Work stressors, depressive symptoms and sleep quality among US Navy members: a parallel process latent growth modelling approach across deployment

Ego-Resiliency and Perceived Social Support in Late Childhood: A Latent Growth Modeling Approach

This study explored the change trajectory of schoolchildren’s ego-resiliency and perceived social support and investigated the effect of perceived social support on ego-resiliency across four time points. A sample of 437 children aged 8–13 years (M = 10.99, SD = 0.70, 51.5% boys) completed assessments at four time points. The results indicated that ego-resiliency showed an increasing linear trend and perceived social support showed a declining linear trend. Perceived social support had a positive effect on ego-resiliency over time. In addition, the initial status of perceived social support negatively predicted the growth trend of ego-resiliency, and the initial status of ego-resiliency negatively predicted the declining trend of perceived social support. The implications for theory and practice are discussed.

Heart Failure Symptom Biology in Response to Ventricular Assist Device Implantation

BACKGROUND

We have a limited understanding of the biological underpinnings of symptoms in heart failure (HF), particularly in response to left ventricular assist device (LVAD) implantation.

OBJECTIVE

The aim of this study was to quantify the degree to which symptoms and biomarkers change in parallel from before implantation through the first 6 months after LVAD implantation in advanced HF.

METHODS

This was a prospective cohort study of 101 patients receiving an LVAD for the management of advanced HF. Data on symptoms (dyspnea, early and subtle symptoms [HF Somatic Perception Scale], pain severity [Brief Pain Inventory], wake disturbance [Epworth Sleepiness Scale], depression [Patient Health Questionnaire], and anxiety [Brief Symptom Inventory]) and peripheral biomarkers of myocardial stretch, systemic inflammation, and hypervolumetric mechanical stress were measured before implantation with a commercially available LVAD and again at 30, 90, and 180 days after LVAD implantation. Latent growth curve and parallel process modeling were used to describe changes in symptoms and biomarkers and the degree to which they change in parallel in response to LVAD implantation.

RESULTS

In response to LVAD implantation, changes in myocardial stretch were closely associated with changes in early and subtle physical symptoms as well as depression, and changes in hypervolumetric stress were closely associated with changes in pain severity and wake disturbances. Changes in systemic inflammation were not closely associated with changes in physical or affective symptoms in response to LVAD implantation.

CONCLUSIONS

These findings provide new insights into the many ways in which symptoms and biomarkers provide concordant or discordant information about LVAD response.

Relationships Between Sleepiness, Mood, and Neurocognitive Performance in Military Personnel

Neurocognitive computerized assessment tools (NCATs) were developed to assist military clinicians with the tracking of recovery from injury and return to full duty decisions with a recent focus on the setting of post-concussion evaluations. However, there is limited data on the impact of deployment on neurocognitive functioning, sleepiness, and mood in healthy, non-concussed Service members. Automated Neuropsychological Assessment Metrics version 4 TBI Military (ANAM) data was obtained for a sample of active duty deployed personnel (n = 72) without recent history of mild traumatic brain injury (mTBI). A linear regression was conducted to examine the effects of sleepiness and mood state on neurocognitive performance. The overall multivariate regression was statistically significant. Negative mood states were the most salient predictors of neurocognitive performance with higher levels of endorsement associated with lower scores. The findings support measures of negative mood state, but not sleepiness, as relevant predictors of neurocognitive performance as measured by the ANAM. These results indicate that mood needs to be considered when reviewing neurocognitive data to ensure that appropriate clinical decisions are made; in particular for return-to-duty decisions in deployed settings after concussion recovery.

Opioid and sedative misuse among veterans wounded in combat

BACKGROUND

Military veterans wounded in combat are a high-risk group for emotional and physical distress, which may be exacerbated by misuse of prescription opioids and sedatives. The goal of the current study was to examine the prevalence and correlates of prescription opioid and sedative misuse among veterans wounded in combat.

METHOD

We recruited veterans from the Combat Wounded Coalition (n = 212; 84% non-Hispanic White; 97.6% male) to complete an online survey of mental health and substance use disorder symptoms, assessed via the DSM-5 Self-Rated Level 1 Cross-Cutting Symptoms Measure, the Posttraumatic Stress Disorder (PTSD) Checklist for DSM-5, the Pain Enjoyment General Activity Scale, and the Alcohol Use Disorders Identification Test (AUDIT). Prescription opioid and sedative misuse was assessed by frequency of use in the past year that was not currently prescribed or using more than prescribed.

RESULTS

Participants reported high rates of past year prescription opioid misuse (46.2%) and sedative misuse (21.7%). Misuse of both opioids and sedatives was associated with the most distress, including greater depression, anger, sleep disturbance, AUDIT scores, PTSD symptoms, suicidality, and pain interference. In multivariable multinomial logistic regression analyses, greater sleep disturbance (OR = 1.73) was associated with greater odds of sedative misuse versus no misuse. Higher AUDIT scores were associated with greater risk of sedative misuse (OR = 1.16) versus opioid misuse only.

CONCLUSIONS

Military veterans wounded in combat have high rates of prescription opioid misuse and sedative misuse. Sleep problems and AUDIT scores might help identify veterans who are at most risk for opioid and sedative misuse.