Stress and Health: A Review of Psychobiological Processes

Meta-analysis of Circulatory mitomiRs in stress Response: Unveiling the significance of miR-34a and miR-146a

BACKGROUND

MicroRNAs (miRNAs) are short, noncoding RNAs with essential roles in cellular pathways and are often associated with various diseases and stress conditions. Recently, they have been discovered in mitochondria, termed "mitomiRs," with unique functions. Mitochondria, crucial organelles for energy production and stress responses, Dysregulated mitomiRs functions and expression has been evident in stress conditions such as cardiovascular and neurodegenerative. In this meta-analysis we have systematically identified miR-34a & miR-146a as possible potential biomarkers for affliction.

METHODS

A meta-analysis was conducted to assess the potential role of miR-34a and miR-146a, two specific mitomiRs, as biomarkers in stress-related conditions. The study followed PRISMA guidelines, involving comprehensive database searches in May and September 2023. Twelve studies meeting predefined inclusion criteria were selected, and data analysis included the evaluation of miR-34a and miR-146a expression levels in various stress conditions compared to control groups. We also performed Gene ontology (GO) and Pathway enrichment analysis to observe how mitomiRs affects our body.

RESULTS

The meta-analysis revealed a significant increase in overall mitomiRs (miR-34a and miR-146a) expression levels in experimental groups experiencing different stress conditions compared to control groups (Z = 3.54, p < 0.05 using RevMan software). miR-34a demonstrated more pronounced upregulation and exhibited potential as a specific biomarker in certain stress-related conditions (Z = 2.22, p < 0.05). However, miR-146a did not show a significant difference, requiring further investigation in various stress-related contexts. The Analysis indicated a high degree of heterogeneity among the studies.

CONCLUSION

This meta-analysis emphasises the importance of mitomiRs, especially miR-34a, as potential biomarkers in the intricate interplay between stress, mitochondrial function, and disease. The study opens new avenues for exploring miRNAs' diagnostic and therapeutic applications in stress-related diseases, highlighting their pivotal role at the crossroads of molecular biology, psychology, and medicine.

Community Hospital Interventions Addressing the Medical and Social Needs of Patients: Patient Perspectives From the CHART Investment Program

High utilizers of acute care in nonurban settings are at risk for poor health outcomes. Much of Massachusetts is nonurban, with many residents experiencing limited access to health care providers, fragmented health care services, inadequate housing, and low health literacy. This study examines patient perspectives on the Community Hospital Acceleration, Revitalization, and Transformation (CHART) investment program, a state-based grant program focused on advancing community hospitals toward value-based care. We found that CHART staff engaged patients in care coordination and patient advocacy, promoted patient agency and health literacy, and provided socioemotional support. These findings may help inform future program development around meeting the medical and social needs of high utilizers of health care services.

Drinking to Cope With the COVID-19 Pandemic Mediates Pathways From COVID-19 Anxiety to Alcohol Use and Alcohol Myopia Consequences

OBJECTIVE

People may consume alcohol to cope with the stressors and anxieties of the COVID-19 pandemic. The present study applied the self-medication hypothesis, tension reduction hypothesis, and alcohol myopia theory to understand COVID-19 alcohol coping as a mediator of the pathways from COVID-19 anxiety to alcohol use and alcohol consequences.

METHODS

Participants (N = 477) were undergraduate college students. The mean age was 22.14 (SD = 5.66) years. Gender distribution included 73% females, 26% males, and 1% transgender. Racial categories included 70% White, 11% Latino, 5% Black, 5% Asian, and 9% multiracial. They completed the Coronavirus Anxiety Scale, the COVID-19 Alcohol Coping Scale developed and validated in the present study, measures of drinking frequency and drinking quantity, and the Alcohol Myopia Scale to assess alcohol consequences.

RESULTS

First, confirmatory factor analysis supported the measurement structure of the COVID-19 Alcohol Coping Scale. Second, a general structural equation model containing only latent factors provided evidence for the following pathways: COVID-19 anxiety to COVID-19 alcohol coping to overall alcohol use to alcohol myopia consequences. Third, a specific structural equation model separated the overall alcohol use factor into two measures of drinking frequency and drinking quantity. Results found that COVID-19 alcohol coping uniquely explained drinking frequency (but not drinking quantity), indicating that the pursuit of alcohol to cope with the pandemic was related to more frequent days of alcohol use but not more concentrated use on drinking days. Tests of indirect effects corroborated the mediational pathways in the explanatory models.

CONCLUSIONS

The research offers insights into understanding that the risk connections from COVID-19 anxiety to alcohol behavioral outcomes are mediated by alcohol use to cope with the pandemic.

Terminalia chebula attenuates restraint stress-induced memory impairment and synaptic loss in the dentate gyrus of the hippocampus and the basolateral and central nuclei of the amygdala by inhibiting oxidative damage

Chronic restraint stress induces cognitive abnormalities through changes in synapses and oxidant levels in the amygdala and hippocampus. Given the neuroprotective effects of fruit of Terminalia chebula (Halileh) in different experimental models, the present investigation aimed to address whether Terminalia chebula is able to reduce chronic restraint stress-induced behavioral, synaptic and oxidant markers in the rat model. Thirty-two male Wistar rats were randomly divided into four groups as follows: control (did not receive any treatment and were not exposed to stress), stress (restraint stress for 2 h a day for 14 consecutive days), Terminalia chebula (received 200 mg/kg hydroalcoholic extract of Terminalia chebula), and stress + Terminalia chebula groups (received 200 mg/kg extract of Terminalia chebula twenty minutes before stress) (n = 8 in each group). We used the shuttle box test to assess learning and memory, Golgi-Cox staining to examine dendritic spine density in the dentate gyrus region of the hippocampus and the basolateral and central nuclei of the amygdala, and total antioxidant capacity (TAC) and total oxidant status (TOS) in the brain. The shuttle box test results demonstrated that Terminalia chebula treatment had a profound positive effect on memory parameters, including step-through latency (STL) and time spent in the dark room, when compared to the stress group. Daily oral treatment with Terminalia chebula effectively suppressed the loss of neural spine density in the dentate gyrus region of the hippocampus and the basolateral and central nuclei of the amygdala caused by chronic restraint stress, as demonstrated by Golgi-Cox staining. Additionally, the results indicate that Terminalia chebula significantly reduced the TOS and increased TAC in the brain compared to the stress group. In conclusion, our results suggest that Terminalia chebula improved memory impairment and synaptic loss in the dentate gyrus of the hippocampus and the basolateral and central nuclei of the amygdala induced by restraint stress via inhibiting oxidative damage.

"Recovery activities are needed every step of the way"-exploring the process of long-term recovery in people previously diagnosed with exhaustion disorder

BACKGROUND

Sick-leave rates are high due to stress-related illnesses, but little is still known about the process of recovery from these conditions. The aim of this study was to explore the experiences of the recovery process, 6 to 10 years after treatment in people previously diagnosed with exhaustion disorder (ED), focusing on facilitators and barriers for the process of recovery from ED, and recovery activities experienced as helpful during the recovery process.

METHOD

Thirty-eight participants (average age: 52 years, 32 females) previously diagnosed with ED were interviewed with semi-structured interviews 6-10 years after undergoing treatment. The interviews were analyzed with thematic analysis.

RESULTS

Three themes resulted from the analysis. The first theme, "A long and rocky road", summarizes the fluctuating path to feeling better and emphasizes barriers and facilitators that affected the process of recovery, with a focus on external life events and the participants' own behaviors. Facilitators were changing workplace, receiving support, a reduction in stressors, and changed behaviors. Barriers were a poor work environment, caregiver responsibilities, negative life events and lack of support. The second theme "Recovery activities are needed every step of the way" describes how both the need for recovery activities and the types of activities experienced as helpful changed during the recovery process, from low-effort recovery activities for long periods of time to shorter and more active recovery activities. Recovery activities were described as important for self-care but hard to prioritize in everyday life. The last theme, "Reorienting to a new place", captures the struggle to cope with the remaining impact of ED, and how internal facilitators in terms of understanding and acceptance were important to reorient and adjust to a new way of functioning.

CONCLUSIONS

Recovering from ED is a long and ongoing process where recovery activities are needed every step of the way. Our results highlight the importance of supporting personal recovery and long-term behavioral change, addressing individual stressors that may perpetuate the condition, and adjusting recovery activities according to where the person is in the recovery process.

TRIAL REGISTRATION

ClinicalTrials.gov: NCT0073772 . Registered on March 8, 2017. This study was pre-registered on Open Science Framework (osf.io).

Exploring Inflammation and Stress as Biological Correlates of Symptoms in Children With Advanced Cancer: A Longitudinal Feasibility Study

Background: Few studies have examined biomarkers of stress and inflammation as underlying mechanisms of symptoms in adolescents and young adults with cancer. This study determined the feasibility of collecting blood and saliva samples across time, described the range and distribution of biomarkers, and explored the association of biomarkers with symptom adverse events (AEs). Method: This longitudinal, prospective repeated-measures single-site feasibility study recruited N  =  10 children (M = 12.5 years) receiving treatment for advanced cancer. Symptom AE data and inflammation (cytokines and C-reactive protein) and physiologic response to stress (salivary cortisol and salivary alpha-amylase) biomarker levels were collected at three time points. Descriptive statistics were used to examine feasibility and acceptability and to summarize symptom AE, stress, and inflammatory biomarker data. A linear regression model was used to determine cortisol diurnal slopes. The relationship between symptom and inflammatory biomarker data was explored and Hedges's g statistic was used to determine its effect size. Results: Participants provided 83% of saliva samples (n  =  199/240) and 185 samples were sufficient to be analyzed. Nurses collected 97% (n  =  29/30) of blood samples. Participants reported the saliva collection instructions, kits, and reminders were clear and helpful. Insomnia, pain, fatigue, and anxiety demonstrated the most medium and large negative effects with inflammatory markers. Symptom AEs demonstrated the highest number of medium and large negative effects with interleukin-8 and tumor necrosis factor-alpha (-0.53 to -2.00). Discussion: The results indicate longitudinal concurrent collection of symptom and biomarker data is feasible and inflammatory and stress biomarkers merit consideration for inclusion in future studies.

An analysis of POMC gene methylation and expression in patients with schizophrenia

Schizophrenia is a chronic mental disorder that affects millions of people and is believed to be caused by both environmental and genetic factors. Despite extensive research, the exact mechanisms underlying schizophrenia are still unclear. Studies have shown that numerous psychiatric disorders are associated with methylation of the POMC gene, which encodes adrenocorticotropic hormone, a critical player in the hypothalamic-pituitary-adrenal axis. However, the association between DNA methylation in POMC patients and schizophrenia remains unclear. In this study, we evaluated three fragments of the POMC promoter region, including 51 CpG sites, in the peripheral blood of schizophrenia patients and healthy controls. The POMC protein level was measured via enzyme-linked immunosorbent assay (ELISA). The schizophrenia group exhibited significantly greater levels of methylation of the POMC gene than those in the control group. The methylation level of the POMC-2 fragment was significantly greater in the patient group than in the control group. There were 17 significantly hypermethylated CpG sites in the patient group. After stratification by sex, POMC methylation levels were found to be significantly greater in male schizophrenia patients than in healthy controls; the methylation levels of POMC-2 fragments were greater in the male patient group; nine CpG sites were significantly hypermethylated in the male patient group; and only one CpG site was significantly hypermethylated in the female patient group. The POMC protein level in patients was significantly lower than that in healthy controls. These findings demonstrate that the DNA methylation of POMC might be associated with the pathophysiology of schizophrenia. Overall, studying the correlation between POMC methylation and schizophrenia may contribute to the diagnosis and evaluation of neuropsychiatric disorders.

Assessing the Role of Cortisol in Anxiety, Major Depression, and Neuroticism: A Mendelian Randomization Study Using SERPINA6/SERPINA1 Variants

Background

Previous evidence informed by the toxic stress model suggests that higher cortisol causes anxiety and major depression, but clinical success is lacking. To clarify the role of cortisol, we used Mendelian randomization to estimate its associations with anxiety, major depression, and neuroticism, leveraging the largest available genome-wide association studies including from the Psychiatric Genomics Consortium, the UK Biobank, and FinnGen.

Methods

After meta-analyzing 2 genome-wide association studies on morning plasma cortisol (n = 32,981), we selected single nucleotide polymorphisms (SNPs) at p < 5 × 10-8 and r2 < 0.3 in the SERPINA6/SERPINA1 gene region encoding proteins that influence cortisol bioavailability. We applied these SNPs to summary genetic associations with the outcomes considered (n = 17,310-449,484), and systolic blood pressure as a positive outcome, using inverse-variance weighted meta-analysis accounting for correlation. Sensitivity analyses addressing SNP correlation and confounding by childhood maltreatment and follow-up analyses using only SNPs that colocalized with SERPINA6 expression were conducted.

Results

Cortisol was associated with anxiety (pooled odds ratio [OR] 1.16 per cortisol z score; 95% CI, 1.04 to 1.31), but not major depression (pooled OR 1.02, 95% CI, 0.95 to 1.10) or neuroticism (β -0.025; 95% CI, -0.071 to 0.022). Sensitivity analyses yielded similar estimates. Cortisol was positively associated with systolic blood pressure, as expected. Using rs9989237 and rs2736898, selected using colocalization, cortisol was associated with anxiety in the UK Biobank (OR 1.32; 95% CI, 1.01 to 1.74) but not with major depression in FinnGen (OR 1.14; 95% CI, 0.95 to 1.37).

Conclusions

Cortisol was associated with anxiety and may be a potential target for prevention. Other targets may be more relevant to major depression and neuroticism.

The effects of childhood trauma on stress-related vulnerability factors and indicators of suicide risk: An ecological momentary assessment study

BACKGROUND

Childhood trauma is experienced by approximately one third of young people in the United Kingdom and has been shown to confer an increased risk for mental health difficulties in adulthood. Understanding the associations between these factors before negative health outcomes manifest in adulthood is imperative to help inform the development of interventions. The aims of this study were two-fold; first, to investigate the effects of childhood trauma on daily stress-related vulnerability factors over a period of 7 days and to test whether any observed relationships were moderated by protective or risk factors. Second, to explore the indirect effects of childhood trauma on reasons for living, optimism, daily suicide ideation, defeat and entrapment through the daily stress-related vulnerability factors.

METHODS

212 participants were recruited to an ecological momentary assessment study to complete three diaries per day for a 7-day period. Participants completed daily measures of stress, hassles, executive functioning, impulsivity, sleep quality (stress-related vulnerability factors) as well as measures of reasons for living, optimism, daily thoughts of suicide, defeat and entrapment. The Childhood Trauma Questionnaire was also completed at baseline.

RESULTS

Analyses found that childhood trauma was significantly associated with higher scores on the daily stress-related vulnerability factors and positively related to each of the daily indicators of suicide risk. The study also uncovered key pathways whereby trauma had indirect effects on reasons for living, optimism, daily thoughts of suicide, defeat and entrapment through executive functioning, impulsivity, sleep quality and stress.

LIMITATIONS

The measures of executive function and sleep were self-reported and future research ought to replicate the current findings using more objective methods.

DISCUSSION

The findings from this study highlight the complexity of childhood trauma and its damaging effects on stress-related vulnerability factors and poorer mental health outcomes. Greater understanding of pathways by which trauma may impact later health outcomes is essential for development of interventions.

Examining parental stress and its link to hair cortisol and DHEA levels in kindergartners

BACKGROUND

Parental work-family conflict (WFC) and parental household income have been linked to negative outcomes for children. So far, no study has associated these two stressors with the hair concentration of cortisol (HCC) and dehydroepiandrosterone (DHEA) in kindergarteners as a measurement of their objective stress.

METHODS AND MEASURES

44 children (40.91% female) with a mean age of 5.16 years and their parents participated in this cross-sectional study. Children's cortisol and DHEA measurements reflected the hormones produced over the past two months. Parents filled out questionnaires concerning their WFC and parenting behavior.

RESULTS

Higher maternal WFC and a lower parental net household income were negatively associated with the DHEA and positively with HCC/DHEA ratio of their children. No significant associations were found between HCC and any included variables. Paternal WFC had no impact on the stress hormones and negatively affected parenting behavior of both parents. Levels of stress hormones were not correlated with parenting behavior.

CONCLUSION

The present results indicated a higher stress exposure in children of mothers with a higher WFC and lower net household income. Conceivably, this may have led to an accumulation of allostatic load. Potential influences of demographic variables on the children's hormones are discussed.

Relationship of domestic violence with pregnancy symptoms and pregnancy experience in Iranian pregnant women: a cross-sectional study

OBJECTIVE

Violence has had adverse effects on the physical and psychological dimensions of pregnant women. This study was conducted with the aim of determining the relationship of domestic violence with pregnancy symptoms and pregnancy experience.

DESIGN

In this cross-sectional study, pregnant women were selected through two-stage cluster sampling method. Data were collected using the domestic violence questionnaire of the WHO, pregnancy symptoms inventory (PSI) and pregnancy experience scale (PES). To determine the relationship between domestic violence with pregnancy symptoms and pregnancy experience, adjusted general linear model was used in multivariate analysis.

SETTING

Health centres in Urmia-Iran in 2022.

PARTICIPANTS

415 pregnant women.

RESULTS

The frequency of emotional, physical and sexual violence was 86.0%, 67.7% and 79.5%, respectively. The mean (SD) of PSI was 49.45 (14.38) with attainable score of 0-123 and PES including happiness and worry was 14.32 (6.48) and 16.21 (2.51) with attainable score of 0-30, respectively. Based on the adjusted general linear model, the mean score of PSI in women who experienced physical violence (mild (p<0.001) and moderate (p<0.001)); sexual violence (mild (p<0.001), moderate (p<0.001) and severe (p<0.001)); and emotional violence (mild (p<0.001), moderate (p=0.002) and severe (p<0.001)) was significantly higher than women without experiencing violence. The mean score of happiness during pregnancy in women who experienced physical violence (moderate (p=0.011)) and emotional violence (mild (p<0.001), moderate (p=0.002) and severe (p<0.001)) was significantly lower than women without experience of violence. Also, the mean score of worry scores in women with experience of sexual violence (mild (p=0.001) and moderate (p=0.012)) and emotional violence (mild (p<0.001), moderate (p<0.001)) and severe (p<0.001)) was significantly higher than women without experiencing violence.

CONCLUSION

Considering the relationship between violence and pregnancy symptoms and pregnancy experiences, it is necessary to use appropriate strategies to prevent violence in pregnant women.

Chronic obstructive pulmonary disease as a risk factor for sarcopenia: A systematic review and meta-analysis

Sarcopenia prevalence and its risk factors in chronic obstructive pulmonary disease (COPD) vary partly due to definition criteria. This systematic review aimed to identify the prevalence and risk factors of sarcopenia in COPD patients. This review was registered in PROSPERO (CRD42022310750). Nine electronic databases were searched from inception to September 1st, 2022, and studies related to sarcopenia and COPD were identified. Study quality was assessed using a validated scale matched to study designs, and a meta-analysis was performed to evaluate sarcopenia prevalence. COPD patients with sarcopenia were compared to those without sarcopenia for BMI, smoking, and mMRC. The current meta-analysis included 15 studies, with a total of 7,583 patients. The overall sarcopenia prevalence was 29% [95% CI: 22%-37%], and the OR of sarcopenia in COPD patients was 1.51 (95% CI: 1.19-1.92). The meta-analysis and systematic review showed that mMRC (OR = 2.02, P = 0.04) and age (OR = 1.15, P = 0.004) were significant risk factors for sarcopenia in COPD patients. In contrast, no significant relationship was observed between sarcopenia and smoking and BMI. Nursing researchers should pay more attention to the symptomatic management of COPD and encourage patients to participate in daily activities in the early stages of the disease.

Association between social dominance hierarchy and PACAP expression in the extended amygdala, corticosterone, and behavior in C57BL/6 male mice

The natural alignment of animals into social dominance hierarchies produces adaptive, and potentially maladaptive, changes in the brain that influence health and behavior. Aggressive and submissive behaviors assumed by animals through dominance interactions engage stress-dependent neural and hormonal systems that have been shown to correspond with social rank. Here, we examined the association between social dominance hierarchy status established within cages of group-housed mice and the expression of the stress peptide PACAP in the bed nucleus of the stria terminalis (BNST) and central nucleus of the amygdala (CeA). We also examined the relationship between social dominance rank and blood corticosterone (CORT) levels, body weight, motor coordination (rotorod) and acoustic startle. Male C57BL/6 mice were ranked as either Dominant, Submissive, or Intermediate based on counts of aggressive/submissive encounters assessed at 12 weeks-old following a change in homecage conditions. PACAP expression was significantly higher in the BNST, but not the CeA, of Submissive mice compared to the other groups. CORT levels were lowest in Submissive mice and appeared to reflect a blunted response following events where dominance status is recapitulated. Together, these data reveal changes in specific neural/neuroendocrine systems that are predominant in animals of lowest social dominance rank, and implicate PACAP in brain adaptations that occur through the development of social dominance hierarchies.

Childhood adversity is associated with reduced BOLD response in inhibitory control regions amongst preadolescents from the ABCD study

Adolescence is characterized by dynamic neurodevelopment, which poses opportunities for risk and resilience. Adverse childhood experiences (ACEs) confer additional risk to the developing brain, where ACEs have been associated with alterations in functional magnetic resonance imaging (fMRI) BOLD signaling in brain regions underlying inhibitory control. Socioenvironmental factors like the family environment may amplify or buffer against the neurodevelopmental risks associated with ACEs. Using baseline to Year 2 follow-up data from the Adolescent Brain Cognitive Development (ABCD) Study, the current study examined how ACEs relate to fMRI BOLD signaling during successful inhibition on the Stop Signal Task in regions associated with inhibitory control and examined whether family conflict levels moderated that relationship. Results showed that greater ACEs were associated with reduced BOLD response in the right opercular region of the inferior frontal gyrus and bilaterally in the pre-supplementary motor area, which are key regions underlying inhibitory control. Further, greater BOLD response was correlated with less impulsivity behaviorally, suggesting reduced activation may not be behaviorally adaptive at this age. No significant two or three-way interactions with family conflict levels or time were found. Findings highlight the continued utility of examining the relationship between ACEs and neurodevelopmental outcomes and the importance of intervention/prevention of ACES.

The effect of family health on suboptimal health status: The parallel mediation role of sleep quality and health behaviour

Background

The prevalence of suboptimal health status has been increasing worldwide, posing a significant challenge to public health. Meanwhile, family health has been recognised as an important factor influencing individual health outcomes. However, the mechanisms through which family health affects suboptimal health status remain unclear. We aimed to investigate the parallel mediation role of sleep quality and health behaviour in the relationship between family health and suboptimal health status.

Methods

We conducted a cross-sectional online survey with a sample of adults >18 years old from four provinces in China. The survey questionnaires queried their demographic characteristics, family health, suboptimal health status, sleep quality, and health behaviour. We assessed family health by the Family Health Scale-Short Form and suboptimal health status using the Suboptimal Health Status Questionnaire. We employed structural equation modelling to analyse the data and test the proposed mediation model.

Results

we collected 4918 valid questionnaires. The mean age of the participants was 30.1 years (standard deviation = 12.5). The correlation analysis demonstrated a significant negative association between family health and suboptimal health status (r = -0.44; P < 0.001). The results of the parallel mediation analysis showed that family health had a significant indirect effect on suboptimal health status through both sleep quality (β = -0.350; P < 0.001) and health behaviour (β = -0.137; P < 0.001). The total indirect effect of family health on suboptimal health status through both sleep quality and health behaviour was also significant (β = -0.569, P < 0.001).

Conclusions

This study highlights the significance of family health as a predictor of suboptimal health status and suggests that sleep quality and health behaviour are parallel mediators in this relationship. By understanding the role of family health, sleep quality, and health behaviour, interventions can be targeted to improve overall health outcomes.

Stress Inoculation in Police Officers Using Virtual Reality: A Controlled Study

Policing is a highly demanding and stressful profession. Virtual reality (VR) has emerged as a promising tool for enhancing stress management programs, including for police officers. The use of VR in combination with biosensors enables measurement of psychophysiological responses such as peripheral temperature (PT) and skin conductance level (SCL). This study investigated the psychophysiological responses of police officers exposed to a VR scenario simulating a car accident. The study included a total of 63 police officers from the Public Security Police. Participants were divided into three groups based on their police divisions: the Investigation Brigade of Traffic Accidents, the Traffic Surveillance Squad (TSS), and a control group from the Lisbon Metropolitan Command. The results indicated that the VR environment effectively induced psychophysiological arousal, particularly in less experienced officers (TSS), that is, there were significant group differences in mean SCL and PT, showing this group with higher SCL and lower PT during the VR exposure. These results support the potential of VR as a stress inoculation strategy for training police officers and highlight the complex nature of stress responses that are influenced by individual factors and psychopathology.

The impact of daily affective touch on cortisol levels in institutionalized & fostered children

Institutionalized children are often deprived of affective touch. Such tactile deprivation often leads to constant stress, as measured by the levels of salivary cortisol. We report here the impact of an affective touch program, optimized to activate a specific population of unmyelinated mechanosensitive nerves in the skin called c-tactile afferents (CT) on stress resistance. Two populations of children (age 4-10) were recruited: (i) a cohort living in an orphanage and (ii) a fostered cohort. Both groups received the affective touch program daily for 10-15 min for 5-6 weeks. A cohort of age-matched children living in a family environment acted as a control group and did not receive any instructions for tactile stimulation. Salivary cortisol was collected at the beginning (T1) and at the end (T2) of the study in all three groups. For institutionalized and fostered children there was a significant improvement in the level of cortisol (p < 0.0001) between T1 and T2, which is manifested in the balancing cortisol levels: a decrease where it was elevated and an increase, where the critically low level testified to the distress of the child. Balancing cortisol levels is a process of recovery to normal values, which indicates the restoration of neurohumoral mechanisms of stress regulation. The effect of balancing cortisol levels was more pronounced in the group of fostered children compared to the group of orphanage children (p = 0.0326). The children in the control group had no significant differences.

Variation in diurnal cortisol patterns among the Indigenous Shuar of Amazonian Ecuador

OBJECTIVES

The hypothalamic-pituitary-adrenal (HPA) axis and its primary end product, the glucocorticoid cortisol, are major components of the evolved human stress response. However, most studies have examined these systems among populations in high-income settings, which differ from the high pathogen and limited resource contexts in which the HPA axis functioned for most of human evolution.

METHODS

We investigated variability in diurnal salivary cortisol patterns among 298 Indigenous Shuar from Amazonian Ecuador (147 males, 151 females; age 2-86 years), focusing on the effects of age, biological sex, and body mass index (BMI) in shaping differences in diurnal cortisol production. Saliva samples were collected three times daily (waking, 30 minutes post-waking, evening) for three consecutive days to measure key cortisol parameters: levels at waking, the cortisol awakening response, the diurnal slope, and total daily output.

RESULTS

Age was positively associated with waking levels and total daily output, with Shuar juveniles and adolescents displaying significantly lower levels than adults (p < .05). Sex was not a significant predictor of cortisol levels (p > .05), as Shuar males and females displayed similar patterns of diurnal cortisol production across the life course. Moreover, age, sex, and BMI significantly interacted to moderate the rate of diurnal cortisol decline (p = .027). Overall, Shuar demonstrated relatively lower cortisol concentrations than high-income populations.

CONCLUSIONS

This study expands the documented range of global variation in HPA axis activity and diurnal cortisol production and provides important insights into the plasticity of human stress physiology across diverse developmental and socioecological settings.

The effect of a prosocial environment on health and well-being during the first COVID-19 lockdown and a year later

The outset of the COVID-19 pandemic was characterized by prolonged periods of chronic stress and social isolation. While studies have investigated the changes to well-being (WB) during this period, the impact of the social environment on long-term physical and mental health requires further study. This study aimed to assess the factors influencing WB and health outcomes, with the hypothesis that a positive social environment would play a significant immediate and long-term role in improving WB and preventing the effects of anxiety associated with the pandemic. At time point 1 (April 2020), an Israeli sample of 206 participants (84% female, mean age 31.5) responded to traditional questionnaires assessing mental health and social support. Factors affecting WB were assessed within subjects during the first COVID-19 lockdown for 6 weeks using a daily survey (Beiwe phone application). A year later, in May 2021, at time point 2, the initial questionnaires were readministered to a subset of the same participants (N = 94). We found that anxiety during the first lockdown adversely affected WB and predicted health and WB deterioration a year later. In contrast, a high quality of social relationships was associated with better short- and long-term WB, and mitigated the adverse effects of anxiety. Daily activities, including physical activity, meditation, and romantic relations, were also positively associated with WB during the first lockdown but did not have long-term effects. In summary, our study underscores the enduring health advantages of a positive social environment, particularly during stressful periods. These results have implications for health policymakers: programs which support individuals with high anxiety and low support, by integrating them into community-based interventions, promise to enhance well-being (WB) and health, as well as to fortify the community as a whole.

Nuclei-specific hypothalamus networks predict a dimensional marker of stress in humans

The hypothalamus is part of the hypothalamic-pituitary-adrenal axis which activates stress responses through release of cortisol. It is a small but heterogeneous structure comprising multiple nuclei. In vivo human neuroimaging has rarely succeeded in recording signals from individual hypothalamus nuclei. Here we use human resting-state fMRI (n = 498) with high spatial resolution to examine relationships between the functional connectivity of specific hypothalamic nuclei and a dimensional marker of prolonged stress. First, we demonstrate that we can parcellate the human hypothalamus into seven nuclei in vivo. Using the functional connectivity between these nuclei and other subcortical structures including the amygdala, we significantly predict stress scores out-of-sample. Predictions use 0.0015% of all possible brain edges, are specific to stress, and improve when using nucleus-specific compared to whole-hypothalamus connectivity. Thus, stress relates to connectivity changes in precise and functionally meaningful subcortical networks, which may be exploited in future studies using interventions in stress disorders.

The missing hallmark of health: psychosocial adaptation

The eight biological hallmarks of health that we initially postulated (Cell. 2021 Jan 7;184(1):33-63) include features of spatial compartmentalization (integrity of barriers, containment of local perturbations), maintenance of homeostasis over time (recycling & turnover, integration of circuitries, rhythmic oscillations) and an array of adequate responses to stress (homeostatic resilience, hormetic regulation, repair & regeneration). These hallmarks affect all eight somatic strata of the human body (molecules, organelles, cells, supracellular units, organs, organ systems, systemic circuitries and meta-organism). Here we postulate that mental and socioeconomic factors must be added to this 8×8 matrix as an additional hallmark of health ("psychosocial adaptation") and as an additional stratum ("psychosocial interactions"), hence building a 9×9 matrix. Potentially, perturbation of each of the somatic hallmarks and strata affects psychosocial factors and vice versa. Finally, we discuss the (patho)physiological bases of these interactions and their implications for mental health improvement.

Social network size moderates the association between loneliness and cardiovascular reactivity to acute stress

Loneliness and objective measures of social isolation (e.g., social network size) have been associated with increased risk of cardiovascular disease (CVD). However, the evidence is mixed and the precise causal mechanisms remain unclear. Cardiovascular reactivity (CVR) to acute stress has been posited as a proposed mechanism. This study aimed to investigate: (i) effects of loneliness and social isolation on CVR to stress and, (ii) whether the loneliness - CVR relationship was moderated by social network size. Two hundred and six participants from the Pittsburgh Cold Study underwent a modified version of the Trier Social Stress Task. Cardiovascular measures of systolic (SBP) and diastolic blood pressure (DBP) and heart rate (HR) were taken throughout the laboratory stress trial. Hierarchical regression analyses found that social network size was positively associated with DBP reactivity (β = 0.19 95 % CI [0.05, 0.29] p = 0.005), while loneliness was not. In addition, social network size moderated the loneliness - DBP reactivity relationship such that a higher number of outer social network ties were beneficial at lower levels of loneliness but not higher. The current study contributes new evidence linking loneliness and social network size to cardiovascular psychophysiology but raises questions about the loneliness - CVD relationship. The findings confirm the importance of social network size and highlight that the characteristics of the networks may be more important than the number of networks.

Validity of mental and physical stress models

Different stress models are employed to enhance our understanding of the underlying mechanisms and explore potential interventions. However, the utility of these models remains a critical concern, as their validities may be limited by the complexity of stress processes. Literature review revealed that both mental and physical stress models possess reasonable construct and criterion validities, respectively reflected in psychometrically assessed stress ratings and in activation of the sympathoadrenal system and the hypothalamic-pituitary-adrenal axis. The findings are less robust, though, in the pharmacological perturbations' domain, including such agents as adenosine or dobutamine. Likewise, stress models' convergent- and discriminant validity vary depending on the stressors' nature. Stress models share similarities, but also have important differences regarding their validities. Specific traits defined by the nature of the stressor stimulus should be taken into consideration when selecting stress models. Doing so can personalize prevention and treatment of stress-related antecedents, its acute processing, and chronic sequelae. Further work is warranted to refine stress models' validity and customize them so they commensurate diverse populations and circumstances.

Relationships Among Number of Stressors, Perceived Stress, and Salivary Cortisol Levels During the Third Trimester of Pregnancy

OBJECTIVE

To examine relationships among the number of stressors, perceived stress, and salivary cortisol levels during the third trimester of pregnancy.

DESIGN

Secondary analysis of cross-sectional data.

SETTING

Participants' homes.

PARTICIPANTS

Women during the third trimester of pregnancy (N = 73).

METHODS

Participants provided saliva samples at four time points over 2 days for cortisol assay and completed questionnaires to assess stressors and perceived stress. We computed multiple linear regression models to examine the relationships among the number of stressors and perceived stress to cortisol awakening response, diurnal slope, and overall cortisol secretion. We also computed a multiple linear regression model to examine the relationship between perceived stress and the number of stressors.

RESULTS

Greater perceived stress was associated with reduced overall cortisol secretion across the day (β = -0.41, p = .01). The number of stressors was associated with perceived stress (β = 0.48, p = .002) but not salivary cortisol measures.

CONCLUSION

Elevated perceived stress and the related cortisol alterations that we identified could represent salient targets for enhancing hypothalamic-pituitary-adrenal axis function during the third trimester. Perceived stress may shape the relationship between exposure to stressors and cortisol response during pregnancy. Future research is warranted to confirm study results and to understand the implications for parturition and fetal development.

Hair cortisol and dehydroepiandrosterone and their associations with optimism and pessimism in older people

The cumulative negative effects of prolonged Hypothalamic-Pituitary-Adrenal axis (HPA axis) activation are associated with several age-related diseases. Some psychological traits such as optimism and pessimism have been shown to be related to both health and the stress response, although their relationship with the HPA axis is inconclusive. More stable HPA axis biomarkers, such as hair samples of cortisol (HC) and dehydroepiandrosterone (HDHEA), would help to clarify the association between these psychological traits and HPA axis functioning. The main aim of this study was to test the relationships between optimism and pessimism and chronic stress biomarkers measured in hair (HC and HDHEA). Additionally, a secondary objective was to explore sex differences in HC and HDHEA levels and their relationship with these psychological traits. We measured optimism, pessimism, and their combination (dispositional optimism) using the Life Orientation Test Revised (LOT-R) and chronic stress biomarkers (HC and HDHEA) in 119 healthy participants (46 men and 73 women) between 56 and 81 years old who belonged to a university program. Regression analyses controlling for perceived stress and BMI indicated that higher dispositional optimism was related to lower HC and HC:HDHEAratio (β = -0.256, p = .008 and β = -0.300, p = .002, respectively). More specifically, higher pessimism was related to higher HC (β = 0.235; p = .012) and HC:HDHEAratio (β = 0.240; p = .011), whereas higher optimism was associated with a lower HC:HDHEAratio(β = -0.205; p = .031). Moderation analyses showed no sex differences. To date, this is the first study to investigate the link between these traits and HC and HDHEA in older people. Our results confirm that positive and negative expectations about the future (i.e. optimism and pessimism) may play an important role in health due to their relationship with the HPA axis. They also strengthen the idea that the negative effects of pessimism have a greater weight than the protective effects of optimism in their relationship with HPA axis regulation.

Associations of perceived stress with loneliness and depressive symptoms: the mediating role of sleep quality

BACKGROUND

Whether perceived stress is associated with loneliness and depressive symptoms in general adults, and to what extent sleep quality mediates the associations, remains unknown. The aim of this study was to estimate the associations of perceived stress with loneliness and depressive symptoms, and the mediating role of sleep quality in these associations.

METHODS

Cross-sectional data on 734 participants (aged 18-87 years) were analyzed. Perceived stress was assessed using the 10-item Perceived Stress Scale (PSS-10; range 0-40). Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI; range 0-21). Loneliness was assessed using the three-item short form of the Revised University of California, Los Angeles (UCLA) loneliness scale (range 3-9). Depressive symptoms were assessed using the 10-item Center for Epidemiologic Studies Depression (CESD-10) Scale (range 0-30). General linear regression models, multivariable logistic regression models, and formal mediation analysis were performed.

RESULTS

After adjustment for age and sex, we found that with each 1-point increment in the perceived stress score, both the loneliness score (β = 0.07; 95% confidence interval [CI]: 0.06, 0.08) and depression score (β = 0.45; 95% CI: 0.40, 0.49) increased significantly. Robust results were observed when adjusting for more confounders. Furthermore, sleep quality mediated 5.3% (95% CI: 1.3%, 10.0%; P = 0.014) and 9.7% (95% CI: 6.2%, 14.0%; P < 0.001) of the associations of perceived stress score with loneliness score and depression score, respectively.

CONCLUSIONS

In general Chinese adults, perceived stress was positively associated with loneliness and depressive symptoms, and sleep quality partially mediated these associations. The findings reveal a potential pathway from perceived stress to mental health through sleep behaviors, and highlight the importance of implementing sleep intervention programs for promoting mental health among those who feel highly stressed.

Prolonged stress response induced by chronic stress and corticosterone exposure causes adult neurogenesis inhibition and astrocyte loss in mouse hippocampus

Chronic stress is a pervasive and complex issue that contributes significantly to various mental and physical health disorders. Using the previously established chronic unpredictable stress (CUS) model, which simulates human stress situations, it has been shown that chronic stress induces major depressive disorder (MDD) and memory deficiency. However, this established model is associated with several drawbacks, such as limited research reproducibility and the inability to sustain stress response. To resolve these issues, we developed a new CUS model (CUS+C) that included exogenous corticosterone exposure to induce continuous stress response. Thereafter, we evaluated the effect of this new model on brain health. Thus, we observed that the use of the CUS+C model decreased body and brain weight gain and induced an uncontrolled coat state as well as depressive-like behavior in adult mice. It also impaired learning memory function and cognitive abilities, reduced adult hippocampal neurogenesis as well as the number of hippocampal astrocytes, and downregulated glial fibrillary acidic protein expression in the brains of adult mice. These findings can promote the utilization and validity of the animal stress model and provide new information for the treatment of chronic stress-induced depressive and memory disorders.

Gut microbiota-derived short-chain fatty acids and depression: deep insight into biological mechanisms and potential applications

The gut microbiota is a complex and dynamic ecosystem known as the 'second brain'. Composing the microbiota-gut-brain axis, the gut microbiota and its metabolites regulate the central nervous system through neural, endocrine and immune pathways to ensure the normal functioning of the organism, tuning individuals' health and disease status. Short-chain fatty acids (SCFAs), the main bioactive metabolites of the gut microbiota, are involved in several neuropsychiatric disorders, including depression. SCFAs have essential effects on each component of the microbiota-gut-brain axis in depression. In the present review, the roles of major SCFAs (acetate, propionate and butyrate) in the pathophysiology of depression are summarised with respect to chronic cerebral hypoperfusion, neuroinflammation, host epigenome and neuroendocrine alterations. Concluding remarks on the biological mechanisms related to gut microbiota will hopefully address the clinical value of microbiota-related treatments for depression.

Beneficial effects of short-term exposure to indoor biophilic environments on psychophysiological health: Evidence from electrophysiological activity and salivary metabolomics

BACKGROUND

The utilization of short-term natural exposure as a health intervention has great potential in the field of public health. However, previous studies have mostly focused on outdoor urban green spaces, with limited research on indoor biophilic environments, and the physiological regulatory mechanisms involved remain unclear.

OBJECTIVES

To explore the affective and physiological impact of short-term exposure to indoor biophilic environments and their potential regulatory mechanisms.

METHODS

A between-group design experiment was conducted, and the psychophysiological responses of participants to the indoor plants (Vicks Plant) were measured by a method combined the subjective survey, electrophysiological measurements, and salivary biochemical analysis. Volatile organic compounds (VOCs) from plants were also detected to analyze the main substances that caused olfactory stimuli.

RESULTS

Compared with the non-biophilic environment, short-term exposure to the indoor biophilic environment was associated with psychological and physiological relaxation, including reduced negative emotions, improved positive emotions, lower heart rate, skin conductance level, salivary cortisol and pro-inflammatory cytokines, and increased alpha brainwave power. Salivary metabolomics analysis revealed that the differential metabolites observed between the groups exhibited enrichment in two metabolic pathways related to neural function and immune response: phenylalanine, tyrosine and tryptophan biosynthesis, and ubiquinone and other terpenoid-quinone biosynthesis. These changes may be associated with the combined visual and olfactory stimuli of the biophilic environment, in which D-limonene was the dominant substance in plant-derived VOCs.

CONCLUSION

This research demonstrated the benefits of short-term exposure to indoor biophilic environments on psychophysiological health through evidence from both the nervous and endocrine systems.

Perceived association of mood and symptom severity in adults with mitochondrial diseases

Individuals with genetic mitochondrial diseases suffer from multisystemic symptoms that vary in severity from day-to-day and week-to-week, but the underlying causes of symptomatic fluctuations are not understood. Based upon observations that: i) patients and their families frequently report that stressful life events either trigger exacerbations of existing symptoms or the onset of new symptoms, ii) psychological states and stress hormones influence mitochondrial energy production capacity, and iii) epidemiological reports document a robust connection between traumatic/stressful life events and various neurologic disorders, we hypothesized that mitochondrial disease symptom severity may vary according to participant's mood. To investigate this we administered the Stress, Health and Emotion Survey (SHES) in 70 adults (majority white (84%) cisgender women (83%), ages 18-74) with self-reported mitochondrial diseases (MELAS, 18%; CPEO, 17%; Complex I deficiency, 13%). Participants rated the severity of each of their symptom(s) over the past year on either good or bad days. On days marked by more stress, sadness and other negative emotions, some but not all symptoms were reported to be worse, including fatigue, exercise intolerance, brain fog, and fine motor coordination. By contrast, on days marked by happiness and calmness, participants reported these and other symptoms to be better, or less severe. Other symptoms including diminished sweating, hearing problems, and dystonia were in general unrelated to mood. Thus, some individuals living with mitochondrial diseases, at times perceive a connection between their mood and symptom severity. These preliminary associative results constitute an initial step towards developing more comprehensive models of the factors that influence the clinical course of mitochondrial diseases.

Psychosocial aspects associated with self-reported oral health in Brazilians older adults

OBJECTIVES

Oral health conditions can be determined by a series of factors that include psychosocial aspects. Therefore, this study aimed to investigate the association between psychosocial aspects and self-reported oral health in Brazilian older adults.

METHODS

The Brazilian Longitudinal Study of Ageing (ELSI-Brazil) baseline data was analysed to develop this cross-sectional study. The outcome was self-reported oral health, and the psychosocial aspects included neighbourhood trust, life satisfaction and depressive symptoms. The associations were determined through Poisson regression models, controlling for socioeconomic, demographic and behavioural characteristics.

RESULTS

A total of 9365 individuals with aged 50 years or over were included in this study. Individuals with good life satisfaction had 16% (PR: 0.84; 95% CI: 0.78-0.90) lower prevalence of having poor self-reported oral health. Individuals who have depressive symptoms and do not trust in the neighbourhood presented 17% (PR: 1.17; 95% CI: 1.09-1.25) and 12% (PR: 1.12; 95% CI: 1.04-1.21) higher prevalence of poor self-report oral health compared to those who did not show depressive symptoms and trust the neighbourhood.

CONCLUSION

Our findings suggest that positive psychosocial aspects are moderately associated with better self-reported oral health. Therefore, we suggest that psychological health and social interaction should be present in public health policy actions.

Do interventions for mood improve inflammatory biomarkers in inflammatory bowel disease?: a systematic review and meta-analysis

BACKGROUND

Psychoneuroimmunological mechanisms and the gut-brain axis appear relevant to disease activity and progression in Inflammatory Bowel Disease (IBD). A recent review showed no effect of psychological therapies on self-reported disease activity in IBD. This meta-analysis aims to establish whether interventions targeting mood outcomes (e.g., depression, anxiety and stress) impact inflammation levels in IBD and possible moderators of these effects.

METHODS

The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were followed. We searched five electronic databases and included randomised controlled trials where interventions targeted mood and assessed inflammatory outcomes pre- and post-intervention in adults with IBD. Independent reviewers screened studies, extracted data, and assessed methodological quality. Data were pooled to estimate standardised mean differences (SMDs) with 95% Confidence Intervals (CIs). A random-effects robust variance estimation accounted for studies measuring multiple biomarkers. Intervention type, mood as a primary or secondary outcome, effect on mood outcomes and IBD subtype were investigated as treatment effect moderators. Where there were sufficient biomarkers, individual meta-analyses were run (Pre-registration PROSPERO: CRD42023389401).

FINDINGS

28 RCTs involving 1789 participants met inclusion criteria. Interventions demonstrated small, statistically significant effects on biomarkers (-0.35, 95% CI: -0.48, -0.22, p < 0.001) and medium effects on mood outcomes (-0.50, 95% CI: -0.73, -0.27, p < 0.001), without evidence of substantive heterogeneity or publication bias. Individual analyses showed small effects for improved faecal calprotectin (-0.19, 95% CI: -0.34, -0.03, p = 0.018) and C-Reactive Protein (-0.29, 95% CI: -0.47, -0.10, p = 0.002). Effect sizes were larger for psychological therapy interventions (compared with exercise or antidepressants) and when there was an effect (SMD ≥0.2) on mood.

INTERPRETATION

Treatments which address mood outcomes have beneficial effects on generic inflammation as well as disease-specific biomarkers (faecal calprotectin and C-Reactive Protein). Psychological interventions and interventions with larger treatment effects on mood accentuated the effect on biomarkers. More research is required to understand the biological or behavioural mechanisms underlying this effect.

FUNDING

The Medical Research Council and the National Institute for Health and Care Research (NIHR) Maudsley Biomedical Research Centre.

An Ego-Involving Motivational Climate Can Trigger Inflammation, a Threat Appraisal, and Basic Psychological Need Frustration in an Achievement Context

In this experimental investigation, male college students (N = 56; Mage = 19.95 years) who did not yet know how to juggle were randomly assigned to a 30-min instructional juggling session with either a caring, task-involving climate or an ego-involving climate. An inflammatory response to psychosocial stress was assessed via salivary interleukin-6 prior to (t = 0) and following (t = +30, +45, +60 min) the session. Surveys were utilized to examine positive and negative affect prior to the session and affect, psychological needs, challenge and threat appraisals, and perceived ability to juggle following the session. This is the first investigation to show that ego-involving climates can trigger inflammation, along with maladaptive psychological responses. Participants in the caring, task-involving climate responded with greater psychological need satisfaction, resource evaluations, positive affect, and perceived juggling ability. This research suggests there may be important physiological consequences to ego-involving climates, in addition to concerning cognitive, affective, and behavioral responses.

Glucocorticoid and Adrenergic Receptor Distribution Across Human Organs and Tissues: A Map for Stress Transduction

OBJECTIVE

Psychosocial stress is transduced into disease risk through energy-dependent release of hormones from the hypothalamic-pituitary-adrenal and sympathetic-adrenal-medullary axes. The levels of glucocorticoid and adrenergic hormones, together with the sensitivity of tissues to their signaling, define stress responses. To understand existing pathways responsible for the psychobiological transduction of stressful experiences, we provide a quantitative whole-body map of glucocorticoid and adrenergic receptor (AR) expression.

METHODS

We systematically examined gene expression levels for the glucocorticoid receptor (GR), α- and β-ARs (AR-α1B, AR-α2B AR-β2, and AR-β3), across 55 different organs using the Human Protein Atlas and Human Proteome Map datasets. Given that mitochondria produce the energy required to respond to stress, we leveraged the Human Protein Atlas and MitoCarta3.0 data to examine the link between stress hormone receptor density and mitochondrial gene expression. Finally, we tested the functional interplay between GR activation and AR expression in human fibroblast cells.

RESULTS

The GR was expressed ubiquitously across all investigated organ systems, whereas AR subtypes showed lower and more localized expression patterns. Receptor co-regulation, meaning the correlated gene expression of multiple stress hormone receptors, was found between GR and AR-α1B, as well as between AR-α1B and AR-α2B. In cultured human fibroblasts, activating the GR selectively increased AR-β2 and AR-α1B expression. Consistent with the known energetic cost of stress responses, GR and AR expressions were positively associated with the expression of specific mitochondrial pathways.

CONCLUSIONS

Our results provide a cartography of GR and AR expression across the human body. Because stress-induced GR and AR signaling triggers energetically expensive cellular pathways involving energy-transforming mitochondria, the tissue-specific expression and co-expression patterns of hormone receptor subtypes may in part determine the resilience or vulnerability of different organ systems.

Purpose in life and stress: An individual-participant meta-analysis of 16 samples

Background

Purpose in life is a psychological resource that has been associated with better regulation of stress. The present research reports a coordinated analysis of the association between purpose in life and subjective stress and evaluates potential sociodemographic and mental health moderators of this association.

Methods

With individual participant data from 16 samples (total N=108,391), linear regression examined the association between purpose in life and general subjective feelings of stress, controlling for sociodemographic characteristics.

Results

Greater purpose in life was associated with less subjective stress (meta-analytic estimate=-.228, 95% Confidence Interval=-.292, -.164; p<.001). Interaction terms between sociodemographic factors and purpose tested in the individual samples and synthesized with meta-analysis were not significant, which indicated that the association between purpose and stress was similar across age, sex, race, ethnicity, and education. The association was also not moderated by psychological distress. Meta-regressions further indicated that this association was generally similar across scale length, content of the purpose measure, and across samples from Eastern and Western countries.

Limitations

The associations reported are observational. Experimental work is needed to evaluate causality.

Conclusions

Purpose in life is associated with less subjective stress across populations. Less subjective stress may be one mechanism through which purpose contributes to better mental and physical health.

Biological Sex as a Moderator of Work Determinants of Health: Implications for Work and Stress

This study examined whether biological sex moderates the relationship between experiences of workplace culture and urinary levels of catecholamines and their metabolites. We conducted a series of regression analyses (predictors: 3-methoxytyramine (3MT), 5-hydroxyindolacetic (5HIAA), and dopamine (DA); outcomes: employee engagement and workplace culture) in a sample of 218 participants. Compared to men, women rated workplace culture less positively (r = -0.210; p < 0.01) and had stronger positive associations with 3MT (r = 0.328; p < 0.001), DA (r = 0.376; p < 0.001), and 5HIAA (r = 0.168; p < 0.01). There was a significant moderation effect between 3MT and sex on employee engagement (b = -1.76 (SE = 0.84); p < 0.01), and 3MT had a positive significant association for men with engagement (p < 0.05); however, there was no significant association for women. Findings suggest that for women, less positive experiences with workplace culture could elevate 3MT, stimulating sympathetic nervous tone and potentially amplifying risks for negative health outcomes. Conversely, men who reported higher employee engagement had higher levels of 3MT, suggesting possible health risks associated with high levels of engagement, rather than lack of engagement. Overall, study findings suggested differential health risks based on biological sex, potentially impacting health risk policy development.

Stress experienced by dental students performing clinical training in different dental disciplines: a cross-sectional study

OBJECTIVES

To assess the stress level, the impact of stress factors, and discrepancies between fourth- and fifth-year undergraduate clinical students at the University of Jordan.

METHODS

A cross-sectional study was conducted in the academic year 2022/2023. The study group included fourth- and fifth-year dental students at the University of Jordan (n = 382) who were asked to voluntarily fill in an online dental environment stress (DES) questionnaire. Analysis was conducted using Mann-Whitney U test, independent t-test, χ2 test, and Spearman ρ rank correlations. Statistical significance was inferred when P < .05.

RESULTS

Fourth-year students reported higher levels of nervousness before treating patients for the first time. Fifth-year students faced more difficulty, higher stress, and/or fear regarding the amount of assigned work, provided treatment, completed requirements, failing the course, time to finish assignments, patient comprehensive care, and financial expenses of the course. Comparison between groups revealed that the fifth-year students scored higher levels of stress on the total DES score and all partial DES scores. Furthermore, the total DES questionnaire scores were significantly correlated with grade point average (GPA) among the total study sample and the prosthodontics clinical course marks among the fourth-year students' group.

CONCLUSIONS

The stress level among students in clinical courses was influenced by their academic performance, gender, year level, and the type and time needed for the provided treatment. Completing course requirements was among the most commonly faced stressors. Future research endeavors might be considered to study each clinical factor, its impact on students' stress level, and how to manage and positively improve these factors.

Relationship Between Multiple Roles and Leisure-Time Physical Activities in Working-Age Women

BACKGROUND

Multiple role theory has proven effective in predicting variations in health, and a growing body of research has shown the importance of taking women's roles into account when analyzing physical activity levels. Nonetheless, researchers have yet to characterize the interaction between the various roles played by women and their physical activity.

PURPOSE

The objectives of this study were to elucidate the relationship between multiple roles and leisure-time physical activities (LTPAs) and to determine whether LTPA varies among women across different roles.

METHODS

Data were derived from the 2013 National Health Interview Survey database provided by the Health Promotion Administration of Taiwan's Ministry of Health and Welfare, which includes 5,147 working-age women. The current study focused on women aged 20-50 years. The roles considered in this study included living with a partner, living with children, and employment status. LTPA levels were categorized as regular, inactive, or insufficient based on the LTPA metabolic equivalent in the previous week. The associations among level of LTPA, multiple roles, and demographic characteristics were analyzed using multiple regression analysis.

RESULTS

We found single mothers with children to be more inactive than partnered mothers, and women living with a partner and those living with children were more likely to be inactive, whereas women working full-time were not at risk of inactivity. Women who assumed a larger number of roles were at a greater risk of inactivity. These findings are consistent with role strain theory.

CONCLUSIONS

Single mothers with children are more inactive than partnered mothers, and appropriate social support programs are necessary to reduce further disparities. Second, multiple demands on working-age women limit the time available for LTPAs, particularly among women living with a partner and children and engaged in full-time work. A physical activity intervention is a program or initiative designed to promote physical activity and improve health outcomes. We should develop and provide sustainable physical activity resources through the help of partners' housework to better promote physical activity intervention for working-age women.

Vitamin E reduces oxidative stress in brains of male albino male rats undergoing immobilization

Stress can lead to various health problems. Exposure to stress is linked to several diseases including cancer, hypertension, diabetes, mental disorders, and heart attacks. Stress stimulates several pathways that produce free radicals, which increases oxidative stress. This results in functional and structural damage to organs, such as the brain, which is highly sensitive to oxidative stress Vitamin E is a naturally occurring potent antioxidant used for various purposes. The main purpose of the current study was to evaluate how vitamin E protects the brain and to what extent it affects antioxidant levels in rats subjected to two hours per day of immobilization stress, the form of stress with the strongest effect. The rats were immobilized by folding their limbs in and wrapping them in netting to prevent movement, while allowing their tails to be extended. The rats were then hung upside down. The effect of vitamin E was tested by intraperitoneally injecting rats with 40 mg/kg of vitamin E daily. Oxidative stress parameters were determined at the completion of the experiment. A dramatic decrease in malondialdehyde (MDA) levels and an increase in catalase (CAT), including glutathione peroxidase (GSH-Px) and superoxide dismutase (SOD), has been shown by vitamin E in the brain. The effects of vitamin E were significantly higher in the acute and chronic stress groups than in the control group. Vitamin E can decrease oxidative stress in stressed rats, indicating that it exerts therapeutic and protective effects owing to its antioxidant properties.

Fluoxetine attenuates stress-induced depression-like behavior due to decrease in pro-inflammatory cytokines in male rats

Background: Pro-inflammatory cytokines are implicated in depression caused by both environmental- and alcohol-induced stress. The purpose of the study was to investigate the cytokine levels in serum and hippocampus following induction of depression-like behaviors (DLB) by either forced swimming test (FST) or ethanol-induced DLB (EID). We also investigated the effect of prior administration of antidepressant drug fluoxetine on cytokines in animals exposed to both models of DLB. Methods: Animals were pretreated with fluoxetine before inducing DLB, while DLB was induced in some animals using FST and ethanol in different groups of rats without fluoxetine pretreatment. The ELISA was used to detect changes in cytokine (IL-1β, IL-6, and TNF-α) levels in serum and hippocampus. Results: The mean levels of IL-1β and IL-6 measured in serum and hippocampus were significantly higher in FST and EID models when compared to the control group. The serum concentrations of IL-1β and IL-6 were significantly reduced in animals pre-treated with 5 mg/kg and 10 mg/kg of fluoxetine in both FST and EID models when compared to the untreated FST and EID groups respectively. Conclusions: In conclusion, both environment and alcohol can induce stress and DLB in rats with similar intensity, and their mechanisms of DLB induction involve activation of pro-inflammatory cytokines. Moreover, fluoxetine can prevent stress-induced inflammation in models of DLB.

Effectiveness of stress management interventions to change cortisol levels: a systematic review and meta-analysis

Stress has a damaging impact on our mental and physical health, and as a result, there is an on-going demand for effective stress management interventions. However, there are no reviews or meta-analyses synthesising the evidence base of randomised controlled trials testing the effectiveness of psychological interventions on changing cortisol levels (the stress hormone) in non-patient groups. Therefore, the primary aim of this systematic review and meta-analysis was to address this gap. Six databases (Medline, PsychInfo, Embase, CINAHL, Cochrane and Web of Science) were searched (1171 studies identified) with 58 studies (combined N = 3508) included in the meta-analysis. The interventions were coded into one of four categories; mind body therapies, mindfulness, relaxation or talking therapies. A random effects meta-analysis on cortisol as measured in blood, saliva or hair found that stress management interventions outperformed pooled control conditions with a medium positive effect size (g = 0.282). The studies that utilised cortisol awakening measures (g = 0.644) revealed larger effects of stress management interventions than those that measured diurnal cortisol (g = 0.255). Mindfulness and meditation (g = 0. 345) and relaxation (g = 0. 347) interventions were most effective at changing cortisol levels, while mind body therapies (g = 0. 129) and talking therapies (g = 0.107) were shown to have smaller and non-significant effect sizes. Additionally, studies that utilised an active control group (g = 0. 477) over passive control group (g = 0.129) were found to have stronger effects. Length of the intervention, study quality, risk of bias, age and gender did not influence the effectiveness of interventions and there was no evidence of publication bias. Overall, the current findings confirm that stress management interventions can positively influence cortisol levels. Future research should investigate the longer term implications for health and health outcomes.

The Stress Phenotyping Framework: A multidisciplinary biobehavioral approach for assessing and therapeutically targeting maladaptive stress physiology

Although dysregulated stress biology is becoming increasingly recognized as a key driver of lifelong disparities in chronic disease, we presently have no validated biomarkers of toxic stress physiology; no biological, behavioral, or cognitive treatments specifically focused on normalizing toxic stress processes; and no agreed-upon guidelines for treating stress in the clinic or evaluating the efficacy of interventions that seek to reduce toxic stress and improve human functioning. We address these critical issues by (a) systematically describing key systems and mechanisms that are dysregulated by stress; (b) summarizing indicators, biomarkers, and instruments for assessing stress response systems; and (c) highlighting therapeutic approaches that can be used to normalize stress-related biopsychosocial functioning. We also present a novel multidisciplinary Stress Phenotyping Framework that can bring stress researchers and clinicians one step closer to realizing the goal of using precision medicine-based approaches to prevent and treat stress-associated health problems.

Financial strain across 25 years and women's bladder health: a life course perspective

BACKGROUND

A small number of cross-sectional studies have found that financial insecurity-a social determinant of health-is associated with lower urinary tract symptoms.

OBJECTIVE

This study aimed to examine (1) whether women in the Coronary Artery Risk Development in Young Adult Study with higher levels of financial strain, assessed at 7 time points across 25 years beginning in 1985-1986, were more likely to report lower urinary tract symptoms and impact after the 2010-2011 financial strain assessment and (2) whether healthcare access and comorbidities mediated potential associations.

STUDY DESIGN

This prospective cohort study recruited Black and White participants aged 18 to 30 years at baseline (1985-1986) from the populations of 4 US cities. The analytical sample was composed of women with complete data for analyses involving financial strain trajectories across 7 assessments (n=841) and mediation tests of data collected at 4 assessments (n=886). The outcome variable was previously developed through a cluster analysis of urinary incontinence severity, urinary incontinence impact, other lower urinary tract symptoms severity, and their impact in 2012-2013, which yielded 4 lower urinary tract symptoms and impact cluster categories: women with no symptom or very mild symptoms and no impact vs women with mild, moderate, or severe symptoms and impact. Financial strain was defined as finding it "very hard," "hard," or "somewhat hard" (vs "not very hard") to pay for the very basics, such as food, heating, and medical care. Using proportional odds logistic regression, cluster categories were regressed on the financial strain trajectory group, adjusting for age, race, education, and parity. For mediation analyses, separate financial strain variables (difficulty paying for the very basics, such as food and heating, and difficulty paying for medical care) were created by combining 1995-1996 and 2000-2001 values. Two healthcare access variables (difficulty receiving care and underutilization of care) and a single comorbidity index (smoking, physical inactivity, body mass index, hypertension, diabetes mellitus, and depressive symptoms) were created by combining 2005-2006 and 2010-2011 values. Regression analyses and structural equation modeling were used to test whether healthcare access and comorbidities mediated associations between financial strain and lower urinary tract symptoms and impact cluster categories.

RESULTS

In comparison to women who were consistently not financially strained, women who were consistently strained (odds ratio, 2.10; 95% confidence interval, 1.13-3.91), shifted into being strained (odds ratio, 2.00; 95% confidence interval, 1.29-3.10), or experienced >1 shift in strain (odds ratio, 1.99; 95% confidence interval, 1.46-2.71) had roughly twice the odds of reporting greater lower urinary tract symptoms and impact. Underutilization of healthcare and comorbidities mediated the association between difficulty paying for medical care and lower urinary tract symptoms and impact. In the structural equation model, difficulty paying for medical care and underutilization of care were associated (β=.31; P<.01), as was underutilization of care and greater lower urinary tract symptoms and impact (β=.09; P<.01). Moreover, difficulty paying for medical care and the comorbidity index were associated (β=.34; P<.01), as was the comorbidity index and greater lower urinary tract symptoms and impact (β=.24; P<.01). Collectively, these mediation pathways eliminated a direct association between difficulty paying for medical care and lower urinary tract symptoms and impact.

CONCLUSION

Underutilization of healthcare and comorbidities explained an association between financial strain (difficulty paying for medical care) and lower urinary tract symptoms and impact. Research is needed to confirm the findings and examine other mechanisms that may further explain the association. Accumulated evidence may inform future policies and practices.

Mitochondria as a sensor, a central hub and a biological clock in psychological stress-accelerated aging

The theory that oxidative damage caused by mitochondrial free radicals leads to aging has brought mitochondria into the forefront of aging research. Psychological stress that encompasses many different experiences and exposures across the lifespan has been identified as a catalyst for accelerated aging. Mitochondria, known for their dynamic nature and adaptability, function as a highly sensitive stress sensor and central hub in the process of accelerated aging. In this review, we explore how mitochondria as sensors respond to psychological stress and contribute to the molecular processes in accelerated aging by viewing mitochondria as hormonal, mechanosensitive and immune suborganelles. This understanding of the key role played by mitochondria and their close association with accelerated aging helps us to distinguish normal aging from accelerated aging, correct misconceptions in aging studies, and develop strategies such as exercise and mitochondria-targeted nutrients and drugs for slowing down accelerated aging, and also hold promise for prevention and treatment of age-related diseases.

Challenge or Threat? The Effects of the Standard and a Second-Generation Mindfulness Intervention with Buddhist Practices on Cognitive Appraisals of Stress: Secondary Analysis of a Randomized Controlled Experiment Performed in Switzerland

Contemplative approaches rooted in Buddhist traditions have been linked to the attenuation of response to social stress. Anticipatory cognitive appraisals of social situations potentially represent a mechanism explaining the stress-reducing effects of contemplative practices. The cognitive appraisal of threat is associated with an anticipated loss of social self-esteem. In contrast, the cognitive appraisal of challenge involves recognizing the potential for gain or growth in stressful situations and is associated with a more adaptive cardiovascular response. In this secondary analysis of a randomized controlled experiment performed in Switzerland, we evaluated the effects of two contemplative interventions on cognitive appraisals of challenge and threat and associated physiological profiles. The interventions were a standard Mindfulness-Based Stress Reduction (MBSR) program and a new program (MBSR-B), which included several elements from Buddhist practices. After an eight-week intervention, participants completed the Trier Social Stress Test (TSST) and underwent the assessment of primary cognitive appraisals and cardiovascular response to stress. The results demonstrated greater challenge appraisal in the MBSR (n = 20) and MBSR-B (n = 21) groups compared to Control (n = 24), and MBSR-B participants scored higher on the challenge than threat appraisal. At the physiological level, the groups did not differ on changes in cardiac output and total peripheral resistance. Still, an exploratory analysis demonstrated that the MBSR-B group's cardiovascular profile best resembled challenge appraisal. The results suggest that contemplative approaches foster challenge appraisal, contributing to a more adaptive response to stress.

Chia seeds oil ameliorate chronic immobilization stress-induced neurodisturbance in rat brains via activation of the antioxidant/anti-inflammatory/antiapoptotic signaling pathways

Chronic immobilization stress plays a key role in several neuropsychiatric disorders. This investigation assessed the possible ameliorative effect of chia seed oil (CSO) against the neurodisturbance-induced in rats by chronic immobilization. Rats were randomly allocated into control, CSO (1 ml/kg b.wt./orally), restrained (6 h/day), CSO pre-restraint, and CSO post-restraint for 60 days. Results revealed a significant reduction in serum corticosterone level, gene expression of corticotrophin-releasing factor, pro-inflammatory cytokines, and oxidative biomarkers in restrained rats treated with CSO. The histopathological findings revealed restoring necrosis and neuronal loss in CSO-treated-restraint rats. The immunohistochemical evaluation revealed a significant reduction in the immuno-expression of caspase-3, nuclear factor kappa B, interleukin-6, and cyclooxygenase-2 (COX-2), and an elevation of calbindin-28k and synaptophysin expression compared to non-treated restraint rats. The molecular docking showed the CSO high affinity for several target proteins, including caspase-3, COX-2, corticotropin-releasing hormone binding protein, corticotropin-releasing factor receptors 1 and 2, interleukin-1 receptor types 1 and 2, interleukin-6 receptor subunits alpha and beta. In conclusion, CSO emerges as a promising candidate against stress-induced brain disruptions by suppressing inflammatory/oxidative/apoptotic signaling pathways due to its numerous antioxidant and anti-inflammatory components, mainly α-linolenic acid. Future studies are necessary to evaluate the CSO therapeutic impacts in human neurodisturbances.

Revisiting effects of teacher characteristics on physiological and psychological stress: a virtual reality study

Identifying personal characteristics associated with teachers' stress is a longstanding research goal with important implications for practice. The present work revisits the effects of individual characteristics in terms of neuroticism, classroom management self-efficacy, and cognitive (reasoning) abilities on stress using virtual reality (VR). Relying on a sample of 56 German pre-service teachers (Mage = 22.73, SDage = 4.93; 50.9% females), we capitalized on a VR classroom environment that allowed the integration of experimental control and authentic teaching situations, where pre-service teachers responded to the disruptive behaviors of the student avatars. We focused on stress responses in terms of psychological stress (self-reported stress) assessed after the VR session, and physiological stress (heart rate) assessed during the VR session. A total of 30 (26) participants was assigned to a condition with higher (lower) levels of disruptive student behavior, referred to as higher and lower complexity condition, respectively. Results from linear mixed-effects models revealed that neuroticism positively predicted psychological and physiological stress responses in pre-service teachers, whereas classroom management self-efficacy and cognitive (reasoning) abilities were not significantly related to stress responses. Level of complexity and the interaction between complexity and individual characteristics did not have an effect. This study underlines the value of VR as a tool for psychological research and contributes to existing knowledge on teacher characteristics and stress.

Health Economic Evaluation of a Controlled Lifestyle Intervention: The Healthy Lifestyle Community Program (Cohort 2; HLCP-2)

Non-communicable diseases (NCD) are associated with high costs for healthcare systems. We evaluated changes in total costs, comprising direct and indirect costs, due to a 24-month non-randomized, controlled lifestyle intervention trial with six measurement time points aiming to improve the risk profile for NCDs. Overall, 187 individuals from the general population aged ≥18 years were assigned to either the intervention group (IG; n = 112), receiving a 10-week intensive lifestyle intervention focusing on a healthy, plant-based diet; physical activity; stress management; and community support, followed by a 22-month follow-up phase including monthly seminars, or a control group (CG; n = 75) without intervention. The complete data sets of 118 participants (IG: n = 79; CG: n = 39) were analyzed. At baseline, total costs per person amounted to 67.80 ± 69.17 EUR in the IG and 48.73 ± 54.41 EUR in the CG per week. The reduction in total costs was significantly greater in the IG compared to the CG after 10 weeks (p = 0.012) and 6 months (p = 0.004), whereas direct costs differed significantly after 10 weeks (p = 0.017), 6 months (p = 0.041) and 12 months (p = 0.012) between the groups. The HLCP-2 was able to reduce health-related economic costs, primarily due to the reduction in direct costs.

Hypoxic acclimatization training improves the resistance to motion sickness

Objective

Vestibular provocation is one of the main causes of flight illusions, and its occurrence is closely related to the susceptibility of motion sickness (MS). However, existing training programs have limited effect in improving the resistance to motion sickness. In this study, we investigated the effects of hypoxia acclimatization training (HAT) on the resistance to motion sickness.

Methods

Healthy military college students were identified as subjects according to the criteria. MS model was induced by a rotary chair. Experimental groups included control, HAT, 3D roller training (3DRT), and combined training.

Results

The Graybiel scores were decreased in the HAT group and the 3DRT group and further decreased in the combined training group in MS induced by the rotary chair. Participants had a significant increase in blood pressure after the rotary chair test and a significant increase in the heart rate during the rotary chair test, but these changes disappeared in all three training groups. Additionally, LFn was increased, HFn was decreased, and LF/HF was increased accordingly during the rotary chair test in the control group, but the changes of these three parameters were completely opposite in the three training groups during the rotary chair test. Compared with the control group, the decreasing changes in pupillary contraction velocity (PCV) and pupillary minimum diameter (PMD) of the three training groups were smaller. In particular, the binocular PCV changes were further attenuated in the combined training group.

Conclusion

Our research provides a possible candidate solution for training military pilots in the resistance to motion sickness.