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Bautmans I, Knoop V, Beyer I, Bruunsgaard H, Molbo D, Mortensen EL, Lund R. The relationship between self-perceived fatigue, muscle endurance, and circulating markers of inflammation in participants of the Copenhagen aging and Midlife Biobank (CAMB). Eur Rev Aging Phys Act 2024; 21:2. [PMID: 38297218 PMCID: PMC10829210 DOI: 10.1186/s11556-024-00336-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 01/14/2024] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND Fatigue, low muscle endurance, muscle weakness and low-grade inflammation are strongly related to frailty at higher age. When signs of self-perceived fatigue and low muscle endurance are interrelated with low-grade inflammation at midlife, they might be used as early markers for frailty. This study investigated whether the interrelationships among self-perceived fatigue, muscle endurance and inflammation can be observed at midlife. METHODS A total of 965 participants of the Copenhagen Aging and Midlife Biobank (aged 52 ± 4 years, 536 males, 426 females) were assessed for self-perceived fatigue (20-item multidimensional fatigue inventory), muscle endurance (grip work), circulating markers of inflammation (hsCRP, IL-6, IL-10, TNF-alpha and IFN-γ), daily physical activity (PAS-2), body composition (%body fat assessed by bio-impedance) and self-reported health status. Participants were categorised (correcting for age and gender) according to high fatigue and/or low muscle endurance, differences in inflammatory profile between fatigue categories were assessed by ANCOVA (corrected for PAS-2, %body fat and presence of inflammatory conditions). RESULTS Overall, muscle endurance, fatigue and inflammatory markers were significantly interrelated. Higher levels of hsCRP (p < 0.001), IL-6 (p < 0.001), IL-10 (p = 0.035) and TNF-alpha (p = 0.028) were observed in participants presenting both low muscle endurance and high fatigue. IFN-γ was highest in those with high fatigue but normal muscle endurance (p = 0.015). CONCLUSIONS Middle-aged participants with higher fatigue in combination with low muscle endurance show higher levels of inflammation, independently from physical activity, body fat and inflammatory pathology. The underlying mechanisms should be identified and future studies should also investigate whether these individuals show early signs of reduced physiological reserve capacity, which in later life come to full expression by means of frailty.
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Affiliation(s)
- Ivan Bautmans
- Gerontology department (GERO), Vrije Universiteit Brussel, Laarbeeklaan 103, Brussel, B-1090, Belgium.
- Frailty in Ageing Research Group (FRIA), Vrije Universiteit Brussel, Laarbeeklaan 103, Brussel, B-1090, Belgium.
- Department of Geriatrics, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, Brussel, B-1090, Belgium.
- SOMT University of Physiotherapy, Softwareweg 5, Amersfoort, 3821, The Netherlands.
| | - Veerle Knoop
- Gerontology department (GERO), Vrije Universiteit Brussel, Laarbeeklaan 103, Brussel, B-1090, Belgium
- Frailty in Ageing Research Group (FRIA), Vrije Universiteit Brussel, Laarbeeklaan 103, Brussel, B-1090, Belgium
- SOMT University of Physiotherapy, Softwareweg 5, Amersfoort, 3821, The Netherlands
| | - Ingo Beyer
- Gerontology department (GERO), Vrije Universiteit Brussel, Laarbeeklaan 103, Brussel, B-1090, Belgium
- Frailty in Ageing Research Group (FRIA), Vrije Universiteit Brussel, Laarbeeklaan 103, Brussel, B-1090, Belgium
| | - Helle Bruunsgaard
- Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Immunology, Center for Inflammation and Metabolism, National University Hospital, Copenhagen, Denmark
| | - Drude Molbo
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Erik Lykke Mortensen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
- Institute of Preventive Medicine, Bispebjerg Hospital, Copenhagen, Denmark
| | - Rikke Lund
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Maayan L, Maayan M. Inflammatory mediation of the relationship between early adversity and major depressive disorder: A systematic review. J Psychiatr Res 2024; 169:364-377. [PMID: 38154266 DOI: 10.1016/j.jpsychires.2023.11.025] [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: 05/03/2023] [Revised: 08/30/2023] [Accepted: 11/15/2023] [Indexed: 12/30/2023]
Abstract
Early adverse experience is related to psychiatric illness that occurs decades later. The mechanisms underlying this phenomenon have not been fully identified. There is a translational and clinical literature linking early adversity with Major Depressive Disorder (MDD) and inflammation. We reviewed articles that examine whether inflammation mediates this relationship. METHODS Literature review of PUB MED, CINAHL and APA Psycinfo articles that explicitly examine inflammation as a mediator between early adversity and depression using ((((((((((adversity) OR (trauma)) OR (maltreatment)) OR (child abuse)) AND (inflammation)) OR (inflammatory cytokines)) OR (crp)) OR (il-6)) OR (tnf)) AND (mediates)) AND (depression))))))))) as key words. RESULTS 2842 articles were initially identified. 1338 non-human studies were excluded and 512 more were filtered out as reviews. The remaining 992 titles and, when necessary, abstracts and manuscripts were reviewed and 956 were removed as being of other non-related phenomena. Four additional studies were added by hand searching the references of remaining studies. Out of these 40, 15 explicitly examined inflammation as a mediator of the relationship between early adversity and later depression. Approximately half (8/15) showed evidence that inflammation mediated the relationship between early adversity and depression. Sensitivity analyses showed that studies taking place in clinical populations, in youth and those that used the Adverse Childhood Events Scale to measure adversity, and IL-6 and TNF-α (as opposed to CRP) to measure inflammation were most likely to show mediation. CONCLUSIONS There is evidence to support the model of inflammation mediating the relationship between early adversity and depression. Certain measures in clinical populations appear more likely to support this model. Further study with more standardized, robust methods will help to answer this question more definitively and may elucidate a subtype of depression related to early adversity by alterations in immune function.
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Affiliation(s)
- Lawrence Maayan
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY, 10032, USA.
| | - Michal Maayan
- Skidmore College, 815 N. Broadway, Saratoga Springs, NY, 12866, USA
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Suwannakul B, Sangkarit N, Manoy P, Amput P, Tapanya W. Association between Stress and Physical Fitness of University Students Post-COVID-19 Pandemic. J Funct Morphol Kinesiol 2023; 8:jfmk8010033. [PMID: 36976130 PMCID: PMC10052582 DOI: 10.3390/jfmk8010033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 02/18/2023] [Accepted: 02/28/2023] [Indexed: 03/29/2023] Open
Abstract
Post-COVID-19 pandemic, most universities changed their educational model from online courses to onsite learning, allowing students to attend regular face-to-face classes. These changes can cause stress in students, which affects physical fitness. The aim of this study was to investigate the relationship between stress levels and physical fitness in female university students. The participants were 101 female university students, 18-23 years of age. All participants completed the Suan Prung Stress Test-60 (SPST-60). The physical fitness test included body composition, cardiorespiratory fitness, as well as musculoskeletal fitness. Multiple linear regression analysis was used to determine the associations between SPST-60 scores and physical fitness. A p-value < 0.05 was considered statistically significant. We found a negative correlation between the sources of stress scores, here environment, and maximal oxygen consumption (β = -0.291; 95% CI, -0.551, -0.031). We also found that symptoms of stress scores in the parasympathetic and sympathetic nervous systems were positively associated with waist-hip circumference ratio (WHR) (β = 0.010; 95% CI, 0.002, 0.017 and β = 0.006; 95% CI, 0.000, 0.012, respectively). Moreover, the symptoms of stress, here emotion, were positively associated with the WHR (β = 0.005; 95 %CI, 0.001, 0.009) and negatively associated with upper extremity muscle strength (β = -0.005; 95% CI, -0.009, 0.000). The results of this study confirmed the associations between stress levels in the post-COVID-19 pandemic era and WHR, maximal oxygen consumption, and upper extremity muscle strength. As a result, stress reduction or prevention alternatives should be considered in order to maintain physical fitness and prevent stress disorders.
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Affiliation(s)
- Boonsita Suwannakul
- Department of Physical Therapy, School of Allied Health Science, University of Phayao, Phayao 56000, Thailand
| | - Noppharath Sangkarit
- Department of Physical Therapy, School of Allied Health Science, University of Phayao, Phayao 56000, Thailand
- Unit of Excellence of Human Performance and Rehabilitations, University of Phayao, Phayao 56000, Thailand
| | - Pacharee Manoy
- Department of Physical Therapy, School of Allied Health Science, University of Phayao, Phayao 56000, Thailand
| | - Patchareeya Amput
- Department of Physical Therapy, School of Allied Health Science, University of Phayao, Phayao 56000, Thailand
- Unit of Excellence of Human Performance and Rehabilitations, University of Phayao, Phayao 56000, Thailand
| | - Weerasak Tapanya
- Department of Physical Therapy, School of Allied Health Science, University of Phayao, Phayao 56000, Thailand
- Unit of Excellence of Human Performance and Rehabilitations, University of Phayao, Phayao 56000, Thailand
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Discrimination and Health Among First-Generation Hispanic/Latinx Immigrants: the Roles of Sleep and Fatigue. J Racial Ethn Health Disparities 2022; 9:2105-2116. [PMID: 34606072 PMCID: PMC10168626 DOI: 10.1007/s40615-021-01149-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 08/21/2021] [Accepted: 09/06/2021] [Indexed: 12/29/2022]
Abstract
INTRODUCTION A growing literature documents the associations between discrimination and health. Emerging evidence suggests that among Hispanic/Latinx immigrants, discrimination leads to the deterioration of health outcomes over time. While sleep has been proposed as an important mediator of the relationship between discrimination and health, few studies have explicitly investigated this pathway, particularly among Hispanic/Latinx populations. OBJECTIVE To investigate the relationships between racial/ethnic discrimination, sleep, and physical and mental health among Hispanic/Latinx immigrants in the USA. Data and Methods Using data from a parent study of first-generation Hispanic/Latinx immigrants in the southeastern USA, we conducted sequential mediation analyses using the bootstrapping method to investigate whether self-reported sleep duration, sleep quality, and fatigue mediate the relationship(s) between self-reported discrimination, as measured by the discrimination subscale of the Riverside Acculturative Stress Inventory, and self-reported physical and mental health. RESULTS Nocturnal awakenings, fatigue, and sleep quality were statistically significant sequential mediators of the relationship between discrimination and physical health (b = -.001, SE = .001, CI [-.0027, -.0001]); fatigue alone also mediated this relationship (b = -.01, SE = .01, CI [-.0279, -.0003]). Nocturnal awakenings, fatigue, and sleep quality were also significant sequential mediators of the relationship between discrimination and mental health (b = -.001, SE = .001, CI [-.0031, -.0001]). CONCLUSION Sleep and fatigue play an important role in linking discrimination and health among first-generation Hispanic/Latinx immigrants. The development and implementation of interventions that focus on reducing fatigue among this population could mitigate the effects of unfair treatment on health outcomes.
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Diamond LM, Alley J. Rethinking minority stress: A social safety perspective on the health effects of stigma in sexually-diverse and gender-diverse populations. Neurosci Biobehav Rev 2022; 138:104720. [PMID: 35662651 DOI: 10.1016/j.neubiorev.2022.104720] [Citation(s) in RCA: 64] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 04/25/2022] [Accepted: 05/30/2022] [Indexed: 12/13/2022]
Abstract
For over two decades, the minority stress model has guided research on the health of sexually-diverse individuals (those who are not exclusively heterosexual) and gender-diverse individuals (those whose gender identity/expression differs from their birth-assigned sex/gender). According to this model, the cumulative stress caused by stigma and social marginalization fosters stress-related health problems. Yet studies linking minority stress to physical health outcomes have yielded mixed results, suggesting that something is missing from our understanding of stigma and health. Social safety may be the missing piece. Social safety refers to reliable social connection, inclusion, and protection, which are core human needs that are imperiled by stigma. The absence of social safety is just as health-consequential for stigmatized individuals as the presence of minority stress, because the chronic threat-vigilance fostered by insufficient safety has negative long-term effects on cognitive, emotional, and immunological functioning, even when exposure to minority stress is low. We argue that insufficient social safety is a primary cause of stigma-related health disparities and a key target for intervention.
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Affiliation(s)
- Lisa M Diamond
- Department of Psychology, University of Utah, Salt Lake City, UT, USA.
| | - Jenna Alley
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
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Cancer-related accelerated ageing and biobehavioural modifiers: a framework for research and clinical care. Nat Rev Clin Oncol 2022; 19:173-187. [PMID: 34873313 PMCID: PMC9974153 DOI: 10.1038/s41571-021-00580-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2021] [Indexed: 12/15/2022]
Abstract
A growing body of evidence indicates that patients with cancer who receive cytotoxic treatments (such as chemotherapy or radiotherapy) have an increased risk of accelerated physical and cognitive ageing. Furthermore, accelerated biological ageing is a suspected driving force behind many of these observed effects. In this Review, we describe the mechanisms of biological ageing and how they apply to patients with cancer. We highlight the important role of specific behavioural factors, namely stress, sleep and lifestyle-related factors such as physical activity, weight management, diet and substance use, in the accelerated ageing of patients with cancer and cancer survivors. We also present a framework of how modifiable behaviours could operate to either increase the risk of accelerated ageing, provide protection, or promote resilience at both the biological level and in terms of patient-reported outcomes.
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Kalmakis KA, Kent NM, Alhowaymel F, Chiodo LM. Perceived stress, fatigue symptoms, and posttraumatic stress disorder symptoms among young adult college students. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2022; 35:60-67. [PMID: 34561938 PMCID: PMC8813883 DOI: 10.1111/jcap.12352] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 09/10/2021] [Accepted: 09/12/2021] [Indexed: 02/03/2023]
Abstract
PROBLEM University students experience stress and fatigue often affecting their health, academic success, and social adjustment. Many also have histories of childhood trauma that may result in posttraumatic stress symptoms. The purpose of this study was to determine the associations between perceptions of stress, symptoms of fatigue, and symptoms of posttraumatic stress disorder (PTSD) among university students, many of whom report childhood adversity. METHODS Sixty-nine students from one university campus participated in this study. A cross-sectional design was used to gather data across six self-report measures. FINDINGS Childhood adversity was associated with PTSD symptoms and acute stress, and PTSD symptoms were related to all three measures of fatigue. PTSD symptoms mediated the relationship between stress and fatigue, but not other fatigue domains. CONCLUSIONS The implications of an association between PTSD, stress, and fatigue are relevant to students' health and academic success. It is important to note that even subclinical levels of PTSD impact fatigue.
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Affiliation(s)
- Karen, A. Kalmakis
- University of Massachusetts Amherst, 651 North Pleasant Street, Amherst, MA 01003
| | - Nicole, M. Kent
- University of Massachusetts Amherst, 651 North Pleasant Street, Amherst, MA 01003
| | - Fahad Alhowaymel
- College of Applied Medical Sciences, Shaqra University, Shaqra, Saudi Arabia
| | - Lisa, M. Chiodo
- University of Massachusetts Amherst, 651 North Pleasant Street, Amherst, MA 01003
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Myint K, Jacobs K, Myint AM, Lam SK, Lim YAL, Boey CCM, Hoe SZ, Guillemin GJ. Psychological Stresses in Children Trigger Cytokine- and Kynurenine Metabolite-Mediated Abdominal Pain and Proinflammatory Changes. Front Immunol 2021; 12:702301. [PMID: 34539633 PMCID: PMC8442661 DOI: 10.3389/fimmu.2021.702301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 08/09/2021] [Indexed: 11/13/2022] Open
Abstract
Recurrent abdominal pain (RAP) is a common medically unexplained symptom among children worldwide. However, the biological mechanisms behind the development of functional and behavioral symptoms and changes in blood markers have not been well explored. This study aimed to assess changes in the concentrations of inflammatory markers, including cytokines and tryptophan catabolites, in the serum of children with RAP compared to those with subclinical infections. Children with RAP but without organic diseases were included, and those with asymptomatic intestinal parasitic infections were used as a subclinical infection cohort. Blood samples were collected and used to measure the cytokine profile using Multiplex Immunoassay and tryptophan catabolites using high performance liquid chromatography. Children with RAP showed significantly higher concentrations of serum tumor necrotic factor-α, p<0.05, but lower concentrations of IL-10, p<0.001, IL-6, p<0.001 and brain-derived neurotrophic factors (BDNF) p<0.01. In addition, a significant increase in the metabolite of the kynurenine pathway, 3-hydroxyanthranilic acid (3-HAA) p<0.01, a significant decrease in the concentrations of anthranilic acid (AA) p<0.001, together with an increased ratio of serum 3-HAA to AA (3-HAA/AA) p<0.001, was found in this cohort. These findings indicate the significant activation of the immune system and presence of inflammation in children with RAP than those with subclinical parasitic infections. Moreover, children with RAP tested with the Strengths and Difficulties Questionnaire (SDQ), displayed high psychological problems though these SDQ scores were not statistically associated with measured cytokines and kynurenine metabolites. We however could hypothesize that the pro-inflammatory state together with concomitant low concentrations of BDNF in those children with RAP could play a role in psychological stress and experiencing medically unexplained symptoms.
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Affiliation(s)
- Kyaimon Myint
- Department of Physiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Kelly Jacobs
- Neuroinflammation Group, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia
| | - Aye-Mu Myint
- Psychoneuroimmunology Research Group, European Collaborative Project, Munich, Germany
| | - Sau Kuen Lam
- Department of Pre-Clinical Sciences, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Bandar Sungai Long, Malaysia
| | - Yvonne Ai-Lian Lim
- Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | - See Ziau Hoe
- Department of Physiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Gilles J Guillemin
- Neuroinflammation Group, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia
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Doedee F, van den Houdt S, Widdershoven J, Kupper N. Chronic stress exposure in men and women, and implications for the course of fatigue after percutaneous coronary intervention; the THORESCI study. Gen Hosp Psychiatry 2021; 72:45-52. [PMID: 34280618 DOI: 10.1016/j.genhosppsych.2021.07.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 07/06/2021] [Accepted: 07/08/2021] [Indexed: 01/19/2023]
Abstract
BACKGROUND Fatigue is a prevalent symptom in patients with coronary heart disease (CHD). Individual differences in chronic stress may affect the experience and persistence of fatigue, and this may vary between the sexes. Therefore, we studied the effect of chronic stress on the course of fatigue over a 2-year period after percutaneous coronary intervention (PCI), and examined the moderating effects of sex. METHODS 1682 patients (78% men, age = 67.1 ± 10.6) were recruited and filled out multiple self-report questionnaires at baseline, one, 12, and 24 months post-PCI, including questions on demographics, fatigue (HCS). Multiple chronic stressors were assessed at baseline: work stress (ERI16), marital stress (MMQ-6), early life events (Life Events Questionnaire) and social stress. Latent class factor analysis (LatentGOLD) was used to construct a comprehensive chronic stress index. Linear mixed modeling examined the predictive quality of predictors and covariates. RESULTS Fatigue was found to substantially decrease over the first month post-PCI, then stabilized at a moderate level. Chronic stress impacted both the level and course of fatigue by increasing its level and delaying recovery. Overall and across time, women reported more fatigue than men. The level and course effects of chronic stress and sex were independent of demographic, health behavioral, and medical covariates. CONCLUSIONS Individual differences in chronic stress impact both the level and course of fatigue post-PCI, with women being affected most. Future research could further explain the mechanisms underlying the observed relationships. Developing and testing interventions focusing on exercise and stress-reduction could be used to alleviate fatigue.
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Affiliation(s)
- Fleur Doedee
- Department of Medical & Clinical Psychology, Center of Research on Psychology in Somatic Diseases, Tilburg University, Tilburg, the Netherlands
| | - Sophie van den Houdt
- Department of Medical & Clinical Psychology, Center of Research on Psychology in Somatic Diseases, Tilburg University, Tilburg, the Netherlands
| | - Jos Widdershoven
- Department of Medical & Clinical Psychology, Center of Research on Psychology in Somatic Diseases, Tilburg University, Tilburg, the Netherlands; Department of Cardiology, Elisabeth-TweeSteden Hospital, Tilburg, the Netherlands
| | - Nina Kupper
- Department of Medical & Clinical Psychology, Center of Research on Psychology in Somatic Diseases, Tilburg University, Tilburg, the Netherlands.
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Diamond LM, Dehlin AJ, Alley J. Systemic inflammation as a driver of health disparities among sexually-diverse and gender-diverse individuals. Psychoneuroendocrinology 2021; 129:105215. [PMID: 34090051 DOI: 10.1016/j.psyneuen.2021.105215] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 03/25/2021] [Accepted: 03/25/2021] [Indexed: 01/28/2023]
Abstract
Sexually-diverse individuals (those who seek sexual or romantic relationships with the same and/or multiple genders) and gender-diverse individuals (those whose gender identity and/or expression differs from their birth-assigned sex/gender) have disproportionately high physical health problems, but the underlying biological causes for these health disparities remain unclear. Building on the minority stress model linking social stigmatization to health outcomes, we argue that systemic inflammation (the body's primary response to both physical and psychological threats, indicated by inflammatory markers such as C-reactive protein and proinflammatory cytokines) is a primary biobehavioral pathway linking sexual and gender stigma to physical health outcomes. Expectations and experiences of social threat (i.e., rejection, shame, and isolation) are widespread and chronic among sexually-diverse and gender-diverse individuals, and social threats are particularly potent drivers of inflammation. We review research suggesting that framing "minority stress" in terms of social safety versus threat, and attending specifically to the inflammatory consequences of these experiences, can advance our understanding of the biobehavioral consequences of sexual and gender stigma and can promote the development of health promoting interventions for this population.
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Hellem T, Benavides-Vaello S, Taylor-Piliae R. National Internet-Based Survey of the Use, Barriers, Reasons and Beliefs of Mind-Body Practices During the Early Months of the COVID-19 Pandemic. J Evid Based Integr Med 2021; 26:2515690X211006332. [PMID: 33829877 PMCID: PMC8040606 DOI: 10.1177/2515690x211006332] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
The purpose of this study was to learn about the use, barriers, reasons and beliefs regarding mind-body practices among adults living in the United States during the beginning months of the 2019 novel coronavirus disease (COVID-19) pandemic. An on-line survey was developed following the Checklist for Reporting Results of Internet e-Surveys (CHERRIES) guidelines and using the online survey software program, Qualtrics®XM, platform. Pilot testing of the survey was conducted for usability and functionality. The final 24-item survey was distributed via email and social media. A total of 338 adults responded to the survey, with 68.8% indicating that they participated in mind-body activities since the start of the pandemic. Physical activity was the most frequently (61.5%, n = 227) used mind-body practice. Further, 2 of the common barriers to engaging in mind-body practices were lack of motivation and wandering mind. Frequently listed reasons for using mind-body practices were to promote health, reduce stress and relaxation. Respondents believed that mind-body practices resulted in less stress. These findings may be applicable for reducing psychological stress related to the pandemic, as the pandemic continues to impact many areas of the United States.
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Affiliation(s)
- Tracy Hellem
- College of Nursing, 33052Montana State University, Missoula, MT, USA
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12
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Tang M, Liu T, Jiang P, Dang R. The interaction between autophagy and neuroinflammation in major depressive disorder: From pathophysiology to therapeutic implications. Pharmacol Res 2021; 168:105586. [PMID: 33812005 DOI: 10.1016/j.phrs.2021.105586] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 03/19/2021] [Accepted: 03/25/2021] [Indexed: 12/14/2022]
Abstract
The past decade has revealed neuroinflammation as an important mechanism of major depressive disorder (MDD). Nod-like receptors family pyrin domain containing 3 (NLRP3) inflammasome is the key regulator interleukin-1β (IL-1β) maturation, whose activation has been reported in MDD patients and various animal models. Function as a dominant driver of neuroinflammation, NLRP3 bridges the gap between immune activation with stress exposure, and further leads to subsequent occurrence of neuropsychiatric disorders such as MDD. Of note, autophagy is a tightly regulated cellular degradation pathway that removes damaged organelles and intracellular pathogens, and maintains cellular homeostasis from varying insults. Serving as a critical cellular monitoring system, normal functioned autophagy signaling prevents excessive NLRP3 inflammasome activation and subsequent release of IL-1 family cytokines. This review will describe the current understanding of how autophagy regulates NLRP3 inflammasome activity and discuss the implications of this regulation on the pathogenesis of MDD. The extensive crosstalk between autophagy pathway and NLRP3 inflammasome is further discussed, as it is critical for developing new therapeutic strategies for MDD aimed at modulating the neuroinflammatory responses.
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Affiliation(s)
- Mimi Tang
- Department of Pharmacy, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Ting Liu
- Department of Pharmacy, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Pei Jiang
- Institute of Clinical Pharmacy, Jining First People's Hospital, Jining Medical University, Jining 272000, China.
| | - Ruili Dang
- Institute of Clinical Pharmacy, Jining First People's Hospital, Jining Medical University, Jining 272000, China.
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Whitaker RC, Herman AN, Dearth-Wesley T, Hubbell K, Huff R, Heneghan LJ, Rowe PC. The association of fatigue with dispositional mindfulness: relationships by levels of depressive symptoms, sleep quality, childhood adversity, and chronic medical conditions. Prev Med 2019; 129:105873. [PMID: 31644898 DOI: 10.1016/j.ypmed.2019.105873] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 10/15/2019] [Accepted: 10/17/2019] [Indexed: 10/25/2022]
Abstract
Although mindfulness-based interventions may be effective in addressing the common symptom of fatigue, no population-based studies have examined the relationship between mindfulness and fatigue. We determined whether higher levels of dispositional mindfulness were associated with lower levels of fatigue. Cross-sectional data were obtained through the Pennsylvania Head Start Staff Wellness Survey, a 2012 web-based survey in which 2199 of 3375 (65%) eligible staff participated. The analytic sample was restricted to the 2083 female respondents with complete data on dispositional mindfulness (Cognitive and Affective Mindfulness Scale-Revised) and fatigue (Fatigue Severity Scale). We determined the mean covariate-adjusted fatigue scores in each quartile of dispositional mindfulness. This relationship was examined in the overall sample and within subgroups defined by levels of four variables: depressive symptoms, poor sleep quality, childhood adversity, and chronic medical conditions. The sample was 86% non-Hispanic White, and 61% had a bachelor's or more advanced degree. The mean (SD) Fatigue Severity Scale score was 3.3 (1.3). The adjusted mean fatigue score decreased significantly and in a graded manner across higher quartiles of mindfulness, with the adjusted fatigue score 1.4 points lower (95% confidence interval: -1.5, -1.2) among those in the highest quartile of dispositional mindfulness compared to the lowest. This significant graded relationship was present within each subgroup examined, and there was not a statistically significant interaction between dispositional mindfulness and any subgroup variable. Future trials of mindfulness-based interventions should consider assessing the outcome of fatigue in both clinical and non-clinical populations.
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Affiliation(s)
- Robert C Whitaker
- Columbia-Bassett Program, Cooperstown, NY, United States of America; Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, United States of America; Bassett Research Institute, Cooperstown, NY, United States of America; Bassett Medical Center, Cooperstown, NY, United States of America.
| | - Allison N Herman
- Columbia-Bassett Program, Cooperstown, NY, United States of America; Bassett Research Institute, Cooperstown, NY, United States of America; Bassett Medical Center, Cooperstown, NY, United States of America
| | - Tracy Dearth-Wesley
- Columbia-Bassett Program, Cooperstown, NY, United States of America; Bassett Research Institute, Cooperstown, NY, United States of America; Bassett Medical Center, Cooperstown, NY, United States of America
| | - Kenneth Hubbell
- Columbia-Bassett Program, Cooperstown, NY, United States of America; Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, United States of America
| | - Ryan Huff
- Columbia-Bassett Program, Cooperstown, NY, United States of America; Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, United States of America
| | - Liam J Heneghan
- Columbia-Bassett Program, Cooperstown, NY, United States of America; Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, United States of America
| | - Peter C Rowe
- Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
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14
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Liu N, Wang Y, An AY, Banker C, Qian YH, O'Donnell JM. Single housing-induced effects on cognitive impairment and depression-like behavior in male and female mice involve neuroplasticity-related signaling. Eur J Neurosci 2019; 52:2694-2704. [PMID: 31471985 DOI: 10.1111/ejn.14565] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 08/10/2019] [Accepted: 08/22/2019] [Indexed: 02/06/2023]
Abstract
Single-housed stress elicits a range of social isolation-related behavioral and neurobiological abnormalities. To investigate single housing-induced behavioral changes and sex differences on stress outcomes, we examined single-housed stress-induced learning and memory impairment, depression-like behaviors, neuroplasticity abnormalities and underlying mechanism. The results showed that male and female mice socially isolated for 8 weeks had significantly decreased memory acquisition, as demonstrated in the learning curve of the Morris water maze task. Memory consolidation and retrieval were also decreased in both the single-housed male and female mice. These findings were corroborated further by the two classical animal models, Y-maze and novel object recognition tests, as demonstrated by reduced spontaneous alternation and recognition index in both sexes of single-housed mice. Subsequent studies suggested that single-housed male mice exhibited increased immobility time in both the forced swim and tail suspension tests, while the female mice only exhibited increased immobility time in the tail suspension test. Moreover, single-housed stress significantly decreased the apical and basal branch points, dendritic length, and spine density in the CA1 of hippocampal neurons in both male and female mice. These effects were consistent with decreased neuroplasticity and neuroprotective-related molecules such as synaptophysin, PSD95, PKA, pCREB and BDNF expression. These findings suggest that loss of neuronal remodeling and neuroprotective mechanisms due to single housing are involved in behavioral changes in both male and female mice. The results provide further evidence that neuroplasticity-related signaling plays a crucial role in isolation-induced effects on neuropsychiatric behavioral deficits in both sexes.
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Affiliation(s)
- Na Liu
- Department of Human Anatomy, Histology and Embryology, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, Xi'an, China.,Department of Traditional Medical Orthopedics, Honghui Hospital, Xi'an Jiaotong University, Xi'an, Shanxi, China.,Department of Pharmaceutical Sciences, School of Pharmacy & Pharmaceutical Sciences, University at Buffalo, the State University of New York, Buffalo, NY, USA
| | - Yulu Wang
- Department of Pharmaceutical Sciences, School of Pharmacy & Pharmaceutical Sciences, University at Buffalo, the State University of New York, Buffalo, NY, USA.,College of Pharmacy, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Aerin Y An
- Department of Pharmaceutical Sciences, School of Pharmacy & Pharmaceutical Sciences, University at Buffalo, the State University of New York, Buffalo, NY, USA
| | - Christopher Banker
- Department of Pharmaceutical Sciences, School of Pharmacy & Pharmaceutical Sciences, University at Buffalo, the State University of New York, Buffalo, NY, USA
| | - Yi-Hua Qian
- Department of Human Anatomy, Histology and Embryology, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - James M O'Donnell
- Department of Pharmaceutical Sciences, School of Pharmacy & Pharmaceutical Sciences, University at Buffalo, the State University of New York, Buffalo, NY, USA
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15
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The reduced bactericidal activity of neutrophils as an incisive indicator of water-immersion restraint stress and impaired exercise performance in mice. Sci Rep 2019; 9:4562. [PMID: 30872740 PMCID: PMC6418158 DOI: 10.1038/s41598-019-41077-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 02/26/2019] [Indexed: 11/30/2022] Open
Abstract
The incisive evaluation of psychological stress may be required to determine the exercise performance of stressed hosts. We investigated objective markers of psychological stress that reflect exercise performance, focusing on the neutrophil function. We used murine water-immersion restraint (WIR) stress for our assessments. After receiving WIR for 1 or 2 h, mice were exercised on an airtight treadmill that monitors their respiratory exchange ratio. The neutrophil function was analyzed after WIR stress. Although the control mice (without WIR) showed good combustion of both carbohydrates and lipids as energy sources during treadmill exercise, mice that underwent 2-h WIR did not combust carbohydrates or lipids effectively, drastically reducing their performance. In contrast, the 1-h WIR mice showed carbohydrate combustion (albeit a slow response) but did not use lipids for energy, thereby running longer than the 2-h WIR mice but shorter than the control mice. The bactericidal activity of neutrophils, but not their superoxide production or microsphere-phagocytic activity, was significantly reduced by 1-h WIR and further reduced by 2-h WIR, indicating a significant association between WIR stress and exercise performance. The neutrophil bactericidal activity may be a good indicator of psychological stress and a useful tool for precisely assessing exercise performance.
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16
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Bower JE. The role of neuro-immune interactions in cancer-related fatigue: Biobehavioral risk factors and mechanisms. Cancer 2019; 125:353-364. [PMID: 30602059 DOI: 10.1002/cncr.31790] [Citation(s) in RCA: 95] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 08/28/2018] [Accepted: 08/30/2018] [Indexed: 12/12/2022]
Abstract
Fatigue is a common and distressing symptom in both patients with cancer and cancer survivors. There is substantial variation in the severity and persistence of cancer-related fatigue that may be driven by individual differences in host factors, including characteristics that predate the cancer experience as well as responses to cancer and its treatment. This review examines biobehavioral risk factors linked to fatigue and the mechanisms through which they influence fatigue across the cancer continuum, with a focus on neuro-immune processes. Among psychosocial risk factors, childhood adversity is a strong and consistent predictor of cancer-related fatigue; other risk factors include history of depression, catastrophizing, lack of physical activity, and sleep disturbance, with compelling preliminary evidence for loneliness and trait anxiety. Among biologic systems, initial work suggests that alterations in immune, neuroendocrine, and neural processes are associated with fatigue. The identification of key risk factors and underlying mechanisms is critical for the development and deployment of targeted interventions to reduce the burden of fatigue in the growing population of cancer survivors. Given the multidimensional nature of fatigue, interventions that influence multiple systems may be most effective.
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Affiliation(s)
- Julienne E Bower
- Department of Psychology, Department of Psychiatry and Biobehavioral Sciences, Cousins Center for Psychoneuroimmunology, and Jonsson Comprehensive Cancer Center, University of California, Los Angeles, California
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17
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Ports KA, Holman DM, Guinn AS, Pampati S, Dyer KE, Merrick MT, Lunsford NB, Metzler M. Adverse Childhood Experiences and the Presence of Cancer Risk Factors in Adulthood: A Scoping Review of the Literature From 2005 to 2015. J Pediatr Nurs 2019; 44:81-96. [PMID: 30683285 PMCID: PMC6355255 DOI: 10.1016/j.pedn.2018.10.009] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 10/11/2018] [Accepted: 10/12/2018] [Indexed: 02/07/2023]
Abstract
Exposure to Adverse Childhood Experiences (ACEs) is associated with a host of harmful outcomes, including increased risk for cancer. A scoping review was conducted to gain a better understanding of how ACEs have been studied in association with risk factors for cancer. This review includes 155 quantitative, peer-reviewed articles published between 2005 and 2015 that examined associations between ACEs and modifiable cancer risk factors, including alcohol, environmental carcinogens, chronic inflammation, sex hormones, immunosuppression, infectious agents, obesity, radiation, ultraviolet (UV) radiation, and tobacco, among U.S. adults. This review highlights the growing body of research connecting ACEs to cancer risk factors, particularly alcohol, obesity, and tobacco. Fewer studies investigated the links between ACEs and chronic inflammation or infectious agents. No included publications investigated associations between ACEs and environmental carcinogens, hormones, immunosuppression, radiation, or ultraviolet radiation. Mitigating the impact of ACEs may provide innovative ways to effect comprehensive, upstream cancer prevention.
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Affiliation(s)
- Katie A Ports
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Dawn M Holman
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Angie S Guinn
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Sanjana Pampati
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA.
| | - Karen E Dyer
- Virginia Commonwealth University, School of Medicine, Department of Health Behavior and Policy, Richmond, VA, USA.
| | - Melissa T Merrick
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Natasha Buchanan Lunsford
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Marilyn Metzler
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA.
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18
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Bower JE, Asher A, Garet D, Petersen L, Ganz PA, Irwin MR, Cole SW, Hurvitz SA, Crespi CM. Testing a biobehavioral model of fatigue before adjuvant therapy in women with breast cancer. Cancer 2018; 125:633-641. [PMID: 30561795 DOI: 10.1002/cncr.31827] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 08/23/2018] [Accepted: 10/01/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND Fatigue is one of the most common and disabling side effects of cancer and its treatment. Although research typically has focused on fatigue that occurs during and after treatment, patients may experience fatigue even before treatment onset. The current study was designed to identify biobehavioral risk factors associated with fatigue before adjuvant therapy in women with early-stage breast cancer. METHODS Patients with stage 0 to stage IIIA breast cancer (270 women) were recruited before the onset of adjuvant or neoadjuvant therapy with radiotherapy, chemotherapy, and/or endocrine therapy. Host factors that may influence fatigue were identified from an empirically based, biobehavioral model and assessed using self-report questionnaires, medical record review, and blood collection (for genetic data). Fatigue was assessed by questionnaire. Linear regression analyses were used to evaluate the association between host factors and dimensions of fatigue, with general fatigue as the primary dimension of interest. RESULTS Fatigue was elevated at the pretreatment assessment compared with published controls. Bivariate analyses identified demographic, cancer-related, and biobehavioral correlates of fatigue. In the multivariable model, predictors of general fatigue included younger age, lower educational level, lower cancer stage, and history of childhood maltreatment (all P values <.05), with the full model accounting for approximately 18.4% of the variance in fatigue. Secondary analyses identified common and specific predictors of emotional, mental, and physical dimensions of fatigue. CONCLUSIONS Among women who have not yet initiated treatment of breast cancer, demographic and psychosocial factors are associated with elevated fatigue and could be used to identify at-risk patients for early intervention.
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Affiliation(s)
- Julienne E Bower
- Department of Psychology, University of California at Los Angeles, Los Angeles, California.,Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, California.,Norman Cousins Center for Psychoneuroimmunology, University of California at Los Angeles, Los Angeles, California.,Jonsson Comprehensive Cancer Center, University of California at Los Angeles, Los Angeles, California
| | - Arash Asher
- Cedars-Sinai Medical Center, Samuel Oschin Comprehensive Cancer Institute, Los Angeles, California
| | - Deborah Garet
- Norman Cousins Center for Psychoneuroimmunology, University of California at Los Angeles, Los Angeles, California
| | - Laura Petersen
- Jonsson Comprehensive Cancer Center, University of California at Los Angeles, Los Angeles, California
| | - Patricia A Ganz
- Jonsson Comprehensive Cancer Center, University of California at Los Angeles, Los Angeles, California.,School of Medicine, University of California at Los Angeles, Los Angeles, California.,School of Public Health, University of California at Los Angeles, Los Angeles, California
| | - Michael R Irwin
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, California.,Norman Cousins Center for Psychoneuroimmunology, University of California at Los Angeles, Los Angeles, California
| | - Steve W Cole
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, California.,Norman Cousins Center for Psychoneuroimmunology, University of California at Los Angeles, Los Angeles, California.,Department of Medicine, University of California at Los Angeles, Los Angeles, California
| | - Sara A Hurvitz
- Department of Medicine, University of California at Los Angeles, Los Angeles, California
| | - Catherine M Crespi
- Jonsson Comprehensive Cancer Center, University of California at Los Angeles, Los Angeles, California.,Department of Biostatistics, University of California at Los Angeles, Los Angeles, California
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19
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Winer JP, Powers SI, Pietromonaco PR, Schreck MC. Childhood family adversity and adult cortisol response: The role of observed marital conflict behavior. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2018; 32:793-803. [PMID: 30188170 PMCID: PMC8252991 DOI: 10.1037/fam0000455] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Childhood family adversity predicts adult interpersonal behavior and physiological responses to interpersonal stress. Additionally, negative marital behaviors (e.g., hostility and distress maintaining attributions) predict maladaptive stress responses and mental health problems, whereas positive marital behaviors (e.g., acceptance and relationship enhancing attributions) predict adaptive physiological and psychological outcomes. The present study examined potential marital behavior mediators and moderators of the link between childhood adversity and cortisol responses to conflict. In a sample of 218 different-sex newlywed couples, we examined (a) actors' marital conflict behaviors as candidate mediators of the link between childhood adversity and cortisol responses to marital conflict discussions, and (b) partners' marital conflict behaviors as candidate moderators of the relation between childhood adversity and cortisol responses to marital discussions. Path analysis using actor-partner interdependence modeling did not confirm mediation. Instead, wives' childhood family adversity directly predicted husbands' attenuated cortisol responses, and wives' negative behavior predicted wives' attenuated cortisol responses. As hypothesized, wives' negative behaviors moderated the association between husbands' childhood family adversity and husbands' cortisol in response to conflict; husbands showed higher cortisol if they had experienced greater family adversity and if their wives displayed more negative behavior. Results suggest that childhood family adversity may carry forward to shape adult cortisol responses to conflict and highlights the importance of wives' negative behavior for both husbands and wives. These findings add to the family psychology literature by further clarifying how the interaction of stressful childhood experiences and conflict behaviors in marriage are associated with adult physiological responses to conflict. (PsycINFO Database Record
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Affiliation(s)
| | - Sally I Powers
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst
| | - Paula R Pietromonaco
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst
| | - Meghan C Schreck
- Obsessive Compulsive Disorder Institute, McLean Hospital/Harvard Medical School
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20
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Jakubowski KP, Boylan JM, Cundiff JM, Matthews KA. Poor sleep moderates the relationship between daytime napping and inflammation in Black and White men. Sleep Health 2017; 3:328-335. [PMID: 28923188 PMCID: PMC5657545 DOI: 10.1016/j.sleh.2017.06.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 06/14/2017] [Accepted: 06/26/2017] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To test whether napping was associated with 2 inflammatory markers with known relationships to cardiovascular disease: high-sensitivity C-reactive protein (hsCRP) and interleukin-6 (IL-6). Because IL-6 is known to impact central inflammatory processes that relate to sleep regulation, including subjective fatigue, we tested whether this relationship was moderated by sleep duration, sleep efficiency, and self-reported sleep quality. DESIGN Cross-sectional. PARTICIPANTS A community sample of Black and White men (N=253) completed a week of actigraphy and diary measures of sleep and napping and provided a fasting blood sample. MEASUREMENTS/ANALYSIS Napping was measured as the proportion of days with at least 30 minutes napped and the average minutes napped per day. Linear regressions adjusted for race, socioeconomic status, employment, body mass index, smoking, medications that affect sleep or inflammation, working the nightshift, and day-sleeping status, followed by interaction terms between napping and sleep duration, efficiency, and quality, respectively. RESULTS There were no significant main effects of actigraphy- or diary-measured napping on IL-6 or hsCRP. Moderation analyses indicated elevated IL-6 values among men who napped more days (by actigraphy) and demonstrated short sleep duration (P=.03). Moderation analyses also indicated elevated IL-6 among men who demonstrated greater average minutes napped (by actigraphy) and short sleep duration (P<.001), low efficiency (P=.03), and poor quality (P=.03). Moderation analyses involving diary napping or hsCRP were not significant. CONCLUSIONS Actigraphy-assessed daytime napping is related to higher IL-6 in men who demonstrate worse sleep characteristics. Daytime napping may pose additional risk for inflammation beyond the known risk conferred by short sleep.
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Affiliation(s)
- Karen P Jakubowski
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA 15260, USA
| | - Jennifer M Boylan
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA 15260, USA
| | - Jenny M Cundiff
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA 15260, USA
| | - Karen A Matthews
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA 15260, USA; Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA 15260, USA.
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21
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De Venter M, Illegems J, Van Royen R, Moorkens G, Sabbe BGC, Van Den Eede F. Differential effects of childhood trauma subtypes on fatigue and physical functioning in chronic fatigue syndrome. Compr Psychiatry 2017; 78:76-82. [PMID: 28806608 DOI: 10.1016/j.comppsych.2017.07.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 05/31/2017] [Accepted: 07/17/2017] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVE There is wide consensus that childhood trauma plays an important role in the aetiology of chronic fatigue syndrome (CFS). The current study examines the differential effects of childhood trauma subtypes on fatigue and physical functioning in individuals suffering from CFS. METHODS Participants were 155 well-documented adult, predominantly female CFS patients receiving treatment at the outpatient treatment centre for CFS of the Antwerp University Hospital in Belgium. Stepwise regression analyses were conducted with outcomes of the total score of the Checklist Individual Strength (CIS) measuring fatigue and the scores on the physical functioning subscale of the Medical Outcomes Short Form 36 Health Status Survey (SF-36) as the dependent variables, and the scores on the five subscales of the Traumatic Experiences Checklist (TEC) as the independent variables. RESULTS The patients' fatigue (β=1.38; p=0.025) and physical functioning scores (β=-1.79; p=0.034) were significantly predicted by childhood sexual harassment. There were no significant effects of emotional neglect, emotional abuse, bodily threat, or sexual abuse during childhood. CONCLUSION Of the childhood trauma subtypes investigated, sexual harassment emerged as the most important predictor of fatigue and poor physical functioning in the CFS patients assessed. These findings have to be taken into account in further clinical research and in the assessment and treatment of individuals coping with chronic fatigue syndrome.
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Affiliation(s)
- Maud De Venter
- University Psychiatric Department, Campus Antwerp University Hospital (UZA), Antwerp (Edegem), Belgium; Collaborative Antwerp Psychiatric Research Institute (CAPRI), Faculty of Medicine and Health Sciences, University of Antwerp (UA), Antwerp, Belgium.
| | - Jela Illegems
- Behaviour Therapy Division for Fatigue and Functional Symptoms, Antwerp University Hospital (UZA), Antwerp (Edegem), Belgium; Department of Internal Medicine, Antwerp University Hospital (UZA), Antwerp (Edegem), Belgium
| | - Rita Van Royen
- Behaviour Therapy Division for Fatigue and Functional Symptoms, Antwerp University Hospital (UZA), Antwerp (Edegem), Belgium; Department of Internal Medicine, Antwerp University Hospital (UZA), Antwerp (Edegem), Belgium
| | - Greta Moorkens
- Behaviour Therapy Division for Fatigue and Functional Symptoms, Antwerp University Hospital (UZA), Antwerp (Edegem), Belgium; Department of Internal Medicine, Antwerp University Hospital (UZA), Antwerp (Edegem), Belgium
| | - Bernard G C Sabbe
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), Faculty of Medicine and Health Sciences, University of Antwerp (UA), Antwerp, Belgium; University Psychiatric Department, Campus Psychiatric Hospital St.-Norbertus, Duffel, Belgium
| | - Filip Van Den Eede
- University Psychiatric Department, Campus Antwerp University Hospital (UZA), Antwerp (Edegem), Belgium; Collaborative Antwerp Psychiatric Research Institute (CAPRI), Faculty of Medicine and Health Sciences, University of Antwerp (UA), Antwerp, Belgium
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22
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Winer JP, Powers SI, Pietromonaco PR. Early Pubertal Timing and Childhood Family Adversity Interact to Predict Newlywed Women's Anxiety Symptoms. JOURNAL OF CHILD AND FAMILY STUDIES 2017; 26:591-602. [PMID: 28458501 PMCID: PMC5409100 DOI: 10.1007/s10826-016-0575-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The contextual amplification hypothesis posits that girls' early pubertal timing will predict anxiety and depression symptoms most strongly when early puberty occurs under adverse conditions. Research supporting this hypothesis has consistently linked early pubertal timing occurring in adverse contexts to symptoms during adolescence, but little is known about the link to adult symptoms. The present study examined the extent to which women's reports of early pubertal timing and childhood family adversity interact to predict symptoms of anxiety and depression during the first two years of marriage. Married women (N = 226) completed questionnaires within 7 months into their first marriage (Time 1) and approximately 19 months later (Time 2). Analyses indicated that at both Time 1 and 2, women's reports of earlier pubertal timing predicted anxiety symptoms only when women reported a history of greater childhood family adversity. Additional analyses indicated that the interaction of earlier pubertal timing and greater childhood family adversity predicted symptoms of traumatic intrusions and panic, but not social anxiety, at Time 1, and panic symptoms at Times 1 and 2. These findings expand our understanding of the relation of early pubertal timing to adult emotional health and the family conditions that moderate this relation.
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Affiliation(s)
- Jeffrey P Winer
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Tobin Hall, 135 Hicks Way, Amherst, MA, 01003
| | - Sally I Powers
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Tobin Hall, 135 Hicks Way, Amherst, MA, 01003
| | - Paula R Pietromonaco
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Tobin Hall, 135 Hicks Way, Amherst, MA, 01003
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23
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Sleep Disturbance, Sleep Duration, and Inflammation: A Systematic Review and Meta-Analysis of Cohort Studies and Experimental Sleep Deprivation. Biol Psychiatry 2016; 80:40-52. [PMID: 26140821 PMCID: PMC4666828 DOI: 10.1016/j.biopsych.2015.05.014] [Citation(s) in RCA: 1016] [Impact Index Per Article: 127.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Revised: 05/05/2015] [Accepted: 05/11/2015] [Indexed: 12/12/2022]
Abstract
BACKGROUND Sleep disturbance is associated with inflammatory disease risk and all-cause mortality. Here, we assess global evidence linking sleep disturbance, sleep duration, and inflammation in adult humans. METHODS A systematic search of English language publications was performed, with inclusion of primary research articles that characterized sleep disturbance and/or sleep duration or performed experimental sleep deprivation and assessed inflammation by levels of circulating markers. Effect sizes (ES) and 95% confidence intervals (CI) were extracted and pooled using a random effect model. RESULTS A total of 72 studies (n > 50,000) were analyzed with assessment of C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor α (TNFα). Sleep disturbance was associated with higher levels of CRP (ES .12; 95% CI = .05-.19) and IL-6 (ES .20; 95% CI = .08-.31). Shorter sleep duration, but not the extreme of short sleep, was associated with higher levels of CRP (ES .09; 95% CI = .01-.17) but not IL-6 (ES .03; 95% CI: -.09 to .14). The extreme of long sleep duration was associated with higher levels of CRP (ES .17; 95% CI = .01-.34) and IL-6 (ES .11; 95% CI = .02-20). Neither sleep disturbances nor sleep duration was associated with TNFα. Neither experimental sleep deprivation nor sleep restriction was associated with CRP, IL-6, or TNFα. Some heterogeneity among studies was found, but there was no evidence of publication bias. CONCLUSIONS Sleep disturbance and long sleep duration, but not short sleep duration, are associated with increases in markers of systemic inflammation.
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24
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Jakubowski KP, Hall MH, Marsland AL, Matthews KA. Is daytime napping associated with inflammation in adolescents? Health Psychol 2016; 35:1298-1306. [PMID: 27253429 DOI: 10.1037/hea0000369] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Daytime napping has been associated with poor health outcomes in adults. It is not known whether daytime napping is similarly linked to adverse health in adolescents, although many report napping. The present study evaluated associations between daytime napping and 2 markers of increased inflammation, high-sensitivity C-reactive protein and interleukin-6 (IL-6), in healthy high school students. METHODS Two hundred thirty-four Black and White high school students completed a week of actigraph and diary measures of sleep and napping and provided a fasting blood sample. Napping measures were the proportion of days napped and the average minutes napped across 1 week during the school year. RESULTS Linear regressions adjusted for age, sex, race, average nocturnal sleep duration, time between sleep protocol and blood draw, and body mass index percentile demonstrated that proportion of days napped measured by actigraphy, B(SE) = .41(.19), p < .05, across the full week was positively associated with IL-6. Higher proportions of school days napped between 2 p.m. and 6 p.m., B(SE) = .40(.20), p < .05, and between 6 p.m. and 10 p.m., B(SE) = .57(.28), p < .05, were associated with increased IL-6. No associations emerged between average actigraphy-assessed nap duration and either study outcome. Diary-reported napping was unrelated to either study outcome. CONCLUSIONS Actigraphy-assessed napping and IL-6 are associated but the direction of the relationship remains to be determined. Overall, napping is an important factor to consider to better understand the relationship between short sleep and cardiovascular health in adolescents. (PsycINFO Database Record
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Szyf M. Epigenetics, a key for unlocking complex CNS disorders? Therapeutic implications. Eur Neuropsychopharmacol 2015; 25:682-702. [PMID: 24857313 DOI: 10.1016/j.euroneuro.2014.01.009] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2013] [Revised: 12/07/2013] [Accepted: 01/11/2014] [Indexed: 12/13/2022]
Abstract
Aberrant changes in gene function are believed to be involved in a wide spectrum of human disease including behavioral, cognitive and neurodegenerative pathologies. Most of the attention in last few decades have focused on changes in gene sequence as a cause of gene dysfunction leading to disease and mental health disorders. Germ line mutations or other alterations in the sequence of DNA that associate with different behavioral and neurological pathologies have been identified. However, sequence alterations explain only a small fraction of the cases. In addition there is evidence for "gene-environment" interactions in the brain suggesting mechanisms that alter gene function and the phenotype through environmental exposure. Genes are programmed by "epigenetic" mechanisms such as chromatin structure, chromatin modification and DNA methylation. These mechanisms confer on similar sequences different identities during cellular differentiation. Epigenetic differences are proposed to be involved in differentiating gene function in response to different environmental contexts and could result in alterations in functional gene networks that lead to brain disease. Epigenetic markers could serve important biomarkers in brain and behavioral diseases. Moreover, epigenetic processes are potentially reversible pointing to epigenetic therapeutics in psychotherapy.
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Affiliation(s)
- Moshe Szyf
- Department of Pharmacology and Therapeutics, McGill University, Montreal, Canada H3G1Y5.
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Cho HJ, Seeman TE, Kiefe CI, Lauderdale DS, Irwin MR. Sleep disturbance and longitudinal risk of inflammation: Moderating influences of social integration and social isolation in the Coronary Artery Risk Development in Young Adults (CARDIA) study. Brain Behav Immun 2015; 46:319-26. [PMID: 25733101 PMCID: PMC4414819 DOI: 10.1016/j.bbi.2015.02.023] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Revised: 02/19/2015] [Accepted: 02/21/2015] [Indexed: 01/08/2023] Open
Abstract
Both sleep disturbance and social isolation increase the risk for morbidity and mortality. Systemic inflammation is suspected as a potential mechanism of these associations. However, the complex relationships between sleep disturbance, social isolation, and inflammation have not been examined in a population-based longitudinal study. This study examined the longitudinal association between sleep disturbance and systemic inflammation, and the moderating effects of social isolation on this association. The CARDIA study is a population-based longitudinal study conducted in four US cities. Sleep disturbance - i.e., insomnia complaints and short sleep duration - was assessed in 2962 African-American and White adults at baseline (2000-2001, ages 33-45years). Circulating C-reactive protein (CRP) was measured at baseline and follow-up (2005-2006). Interleukin-6 (IL-6) and subjective and objective social isolation (i.e., feelings of social isolation and social network size) were measured at follow-up. Sleep disturbance was a significant predictor of inflammation five years later after full adjustment for covariates (adjusted betas: 0.048, P=0.012 for CRP; 0.047, P=0.017 for IL-6). Further adjustment for baseline CRP revealed that sleep disturbance also impacted the longitudinal change in CRP levels over five years (adjusted beta: 0.044, P=0.013). Subjective social isolation was a significant moderator of this association between sleep disturbance and CRP (adjusted beta 0.131, P=0.002). Sleep disturbance was associated with heightened systemic inflammation in a general population over a five-year follow-up, and this association was significantly stronger in those who reported feelings of social isolation. Clinical interventions targeting sleep disturbances may be a potential avenue for reducing inflammation, particularly in individuals who feel socially isolated.
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Affiliation(s)
- Hyong Jin Cho
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine at UCLA, United States.
| | - Teresa E Seeman
- Division of Geriatrics, David Geffen School of Medicine at UCLA, United States
| | - Catarina I Kiefe
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, United States
| | | | - Michael R Irwin
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine at UCLA, United States
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Ege MA, Messias E, Thapa PB, Krain LP. Adverse childhood experiences and geriatric depression: results from the 2010 BRFSS. Am J Geriatr Psychiatry 2015; 23:110-4. [PMID: 25306195 PMCID: PMC4267899 DOI: 10.1016/j.jagp.2014.08.014] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Revised: 08/22/2014] [Accepted: 08/29/2014] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Adverse childhood experiences (ACEs), including physical, sexual, and emotional abuse, have been shown to result in a variety of poor outcomes including depression. The majority of research has examined the impact of such events on adolescents and young adults leaving a dearth of information regarding how these events may affect depressive symptom point prevalence later in life. METHODS Data from the U.S. CDC's 2010 Behavioral Risk Factor Surveillance Survey (BRFSS) were used to estimate the point prevalence of depression in individuals 60 years of age and greater based on presence or absence of certain ACEs. Depressive symptoms were assessed using eight items from the Patient Health Questionnaire (PHQ). Subjects with a PHQ score of 10 or greater were categorized as depressed. Six different types of ACE were included in the study: parents being physically abusive to each other, being physically harmed by a parent, being sworn at by the parent, being touched sexually by an adult, being forced to sexually touch an adult, and being forced into a sexual encounter. ACEs were categorized as never, single if subject reported it occurring once, or repeated if subject reported multiple episodes. RESULTS The study sample consisted of 8,051 adults aged 60 years and greater who responded to questions about adverse childhood experiences. The study sample comprised 53% women, 83% Caucasian patients, and had a mean age of 70.4 years. After controlling for age, sex, and race, depression was significantly correlated with repeated ACEs of all types (adjusted odds ratio [AOR] ranging from 2.41 to 9.78, all statistically significant). The only ACE where a single occurrence was significantly associated with late-life depression was forced sexual intercourse (AOR: 2.92, 95% CI: 1.06-8.02). After controlling for all types of abuse in a single model, repeated physical abuse and repeated forced sexual intercourse remained significant (AOR: 2.94, 95% CI: 1.68-5.13; AOR: 3.66, 95% CI: 1.01-13.2, respectively). DISCUSSION These results indicate a significant association between repeated ACEs and depression in older adults. When controlling for all forms of abuse, repeated physical abuse and forced sexual intercourse are significantly correlated with late-life depression. They emphasize the need to continue developing techniques to help individuals with a history of ACEs in order to decrease their negative effects, not only immediately, but also later in life.
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Affiliation(s)
- Margaret A Ege
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AK
| | - Erick Messias
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AK.
| | - Purushottam B Thapa
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AK; Arkansas State Hospital, Little Rock, AK
| | - Lewis P Krain
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AK
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Association of trauma exposure with proinflammatory activity: a transdiagnostic meta-analysis. Transl Psychiatry 2014; 4:e413. [PMID: 25050993 PMCID: PMC4119223 DOI: 10.1038/tp.2014.56] [Citation(s) in RCA: 131] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2014] [Revised: 05/02/2014] [Accepted: 05/22/2014] [Indexed: 12/15/2022] Open
Abstract
Exposure to psychological trauma (for example, childhood/early life adversity, exposure to violence or assault, combat exposure, accidents or natural disasters) is known to increase one's risk of developing certain chronic medical conditions. Clinical and population studies provide evidence of systemic inflammatory activity in trauma survivors with various psychiatric and nonpsychiatric conditions. This transdiagnostic meta-analysis quantitatively integrates the literature on the relationship of inflammatory biomarkers to trauma exposure and related symptomatology. We conducted random effects meta-analyses relating trauma exposure to log-transformed inflammatory biomarker concentrations, using meta-regression models to test the effects of study quality and psychiatric symptomatology on the inflammatory outcomes. Across k=36 independent samples and n=14,991 participants, trauma exposure was positively associated with C-reactive protein (CRP), interleukin (IL)-1β, IL-6, and tumor necrosis factor (TNF)-α (mean rs =0.2455, 0.3067, 0.2890, and 0.2998, respectively). No significant relationships were noted with fibrinogen, IL-2, IL-4, IL-8, or IL-10. In meta-regression models, the presence of psychiatric symptoms was a significant predictor of increased effect sizes for IL-1β and IL-6 (β=1.0175 and 0.3568, respectively), whereas study quality assessment scores were associated with increased effect sizes for IL-6 (β=0.3812). Positive correlations between inflammation and trauma exposure across a range of sample types and diagnoses were found. Although reviewed studies spanned an array of populations, research on any one specific psychiatric diagnosis was generally limited to one or two studies. The results suggest that chronic inflammation likely represents one potential mechanism underlying risk of health problems in trauma survivors.
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Abstract
BACKGROUND Psychological stress and physical activity (PA) are believed to be reciprocally related; however, most research examining the relationship between these constructs is devoted to the study of exercise and/or PA as an instrument to mitigate distress. OBJECTIVE The aim of this paper was to review the literature investigating the influence of stress on indicators of PA and exercise. METHODS A systematic search of Web of Science, PubMed, and SPORTDiscus was employed to find all relevant studies focusing on human participants. Search terms included "stress", "exercise", and "physical activity". A rating scale (0-9) modified for this study was utilized to assess the quality of all studies with multiple time points. RESULTS The literature search found 168 studies that examined the influence of stress on PA. Studies varied widely in their theoretical orientation and included perceived stress, distress, life events, job strain, role strain, and work-family conflict but not lifetime cumulative adversity. To more clearly address the question, prospective studies (n = 55) were considered for further review, the majority of which indicated that psychological stress predicts less PA (behavioral inhibition) and/or exercise or more sedentary behavior (76.4 %). Both objective (i.e., life events) and subjective (i.e., distress) measures of stress related to reduced PA. Prospective studies investigating the effects of objective markers of stress nearly all agreed (six of seven studies) that stress has a negative effect on PA. This was true for research examining (a) PA at periods of objectively varying levels of stress (i.e., final examinations vs. a control time point) and (b) chronically stressed populations (e.g., caregivers, parents of children with a cancer diagnosis) that were less likely to be active than controls over time. Studies examining older adults (>50 years), cohorts with both men and women, and larger sample sizes (n > 100) were more likely to show an inverse association. 85.7 % of higher-quality prospective research (≥ 7 on a 9-point scale) showed the same trend. Interestingly, some prospective studies (18.2 %) report evidence that PA was positively impacted by stress (behavioral activation). This should not be surprising as some individuals utilize exercise to cope with stress. Several other factors may moderate stress and PA relationships, such as stages of change for exercise. Habitually active individuals exercise more in the face of stress, and those in beginning stages exercise less. Consequently, stress may have a differential impact on exercise adoption, maintenance, and relapse. Preliminary evidence suggests that combining stress management programming with exercise interventions may allay stress-related reductions in PA, though rigorous testing of these techniques has yet to be produced. CONCLUSIONS Overall, the majority of the literature finds that the experience of stress impairs efforts to be physically active. Future work should center on the development of a theory explaining the mechanisms underlying the multifarious influences of stress on PA behaviors.
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Affiliation(s)
- Matthew A Stults-Kolehmainen
- Department of Psychiatry, Yale Stress Center, Yale University School of Medicine, 2 Church Street South, Suite 209, New Haven, CT, 06519, USA,
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Bower JE, Crosswell AD, Slavich GM. Childhood Adversity and Cumulative Life Stress: Risk Factors for Cancer-Related Fatigue. Clin Psychol Sci 2013; 2. [PMID: 24377083 DOI: 10.1177/2167702613496243] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Fatigue is a common symptom in healthy and clinical populations, including cancer survivors. However, risk factors for cancer-related fatigue have not been identified. On the basis of research linking stress with other fatigue-related disorders, we tested the hypothesis that stress exposure during childhood and throughout the life span would be associated with fatigue in breast cancer survivors. Stress exposure was assessed using the Stress and Adversity Inventory, a novel computer-based instrument that assesses for 96 types of acute and chronic stressors that may affect health. Results showed that breast cancer survivors with persistent fatigue reported significantly higher levels of cumulative lifetime stress exposure, including more stressful experiences in childhood and in adulthood, compared to a control group of nonfatigued survivors. These findings identify a novel risk factor for fatigue in the growing population of cancer survivors and suggest targets for treatment.
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Affiliation(s)
- Julienne E Bower
- Department of Psychology, University of California, Los Angeles ; Cousins Center for Psychoneuroimmunology and Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | | | - George M Slavich
- Cousins Center for Psychoneuroimmunology and Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
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Bower JE. Fatigue, brain, behavior, and immunity: summary of the 2012 Named Series on fatigue. Brain Behav Immun 2012; 26:1220-3. [PMID: 22964543 DOI: 10.1016/j.bbi.2012.08.009] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2012] [Revised: 08/16/2012] [Accepted: 08/16/2012] [Indexed: 01/09/2023] Open
Abstract
The focus on fatigue for the 2012 Named Series in brain, behavior, and immunity reflects the growing wave of research examining immune underpinnings of fatigue in healthy and clinical populations. Fatigue is prevalent in the general population and in patients with a variety of medical conditions. However, the etiology of fatigue remains elusive. Psychoneuroimmunological approaches to fatigue have yielded important advances in our understanding of this complex symptom and are represented in the twelve articles included in the Named Series. These articles include animal and human models of fatigue and cross a variety of different medical conditions, including cancer, chronic fatigue syndrome, and diabetes. This review briefly summarizes the articles included in the series and highlights the themes that have emerged from this body of work.
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Affiliation(s)
- Julienne E Bower
- UCLA Department of Psychology, 1285 Franz Hall, Los Angeles, CA 90095-1563, USA.
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