Department of Clinical Psychology and Psychotherapy, Saarland University, Saarbrücken, Germany
- Department of Clinical Psychology, Psychotherapy and Psychodiagnostics, Technische Universität Braunschweig, Braunschweig, Germany
| | - Jessica Fritz
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
- Department of Clinical Psychology, Philipps-University Marburg, Marburg, Germany
| | - M Roxanne Sopp
- Department of Clinical Psychology and Psychotherapy, Saarland University, Saarbrücken, Germany
| | - Angela M Kunzler
- Leibniz Institute for Resilience Research, Mainz, Germany
- Institute for Evidence in Medicine, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Lisa von Boros
- Leibniz Institute for Resilience Research, Mainz, Germany
| | - Oliver Tüscher
- Leibniz Institute for Resilience Research, Mainz, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center of Johannes Gutenberg University, Mainz, Germany
- Institute for Molecular Biology, Mainz, Germany
| | - Anja S Göritz
- Behavioral Health Technology, Augsburg University, Augsburg, Germany
| | - Klaus Lieb
- Leibniz Institute for Resilience Research, Mainz, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center of Johannes Gutenberg University, Mainz, Germany
| | - Tanja Michael
- Department of Clinical Psychology and Psychotherapy, Saarland University, Saarbrücken, Germany.
| |
Collapse
|
8
|
Bögemann SA, Riepenhausen A, Puhlmann LMC, Bar S, Hermsen EJC, Mituniewicz J, Reppmann ZC, Uściƚko A, van Leeuwen JMC, Wackerhagen C, Yuen KSL, Zerban M, Weermeijer J, Marciniak MA, Mor N, van Kraaij A, Köber G, Pooseh S, Koval P, Arias-Vásquez A, Binder H, De Raedt W, Kleim B, Myin-Germeys I, Roelofs K, Timmer J, Tüscher O, Hendler T, Kobylińska D, Veer IM, Kalisch R, Hermans EJ, Walter H. Investigating two mobile just-in-time adaptive interventions to foster psychological resilience: research protocol of the DynaM-INT study. BMC Psychol 2023; 11:245. [PMID: 37626397 PMCID: PMC10464364 DOI: 10.1186/s40359-023-01249-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 07/14/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Stress-related disorders such as anxiety and depression are highly prevalent and cause a tremendous burden for affected individuals and society. In order to improve prevention strategies, knowledge regarding resilience mechanisms and ways to boost them is highly needed. In the Dynamic Modelling of Resilience - interventional multicenter study (DynaM-INT), we will conduct a large-scale feasibility and preliminary efficacy test for two mobile- and wearable-based just-in-time adaptive interventions (JITAIs), designed to target putative resilience mechanisms. Deep participant phenotyping at baseline serves to identify individual predictors for intervention success in terms of target engagement and stress resilience. METHODS DynaM-INT aims to recruit N = 250 healthy but vulnerable young adults in the transition phase between adolescence and adulthood (18-27 years) across five research sites (Berlin, Mainz, Nijmegen, Tel Aviv, and Warsaw). Participants are included if they report at least three negative burdensome past life events and show increased levels of internalizing symptoms while not being affected by any major mental disorder. Participants are characterized in a multimodal baseline phase, which includes neuropsychological tests, neuroimaging, bio-samples, sociodemographic and psychological questionnaires, a video-recorded interview, as well as ecological momentary assessments (EMA) and ecological physiological assessments (EPA). Subsequently, participants are randomly assigned to one of two ecological momentary interventions (EMIs), targeting either positive cognitive reappraisal or reward sensitivity. During the following intervention phase, participants' stress responses are tracked using EMA and EPA, and JITAIs are triggered if an individually calibrated stress threshold is crossed. In a three-month-long follow-up phase, parts of the baseline characterization phase are repeated. Throughout the entire study, stressor exposure and mental health are regularly monitored to calculate stressor reactivity as a proxy for outcome resilience. The online monitoring questionnaires and the repetition of the baseline questionnaires also serve to assess target engagement. DISCUSSION The DynaM-INT study intends to advance the field of resilience research by feasibility-testing two new mechanistically targeted JITAIs that aim at increasing individual stress resilience and identifying predictors for successful intervention response. Determining these predictors is an important step toward future randomized controlled trials to establish the efficacy of these interventions.
Collapse
Grants
- 777084 European Union's Horizon 2020 research and innovation program
- 777084 European Union's Horizon 2020 research and innovation program
- 777084 European Union's Horizon 2020 research and innovation program
- 777084 European Union's Horizon 2020 research and innovation program
- 777084 European Union's Horizon 2020 research and innovation program
- 777084 European Union's Horizon 2020 research and innovation program
- 777084 European Union's Horizon 2020 research and innovation program
- 777084 European Union's Horizon 2020 research and innovation program
- 777084 European Union's Horizon 2020 research and innovation program
- 777084 European Union's Horizon 2020 research and innovation program
- 777084 European Union's Horizon 2020 research and innovation program
- 777084 European Union's Horizon 2020 research and innovation program
- 777084 European Union's Horizon 2020 research and innovation program
- 777084 European Union's Horizon 2020 research and innovation program
- 777084 European Union's Horizon 2020 research and innovation program
- 777084 European Union's Horizon 2020 research and innovation program
- DFG Grant CRC 1193, subprojects B01, C01, C04, Z03 Deutsche Forschungsgemeinschaft
- DFG Grant CRC 1193, subprojects B01, C01, C04, Z03 Deutsche Forschungsgemeinschaft
- 01KX2021 German Federal Ministry for Education and Research (BMBF) as part of the Network for University Medicine
- MARP program, DRZ program, Leibniz Institute for Resilience Research State of Rhineland-Palatinate, Germany
- MARP program, DRZ program, Leibniz Institute for Resilience Research State of Rhineland-Palatinate, Germany
- European Union’s Horizon 2020 research and innovation program
Collapse
Affiliation(s)
- S A Bögemann
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Kapittelweg 29, Nijmegen, 6525 EN, The Netherlands.
| | - A Riepenhausen
- Research Division of Mind and Brain, Department of Psychiatry and Neurosciences CCM, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Faculty of Philosophy, Berlin School of Mind and Brain, Humboldt-Universität Zu Berlin, Berlin, Germany
| | - L M C Puhlmann
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - S Bar
- Sagol Brain Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - E J C Hermsen
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Kapittelweg 29, Nijmegen, 6525 EN, The Netherlands
| | - J Mituniewicz
- Faculty of Psychology, University of Warsaw, Warsaw, Poland
| | - Z C Reppmann
- Research Division of Mind and Brain, Department of Psychiatry and Neurosciences CCM, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - A Uściƚko
- Faculty of Psychology, University of Warsaw, Warsaw, Poland
| | - J M C van Leeuwen
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Kapittelweg 29, Nijmegen, 6525 EN, The Netherlands
| | - C Wackerhagen
- Research Division of Mind and Brain, Department of Psychiatry and Neurosciences CCM, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - K S L Yuen
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
| | - M Zerban
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
| | - J Weermeijer
- Center for Contextual Psychiatry, Department of Neurosciences, KU Leuven, Louvain, Belgium
| | - M A Marciniak
- Division of Experimental Psychopathology and Psychotherapy, Department of Psychology, University of Zurich, Zurich, Switzerland
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital (PUK), University of Zurich, Zurich, Switzerland
| | - N Mor
- Sagol Brain Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - A van Kraaij
- OnePlanet Research Center, Wageningen, The Netherlands
| | - G Köber
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
- Freiburg Center for Data Analysis and Modelling, University of Freiburg, Freiburg, Germany
| | - S Pooseh
- Freiburg Center for Data Analysis and Modelling, University of Freiburg, Freiburg, Germany
| | - P Koval
- Melbourne School of Psychological Sciences, The University of Melbourne, Vic, 3010, Australia
| | - A Arias-Vásquez
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Kapittelweg 29, Nijmegen, 6525 EN, The Netherlands
| | - H Binder
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
- Freiburg Center for Data Analysis and Modelling, University of Freiburg, Freiburg, Germany
| | - W De Raedt
- Life Sciences Department, Imec, Louvain, Belgium
| | - B Kleim
- Division of Experimental Psychopathology and Psychotherapy, Department of Psychology, University of Zurich, Zurich, Switzerland
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital (PUK), University of Zurich, Zurich, Switzerland
| | - I Myin-Germeys
- Center for Contextual Psychiatry, Department of Neurosciences, KU Leuven, Louvain, Belgium
| | - K Roelofs
- Center for Cognitive Neuroimaging, Donders Institute for Brain Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - J Timmer
- Freiburg Center for Data Analysis and Modelling, University of Freiburg, Freiburg, Germany
- Institute of Physics, University of Freiburg, Freiburg, Germany
- Signalling Research Centres BIOSS and CIBSS, University of Freiburg, Freiburg, Germany
| | - O Tüscher
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Department of Psychiatry and Psychotherapy, Johannes Gutenberg University Medical Center, Mainz, Germany
| | - T Hendler
- Sagol Brain Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- School of Psychological Science, Tel Aviv University, Tel Aviv, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - D Kobylińska
- Faculty of Psychology, University of Warsaw, Warsaw, Poland
| | - I M Veer
- Department of Developmental Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - R Kalisch
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
| | - E J Hermans
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Kapittelweg 29, Nijmegen, 6525 EN, The Netherlands
| | - H Walter
- Research Division of Mind and Brain, Department of Psychiatry and Neurosciences CCM, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Faculty of Philosophy, Berlin School of Mind and Brain, Humboldt-Universität Zu Berlin, Berlin, Germany
| |
Collapse
|
9
|
Ruf A, Neubauer AB, Koch ED, Ebner-Priemer U, Reif A, Matura S. Microtemporal Dynamics of Dietary Intake, Physical Activity, and Impulsivity in Adult Attention-Deficit/Hyperactivity Disorder: Ecological Momentary Assessment Study Within Nutritional Psychiatry. JMIR Ment Health 2023; 10:e46550. [PMID: 37590053 PMCID: PMC10472180 DOI: 10.2196/46550] [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: 02/17/2023] [Revised: 05/24/2023] [Accepted: 06/17/2023] [Indexed: 08/18/2023] Open
Abstract
BACKGROUND Increasing attention is being paid to lifestyle factors, such as nutrition and physical activity (PA), as potential complementary treatment options in attention-deficit/hyperactivity disorder (ADHD). Previous research indicates that sugar and saturated fat intake may be linked to increased impulsivity, a core symptom of ADHD, whereas protein intake and PA may be related to reduced impulsivity. However, most studies rely on cross-sectional data that lack microtemporal resolution and ecological validity, wherefore questions of microtemporal dynamics (eg, is the consumption of foods high in sugar associated with increased impulsivity within minutes or hours?) remain largely unanswered. Ecological momentary assessment (EMA) has the potential to bridge this gap. OBJECTIVE This study is the first to apply EMA to assess microtemporal associations among macronutrient intake, PA, and state impulsivity in the daily life of adults with and without ADHD. METHODS Over a 3-day period, participants reported state impulsivity 8 times per day (signal-contingent), recorded food and drink intake (event-contingent), and wore an accelerometer. Multilevel 2-part models were used to study the association among macronutrient intake, PA, and the probability to be impulsive as well as the intensity of impulsivity (ADHD: n=36; control: n=137). RESULTS No association between macronutrient intake and state impulsivity was found. PA was not related to the intensity of impulsivity but to a higher probability to be impulsive (ADHD: β=-.09, 95% CI -0.14 to -0.04; control: β=-.03, 95% CI -0.05 to -0.01). No evidence was found that the combined intake of saturated fat and sugar amplified the increase in state impulsivity and that PA alleviated the positive association between sugar or fat intake and state impulsivity. CONCLUSIONS Important methodological considerations are discussed that can contribute to the optimization of future EMA protocols. EMA research in the emerging field of nutritional psychiatry is still in its infancy; however, EMA is a highly promising and innovative approach as it offers insights into the microtemporal dynamics of psychiatric symptomology, dietary intake, and PA in daily life.
Collapse
Affiliation(s)
- Alea Ruf
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| | - Andreas B Neubauer
- DIPF | Leibniz Institute for Research and Information in Education, Frankfurt, Germany
- Center for Research on Individual Development and Adaptive Education of Children at Risk (IDeA), Frankfurt, Germany
| | - Elena D Koch
- Mental mHealth Lab, Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
| | - Ulrich Ebner-Priemer
- Mental mHealth Lab, Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| | - Silke Matura
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| |
Collapse
|
10
|
Lo HKY, Wong GHS, Chan JKN, Wong CSM, Lei JHC, So YK, Fung VSC, Chu RST, Chung AKK, Lee KCK, Cheng CPW, Chan WC, Chang WC. COVID-19 perseverative cognition and depressive symptoms in Hong Kong: The moderating role of resilience, loneliness and coping strategies. J Affect Disord 2023:S0165-0327(23)00699-7. [PMID: 37230268 DOI: 10.1016/j.jad.2023.05.058] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 05/11/2023] [Accepted: 05/18/2023] [Indexed: 05/27/2023]
Abstract
BACKGROUND The COVID-19 pandemic significantly increased depression prevalence in general population. However, the relationship between persistent dysfunctional thinking associated with COVID-19 (perseverative-cognition) and depression, and its potential moderators are understudied. We aimed to examine the association between COVID-19 perseverative-cognition and depression, and the moderating effect of potential risk and protective factors on this association in general public during the peak of fifth COVID-19 wave in Hong Kong. METHODS This survey recruited 14,269 community-dwelling adults between March 15-April 3, 2022 to investigate association between COVID-19 perseverative-cognition and depression, and the moderating effect of resilience, loneliness and three coping strategies (including emotion-focused, problem-focused and avoidant coping) on this association, using hierarchical regression models and simple slope analyses. COVID-19 perseverative cognition was assessed by the Obsession with COVID-19 Scale (OCS) and depressive symptoms were measured by the Patient Health Questionnaire-9 (PHQ-9). RESULTS Perseverative-cognition was positively associated with depression severity. Resilience, loneliness and three coping strategies moderated the association between perseverative-cognition and depression. Specifically, greater resilience and emotion-focused coping ameliorated the association between perseverative-cognition and depression, while higher levels of loneliness, avoidant and problem-focused coping accentuated such association. LIMITATIONS Cross-sectional design precluded establishing causality among variables. CONCLUSION This study affirms that COVID-19 perseverative-cognition is significantly related to depression. Our findings indicate the potential critical role of enhanced personal resilience and social support, and adoption of emotion-focused coping in mitigating negative effect of COVID-19 related maladaptive thinking on depression severity, thereby facilitating development of targeted strategies to reduce psychological distress amidst the prolonged pandemic.
Collapse
Affiliation(s)
- Heidi Ka Ying Lo
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong
| | - Gabbie Hou Sem Wong
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong
| | - Joe Kwun Nam Chan
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong
| | - Corine Sau Man Wong
- School of Public Health, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong
| | - Janet Hiu Ching Lei
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong
| | - Yuen Kiu So
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong
| | - Vivian Shi Cheng Fung
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong
| | - Ryan Sai Ting Chu
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong
| | - Albert Kar Kin Chung
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong
| | - Krystal Chi Kei Lee
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong
| | - Calvin Pak Wing Cheng
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong
| | - Wai Chi Chan
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong
| | - Wing Chung Chang
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong; State Key Laboratory of Brain and Cognitive Sciences, the University of Hong Kong, Hong Kong.
| |
Collapse
|
11
|
Bischops AC, Reinauer C, Pischke C, Mayatepek E, Meißner T. Strengthening the Resilience of Children and Adolescents during a Pandemic: A Scoping Review on Eligible Interventions. KLINISCHE PADIATRIE 2023; 235:13-22. [PMID: 35948048 DOI: 10.1055/a-1849-1355] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND The COVID-19 pandemic dramatically affects children's and adolescents' mental health. The accumulation of stress factors and a lack of social support complicate a healthy development. Since the beginning of the pandemic, there has been almost a doubling of mental health problems in children and adolescents. Promoting resilience is a possible approach to reduce the incidence of mental health problems despite these adverse circumstances. OBJECTIVES This literature search aims at identifying and evaluating interventions to promote resilience mechanisms, with a special focus on feasibility in a crisis situation. MATERIALS AND METHODS This scoping review is based on a systematic literature search including the databases Cochrane Library, PubMed, Psyc-Info, Psyndex and Google Scholar (2006-2020). Of 1733 identified articles 75 were included. RESULTS Out of 72 identified intervention studies 28% were feasible under pandemic conditions. The most effective resilience trainings seem to be individualized interventions using cognitive behavioral therapy elements. However, many approaches primarily show short-term success. DISCUSSION Few evidence-based programs are feasible online or under pandemic restrictions. Most of them show short-term effects and focus on parents and individuals. Multiple programs are ready for use, but still lack proof of efficacy. The development and improvement of (digital) resilience interventions should be an essential part of preventive health care, especially for risk groups. HINTERGRUND Die COVID-19-Pandemie beeinflusst die mentale Gesundheit von Kindern und Jugendlichen auf dramatische Weise. Durch eine Akkumulation von Belastungsfaktoren und das Wegfallen sozialer Unterstützung ist eine regelrechte Entwicklung erschwert. Seit Beginn der Pandemie kam es nahezu zu einer Verdopplung der psychischen Auffälligkeiten. Die Förderung der Resilienz kann ein Ansatz sein, das Auftreten von psychischen Auffälligkeiten trotz dieser widrigen Umstände zu vermindern. ZIEL DER ARBEIT Ziel dieser Literaturrecherche ist die Identifikation und Bewertung von Interventionen zur Förderung von Resilienzmechanismen, mit Fokus auf die Durchführbarkeit unter Krisenbedingungen. MATERIAL UND METHODEN Dieses Scoping Review basiert auf einer systematischen Literaturrecherche der Datenbanken Cochrane Library, PubMed, Psyc-Info, Psyndex sowie Google Scholar (2006-2021). Von der insgesamt 1733 Artikel umfassenden Suche wurden 75 Artikel eingeschlossen. ERGEBNISSE Von 72 identifizierten Interventionsstudien sind 28% unter Pandemiebedingungen durchführbar. Die wirksamsten Resilienztrainings scheinen individualisierte Interventionen mit Elementen der kognitiven Verhaltenstherapie zu sein. Viele Ansätze zeigen jedoch in erster Linie kurzfristige Erfolge. DISKUSSION Nur wenige evidenzbasierte Programme sind online oder unter Pandemiebedingungen verfügbar. Die meisten von ihnen zeigen kurzfristige Effekte und konzentrieren sich auf Eltern und Einzelpersonen. Zahlreiche Programme sind nutzbar, allerdings fehlt häufig ein Evidenznachweis. Die Entwicklung und Verbesserung von (digitalen) Resilienzmaßnahmen sollte ein wesentlicher Bestandteil der präventiven Gesundheitsversorgung sein, insbesondere für Risikogruppen.
Collapse
Affiliation(s)
- Anne Christine Bischops
- Department of General Paediatrics, Neonatology and Paediatric Cardiology, Medical Faculty, Heinrich-Heine-University, Düsseldorf University Hospital, Düsseldorf, Germany
| | - Christina Reinauer
- Department of General Paediatrics, Neonatology and Paediatric Cardiology, Medical Faculty, Heinrich-Heine-University, Düsseldorf University Hospital, Düsseldorf, Germany
| | - Claudia Pischke
- Institute of Medical Sociology, Universitätsklinikum Düsseldorf Centre for Health and Society, Dusseldorf, Germany
| | - Ertan Mayatepek
- Department of General Paediatrics, Neonatology and Paediatric Cardiology, Medical Faculty, Heinrich-Heine-University, Düsseldorf University Hospital, Düsseldorf, Germany
| | - Thomas Meißner
- Department of General Paediatrics, Neonatology and Paediatric Cardiology, Medical Faculty, Heinrich-Heine-University, Düsseldorf University Hospital, Düsseldorf, Germany
| |
Collapse
|
12
|
Schäfer SK, Kunzler AM, Kalisch R, Tüscher O, Lieb K. Trajectories of resilience and mental distress to global major disruptions. Trends Cogn Sci 2022; 26:1171-1189. [PMID: 36302711 PMCID: PMC9595401 DOI: 10.1016/j.tics.2022.09.017] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 09/20/2022] [Accepted: 09/24/2022] [Indexed: 11/06/2022]
Abstract
The COVID-19 pandemic has resulted in a major societal disruption, raising the question of how people can maintain or quickly regain their mental health (i.e., be resilient) during such times. Researchers have used the pandemic as a use case for studying resilience in response to a global, synchronously starting, and chronic set of stressors on the individual and societal level. Our review of this recent literature reveals that mental distress trajectories during the pandemic largely resemble mental distress responses to individual-level macro-stressors, except for a lower prevalence of recovery trajectories. Results suggest more resilient responses in older adults, but trajectories are less consistent for younger and older ages compared with middle-aged adults. We call for more research integrating state-of-the-art operationalizations of resilience and using these to study resilience over the lifespan.
Collapse
Affiliation(s)
- Sarah K Schäfer
- Leibniz Institute for Resilience Research (LIR), D-55122 Mainz, Germany
| | - Angela M Kunzler
- Leibniz Institute for Resilience Research (LIR), D-55122 Mainz, Germany
| | - Raffael Kalisch
- Leibniz Institute for Resilience Research (LIR), D-55122 Mainz, Germany; Neuroimaging Center, Focus Program Translational Neuroscience, University Medical Center of the Johannes Gutenberg University Mainz, D-55131 Mainz, Germany
| | - Oliver Tüscher
- Leibniz Institute for Resilience Research (LIR), D-55122 Mainz, Germany; Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, D-55131 Mainz, Germany
| | - Klaus Lieb
- Leibniz Institute for Resilience Research (LIR), D-55122 Mainz, Germany; Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, D-55131 Mainz, Germany.
| |
Collapse
|
13
|
Hubenschmid L, Helmreich I, Köber G, Gilan D, Frenzel SB, van Dick R, Lieb K. Effects of general and corona-specific stressors on mental burden during the SARS-CoV-2 pandemic in Germany. Front Public Health 2022; 10:991292. [PMID: 36483250 PMCID: PMC9724653 DOI: 10.3389/fpubh.2022.991292] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 10/18/2022] [Indexed: 11/23/2022] Open
Abstract
The SARS-CoV-2 pandemic turned out to be a serious threat to mental and physical health. However, the relative contribution of corona-specific (DHs) and general stressors (DHg) on mental burden, and specific protective and risk factors for mental health are still not well understood. In a representative sample (N = 3,055) of the German adult population, mental health, potential risk, and protective factors as well as DHs and DHg exposure were assessed online during the SARS-CoV-2 pandemic (June and July 2020). The impact of these factors on mental health was analyzed using descriptive statistics, data visualizations, multiple regressions, and moderation analyses. The most burdensome DHg were financial and sleeping problems, respectively, and DHs corona-media reports and exclusion from recreational activities/important social events. 31 and 24% of total mental health was explained by DHg and DHs, respectively. Both predictors combined explained 36%, resulting in an increase in variance due to DHs of only 5% (R2 adjusted). Being female, older and a lower educational level were identified as general risk factors, somatic diseases as a corona-specific risk factor, and self-efficacy and locus of control (LOC) proved to be corona-specific protective factors. Further analyses showed that older age and being diagnosed with a somatic illness attenuated the positive influence of LOC, self-efficacy, and social support on resilience. Although the data showed that after the first easing restrictions, the stressor load was comparable to pre-pandemic data (with DHs not making a significant contribution), different risk and protective factors could be identified for general and corona-specific stressors. In line with observations from network analysis from other groups, the positive impact of resilience factors was especially diminished in the most vulnerable groups (elderly and somatically ill). This highlights the need to especially target these vulnerable groups to foster their resilience in upcoming waves of the corona pandemic.
Collapse
Affiliation(s)
- Lara Hubenschmid
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany,*Correspondence: Lara Hubenschmid
| | | | - Göran Köber
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center – University of Freiburg, Freiburg im Breisgau, Germany,Freiburg Center for Data Analysis and Modeling, University of Freiburg, Freiburg im Breisgau, Germany
| | - Donya Gilan
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany,Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Svenja B. Frenzel
- Department of Psychology, Goethe-University Frankfurt, Frankfurt, Germany
| | - Rolf van Dick
- Department of Psychology, Goethe-University Frankfurt, Frankfurt, Germany
| | - Klaus Lieb
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany,Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| |
Collapse
|
14
|
Ahrens KF, Neumann RJ, von Werthern NM, Kranz TM, Kollmann B, Mattes B, Puhlmann LMC, Weichert D, Lutz B, Basten U, Fiebach CJ, Wessa M, Kalisch R, Lieb K, Chiocchetti AG, Tüscher O, Reif A, Plichta MM. Association of polygenic risk scores and hair cortisol with mental health trajectories during COVID lockdown. Transl Psychiatry 2022; 12:396. [PMID: 36130942 PMCID: PMC9490720 DOI: 10.1038/s41398-022-02165-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 09/06/2022] [Accepted: 09/08/2022] [Indexed: 11/25/2022] Open
Abstract
The COVID-19 pandemic is a global stressor with inter-individually differing influences on mental health trajectories. Polygenic Risk Scores (PRSs) for psychiatric phenotypes are associated with individual mental health predispositions. Elevated hair cortisol concentrations (HCC) and high PRSs are related to negative mental health outcomes. We analyzed whether PRSs and HCC are related to different mental health trajectories during the first COVID lockdown in Germany. Among 523 participants selected from the longitudinal resilience assessment study (LORA), we previously reported three subgroups (acute dysfunction, delayed dysfunction, resilient) based on weekly mental health (GHQ-28) assessment during COVID lockdown. DNA from blood was collected at the baseline of the original LORA study (n = 364) and used to calculate the PRSs of 12 different psychopathological phenotypes. An explorative bifactor model with Schmid-Leiman transformation was calculated to extract a general genetic factor for psychiatric disorders. Hair samples were collected quarterly prior to the pandemic for determining HCC (n = 192). Bivariate logistic regressions were performed to test the associations of HCC and the PRS factors with the reported trajectories. The bifactor model revealed 1 general factor and 4 sub-factors. Results indicate a significant association between increased values on the general risk factor and the allocation to the acute dysfunction class. The same was found for elevated HCC and the exploratorily tested sub-factor "childhood-onset neurodevelopmental disorders". Genetic risk and long-term cortisol secretion as a potential indicator of stress, indicated by PRSs and HCC, respectively, predicted different mental health trajectories. Results indicate a potential for future studies on risk prediction.
Collapse
Affiliation(s)
- Kira F. Ahrens
- Goethe University Frankfurt, University Hospital, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Frankfurt, Germany
| | - Rebecca J. Neumann
- Goethe University Frankfurt, University Hospital, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Frankfurt, Germany
| | - Nina M. von Werthern
- Goethe University Frankfurt, University Hospital, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Frankfurt, Germany
| | - Thorsten M. Kranz
- Goethe University Frankfurt, University Hospital, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Frankfurt, Germany
| | - Bianca Kollmann
- grid.410607.4Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany ,grid.509458.50000 0004 8087 0005Leibniz Institute for Resilience Research (LIR), Mainz, Germany
| | - Björn Mattes
- grid.6546.10000 0001 0940 1669Institute of Psychology, Technical University of Darmstadt, Darmstadt, Germany
| | - Lara M. C. Puhlmann
- grid.509458.50000 0004 8087 0005Leibniz Institute for Resilience Research (LIR), Mainz, Germany
| | - Danuta Weichert
- grid.410607.4Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany
| | - Beat Lutz
- grid.509458.50000 0004 8087 0005Leibniz Institute for Resilience Research (LIR), Mainz, Germany ,grid.410607.4Institute of Physiological Chemistry, University Medical Center Mainz, Mainz, Germany
| | - Ulrike Basten
- grid.7839.50000 0004 1936 9721Department of Psychology, Goethe University Frankfurt, Frankfurt am Main, Germany ,grid.7839.50000 0004 1936 9721Brain Imaging Center, Goethe University, Frankfurt, Germany
| | - Christian J. Fiebach
- grid.7839.50000 0004 1936 9721Department of Psychology, Goethe University Frankfurt, Frankfurt am Main, Germany ,grid.7839.50000 0004 1936 9721Brain Imaging Center, Goethe University, Frankfurt, Germany
| | - Michèle Wessa
- grid.509458.50000 0004 8087 0005Leibniz Institute for Resilience Research (LIR), Mainz, Germany ,grid.5802.f0000 0001 1941 7111Department of Clinical Psychology and Neuropsychology, Institute for Psychology, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Raffael Kalisch
- grid.509458.50000 0004 8087 0005Leibniz Institute for Resilience Research (LIR), Mainz, Germany ,grid.410607.4Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center Mainz, Mainz, Germany
| | - Klaus Lieb
- grid.410607.4Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany ,grid.509458.50000 0004 8087 0005Leibniz Institute for Resilience Research (LIR), Mainz, Germany
| | - Andreas G. Chiocchetti
- grid.7839.50000 0004 1936 9721Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Goethe University Frankfurt, Frankfurt, Germany
| | - Oliver Tüscher
- grid.410607.4Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany ,grid.509458.50000 0004 8087 0005Leibniz Institute for Resilience Research (LIR), Mainz, Germany
| | - Andreas Reif
- Goethe University Frankfurt, University Hospital, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Frankfurt, Germany
| | - Michael M. Plichta
- Goethe University Frankfurt, University Hospital, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Frankfurt, Germany
| |
Collapse
|
15
|
Ruf A, Neubauer AB, Koch ED, Ebner-Priemer U, Reif A, Matura S. Individual differences in the dietary response to stress in ecological momentary assessment: Does the individual-difference model need expansion? Appl Psychol Health Well Being 2022; 15:629-649. [PMID: 36082743 DOI: 10.1111/aphw.12400] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 08/30/2022] [Indexed: 11/27/2022]
Abstract
According to the individual-difference model, individuals differ in the way stress changes their eating behaviour. Research shows that some increase, some decrease, and others show no change in food intake. Despite numerous efforts to identify moderating variables that explain these individual (i.e., between-person) differences, evidence remains inconclusive. The present study aims at deepening the understanding of the stress and eating relationship by applying ecological momentary assessment to study (1) the influence of stress on whether and how much individuals eat and (2) the moderating role of gender, age, BMI, trait stress-eating, and eating styles. The APPetite-mobile-app was used for 3 days to capture actual food intake (event-contingent) and perceived stress (signal-contingent). Data of 154 healthy adults suggest that stress is not associated with whether but how much individuals eat. Only gender moderated the relationship between stress and the amount of food intake. Individual differences were small indicating that an individual's dietary response to stress might not be as stable as yet assumed. Moreover, a study suggests that time-varying factors (e.g., food availability) moderate the stress and eating relationship. Hence, intraindividual (i.e., within-person) variability may be relevant. Therefore, we propose an expansion of the individual-difference model, which accounts for time-varying factors.
Collapse
Affiliation(s)
- Alea Ruf
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University Frankfurt, University Hospital, Frankfurt, Germany
| | - Andreas B Neubauer
- DIPF
- Leibniz Institute for Research and Information in Education, Frankfurt, Germany.,Center for Research on Individual Development and Adaptive Education of Children at Risk (IDeA), Frankfurt, Germany
| | - Elena D Koch
- Mental mHealth Lab, Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
| | - Ulrich Ebner-Priemer
- Mental mHealth Lab, Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany.,Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University Frankfurt, University Hospital, Frankfurt, Germany
| | - Silke Matura
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University Frankfurt, University Hospital, Frankfurt, Germany
| |
Collapse
|
16
|
Neumann RJ, Ahrens KF, Kollmann B, Goldbach N, Chmitorz A, Weichert D, Fiebach CJ, Wessa M, Kalisch R, Lieb K, Tüscher O, Plichta MM, Reif A, Matura S. The impact of physical fitness on resilience to modern life stress and the mediating role of general self-efficacy. Eur Arch Psychiatry Clin Neurosci 2022; 272:679-692. [PMID: 34622343 PMCID: PMC9095527 DOI: 10.1007/s00406-021-01338-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 09/22/2021] [Indexed: 12/18/2022]
Abstract
Substantial evidence shows that physical activity and fitness play a protective role in the development of stress related disorders. However, the beneficial effects of fitness for resilience to modern life stress are not fully understood. Potentially protective effects may be attributed to enhanced resilience via underlying psychosocial mechanisms such as self-efficacy expectations. This study investigated whether physical activity and fitness contribute to prospectively measured resilience and examined the mediating effect of general self-efficacy. 431 initially healthy adults participated in fitness assessments as part of a longitudinal-prospective study, designed to identify mechanisms of resilience. Self-efficacy and habitual activity were assessed in parallel to cardiorespiratory and muscular fitness, which were determined by a submaximal step-test, hand strength and standing long jump test. Resilience was indexed by stressor reactivity: mental health problems in relation to reported life events and daily hassles, monitored quarterly for nine months. Hierarchical linear regression models and bootstrapped mediation analyses were applied. We could show that muscular and self-perceived fitness were positively associated with stress resilience. Extending this finding, the muscular fitness-resilience relationship was partly mediated by self-efficacy expectations. In this context, self-efficacy expectations may act as one underlying psychological mechanism, with complementary benefits for the promotion of mental health. While physical activity and cardiorespiratory fitness did not predict resilience prospectively, we found muscular and self-perceived fitness to be significant prognostic parameters for stress resilience. Although there is still more need to identify specific fitness parameters in light of stress resilience, our study underscores the general relevance of fitness for stress-related disorders prevention.
Collapse
Affiliation(s)
- R J Neumann
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe-University, Heinrich-Hoffmann-Str. 10, 60528, Frankfurt/Main, Germany.
| | - K F Ahrens
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe-University, Heinrich-Hoffmann-Str. 10, 60528, Frankfurt/Main, Germany
| | - B Kollmann
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany
- Leibniz Institute for Resilience Research (LIR) gGmbH, Mainz, Germany
| | - N Goldbach
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe-University, Heinrich-Hoffmann-Str. 10, 60528, Frankfurt/Main, Germany
| | - A Chmitorz
- Faculty of Social Work, Education and Nursing Sciences, Esslingen University of Applied Sciences, Esslingen, Germany
| | - D Weichert
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany
- Leibniz Institute for Resilience Research (LIR) gGmbH, Mainz, Germany
| | - C J Fiebach
- Department of Psychology, Goethe University, Frankfurt, Frankfurt am Main, Germany
- Brain Imaging Center, Goethe University, Frankfurt am Main, Germany
| | - M Wessa
- Leibniz Institute for Resilience Research (LIR) gGmbH, Mainz, Germany
- Department of Clinical Psychology and Neuropsychology, Institute for Psychology, Johannes Gutenberg University Mainz, Mainz, Germany
| | - R Kalisch
- Leibniz Institute for Resilience Research (LIR) gGmbH, Mainz, Germany
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), University Medical Center Mainz, Mainz, Germany
| | - K Lieb
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany
- Leibniz Institute for Resilience Research (LIR) gGmbH, Mainz, Germany
| | - O Tüscher
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany
- Leibniz Institute for Resilience Research (LIR) gGmbH, Mainz, Germany
| | - M M Plichta
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe-University, Heinrich-Hoffmann-Str. 10, 60528, Frankfurt/Main, Germany
| | - A Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe-University, Heinrich-Hoffmann-Str. 10, 60528, Frankfurt/Main, Germany
| | - S Matura
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe-University, Heinrich-Hoffmann-Str. 10, 60528, Frankfurt/Main, Germany
| |
Collapse
|
17
|
Wackerhagen C, Veer IM, van Leeuwen JMC, Reppmann Z, Riepenhausen A, Bögemann SA, Mor N, Puhlmann LM, Uściƚko A, Zerban M, Yuen KSL, Köber G, Pooseh S, Weermeijer J, Marciniak MA, Arias-Vásquez A, Binder H, de Raedt W, Kleim B, Myin-Germeys I, Roelofs K, Timmer J, Tüscher O, Hendler T, Kobylińska D, Hermans EJ, Kalisch R, Walter H. Study protocol description: Dynamic Modelling of Resilience - Observational Study (DynaM-OBS) (Preprint). JMIR Res Protoc 2022. [DOI: 10.2196/39817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
|
18
|
Meine LE, Strömer E, Schönfelder S, Eckhardt EI, Bergmann AK, Wessa M. Look After Yourself: Students Consistently Showing High Resilience Engaged in More Self-Care and Proved More Resilient During the COVID-19 Pandemic. Front Psychiatry 2021; 12:784381. [PMID: 34992556 PMCID: PMC8725157 DOI: 10.3389/fpsyt.2021.784381] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 11/15/2021] [Indexed: 12/12/2022] Open
Abstract
The COVID-19 pandemic has prompted severe restrictions on everyday life to curb the spread of infections. For example, teaching at universities has been switched to an online format, reducing students' opportunities for exchange, and social interaction. Consequently, their self-reported mental health has significantly decreased and there is a pressing need to elucidate the underlying mechanisms-ideally considering not only data collected during the pandemic, but also before. One hundred seventeen German university students aged 18-27 were assessed for known resilience factors (optimism, self-care, social support, generalized self-efficacy) and subsequently completed surveys on stress experiences and mental health every 3 months over a period of 9 months before the outbreak of the pandemic and once during the first lockdown in Germany. For each timepoint before the pandemic, we regressed participants' mental health against the reported stressor load, such that the resulting residuals denote better or worse than expected outcomes, i.e., the degree of resilient functioning. We then tested whether different expressions in the resilience factors were predictive of distinct resilient functioning trajectories, which were identified through latent class growth analysis. Finally, we investigated whether trajectory class, resilience factors, and perceived stress predicted resilience during the pandemic. Results show rather stable resilient functioning trajectories, with classes differing mainly according to degree rather than change over time. More self-care was associated with a higher resilient functioning trajectory, which in turn was linked with the most favorable pandemic response (i.e., lower perceived stress and more self-care). Although findings should be interpreted with caution given the rather small sample size, they represent a rare examination of established resilience factors in relation to resilience over an extended period and highlight the relevance of self-care in coping with real-life stressors such as the pandemic.
Collapse
Affiliation(s)
- Laura E. Meine
- Department of Clinical Psychology and Neuropsychology, Institute of Psychology, Johannes Gutenberg-University Mainz, Mainz, Germany
- Department of Psychology, University of Zurich, Zurich, Switzerland
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, Zurich, Switzerland
| | - Eike Strömer
- Leibniz Institute for Resilience Research, Research Group Wessa, Mainz, Germany
| | - Sandra Schönfelder
- Leibniz Institute for Resilience Research, Research Group Wessa, Mainz, Germany
| | - Eliza I. Eckhardt
- Leibniz Institute for Resilience Research, Research Group Wessa, Mainz, Germany
| | - Anna K. Bergmann
- Leibniz Institute for Resilience Research, Research Group Wessa, Mainz, Germany
| | - Michèle Wessa
- Department of Clinical Psychology and Neuropsychology, Institute of Psychology, Johannes Gutenberg-University Mainz, Mainz, Germany
- Leibniz Institute for Resilience Research, Research Group Wessa, Mainz, Germany
| |
Collapse
|
19
|
Schueler K, Fritz J, Dorfschmidt L, van Harmelen AL, Stroemer E, Wessa M. Psychological Network Analysis of General Self-Efficacy in High vs. Low Resilient Functioning Healthy Adults. Front Psychiatry 2021; 12:736147. [PMID: 34867526 PMCID: PMC8635703 DOI: 10.3389/fpsyt.2021.736147] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Accepted: 10/14/2021] [Indexed: 01/10/2023] Open
Abstract
Resilience to stress has gained increasing interest by researchers from the field of mental health and illness and some recent studies have investigated resilience from a network perspective. General self-efficacy constitutes an important resilience factor. High levels of self-efficacy have shown to promote resilience by serving as a stress buffer. However, little is known about the role of network connectivity of self-efficacy in the context of stress resilience. The present study aims at filling this gap by using psychological network analysis to study self-efficacy and resilience. Based on individual resilient functioning scores, we divided a sample of 875 mentally healthy adults into a high and low resilient functioning group. To compute these scores, we applied a novel approach based on Partial Least Squares Regression on self-reported stress and mental health measures. Separately for both groups, we then estimated regularized partial correlation networks of a ten-item self-efficacy questionnaire. We compared three different global connectivity measures-strength, expected influence, and shortest path length-as well as absolute levels of self-efficacy between the groups. Our results supported our hypothesis that stronger network connectivity of self-efficacy would be present in the highly resilient functioning group compared to the low resilient functioning group. In addition, the former showed higher absolute levels of general self-efficacy. Future research could consider using partial least squares regression to quantify resilient functioning to stress and to study the association between network connectivity and resilient functioning in other resilience factors.
Collapse
Affiliation(s)
- Katja Schueler
- Department of Clinical Psychology and Neuropsychology, Institute of Psychology, Johannes Gutenberg-University of Mainz, Mainz, Germany
- Medical Informatics Group, University Hospital of Frankfurt, Frankfurt, Germany
| | - Jessica Fritz
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Lena Dorfschmidt
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | | | - Eike Stroemer
- Leibniz Institute for Resilience Research Mainz, Mainz, Germany
| | - Michèle Wessa
- Department of Clinical Psychology and Neuropsychology, Institute of Psychology, Johannes Gutenberg-University of Mainz, Mainz, Germany
- Leibniz Institute for Resilience Research Mainz, Mainz, Germany
| |
Collapse
|
20
|
Riello M, Purgato M, Bove C, Tedeschi F, MacTaggart D, Barbui C, Rusconi E. Effectiveness of self-help plus (SH+) in reducing anxiety and post-traumatic symptomatology among care home workers during the COVID-19 pandemic: a randomized controlled trial. ROYAL SOCIETY OPEN SCIENCE 2021; 8:210219. [PMID: 34849238 PMCID: PMC8611343 DOI: 10.1098/rsos.210219] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 11/08/2021] [Indexed: 05/16/2023]
Abstract
This article describes a randomized controlled trial to evaluate the effectiveness of a supervised online delivery of self-help plus (SH+), during the second wave of COVID-19 contagions in Northern Italy. The SH+ is a psychological intervention developed by the World Health Organization to increase a person's ability to deal with stress. In this trial, it was tested primarily as a tool to reduce anxiety and post-traumatic symptomatology in workers of residential nursing and care homes. In order to partial out non-specific effects of the intervention, the SH+ was compared to an equally supervised and structured alternative activity. Secondarily, in view of future emergencies, the potential of SH+ as a tool to reduce perceived stress, increase subjective well-being and foster individual resilience was explored. At post-intervention, the preregistered analysis revealed no difference in self-reported anxiety and/or post-traumatic symptomatology between the group receiving the SH+ and the group engaged in an alternative activity. Some specific and positive effects of the SH+ intervention were only found on self-reported intervention effectiveness and engagement in exploratory analyses. These findings raise the question whether the previously documented effectiveness of the SH+ on self-reported symptomatology and on the prevention of psychiatric conditions could be attributed mostly to non-specific rather than specific factors connected with participant enrolment in a psychological intervention. Indeed, the effects of the SH+ had been previously compared only to the effects of not being engaged in any alternative activity (often described in the literature as 'treatment as usual'-or 'enhanced treatment as usual', when some relevant information is given to the control group as a one-off). Given the negative findings of this study, before the SH+ is implemented in clinical practice, further studies should be conducted to examine its short- and long-term beneficial effects, by means of randomized studies that employ alternative but similarly structured interventions as control conditions, aiming to minimize the confounding effect of non-specific factors.
Collapse
Affiliation(s)
- Marianna Riello
- Department of Psychology and Cognitive Science, University of Trento, Corso Bettini, 31, 3868 Rovereto, Trentino, Italy
- Gruppo SPES, Trento, Italy
| | - Marianna Purgato
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
- Section of Psychiatry, University of Verona, Verona, Italy
| | - Chiara Bove
- Department of Psychology and Cognitive Science, University of Trento, Corso Bettini, 31, 3868 Rovereto, Trentino, Italy
| | - Federico Tedeschi
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
- Section of Psychiatry, University of Verona, Verona, Italy
| | - David MacTaggart
- School of Mathematics and Statistics, University of Glasgow, Glasgow, UK
| | - Corrado Barbui
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
- Section of Psychiatry, University of Verona, Verona, Italy
| | - Elena Rusconi
- Department of Psychology and Cognitive Science, University of Trento, Corso Bettini, 31, 3868 Rovereto, Trentino, Italy
| |
Collapse
|
21
|
Kalisch R, Köber G, Binder H, Ahrens KF, Basten U, Chmitorz A, Choi KW, Fiebach CJ, Goldbach N, Neumann RJ, Kampa M, Kollmann B, Lieb K, Plichta MM, Reif A, Schick A, Sebastian A, Walter H, Wessa M, Yuen KSL, Tüscher O, Engen H. The Frequent Stressor and Mental Health Monitoring-Paradigm: A Proposal for the Operationalization and Measurement of Resilience and the Identification of Resilience Processes in Longitudinal Observational Studies. Front Psychol 2021; 12:710493. [PMID: 34539510 PMCID: PMC8444985 DOI: 10.3389/fpsyg.2021.710493] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 07/19/2021] [Indexed: 11/13/2022] Open
Abstract
Resilience has been defined as the maintenance or quick recovery of mental health during and after times of adversity. How to operationalize resilience and to determine the factors and processes that lead to good long-term mental health outcomes in stressor-exposed individuals is a matter of ongoing debate and of critical importance for the advancement of the field. One of the biggest challenges for implementing an outcome-based definition of resilience in longitudinal observational study designs lies in the fact that real-life adversity is usually unpredictable and that its substantial qualitative as well as temporal variability between subjects often precludes defining circumscribed time windows of inter-individually comparable stressor exposure relative to which the maintenance or recovery of mental health can be determined. To address this pertinent issue, we propose to frequently and regularly monitor stressor exposure (E) and mental health problems (P) throughout a study's observation period [Frequent Stressor and Mental Health Monitoring (FRESHMO)-paradigm]. On this basis, a subject's deviation at any single monitoring time point from the study sample's normative E-P relationship (the regression residual) can be used to calculate that subject's current mental health reactivity to stressor exposure ("stressor reactivity," SR). The SR score takes into account the individual extent of experienced adversity and is comparable between and within subjects. Individual SR time courses across monitoring time points reflect intra-individual temporal variability in SR, where periods of under-reactivity (negative SR score) are associated with accumulation of fewer mental health problems than is normal for the sample. If FRESHMO is accompanied by regular measurement of potential resilience factors, temporal changes in resilience factors can be used to predict SR time courses. An increase in a resilience factor measurement explaining a lagged decrease in SR can then be considered to index a process of adaptation to stressor exposure that promotes a resilient outcome (an allostatic resilience process). This design principle allows resilience research to move beyond merely determining baseline predictors of resilience outcomes, which cannot inform about how individuals successfully adjust and adapt when confronted with adversity. Hence, FRESHMO plus regular resilience factor monitoring incorporates a dynamic-systems perspective into resilience research.
Collapse
Affiliation(s)
- Raffael Kalisch
- Leibniz Institute for Resilience Research, Mainz, Germany
- Neuroimaging Center, Focus Program Translational Neuroscience, Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Göran Köber
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
- Freiburg Center of Data Analysis and Modelling, University of Freiburg, Freiburg, Germany
| | - Harald Binder
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
- Freiburg Center of Data Analysis and Modelling, University of Freiburg, Freiburg, Germany
| | - Kira F. Ahrens
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt, Germany
| | - Ulrike Basten
- Department of Psychology, Goethe University Frankfurt, Frankfurt, Germany
- Department of Psychology, University of Koblenz-Landau, Landau, Germany
| | - Andrea Chmitorz
- Leibniz Institute for Resilience Research, Mainz, Germany
- Department of Psychiatry and Psychotherapy, Johannes Gutenberg University Medical Center, Mainz, Germany
- Faculty of Social Work, Health Care and Nursing Science, Esslingen University of Applied Sciences, Esslingen, Germany
| | - Karmel W. Choi
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, United States
- Lee Kum Sheung Center for Health and Happiness, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Christian J. Fiebach
- Department of Psychology, Goethe University Frankfurt, Frankfurt, Germany
- Brain Imaging Center, Goethe University Frankfurt, Frankfurt, Germany
| | - Nele Goldbach
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt, Germany
| | - Rebecca J. Neumann
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt, Germany
| | - Miriam Kampa
- Leibniz Institute for Resilience Research, Mainz, Germany
- Department of Clinical Psychology and Psychotherapy, University of Siegen, Siegen, Germany
- Department of Psychology, Bender Institute of Neuroimaging, Justus Liebig University, Gießen, Germany
| | - Bianca Kollmann
- Leibniz Institute for Resilience Research, Mainz, Germany
- Department of Psychiatry and Psychotherapy, Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Klaus Lieb
- Leibniz Institute for Resilience Research, Mainz, Germany
- Department of Psychiatry and Psychotherapy, Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Michael M. Plichta
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt, Germany
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt, Germany
| | - Anita Schick
- Leibniz Institute for Resilience Research, Mainz, Germany
- Neuroimaging Center, Focus Program Translational Neuroscience, Johannes Gutenberg University Medical Center, Mainz, Germany
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Alexandra Sebastian
- Department of Psychiatry and Psychotherapy, Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Henrik Walter
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Michèle Wessa
- Leibniz Institute for Resilience Research, Mainz, Germany
- Department of Clinical Psychology and Neuropsychology, Institute of Psychology, Johannes Gutenberg University, Mainz, Germany
| | - Kenneth S. L. Yuen
- Leibniz Institute for Resilience Research, Mainz, Germany
- Neuroimaging Center, Focus Program Translational Neuroscience, Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Oliver Tüscher
- Leibniz Institute for Resilience Research, Mainz, Germany
- Department of Psychiatry and Psychotherapy, Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Haakon Engen
- Neuroimaging Center, Focus Program Translational Neuroscience, Johannes Gutenberg University Medical Center, Mainz, Germany
- Department of Psychology, University of Oslo, Oslo, Norway
| |
Collapse
|
22
|
Pérez-Balaguer A, Sanz-Aranguez-Ávila B, Gil-Benito E, Solari-Heresmann LM, Sol-Calderón PD, Gayubo-Moreo L, Arce-Cordón RD. [Does the COVID-19 pandemic condition the delusional content of patients with psychosis? An observational study]. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2021; 52:S0034-7450(21)00133-5. [PMID: 34393280 PMCID: PMC8349682 DOI: 10.1016/j.rcp.2021.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 07/05/2021] [Indexed: 11/20/2022]
Abstract
Introduction: The primary objective is to analyse the impact of the COVID-19 pandemic on the triggers of psychopathology and on the delusional content of patients with psychotic symptoms treated during the first three months of the pandemic in a tertiary hospital in Madrid.Methods: We conducted a cross-sectional, observational and retrospective study of all patients attending the psychiatric emergency room (ER) between 11th March and 11th June 2020. Sociodemographic and clinical variables were included. The chi-squared test or Fisher's exact test were performed to compare categorical variables. The level of statistical significance was set at p<0.05.Results: In the first month of the pandemic, COVID-19 conditioned the delirious content of 38.5% of the admitted patients and acted as a direct trigger for 46.2% of consultations. In the second week it affected 100.0% of the patients in both cases. Subsequently, a progressive and significant decrease was observed, with COVID-19 being the triggering factor for 17.6% and 11.5% of consultations in the second and third months of the pandemic respectively. Similarly, it was the main determinant of the delusional content in 13.7% and 3.8% of cases respectively.Conclusions: The current pandemic affects delirium's pathoplasty. The delusional content of patients admitted with psychotic symptoms is quickly conditioned, which may be related to the radical change in their life, without transition or prior preparation. The patient's environmental context and events have a huge impact on the dynamics and characteristics of mental disorders.
Collapse
Affiliation(s)
- Ana Pérez-Balaguer
- Servicio de Psiquiatría, Hospital Universitario Puerta de Hierro de Majadahonda, Madrid, España
| | | | - Elena Gil-Benito
- Servicio de Psiquiatría, Hospital Universitario Puerta de Hierro de Majadahonda, Madrid, España
| | | | - Pablo Del Sol-Calderón
- Servicio de Psiquiatría, Hospital Universitario Puerta de Hierro de Majadahonda, Madrid, España
| | - Lydia Gayubo-Moreo
- Servicio de Psiquiatría, Hospital Universitario Puerta de Hierro de Majadahonda, Madrid, España
| | - Rosario De Arce-Cordón
- Departamento de Psiquiatría, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, España
| |
Collapse
|
23
|
Ahrens KF, Neumann RJ, Kollmann B, Brokelmann J, von Werthern NM, Malyshau A, Weichert D, Lutz B, Fiebach CJ, Wessa M, Kalisch R, Plichta MM, Lieb K, Tüscher O, Reif A. Impact of COVID-19 lockdown on mental health in Germany: longitudinal observation of different mental health trajectories and protective factors. Transl Psychiatry 2021; 11:392. [PMID: 34282129 PMCID: PMC8287278 DOI: 10.1038/s41398-021-01508-2] [Citation(s) in RCA: 85] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 06/02/2021] [Accepted: 06/21/2021] [Indexed: 12/29/2022] Open
Abstract
The COVID-19 pandemic and resulting measures can be regarded as a global stressor. Cross-sectional studies showed rather negative impacts on people's mental health, while longitudinal studies considering pre-lockdown data are still scarce. The present study investigated the impact of COVID-19 related lockdown measures in a longitudinal German sample, assessed since 2017. During lockdown, 523 participants completed additional weekly online questionnaires on e.g., mental health, COVID-19-related and general stressor exposure. Predictors for and distinct trajectories of mental health outcomes were determined, using multilevel models and latent growth mixture models, respectively. Positive pandemic appraisal, social support, and adaptive cognitive emotion regulation were positively, whereas perceived stress, daily hassles, and feeling lonely negatively related to mental health outcomes in the entire sample. Three subgroups ("recovered," 9.0%; "resilient," 82.6%; "delayed dysfunction," 8.4%) with different mental health responses to initial lockdown measures were identified. Subgroups differed in perceived stress and COVID-19-specific positive appraisal. Although most participants remained mentally healthy, as observed in the resilient group, we also observed inter-individual differences. Participants' psychological state deteriorated over time in the delayed dysfunction group, putting them at risk for mental disorder development. Consequently, health services should especially identify and allocate resources to vulnerable individuals.
Collapse
Affiliation(s)
- K F Ahrens
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt, Germany
| | - R J Neumann
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt, Germany
| | - B Kollmann
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany.
- Leibniz Institute for Resilience Research (LIR) gGmbH, Mainz, Germany.
| | - J Brokelmann
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt, Germany
| | - N M von Werthern
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt, Germany
| | - A Malyshau
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt, Germany
| | - D Weichert
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany
| | - B Lutz
- Leibniz Institute for Resilience Research (LIR) gGmbH, Mainz, Germany
- Institute of Physiological Chemistry, University Medical Center Mainz, Mainz, Germany
| | - C J Fiebach
- Department of Psychology, Goethe University Frankfurt, Frankfurt, Germany
- Brain Imaging Center, Goethe University, Frankfurt, Germany
| | - M Wessa
- Leibniz Institute for Resilience Research (LIR) gGmbH, Mainz, Germany
- Department of Clinical Psychology and Neuropsychology, Institute for Psychology, Johannes Gutenberg University Mainz, Mainz, Germany
| | - R Kalisch
- Leibniz Institute for Resilience Research (LIR) gGmbH, Mainz, Germany
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), University Medical Center Mainz, Mainz, Germany
| | - M M Plichta
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt, Germany
| | - K Lieb
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany
- Leibniz Institute for Resilience Research (LIR) gGmbH, Mainz, Germany
| | - O Tüscher
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany
- Leibniz Institute for Resilience Research (LIR) gGmbH, Mainz, Germany
| | - A Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt, Germany
| |
Collapse
|
24
|
Ruf A, Koch ED, Ebner-Priemer U, Knopf M, Reif A, Matura S. Studying Microtemporal, Within-Person Processes of Diet, Physical Activity, and Related Factors Using the APPetite-Mobile-App: Feasibility, Usability, and Validation Study. J Med Internet Res 2021; 23:e25850. [PMID: 34342268 PMCID: PMC8406112 DOI: 10.2196/25850] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 01/12/2021] [Accepted: 05/04/2021] [Indexed: 12/16/2022] Open
Abstract
Background Diet and physical activity (PA) have a major impact on physical and mental health. However, there is a lack of effective strategies for sustaining these health-protective behaviors. A shift to a microtemporal, within-person approach is needed to capture dynamic processes underlying eating behavior and PA, as they change rapidly across minutes or hours and differ among individuals. However, a tool that captures these microtemporal, within-person processes in daily life is currently not present. Objective The APPetite-mobile-app is developed for the ecological momentary assessment of microtemporal, within-person processes of complex dietary intake, objectively recorded PA, and related factors. This study aims to evaluate the feasibility and usability of the APPetite-mobile-app and the validity of the incorporated APPetite-food record. Methods The APPetite-mobile-app captures dietary intake event-contingently through a food record, captures PA continuously through accelerometers, and captures related factors (eg, stress) signal-contingently through 8 prompts per day. Empirical data on feasibility (n=157), usability (n=84), and validity (n=44) were collected within the Eat2beNICE-APPetite-study. Feasibility and usability were examined in healthy participants and psychiatric patients. The relative validity of the APPetite-food record was assessed with a subgroup of healthy participants by using a counterbalanced crossover design. The reference method was a 24-hour recall. In addition, the energy intake was compared with the total energy expenditure estimated from accelerometry. Results Good feasibility, with compliance rates above 80% for prompts and the accelerometer, as well as reasonable average response and recording durations (prompt: 2.04 min; food record per day: 17.66 min) and latencies (prompts: 3.16 min; food record: 58.35 min) were found. Usability was rated as moderate, with a score of 61.9 of 100 on the System Usability Scale. The evaluation of validity identified large differences in energy and macronutrient intake between the two methods at the group and individual levels. The APPetite-food record captured higher dietary intakes, indicating a lower level of underreporting, compared with the 24-hour recall. Energy intake was assessed fairly accurately by the APPetite-food record at the group level on 2 of 3 days when compared with total energy expenditure. The comparison with mean total energy expenditure (2417.8 kcal, SD 410) showed that the 24-hour recall (1909.2 kcal, SD 478.8) underestimated habitual energy intake to a larger degree than the APPetite-food record (2146.4 kcal, SD 574.5). Conclusions The APPetite-mobile-app is a promising tool for capturing microtemporal, within-person processes of diet, PA, and related factors in real time or near real time and is, to the best of our knowledge, the first of its kind. First evidence supports the good feasibility and moderate usability of the APPetite-mobile-app and the validity of the APPetite-food record. Future findings in this context will build the foundation for the development of personalized lifestyle modification interventions, such as just-in-time adaptive interventions.
Collapse
Affiliation(s)
- Alea Ruf
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| | - Elena Doris Koch
- Mental mHealth Lab, Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Ulrich Ebner-Priemer
- Mental mHealth Lab, Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany.,Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Monika Knopf
- Department of Developmental Psychology, Goethe University, Frankfurt, Germany
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| | - Silke Matura
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| |
Collapse
|
25
|
Building up resilience in an uncertain world: mental health challenges in the aftermath of the first modern pandemic. Eur Arch Psychiatry Clin Neurosci 2021; 271:1001-1003. [PMID: 34347168 PMCID: PMC8334334 DOI: 10.1007/s00406-021-01313-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
26
|
Milic M, Schmitt U, Lutz B, Müller MB. Individual baseline behavioral traits predict the resilience phenotype after chronic social defeat. Neurobiol Stress 2020; 14:100290. [PMID: 33457472 PMCID: PMC7797906 DOI: 10.1016/j.ynstr.2020.100290] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 12/22/2020] [Accepted: 12/22/2020] [Indexed: 12/15/2022] Open
Abstract
Chronic social defeat (CSD) has been widely used as a psychosocial stress model in mice, with the magnitude of CSD-induced social avoidance as the major behavioral hallmark of the resilient and susceptible groups. Despite significant progress in the study of the neurobiology of resilient and susceptible mice, the nature and ethological relevance of CSD-induced social avoidance and social approach, particularly measured using a CD1 mouse, needs conceptual clarification. Based on the findings of a recent study revealing substantial individuality in genetically homogeneous inbred mice, we investigated whether certain baseline individual characteristics of male C57BL/6J mice predict the resilient outcome after CSD. We focused on two well-studied individual traits that seem to have heritable underpinnings—approach to novelty and avoidance of harm, which are essential for the expression of the exploratory drive. Our results showed that the exploration levels and the approach to novelty and harm were different before and after CSD in resilient and susceptible mice. Before the stress, resilient mice had higher horizontal activity in a novel environment, shorter approach latencies, and higher exploration times for social and non-social targets than susceptible mice. However, susceptible mice performed better in the passive avoidance task than resilient mice as they were more successful in learning to avoid potential adversity by suppressing the spontaneous exploratory drive. Our findings challenge the validity of the current selection criteria for the susceptible and resilient groups and encourage comprehensive assessment of both baseline and stress-induced individual behavioral signatures of mice.
Collapse
Affiliation(s)
- Marija Milic
- Department of Psychiatry and Psychotherapy, Johannes Gutenberg University Medical Center, Mainz, Germany
- Corresponding author.
| | - Ulrich Schmitt
- Leibniz Institute for Resilience Research, Mainz, Germany
| | - Beat Lutz
- Leibniz Institute for Resilience Research, Mainz, Germany
- Institute of Physiological Chemistry, University Medical Center, Mainz, Germany
| | - Marianne B. Müller
- Department of Psychiatry and Psychotherapy, Johannes Gutenberg University Medical Center, Mainz, Germany
- Leibniz Institute for Resilience Research, Mainz, Germany
| |
Collapse
|
27
|
Biere S, Kranz TM, Matura S, Petrova K, Streit F, Chiocchetti AG, Grimm O, Brum M, Brunkhorst-Kanaan N, Oertel V, Malyshau A, Pfennig A, Bauer M, Schulze TG, Kittel-Schneider S, Reif A. Risk Stratification for Bipolar Disorder Using Polygenic Risk Scores Among Young High-Risk Adults. Front Psychiatry 2020; 11:552532. [PMID: 33192665 PMCID: PMC7653940 DOI: 10.3389/fpsyt.2020.552532] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 09/10/2020] [Indexed: 11/30/2022] Open
Abstract
Objective: Identifying high-risk groups with an increased genetic liability for bipolar disorder (BD) will provide insights into the etiology of BD and contribute to early detection of BD. We used the BD polygenic risk score (PRS) derived from BD genome-wide association studies (GWAS) to explore how such genetic risk manifests in young, high-risk adults. We postulated that BD-PRS would be associated with risk factors for BD. Methods: A final sample of 185 young, high-risk German adults (aged 18-35 years) were grouped into three risk groups and compared to a healthy control group (n = 1,100). The risk groups comprised 117 cases with attention deficit hyperactivity disorder (ADHD), 45 with major depressive disorder (MDD), and 23 help-seeking adults with early recognition symptoms [ER: positive family history for BD, (sub)threshold affective symptomatology and/or mood swings, sleeping disorder]. BD-PRS was computed for each participant. Logistic regression models (controlling for sex, age, and the first five ancestry principal components) were used to assess associations of BD-PRS and the high-risk phenotypes. Results: We observed an association between BD-PRS and combined risk group status (OR = 1.48, p < 0.001), ADHD diagnosis (OR = 1.32, p = 0.009), MDD diagnosis (OR = 1.96, p < 0.001), and ER group status (OR = 1.7, p = 0.025; not significant after correction for multiple testing) compared to healthy controls. Conclusions: In the present study, increased genetic risk for BD was a significant predictor for MDD and ADHD status, but not for ER. These findings support an underlying shared risk for both MDD and BD as well as ADHD and BD. Improving our understanding of the underlying genetic architecture of these phenotypes may aid in early identification and risk stratification.
Collapse
Affiliation(s)
- Silvia Biere
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| | - Thorsten M. Kranz
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| | - Silke Matura
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| | - Kristiyana Petrova
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| | - Fabian Streit
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim/University of Heidelberg, Mannheim, Germany
| | - Andreas G. Chiocchetti
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Autism Research and Intervention Center of Excellence Frankfurt, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Oliver Grimm
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| | - Murielle Brum
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| | - Natalie Brunkhorst-Kanaan
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| | - Viola Oertel
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| | - Aliaksandr Malyshau
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| | - Andrea Pfennig
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Dresden University of Technology, Dresden, Germany
| | - Michael Bauer
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Dresden University of Technology, Dresden, Germany
| | - Thomas G. Schulze
- Institute of Psychiatric Phenomics and Genomics, University Hospital Munich, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Sarah Kittel-Schneider
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital of Würzburg, University of Würzburg, Würzburg, Germany
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| |
Collapse
|