Suppression, but not reappraisal, is associated with inflammation in trauma-exposed veterans

BACKGROUND

Emotion dysregulation can elicit inflammatory activity. The current study examined whether specific maladaptive and adaptive emotion regulation strategies were associated with inflammatory markers in trauma-exposed veterans, above and beyond PTSD.

METHODS

In a cohort study, 606 participants exposed to a Criterion A trauma and recruited from Veteran Health Administration facilities completed fasting blood draws, the Emotion Regulation Questionnaire, and the Clinician Administered PTSD Scale-IV. Inflammation was assessed with high sensitivity C-reactive protein (hsCRP), white blood cell count (WBC), and fibrinogen levels. An inflammation index was created by summing standardized log-transformed levels of the three biomarkers. Our primary linear regression models were adjusted for sex, age, race, education, income, creatinine, and PTSD.

RESULTS

Suppression, but not cognitive reappraisal, was significantly associated with higher levels of the inflammatory index (β = 0.14, p = 0.001). Parallel analyses for the individual inflammatory markers also showed suppression, but not reappraisal, was significantly associated with higher hsCRP (β = 0.11, p = 0.01), WBC (β = 0.11, p = 0.01), and fibrinogen (β = 0.10, p = 0.02).

CONCLUSIONS

Emotional suppression is related to elevated systemic inflammation independent of PTSD. Cognitive reappraisal is unrelated to inflammation. Findings suggest over-utilization of maladaptive, rather than under-utilization of adaptive, emotion regulation strategies may be associated with systemic inflammation in trauma-exposed veterans.

1112 Mental Health And Sleep Disorders Are Associated With Elevated C-reactive Protein In Returning Veterans

Introduction

Mental health disorders and sleep disorders are associated with systemic inflammation, which may be a key element linking these highly co-occurring conditions to negative health outcomes. This study used national VA medical records to examine C-reactive protein (CRP) levels in Iraq/Afghanistan veterans based on presence of mental health and/or sleep disorder diagnoses.

Methods

We examined medical records for 16,576 Iraq/Afghanistan veterans under age 55 who had high-sensitivity CRP results reported. ICD diagnostic codes were used to compare CRP values for: a) veterans without sleep disorders or mental health diagnoses, b) veterans with mental health disorders only, c) veterans with sleep disorders only, and d) veterans with both conditions. In generalized linear models controlling for demographics, we examined the impact of diagnostic category on continuous CRP value as well as the risk of elevated CRP (>3mg/L).

Results

Veterans with mental health disorders (coeff=.14, p<.001) and comorbid sleep and mental health disorders (coeff=.21, p<.001) had higher continuous CRP values compared to veterans without either condition. Veterans with comorbid sleep and mental health disorders had higher continuous CRP values than veterans with sleep disorders alone (coeff=.22, p<.041); however, there were few patients in the current sample who were diagnosed with sleep disorders alone (n=401, 2.4%). Additionally, veterans with mental health disorders (ARR=1.12, p=.004) and comorbid sleep and mental health disorders (ARR=1.15, p=.001) were more likely to have CRP values >3mg/L compared to veterans without either condition.

Conclusion

Sleep disorders were highly likely to co-occur with mental health disorders in this sample of Iraq/Afghanistan veterans. Mental health disorders and comorbid mental health/sleep disorders were associated with elevated C-reactive protein, indicating these patients are at highest risk for negative health outcomes. Future studies should investigate directionality of relationships among sleep disruption, mental health symptoms, and inflammation.

Support

VA Advanced Fellowship Program in Mental Illness Research and Treatment

Oxytocin administration enhances controlled social cognition in patients with schizophrenia

BACKGROUND

Individuals with schizophrenia have functionally significant deficits in automatic and controlled social cognition, but no currently available pharmacologic treatments reduce these deficits. The neuropeptide oxytocin has multiple prosocial effects when administered intranasally in humans and there is growing interest in its therapeutic potential in schizophrenia.

METHODS

We administered 40 IU of oxytocin and saline placebo intranasally to 29 male subjects with schizophrenia and 31 age-matched, healthy controls in a randomized, double-blind, placebo-controlled, cross-over study. Social cognition was assessed with The Awareness of Social Inference Test (TASIT) and the Reading the Mind in the Eyes Test (RMET). We examined the effects of oxytocin administration on automatic social cognition (the ability to rapidly interpret and understand emotional cues from the voice, face, and body); controlled social cognition (the ability to comprehend indirectly expressed emotions, thoughts, and intentions through complex deliberations over longer time periods); and a control task (the ability to comprehend truthful dialog and perform general task procedures) in individuals with and without schizophrenia using mixed factorial analysis of variance models.

RESULTS

Patients with schizophrenia showed significant impairments in automatic and controlled social cognition compared to healthy controls, and administration of oxytocin significantly improved their controlled, but not automatic, social cognition, F(1, 58)=8.75; p=0.004. Conversely, oxytocin administration had limited effects on social cognition in healthy participants. Patients and controls performed equally well and there were no effects of oxytocin administration on the control task.

DISCUSSION

Intact social cognitive abilities are associated with better functional outcomes in individuals with schizophrenia. Our data highlight the potentially complex effects of oxytocin on some but not all aspects of social cognition, and support the exploration of intranasal oxytocin as a potential adjunct treatment to improve controlled social cognition in schizophrenia.

Pessimism correlates with leukocyte telomere shortness and elevated interleukin-6 in post-menopausal women

The combination of less positive and more negative expectations for the future (i.e., lower optimism and higher pessimism) increases risk for disease and early mortality. We tested the possibility that expectancies might influence health outcomes by altering the rate of biological aging, specifically of the immune system (immunosenescence). However, no studies to date have examined associations between optimism or pessimism and indicators of immunosenescence such as leukocyte telomere length (TL) and interleukin-6 (IL-6) levels. We investigated whether dispositional tendencies towards optimism and pessimism were associated with TL and IL-6 in a sample of 36 healthy post-menopausal women. Multiple regression analyses where optimism and pessimism were entered simultaneously, and chronological age and caregiver status were controlled, indicated that pessimism was independently associated with shorter TL (beta=-.68, p=.001) and higher IL-6 concentrations (beta=.50, p=.02). In contrast, optimism was not independently associated with either measure of immunosenescence. These findings suggest that dispositional pessimism may increase IL-6 and accelerate rate of telomere shortening. Mechanistic causal relationships between these parameters need to be investigated.