1
|
Schultchen D, Küchler AM, Schillings C, Weineck F, Karabatsiakis A, Ebert DD, Baumeister H, Pollatos O. Effectiveness of a guided online mindfulness-focused intervention in a student population: Study protocol for a randomised control trial. BMJ Open 2020; 10:e032775. [PMID: 32209621 PMCID: PMC7202707 DOI: 10.1136/bmjopen-2019-032775] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 02/07/2020] [Accepted: 03/04/2020] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Previous studies show that university students experience higher psychological stress than the general population, resulting in increased vulnerability for mental disorders for the student population. Online mindfulness interventions will be delivered to students as a potentially promising and more flexible approach compared to face-to-face interventions with the aim of improving their mental health. This study purposes to investigate the effectiveness of a guided online mindfulness-focused intervention for university students by using both self-reported and psychobiological measures. METHODS AND ANALYSES In this multicentre, two-armed randomised controlled trial with a parallel design, a guided version of the online mindfulness-focused intervention 'StudiCare Mindfulness' will be compared with a waitlist control group. In total, 120 participants will be recruited at different universities (of Applied Sciences) in (Neu-) Ulm. Data will be assessed prior to randomisation, after eight weeks (post-intervention) and six months after randomisation (follow-up). The primary outcome measure is mindfulness. The secondary outcome measures include depression, anxiety and stress levels, well-being, interoceptive sensibility, emotion regulation and alexithymia. Psychobiological parameters comprise interoceptive accuracy, hair cortisol and FKBP5 genotype. Sociodemographic variables, treatment expectations, side and adverse side effects, as well as intervention satisfaction and adherence will be assessed. All data analyses will be conducted according to the intention-to-treat principle. ETHICS AND DISSEMINATION All study procedures have been approved by the Ethics Committee of Ulm University (application No. 48/18). The findings will be disseminated widely through peer-reviewed publications and conference presentations. TRIAL REGISTRATION NUMBER DRKS00014701.
Collapse
Affiliation(s)
- Dana Schultchen
- Department of Clinical & Health Psychology, Ulm University, Ulm, Baden-Württemberg, Germany
| | - Ann-Marie Küchler
- Department of Clinical Psychology & Psychotherapy, Ulm University, Ulm, Baden-Württemberg, Germany
| | - Christine Schillings
- Department of Clinical & Health Psychology, Ulm University, Ulm, Baden-Württemberg, Germany
| | - Felicitas Weineck
- Department of Clinical & Health Psychology, Ulm University, Ulm, Baden-Württemberg, Germany
| | | | - David D Ebert
- Department of Clinical, Neuro- & Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Harald Baumeister
- Department of Clinical Psychology & Psychotherapy, Ulm University, Ulm, Baden-Württemberg, Germany
| | - Olga Pollatos
- Department of Clinical & Health Psychology, Ulm University, Ulm, Baden-Württemberg, Germany
| |
Collapse
|
2
|
Takeshita RSC, Mendonça RS, Bercovitch FB, Huffman MA. Developmental changes in the endocrine stress response in orangutans (Pongo pygmaeus). J Comp Physiol B 2019; 189:659-72. [DOI: 10.1007/s00360-019-01235-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 07/16/2019] [Accepted: 09/12/2019] [Indexed: 12/11/2022]
|
3
|
McIntosh R, Antoni M, Seay J, Fletcher MA, Ironson G, Klimas N, Kumar M, Schneiderman N. Associations Among Trajectories of Sleep Disturbance, Depressive Symptomology and 24-Hour Urinary Cortisol in HIV+ Women Following a Stress Management Intervention. Behav Sleep Med 2019; 17:605-620. [PMID: 29461096 DOI: 10.1080/15402002.2018.1435545] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Objective: The burden of sleep disturbance and depressive symptomology is high for persons living with HIV and particularly so for women. While cognitive behavioral stress management (CBSM) is shown to reduce symptoms of depression and 24-hr urinary free cortisol output (CORT) in HIV+ men, less is known about the effects of CBSM on mood and concomitant sleep disturbance in HIV+ women. The study aim is to model longitudinal change in sleep disturbance, depressive symptomology, and CORT for HIV+ women exposed to a 12-week CBSM intervention or control condition. Methods: Self-reported sleep quality and depressive symptomology, along with CORT, was collected from surveys at baseline and approximately every three months thereafter for nine months from 130 HIV+ women (Mage = 38.44, SD = 7.73). The data was used to specify a parallel process latent growth model with CORT as a time-varying covariate. Results: The model showed acceptable fit. There was a linear decline in sleep disturbance (β = -0.32, p < .05) and logarithmic decline in depressive symptomology (β = -0.33, p < .05) for those receiving the intervention. Decline in sleep disturbance predicted lower CORT at nine months. Furthermore, having less depressive symptoms at baseline was associated with lower initial levels of sleep disturbance and greater improvement in sleep quality over time. There was no discernible association between sleep and mood disturbance in the control group. Across groups, there was a consistent association between older age and greater sleep disturbance (r = 0.34, p < .01). Conclusion: Sleep disturbance appears to be a behavioral target for CBSM in HIV+ women although older age, preintervention levels of depressive mood, and time-varying levels of CORT output may limit improvement in sleep quality over time.
Collapse
Affiliation(s)
- Roger McIntosh
- a Department of Psychology, University of Miami , Coral Gables , Florida , USA
| | - Michael Antoni
- a Department of Psychology, University of Miami , Coral Gables , Florida , USA.,b Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami , Miami , Florida , USA.,e Departments of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine , Miami , Florida , USA
| | - Julia Seay
- b Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami , Miami , Florida , USA
| | - Mary Ann Fletcher
- c Miami Veterans Affairs Medical Center , Miami , Florida , USA.,d Institute for Neuro-immune Medicine, Nova Southeastern University , Davie , Florida , USA
| | - Gail Ironson
- a Department of Psychology, University of Miami , Coral Gables , Florida , USA
| | - Nancy Klimas
- c Miami Veterans Affairs Medical Center , Miami , Florida , USA.,d Institute for Neuro-immune Medicine, Nova Southeastern University , Davie , Florida , USA
| | - Mahendra Kumar
- e Departments of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine , Miami , Florida , USA
| | - Neil Schneiderman
- a Department of Psychology, University of Miami , Coral Gables , Florida , USA.,c Miami Veterans Affairs Medical Center , Miami , Florida , USA.,f Behavioral Medicine Research Center, Miller School of Medicine, University of Miami , Miami , Florida , USA
| |
Collapse
|
4
|
|
5
|
Cao Z(, Wemm SE, Han L, Spink DC, Wulfert E. Noninvasive determination of human cortisol and dehydroepiandrosterone sulfate using liquid chromatography-tandem mass spectrometry. Anal Bioanal Chem 2019; 411:1203-10. [DOI: 10.1007/s00216-018-1549-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 11/30/2018] [Accepted: 12/13/2018] [Indexed: 10/27/2022]
|
6
|
Lee DS, Jo HG, Kim MJ, Lee H, Cheong SH. Antioxidant and Anti-Stress Effects of Taurine Against Electric Foot-Shock-Induced Acute Stress in Rats. Adv Exp Med Biol 2019; 1155:185-196. [PMID: 31468397 DOI: 10.1007/978-981-13-8023-5_17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
In the present study, we evaluated the antioxidant and anti-stress activities of taurine in electric foot-shock stress model rats. Taurine supplementation markedly increased the hepatic glutathione (GSH) levels, compared to the levels in the stress group. In addition, activities of antioxidant enzymes such as catalase (CAT), glutathione peroxidase (GPx) and glutathione-S-transferase (GST) were improved in the taurine-treated group. Plasma cortisol and dehydroepiandrosterone-sulfate (DHEA-S) levels were significantly reduced in the taurine-supplemented group compared to those in the stress group. In contrast, the levels of 5-hydroxytryptamine (5-HT) and 5-hydroxyindoleacetic acid (5-HIAA) were markedly increased in the taurine or betaine-treated group compared to those in the stress group. It may be concluded that taurine produces beneficial effects in the form of antioxidant status and biochemical alterations in foot-shock-induced acute stress in rats.
Collapse
Affiliation(s)
- Dong-Sung Lee
- College of Pharmacy, Chosun University, Dong-gu, Gwangju, Republic of Korea
| | - Hee Geun Jo
- Department of Marine Bio-Food Sciences, Chonnam National University, Yeosu, Republic of Korea
| | - Min Ji Kim
- Department of Marine Bio-Food Sciences, Chonnam National University, Yeosu, Republic of Korea
| | - Hwan Lee
- College of Pharmacy, Chosun University, Dong-gu, Gwangju, Republic of Korea
| | - Sun Hee Cheong
- Department of Marine Bio-Food Sciences, Chonnam National University, Yeosu, Republic of Korea.
| |
Collapse
|
7
|
Abstract
A hypothesis suggests that objects with a high degree of visual similarity to real humans trigger negative impressions (i.e., the uncanny valley). Previous studies have suggested that difficulty in object categorization elicits negative emotional reactions to enable the avoidance of potential threats. The present study further investigated this categorization-difficulty hypothesis. In an experiment, observers categorized morphed images of photographs and human doll faces as "photograph" or "doll" and evaluated the perceived eeriness of the images. Additionally, we asked the observers to answer questionnaires on behavioral inhibition systems (BIS). The results indicated that individual differences in the BIS score were associated with enhanced eeriness in the objects with a specific human likeness. These findings suggest that the tendency to avoid a potentially threatening novel experience contributes to promoting the perceived eeriness of objects with some degree of visual similarity to real humans.
Collapse
Affiliation(s)
- Kyoshiro Sasaki
- Faculty of Science and Engineering, Waseda University, Tokyo, Japan
- Faculty of Arts and Science, Kyushu University, Fukuoka, Japan
- Japan Society for the Promotion of Science, Tokyo, Japan
| | - Keiko Ihaya
- Admission Center, Kyushu University, Fukuoka, Japan
| | - Yuki Yamada
- Faculty of Arts and Science, Kyushu University, Fukuoka, Japan
| |
Collapse
|
8
|
Cronjé FJ, Sommers LS, Faulkner JK, Meintjes WAJ, Van Wijk CH, Turner RP. Effect of a Faith-Based Education Program on Self-Assessed Physical, Mental and Spiritual (Religious) Health Parameters. J Relig Health 2017; 56:89-108. [PMID: 26387116 DOI: 10.1007/s10943-015-0129-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The aim of the study was to determine the effect of attending a faith-based education program (FBEP) on self-assessed physical, mental and spiritual health parameters. The study was designed as a prospective, observational, cohort study of individuals attending a 5-day FBEP. Out of 2650 sequential online registrants, those previously unexposed to the FBEP received automated invitations to complete 5 sequential Self-Assessment Questionnaire's (SAQ's) containing: (1) Duke University Religion Index (DUREL); (2) Negative Religious Coping (N-RCOPE); (3) Perceived Stress Scale (PSS); (4) Center for Epidemiology and Statistics-Depression Scale (CES-D); (5) Brief Illness Perception Questionnaire (BIPQ); and the (6) State Trait Anxiety Inventory (STAI). Pre-attendance SAQ (S1) was repeated immediately post-FBEP (S2), at 30 days (S3), 90 days (S4) and after 1 year (S5). Of 655 invited, 274 (42 %) succeeded, 242 (37 %) failed and 139 (21 %) declined to complete S1. Of the 274, 37 (14 %) were excluded at on-site interview; 26 (9 %) never attended the FBEP (i.e., controls: 5♂; 21♀; 27-76 years); and 211 (77 %) participated (i.e., cases: 105♂; 106♀; 18-84 years) and were analyzed over time: 211 (S1); 192 (S2); 99 (S3); 52 (S4); 51 (S5). IRB approval was via the Human Research Ethics Committee of Stellenbosch University. DUREL showed significant, sustained changes in Intrinsic Religiosity. N-RCOPE showed significant, lasting improvement. In others, median values dropped significantly immediately after the FBEP (S1:S2) for STAI-State p < 0.0001; PSS p < 0.0001; BIPQ p < 0.0001; and CES-D p < 0.0001; and at 1 month (S1:S3) for STAI-Trait p < 0.001; all changes were sustained (S3 through S5). This FBEP produced statistically and clinically significant changes; these lasted in those followed up >1 year.
Collapse
Affiliation(s)
- Frans J Cronjé
- Department of Interdisciplinary Health Sciences, Faculty of Health Sciences, University of Stellenbosch, Parow, South Africa.
- Division of Community Health, Faculty of Medicine, University of Stellenbosch, Room 0073 (Baromedical Facility); Education Building, Francie van Zijl Drive, Tygerberg Campus, Parow, 7500, South Africa.
| | | | | | - W A J Meintjes
- Department of Interdisciplinary Health Sciences, Faculty of Health Sciences, University of Stellenbosch, Parow, South Africa.
- Division of Community Health, Faculty of Medicine, University of Stellenbosch, Room 0073 (Baromedical Facility); Education Building, Francie van Zijl Drive, Tygerberg Campus, Parow, 7500, South Africa.
| | - Charles H Van Wijk
- South African Military Health Service, Institute for Maritime Medicine, Simon's Town, South Africa
| | - Robert P Turner
- Division of Biostatistics and Epidemiology, MUSC, Charleston, SC, USA
| |
Collapse
|
9
|
Qiao S, Li X, Zilioli S, Chen Z, Deng H, Pan J, Guo W. Hair Measurements of Cortisol, DHEA, and DHEA to Cortisol Ratio as Biomarkers of Chronic Stress among People Living with HIV in China: Known-Group Validation. PLoS One 2017; 12:e0169827. [PMID: 28095431 PMCID: PMC5240944 DOI: 10.1371/journal.pone.0169827] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Accepted: 12/23/2016] [Indexed: 12/29/2022] Open
Abstract
Background Existing literature suggests that endocrine measures, including the steroid hormones of cortisol and Dehydroepiandrosterone (DHEA), as well as the DHEA to cortisol ratio in the human hair can be used as promising biomarkers of chronic stress among humans. However, data are limited regarding the validity of these measures as biomarkers of chronic stress among people living with HIV (PLWH), whose endocrine system or hypothalamic pituitary adrenal (HPA) axis may be affected by HIV infection and/or antiretroviral therapy (ART) medications. Method Using hair sample data and self-reported survey from 60 PLWH in China, we examined the validity of three endocrine measures among Chinese PLWH using a known-groups validation strategy. High-stress group (n = 30) and low-stress group (n = 30) of PLWH were recruited through individual assessment interviews by a local licensed psychologist. The endocrine measures in hair were extracted and assessed by LC-APCI-MS/MS method. Both bivariate and multivariate analyses were conducted to examine the associations between the endocrine measures and the stress level, and to investigate if the associations differ by ART status. Results The levels of endocrine measures among Chinese PLWH were consistent with existing studies among PLWH. Generally, this pilot study confirmed the association between endocrine measures and chronic stress. The high stress group showed higher level hair cortisol and lower DHEA to cortisol ratio. The higher stress group also reported higher scores of stressful life events, perceived stress, anxiety and depression. Hair cortisol level was positively related to anxiety; DHEA was negatively associated with stressful life events; and the DHEA to cortisol ratio was positively related to stressful life events and perceived stress. ART did not affect the associations between the endocrine measures and stress level. Conclusions Our findings suggest that hair cortisol and DHEA to cortisol ratio can be used as promising biomarkers of chronic stress among PLWH. Clarifying the role of steroid hormones in the psychoimmunology of PLWH may yield important implications for clinical practice and psychological intervention.
Collapse
Affiliation(s)
- Shan Qiao
- Department of Health Promotion Education and Behavior, School of Public Health, University of South Carolina, Columbia, South Carolina, United States of America
| | - Xiaoming Li
- Department of Health Promotion Education and Behavior, School of Public Health, University of South Carolina, Columbia, South Carolina, United States of America
| | - Samuele Zilioli
- Department of Psychology, Wayne State University, Detroit, Michigan, United States of America
| | - Zheng Chen
- Research Center for Learning Science, Southeast University, Nanjing, China
| | - Huihua Deng
- Research Center for Learning Science, Southeast University, Nanjing, China
| | - Juxian Pan
- Beihai Center of Disease Control and Prevention, Beihai, Guangxi, China
| | - Weigui Guo
- Beihai Center of Disease Control and Prevention, Beihai, Guangxi, China
| |
Collapse
|
10
|
Abstract
BACKGROUND Asymptomatic in its early stages, glaucoma is the second leading cause of blindness worldwide. While psychosocial factors are taken into consideration for a host of diseases such as cancer, heart disease and autoimmune conditions, to date, psychological issues have been ignored in the clinical management of glaucoma. OBJECTIVE This work reviews the most relevant contributions from a health psychology perspective for the assessment and treatment of glaucoma, which is emerging in the field of psycho-ophthalmology. METHOD To provide scientific evidence regarding contributions of psychology to the comprehension of glaucoma, a bibliographic review of three databases (Psicodoc, PsycInfo and Medline) was conducted, spanning the period between 1940 and 2016. RESULTS This review yielded a total of 66 studies published in the period analysed and identified three areas where health psychology has made substantive contributions to glaucoma screening, monitoring and treatment: the emotional impact on patients suffering from glaucoma, the adherence to treatment and the effects of stress on intraocular pressure. CONCLUSIONS A health psychology approach for research and therapy of glaucoma must focus on the management of the negative affect associated with the diagnosis, the optimisation of treatment adherence and the stress management of the intraocular pressure measurements.
Collapse
Affiliation(s)
- Jorge Luis Méndez-Ulrich
- a Faculty of Psychology, Research Group on Stress and Health, Department of Basic, Developmental and Educational Psychology , Universitat Autònoma de Barcelona , Catalonia , Spain
| | - Antoni Sanz
- a Faculty of Psychology, Research Group on Stress and Health, Department of Basic, Developmental and Educational Psychology , Universitat Autònoma de Barcelona , Catalonia , Spain
| |
Collapse
|
11
|
Abstract
Despite the increasing use of psychophysiological measures to investigate social and interpersonal phenomena, few studies of adult romantic attachment have taken advantage of this approach. In this article I argue for a biologically-specific, theory-based integration of psychophysiological measures into adult attachment research. This approach would help elucidate the normative psychobiological properties of the attachment system, which have received little study in humans. Specifically, it would allow researchers to test targeted hypotheses regarding affect and arousal regulation in attachment relationships. I provide a general introduction to 2 biological systems that hold particular promise for adult attachment research: the parasympathetic branch of the autonomic nervous system and the hypothalamic-pituitary-adrenocortical axis of the endocrine system. I highlight the relevance of these systems for attachment phenomena and review findings from selected social psychophysiological research. I conclude by outlining a tentative theoretical model of the psychobiology of adult attachment and identifying specific directions for future research.
Collapse
|
12
|
Sherman AC, Mosier J, Leszcz M, Burlingame GM, Ulman KH, Cleary T, Simonton S, Latif U, Hazelton L, Strauss B. Group Interventions for Patients with Cancer and HIV Disease: Part I: Effects on Psychosocial and Functional Outcomes at Different Phases of Illness. Int J Group Psychother 2015; 54:29-82. [PMID: 14986573 DOI: 10.1521/ijgp.54.1.29.40376] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Group interventions for individuals facing cancer or HIV disease have drawn considerable attention among researchers and clinicians over the past 20 years. There is growing evidence that group services may be helpful, but which interventions are most effective for participants at which phases in the trajectory of disease has been less clear. Moreover, professionals working in different intervention settings (e.g., primary prevention vs. clinical care) and different disease sites (cancer vs. HIV disease) often have little awareness of relevant advances in other fields. Efforts to integrate findings in the literature may accelerate research and advance the standard of clinical care. The current article, the first in a series of four special reports, critically evaluates the efficacy of group interventions led by professional or trained facilitators for individuals confronted by cancer or HIV, across the spectrum of illness from elevated risk through advanced disease. We examine psychosocial and functional outcomes for different interventions directed toward different patient subgroups, trace common themes, highlight limitations, and offer recommendations for further research.
Collapse
Affiliation(s)
- Allen C Sherman
- Department of Otolaryngology, University of Arkansas for Medical Sciences, USA.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
13
|
Abstract
This introduction sets out to present a series of paper about a novel perspective regarding stress and sex hormones, or what the authors within this special issue term "coupling" of hypothalamic-pituitary-adrenal and--gonadal axes. This view postulates that these axes do not necessarily operate in opposition, but can operate together as evidenced empirically as a positive within-person association between stress hormones like cortisol or sex hormones like testosterone. A wealth of papers within the special issue demonstrate positive coupling across acute, diurnal, basal, and longitudinal timeframes and across several different types of contexts. Reviews were meant to challenge whether this was physiologically plausible. Consistently, sophisticated statistical models were utilized in order to show a template for how to model positive coupling and to ensure that coupling was a within-person phenomenon. We cautiously considered positive coupling until the consistency of observing coupling was robust enough for us to consider challenging the prevailing oppositional view of these axes. We do so to acknowledge that there are contexts, moments and stages in which the function of these axes should work together: for example when contexts are both stressful and challenging or at developmental stages (like adolescence) in which the youth must grow up despite the storm and stress of youth. We hope that by putting forward a functional dual-axis approach, the field will be able to consider when and how these axes work together.
Collapse
Affiliation(s)
| | - Andrew R Dismukes
- Human Development Family Studies, Iowa State University, Ames, IA, 50011
| | | | | | - Julian G Simmons
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, 3071
| | - Georges Han
- Department of Psychology, University of California, Davis, CA, 95616
| |
Collapse
|
14
|
Abstract
In the original submission two of the authors declared a filing of a pharmaceutical patent. This does not comply with Cochrane's Commercial Sponsorship Policy. The remaining authors are unable to update the review at this time and have therefore withdrawn it from the Cochrane library. The editorial group responsible for this previously published document have withdrawn it from publication.
Collapse
Affiliation(s)
- Peter Gallagher
- University of Newcastle upon TyneSchool of Neurology, Neurobiology and PsychiatryQueen Victoria RoadNewcastle upon TyneUKNE1 4LP
| | - Navdeep Malik
- Leazes Wing, The Royal Victoria InfirmaryDepartment of PsychiatryRichardson RoadNewcastle upon TyneUKNE1 4LP
| | - James Newham
- Leazes Wing, The Royal Victoria InfirmaryDepartment of PsychiatryRichardson RoadNewcastle upon TyneUKNE1 4LP
| | - Allan H Young
- Institute of Psychiatry, King's College LondonCentre for Affective DisordersPO72, De Crespigny ParkDenmark HillLondonUKSE5 8AF
| | - I Nicol Ferrier
- University of Newcastle upon TyneDepartment of PsychiatryQueen Victoria RoadNewcastle upon TyneUKNE1 4LP
| | - Paul Mackin
- University of Newcastle upon TyneDepartment of PsychiatryQueen Victoria RoadNewcastle upon TyneUKNE1 4LP
| | | |
Collapse
|
15
|
Laudenslager ML, Simoneau TL, Kilbourn K, Natvig C, Philips S, Spradley J, Benitez P, McSweeney P, Mikulich-Gilbertson SK. A randomized control trial of a psychosocial intervention for caregivers of allogeneic hematopoietic stem cell transplant patients: effects on distress. Bone Marrow Transplant 2015; 50:1110-8. [PMID: 25961767 PMCID: PMC4527944 DOI: 10.1038/bmt.2015.104] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Revised: 03/13/2015] [Accepted: 03/18/2015] [Indexed: 01/20/2023]
Abstract
Caregivers of patients receiving allogeneic hematopoietic stem cell transplants (Allo-HSCT) serve a pivotal role in patient care but experience high stress, anxiety, and depression as a result. We theorized that a stress management adapted for Allo-HSCT caregivers would reduce distress compared to treatment as usual (TAU). From 267 consecutive caregivers of Allo-HSCT patients approached, 148 (mean=53.5 years, 75.7% female) were randomized to either psychosocial intervention (n=74) or TAU (n=74). Eight 1-on-1 stress management sessions delivered across the 100 day post-transplant period focused on understanding stress, changing role(s) as caregiver, cognitive behavioral stress management, pacing respiration, and identifying social support. Primary outcomes included perceived stress (psychological) and salivary cortisol awakening response (CAR) (physiological). Randomized groups were not statistically different at baseline. Mixed models analysis of covariance (intent-to-treat) showed that intervention was associated with significantly lower caregiver stress 3 months post-transplant (Mean=20.0, CI95=17.9-22.0) compared to TAU (Mean=23.0, CI95=21.0-25.0) with an effect size (ES) of 0.39 (p=0.039). Secondary psychological outcomes, including depression and anxiety, were significantly reduced with ESs of 0.46 and 0.66 respectively. Caregiver CAR did not differ from non-caregiving controls at baseline and was unchanged by intervention. Despite significant caregiving burden, this psychosocial intervention significantly mitigated distress in Allo-HSCT caregivers.
Collapse
Affiliation(s)
- M L Laudenslager
- Department of Psychiatry, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA
| | - T L Simoneau
- Department of Psychiatry, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA
| | - K Kilbourn
- Department of Psychology, Univerity of Colorado Denver, Denver, CO, USA
| | - C Natvig
- Department of Psychiatry, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA
| | - S Philips
- Department of Psychiatry, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA
| | - J Spradley
- 1] Presbyterian/St Luke's Medical Center, Denver, CO, USA [2] Colorado Blood Cancer Institute, Denver, CO, USA
| | - P Benitez
- Department of Psychiatry, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA
| | - P McSweeney
- 1] Presbyterian/St Luke's Medical Center, Denver, CO, USA [2] Colorado Blood Cancer Institute, Denver, CO, USA
| | - S K Mikulich-Gilbertson
- Department of Psychiatry, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA
| |
Collapse
|
16
|
Plag J, Gaudlitz K, Schumacher S, Dimeo F, Bobbert T, Kirschbaum C, Ströhle A. Effect of combined cognitive-behavioural therapy and endurance training on cortisol and salivary alpha-amylase in panic disorder. J Psychiatr Res 2014; 58:12-9. [PMID: 25085607 DOI: 10.1016/j.jpsychires.2014.07.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Revised: 06/10/2014] [Accepted: 07/11/2014] [Indexed: 01/29/2023]
Abstract
Current data point to an alteration of both the hypothalamo-pituitary-adrenal (HPA)-system and the peripheral transmission of catecholamines in anxiety disorders. There is also some evidence for the effect of several components of cognitive-behavioural interventions such as coping and control and for an effect of exercise training on the neuroendocrine stress response in healthy subjects as well as patients suffering from distinct (mental) disorders. This double-blind, controlled study investigated the effect of cognitive-behavioural therapy (CBT) in combination with either high-level endurance training or low-level exercise on salivary cortisol (sC) and on levels of salivary alpha-amylase (sAA) in patients suffering from panic disorder (PD) with and without agoraphobia. In comparison to the low-level exercise condition, there were significantly lower sC-levels in the experimental group performing high-level endurance training at a 7-month follow-up. In contrast, there were no group differences in sAA levels during the study period. In this trial, we found evidence for a decelerated effect of endurance-training on HPA-system's functioning in PD. Further studies addressing the alteration of sAA levels in this population might investigate physical exercise different in intensity and duration.
Collapse
Affiliation(s)
- Jens Plag
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Germany
| | - Katharina Gaudlitz
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Germany.
| | - Sarah Schumacher
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Germany
| | - Fernando Dimeo
- Section of Sports Medicine, Charité - Universitätsmedizin Berlin, Germany
| | - Thomas Bobbert
- Department of Endocrinology, Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Germany
| | - Clemens Kirschbaum
- Department of Biological Psychology, Technical University Dresden, Germany
| | - Andreas Ströhle
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Germany
| |
Collapse
|
17
|
Takeshita RSC, Bercovitch FB, Huffman MA, Mouri K, Garcia C, Rigaill L, Shimizu K. Environmental, biological, and social factors influencing fecal adrenal steroid concentrations in female Japanese macaques (Macaca fuscata). Am J Primatol 2014; 76:1084-93. [DOI: 10.1002/ajp.22295] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Revised: 02/23/2014] [Accepted: 03/28/2014] [Indexed: 11/10/2022]
Affiliation(s)
- Rafaela S. C. Takeshita
- Department of Ecology and Social Behavior; Primate Research Institute; Kyoto University; Inuyama Aichi Japan
| | - Fred B. Bercovitch
- Department of Ecology and Social Behavior; Primate Research Institute; Kyoto University; Inuyama Aichi Japan
| | - Michael A. Huffman
- Department of Ecology and Social Behavior; Primate Research Institute; Kyoto University; Inuyama Aichi Japan
| | - Keiko Mouri
- Department of Ecology and Social Behavior; Primate Research Institute; Kyoto University; Inuyama Aichi Japan
| | - Cécile Garcia
- Laboratoire de Dynamique de l'Evolution Humaine; CNRS UPR 2147; Paris France
| | - Lucie Rigaill
- Department of Ecology and Social Behavior; Primate Research Institute; Kyoto University; Inuyama Aichi Japan
| | - Keiko Shimizu
- Faculty of Science; Department of Zoology; Okayama University of Science; Okayama City Okayama Japan
| |
Collapse
|
18
|
Abstract
This paper presents evidence from a heterogeneous sample of 440 Spanish adults, for the reliability and validity of a European Spanish version of the Perceived Stress Scale (PSS), designed to measure the degree to which situations in one's life are appraised as stressful. The European Spanish version PSS (14-item) demonstrated adequate reliability (internal consistency, α = .81, and test-retest, r = .73), validity (concurrent), and sensitivity. Additional data indicate adequate reliability (α = .82, test-retest, r = .77), validity, and sensitivity of a 10-item short version of the PSS.
Collapse
Affiliation(s)
- Eduardo Remor
- Departamento de Psicología Biológica y de la Salud, Facultad de Psicologâia, C/Ivan Pavlov, 6, Universidad Autónoma de Madrid, Ciudad Universitaria de Cantoblanco, 28049 Madrid, Spain.
| |
Collapse
|
19
|
Abstract
It has been hypothesized that chronic psychological stress is associated with shorter telomere length; however, the mechanisms that link stress and telomere length are not well understood. To examine the interplay between biochemical factors related to stress arousal and cellular aging, we investigate the association between anabolic/catabolic (A/C) imbalance and leukocyte telomere length (LTL) in the Social Environment and Biomarkers of Aging Study (SEBAS), conducted in Taiwan (N = 925). SEBAS participants aged 54 and older (mean age 68.3) with values for two anabolic hormones (serum dehydroepiandrosterone sulfate [DHEAS] and insulin growth factor [IGF]-1), four catabolic hormones (cortisol, epinephrine, norepinephrine, and interleukin-6 [IL-6]), and LTL were examined. We found that high IL-6 was associated with short LTL (≤ 0.88 T/S ratio; odds ratio [OR] 1.41, 95% confidence interval [CI] = 1.04-1.92). Neither DHEAS/cortisol nor IGF-1/cortisol ratio was associated with telomere length; however, a high A/C imbalance summary score was associated with greater odds of having a short LTL relative to long LTL (OR 1.19, 95% CI = 1.05-1.35). These results indicate that our A/C imbalance score, defined by several anabolic and catabolic biochemical factors, may be one mechanism through which psychological stress is associated with short LTL and possibly cellular senescence.
Collapse
|
20
|
Su X, Lau JTF, Mak WWS, Choi KC, Chen L, Song J, Zhang Y, Zhao G, Feng T, Chen X, Liu C, Liu J, Liu D, Cheng J. Prevalence and associated factors of depression among people living with HIV in two cities in China. J Affect Disord 2013; 149:108-15. [PMID: 23452645 DOI: 10.1016/j.jad.2013.01.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2012] [Revised: 12/31/2012] [Accepted: 01/02/2013] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Depression has significant effects on morbidity and mortality in people living with HIV (PLWH). Current study estimated the rate of depressive disorder and identified the correlates of depressive disorder among PLWH in China. METHODS 258 PLWH in China were recruited and interviewed with a structured questionnaire including measurements testing perceived stress, social support, perceived discrimination, and depression. Mediating effect of perceived stress between perceived discrimination and depression and moderating effect of social support on effect of perceived discrimination and perceived stress to depression were tested. Multivariate regression was used to examine the determinants of depression. RESULTS The prevalence of mild to severe depression is 71.9%. The relationship between the perceived discrimination and depression is fully mediated by perceived stress (perceived discrimination that was statistically significant (β=0.153) to depression became non-significant after adding perceived stress in the regression model). Interaction term between social support and perceived stress has negative effects (β=-0.117) and explained a significant amount of variance (R(2)=0.018) in depression. Lower income, and higher perceived stress predicted more depressive symptoms. LIMITATIONS Cross-sectional study and self-report bias are major limitations of this study. CONCLUSION Depression among PLWH is a severe problem in China. Primary health care workers need to be trained in recognition and treatment in depression. Stress management skills and social support for PLWH are warranted.
Collapse
Affiliation(s)
- Xiaoyou Su
- Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
21
|
Chen Z, Li J, Zhang J, Xing X, Gao W, Lu Z, Deng H. Simultaneous determination of hair cortisol, cortisone and DHEAS with liquid chromatography–electrospray ionization-tandem mass spectrometry in negative mode. J Chromatogr B Analyt Technol Biomed Life Sci 2013; 929:187-94. [DOI: 10.1016/j.jchromb.2013.04.026] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Revised: 04/18/2013] [Accepted: 04/19/2013] [Indexed: 11/30/2022]
|
22
|
Bleil ME, Adler NE, Pasch LA, Sternfeld B, Gregorich SE, Rosen MP, Cedars MI. Psychological stress and reproductive aging among pre-menopausal women. Hum Reprod 2012; 27:2720-8. [PMID: 22767452 DOI: 10.1093/humrep/des214] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Life history models suggest that biological preparation for current versus longer term reproduction is favored in environments of adversity. In this context, we present a model of reproductive aging in which environmental adversity is proposed to increase the number of growing follicles at the cost of hastening the depletion of the ovarian reserve over time. We evaluated this model by examining psychological stress in relation to reproductive aging indexed by antral follicle count (AFC), a marker of total ovarian reserve. We hypothesized that stress would be related to (i) higher AFC in younger women, reflecting greater reproductive readiness as well as (ii) greater AFC loss across women, reflecting more accelerated reproductive aging. METHODS In a multi-ethnic, community sample of 979 participants [ages 25-45 (mean (standard deviation) = 35.2 (5.5)); 27.5% Caucasian] in the Ovarian Aging study, an investigation of the correlates of reproductive aging, the interaction of age-x-stress was assessed in relation to AFC to determine whether AFC and AFC loss varied across women experiencing differing levels of stress. Stress was assessed by the perceived stress scale and AFC was assessed by summing the total number of antral follicles visible by transvaginal ultrasound. RESULTS In linear regression examining AFC as the dependent variable, covariates (race/ethnicity, socio-economic status, menarcheal age, hormone-containing medication for birth control, parity, cigarette smoking, bodymass index, waist-to-hip ratio) and age were entered on step 1, stress on step 2 and the interaction term (age-x-stress) on step 3. On step 3, significant main effects showed that older age was related to lower AFC (b = -0.882, P = 0.000) and greater stress was related to higher AFC (b = 0.545, P = 0.005). Follow-up analyses showed that the main effect of stress on AFC was present in the younger women only. A significant interaction term (b = -0.036, P = 0.031) showed the relationship between age and AFC varied as function of stress. When the sample was divided into tertiles of stress, the average follicle loss was -0.781, -0.842 and -0.994 follicles/year in the low-, mid- and high-stress groups, respectively. CONCLUSIONS Psychological stress was related to higher AFC among younger women and greater AFC decline across women, suggesting that greater stress may enhance reproductive readiness in the short term at the cost of accelerating reproductive aging in the long term. Findings are preliminary, however, due to the cross-sectional nature of the current study.
Collapse
Affiliation(s)
- M E Bleil
- Department of Psychiatry, University of California San Francisco, 3333 California Street, San Francisco, CA 94143, USA.
| | | | | | | | | | | | | |
Collapse
|
23
|
Mohammad AAA. Resilience, burnout, and role stress among military personnel. Middle East Current Psychiatry 2012; 19:123-129. [DOI: 10.1097/01.xme.0000407820.80263.73] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
|
24
|
Ruuska PS, Hautala AJ, Kiviniemi AM, Mäkikallio TH, Tulppo MP. Self-rated mental stress and exercise training response in healthy subjects. Front Physiol 2012; 3:51. [PMID: 22416235 PMCID: PMC3298959 DOI: 10.3389/fphys.2012.00051] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2011] [Accepted: 02/26/2012] [Indexed: 12/20/2022] Open
Abstract
Purpose: Individual responses to aerobic training vary from almost none to a 40% increase in aerobic fitness in healthy subjects. We hypothesized that the baseline self-rated mental stress may influence to the training response. Methods: The study population included 44 healthy sedentary subjects (22 women) and 14 controls. The laboratory controlled training period was 2 weeks, including five sessions a week at an intensity of 75% of the maximum heart rate for 40 min/session. Self-rated mental stress was assessed by inquiry prior to the training period from 1 (low psychological resources and a lot of stressors in my life) to 10 (high psychological resources and no stressors in my life), respectively. Results: Mean peak oxygen uptake (VO2peak) increased from 34 ± 7 to 37 ± 7 ml kg−1 min−1 in training group (p < 0.001) and did not change in control group (from 34 ± 7 to 34 ± 7 ml kg−1 min−1). Among the training group, the self-rated stress at the baseline condition correlated with the change in fitness after training intervention, e.g., with the change in maximal power (r = 0.45, p = 0.002, W/kg) and with the change in VO2peak (r = 0.32, p = 0.039, ml kg−1 min−1). The self-rated stress at the baseline correlated with the change in fitness in both female and male, e.g., r = 0.44, p = 0.039 and r = 0.43, p = 0.045 for ΔW/kg in female and male, respectively. Conclusion: As a novel finding the baseline self-rated mental stress is associated with the individual training response among healthy females and males after highly controlled aerobic training intervention. The changes in fitness were very low or absent in the subjects who experience their psychological resources low and a lot of stressors in their life at the beginning of aerobic training intervention.
Collapse
Affiliation(s)
- Piritta S Ruuska
- Department of Exercise and Medical Physiology Verve, Oulu, Finland
| | | | | | | | | |
Collapse
|
25
|
Almadi T, Cathers I, Hamdan Mansour AM, Chow CM. An Arabic version of the perceived stress scale: translation and validation study. Int J Nurs Stud 2012; 49:84-9. [PMID: 21851941 DOI: 10.1016/j.ijnurstu.2011.07.012] [Citation(s) in RCA: 93] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2011] [Revised: 07/12/2011] [Accepted: 07/21/2011] [Indexed: 11/22/2022]
Abstract
BACKGROUND The Perceived Stress Scale has been designed to measure the degree to which situations in a person's life are perceived as stressful. OBJECTIVE The paper describes the development of an Arabic version of the Perceived Stress Scale. DESIGN A translation process with cross-cultural considerations was employed to produce an Arabic version of the Perceived Stress Scale. SETTINGS Participants were asked to complete the Arabic version Perceived Stress Scale twice in their homes. PARTICIPANTS The Jordanian study population for the Arabic version Perceived Stress Scale validation consisted of 126 volunteers (74 male, 52 female). Ninety participants completed the scale twice (55 male, 35 female), of whom 58 were high schools teachers and 32 technical workers. Arabic was the first language of all participants and all gave informed consent. RESULTS The Arabic version Perceived Stress Scale reliability and validity were evaluated. Prior to an exploratory factor analysis, the suitability of data for factor analysis was assessed with acceptable results. The exploratory factor analysis showed two factors with eigenvalues greater than 1.0 (45.0% of variance). The Cronbach's alpha coefficients were 0.74 (Factor 1), 0.77 (Factor 2) and 0.80 for the Arabic version Perceived Stress Scale overall. The test-retest reliability had an intra-correlation coefficient of 0.90. CONCLUSIONS The Arabic version Perceived Stress Scale showed an adequate reliability and validity. Therefore, the Arabic Perceived Stress Scale is considered a suitable instrument to assess perceived stress in Arabic people.
Collapse
|
26
|
Andreou E, Alexopoulos EC, Lionis C, Varvogli L, Gnardellis C, Chrousos GP, Darviri C. Perceived Stress Scale: reliability and validity study in Greece. Int J Environ Res Public Health 2011; 8:3287-98. [PMID: 21909307 DOI: 10.3390/ijerph8083287] [Citation(s) in RCA: 305] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/01/2011] [Revised: 07/02/2011] [Accepted: 08/04/2011] [Indexed: 11/17/2022]
Abstract
Objective: To translate the Perceived Stress Scale (versions PSS-4, −10 and −14) and to assess its psychometric properties in a sample of general Greek population. Methods: 941 individuals completed anonymously questionnaires comprising of PSS, the Depression Anxiety and Stress scale (DASS-21 version), and a list of stress-related symptoms. Psychometric properties of PSS were investigated by confirmatory factor analysis (construct validity), Cronbach’s alpha (reliability), and by investigating relations with the DASS-21 scores and the number of symptoms, across individuals’ characteristics. The two-factor structure of PSS-10 and PSS-14 was confirmed in our analysis. We found satisfactory Cronbach’s alpha values (0.82 for the full scale) for PSS-14 and PSS-10 and marginal satisfactory values for PSS-4 (0.69). PSS score exhibited high correlation coefficients with DASS-21 subscales scores, meaning stress (r = 0.64), depression (r = 0.61), and anxiety (r = 0.54). Women reported significantly more stress compared to men and divorced or widows compared to married or singled only. A strong significant (p < 0.001) positive correlation between the stress score and the number of self-reported symptoms was also noted. Conclusions: The Greek versions of the PSS-14 and PSS-10 exhibited satisfactory psychometric properties and their use for research and health care practice is warranted.
Collapse
|
27
|
Du CL, Lin MC, Lu L, Tai JJ. Correlation of Occupational Stress Index with 24-hour Urine Cortisol and Serum DHEA Sulfate among City Bus Drivers: A Cross-sectional Study. Saf Health Work 2011; 2:169-75. [PMID: 22953199 DOI: 10.5491/SHAW.2011.2.2.169] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2011] [Accepted: 05/03/2011] [Indexed: 11/08/2022] Open
Abstract
Objectives The questionnaire of occupational stress index (OSI) has been popular in the workplace, and it has been tailored for bus drivers in Taiwan. Nevertheless, its outcomes for participants are based on self-evaluations, thus validation by their physiological stress biomarker is warranted and this is the main goal of this study. Methods A cross-sectional study of sixty-three city bus drivers and fifty-four supporting staffs for comparison was conducted. Questionnaire surveys, 24-hour urine cortisol testing, and blood draws for dehydroepiandrosterone-sulfate (DHEA-S) testing were performed. The measured concentrations of these biological measures were logarithmically transformed before the statistical analysis where various scores of stressor factors, moderators, and stress effects of each OSI domain were analyzed by applying multiple linear regression models. Results For drivers, the elevated 24-hour urine cortisol level was associated with a worker's relationship with their supervisor and any life change events in the most recent 3 months. The DHEA-S level was higher in drivers of younger age as well as drivers with more concerns relating to their salary and bonuses. Non-drivers showed no association between any stressor or satisfaction and urine cortisol and blood DHEA-S levels. Conclusion Measurements of biomarkers may offer additional stress evaluations with OSI questionnaires for bus drivers. Increased DHEA-S and cortisol levels may result from stressors like income security. Prevention efforts towards occupational stress and life events and health promotional efforts for aged driver were important anti-stress remedies.
Collapse
|
28
|
Whetzel CA, Klein LC. Measuring DHEA-S in saliva: time of day differences and positive correlations between two different types of collection methods. BMC Res Notes 2010; 3:204. [PMID: 20646292 PMCID: PMC2916011 DOI: 10.1186/1756-0500-3-204] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2010] [Accepted: 07/20/2010] [Indexed: 11/23/2022] Open
Abstract
Background The anabolic steroid, dehydroepiandosterone sulfate (DHEA-S), is secreted from the adrenal cortex. It plays a significant role in the body as a precursor to sex steroids as well as a lesser known role in the hypothalamic pituitary adrenal axis (HPA) response to stress. DHEA-S can be measured reliably in saliva, making saliva collection a valuable tool for health research because it minimizes the need for invasive sampling procedures (e.g., blood draws). Typical saliva collection methods include the use of plain cotton swab collection devices (e.g., Salivette®) or passive drool. There has been some speculation that the plain saliva cotton collection device may interfere with determination of DHEA-S by enzyme immunoassay (EIA) bringing this saliva collection method into question. Because of the increasing popularity of salivary biomarker research, we sought to determine whether the cotton swab interferes with DHEA-S determination through EIA techniques. Findings Fifty-six healthy young adult men and women aged 18-30 years came to the lab in the morning (0800 hrs; 14 men, 14 women) or late afternoon (1600 hrs; 14 men, 14 women) and provided saliva samples via cotton Salivette and passive drool. Passive drool collection was taken first to minimize particle cross contamination from the cotton swab. Samples were assayed for DHEA-S in duplicate using a commercially available kit (DSL, Inc., Webster, TX). DHEA-S levels collected via Salivette and passive drool were positively correlated (r = + 0.83, p < 0.05). Mean DHEA-S levels were not significantly different between collection methods. Salivary DHEA-S levels were significantly higher in males than in females, regardless of saliva collection method (p < 0.05), and morning DHEA-S values were higher than evening levels (p < 0.05). Conclusions Results suggest that DHEA-S can be measured accurately using passive drool or cotton Salivette collection methods. Results also suggest that DHEA-S levels change across the day and that future studies need to take this time of day difference into account when measuring DHEA-S.
Collapse
Affiliation(s)
- Courtney A Whetzel
- Biobehavioral Health Department, 315 East Health and Human Development Building, The Pennsylvania State University, University Park, PA, USA.
| | | |
Collapse
|
29
|
Jahnke RA, Larkey LK, Rogers C. Dissemination and Benefits of a Replicable Tai Chi and Qigong Program for Older Adults. Geriatr Nurs 2010; 31:272-80. [DOI: 10.1016/j.gerinurse.2010.04.012] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2009] [Revised: 04/19/2010] [Accepted: 04/23/2010] [Indexed: 11/26/2022]
|
30
|
Chittiprol S, Kumar AM, Shetty KT, Kumar HR, Satishchandra P, Rao RSB, Ravi V, Desai A, Subbakrishna DK, Philip M, Satish KS, Kumar M. HIV-1 clade C infection and progressive disruption in the relationship between cortisol, DHEAS and CD4 cell numbers: a two-year follow-up study. Clin Chim Acta 2009; 409:4-10. [PMID: 19576195 DOI: 10.1016/j.cca.2009.06.032] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2008] [Revised: 06/19/2009] [Accepted: 06/22/2009] [Indexed: 10/20/2022]
Abstract
BACKGROUND It is well established that there is mutual interaction between the neuroendocrines and immune systems and that the disturbance in any one system could affect the function of the other. While there is a large body of evidence suggesting negative impact of human immunodeficiency virus type 1B (HIV-1B) infection on both immune and neuroendocrine systems, the consequence of HIV-1 clade C infection (with structural differences from HIV-1B virus) on these systems is not clearly understood. METHODS We carried out a 2-year longitudinal study on plasma profile of adrenocorticosteroids, including cortisol and DHEAS and their relationship with declining CD4+ cell counts in neurologically asymptomatic HIV-C infected individuals (N=84) in order to understand the impact of HIV-1 clade C infection on adrenocortical dysfunction and its relationship with the progressive decline in the cell mediated immunity. RESULTS We found that while plasma cortisol levels increased significantly at baseline in HIV-1C infected individuals compared to those in HIV-negative controls (HIV-1C+, 9.83+/-0.39 vs controls, 8.04+/-0.45; p<0.01), there was a significant decrease in DHEAS in HIV-1C+ individuals, compared to that in HIV-negative controls (81.02+/-4.9 vs 185.1+/-12.03, p<0.001), and consequently a significant increase in cortisol:DHEAS ratio in HIV-1 clade C infected persons (0.19+/-0.002 vs control 0.058+/-0.006; p<0.001). Moreover, in HIV-1C infected individuals, there was a strong positive correlation between DHEAS and CD4 cells (r=0.2; p<0.05), and a strong negative correlation between cortisol, as well as cortisol:DHEAS ratio and CD4 cells (r=-0.25; p<0.01; and r=-0.31; p<0.001, respectively). CONCLUSIONS These findings suggest the persistent and progressive adrenocortical dysfunction during the asymptomatic phase of HIV infection, and that the evaluation of increase in plasma cortisol, a decrease in DHEAS, and an increase in cortisol:DHEAS ratio may serve as important biomarkers preceding the impending down regulation of CD4 cell counts and progressive decline in the immune system function in HIV-1C infection. Furthermore, these findings may indicate the dysregulation of 3beta-hydroxysteroid dehydrogenase (3beta-HSD) activity, the enzyme involved in the biosynthesis of cortisol and DHEA through the pregnenolone-progesterone pathway, and that it may offer an opportunity for drug discovery targeting re-regulation of 3beta-HSD activity for potential therapeutic application in HIV-1C infection.
Collapse
Affiliation(s)
- Seetharamaiah Chittiprol
- Department of Neurochemistry, National Institute of Mental Health and Neuro Sciences, Bangalore, Karnataka, India.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
31
|
Su X, Lau JT, Mak WW, Chen L, Feng T, Chen X, Liu C, Liu J, Liu D, Cheng J. Development of the perceived stress scale for people living with HIV/AIDS in China. AIDS Patient Care STDS 2008; 22:989-98. [PMID: 19072105 DOI: 10.1089/apc.2008.0095] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Stress among people living with HIV/AIDS (PLWHA) is associated with psychological morbidity. There are only a few stress scales specially developed for PLWHA and none of them is in Chinese. This study develops and validates a new Chinese Perceived Stress Scale among PLWHA (PSSHIV) in Shenzhen of Guangdong Province and Hengyang of Hunan Province in China during September 2006 through July 2007. In-depth interviews were administered to 58 PLWHA (33 males, mean age, 32) to generate the items, while 215 other PLWHA were interviewed in another survey to validate the instrument (136 males, mean age, 33). Exploratory factor analysis yielded 8 factors (percent variance explained, 71.47%), namely: social/psychological problems, sexual relationship, functional problems, social acceptance/rejection issues, work-related issues, family/offspring issues, accessibility to treatment, and treatment outcomes. The Cronbach alpha values ranged from 0.76 to 0.94 for the overall scale and the 8 subscales. The scores of the overall scale, the social/psychological problems, and functional problems subscales of the PSSHIV were significantly correlated with the Perceived Stress Scale (PSS), Depression, Anxiety and Stress Scale (DASS), and all domains of the Medical Outcomes Study HIV Health Survey (MOS-HIV) (correlation coefficient = 0.50 to 0.71 for positive correlations, and -0.73 to -0.21 for negative correlations, p < 0.05). The other 6 subscales of the PSSHIV were significantly correlated with the PSS, subscales of the DASS, and MOS-HIV (correlation coefficient = 0.16 to 0.39 for positive correlation, -0.58 to -0.15 for negative correlation, p < 0.05). This new instrument collected information from the PLWHA from qualitative interviews and the items are specific to the HIV/AIDS context. PSSHIV can be used for assessing the level of stress faced by PLWHA in China.
Collapse
Affiliation(s)
- Xiaoyou Su
- School of Public Health, The Chinese University of Hong Kong, Hong Kong
| | - Joseph T.F. Lau
- School of Public Health, The Chinese University of Hong Kong, Hong Kong
| | - Winnie W.S. Mak
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong
| | - Lin Chen
- Shenzhen City CDC, Shenzhen, China
| | - Tiejian Feng
- Shenzhen Chronic Disease Hospital, Shenzhen, China
| | - Xi Chen
- Hunan Province CDC, ChaSa, Chang Sha, China
| | - Chuliang Liu
- Hengyang City CDC, Hunan Province, Hengyang, China
| | - Jun Liu
- Hengyang City CDC, Hunan Province, Hengyang, China
| | - De Liu
- The 5th Hospital, Hengyang, Hunan Province, Hengyang, China
| | | |
Collapse
|
32
|
Scott-Sheldon LAJ, Kalichman SC, Carey MP, Fielder RL. Stress management interventions for HIV+ adults: a meta-analysis of randomized controlled trials, 1989 to 2006. Health Psychol 2008; 27:129-39. [PMID: 18377131 DOI: 10.1037/0278-6133.27.2.129] [Citation(s) in RCA: 150] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Numerous studies document that stress accelerates disease processes in a variety of diseases including HIV. As a result, investigators have developed and evaluated interventions to reduce stress as a means to improve health among persons living with HIV. Therefore, the current meta-analysis examines the impact of stress-management interventions at improving psychological, immunological, hormonal, and other behavioral health outcomes among HIV+ adults. DESIGN This meta-analytic review integrated the results of 35 randomized controlled trials examining the efficacy of 46 separate stress management interventions for HIV+ adults (N=3,077). MAIN OUTCOME MEASURES Effect sizes were calculated for stress processes (coping and social support), psychological/psychosocial (anxiety, depression, distress, and quality of life), immunological (CD4+ counts and viral load), hormonal (cortisol, dehydroepiandrosterone sulfate [DHEA-S], cortisol/DHEA-S ratio, and testosterone) and other behavioral health outcomes (fatigue). RESULTS Compared to controls, stress-management interventions reduce anxiety, depression, distress, and fatigue and improve quality of life (d+s=0.16 to 0.38). Stress-management interventions do not appear to improve CD4+ counts, viral load, or hormonal outcomes compared with controls. CONCLUSION Overall, stress-management interventions for HIV+ adults significantly improve mental health and quality of life but do not alter immunological or hormonal processes. The absence of immunological or hormonal benefits may reflect the studies' limited assessment period (measured typically within 1-week postintervention), participants' advanced stage of HIV (HIV+ status known for an average of 5 years), and/or sample characteristics (predominately male and White participants). Future research might test these hypotheses and refine our understanding of stress processes and their amelioration.
Collapse
|
33
|
Carrico AW, Antoni MH. Effects of psychological interventions on neuroendocrine hormone regulation and immune status in HIV-positive persons: a review of randomized controlled trials. Psychosom Med 2008; 70:575-84. [PMID: 18541907 DOI: 10.1097/PSY.0b013e31817a5d30] [Citation(s) in RCA: 118] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
We reviewed randomized controlled trials (RCTs) that examined the effects of psychological interventions on HIV disease markers including neuroendocrine hormone regulation and immune status. Utilizing both PubMed and PsycINFO, we searched for RCTs published over the past 20 years (1987-2007). Of the 31 RCTs identified, 14 tested effects of psychological interventions on neuroendocrine regulation or immune status. Despite the fact that there are significant methodological limitations of RCTs that have been conducted to date, psychological interventions for HIV-positive persons have been shown to be efficacious in improving psychological adjustment compared with wait-list or treatment as usual control conditions. However, there is little support for differential efficacy of group-based interventions that have been tested to date, even in comparison with semistructured social support groups. Irrespective of the treatment modality, it seems that interventions that are successful in improving psychological adjustment are more likely to have salutary effects on neuroendocrine regulation and immune status. Psychological interventions represent a viable adjuvant treatment that can assist patients with improving psychological adjustment and potentially enhancing immune status. To inform the development of innovative treatments with potentially superior efficacy, deconstruction trials are necessary to examine the effects of distinct components of multimodal psychological interventions compared with nonspecific social support effects. Effectiveness trials of promising psychological interventions with more representative samples of HIV-positive persons are also needed to provide more definitive information on the clinical utility and potential cost-effectiveness of treatments that have been developed to date.
Collapse
|
34
|
Berger S, Schad T, von Wyl V, Ehlert U, Zellweger C, Furrer H, Regli D, Vernazza P, Ledergerber B, Battegay M, Weber R, Gaab J. Effects of cognitive behavioral stress management on HIV-1 RNA, CD4 cell counts and psychosocial parameters of HIV-infected persons. AIDS 2008; 22:767-75. [PMID: 18356607 DOI: 10.1097/QAD.0b013e3282f511dc] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To determine the effects of cognitive-behavioral stress management (CBSM) training on clinical and psychosocial markers in HIV-infected persons. METHODS A randomized controlled trial in four HIV outpatient clinics of 104 HIV-infected persons taking combination antiretroviral therapy (cART), measuring HIV-1 surrogate markers, adherence to therapy and well-being 12 months after 12 group sessions of 2 h CBSM training. RESULTS Intent-to-treat analyses showed no effects on HIV-1 surrogate markers in the CBSM group compared with the control group: HIV-1 RNA < 50 copies/ml in 81.1% [95% confidence interval (CI), 68.0-90.6] and 74.5% (95% CI, 60.4-85.7), respectively (P = 0.34), and mean CD4 cell change from baseline of 53.0 cells/microl (95% CI, 4.1-101.8) and 15.5 cells/microl (95% CI, -34.3 to 65.4), respectively (P = 0.29). Self-reported adherence to therapy did not differ between groups at baseline (P = 0.53) or at 12 month's post-intervention (P = 0.47). Significant benefits of CBSM over no intervention were observed in mean change of quality of life scores: physical health 2.9 (95% CI, 0.7-5.1) and -0.2 (95% CI, -2.1 to 1.8), respectively (P = 0.05); mental health 4.8 (95% CI, 1.8-7.3) and -0.5 (95% CI, -3.3 to 2.2) (P = 0.02); anxiety -2.1 (95% CI, -3.6 to -1.0) and 0.3 (95% CI, -0.7 to 1.4), respectively (P = 0.002); and depression -2.1 (95% CI, -3.2 to -0.9) and 0.02 (95% CI, -1.0 to 1.1), respectively (P = 0.001). Alleviation of depression and anxiety symptoms were most pronounced among participants with high psychological distress at baseline. CONCLUSION CBSM training of HIV-infected persons taking on cART does not improve clinical outcome but has lasting effects on quality of life and psychological well-being.
Collapse
|
35
|
Chang BH, Boehmer U, Zhao Y, Sommers E. The combined effect of relaxation response and acupuncture on quality of life in patients with HIV: a pilot study. J Altern Complement Med 2008; 13:807-15. [PMID: 17983336 DOI: 10.1089/acm.2007.7024] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Treatment advances have transformed human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) into a chronic manageable disease; quality of life (QoL) has become an important health outcome. Some studies have shown the individual effects of acupuncture and the relaxation response (RR) in improving QoL of patients with HIV/AIDS. In light of the presumed shared features of acupuncture and the RR, we conducted a pilot study to examine the effects of adding the RR to usual acupuncture treatment on improving the QoL of HIV/AIDS patients. DESIGN Two-arm double-blind randomized controlled trial. SETTINGS/LOCATION AND SUBJECTS: We enrolled 119 patients with HIV/AIDS (mean age 46 years, 85% male) who had at least 1 of the highly prevalent HIV-related symptoms and who were receiving acupuncture treatment in an acupuncture clinic in Boston, MA. INTERVENTION We randomized patients into intervention (N = 58) and control (N = 61) groups. All participants received individualized acupuncture treatments prescribed by their acupuncturists. While receiving acupuncture treatment, the intervention group wore earphones to listen to tapes with instructions to elicit the RR followed by soft music that was routinely played in the clinic; the control group listened only to soft music. OUTCOME MEASURES Three (3) QoL scales: the Medical Outcomes Study HIV health survey, the Functional Assessment of HIV Infection, and the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being, measured at baseline, 4-week, 8-week, and 12-week follow-ups. RESULTS At the 12-week follow-up, the intervention group showed significant improvements in emotional (p = 0.0002), spiritual/peace (p = 0.02), physical (p = 0.003) and mental health (p = 0.0003) QoL from baseline. Results of mixed effects regression models indicated linear trends of improvement over time in these dimensions of QoL for the intervention group (p < 0.02). In the control group, the only significant improvement was observed in the emotional QoL (p < 0.01). The intervention group showed trends of greater improvements than the control group (p = 0.07 for 12-week physical health QoL). CONCLUSIONS Data from this pilot trial suggested that adding the RR to acupuncture may enhance improvement in QoL of patients with HIV/AIDS. Further investigation on this putative synergistic effect is warranted.
Collapse
Affiliation(s)
- Bei-Hung Chang
- Department of Health Policy and Management, Boston University School of Public Health, Boston, MA 02130, USA.
| | | | | | | |
Collapse
|
36
|
Abstract
BACKGROUND Antiglucocorticoids may have antidepressant effects and have been reported to be efficacious in the treatment of severe psychiatric disorders. The efficacy and safety of antiglucocorticoid treatments for mood disorders is the subject of this systematic review. OBJECTIVES To compare the efficacy and safety of antiglucocorticoid agents in the treatment of mood episodes (manic, mixed affective or depressive) with placebo or alternative drug treatment in mood disorders. SEARCH STRATEGY CCDANCTR-Studies and CCDANCTR-References were searched on 11-9-2007. Additional searches of electronic databases were conducted in December 2006. Conference proceedings were searched. Experts and pharmaceutical companies were contacted. SELECTION CRITERIA Randomised controlled trials comparing antiglucocorticoid drugs in the treatment of mood episodes with placebo or alternative drug treatment in mood disorders were selected. DATA COLLECTION AND ANALYSIS Data were extracted and the methodological quality of each study was assessed independently by two review authors. Meta-analyses were performed using Review Manager software. Relative risk (RR) with 95% confidence intervals (CI) were calculated for dichotomous outcomes. For continuous data, weighted mean differences (WMD) were calculated. MAIN RESULTS Nine studies met criteria for inclusion. A number of drugs were examined, including mifepristone [RU-486], ketoconazole, metyrapone and DHEA. Three trials were in patients with psychotic major depression (pMDD), five trials in non-psychotic major depression and one trial in bipolar disorder. When examining all trials together across all affective episodes, there was no significant difference in the overall proportion of patients responding to antiglucocorticoid treatment over placebo, although the mean change in HAM-D scores indicated a significant difference in favour of treatment (WMD -4.54, 95%CI -6.78 to -2.29). Of the five trials in non-psychotic depression (unipolar or bipolar), there was a significant difference favouring treatment (HAM-D 50% reduction: RR 0.72, 95%CI 0.56 to 0.91). In pMDD, there was no evidence of an overall antidepressant effect (HAM-D 50% reduction: RR 0.98, 95%CI 0.79 to 1.22) or an effect on overall psychopathology (BPRS 30% reduction: RR 0.96, 95%CI 0.76 to 1.22). In these subtypes, the mean change in HAM-D indicated a significant difference in favour of treatment. AUTHORS' CONCLUSIONS The use of antiglucocorticoids in the treatment of mood disorders is at the proof-of-concept stage. Considerable methodological differences exist between studies with respect to the compounds used and the patient cohorts studied. Results in some diagnostic subtypes are promising and warrant further investigation to establish the clinical utility of these drugs in the treatment of mood disorders.
Collapse
|
37
|
Abstract
This study assessed whether perceived stress as measured by the Perceived Stress Scale (PSS) was associated with a decline in CD4+ cell counts over a six-month period in 59 men and 41 women living with HIV-1. Participants underwent psychological and medical assessment at the study entry (baseline) and again at six months post-baseline. In a hierarchical regression model controlling for sociodemographic (e.g. age, gender, education, income) and disease-related variables (e.g. duration of antiretroviral treatment, antiretroviral treatment and adherence, CD4+ cell count and viral load), perceived stress was associated with the decline in CD4+ cell count over the six-month period. These findings suggest perceived psychosocial stress is associated with CD4+ cell count decline independent of sociodemographic factors and disease status among men and women on antiretroviral medication for HIV/AIDS.
Collapse
Affiliation(s)
- E Remor
- Universidad Autónoma de Madrid, Spain.
| | | | | | | |
Collapse
|
38
|
Chang BH, Jones D, Hendricks A, Boehmer U, Locastro JS, Slawsky M. Relaxation Response for Veterans Affairs Patients With Congestive Heart Failure: Results From a Qualitative Study Within a Clinical Trial. ACTA ACUST UNITED AC 2007. [DOI: 10.1111/j.1520-037x.2004.3164.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
39
|
Abstract
The growing recognition and occurrence of traumatic exposure in the general population has given increased salience to the need to understand the concept of resilience. More than just the "flip side" of a risk factor, the notion of resilience encompasses psychological and biological characteristics, intrinsic to an individual, that might be modifiable and that confer protection against the development of psychopathology in the face of stress. In this review, we provide some perspective on the concept of "resilience" by examining early use of the term in research on "children at risk" and discuss the relationship between risk and resilience factors. We then review psychological and biological factors that may confer resilience to the development of posttraumatic stress disorder (PTSD) following trauma, examine how resilience has been assessed and measured, and discuss issues to be addressed in furthering our understanding of this critical concept going forward.
Collapse
Affiliation(s)
- Elizabeth A Hoge
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts 02114, USA.
| | | | | |
Collapse
|
40
|
Campagne D. El tratamiento con dehidroepiandrosterona de la depresión resistente a los antidepresivos. Semergen 2007; 33:293-295. [DOI: 10.1016/s1138-3593(07)73898-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
41
|
Abstract
The purpose of this study was to determine the correlation of perceived stress with selected physiological and psychological factors in an HIV-infected, predominantly African American population and to assess the multivariable effects on perceived stress. The variables that correlated significantly with perceived stress were entered into a backward stepwise regression model. Pearson's r analysis showed significant correlations between perceived stress and state and trait anxiety, depression, HIV-related symptoms, sleep quality, daytime sleepiness and fatigue. State and trait anxiety, depression and fatigue retained significance (p<0.1) in the final regression model. These factors explained approximately 80% of the variance in perceived stress. The significant interactions of multiple physiological and psychological correlates suggest that perceived stress is a complex outcome with a multifactorial etiology. Further, the model suggests that psychological factors may contribute to perceived stress in this population more than physiological factors such as HIV-related symptomatology or stage of disease.
Collapse
Affiliation(s)
- G A Hand
- Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA.
| | | | | |
Collapse
|
42
|
Floyd K, Mikkelson AC, Tafoya MA, Farinelli L, La Valley AG, Judd J, Haynes MT, Davis KL, Wilson J. Human affection exchange: XIII. Affectionate communication accelerates neuroendocrine stress recovery. Health Commun 2007; 22:123-32. [PMID: 17668992 DOI: 10.1080/10410230701454015] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Contemporary theory in interpersonal communication and health psychology supports the prediction that engaging in affectionate behavior within established relationships has a direct effect on the alleviation of stress symptoms following exposure to an acute stressor. Participants in this study were exposed to a series of standard laboratory stressors and were subsequently assigned either to an experimental group or to 1 of 2 control groups. Those in the experimental group were instructed to write a letter to a loved one in which they expressed their feelings of affection for that person. Those in 1 control group thought about a loved one but did not engage in any communicative behavior, and those in the other control group simply sat quietly. All 3 conditions were compared with respect to their levels of salivary free cortisol, an adrenal steroid hormone that is instrumental in the body's neuroendocrine stress response. Results indicated that, compared to the control groups, those in the experimental group experienced accelerated cortisol recovery following exposure to the acute stressors.
Collapse
Affiliation(s)
- Kory Floyd
- School of Human Communication, Arizona State University, Tempe 85287, USA.
| | | | | | | | | | | | | | | | | |
Collapse
|
43
|
Huang YJ, Chen MT, Fang CL, Lee WC, Yang SC, Kuo CH. A possible link between exercise-training adaptation and dehydroepiandrosterone sulfate- an oldest-old female study. Int J Med Sci 2006; 3:141-7. [PMID: 17003845 PMCID: PMC1570619 DOI: 10.7150/ijms.3.141] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2006] [Accepted: 09/10/2006] [Indexed: 11/10/2022] Open
Abstract
The purpose of this study was to determine the association between the level of salivary dehydroepiandrosterone sulfate (DHEA-S) and the magnitude of adaptation to exercise training in insulin sensitivity for aged females. A group of 16 females, aged 80-93 years old, was divided into 2 groups according to their baseline DHEA-S levels: Lower Halves (N = 8) and Upper Halves (N = 8), and participated in a 4-month exercise intervention trial. Insulin response with an oral glucose tolerance test (OGTT), cholesterol, blood pressure (BP), motor performance, and DHEA-S were determined at baseline and 4 months after the training program. Glucose tolerance and body mass index (BMI) remained unchanged with training for both groups. Insulin, fasted cholesterol, diastolic blood pressure, reaction time, and locomotive function were significantly lowered by training only in the Upper Halves group. Changes in the area under curve of insulin (IAUC) were negatively correlated with the baseline DHEA-S level (R= - 0.60, P < 0.05). The current study provides the first evidence that oldest-old subjects with low DHEA-S level appear to be poor responders to exercise-training adaptations.
Collapse
Affiliation(s)
- Yi-Jen Huang
- 1. Department of Kinesiology, SooChow University, Taipei, Taiwan
| | - Mu-Tsung Chen
- 2. Laboratory of Exercise Biochemistry, Taipei Physical Education College, Taipei, Taiwan
| | - Chin-Lung Fang
- 3. Department of Kinesiology, National Normal Taiwan University, Taipei, Taiwan
| | - Wen-Chih Lee
- 4. Committee of General Studies, Shih Hsin University, Taipei, Taiwan
| | - Sun-Chin Yang
- 2. Laboratory of Exercise Biochemistry, Taipei Physical Education College, Taipei, Taiwan
| | - Chia-Hua Kuo
- 2. Laboratory of Exercise Biochemistry, Taipei Physical Education College, Taipei, Taiwan
| |
Collapse
|
44
|
Lee WC, Chen SM, Wu MC, Hou CW, Lai YC, Laio YH, Lin CH, Kuo CH. The Role of Dehydroepiandrosterone Levels on Physiologic Acclimatization to Chronic Mountaineering Activity. High Alt Med Biol 2006; 7:228-36. [PMID: 16978135 DOI: 10.1089/ham.2006.7.228] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Previous studies have reported that glucose tolerance can be improved by short-term altitude living and activity. However, not all literature agrees that insulin sensitivity is increased at altitude. The present study investigated the effect of a 25-day mountaineering activity on glucose tolerance and its relation to serum levels of dehydroepiandrosterone-sulfate (DHEA-S) and tumor necrosis factor-alpha (TNF-alpha) in 12 male subjects. On day 3 at altitude, we found that serum DHEAS was reduced in the subjects with initially greater DHEA-S value, whereas the subjects with initially lower DHEA-S remained unchanged. To further elucidate the role of DHEA-S in acclimatization to mountaineering activity, all subjects were then divided into lower and upper halves according to their sea-level DHEA-S concentrations: low DHEA-S (n = 6) and high DHEA-S groups (n = 6). Glucose tolerance, insulin level, and the normal physiologic responses to altitude exposure, including hematocrit, hemoglobin, erythropoietin (EPO), and cortisol were measured. We found that glucose and insulin concentrations on an oral glucose tolerance test were significantly lowered by the mountaineering activity only in the high DHEA-S group. Similarly, hematocrit and hemoglobin concentration in altitude were increased only in the high DHEA-S group. In contrast, the low DHEA-S subjects exhibited an EPO value at sea level and altitude greater than the high DHEA-S group, suggesting an EPO resistance. The findings of the study imply that DHEA-S is essential for physiologic acclimatization to mountaineering challenge.
Collapse
Affiliation(s)
- Wen-Chih Lee
- Committee of General Studies, Shih Hsin University, Taipei, Taiwan, ROC
| | | | | | | | | | | | | | | |
Collapse
|
45
|
Rasmusson AM, Picciotto MR, Krishnan-Sarin S. Smoking as a complex but critical covariate in neurobiological studies of posttraumatic stress disorders: a review. J Psychopharmacol 2006; 20:693-707. [PMID: 16401662 DOI: 10.1177/0269881106060193] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
As smoking rates in the general population continue to fall in response to new information and changing social values, the continued high rate of smoking among persons with psychiatric disorders has caught the attention of society at many levels: public health officials, medical and mental health care providers, and concerned family members alike. As a consequence, research studies aimed at quantifying the problem and understanding its cause have increased dramatically over the past several years. The following review first examines epidemiological studies that have revealed a bidirectional causal relationship between tobacco dependence and posttraumatic stress disorder (PTSD), one of several mental health disorders in which tobacco dependence remains prevalent and resistant to intervention. Second, we use a translational neuroscience perspective to discuss possible neurobiological mediators of the relationship between PTSD and tobacco dependence, hoping to spur further human and animal research that will elucidate pathogenetic mechanisms involved and inspire novel treatment interventions. Finally, to enable more effective clinical research in this area, we provide an overview of effective scientific methods for assessing and managing 'smoking status' as an experimental variable in clinical research studies of PTSD as well as other mental health disorders.
Collapse
Affiliation(s)
- Ann M Rasmusson
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
| | | | | |
Collapse
|
46
|
|
47
|
Tsai YM, Chou SW, Lin YC, Hou CW, Hung KC, Kung HW, Lin TW, Chen SM, Lin CY, Kuo CH. Effect of resistance exercise on dehydroepiandrosterone sulfate concentrations during a 72-h recovery: Relation to glucose tolerance and insulin response. Life Sci 2006; 79:1281-6. [PMID: 16716364 DOI: 10.1016/j.lfs.2006.04.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2005] [Revised: 04/04/2006] [Accepted: 03/28/2006] [Indexed: 11/18/2022]
Abstract
Serum dehydroepiandrosterone sulfate (DHEA-S) concentration is known to be associated with the whole-body insulin sensitivity. The main purpose of the study was to investigate the effect of resistance exercise on DHEA-S concentration during a 72 h post-exercise recovery, and its relation to glucose tolerance and insulin sensitivity. Morning fasted serum samples was obtained from 19 male volunteers (aged 21.1+/-0.4 years) 24 h before the onset of exercise and 24 h, 48 h, and 72 h following exercise for measurements of DHEA-S, cortisol, and TNF-alpha. Oral glucose tolerance test (OGTT) and insulin response were determined 24 h before and 48 h after exercise. We found that resistance exercise causes a delayed suppression in serum DHEA-S levels during recovery (48 h and 72 h). This exercise challenge did not affect glucose tolerance, but insulin response during OGTT was significantly elevated. The increased insulin level was not associated with serum levels of cortisol and TNF-alpha. In conclusion, the present study found that resistance exercise has a DHEA-S lowering effect that persisted for 72 h. This change could be related to the elevated insulin concentrations during OGTT.
Collapse
Affiliation(s)
- Yi-Ming Tsai
- Laboratory of Exercise Biochemistry, Taipei Physical Education College, 5 Dun-Hua N. Rd, Taiepi, Taiwan, ROC
| | | | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Grillon C, Pine DS, Baas JMP, Lawley M, Ellis V, Charney DS. Cortisol and DHEA-S are associated with startle potentiation during aversive conditioning in humans. Psychopharmacology (Berl) 2006; 186:434-41. [PMID: 16052364 PMCID: PMC2702204 DOI: 10.1007/s00213-005-0124-2] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2005] [Accepted: 07/01/2005] [Indexed: 11/28/2022]
Abstract
RATIONALE Fear conditioning reliably increases the startle reflex and stress hormones, yet very little is known about the effect of stress hormones on fear-potentiated startle. Cortisol and the sulfate ester of dehydroepiandrosterone (DHEA-S) are involved in stress and anxiety. Evidence suggests that low cortisol/DHEA-S ratio has a buffering effect on stress and anxiety in preclinical and clinical studies, suggesting that there may be a relationship between fear-potentiated startle and cortisol and DHEA-S activity. OBJECTIVE The aim of the study was to examine whether there is a relationship between cortisol/DHEA-S ratio and fear-potentiated startle. METHODS Thirty healthy subjects participated in a differential aversive conditioning experiment during which one of two stimuli (CS+) was paired with a shock, and the other was not (CS-). Conditioned responses were assessed with the startle reflex, defined as startle potentiation during CS+ compared to CS-. DHEA-S and cortisol levels were assayed from blood samples collected in both a baseline and an aversive conditioning session. Subjective state anxiety, arousal, and valence were assessed at various times during testing. RESULTS Fear-potentiated startle was larger in individuals with high compared to low cortisol/DHEA-S ratio. Multiple regression analyses revealed that fear-potentiated startle was positively associated with cortisol and negatively associated with DHEA-S. There was no significant correlation between DHEA-S and cortisol levels. CONCLUSION These data suggest that cortisol and DHEA-S are involved in fear conditioning.
Collapse
Affiliation(s)
- Christian Grillon
- NIMH/NIH/DHHS, Mood and Anxiety Disorder Program, 15K North Drive, MSC 2670, Bethesda, MD 20892-2670, USA.
| | | | | | | | | | | |
Collapse
|
49
|
Rasmusson AM, Wu R, Paliwal P, Anderson GM, Krishnan-Sarin S. A decrease in the plasma DHEA to cortisol ratio during smoking abstinence may predict relapse: a preliminary study. Psychopharmacology (Berl) 2006; 186:473-80. [PMID: 16609903 DOI: 10.1007/s00213-006-0367-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2005] [Accepted: 03/01/2006] [Indexed: 10/24/2022]
Abstract
RATIONALE Increases in depressive symptoms during smoking cessation have been associated with risk for relapse. Several studies have linked plasma levels of cortisol and dehydroepiandrosterone (DHEA) or DHEA-sulfate (DHEAS) to depressive symptoms. OBJECTIVES To determine whether changes in plasma cortisol, DHEA, or DHEAS levels and emergence of depressive symptoms during smoking cessation are associated with smoking relapse. MATERIALS AND METHODS Subjects were healthy non-medicated men and women, aged 39+/-12 years, who smoked, on average, 22 cigarettes per day. Depressive symptoms, smoking withdrawal symptoms, and plasma steroid levels were measured before and after 8 days of verified smoking abstinence. Relapse status at day 15 was then determined. RESULTS In the full sample (n=63), there was a trend for changes in depressive symptoms to be associated with relapse. In the subset of 25 subjects with plasma neuroactive steroid data, there was a significant interaction between the change in the plasma DHEA/cortisol ratio from day 0 to day 8 and relapse status at day 15. This ratio was similar before abstinence, but lower at day 8 in relapsed, compared to abstinent, subjects. Changes in the DHEA/cortisol ratio tended to predict changes in depressive symptoms in the women only. CONCLUSION A decrease in the plasma DHEA/cortisol ratio during 8 days of smoking abstinence was associated with relapse over the following week. Further research is needed to fully characterize sex-specific relationships between abstinence-induced changes in neuroactive steroid levels, depressive or withdrawal symptoms, and relapse. Such research may lead to new interventions for refractory smoking dependence.
Collapse
Affiliation(s)
- Ann M Rasmusson
- Department of Psychiatry, Yale University School of Medicine, New Haven, and Clinical Neuroscience Division, VA National Center for PTSD, West Haven, CT 06516, USA.
| | | | | | | | | |
Collapse
|
50
|
Arai H, Takechi H, Wada T, Ishine M, Wakatsuki Y, Horiuchi H, Murayama T, Yokode M, Tanaka M, Kita T, Matsubayashi K, Kume N. Usefulness of measuring serum markers in addition to comprehensive geriatric assessment for cognitive impairment and depressive mood in the elderly. Geriatr Gerontol Int 2006. [DOI: 10.1111/j.1447-0594.2006.00327.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|