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Kalisch R, Russo SJ, Müller MB. Neurobiology and systems biology of stress resilience. Physiol Rev 2024; 104:1205-1263. [PMID: 38483288 DOI: 10.1152/physrev.00042.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 03/06/2024] [Accepted: 03/12/2024] [Indexed: 05/16/2024] Open
Abstract
Stress resilience is the phenomenon that some people maintain their mental health despite exposure to adversity or show only temporary impairments followed by quick recovery. Resilience research attempts to unravel the factors and mechanisms that make resilience possible and to harness its insights for the development of preventative interventions in individuals at risk for acquiring stress-related dysfunctions. Biological resilience research has been lagging behind the psychological and social sciences but has seen a massive surge in recent years. At the same time, progress in this field has been hampered by methodological challenges related to finding suitable operationalizations and study designs, replicating findings, and modeling resilience in animals. We embed a review of behavioral, neuroimaging, neurobiological, and systems biological findings in adults in a critical methods discussion. We find preliminary evidence that hippocampus-based pattern separation and prefrontal-based cognitive control functions protect against the development of pathological fears in the aftermath of singular, event-type stressors [as found in fear-related disorders, including simpler forms of posttraumatic stress disorder (PTSD)] by facilitating the perception of safety. Reward system-based pursuit and savoring of positive reinforcers appear to protect against the development of more generalized dysfunctions of the anxious-depressive spectrum resulting from more severe or longer-lasting stressors (as in depression, generalized or comorbid anxiety, or severe PTSD). Links between preserved functioning of these neural systems under stress and neuroplasticity, immunoregulation, gut microbiome composition, and integrity of the gut barrier and the blood-brain barrier are beginning to emerge. On this basis, avenues for biological interventions are pointed out.
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Affiliation(s)
- Raffael Kalisch
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Scott J Russo
- Nash Family Department of Neuroscience, Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, New York, United States
- Brain and Body Research Center, Icahn School of Medicine at Mount Sinai, New York, New York, United States
| | - Marianne B Müller
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Translational Psychiatry, Department of Psychiatry and Psychotherapy, Johannes Gutenberg University Medical Center, Mainz, Germany
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2
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Marciniak MA, Shanahan L, Myin-Germeys I, Veer IM, Yuen KSL, Binder H, Walter H, Hermans EJ, Kalisch R, Kleim B. Imager-A mobile health mental imagery-based ecological momentary intervention targeting reward sensitivity: A randomized controlled trial. Appl Psychol Health Well Being 2024; 16:576-596. [PMID: 37942875 DOI: 10.1111/aphw.12505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 10/16/2023] [Indexed: 11/10/2023]
Abstract
Robust reward sensitivity may help preserve mental well-being in the face of adversity and has been proposed as a key stress resilience factor. Here, we present a mobile health application, "Imager," which targets reward sensitivity by training individuals to create mental images of future rewarding experiences. We conducted a two-arm randomized controlled trial with 95 participants screened for reward sensitivity. Participants in the intervention group received an ecological momentary intervention-Imager, which encouraged participants to create mental images of rewarding events for 1 week. The control group participants received only ecological momentary assessment, without the instruction to generate mental images. Adherence to Imager was high; participants in the intervention group engaged in 88% of the planned activities. In the follow-up assessment, the intervention group reported less mental health symptoms, mainly in depression (β = -0.34, df = 93, p = .004) and less perceived stress (β = -0.18, df = 93, p = .035), than control group participants and compared with the baseline assessment. Our results show the positive effects of Imager on mental health symptoms. The encouraging effects of the app on mental health outcomes may lead to greater use of ecological momentary interventions in the clinical preventive practice of affective disorders.
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Affiliation(s)
- Marta Anna Marciniak
- Department of Psychology, University of Zurich, Zurich, Switzerland
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital (PUK), University of Zurich, Zurich, Switzerland
| | - Lilly Shanahan
- Department of Psychology, University of Zurich, Zurich, Switzerland
- Jacobs Center for Productive Youth Development, University of Zurich, Zurich, Switzerland
| | - Inez Myin-Germeys
- Center for Contextual Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Ilya Milos Veer
- Research Division of Mind and Brain, Department of Psychiatry and Psychotherapy CCM, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Department of Developmental Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Kenneth S L Yuen
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Harald Binder
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
- Freiburg Center for Data Analysis and Modelling, University of Freiburg, Freiburg, Germany
| | - Henrik Walter
- Research Division of Mind and Brain, Department of Psychiatry and Psychotherapy CCM, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Erno J Hermans
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Raffael Kalisch
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Birgit Kleim
- Department of Psychology, University of Zurich, Zurich, Switzerland
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital (PUK), University of Zurich, Zurich, Switzerland
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van Houtum LAEM, Baaré WFC, Beckmann CF, Castro-Fornieles J, Cecil CAM, Dittrich J, Ebdrup BH, Fegert JM, Havdahl A, Hillegers MHJ, Kalisch R, Kushner SA, Mansuy IM, Mežinska S, Moreno C, Muetzel RL, Neumann A, Nordentoft M, Pingault JB, Preisig M, Raballo A, Saunders J, Sprooten E, Sugranyes G, Tiemeier H, van Woerden GM, Vandeleur CL, van Haren NEM. Running in the FAMILY: understanding and predicting the intergenerational transmission of mental illness. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02423-9. [PMID: 38613677 DOI: 10.1007/s00787-024-02423-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 03/15/2024] [Indexed: 04/15/2024]
Abstract
Over 50% of children with a parent with severe mental illness will develop mental illness by early adulthood. However, intergenerational transmission of risk for mental illness in one's children is insufficiently considered in clinical practice, nor is it sufficiently utilised into diagnostics and care for children of ill parents. This leads to delays in diagnosing young offspring and missed opportunities for protective actions and resilience strengthening. Prior twin, family, and adoption studies suggest that the aetiology of mental illness is governed by a complex interplay of genetic and environmental factors, potentially mediated by changes in epigenetic programming and brain development. However, how these factors ultimately materialise into mental disorders remains unclear. Here, we present the FAMILY consortium, an interdisciplinary, multimodal (e.g., (epi)genetics, neuroimaging, environment, behaviour), multilevel (e.g., individual-level, family-level), and multisite study funded by a European Union Horizon-Staying-Healthy-2021 grant. FAMILY focuses on understanding and prediction of intergenerational transmission of mental illness, using genetically informed causal inference, multimodal normative prediction, and animal modelling. Moreover, FAMILY applies methods from social sciences to map social and ethical consequences of risk prediction to prepare clinical practice for future implementation. FAMILY aims to deliver: (i) new discoveries clarifying the aetiology of mental illness and the process of resilience, thereby providing new targets for prevention and intervention studies; (ii) a risk prediction model within a normative modelling framework to predict who is at risk for developing mental illness; and (iii) insight into social and ethical issues related to risk prediction to inform clinical guidelines.
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Affiliation(s)
- Lisanne A E M van Houtum
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Centre-Sophia, Rotterdam, The Netherlands
| | - William F C Baaré
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital-Amager and Hvidovre, Copenhagen, Denmark
| | - Christian F Beckmann
- Centre for Functional MRI of the Brain, Wellcome Centre for Integrative Neuroimaging, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
- Department of Cognitive Neuroscience, Radboud University Medical Centre, Nijmegen, the Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, the Netherlands
| | - Josefina Castro-Fornieles
- Department of Child and Adolescent Psychiatry and Psychology, 2021SGR01319, Institut Clinic de Neurociències, Hospital Clínic de Barcelona, FCRB-IDIBAPS, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Spain
| | - Charlotte A M Cecil
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Centre-Sophia, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands
| | | | - Bjørn H Ebdrup
- Center for Neuropsychiatric Schizophrenia Research and Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jörg M Fegert
- President European Society for Child and Adolescent Psychiatry (ESCAP), Brussels, Belgium
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital Ulm, Ulm, Germany
| | - Alexandra Havdahl
- PsychGen Centre for Genetic Epidemiology and Mental Health, Norwegian Institute of Public Health, Oslo, Norway
- PROMENTA Research Centre, Department of Psychology, University of Oslo, Oslo, Norway
- Nic Waals Institute, Lovisenberg Diaconal Hospital, Oslo, Norway
| | - Manon H J Hillegers
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Centre-Sophia, Rotterdam, The Netherlands
| | - Raffael Kalisch
- Leibniz Institute for Resilience Research, Mainz, Germany
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Steven A Kushner
- Department of Psychiatry, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Isabelle M Mansuy
- Laboratory of Neuroepigenetics, Medical Faculty, Brain Research Institute, Department of Health Science and Technology of ETH, University of Zurich and Institute for Neuroscience, Zurich, Switzerland
- Zurich Neuroscience Centre, ETH and University of Zurich, Zurich, Switzerland
| | - Signe Mežinska
- Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia
| | - Carmen Moreno
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, ISCIII, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Ryan L Muetzel
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Centre-Sophia, Rotterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Alexander Neumann
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Centre-Sophia, Rotterdam, The Netherlands
| | - Merete Nordentoft
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- Copenhagen Research Centre for Mental Health, Mental Health Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
| | - Jean-Baptiste Pingault
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Centre-Sophia, Rotterdam, The Netherlands
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Martin Preisig
- Psychiatric Epidemiology and Psychopathology Research Centre, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Andrea Raballo
- Public Health Division, Department of Health and Social Care, Cantonal Socio-Psychiatric Organization, Repubblica e Cantone Ticino, Mendrisio, Switzerland
- Chair of Psychiatry, Faculty of Biomedical Sciences, Università Della Svizzera Italiana, Lugano, Switzerland
| | - John Saunders
- Executive Director European Federation of Associations of Families of People with Mental Illness (EUFAMI), Louvain, Belgium
| | - Emma Sprooten
- Department of Cognitive Neuroscience, Radboud University Medical Centre, Nijmegen, the Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, the Netherlands
- Department of Human Genetics, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Gisela Sugranyes
- Department of Child and Adolescent Psychiatry and Psychology, 2021SGR01319, Institut Clinic de Neurociències, Hospital Clínic de Barcelona, FCRB-IDIBAPS, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Spain
| | - Henning Tiemeier
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Centre-Sophia, Rotterdam, The Netherlands
- Department of Social and Behavioural Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Geeske M van Woerden
- Department of Neuroscience, Erasmus University Medical Centre, Rotterdam, The Netherlands
- ENCORE Expertise Center for Neurodevelopmental Disorders, Erasmus University Medical Centre, Rotterdam, The Netherlands
- Department of Clinical Genetics, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Caroline L Vandeleur
- Psychiatric Epidemiology and Psychopathology Research Centre, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Neeltje E M van Haren
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Centre-Sophia, Rotterdam, The Netherlands.
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van der Heide A, Dommershuijsen LJ, Puhlmann LMC, Kalisch R, Bloem BR, Speckens AEM, Helmich RC. Predictors of stress resilience in Parkinson's disease and associations with symptom progression. NPJ Parkinsons Dis 2024; 10:81. [PMID: 38605033 PMCID: PMC11009258 DOI: 10.1038/s41531-024-00692-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 03/21/2024] [Indexed: 04/13/2024] Open
Abstract
People with Parkinson's disease (PD) are sensitive to effects of long-term stress, but might differ in stress resilience, i.e. the ability to maintain mental health despite adversity. It is unclear whether stress resilience in PD is predominantly determined by dopamine deficiency, psychosocial factors, or both. In PD animal models, chronic stressors accelerate disease progression, but evidence in humans is lacking. Our objectives were to (1) distinguish stressor-reactive from resilient PD patients, (2) identify resilience factors, and (3) compare symptom progression between stressor-reactive and resilient patients. We conducted a longitudinal survey in Personalized Parkinson Project participants (N = 350 PD). We used the COVID-19 pandemic as a model of a stressor, aligned in time for the entire cohort. COVID-19-related stressors, perceived stress, and PD symptoms were assessed at 11 timepoints (April-October 2020). Both pre-COVID and in-COVID clinical assessments were available. We quantified stressor-reactivity as the residual between actual and predicted perceived stress relative to COVID-19-related stressors, and modeled trajectories of stressor-reactivity across timepoints. We explored pre-COVID predictors of 6-month average stressor-reactivity, and tested whether stressor-reactivity was prospectively associated with one-year clinical progression rates. Latent class trajectory models distinguished patients with high (N = 123) or low (N = 227) stressor-reactivity. Pre-existing anxiety, rumination and non-motor symptom severity predicted high stressor-reactivity (risk factors), whereas quality of life, social support, positive appraisal style and cognitive abilities predicted low stressor-reactivity (resilience factors). PD-specific factors, e.g. disease duration, motor severity, and levodopa use, did not predict stressor-reactivity. The COVID-19 pandemic did not accelerate disease progression, but worsened depressive symptoms in stressor-reactive PD patients.
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Affiliation(s)
- Anouk van der Heide
- Radboud University Medical Centre, Department of Neurology, Centre of Expertise for Parkinson & Movement Disorders, Nijmegen, the Netherlands.
- Radboud University, Donders Institute for Brain Cognition and Behavior, Centre for Cognitive Neuroimaging, Nijmegen, the Netherlands.
| | - Lisanne J Dommershuijsen
- Radboud University Medical Centre, Department of Neurology, Centre of Expertise for Parkinson & Movement Disorders, Nijmegen, the Netherlands
| | - Lara M C Puhlmann
- Leibniz Institute for Resilience Research, Mainz, Germany
- Neuroimaging Center, Focus Program Translational Neuroscience, Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Raffael Kalisch
- Leibniz Institute for Resilience Research, Mainz, Germany
- Neuroimaging Center, Focus Program Translational Neuroscience, Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Bastiaan R Bloem
- Radboud University Medical Centre, Department of Neurology, Centre of Expertise for Parkinson & Movement Disorders, Nijmegen, the Netherlands
| | - Anne E M Speckens
- Radboud University Medical Centre, Department of Psychiatry, Nijmegen, the Netherlands
| | - Rick C Helmich
- Radboud University Medical Centre, Department of Neurology, Centre of Expertise for Parkinson & Movement Disorders, Nijmegen, the Netherlands
- Radboud University, Donders Institute for Brain Cognition and Behavior, Centre for Cognitive Neuroimaging, Nijmegen, the Netherlands
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Pooseh S, Kalisch R, Köber G, Binder H, Timmer J. Intraindividual time-varying dynamic network of affects: linear autoregressive mixed-effects models for ecological momentary assessment. Front Psychiatry 2024; 15:1213863. [PMID: 38585485 PMCID: PMC10997345 DOI: 10.3389/fpsyt.2024.1213863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 02/21/2024] [Indexed: 04/09/2024] Open
Abstract
An interesting recent development in emotion research and clinical psychology is the discovery that affective states can be modeled as a network of temporally interacting moods or emotions. Additionally, external factors like stressors or treatments can influence the mood network by amplifying or dampening the activation of specific moods. Researchers have turned to multilevel autoregressive models to fit these affective networks using intensive longitudinal data gathered through ecological momentary assessment. Nonetheless, a more comprehensive examination of the performance of such models is warranted. In our study, we focus on simple directed intraindividual networks consisting of two interconnected mood nodes that mutually enhance or dampen each other. We also introduce a node representing external factors that affect both mood nodes unidirectionally. Importantly, we disregard the potential effects of a current mood/emotion on the perception of external factors. We then formalize the mathematical representation of such networks by exogenous linear autoregressive mixed-effects models. In this representation, the autoregressive coefficients signify the interactions between moods, while external factors are incorporated as exogenous covariates. We let the autoregressive and exogenous coefficients in the model have fixed and random components. Depending on the analysis, this leads to networks with variable structures over reasonable time units, such as days or weeks, which are captured by the variability of random effects. Furthermore, the fixed-effects parameters encapsulate a subject-specific network structure. Leveraging the well-established theoretical and computational foundation of linear mixed-effects models, we transform the autoregressive formulation to a classical one and utilize the existing methods and tools. To validate our approach, we perform simulations assuming our model as the true data-generating process. By manipulating a predefined set of parameters, we investigate the reliability and feasibility of our approach across varying numbers of observations, levels of noise intensity, compliance rates, and scalability to higher dimensions. Our findings underscore the challenges associated with estimating individualized parameters in the context of common longitudinal designs, where the required number of observations may often be unattainable. Moreover, our study highlights the sensitivity of autoregressive mixed-effect models to noise levels and the difficulty of scaling due to the substantial number of parameters.
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Affiliation(s)
- Shakoor Pooseh
- Center for Interdisciplinary Digital Sciences (CIDS), Technische Universität Dresden, Dresden, Germany
- Freiburg Center for Data Analysis and Modeling (FDM), Institute of Physics, University of Freiburg, Freiburg, Germany
| | - Raffael Kalisch
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Göran Köber
- Institute of Medical Biometry and Statistics (IMBI), Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Harald Binder
- Institute of Medical Biometry and Statistics (IMBI), Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Jens Timmer
- Freiburg Center for Data Analysis and Modeling (FDM), Institute of Physics, University of Freiburg, Freiburg, Germany
- CIBSS-Centre for Integrative Biological Signalling Studies, University of Freiburg, Freiburg, Germany
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Petri-Romão P, Engen H, Rupanova A, Puhlmann L, Zerban M, Neumann RJ, Malyshau A, Ahrens KF, Schick A, Kollmann B, Wessa M, Walker H, Plichta MM, Reif A, Chmitorz A, Tuescher O, Basten U, Kalisch R. Self-report assessment of Positive Appraisal Style (PAS): Development of a process-focused and a content-focused questionnaire for use in mental health and resilience research. PLoS One 2024; 19:e0295562. [PMID: 38306328 PMCID: PMC10836662 DOI: 10.1371/journal.pone.0295562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 11/23/2023] [Indexed: 02/04/2024] Open
Abstract
Positive Appraisal Style Theory of Resilience posits that a person's general style of evaluating stressors plays a central role in mental health and resilience. Specifically, a tendency to appraise stressors positively (positive appraisal style; PAS) is theorized to be protective of mental health and thus a key resilience factor. To this date no measures of PAS exist. Here, we present two scales that measure perceived positive appraisal style, one focusing on cognitive processes that lead to positive appraisals in stressful situations (PASS-process), and the other focusing on the appraisal contents (PASS-content). For PASS-process, the items of the existing questionnaires Brief COPE and CERQ-short were analyzed in exploratory and confirmatory factor analyses (EFA, CFA) in independent samples (N = 1157 and N = 1704). The resulting 10-item questionnaire was internally consistent (α = .78, 95% CI [.86, .87]) and showed good convergent and discriminant validity in comparisons with self-report measures of trait optimism, neuroticism, urgency, and spontaneity. For PASS-content, a newly generated item pool of 29 items across stressor appraisal content dimensions (probability, magnitude, and coping potential) were subjected to EFA and CFA in two independent samples (N = 1174 and N = 1611). The resulting 14-item scale showed good internal consistency (α = .87, 95% CI [.86, .87]), as well as good convergent and discriminant validity within the nomological network. The two scales are a new and reliable way to assess self-perceived positive appraisal style in large-scale studies, which could offer key insights into mechanisms of resilience.
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Affiliation(s)
| | - Haakon Engen
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Anna Rupanova
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Lara Puhlmann
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
| | - Matthias Zerban
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Rebecca J Neumann
- Department of Psychiatry, University Hospital, Psychosomatic Medicine and Psychotherapy, Goethe University Frankfurt, Frankfurt, Germany
| | - Aliaksandr Malyshau
- Department of Psychiatry, University Hospital, Psychosomatic Medicine and Psychotherapy, Goethe University Frankfurt, Frankfurt, Germany
| | - Kira F Ahrens
- Department of Psychiatry, University Hospital, Psychosomatic Medicine and Psychotherapy, Goethe University Frankfurt, Frankfurt, Germany
| | - Anita Schick
- Medical Faculty Mannheim, Department of Public Mental Health, Central Institute of Mental Health (CIMH), Heidelberg University, Mannheim, Germany
| | - Bianca Kollmann
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Department of Psychiatry and Psychotherapy, Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Michèle Wessa
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Department of Clinical Psychology and Neuropsychology, Institute of Psychology, Johannes Gutenberg University, Mainz, Germany
| | - Henrik Walker
- Department of Psychiatry & Psychotherapy, Division of Mind and Brain Research, Campus Charité Mitte, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Michael M Plichta
- Department of Psychiatry, University Hospital, Psychosomatic Medicine and Psychotherapy, Goethe University Frankfurt, Frankfurt, Germany
| | - Andreas Reif
- Department of Psychiatry, University Hospital, Psychosomatic Medicine and Psychotherapy, Goethe University Frankfurt, Frankfurt, Germany
| | - Andrea Chmitorz
- Faculty of Social Work, Health Care and Nursing, Esslingen University of Applied Sciences, Esslingen, Germany
| | - Oliver Tuescher
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Department of Psychiatry and Psychotherapy, Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Ulrike Basten
- Department of Psychology, University of Kaiserslautern-Landau, Landau, Germany
| | - Raffael Kalisch
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
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7
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Crane MF, Hazel G, Kunzelmann A, Kho M, Gucciardi DF, Rigotti T, Kalisch R, Karin E. An exploratory domain analysis of deployment risks and protective features and their association to mental health, cognitive functioning and job performance in military personnel. Anxiety Stress Coping 2024; 37:16-28. [PMID: 37379256 DOI: 10.1080/10615806.2023.2228707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 06/09/2023] [Accepted: 06/09/2023] [Indexed: 06/30/2023]
Abstract
BACKGROUND Meta-analyses of military deployment involve the exploration of focused associations between predictors and peri and post-deployment outcomes. OBJECTIVE We aimed to provide a large-scale and high-level perspective of deployment-related predictors across eight peri and post-deployment outcomes. DESIGN Articles reporting effect sizes for associations between deployment-related features and indices of peri and post-deployment outcomes were selected. Three-hundred and fourteen studies (N = 2,045,067) and 1,893 relevant effects were retained. Deployment features were categorized into themes, mapped across outcomes, and integrated into a big-data visualization. METHODS Studies of military personnel with deployment experience were included. Extracted studies investigated eight possible outcomes reflecting functioning (e.g., post-traumatic stress, burnout). To allow comparability, effects were transformed into a Fisher's Z. Moderation analyses investigating methodological features were performed. RESULTS The strongest correlates across outcomes were emotional (e.g., guilt/shame: Z = 0.59 to 1.21) and cognitive processes (e.g., negative appraisals: Z = -0.54 to 0.26), adequate sleep on deployment (Z = -0.28 to - 0.61), motivation (Z = -0.33 to - 0.71), and use of various coping strategies/recovery strategies (Z = -0.25 to - 0.59). CONCLUSIONS Findings pointed to interventions that target coping and recovery strategies, and the monitoring of emotional states and cognitive processes post-deployment that may indicate early risk.
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Affiliation(s)
- M F Crane
- School of Psychological Sciences, Macquarie University, North Ryde, Australia
| | - G Hazel
- School of Psychological Sciences, Macquarie University, North Ryde, Australia
| | - A Kunzelmann
- Department of Psychology, Johannes Gutenberg-University, Mainz, Germany
| | - M Kho
- School of Psychological Sciences, Macquarie University, North Ryde, Australia
| | - D F Gucciardi
- Curtin School of Allied Health, Curtin University, Perth, Australia
| | - T Rigotti
- Department of Psychology, Johannes Gutenberg-University, Mainz, Germany
| | - R Kalisch
- Leibniz Institute for Resilience Research, Mainz, Germany
| | - E Karin
- School of Psychological Sciences, Macquarie University, North Ryde, Australia
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8
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Marciniak MA, Shanahan L, Yuen KSL, Veer IM, Walter H, Tuescher O, Kobylińska D, Kalisch R, Hermans E, Binder H, Kleim B. Burst versus continuous delivery design in digital mental health interventions: Evidence from a randomized clinical trial. Digit Health 2024; 10:20552076241249267. [PMID: 38698832 PMCID: PMC11064753 DOI: 10.1177/20552076241249267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 04/08/2024] [Indexed: 05/05/2024] Open
Abstract
Objective Digital mental health interventions delivered via smartphone-based apps effectively treat various conditions; however, optimizing their efficacy while minimizing participant burden remains a key challenge. In this study, we investigated the potential benefits of a burst delivery design (i.e. interventions delivered only in pre-defined time intervals) in comparison to the continuous delivery of interventions. Methods We randomly assigned 93 participants to the continuous delivery (CD) or burst delivery (BD) group. The CD group engaged in ReApp, a mobile app that increases positive cognitive reappraisal with a consistent delivery schedule that provides five prompts per day throughout the 3-week-long study, while the BD group received five daily prompts only in the first and third weeks of the study. Results No significant differences were found between the groups in terms of adherence, mental health outcomes (specifically depressive and anxiety symptoms), level of perceived stress, and perceived helpfulness of intervention. The BD group showed a significantly decreased perceived difficulty of intervention over time. Conclusions The results suggest that the burst delivery may be as suitable for digital mental health interventions as the continuous delivery. The perceived difficulty of the intervention declined more steeply for the BD group, indicating that it improved the feasibility of the positive cognitive reappraisal intervention without hurting its efficacy. This outcome may inform the design of less burdensome interventions with improved outcomes in future research.
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Affiliation(s)
- Marta Anna Marciniak
- Department of Psychology, University of Zurich, Zurich, Switzerland
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital (PUK), University of Zurich, Zurich, Switzerland
| | - Lilly Shanahan
- Department of Psychology, University of Zurich, Zurich, Switzerland
- Jacobs Center for Productive Youth Development, University of Zurich, Zurich, Switzerland
| | - Kenneth S L Yuen
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Ilya Milos Veer
- Department of Developmental Psychology, University of Amsterdam, Amsterdam, The Netherlands; Research Division of Mind and Brain, Department of Psychiatry and Psychotherapy CCM
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Henrik Walter
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Oliver Tuescher
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
- Institute for Molecular Biology (IMB), Mainz, Germany
| | | | - Raffael Kalisch
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Erno Hermans
- Radboud University Medical Center, Donders Institute for Brain, Cognition, and Behaviour, Nijmegen, The Netherlands
| | - Harald Binder
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
- Freiburg Center for Data Analysis and Modelling, University of Freiburg, Freiburg, Germany
| | - Birgit Kleim
- Freiburg Center for Data Analysis and Modelling, University of Freiburg, Freiburg, Germany
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9
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Zerban M, Puhlmann LMC, Lassri D, Fonagy P, Montague PR, Kiselnikova N, Lorenzini N, Desatnik A, Kalisch R, Nolte T. What helps the helpers? Resilience and risk factors for general and profession-specific mental health problems in psychotherapists during the COVID-19 pandemic. Front Psychol 2023; 14:1272199. [PMID: 38164261 PMCID: PMC10757941 DOI: 10.3389/fpsyg.2023.1272199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 11/30/2023] [Indexed: 01/03/2024] Open
Abstract
Introduction Although the COVID-19 pandemic has severely affected wellbeing of at-risk groups, most research on resilience employed convenience samples. We investigated psychosocial resilience and risk factors (RFs) for the wellbeing of psychotherapists and other mental health practitioners, an under-researched population that provides essential support for other at-risk groups and was uniquely burdened by the pandemic. Method We examined 18 psychosocial factors for their association with resilience, of which four were chosen due to their likely relevance specifically for therapists, in a cross-sectional multi-national sample (N = 569) surveyed between June and September 2020. Resilience was operationalized dimensionally and outcome-based as lower stressor reactivity (SR), meaning fewer mental health problems than predicted given a participant's levels of stressor exposure. General SR (SRG) scores expressed reactivity in terms of general internalizing problems, while profession-specific SR (SRS) scores expressed reactivity in terms of burnout and secondary trauma, typical problems of mental health practitioners. Results Factors previously identified as RFs in other populations, including perceived social support, optimism and self-compassion, were almost all significant in the study population (SRG: 18/18 RFs, absolute βs = 0.16-0.40; SRS: 15/18 RFs, absolute βs = 0.19-0.39 all Ps < 0.001). Compassion satisfaction emerged as uniquely relevant for mental health practitioners in regularized regression. Discussion Our work identifies psychosocial RFs for mental health practitioners' wellbeing during crisis. Most identified factors are general, in that they are associated with resilience to a wider range of mental health problems, and global, in that they have also been observed in other populations and stressor constellations.
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Affiliation(s)
- Matthias Zerban
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Lara Marie Christine Puhlmann
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Dana Lassri
- Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
- The Paul Baerwald School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Peter Fonagy
- Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
- Anna Freud National Centre for Children and Families, London, United Kingdom
| | - P. Read Montague
- Virginia Tech Carilion Fralin Biomedical Research Institute, Virginia Polytechnic Institute and State University, Roanoke, VA, United States
| | - Natalia Kiselnikova
- Department of Psychosocial Studies, Birkbeck College, University of London, London, United Kingdom
| | - Nicolas Lorenzini
- Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
| | - Alex Desatnik
- Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
- Open Door Young People’s Service, London, United Kingdom
| | - Raffael Kalisch
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
| | - Tobias Nolte
- Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
- Anna Freud National Centre for Children and Families, London, United Kingdom
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10
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Melchior M, Figueiredo N, Roversi A, Dubanchet A, Bui E, Vadell-Martínez J, Barbui C, Purgato M, Ayuso-Mateos JL, Mediavilla R, McDaid D, Park AL, Petri-Romão P, Kalisch R, Nicaise P, Lorant V, Sijbrandij M, Witteveen AB, Bryant R, Felez M, Underhill J, Pollice G, Tortelli A. Addressing mental health problems among persons without stable housing in the context of the COVID-19 pandemic: study protocol for a randomised trial. RESPOND - France. BMC Public Health 2023; 23:2275. [PMID: 37978577 PMCID: PMC10656934 DOI: 10.1186/s12889-023-17238-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 11/16/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has had an impact on population-wide mental health and well-being. Although people experiencing socioeconomic disadvantage may be especially vulnerable, they experience barriers in accessing mental health care. To overcome these barriers, the World Health Organization (WHO) designed two scalable psychosocial interventions, namely the web-based Doing What Matters in Times of Stress (DWM) and the face-to-face Problem Management Plus (PM+), to help people manage stressful situations. Our study aims to test the effectiveness of a stepped-care program using DWM and PM + among individuals experiencing unstable housing in France - a majority of whom are migrant or have sought asylum. METHODS This is a randomised controlled trial to evaluate the effectiveness and cost effectiveness of a stepped-care program using DWM and PM + among persons with psychological distress and experiencing unstable housing, in comparison to enhanced care as usual (eCAU). Participants (N = 210) will be randomised to two parallel groups: eCAU or eCAU plus the stepped-care program. The main study outcomes are symptoms of depression and anxiety measured using the Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS). DISCUSSION This randomised controlled trial will contribute to a better understanding of effective community-based scalable strategies that can help address the mental health needs of persons experiencing socioeconomic disadvantage, whose needs are high yet who frequently have limited access to mental health care services. TRIAL REGISTRATION this randomised trial has been registered at ClinicalTrials.gov under the number NCT05033210.
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Affiliation(s)
- Maria Melchior
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, (IPLESP), Equipe de Recherche en Epidémiologie Sociale, Paris, F75012, France.
| | - Natasha Figueiredo
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, (IPLESP), Equipe de Recherche en Epidémiologie Sociale, Paris, F75012, France
| | - Aurélia Roversi
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, (IPLESP), Equipe de Recherche en Epidémiologie Sociale, Paris, F75012, France
| | - Alexandre Dubanchet
- CHU Caen, & Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", NeuroPresage Team, Cyceron, Caen, 14000, France
| | - Eric Bui
- CHU Caen, & Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", NeuroPresage Team, Cyceron, Caen, 14000, France
| | - Julian Vadell-Martínez
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, (IPLESP), Equipe de Recherche en Epidémiologie Sociale, Paris, F75012, France
| | - Corrado Barbui
- Department of Neuroscience, Biomedicine, and Movement Sciences, Section of Psychiatry, WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy
| | - Marianna Purgato
- Department of Neuroscience, Biomedicine, and Movement Sciences, Section of Psychiatry, WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy
| | - José Luis Ayuso-Mateos
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
- Instituto de Investigación Sanitaria del Hospital Universitario La Princesa, Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Roberto Mediavilla
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
- Instituto de Investigación Sanitaria del Hospital Universitario La Princesa, Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - David McDaid
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, UK
| | - A-La Park
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, UK
| | - Papoula Petri-Romão
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Raffael Kalisch
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Pablo Nicaise
- Institute of Health and Society (IRSS), Université Catholique de Louvain, Brussels, Belgium
| | - Vincent Lorant
- Institute of Health and Society (IRSS), Université Catholique de Louvain, Brussels, Belgium
| | - Marit Sijbrandij
- Clinical, Neuro and Developmental Psychology, WHO Collaborating Centre for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Institute, VU University, Amsterdam, the Netherlands
| | - Anke B Witteveen
- Clinical, Neuro and Developmental Psychology, WHO Collaborating Centre for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Institute, VU University, Amsterdam, the Netherlands
| | - Richard Bryant
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Mireia Felez
- Institut de recerca Sant Joan de Déu, Dr. Antoni Pujadas, Sant Boi de Llobregat (Barcelona), 4208830, Spain
| | | | - Giulia Pollice
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, (IPLESP), Equipe de Recherche en Epidémiologie Sociale, Paris, F75012, France
| | - Andrea Tortelli
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, (IPLESP), Equipe de Recherche en Epidémiologie Sociale, Paris, F75012, France
- GHU Paris, Psychiatrie & Neurosciences - Pôle Psychiatrie Précarité, Paris, France
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11
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von Wulffen C, Marciniak MA, Rohde J, Kalisch R, Binder H, Tuescher O, Kleim B. German Version of the Mobile Agnew Relationship Measure: Translation and Validation Study. J Med Internet Res 2023; 25:e43368. [PMID: 37955952 PMCID: PMC10682917 DOI: 10.2196/43368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 07/03/2023] [Accepted: 07/27/2023] [Indexed: 11/14/2023] Open
Abstract
BACKGROUND The mobile Agnew Relationship Measure (mARM) is a self-report questionnaire for the evaluation of digital mental health interventions and their interactions with users. With the global increase in digital mental health intervention research, translated measures are required to conduct research with local populations. OBJECTIVE The aim of this study was to translate and validate the original English version of the mARM into a German version (mARM-G). METHODS A total of 2 native German speakers who spoke English as their second language conducted forward translation of the original items. This version was then back translated by 2 native German speakers with a fluent knowledge of English. An independent bilingual reviewer then compared these drafts and created a final German version. The mARM-G was validated by 15 experts in the field of mobile app development and 15 nonexperts for content validity and face validity; 144 participants were recruited to conduct reliability testing as well as confirmatory factor analysis. RESULTS The content validity index of the mARM-G was 0.90 (expert ratings) and 0.79 (nonexperts). The face validity index was 0.89 (experts) and 0.86 (nonexperts). Internal consistency for the entire scale was Cronbach α=.91. Confirmatory factor analysis results were as follows: the chi-square statistic to df ratio was 1.66. Comparative Fit Index was 0.87 and the Tucker-Lewis Index was 0.86. The root mean square error of approximation was 0.07. CONCLUSIONS The mARM-G is a valid and reliable tool that can be used for future studies in German-speaking countries.
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Affiliation(s)
- Clemens von Wulffen
- Department of Psychology, University of Zurich, Zürich, Switzerland
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital, University of Zurich, Zurich, Switzerland
| | - Marta Anna Marciniak
- Department of Psychology, University of Zurich, Zürich, Switzerland
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital, University of Zurich, Zurich, Switzerland
| | - Judith Rohde
- Department of Psychology, University of Zurich, Zürich, Switzerland
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital, University of Zurich, Zurich, Switzerland
| | - Raffael Kalisch
- Leibniz Institute for Resilience Research, Mainz, Germany
- Neuroimaging Center, Focus Program Translational Neuroscience, Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Harald Binder
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
- Freiburg Center for Data Analysis and Modelling, University of Freiburg, Freiburg, Germany
| | - Oliver Tuescher
- Leibniz Institute for Resilience Research, Mainz, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center, University Johannes Gutenberg University, Mainz, Germany
| | - Birgit Kleim
- Department of Psychology, University of Zurich, Zürich, Switzerland
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital, University of Zurich, Zurich, Switzerland
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12
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Roos R, Witteveen AB, Ayuso-Mateos JL, Barbui C, Bryant RA, Felez-Nobrega M, Figueiredo N, Kalisch R, Haro JM, McDaid D, Mediavilla R, Melchior M, Nicaise P, Park AL, Petri-Romão P, Purgato M, van Straten A, Tedeschi F, Underhill J, Sijbrandij M. Effectiveness of a scalable, remotely delivered stepped-care intervention to reduce symptoms of psychological distress among Polish migrant workers in the Netherlands: study protocol for the RESPOND randomised controlled trial. BMC Psychiatry 2023; 23:801. [PMID: 37919694 PMCID: PMC10623706 DOI: 10.1186/s12888-023-05288-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 10/17/2023] [Indexed: 11/04/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has negatively affected the mental health of international migrant workers (IMWs). IMWs experience multiple barriers to accessing mental health care. Two scalable interventions developed by the World Health Organization (WHO) were adapted to address some of these barriers: Doing What Matters in times of stress (DWM), a guided self-help web application, and Problem Management Plus (PM +), a brief facilitator-led program to enhance coping skills. This study examines whether DWM and PM + remotely delivered as a stepped-care programme (DWM/PM +) is effective and cost-effective in reducing psychological distress, among Polish migrant workers with psychological distress living in the Netherlands. METHODS The stepped-care DWM/PM + intervention will be tested in a two-arm, parallel-group, randomized controlled trial (RCT) among adult Polish migrant workers with self-reported psychological distress (Kessler Psychological Distress Scale; K10 > 15.9). Participants (n = 212) will be randomized into either the intervention group that receives DWM/PM + with psychological first aid (PFA) and care-as-usual (enhanced care-as-usual or eCAU), or into the control group that receives PFA and eCAU-only (1:1 allocation ratio). Baseline, 1-week post-DWM (week 7), 1-week post-PM + (week 13), and follow-up (week 21) self-reported assessments will be conducted. The primary outcome is psychological distress, assessed with the Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS). Secondary outcomes are self-reported symptoms of depression, anxiety, posttraumatic stress disorder (PTSD), resilience, quality of life, and cost-effectiveness. In a process evaluation, stakeholders' views on barriers and facilitators to the implementation of DWM/PM + will be evaluated. DISCUSSION To our knowledge, this is one of the first RCTs that combines two scalable, psychosocial WHO interventions into a stepped-care programme for migrant populations. If proven to be effective, this may bridge the mental health treatment gap IMWs experience. TRIAL REGISTRATION Dutch trial register NL9630, 20/07/2021, https://www.onderzoekmetmensen.nl/en/trial/27052.
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Affiliation(s)
- Rinske Roos
- Department of Clinical, Neuro- and Developmental Psychology and WHO Collaborating Center for Research and Dissemination of Psychological Interventions, VU University, Amsterdam, Netherlands.
| | - Anke B Witteveen
- Department of Clinical, Neuro- and Developmental Psychology and WHO Collaborating Center for Research and Dissemination of Psychological Interventions, VU University, Amsterdam, Netherlands
| | - José Luis Ayuso-Mateos
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
- Department of Psychiatry, La Princesa University Hospital, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Corrado Barbui
- Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy
| | - Richard A Bryant
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Mireia Felez-Nobrega
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
| | - Natasha Figueiredo
- Equipe de Recherche en Epidémiologie Sociale (ERES), Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), INSERM, Sorbonne Université, Faculté de Médecine St Antoine, Paris, France
| | - Raffael Kalisch
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Focus Program Translational Neuroscience (FTN), Neuroimaging Center (NIC), Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Josep Maria Haro
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
| | - David McDaid
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, UK
| | - Roberto Mediavilla
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
- Department of Psychiatry, La Princesa University Hospital, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Maria Melchior
- Equipe de Recherche en Epidémiologie Sociale (ERES), Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), INSERM, Sorbonne Université, Faculté de Médecine St Antoine, Paris, France
| | - Pablo Nicaise
- Institute of Health and Society (IRSS), Université Catholique de Louvain, Brussels, Belgium
| | - A-La Park
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, UK
| | | | - Marianna Purgato
- Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy
| | - Annemieke van Straten
- Department of Clinical, Neuro- and Developmental Psychology and WHO Collaborating Center for Research and Dissemination of Psychological Interventions, VU University, Amsterdam, Netherlands
| | - Federico Tedeschi
- Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy
| | | | - Marit Sijbrandij
- Department of Clinical, Neuro- and Developmental Psychology and WHO Collaborating Center for Research and Dissemination of Psychological Interventions, VU University, Amsterdam, Netherlands
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13
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Bögemann SA, Puhlmann LMC, Wackerhagen C, Zerban M, Riepenhausen A, Köber G, Yuen KSL, Pooseh S, Marciniak MA, Reppmann Z, Uściƚko A, Weermeijer J, Lenferink DB, Mituniewicz J, Robak N, Donner NC, Mestdagh M, Verdonck S, van Dick R, Kleim B, Lieb K, van Leeuwen JMC, Kobylińska D, Myin-Germeys I, Walter H, Tüscher O, Hermans EJ, Veer IM, Kalisch R. Psychological Resilience Factors and Their Association With Weekly Stressor Reactivity During the COVID-19 Outbreak in Europe: Prospective Longitudinal Study. JMIR Ment Health 2023; 10:e46518. [PMID: 37847551 PMCID: PMC10618882 DOI: 10.2196/46518] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 07/26/2023] [Accepted: 07/28/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND Cross-sectional relationships between psychosocial resilience factors (RFs) and resilience, operationalized as the outcome of low mental health reactivity to stressor exposure (low "stressor reactivity" [SR]), were reported during the first wave of the COVID-19 pandemic in 2020. OBJECTIVE Extending these findings, we here examined prospective relationships and weekly dynamics between the same RFs and SR in a longitudinal sample during the aftermath of the first wave in several European countries. METHODS Over 5 weeks of app-based assessments, participants reported weekly stressor exposure, mental health problems, RFs, and demographic data in 1 of 6 different languages. As (partly) preregistered, hypotheses were tested cross-sectionally at baseline (N=558), and longitudinally (n=200), using mixed effects models and mediation analyses. RESULTS RFs at baseline, including positive appraisal style (PAS), optimism (OPT), general self-efficacy (GSE), perceived good stress recovery (REC), and perceived social support (PSS), were negatively associated with SR scores, not only cross-sectionally (baseline SR scores; all P<.001) but also prospectively (average SR scores across subsequent weeks; positive appraisal (PA), P=.008; OPT, P<.001; GSE, P=.01; REC, P<.001; and PSS, P=.002). In both associations, PAS mediated the effects of PSS on SR (cross-sectionally: 95% CI -0.064 to -0.013; prospectively: 95% CI -0.074 to -0.0008). In the analyses of weekly RF-SR dynamics, the RFs PA of stressors generally and specifically related to the COVID-19 pandemic, and GSE were negatively associated with SR in a contemporaneous fashion (PA, P<.001; PAC,P=.03; and GSE, P<.001), but not in a lagged fashion (PA, P=.36; PAC, P=.52; and GSE, P=.06). CONCLUSIONS We identified psychological RFs that prospectively predict resilience and cofluctuate with weekly SR within individuals. These prospective results endorse that the previously reported RF-SR associations do not exclusively reflect mood congruency or other temporal bias effects. We further confirm the important role of PA in resilience.
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Affiliation(s)
- Sophie A Bögemann
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, Netherlands
| | - Lara M C Puhlmann
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Carolin Wackerhagen
- Research Division of Mind and Brain, Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Matthias Zerban
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Antje Riepenhausen
- Research Division of Mind and Brain, Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Berlin School of Mind and Brain, Faculty of Philosophy, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Göran Köber
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
- Freiburg Center for Data Analysis and Modelling, Institute of Physics, University of Freiburg, Freiburg, Germany
| | - Kenneth S L Yuen
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Shakoor Pooseh
- Freiburg Center for Data Analysis and Modelling, Institute of Physics, University of Freiburg, Freiburg, Germany
| | - Marta A Marciniak
- Division of Experimental Psychopathology and Psychotherapy, Department of Psychology, University of Zurich, Zurich, Switzerland
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital (PUK), University of Zurich, Zurich, Switzerland
| | - Zala Reppmann
- Research Division of Mind and Brain, Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | | | - Jeroen Weermeijer
- Center for Contextual Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Dionne B Lenferink
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, Netherlands
| | | | - Natalia Robak
- College of Inter-Faculty Individual Studies in Mathematics and Natural Sciences, University of Warsaw, Warsaw, Poland
| | - Nina C Donner
- Concentris Research Management GmbH, Fürstenfeldbruck, Germany
| | - Merijn Mestdagh
- Research Group of Quantitative Psychology and Individual Differences, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Stijn Verdonck
- Research Group of Quantitative Psychology and Individual Differences, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Rolf van Dick
- Institute of Psychology, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Birgit Kleim
- Division of Experimental Psychopathology and Psychotherapy, Department of Psychology, University of Zurich, Zurich, Switzerland
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital (PUK), University of Zurich, Zurich, Switzerland
| | - Klaus Lieb
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Department of Psychiatry and Psychotherapy, Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Judith M C van Leeuwen
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, Netherlands
| | | | - Inez Myin-Germeys
- Center for Contextual Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Henrik Walter
- Research Division of Mind and Brain, Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Berlin School of Mind and Brain, Faculty of Philosophy, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Oliver Tüscher
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Department of Psychiatry and Psychotherapy, Johannes Gutenberg University Medical Center, Mainz, Germany
- Institute of Molecular Biology (IMB), Mainz, Germany
| | - Erno J Hermans
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, Netherlands
| | - Ilya M Veer
- Research Division of Mind and Brain, Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Developmental Psychology, University of Amsterdam, Amsterdam, Netherlands
| | - Raffael Kalisch
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
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14
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Bögemann SA, Riepenhausen A, Puhlmann LMC, Bar S, Hermsen EJC, Mituniewicz J, Reppmann ZC, Uściƚko A, van Leeuwen JMC, Wackerhagen C, Yuen KSL, Zerban M, Weermeijer J, Marciniak MA, Mor N, van Kraaij A, Köber G, Pooseh S, Koval P, Arias-Vásquez A, Binder H, De Raedt W, Kleim B, Myin-Germeys I, Roelofs K, Timmer J, Tüscher O, Hendler T, Kobylińska D, Veer IM, Kalisch R, Hermans EJ, Walter H. Investigating two mobile just-in-time adaptive interventions to foster psychological resilience: research protocol of the DynaM-INT study. BMC Psychol 2023; 11:245. [PMID: 37626397 PMCID: PMC10464364 DOI: 10.1186/s40359-023-01249-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 07/14/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Stress-related disorders such as anxiety and depression are highly prevalent and cause a tremendous burden for affected individuals and society. In order to improve prevention strategies, knowledge regarding resilience mechanisms and ways to boost them is highly needed. In the Dynamic Modelling of Resilience - interventional multicenter study (DynaM-INT), we will conduct a large-scale feasibility and preliminary efficacy test for two mobile- and wearable-based just-in-time adaptive interventions (JITAIs), designed to target putative resilience mechanisms. Deep participant phenotyping at baseline serves to identify individual predictors for intervention success in terms of target engagement and stress resilience. METHODS DynaM-INT aims to recruit N = 250 healthy but vulnerable young adults in the transition phase between adolescence and adulthood (18-27 years) across five research sites (Berlin, Mainz, Nijmegen, Tel Aviv, and Warsaw). Participants are included if they report at least three negative burdensome past life events and show increased levels of internalizing symptoms while not being affected by any major mental disorder. Participants are characterized in a multimodal baseline phase, which includes neuropsychological tests, neuroimaging, bio-samples, sociodemographic and psychological questionnaires, a video-recorded interview, as well as ecological momentary assessments (EMA) and ecological physiological assessments (EPA). Subsequently, participants are randomly assigned to one of two ecological momentary interventions (EMIs), targeting either positive cognitive reappraisal or reward sensitivity. During the following intervention phase, participants' stress responses are tracked using EMA and EPA, and JITAIs are triggered if an individually calibrated stress threshold is crossed. In a three-month-long follow-up phase, parts of the baseline characterization phase are repeated. Throughout the entire study, stressor exposure and mental health are regularly monitored to calculate stressor reactivity as a proxy for outcome resilience. The online monitoring questionnaires and the repetition of the baseline questionnaires also serve to assess target engagement. DISCUSSION The DynaM-INT study intends to advance the field of resilience research by feasibility-testing two new mechanistically targeted JITAIs that aim at increasing individual stress resilience and identifying predictors for successful intervention response. Determining these predictors is an important step toward future randomized controlled trials to establish the efficacy of these interventions.
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Grants
- 777084 European Union's Horizon 2020 research and innovation program
- 777084 European Union's Horizon 2020 research and innovation program
- 777084 European Union's Horizon 2020 research and innovation program
- 777084 European Union's Horizon 2020 research and innovation program
- 777084 European Union's Horizon 2020 research and innovation program
- 777084 European Union's Horizon 2020 research and innovation program
- 777084 European Union's Horizon 2020 research and innovation program
- 777084 European Union's Horizon 2020 research and innovation program
- 777084 European Union's Horizon 2020 research and innovation program
- 777084 European Union's Horizon 2020 research and innovation program
- 777084 European Union's Horizon 2020 research and innovation program
- 777084 European Union's Horizon 2020 research and innovation program
- 777084 European Union's Horizon 2020 research and innovation program
- 777084 European Union's Horizon 2020 research and innovation program
- 777084 European Union's Horizon 2020 research and innovation program
- 777084 European Union's Horizon 2020 research and innovation program
- DFG Grant CRC 1193, subprojects B01, C01, C04, Z03 Deutsche Forschungsgemeinschaft
- DFG Grant CRC 1193, subprojects B01, C01, C04, Z03 Deutsche Forschungsgemeinschaft
- 01KX2021 German Federal Ministry for Education and Research (BMBF) as part of the Network for University Medicine
- MARP program, DRZ program, Leibniz Institute for Resilience Research State of Rhineland-Palatinate, Germany
- MARP program, DRZ program, Leibniz Institute for Resilience Research State of Rhineland-Palatinate, Germany
- European Union’s Horizon 2020 research and innovation program
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Affiliation(s)
- S A Bögemann
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Kapittelweg 29, Nijmegen, 6525 EN, The Netherlands.
| | - A Riepenhausen
- Research Division of Mind and Brain, Department of Psychiatry and Neurosciences CCM, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Faculty of Philosophy, Berlin School of Mind and Brain, Humboldt-Universität Zu Berlin, Berlin, Germany
| | - L M C Puhlmann
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - S Bar
- Sagol Brain Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - E J C Hermsen
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Kapittelweg 29, Nijmegen, 6525 EN, The Netherlands
| | - J Mituniewicz
- Faculty of Psychology, University of Warsaw, Warsaw, Poland
| | - Z C Reppmann
- Research Division of Mind and Brain, Department of Psychiatry and Neurosciences CCM, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - A Uściƚko
- Faculty of Psychology, University of Warsaw, Warsaw, Poland
| | - J M C van Leeuwen
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Kapittelweg 29, Nijmegen, 6525 EN, The Netherlands
| | - C Wackerhagen
- Research Division of Mind and Brain, Department of Psychiatry and Neurosciences CCM, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - K S L Yuen
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
| | - M Zerban
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
| | - J Weermeijer
- Center for Contextual Psychiatry, Department of Neurosciences, KU Leuven, Louvain, Belgium
| | - M A Marciniak
- Division of Experimental Psychopathology and Psychotherapy, Department of Psychology, University of Zurich, Zurich, Switzerland
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital (PUK), University of Zurich, Zurich, Switzerland
| | - N Mor
- Sagol Brain Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - A van Kraaij
- OnePlanet Research Center, Wageningen, The Netherlands
| | - G Köber
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
- Freiburg Center for Data Analysis and Modelling, University of Freiburg, Freiburg, Germany
| | - S Pooseh
- Freiburg Center for Data Analysis and Modelling, University of Freiburg, Freiburg, Germany
| | - P Koval
- Melbourne School of Psychological Sciences, The University of Melbourne, Vic, 3010, Australia
| | - A Arias-Vásquez
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Kapittelweg 29, Nijmegen, 6525 EN, The Netherlands
| | - H Binder
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
- Freiburg Center for Data Analysis and Modelling, University of Freiburg, Freiburg, Germany
| | - W De Raedt
- Life Sciences Department, Imec, Louvain, Belgium
| | - B Kleim
- Division of Experimental Psychopathology and Psychotherapy, Department of Psychology, University of Zurich, Zurich, Switzerland
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital (PUK), University of Zurich, Zurich, Switzerland
| | - I Myin-Germeys
- Center for Contextual Psychiatry, Department of Neurosciences, KU Leuven, Louvain, Belgium
| | - K Roelofs
- Center for Cognitive Neuroimaging, Donders Institute for Brain Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - J Timmer
- Freiburg Center for Data Analysis and Modelling, University of Freiburg, Freiburg, Germany
- Institute of Physics, University of Freiburg, Freiburg, Germany
- Signalling Research Centres BIOSS and CIBSS, University of Freiburg, Freiburg, Germany
| | - O Tüscher
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Department of Psychiatry and Psychotherapy, Johannes Gutenberg University Medical Center, Mainz, Germany
| | - T Hendler
- Sagol Brain Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- School of Psychological Science, Tel Aviv University, Tel Aviv, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - D Kobylińska
- Faculty of Psychology, University of Warsaw, Warsaw, Poland
| | - I M Veer
- Department of Developmental Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - R Kalisch
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
| | - E J Hermans
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Kapittelweg 29, Nijmegen, 6525 EN, The Netherlands
| | - H Walter
- Research Division of Mind and Brain, Department of Psychiatry and Neurosciences CCM, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Faculty of Philosophy, Berlin School of Mind and Brain, Humboldt-Universität Zu Berlin, Berlin, Germany
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15
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Riepenhausen A, Veer IM, Wackerhagen C, Reppmann ZC, Köber G, Ayuso-Mateos JL, Bögemann SA, Corrao G, Felez-Nobrega M, Abad JMH, Hermans E, van Leeuwen J, Lieb K, Lorant V, Mary-Krause M, Mediavilla R, Melchior M, Mittendorfer-Rutz E, Compagnoni MM, Pan KY, Puhlmann L, Roelofs K, Sijbrandij M, Smith P, Tüscher O, Witteveen A, Zerban M, Kalisch R, Kröger H, Walter H. Coping with COVID: risk and resilience factors for mental health in a German representative panel study. Psychol Med 2023; 53:3897-3907. [PMID: 35301966 PMCID: PMC8943230 DOI: 10.1017/s0033291722000563] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 11/23/2021] [Accepted: 02/15/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic might affect mental health. Data from population-representative panel surveys with multiple waves including pre-COVID data investigating risk and protective factors are still rare. METHODS In a stratified random sample of the German household population (n = 6684), we conducted survey-weighted multiple linear regressions to determine the association of various psychological risk and protective factors assessed between 2015 and 2020 with changes in psychological distress [(PD; measured via Patient Health Questionnaire for Depression and Anxiety (PHQ-4)] from pre-pandemic (average of 2016 and 2019) to peri-pandemic (both 2020 and 2021) time points. Control analyses on PD change between two pre-pandemic time points (2016 and 2019) were conducted. Regularized regressions were computed to inform on which factors were statistically most influential in the multicollinear setting. RESULTS PHQ-4 scores in 2020 (M = 2.45) and 2021 (M = 2.21) were elevated compared to 2019 (M = 1.79). Several risk factors (catastrophizing, neuroticism, and asking for instrumental support) and protective factors (perceived stress recovery, positive reappraisal, and optimism) were identified for the peri-pandemic outcomes. Control analyses revealed that in pre-pandemic times, neuroticism and optimism were predominantly related to PD changes. Regularized regression mostly confirmed the results and highlighted perceived stress recovery as most consistent influential protective factor across peri-pandemic outcomes. CONCLUSIONS We identified several psychological risk and protective factors related to PD outcomes during the COVID-19 pandemic. A comparison of pre-pandemic data stresses the relevance of longitudinal assessments to potentially reconcile contradictory findings. Implications and suggestions for targeted prevention and intervention programs during highly stressful times such as pandemics are discussed.
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Affiliation(s)
- Antje Riepenhausen
- Department of Psychiatry and Neurosciences - CCM, Research Division of Mind and Brain, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
- Berlin School of Mind and Brain, Faculty of Philosophy, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Ilya M. Veer
- Department of Psychiatry and Neurosciences - CCM, Research Division of Mind and Brain, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
- Department of Developmental Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Carolin Wackerhagen
- Department of Psychiatry and Neurosciences - CCM, Research Division of Mind and Brain, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Zala C. Reppmann
- Department of Psychiatry and Neurosciences - CCM, Research Division of Mind and Brain, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Göran Köber
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
- Freiburg Center for Data Analysis and Modelling, University of Freiburg, Freiburg, Germany
| | - José Luis Ayuso-Mateos
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Department of Psychiatry, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), La Princesa University Hospital, Madrid, Spain
| | - Sophie A. Bögemann
- Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Giovanni Corrao
- Unit of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy
- National Centre for Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, Milan, Italy
| | - Mireia Felez-Nobrega
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
| | - Josep Maria Haro Abad
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
| | - Erno Hermans
- Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Judith van Leeuwen
- Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Klaus Lieb
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany
| | - Vincent Lorant
- Institute of Health and Society (IRSS), Université Catholique de Louvain, Brussels, Belgium
| | - Murielle Mary-Krause
- Department of Social Epidemiology, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Université, INSERM, 75012 Paris, France
| | - Roberto Mediavilla
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Maria Melchior
- Department of Social Epidemiology, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Université, INSERM, 75012 Paris, France
| | - Ellenor Mittendorfer-Rutz
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Berzelius väg 3, 17177 Stockholm, Sweden
| | - Matteo Monzio Compagnoni
- Unit of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy
- National Centre for Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, Milan, Italy
| | - Kuan-Yu Pan
- Department of Psychiatry, Amsterdam Public Health, Amsterdam University Medical Center, Vrije Universiteit, Amsterdam, The Netherlands
| | - Lara Puhlmann
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Research Group Social Stress and Family Health, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Karin Roelofs
- Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
- Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Marit Sijbrandij
- Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute and WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Vrije Universiteit, Amsterdam, The Netherlands
| | - Pierre Smith
- Institute of Health and Society (IRSS), Université Catholique de Louvain, Brussels, Belgium
- Department Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Oliver Tüscher
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany
| | - Anke Witteveen
- Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute and WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Vrije Universiteit, Amsterdam, The Netherlands
| | - Matthias Zerban
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Raffael Kalisch
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Hannes Kröger
- Socio-Economic Panel (SOEP), German Institute for Economic Research (DIW), Berlin, Germany
- Munich Center for the Economics of Aging (MEA), Max Planck Institute for Social Law and Social Policy, Munich, Germany
| | - Henrik Walter
- Department of Psychiatry and Neurosciences - CCM, Research Division of Mind and Brain, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
- Berlin School of Mind and Brain, Faculty of Philosophy, Humboldt-Universität zu Berlin, Berlin, Germany
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Mediavilla R, Felez-Nobrega M, McGreevy KR, Monistrol-Mula A, Bravo-Ortiz MF, Bayón C, Giné-Vázquez I, Villaescusa R, Muñoz-Sanjosé A, Aguilar-Ortiz S, Figueiredo N, Nicaise P, Park AL, Petri-Romão P, Purgato M, Witteveen AB, Underhill J, Barbui C, Bryant R, Kalisch R, Lorant V, McDaid D, Melchior M, Sijbrandij M, Haro JM, Ayuso-Mateos JL. Effectiveness of a mental health stepped-care programme for healthcare workers with psychological distress in crisis settings: a multicentre randomised controlled trial. BMJ Ment Health 2023; 26:e300697. [PMID: 37263708 PMCID: PMC10254812 DOI: 10.1136/bmjment-2023-300697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 04/25/2023] [Indexed: 06/03/2023]
Abstract
BACKGROUND Evidence-based mental health interventions to support healthcare workers (HCWs) in crisis settings are scarce. OBJECTIVE To evaluate the capacity of a mental health intervention in reducing anxiety and depression symptoms in HCWs, relative to enhanced care as usual (eCAU), amidst the COVID-19 pandemic. METHODS We conducted an analyst-blind, parallel, multicentre, randomised controlled trial. We recruited HCWs with psychological distress from Madrid and Catalonia (Spain). The intervention arm received a stepped-care programme consisting of two WHO-developed interventions adapted for HCWs: Doing What Matters in Times of Stress (DWM) and Problem Management Plus (PM+). Each intervention lasted 5 weeks and was delivered remotely by non-specialist mental health providers. HCWs reporting psychological distress after DWM completion were invited to continue to PM+. The primary endpoint was self-reported anxiety/depression symptoms (Patient Health Questionnaire-Anxiety and Depression Scale) at week 21. FINDINGS Between 3 November 2021 and 31 March 2022, 115 participants were randomised to stepped care and 117 to eCAU (86% women, mean age 37.5). The intervention showed a greater decrease in anxiety/depression symptoms compared with eCAU at the primary endpoint (baseline-adjusted difference 4.4, 95% CI 2.1 to 6.7; standardised effect size 0.8, 95% CI 0.4 to 1.2). No serious adverse events occurred. CONCLUSIONS Brief stepped-care psychological interventions reduce anxiety and depression during a period of stress among HCWs. CLINICAL IMPLICATIONS Our results can inform policies and actions to protect the mental health of HCWs during major health crises and are potentially rapidly replicable in other settings where workers are affected by global emergencies. TRIAL REGISTRATION NUMBER NCT04980326.
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Affiliation(s)
- Roberto Mediavilla
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
- Consorcio de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Investigación Sanitaria del Hospital Universitario La Princesa (IIS-Princesa), Madrid, Spain
- Leibniz Institute for Resilience Research, Mainz, Germany
| | - Mireia Felez-Nobrega
- Consorcio de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Parc Sanitari Sant Joan de Deu, Sant Boi de Llobregat, Spain
| | - Kerry R McGreevy
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
- Consorcio de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Anna Monistrol-Mula
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
| | - María-Fe Bravo-Ortiz
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
- Consorcio de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Psychiatry, Hospital Universitario La Paz - IdiPAZ, Madrid, Spain
| | - Carmen Bayón
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
- Consorcio de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Psychiatry, Hospital Universitario La Paz - IdiPAZ, Madrid, Spain
| | - Iago Giné-Vázquez
- Consorcio de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
| | - Rut Villaescusa
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
| | - Ainoa Muñoz-Sanjosé
- Department of Psychiatry, Hospital Universitario La Paz - IdiPAZ, Madrid, Spain
| | | | - Natasha Figueiredo
- Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), Institut national de la santé et de la recherche médicale (INSERM), Paris, France
| | - Pablo Nicaise
- Institute of Health and Society (IRSS), Université Catholique de Louvain, Brussels, Belgium
| | - A-La Park
- Department of Health Policy, London School of Economics and Political Science, London, UK
| | | | - Marianna Purgato
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation - Department of Neuroscience, Biomedicine, and Movement Sciences, University of Verona, Verona, Italy
| | - Anke B Witteveen
- Department of Clinical Neuro- and Developmental Psychology - WHO Collaborating Centre for Research and Dissemination of Psychological Interventions, Vrije University, Amsterdam, Netherlands
| | - James Underhill
- Department of Clinical Neuro- and Developmental Psychology - WHO Collaborating Centre for Research and Dissemination of Psychological Interventions, Vrije University, Amsterdam, Netherlands
| | - Corrado Barbui
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation - Department of Neuroscience, Biomedicine, and Movement Sciences, University of Verona, Verona, Italy
| | - Richard Bryant
- School of Psychology, UNSW, Sydney, New South Wales, Australia
| | - Raffael Kalisch
- Leibniz Institute for Resilience Research, Mainz, Germany
- Neuroimaging Center (NIC) - Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Vincent Lorant
- Institute of Health and Society (IRSS), Université Catholique de Louvain, Brussels, Belgium
| | - David McDaid
- Department of Health Policy, London School of Economics and Political Science, London, UK
| | - Maria Melchior
- Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), Institut national de la santé et de la recherche médicale (INSERM), Paris, France
| | - Marit Sijbrandij
- Department of Clinical Neuro- and Developmental Psychology - WHO Collaborating Centre for Research and Dissemination of Psychological Interventions, Vrije University, Amsterdam, Netherlands
| | - Josep Maria Haro
- Consorcio de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
| | - Jose Luis Ayuso-Mateos
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
- Consorcio de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Investigación Sanitaria del Hospital Universitario La Princesa (IIS-Princesa), Madrid, Spain
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17
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Andersen AJ, Hecker I, Wallez S, Witteveen A, Lora A, Mittendorfer-Rutz E, Corrao G, Walter H, Haro JM, Sijbrandij M, Compagnoni MM, Felez-Nobrega M, Kalisch R, Bryant R, Melchior M, Mary-Krause M. Are we equally at risk of changing smoking behavior during a public health crisis? Impact of educational level on smoking from the TEMPO cohort. BMC Public Health 2023; 23:1016. [PMID: 37254131 DOI: 10.1186/s12889-023-15799-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 05/03/2023] [Indexed: 06/01/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic as a public health crisis has led to a significant increase in mental health difficulties. Smoking is strongly associated with mental health conditions, which is why the pandemic might have influenced the otherwise decline in smoking rates. Persons belonging to socioeconomically disadvantaged groups may be particularly affected, both because the pandemic has exacerbated existing social inequalities and because this group was more likely to smoke before the pandemic. We examined smoking prevalence in a French cohort study, focusing on differences between educational attainment. In addition, we examined the association between interpersonal changes in tobacco consumption and educational level from 2018 to 2021. METHODS Using four assessments of smoking status available from 2009 to 2021, we estimated smoking prevalence over time, stratified by highest educational level in the TEMPO cohort and the difference was tested using chi2 test. We studied the association between interpersonal change in smoking status between 2018 and 2021 and educational attainment among 148 smokers, using multinomial logistic regression. RESULTS Smoking prevalence was higher among those with low education. The difference between the two groups increased from 2020 to 2021 (4.8-9.4%, p < 0.001). Smokers with high educational level were more likely to decrease their tobacco consumption from 2018 to 2021 compared to low educated smokers (aOR = 2.72 [1.26;5.89]). CONCLUSION Current findings showed a widening of the social inequality gap in relation to smoking rates, underscoring the increased vulnerability of persons with low educational level to smoking and the likely inadequate focus on social inequalities in relation to tobacco control policies during the pandemic.
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Affiliation(s)
- Astrid Juhl Andersen
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, Equipe de Recherche en Epidémiologie Sociale, ERES, F75012, Paris, France.
- Sorbonne Université - Faculté de Médecine, Site Saint-Antoine, UMR-S 1136 - N° BC 2908, 27 rue Chaligny, Paris, 75012, France.
| | - Irwin Hecker
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, Equipe de Recherche en Epidémiologie Sociale, ERES, F75012, Paris, France
| | - Solène Wallez
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, Equipe de Recherche en Epidémiologie Sociale, ERES, F75012, Paris, France
| | - Anke Witteveen
- Department of Clinical, Neuro-, and Developmental Psychology and WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Vrije Universiteit, Amsterdam, the Netherlands
| | - Antonio Lora
- Direttore Dipartimento di Salute Mentale e Dipendenze, Azienda Socio-Sanitaria Territoriale (ASST) di Lecco, Via dell'Eremo 9/11, 23900, Lecco, Spain
| | - Ellenor Mittendorfer-Rutz
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Giovanni Corrao
- Unit of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, National Centre for Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, University of Milano-Bicocca, Milan, Italy
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
| | - Henrik Walter
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, D-10117, Berlin, Germany
| | - Josep Maria Haro
- Parc Sanitari Sant Joan de Déu, Research and Innovation Unit, CIBERSAM, University of Barcelona, Sant Boi de Llobregat, Barcelona, Spain
| | - Marit Sijbrandij
- Department of Clinical, Neuro-, and Developmental Psychology and WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Vrije Universiteit, Amsterdam, the Netherlands
| | - Matteo Monzio Compagnoni
- Unit of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, National Centre for Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, University of Milano-Bicocca, Milan, Italy
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
| | - Mireia Felez-Nobrega
- Parc Sanitari Sant Joan de Déu, Research and Innovation Unit, CIBERSAM, University of Barcelona, Sant Boi de Llobregat, Barcelona, Spain
| | - Raffael Kalisch
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Richard Bryant
- School of Psychology, University of New South Wales, Sydney, 2052, NSW, Australia
| | - Maria Melchior
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, Equipe de Recherche en Epidémiologie Sociale, ERES, F75012, Paris, France
| | - Murielle Mary-Krause
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, Equipe de Recherche en Epidémiologie Sociale, ERES, F75012, Paris, France
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18
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Bach DR, Sporrer J, Abend R, Beckers T, Dunsmoor JE, Fullana MA, Gamer M, Gee DG, Hamm A, Hartley CA, Herringa RJ, Jovanovic T, Kalisch R, Knight DC, Lissek S, Lonsdorf TB, Merz CJ, Milad M, Morriss J, Phelps EA, Pine DS, Olsson A, van Reekum CM, Schiller D. Consensus design of a calibration experiment for human fear conditioning. Neurosci Biobehav Rev 2023; 148:105146. [PMID: 36990370 PMCID: PMC10618407 DOI: 10.1016/j.neubiorev.2023.105146] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/23/2023] [Accepted: 03/24/2023] [Indexed: 03/29/2023]
Abstract
Fear conditioning is a widely used laboratory model to investigate learning, memory, and psychopathology across species. The quantification of learning in this paradigm is heterogeneous in humans and psychometric properties of different quantification methods can be difficult to establish. To overcome this obstacle, calibration is a standard metrological procedure in which well-defined values of a latent variable are generated in an established experimental paradigm. These intended values then serve as validity criterion to rank methods. Here, we develop a calibration protocol for human fear conditioning. Based on a literature review, series of workshops, and survey of N = 96 experts, we propose a calibration experiment and settings for 25 design variables to calibrate the measurement of fear conditioning. Design variables were chosen to be as theory-free as possible and allow wide applicability in different experimental contexts. Besides establishing a specific calibration procedure, the general calibration process we outline may serve as a blueprint for calibration efforts in other subfields of behavioral neuroscience that need measurement refinement.
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Affiliation(s)
- Dominik R Bach
- Wellcome Centre for Human Neuroimaging and Max Planck UCL Centre for Computational Psychiatry and Ageing Research, University College London, United Kingdom; Hertz Chair for Artificial Intelligence and Neuroscience, Transdisciplinary Research Area "Life & Health", University of Bonn, Germany.
| | - Juliana Sporrer
- Wellcome Centre for Human Neuroimaging and Max Planck UCL Centre for Computational Psychiatry and Ageing Research, University College London, United Kingdom
| | - Rany Abend
- National Institute of Mental Health Intramural Research Program, Bethesda, MD, USA
| | - Tom Beckers
- KU Leuven, Faculty of Psychology and Educational Sciences/Leuven Brain Institute, Leuven, Belgium
| | - Joseph E Dunsmoor
- Department of Psychiatry and Behavioral Sciences, University of Texas at Austin, USA
| | - Miquel A Fullana
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERSAM, & Adult Psychiatry and Psychology Department, Institute of Neurosciences, Hospital Clínic, Barcelona, Spain
| | - Matthias Gamer
- Julius-Maximilians-University of Würzburg, Department of Psychology, Würzburg, Germany
| | - Dylan G Gee
- Yale University, Department of Psychology, New Haven, CT, USA
| | - Alfons Hamm
- Department of Psychology, University of Greifswald, Germany
| | | | - Ryan J Herringa
- Department of Psychiatry, University of Wisconsin School of Medicine & Public Health, USA
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI, USA
| | - Raffael Kalisch
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany; and Leibniz Institute for Resilience Research (LIR), Mainz, Germany
| | - David C Knight
- University of Alabama at Birmingham, Department of Psychology, Birmingham, AL, USA
| | - Shmuel Lissek
- Clinical Science and Psychopathology Research Program, Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Tina B Lonsdorf
- University Medical Center Hamburg-Eppendorf, Institute of Systems Neuroscience, Hamburg, Germany
| | - Christian J Merz
- Ruhr University Bochum, Faculty of Psychology, Institute of Cognitive Neuroscience, Department of Cognitive Psychology, Bochum, Germany
| | - Mohammed Milad
- Department of Psychiatry and Neuroscience Institute, NYU Grossman School of Medicine, New York, NY, USA; The Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - Jayne Morriss
- School of Psychology and Clinical Language Sciences, University of Reading, United Kingdom
| | - Elizabeth A Phelps
- Department of Psychology, Harvard University, 52 Oxford St., Cambridge, MA, USA
| | - Daniel S Pine
- National Institute of Mental Health Intramural Research Program, Bethesda, MD, USA
| | - Andreas Olsson
- Karolinska Institutet, Department of Clinical Neuroscience, Division of Psychology, Stockholm, Sweden
| | - Carien M van Reekum
- School of Psychology and Clinical Language Sciences, University of Reading, United Kingdom
| | - Daniela Schiller
- Friedman Brain Institute, Department of Neuroscience, Department of Psychiatry, Icahn School of Medicine at Mt. Sinai, New York, NY, USA
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19
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Marciniak MA, Shanahan L, Binder H, Kalisch R, Kleim B. Positive Prospective Mental Imagery Characteristics in Young Adults and Their Associations with Depressive Symptoms. Cognit Ther Res 2023; 47:1-12. [PMID: 37363749 PMCID: PMC10140715 DOI: 10.1007/s10608-023-10378-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2023] [Indexed: 06/28/2023]
Abstract
Background Positive prospective mental imagery plays an important role in mental well-being, and depressive symptoms have been associated with difficulties in generating positive prospective mental images (PPMIs). We used a mobile app to gather PPMIs generated by young adults during the COVID-19 pandemic and analyzed content, characteristics, and associations with depressive symptoms. Methods This is a secondary analysis of a randomized controlled trial with 95 healthy young adults allocated into two groups (intervention and control). Participants used the mobile app decreasing mental health symptoms for seven consecutive days. Fifty participants in the intervention group reported PPMIs at least three times per day using a mobile app inducing PPMI generation. We categorized entries into themes and applied moderation models to investigate associations between PPMI characteristics and depressive symptoms. Results We distinguished 25 PPMI themes. The most frequent were related to consuming food and drinks, watching TV/streaming platforms, and doing sports. Vividness and ease of generation of PPMIs, but not their anticipation, pleasure intensity or number of engagements with the app were associated with fewer depressive symptoms. Conclusions We identified PPMI themes in young adults and found significant negative associations between depressive symptoms and vividness and generation ease of PPMIs. These results may inform prevention and intervention science, including the design of personalized interventions. We discuss implications for future studies and treatment development for individuals experiencing diminished PPMI. Supplementary Information The online version contains supplementary material available at 10.1007/s10608-023-10378-5.
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Affiliation(s)
- Marta Anna Marciniak
- Department of Psychology, University of Zurich, Lenggstrasse 31, Zurich, 8032 Switzerland
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital (PUK), University of Zurich, Zurich, Switzerland
| | - Lilly Shanahan
- Department of Psychology, University of Zurich, Lenggstrasse 31, Zurich, 8032 Switzerland
- Jacobs Center for Productive Youth Development, University of Zurich, Zurich, Switzerland
| | - Harald Binder
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
- Freiburg Center for Data Analysis and Modelling, University of Freiburg, Freiburg, Germany
| | - Raffael Kalisch
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Birgit Kleim
- Department of Psychology, University of Zurich, Lenggstrasse 31, Zurich, 8032 Switzerland
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital (PUK), University of Zurich, Zurich, Switzerland
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20
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Ayash S, Lingner T, Ramisch A, Ryu S, Kalisch R, Schmitt U, Müller MB. Fear circuit-based neurobehavioral signatures mirror resilience to chronic social stress in mouse. Proc Natl Acad Sci U S A 2023; 120:e2205576120. [PMID: 37068238 PMCID: PMC10151471 DOI: 10.1073/pnas.2205576120] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2023] Open
Abstract
Consistent evidence from human data points to successful threat-safety discrimination and responsiveness to extinction of fear memories as key characteristics of resilient individuals. To promote valid cross-species approaches for the identification of resilience mechanisms, we establish a translationally informed mouse model enabling the stratification of mice into three phenotypic subgroups following chronic social defeat stress, based on their individual ability for threat-safety discrimination and conditioned learning: the Discriminating-avoiders, characterized by successful social threat-safety discrimination and extinction of social aversive memories; the Indiscriminate-avoiders, showing aversive response generalization and resistance to extinction, in line with findings on susceptible individuals; and the Non-avoiders displaying impaired aversive conditioned learning. To explore the neurobiological mechanisms underlying the stratification, we perform transcriptome analysis within three key target regions of the fear circuitry. We identify subgroup-specific differentially expressed genes and gene networks underlying the behavioral phenotypes, i.e., the individual ability to show threat-safety discrimination and respond to extinction training. Our approach provides a translationally informed template with which to characterize the behavioral, molecular, and circuit bases of resilience in mice.
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Affiliation(s)
- Sarah Ayash
- Leibniz Institute for Resilience Research, Mainz 55122, Germany
- Translational Psychiatry, Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz 55128, Germany
| | | | - Anna Ramisch
- Department of Basic Neuroscience, University of Geneva, Geneva 1205, Switzerland
| | - Soojin Ryu
- Institute for Human Genetics, University Medical Center Mainz, Johannes Gutenberg University Mainz, Mainz 55128, Germany
- Living Systems Institute and Department of Clinical and Biomedical Sciences, University of Exeter, Exeter EX4 4QD, United Kingdom
| | - Raffael Kalisch
- Leibniz Institute for Resilience Research, Mainz 55122, Germany
- Neuroimaging Center, Focus Program Translational Neuroscience, Johannes Gutenberg University Medical Center Mainz, Mainz 55131, Germany
| | - Ulrich Schmitt
- Leibniz Institute for Resilience Research, Mainz 55122, Germany
- Translational Psychiatry, Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz 55128, Germany
| | - Marianne B Müller
- Leibniz Institute for Resilience Research, Mainz 55122, Germany
- Translational Psychiatry, Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz 55128, Germany
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21
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Köber G, Kalisch R, Puhlmann LMC, Chmitorz A, Schick A, Binder H. Deep learning and differential equations for modeling changes in individual-level latent dynamics between observation periods. Biom J 2023:e2100381. [PMID: 36928993 DOI: 10.1002/bimj.202100381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/23/2022] [Accepted: 12/30/2022] [Indexed: 03/18/2023]
Abstract
When modeling longitudinal biomedical data, often dimensionality reduction as well as dynamic modeling in the resulting latent representation is needed. This can be achieved by artificial neural networks for dimension reduction and differential equations for dynamic modeling of individual-level trajectories. However, such approaches so far assume that parameters of individual-level dynamics are constant throughout the observation period. Motivated by an application from psychological resilience research, we propose an extension where different sets of differential equation parameters are allowed for observation subperiods. Still, estimation for intra-individual subperiods is coupled for being able to fit the model also with a relatively small dataset. We subsequently derive prediction targets from individual dynamic models of resilience in the application. These serve as outcomes for predicting resilience from characteristics of individuals, measured at baseline and a follow-up time point, and selecting a small set of important predictors. Our approach is seen to successfully identify individual-level parameters of dynamic models that allow to stably select predictors, that is, resilience factors. Furthermore, we can identify those characteristics of individuals that are the most promising for updates at follow-up, which might inform future study design. This underlines the usefulness of our proposed deep dynamic modeling approach with changes in parameters between observation subperiods.
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Affiliation(s)
- Göran Köber
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany.,Freiburg Center for Data Analysis and Modelling, University of Freiburg, Freiburg, Germany
| | - Raffael Kalisch
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
| | | | - Andrea Chmitorz
- Faculty of Social Work, Education and Nursing Sciences, University Esslingen, Esslingen am Neckar, Germany
| | - Anita Schick
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Harald Binder
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany.,Freiburg Center for Data Analysis and Modelling, University of Freiburg, Freiburg, Germany
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22
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Purgato M, Turrini G, Tedeschi F, Serra R, Tarsitani L, Compri B, Muriago G, Cadorin C, Ostuzzi G, Nicaise P, Lorant V, Sijbrandij M, Witteveen AB, Ayuso-Mateos JL, Mediavilla R, Haro JM, Felez-Nobrega M, Figueiredo N, Pollice G, McDaid D, Park AL, Kalisch R, Petri-Romão P, Underhill J, Bryant RA, Nosè M, Barbui C. Effectiveness of a stepped-care programme of WHO psychological interventions in migrant populations resettled in Italy: Study protocol for the RESPOND randomized controlled trial. Front Public Health 2023; 11:1100546. [PMID: 36761135 PMCID: PMC9905848 DOI: 10.3389/fpubh.2023.1100546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 01/06/2023] [Indexed: 01/26/2023] Open
Abstract
Introduction Migrant populations, including workers, undocumented migrants, asylum seekers, refugees, internationally displaced persons, and other populations on the move, are exposed to a variety of stressors and potentially traumatic events before, during, and after the migration process. In recent years, the COVID-19 pandemic has represented an additional stressor, especially for migrants on the move. As a consequence, migration may increase vulnerability of individuals toward a worsening of subjective wellbeing, quality of life, and mental health, which, in turn, may increase the risk of developing mental health conditions. Against this background, we designed a stepped-care programme consisting of two scalable psychological interventions developed by the World Health Organization and locally adapted for migrant populations. The effectiveness and cost-effectiveness of this stepped-care programme will be assessed in terms of mental health outcomes, resilience, wellbeing, and costs to healthcare systems. Methods and analysis We present the study protocol for a pragmatic randomized study with a parallel-group design that will enroll participants with a migrant background and elevated level of psychological distress. Participants will be randomized to care as usual only or to care a usual plus a guided self-help stress management guide (Doing What Matters in Times of Stress, DWM) and a five-session cognitive behavioral intervention (Problem Management Plus, PM+). Participants will self-report all measures at baseline before random allocation, 2 weeks after DWM delivery, 1 week after PM+ delivery and 2 months after PM+ delivery. All participants will receive a single-session of a support intervention, namely Psychological First Aid. We will include 212 participants. An intention-to-treat analysis using linear mixed models will be conducted to explore the programme's effect on anxiety and depression symptoms, as measured by the Patient Health Questionnaire-Anxiety and Depression Scale summary score 2 months after PM+ delivery. Secondary outcomes include post-traumatic stress disorder symptoms, resilience, quality of life, resource utilization, cost, and cost-effectiveness. Discussion This study is the first randomized controlled trial that combines two World Health Organization psychological interventions tailored for migrant populations with an elevated level of psychological distress. The present study will make available DWM/PM+ packages adapted for remote delivery following a task-shifting approach, and will generate evidence to inform policy responses based on a more efficient use of resources for improving resilience, wellbeing and mental health. Clinical trial registration ClinicalTrials.gov, identifier: NCT04993534.
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Affiliation(s)
- Marianna Purgato
- Department of Neuroscience, Biomedicine, and Movement Sciences, Section of Psychiatry, WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy
| | - Giulia Turrini
- Department of Neuroscience, Biomedicine, and Movement Sciences, Section of Psychiatry, WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy
| | - Federico Tedeschi
- Department of Neuroscience, Biomedicine, and Movement Sciences, Section of Psychiatry, WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy
| | - Riccardo Serra
- Department of Neuroscience, Biomedicine, and Movement Sciences, Section of Psychiatry, WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Lorenzo Tarsitani
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Beatrice Compri
- Department of Neuroscience, Biomedicine, and Movement Sciences, Section of Psychiatry, WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy
| | - Giulia Muriago
- Department of Neuroscience, Biomedicine, and Movement Sciences, Section of Psychiatry, WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy
| | - Camilla Cadorin
- Department of Neuroscience, Biomedicine, and Movement Sciences, Section of Psychiatry, WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy
| | - Giovanni Ostuzzi
- Department of Neuroscience, Biomedicine, and Movement Sciences, Section of Psychiatry, WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy
| | - Pablo Nicaise
- Institute of Health and Society (IRSS) - UCLouvain, Brussels, Belgium
| | - Vincent Lorant
- Institute of Health and Society (IRSS) - UCLouvain, Brussels, Belgium
| | - Marit Sijbrandij
- Department of Clinical, Neuro- and Developmental Psychology, WHO Collaborating Center for Research and Dissemination of Psychological Interventions, VU University, Amsterdam, Netherlands
| | - Anke B. Witteveen
- Department of Clinical, Neuro- and Developmental Psychology, WHO Collaborating Center for Research and Dissemination of Psychological Interventions, VU University, Amsterdam, Netherlands
| | - José Luis Ayuso-Mateos
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Psychiatry, La Princesa University Hospital, Instituto de Investigación Sanitaria La Princesa (IIS-Princesa), Madrid, Spain
| | - Roberto Mediavilla
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), Madrid, Spain
| | - Josep Maria Haro
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
| | - Mireia Felez-Nobrega
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
| | - Natasha Figueiredo
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, ERES, Paris, France
| | - Giulia Pollice
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, ERES, Paris, France
| | - David McDaid
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
| | - A-La Park
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
| | - Raffael Kalisch
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
- Leibniz Institute for Resilience Research, Mainz, Germany
| | | | | | - Richard A. Bryant
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Michela Nosè
- Department of Neuroscience, Biomedicine, and Movement Sciences, Section of Psychiatry, WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy
| | - Corrado Barbui
- Department of Neuroscience, Biomedicine, and Movement Sciences, Section of Psychiatry, WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy
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Lueckel M, Radetz A, Hassan U, Yuen K, Mueller-Dahlhaus F, Kalisch R, Bergmann TO. Functional connectivity- and E-field-optimized TMS targeting: method development and concurrent TMS-fMRI validation. Brain Stimul 2023. [DOI: 10.1016/j.brs.2023.01.223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
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24
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Mediavilla R, McGreevy KR, Felez-Nobrega M, Monistrol-Mula A, Bravo-Ortiz MF, Bayón C, Rodríguez-Vega B, Nicaise P, Delaire A, Sijbrandij M, Witteveen AB, Purgato M, Barbui C, Tedeschi F, Melchior M, van der Waerden J, McDaid D, Park AL, Kalisch R, Petri-Romão P, Underhill J, Bryant RA, Haro JM, Ayuso-Mateos JL. Effectiveness of a stepped-care programme of internet-based psychological interventions for healthcare workers with psychological distress: Study protocol for the RESPOND healthcare workers randomised controlled trial. Digit Health 2022; 8:20552076221129084. [PMID: 36211795 PMCID: PMC9537484 DOI: 10.1177/20552076221129084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 09/11/2022] [Indexed: 11/05/2022] Open
Abstract
Background and aims The coronavirus disease 2019 pandemic has challenged health services worldwide, with a worsening of healthcare workers' mental health within initial pandemic hotspots. In early 2022, the Omicron variant is spreading rapidly around the world. This study explores the effectiveness and cost-effectiveness of a stepped-care programme of scalable, internet-based psychological interventions for distressed health workers on self-reported anxiety and depression symptoms. Methods We present the study protocol for a multicentre (two sites), parallel-group (1:1 allocation ratio), analyst-blinded, superiority, randomised controlled trial. Healthcare workers with psychological distress will be allocated either to care as usual only or to care as usual plus a stepped-care programme that includes two scalable psychological interventions developed by the World Health Organization: A guided self-help stress management guide (Doing What Matters in Times of Stress) and a five-session cognitive behavioural intervention (Problem Management Plus). All participants will receive a single-session emotional support intervention, namely psychological first aid. We will include 212 participants. An intention-to-treat analysis using linear mixed models will be conducted to explore the programme's effect on anxiety and depression symptoms, as measured by the Patient Health Questionnaire - Anxiety and Depression Scale summary score at 21 weeks from baseline. Secondary outcomes include post-traumatic stress disorder symptoms, resilience, quality of life, cost impact and cost-effectiveness. Conclusions This study is the first randomised trial that combines two World Health Organization psychological interventions tailored for health workers into one stepped-care programme. Results will inform occupational and mental health prevention, treatment, and recovery strategies. Registration details ClinicalTrials.gov Identifier: NCT04980326.
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Affiliation(s)
- Roberto Mediavilla
- Department of Psychiatry, Universidad Autónoma de Madrid
(UAM), Madrid, Spain,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM),
Instituto de Salud Carlos III, Madrid, Spain
| | - Kerry R McGreevy
- Department of Psychiatry, Universidad Autónoma de Madrid
(UAM), Madrid, Spain,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM),
Instituto de Salud Carlos III, Madrid, Spain,Kerry R. McGreevy, Department of
Psychiatry, Universidad Autónoma de Madrid, Arzobispo Morcillo, 4, 28029,
Madrid, Spain.
| | - Mireia Felez-Nobrega
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM),
Instituto de Salud Carlos III, Madrid, Spain,Research and Development Unit, Parc Sanitari Sant Joan de
Déu, Barcelona, Spain
| | - Anna Monistrol-Mula
- Research and Development Unit, Parc Sanitari Sant Joan de
Déu, Barcelona, Spain
| | - María-Fe Bravo-Ortiz
- Department of Psychiatry, Universidad Autónoma de Madrid
(UAM), Madrid, Spain,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM),
Instituto de Salud Carlos III, Madrid, Spain,Department of Psychiatry, Clinical Psychology and Mental Health,
Hospital Univeristario La Paz, Madrid, Spain,Instituto de Investigación del Hospital
Universitario La Paz (IdiPAZ), Madrid, Spain
| | - Carmen Bayón
- Department of Psychiatry, Universidad Autónoma de Madrid
(UAM), Madrid, Spain,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM),
Instituto de Salud Carlos III, Madrid, Spain,Department of Psychiatry, Clinical Psychology and Mental Health,
Hospital Univeristario La Paz, Madrid, Spain,Instituto de Investigación del Hospital
Universitario La Paz (IdiPAZ), Madrid, Spain
| | - Beatriz Rodríguez-Vega
- Department of Psychiatry, Universidad Autónoma de Madrid
(UAM), Madrid, Spain,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM),
Instituto de Salud Carlos III, Madrid, Spain,Department of Psychiatry, Clinical Psychology and Mental Health,
Hospital Univeristario La Paz, Madrid, Spain,Instituto de Investigación del Hospital
Universitario La Paz (IdiPAZ), Madrid, Spain
| | - Pablo Nicaise
- Institute of Health & Society (IRSS), Université Catholique de
Louvain, Brussels, Belgium
| | - Audrey Delaire
- Institute of Health & Society (IRSS), Université Catholique de
Louvain, Brussels, Belgium
| | - Marit Sijbrandij
- Clinical, Neuro- and Developmental Psychology, WHO Collaborating
Centre for Research and Dissemination of Psychological Interventions, Amsterdam
Public Health Institute, Vrije Universiteit
Amsterdam, Amsterdam, the Netherlands
| | - Anke B. Witteveen
- Clinical, Neuro- and Developmental Psychology, WHO Collaborating
Centre for Research and Dissemination of Psychological Interventions, Amsterdam
Public Health Institute, Vrije Universiteit
Amsterdam, Amsterdam, the Netherlands
| | - Marianna Purgato
- WHO Collaborating Centre for Research and Training in Mental Health
and Service Evaluation, Department of Neuroscience, Biomedicine, and Movement
Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - Corrado Barbui
- WHO Collaborating Centre for Research and Training in Mental Health
and Service Evaluation, Department of Neuroscience, Biomedicine, and Movement
Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - Federico Tedeschi
- WHO Collaborating Centre for Research and Training in Mental Health
and Service Evaluation, Department of Neuroscience, Biomedicine, and Movement
Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - Maria Melchior
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé
Publique (IPLESP), Equipe de Recherche en Epidémiologie Sociale (ERES), Faculté de
Médecine St Antoine, , Paris, France
| | - Judith van der Waerden
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé
Publique (IPLESP), Equipe de Recherche en Epidémiologie Sociale (ERES), Faculté de
Médecine St Antoine, , Paris, France
| | - David McDaid
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political
Science, London, UK
| | - A-La Park
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political
Science, London, UK
| | - Raffael Kalisch
- Leibniz Institute for Resilience Research
(LIR), Mainz, Germany,Neuroimaging Center (NIC), Focus Program Translational Neuroscience
(FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
| | | | | | - Richard A. Bryant
- School of Psychology, University of New
South Wales, Sydney, NSW, Australia
| | - Josep Maria Haro
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM),
Instituto de Salud Carlos III, Madrid, Spain,Research and Development Unit, Parc Sanitari Sant Joan de
Déu, Barcelona, Spain
| | - José Luis Ayuso-Mateos
- Department of Psychiatry, Universidad Autónoma de Madrid
(UAM), Madrid, Spain,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM),
Instituto de Salud Carlos III, Madrid, Spain,Department of Psychiatry, La Princesa University
Hospital, Instituto de Investigación Sanitaria Princesa (IIS-Princesa),
Madrid, Spain
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25
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Ahrens KF, Neumann RJ, von Werthern NM, Kranz TM, Kollmann B, Mattes B, Puhlmann LMC, Weichert D, Lutz B, Basten U, Fiebach CJ, Wessa M, Kalisch R, Lieb K, Chiocchetti AG, Tüscher O, Reif A, Plichta MM. Association of polygenic risk scores and hair cortisol with mental health trajectories during COVID lockdown. Transl Psychiatry 2022; 12:396. [PMID: 36130942 PMCID: PMC9490720 DOI: 10.1038/s41398-022-02165-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 09/06/2022] [Accepted: 09/08/2022] [Indexed: 11/25/2022] Open
Abstract
The COVID-19 pandemic is a global stressor with inter-individually differing influences on mental health trajectories. Polygenic Risk Scores (PRSs) for psychiatric phenotypes are associated with individual mental health predispositions. Elevated hair cortisol concentrations (HCC) and high PRSs are related to negative mental health outcomes. We analyzed whether PRSs and HCC are related to different mental health trajectories during the first COVID lockdown in Germany. Among 523 participants selected from the longitudinal resilience assessment study (LORA), we previously reported three subgroups (acute dysfunction, delayed dysfunction, resilient) based on weekly mental health (GHQ-28) assessment during COVID lockdown. DNA from blood was collected at the baseline of the original LORA study (n = 364) and used to calculate the PRSs of 12 different psychopathological phenotypes. An explorative bifactor model with Schmid-Leiman transformation was calculated to extract a general genetic factor for psychiatric disorders. Hair samples were collected quarterly prior to the pandemic for determining HCC (n = 192). Bivariate logistic regressions were performed to test the associations of HCC and the PRS factors with the reported trajectories. The bifactor model revealed 1 general factor and 4 sub-factors. Results indicate a significant association between increased values on the general risk factor and the allocation to the acute dysfunction class. The same was found for elevated HCC and the exploratorily tested sub-factor "childhood-onset neurodevelopmental disorders". Genetic risk and long-term cortisol secretion as a potential indicator of stress, indicated by PRSs and HCC, respectively, predicted different mental health trajectories. Results indicate a potential for future studies on risk prediction.
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Affiliation(s)
- Kira F. Ahrens
- Goethe University Frankfurt, University Hospital, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Frankfurt, Germany
| | - Rebecca J. Neumann
- Goethe University Frankfurt, University Hospital, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Frankfurt, Germany
| | - Nina M. von Werthern
- Goethe University Frankfurt, University Hospital, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Frankfurt, Germany
| | - Thorsten M. Kranz
- Goethe University Frankfurt, University Hospital, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Frankfurt, Germany
| | - Bianca Kollmann
- grid.410607.4Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany ,grid.509458.50000 0004 8087 0005Leibniz Institute for Resilience Research (LIR), Mainz, Germany
| | - Björn Mattes
- grid.6546.10000 0001 0940 1669Institute of Psychology, Technical University of Darmstadt, Darmstadt, Germany
| | - Lara M. C. Puhlmann
- grid.509458.50000 0004 8087 0005Leibniz Institute for Resilience Research (LIR), Mainz, Germany
| | - Danuta Weichert
- grid.410607.4Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany
| | - Beat Lutz
- grid.509458.50000 0004 8087 0005Leibniz Institute for Resilience Research (LIR), Mainz, Germany ,grid.410607.4Institute of Physiological Chemistry, University Medical Center Mainz, Mainz, Germany
| | - Ulrike Basten
- grid.7839.50000 0004 1936 9721Department of Psychology, Goethe University Frankfurt, Frankfurt am Main, Germany ,grid.7839.50000 0004 1936 9721Brain Imaging Center, Goethe University, Frankfurt, Germany
| | - Christian J. Fiebach
- grid.7839.50000 0004 1936 9721Department of Psychology, Goethe University Frankfurt, Frankfurt am Main, Germany ,grid.7839.50000 0004 1936 9721Brain Imaging Center, Goethe University, Frankfurt, Germany
| | - Michèle Wessa
- grid.509458.50000 0004 8087 0005Leibniz Institute for Resilience Research (LIR), Mainz, Germany ,grid.5802.f0000 0001 1941 7111Department of Clinical Psychology and Neuropsychology, Institute for Psychology, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Raffael Kalisch
- grid.509458.50000 0004 8087 0005Leibniz Institute for Resilience Research (LIR), Mainz, Germany ,grid.410607.4Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center Mainz, Mainz, Germany
| | - Klaus Lieb
- grid.410607.4Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany ,grid.509458.50000 0004 8087 0005Leibniz Institute for Resilience Research (LIR), Mainz, Germany
| | - Andreas G. Chiocchetti
- grid.7839.50000 0004 1936 9721Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Goethe University Frankfurt, Frankfurt, Germany
| | - Oliver Tüscher
- grid.410607.4Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany ,grid.509458.50000 0004 8087 0005Leibniz Institute for Resilience Research (LIR), Mainz, Germany
| | - Andreas Reif
- Goethe University Frankfurt, University Hospital, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Frankfurt, Germany
| | - Michael M. Plichta
- Goethe University Frankfurt, University Hospital, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Frankfurt, Germany
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26
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Riepenhausen A, Wackerhagen C, Reppmann ZC, Deter HC, Kalisch R, Veer IM, Walter H. Positive Cognitive Reappraisal in Stress Resilience, Mental Health, and Well-Being: A Comprehensive Systematic Review. Emotion Review 2022. [DOI: 10.1177/17540739221114642] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Stress-related psychopathology is on the rise, and there is a pressing need for improved prevention strategies. Positive appraisal style, the tendency to appraise potentially threatening situations in a positive way, has been proposed to act as a key resilience mechanism and therefore offers a potential target for preventive approaches. In this article, we review n = 99 studies investigating associations of positive cognitive reappraisal, an important sub-facet of positive appraisal style, with outcome-based resilience and relevant other outcomes, which are considered resilience-related. According to the studies reviewed, positive cognitive reappraisal moderates the relation between stressors and negative outcomes and is positively related to several resilience-related outcomes. It also mediates between other resilience factors and resilience, suggesting it is a proximal resilience factor.
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Affiliation(s)
- Antje Riepenhausen
- Department of Psychiatry and Neurosciences CCM, Research Division of Mind and Brain, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
- Berlin School of Mind and Brain, Faculty of Philosophy, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Carolin Wackerhagen
- Department of Psychiatry and Neurosciences CCM, Research Division of Mind and Brain, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Zala C. Reppmann
- Department of Psychiatry and Neurosciences CCM, Research Division of Mind and Brain, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Hans-Christian Deter
- Berlin School of Mind and Brain, Faculty of Philosophy, Humboldt-Universität zu Berlin, Berlin, Germany
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Medical Clinic, Psychosomatics, Campus Benjamin Franklin, Hindenburgdamm 30, 12203 Berlin, Germany
| | - Raffael Kalisch
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
| | - Ilya M. Veer
- Department of Psychiatry and Neurosciences CCM, Research Division of Mind and Brain, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
- Department of Developmental Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Henrik Walter
- Department of Psychiatry and Neurosciences CCM, Research Division of Mind and Brain, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
- Berlin School of Mind and Brain, Faculty of Philosophy, Humboldt-Universität zu Berlin, Berlin, Germany
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27
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Wackerhagen C, Veer IM, van Leeuwen JMC, Reppmann Z, Riepenhausen A, Bögemann SA, Mor N, Puhlmann LM, Uściƚko A, Zerban M, Yuen KSL, Köber G, Pooseh S, Weermeijer J, Marciniak MA, Arias-Vásquez A, Binder H, de Raedt W, Kleim B, Myin-Germeys I, Roelofs K, Timmer J, Tüscher O, Hendler T, Kobylińska D, Hermans EJ, Kalisch R, Walter H. Study protocol description: Dynamic Modelling of Resilience - Observational Study (DynaM-OBS) (Preprint). JMIR Res Protoc 2022. [DOI: 10.2196/39817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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28
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Köber G, Pooseh S, Engen H, Chmitorz A, Kampa M, Schick A, Sebastian A, Tüscher O, Wessa M, Yuen KSL, Walter H, Kalisch R, Timmer J, Binder H. Individualizing deep dynamic models for psychological resilience data. Sci Rep 2022; 12:8061. [PMID: 35577829 PMCID: PMC9110739 DOI: 10.1038/s41598-022-11650-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 04/25/2022] [Indexed: 11/29/2022] Open
Abstract
Deep learning approaches can uncover complex patterns in data. In particular, variational autoencoders achieve this by a non-linear mapping of data into a low-dimensional latent space. Motivated by an application to psychological resilience in the Mainz Resilience Project, which features intermittent longitudinal measurements of stressors and mental health, we propose an approach for individualized, dynamic modeling in this latent space. Specifically, we utilize ordinary differential equations (ODEs) and develop a novel technique for obtaining person-specific ODE parameters even in settings with a rather small number of individuals and observations, incomplete data, and a differing number of observations per individual. This technique allows us to subsequently investigate individual reactions to stimuli, such as the mental health impact of stressors. A potentially large number of baseline characteristics can then be linked to this individual response by regularized regression, e.g., for identifying resilience factors. Thus, our new method provides a way of connecting different kinds of complex longitudinal and baseline measures via individualized, dynamic models. The promising results obtained in the exemplary resilience application indicate that our proposal for dynamic deep learning might also be more generally useful for other application domains.
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29
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Neumann RJ, Ahrens KF, Kollmann B, Goldbach N, Chmitorz A, Weichert D, Fiebach CJ, Wessa M, Kalisch R, Lieb K, Tüscher O, Plichta MM, Reif A, Matura S. The impact of physical fitness on resilience to modern life stress and the mediating role of general self-efficacy. Eur Arch Psychiatry Clin Neurosci 2022; 272:679-692. [PMID: 34622343 PMCID: PMC9095527 DOI: 10.1007/s00406-021-01338-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 09/22/2021] [Indexed: 12/18/2022]
Abstract
Substantial evidence shows that physical activity and fitness play a protective role in the development of stress related disorders. However, the beneficial effects of fitness for resilience to modern life stress are not fully understood. Potentially protective effects may be attributed to enhanced resilience via underlying psychosocial mechanisms such as self-efficacy expectations. This study investigated whether physical activity and fitness contribute to prospectively measured resilience and examined the mediating effect of general self-efficacy. 431 initially healthy adults participated in fitness assessments as part of a longitudinal-prospective study, designed to identify mechanisms of resilience. Self-efficacy and habitual activity were assessed in parallel to cardiorespiratory and muscular fitness, which were determined by a submaximal step-test, hand strength and standing long jump test. Resilience was indexed by stressor reactivity: mental health problems in relation to reported life events and daily hassles, monitored quarterly for nine months. Hierarchical linear regression models and bootstrapped mediation analyses were applied. We could show that muscular and self-perceived fitness were positively associated with stress resilience. Extending this finding, the muscular fitness-resilience relationship was partly mediated by self-efficacy expectations. In this context, self-efficacy expectations may act as one underlying psychological mechanism, with complementary benefits for the promotion of mental health. While physical activity and cardiorespiratory fitness did not predict resilience prospectively, we found muscular and self-perceived fitness to be significant prognostic parameters for stress resilience. Although there is still more need to identify specific fitness parameters in light of stress resilience, our study underscores the general relevance of fitness for stress-related disorders prevention.
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Affiliation(s)
- R. J. Neumann
- grid.7839.50000 0004 1936 9721Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe-University, Heinrich-Hoffmann-Str. 10, 60528 Frankfurt/Main, Germany
| | - K. F. Ahrens
- grid.7839.50000 0004 1936 9721Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe-University, Heinrich-Hoffmann-Str. 10, 60528 Frankfurt/Main, Germany
| | - B. Kollmann
- grid.410607.4Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany ,grid.509458.50000 0004 8087 0005Leibniz Institute for Resilience Research (LIR) gGmbH, Mainz, Germany
| | - N. Goldbach
- grid.7839.50000 0004 1936 9721Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe-University, Heinrich-Hoffmann-Str. 10, 60528 Frankfurt/Main, Germany
| | - A. Chmitorz
- grid.448696.10000 0001 0338 9080Faculty of Social Work, Education and Nursing Sciences, Esslingen University of Applied Sciences, Esslingen, Germany
| | - D. Weichert
- grid.410607.4Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany ,grid.509458.50000 0004 8087 0005Leibniz Institute for Resilience Research (LIR) gGmbH, Mainz, Germany
| | - C. J. Fiebach
- grid.7839.50000 0004 1936 9721Department of Psychology, Goethe University, Frankfurt, Frankfurt am Main Germany ,grid.7839.50000 0004 1936 9721Brain Imaging Center, Goethe University, Frankfurt am Main, Germany
| | - M. Wessa
- grid.509458.50000 0004 8087 0005Leibniz Institute for Resilience Research (LIR) gGmbH, Mainz, Germany ,grid.5802.f0000 0001 1941 7111Department of Clinical Psychology and Neuropsychology, Institute for Psychology, Johannes Gutenberg University Mainz, Mainz, Germany
| | - R. Kalisch
- grid.509458.50000 0004 8087 0005Leibniz Institute for Resilience Research (LIR) gGmbH, Mainz, Germany ,grid.410607.4Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), University Medical Center Mainz, Mainz, Germany
| | - K. Lieb
- grid.410607.4Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany ,grid.509458.50000 0004 8087 0005Leibniz Institute for Resilience Research (LIR) gGmbH, Mainz, Germany
| | - O. Tüscher
- grid.410607.4Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany ,grid.509458.50000 0004 8087 0005Leibniz Institute for Resilience Research (LIR) gGmbH, Mainz, Germany
| | - M. M. Plichta
- grid.7839.50000 0004 1936 9721Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe-University, Heinrich-Hoffmann-Str. 10, 60528 Frankfurt/Main, Germany
| | - A. Reif
- grid.7839.50000 0004 1936 9721Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe-University, Heinrich-Hoffmann-Str. 10, 60528 Frankfurt/Main, Germany
| | - S. Matura
- grid.7839.50000 0004 1936 9721Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe-University, Heinrich-Hoffmann-Str. 10, 60528 Frankfurt/Main, Germany
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30
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Kalisch R, Köber G, Binder H, Ahrens KF, Basten U, Chmitorz A, Choi KW, Fiebach CJ, Goldbach N, Neumann RJ, Kampa M, Kollmann B, Lieb K, Plichta MM, Reif A, Schick A, Sebastian A, Walter H, Wessa M, Yuen KSL, Tüscher O, Engen H. The Frequent Stressor and Mental Health Monitoring-Paradigm: A Proposal for the Operationalization and Measurement of Resilience and the Identification of Resilience Processes in Longitudinal Observational Studies. Front Psychol 2021; 12:710493. [PMID: 34539510 PMCID: PMC8444985 DOI: 10.3389/fpsyg.2021.710493] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 07/19/2021] [Indexed: 11/13/2022] Open
Abstract
Resilience has been defined as the maintenance or quick recovery of mental health during and after times of adversity. How to operationalize resilience and to determine the factors and processes that lead to good long-term mental health outcomes in stressor-exposed individuals is a matter of ongoing debate and of critical importance for the advancement of the field. One of the biggest challenges for implementing an outcome-based definition of resilience in longitudinal observational study designs lies in the fact that real-life adversity is usually unpredictable and that its substantial qualitative as well as temporal variability between subjects often precludes defining circumscribed time windows of inter-individually comparable stressor exposure relative to which the maintenance or recovery of mental health can be determined. To address this pertinent issue, we propose to frequently and regularly monitor stressor exposure (E) and mental health problems (P) throughout a study's observation period [Frequent Stressor and Mental Health Monitoring (FRESHMO)-paradigm]. On this basis, a subject's deviation at any single monitoring time point from the study sample's normative E-P relationship (the regression residual) can be used to calculate that subject's current mental health reactivity to stressor exposure ("stressor reactivity," SR). The SR score takes into account the individual extent of experienced adversity and is comparable between and within subjects. Individual SR time courses across monitoring time points reflect intra-individual temporal variability in SR, where periods of under-reactivity (negative SR score) are associated with accumulation of fewer mental health problems than is normal for the sample. If FRESHMO is accompanied by regular measurement of potential resilience factors, temporal changes in resilience factors can be used to predict SR time courses. An increase in a resilience factor measurement explaining a lagged decrease in SR can then be considered to index a process of adaptation to stressor exposure that promotes a resilient outcome (an allostatic resilience process). This design principle allows resilience research to move beyond merely determining baseline predictors of resilience outcomes, which cannot inform about how individuals successfully adjust and adapt when confronted with adversity. Hence, FRESHMO plus regular resilience factor monitoring incorporates a dynamic-systems perspective into resilience research.
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Affiliation(s)
- Raffael Kalisch
- Leibniz Institute for Resilience Research, Mainz, Germany
- Neuroimaging Center, Focus Program Translational Neuroscience, Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Göran Köber
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
- Freiburg Center of Data Analysis and Modelling, University of Freiburg, Freiburg, Germany
| | - Harald Binder
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
- Freiburg Center of Data Analysis and Modelling, University of Freiburg, Freiburg, Germany
| | - Kira F. Ahrens
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt, Germany
| | - Ulrike Basten
- Department of Psychology, Goethe University Frankfurt, Frankfurt, Germany
- Department of Psychology, University of Koblenz-Landau, Landau, Germany
| | - Andrea Chmitorz
- Leibniz Institute for Resilience Research, Mainz, Germany
- Department of Psychiatry and Psychotherapy, Johannes Gutenberg University Medical Center, Mainz, Germany
- Faculty of Social Work, Health Care and Nursing Science, Esslingen University of Applied Sciences, Esslingen, Germany
| | - Karmel W. Choi
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, United States
- Lee Kum Sheung Center for Health and Happiness, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Christian J. Fiebach
- Department of Psychology, Goethe University Frankfurt, Frankfurt, Germany
- Brain Imaging Center, Goethe University Frankfurt, Frankfurt, Germany
| | - Nele Goldbach
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt, Germany
| | - Rebecca J. Neumann
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt, Germany
| | - Miriam Kampa
- Leibniz Institute for Resilience Research, Mainz, Germany
- Department of Clinical Psychology and Psychotherapy, University of Siegen, Siegen, Germany
- Department of Psychology, Bender Institute of Neuroimaging, Justus Liebig University, Gießen, Germany
| | - Bianca Kollmann
- Leibniz Institute for Resilience Research, Mainz, Germany
- Department of Psychiatry and Psychotherapy, Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Klaus Lieb
- Leibniz Institute for Resilience Research, Mainz, Germany
- Department of Psychiatry and Psychotherapy, Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Michael M. Plichta
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt, Germany
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt, Germany
| | - Anita Schick
- Leibniz Institute for Resilience Research, Mainz, Germany
- Neuroimaging Center, Focus Program Translational Neuroscience, Johannes Gutenberg University Medical Center, Mainz, Germany
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Alexandra Sebastian
- Department of Psychiatry and Psychotherapy, Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Henrik Walter
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Michèle Wessa
- Leibniz Institute for Resilience Research, Mainz, Germany
- Department of Clinical Psychology and Neuropsychology, Institute of Psychology, Johannes Gutenberg University, Mainz, Germany
| | - Kenneth S. L. Yuen
- Leibniz Institute for Resilience Research, Mainz, Germany
- Neuroimaging Center, Focus Program Translational Neuroscience, Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Oliver Tüscher
- Leibniz Institute for Resilience Research, Mainz, Germany
- Department of Psychiatry and Psychotherapy, Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Haakon Engen
- Neuroimaging Center, Focus Program Translational Neuroscience, Johannes Gutenberg University Medical Center, Mainz, Germany
- Department of Psychology, University of Oslo, Oslo, Norway
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31
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Ahrens KF, Neumann RJ, Kollmann B, Brokelmann J, von Werthern NM, Malyshau A, Weichert D, Lutz B, Fiebach CJ, Wessa M, Kalisch R, Plichta MM, Lieb K, Tüscher O, Reif A. Impact of COVID-19 lockdown on mental health in Germany: longitudinal observation of different mental health trajectories and protective factors. Transl Psychiatry 2021; 11:392. [PMID: 34282129 PMCID: PMC8287278 DOI: 10.1038/s41398-021-01508-2] [Citation(s) in RCA: 66] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 06/02/2021] [Accepted: 06/21/2021] [Indexed: 12/29/2022] Open
Abstract
The COVID-19 pandemic and resulting measures can be regarded as a global stressor. Cross-sectional studies showed rather negative impacts on people's mental health, while longitudinal studies considering pre-lockdown data are still scarce. The present study investigated the impact of COVID-19 related lockdown measures in a longitudinal German sample, assessed since 2017. During lockdown, 523 participants completed additional weekly online questionnaires on e.g., mental health, COVID-19-related and general stressor exposure. Predictors for and distinct trajectories of mental health outcomes were determined, using multilevel models and latent growth mixture models, respectively. Positive pandemic appraisal, social support, and adaptive cognitive emotion regulation were positively, whereas perceived stress, daily hassles, and feeling lonely negatively related to mental health outcomes in the entire sample. Three subgroups ("recovered," 9.0%; "resilient," 82.6%; "delayed dysfunction," 8.4%) with different mental health responses to initial lockdown measures were identified. Subgroups differed in perceived stress and COVID-19-specific positive appraisal. Although most participants remained mentally healthy, as observed in the resilient group, we also observed inter-individual differences. Participants' psychological state deteriorated over time in the delayed dysfunction group, putting them at risk for mental disorder development. Consequently, health services should especially identify and allocate resources to vulnerable individuals.
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Affiliation(s)
- K F Ahrens
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt, Germany
| | - R J Neumann
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt, Germany
| | - B Kollmann
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany.
- Leibniz Institute for Resilience Research (LIR) gGmbH, Mainz, Germany.
| | - J Brokelmann
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt, Germany
| | - N M von Werthern
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt, Germany
| | - A Malyshau
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt, Germany
| | - D Weichert
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany
| | - B Lutz
- Leibniz Institute for Resilience Research (LIR) gGmbH, Mainz, Germany
- Institute of Physiological Chemistry, University Medical Center Mainz, Mainz, Germany
| | - C J Fiebach
- Department of Psychology, Goethe University Frankfurt, Frankfurt, Germany
- Brain Imaging Center, Goethe University, Frankfurt, Germany
| | - M Wessa
- Leibniz Institute for Resilience Research (LIR) gGmbH, Mainz, Germany
- Department of Clinical Psychology and Neuropsychology, Institute for Psychology, Johannes Gutenberg University Mainz, Mainz, Germany
| | - R Kalisch
- Leibniz Institute for Resilience Research (LIR) gGmbH, Mainz, Germany
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), University Medical Center Mainz, Mainz, Germany
| | - M M Plichta
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt, Germany
| | - K Lieb
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany
- Leibniz Institute for Resilience Research (LIR) gGmbH, Mainz, Germany
| | - O Tüscher
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany
- Leibniz Institute for Resilience Research (LIR) gGmbH, Mainz, Germany
| | - A Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt, Germany
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32
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Veer IM, Riepenhausen A, Zerban M, Wackerhagen C, Puhlmann LMC, Engen H, Köber G, Bögemann SA, Weermeijer J, Uściłko A, Mor N, Marciniak MA, Askelund AD, Al-Kamel A, Ayash S, Barsuola G, Bartkute-Norkuniene V, Battaglia S, Bobko Y, Bölte S, Cardone P, Chvojková E, Damnjanović K, De Calheiros Velozo J, de Thurah L, Deza-Araujo YI, Dimitrov A, Farkas K, Feller C, Gazea M, Gilan D, Gnjidić V, Hajduk M, Hiekkaranta AP, Hofgaard LS, Ilen L, Kasanova Z, Khanpour M, Lau BHP, Lenferink DB, Lindhardt TB, Magas DÁ, Mituniewicz J, Moreno-López L, Muzychka S, Ntafouli M, O’Leary A, Paparella I, Põldver N, Rintala A, Robak N, Rosická AM, Røysamb E, Sadeghi S, Schneider M, Siugzdaite R, Stantić M, Teixeira A, Todorovic A, Wan WWN, van Dick R, Lieb K, Kleim B, Hermans EJ, Kobylińska D, Hendler T, Binder H, Myin-Germeys I, van Leeuwen JMC, Tüscher O, Yuen KSL, Walter H, Kalisch R. Psycho-social factors associated with mental resilience in the Corona lockdown. Transl Psychiatry 2021; 11:67. [PMID: 33479211 PMCID: PMC7817958 DOI: 10.1038/s41398-020-01150-4] [Citation(s) in RCA: 98] [Impact Index Per Article: 32.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 12/03/2020] [Accepted: 12/04/2020] [Indexed: 12/11/2022] Open
Abstract
The SARS-CoV-2 pandemic is not only a threat to physical health but is also having severe impacts on mental health. Although increases in stress-related symptomatology and other adverse psycho-social outcomes, as well as their most important risk factors have been described, hardly anything is known about potential protective factors. Resilience refers to the maintenance of mental health despite adversity. To gain mechanistic insights about the relationship between described psycho-social resilience factors and resilience specifically in the current crisis, we assessed resilience factors, exposure to Corona crisis-specific and general stressors, as well as internalizing symptoms in a cross-sectional online survey conducted in 24 languages during the most intense phase of the lockdown in Europe (22 March to 19 April) in a convenience sample of N = 15,970 adults. Resilience, as an outcome, was conceptualized as good mental health despite stressor exposure and measured as the inverse residual between actual and predicted symptom total score. Preregistered hypotheses (osf.io/r6btn) were tested with multiple regression models and mediation analyses. Results confirmed our primary hypothesis that positive appraisal style (PAS) is positively associated with resilience (p < 0.0001). The resilience factor PAS also partly mediated the positive association between perceived social support and resilience, and its association with resilience was in turn partly mediated by the ability to easily recover from stress (both p < 0.0001). In comparison with other resilience factors, good stress response recovery and positive appraisal specifically of the consequences of the Corona crisis were the strongest factors. Preregistered exploratory subgroup analyses (osf.io/thka9) showed that all tested resilience factors generalize across major socio-demographic categories. This research identifies modifiable protective factors that can be targeted by public mental health efforts in this and in future pandemics.
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Affiliation(s)
- Ilya M. Veer
- Research Division of Mind and Brain, Department of Psychiatry and Psychotherapy CCM, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Antje Riepenhausen
- Research Division of Mind and Brain, Department of Psychiatry and Psychotherapy CCM, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany ,grid.7468.d0000 0001 2248 7639Faculty of Philosophy, Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Matthias Zerban
- grid.410607.4Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Carolin Wackerhagen
- Research Division of Mind and Brain, Department of Psychiatry and Psychotherapy CCM, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Lara M. C. Puhlmann
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany ,grid.4372.20000 0001 2105 1091Research Group Social Stress and Family Health, Max Planck Institute for Cognitive and Brain Sciences, Leipzig, Germany
| | - Haakon Engen
- grid.410607.4Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany ,grid.5510.10000 0004 1936 8921Department of Psychology, University of Oslo, Oslo, Norway
| | - Göran Köber
- grid.5963.9Faculty of Medicine and Medical Center, Institute of Medical Biometry and Statistics, University of Freiburg, Freiburg, Germany ,grid.5963.9Freiburg Center for Data Analysis and Modelling, University of Freiburg, Freiburg, Germany
| | - Sophie A. Bögemann
- Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jeroen Weermeijer
- grid.5596.f0000 0001 0668 7884Center for Contextual Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Aleksandra Uściłko
- grid.12847.380000 0004 1937 1290Faculty of Psychology, University of Warsaw, Warsaw, Poland
| | - Netali Mor
- grid.413449.f0000 0001 0518 6922Tel Aviv Sourasky Medical Center, Sagol Brain Institute Tel Aviv, Tel Aviv, Israel ,grid.12136.370000 0004 1937 0546Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Marta A. Marciniak
- grid.7400.30000 0004 1937 0650Division of Experimental Psychopathology and Psychotherapy, Department of Psychology, University of Zurich, Zurich, Switzerland ,Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital (PUK), University of Zurich, Zurich, Switzerland
| | - Adrian Dahl Askelund
- grid.5510.10000 0004 1936 8921Department of Psychology, University of Oslo, Oslo, Norway
| | - Abbas Al-Kamel
- grid.33236.370000000106929556University of Bergamo, Bergamo, Italy
| | - Sarah Ayash
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
| | - Giulia Barsuola
- grid.5335.00000000121885934MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - Vaida Bartkute-Norkuniene
- grid.466222.60000 0004 0382 1349Faculty of Business and Technologies at Utena University of Applied Sciences, Utena, Lithuania
| | - Simone Battaglia
- grid.6292.f0000 0004 1757 1758Center for Studies and Research in Cognitive Neuroscience, Department of Psychology, University of Bologna, Bologna, Italy
| | - Yaryna Bobko
- Faculty of Psychology, University of Economics and Human Sciences, Warsaw, Warsaw, Poland
| | - Sven Bölte
- grid.467087.a0000 0004 0442 1056Center for Psychiatry Research, Department of Women’s and Children’s Health, Karolinska Institutet Center of Neurodevelopmental Disorders (KIND), Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden ,grid.467087.a0000 0004 0442 1056Child and Adolescent Psychiatry, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden ,grid.1032.00000 0004 0375 4078Curtin Autism Research Group, School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, WA Australia
| | - Paolo Cardone
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
| | - Edita Chvojková
- grid.7177.60000000084992262Department of Psychological Methods, University of Amsterdam, Amsterdam, The Netherlands
| | - Kaja Damnjanović
- grid.7149.b0000 0001 2166 9385Laboratory for Experimental Psychology, Department of Psychology, University of Belgrade, Belgrade, Serbia
| | - Joana De Calheiros Velozo
- grid.5596.f0000 0001 0668 7884Center for Contextual Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Lena de Thurah
- grid.5596.f0000 0001 0668 7884Center for Contextual Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Yacila I. Deza-Araujo
- grid.8591.50000 0001 2322 4988Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland ,grid.8591.50000 0001 2322 4988Laboratory for Behavioral Neurology and Imaging of Cognition, Department of Neuroscience, Medical School, University of Geneva, Geneva, Switzerland
| | - Annika Dimitrov
- Research Division of Mind and Brain, Department of Psychiatry and Psychotherapy CCM, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Kinga Farkas
- grid.11804.3c0000 0001 0942 9821Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary ,grid.6759.d0000 0001 2180 0451Department of Cognitive Science, Budapest University of Technology and Economics, Budapest, Hungary
| | - Clémence Feller
- grid.8591.50000 0001 2322 4988Clinical Psychology Unit for Intellectual and Developmental Disabilities, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Mary Gazea
- grid.424223.1Concentris Research Management GmbH, Fürstenfeldbruck, Germany
| | - Donya Gilan
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany ,grid.410607.4Department of Psychiatry and Psychotherapy, Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Vedrana Gnjidić
- grid.4808.40000 0001 0657 4636Faculty of Humanities and Social Sciences, University of Zagreb, Zagreb, Croatia
| | - Michal Hajduk
- grid.7634.60000000109409708Department of Psychology, Faculty of Arts, Comenius University in Bratislava, Bratislava, Slovak Republic ,grid.7634.60000000109409708Center for Psychiatric Disorders Research, University in Bratislava, Science Park Comenius, Bratislava, Slovak Republic ,grid.7634.60000000109409708Department of Psychiatry, Faculty of Medicine, Comenius University in Bratislava, Bratislava, Slovak Republic
| | - Anu P. Hiekkaranta
- grid.5596.f0000 0001 0668 7884Center for Contextual Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Live S. Hofgaard
- grid.5510.10000 0004 1936 8921PROMENTA Research Centre, Department of Psychology, University of Oslo, Oslo, Norway
| | - Laura Ilen
- grid.8591.50000 0001 2322 4988Clinical Psychology Unit for Intellectual and Developmental Disabilities, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Zuzana Kasanova
- grid.5596.f0000 0001 0668 7884Leuven Research and Development, Spin-off and Innovation Unit, KU Leuven, Leuven, Belgium
| | - Mohsen Khanpour
- grid.46072.370000 0004 0612 7950University of Tehran, Tehran, Iran
| | - Bobo Hi Po Lau
- grid.445012.60000 0001 0643 7658Department of Counselling and Psychology, Hong Kong Shue Yan University, Hong Kong, Hong Kong
| | - Dionne B. Lenferink
- Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Thomas B. Lindhardt
- grid.7048.b0000 0001 1956 2722Center of Functionally Integrative Neuroscience (CFIN) and MINDLab, Department of Clinical Medicine, Århus University, Århus, Denmark
| | - Dávid Á. Magas
- grid.6759.d0000 0001 2180 0451Department of Cognitive Science, Budapest University of Technology and Economics, Budapest, Hungary
| | - Julian Mituniewicz
- grid.12847.380000 0004 1937 1290Faculty of Psychology, University of Warsaw, Warsaw, Poland
| | - Laura Moreno-López
- grid.5335.00000000121885934Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Sofiia Muzychka
- Faculty of Psychology, University of Economics and Human Sciences, Warsaw, Warsaw, Poland
| | - Maria Ntafouli
- grid.5216.00000 0001 2155 0800Sleep Research Unit, First Department of Psychiatry, National and Kapodistrian University of Athens, Athens, Greece
| | - Aet O’Leary
- grid.411088.40000 0004 0578 8220Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Frankfurt am Main, Germany ,grid.10939.320000 0001 0943 7661Institute of Psychology, University of Tartu, Tartu, Estonia
| | - Ilenia Paparella
- grid.465537.6Institut des Sciences Cognitives Marc Jeannerod, Lyon, France
| | - Nele Põldver
- grid.10939.320000 0001 0943 7661Institute of Psychology, University of Tartu, Tartu, Estonia
| | - Aki Rintala
- grid.5596.f0000 0001 0668 7884Center for Contextual Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium ,grid.508322.eFaculty of Social Services and Health Care, LAB University of Applied Sciences, Lahti, Finland
| | - Natalia Robak
- grid.12847.380000 0004 1937 1290College of Inter-faculty Individual Studies in Mathematics and Natural Sciences, University of Warsaw, Warsaw, Poland
| | - Anna M. Rosická
- grid.10267.320000 0001 2194 0956Faculty of Social Studies, Department of Psychology, Masaryk University, Brno, Czech Republic
| | - Espen Røysamb
- grid.5510.10000 0004 1936 8921PROMENTA Research Centre, Department of Psychology, University of Oslo, Oslo, Norway
| | - Siavash Sadeghi
- grid.5802.f0000 0001 1941 7111Johannes Gutenberg University Mainz, Mainz, Germany
| | - Maude Schneider
- grid.8591.50000 0001 2322 4988Clinical Psychology Unit for Intellectual and Developmental Disabilities, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Roma Siugzdaite
- grid.5335.00000000121885934MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK ,grid.5342.00000 0001 2069 7798Department of Experimental Clinical and Health Psychology, Ghent University, Gent, Belgium
| | - Mirta Stantić
- grid.4991.50000 0004 1936 8948Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Ana Teixeira
- grid.5596.f0000 0001 0668 7884Center for Contextual Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Ana Todorovic
- grid.4991.50000 0004 1936 8948Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Wendy W. N. Wan
- grid.265231.10000 0004 0532 1428Department of International Business, Tunghai University, Taichung City, Taiwan
| | - Rolf van Dick
- grid.7839.50000 0004 1936 9721Institute of Psychology, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Klaus Lieb
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany ,grid.410607.4Department of Psychiatry and Psychotherapy, Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Birgit Kleim
- grid.7400.30000 0004 1937 0650Division of Experimental Psychopathology and Psychotherapy, Department of Psychology, University of Zurich, Zurich, Switzerland ,Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital (PUK), University of Zurich, Zurich, Switzerland
| | - Erno J. Hermans
- Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Dorota Kobylińska
- grid.12847.380000 0004 1937 1290Faculty of Psychology, University of Warsaw, Warsaw, Poland
| | - Talma Hendler
- grid.413449.f0000 0001 0518 6922Tel Aviv Sourasky Medical Center, Sagol Brain Institute Tel Aviv, Tel Aviv, Israel ,grid.12136.370000 0004 1937 0546Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel ,grid.12136.370000 0004 1937 0546School of Psychological Science, Tel Aviv University, Tel Aviv, Israel ,grid.12136.370000 0004 1937 0546Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Harald Binder
- grid.5963.9Faculty of Medicine and Medical Center, Institute of Medical Biometry and Statistics, University of Freiburg, Freiburg, Germany ,grid.5963.9Freiburg Center for Data Analysis and Modelling, University of Freiburg, Freiburg, Germany
| | - Inez Myin-Germeys
- grid.5596.f0000 0001 0668 7884Center for Contextual Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Judith M. C. van Leeuwen
- Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Oliver Tüscher
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany ,grid.410607.4Department of Psychiatry and Psychotherapy, Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Kenneth S. L. Yuen
- grid.410607.4Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany ,Leibniz Institute for Resilience Research (LIR), Mainz, Germany
| | - Henrik Walter
- Research Division of Mind and Brain, Department of Psychiatry and Psychotherapy CCM, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany ,grid.7468.d0000 0001 2248 7639Faculty of Philosophy, Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Raffael Kalisch
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany. .,Leibniz Institute for Resilience Research (LIR), Mainz, Germany.
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Chmitorz A, Neumann RJ, Kollmann B, Ahrens KF, Öhlschläger S, Goldbach N, Weichert D, Schick A, Lutz B, Plichta MM, Fiebach CJ, Wessa M, Kalisch R, Tüscher O, Lieb K, Reif A. Longitudinal determination of resilience in humans to identify mechanisms of resilience to modern-life stressors: the longitudinal resilience assessment (LORA) study. Eur Arch Psychiatry Clin Neurosci 2021; 271:1035-1051. [PMID: 32683526 PMCID: PMC8354914 DOI: 10.1007/s00406-020-01159-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 06/29/2020] [Indexed: 12/14/2022]
Abstract
Resilience is the maintenance and/or quick recovery of mental health during and after periods of adversity. It is conceptualized to result from a dynamic process of successful adaptation to stressors. Up to now, a large number of resilience factors have been proposed, but the mechanisms underlying resilience are not yet understood. To shed light on the complex and time-varying processes of resilience that lead to a positive long-term outcome in the face of adversity, the Longitudinal Resilience Assessment (LORA) study has been established. In this study, 1191 healthy participants are followed up at 3- and 18-month intervals over a course of 4.5 years at two study centers in Germany. Baseline and 18-month visits entail multimodal phenotyping, including the assessment of mental health status, sociodemographic and lifestyle variables, resilience factors, life history, neuropsychological assessments (of proposed resilience mechanisms), and biomaterials (blood for genetic and epigenetic, stool for microbiome, and hair for cortisol analysis). At 3-monthly online assessments, subjects are monitored for subsequent exposure to stressors as well as mental health measures, which allows for a quantitative assessment of stressor-dependent changes in mental health as the main outcome. Descriptive analyses of mental health, number of stressors including major life events, daily hassles, perceived stress, and the ability to recover from stress are here presented for the baseline sample. The LORA study is unique in its design and will pave the way for a better understanding of resilience mechanisms in humans and for further development of interventions to successfully prevent stress-related disorder.
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Affiliation(s)
- A. Chmitorz
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany ,Faculty of Social Work, Health Care and Nursing Science, Esslingen University of Applied Sciences, Esslingen am Neckar, Germany
| | - R. J. Neumann
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt, Germany
| | - B. Kollmann
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany ,Leibniz Institute for Resilience Research (LIR), Wallstraße 7, Mainz, 55122 Deutschland
| | - K. F. Ahrens
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt, Germany
| | - S. Öhlschläger
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt, Germany
| | - N. Goldbach
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt, Germany
| | - D. Weichert
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany
| | - A. Schick
- Leibniz Institute for Resilience Research (LIR), Wallstraße 7, Mainz, 55122 Deutschland ,Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), University Medical Center Mainz, Mainz, Germany ,Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - B. Lutz
- Leibniz Institute for Resilience Research (LIR), Wallstraße 7, Mainz, 55122 Deutschland ,Department of Physiological Chemistry, University Medical Center Mainz, Mainz, Germany
| | - M. M. Plichta
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt, Germany
| | - C. J. Fiebach
- Department of Psychology, Goethe University Frankfurt, Frankfurt am Main, Germany ,Brain Imaging Center, Goethe University, Frankfurt, Germany
| | - M. Wessa
- Leibniz Institute for Resilience Research (LIR), Wallstraße 7, Mainz, 55122 Deutschland ,Department of Clinical Psychology and Neuropsychology, Institute for Psychology, Johannes Gutenberg University Mainz, Mainz, Germany
| | - R. Kalisch
- Leibniz Institute for Resilience Research (LIR), Wallstraße 7, Mainz, 55122 Deutschland ,Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), University Medical Center Mainz, Mainz, Germany
| | - O. Tüscher
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany ,Leibniz Institute for Resilience Research (LIR), Wallstraße 7, Mainz, 55122 Deutschland
| | - K. Lieb
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany ,Leibniz Institute for Resilience Research (LIR), Wallstraße 7, Mainz, 55122 Deutschland
| | - A. Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt, Germany
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34
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Mey LK, Chmitorz A, Kurth K, Wenzel M, Kalisch R, Tüscher O, Kubiak T. Increases of negative affect following daily hassles are not moderated by neuroticism: An ecological momentary assessment study. Stress Health 2020; 36:615-628. [PMID: 32419371 DOI: 10.1002/smi.2964] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 04/24/2020] [Accepted: 05/01/2020] [Indexed: 11/06/2022]
Abstract
The occurrence of daily hassles is associated with increased subsequent levels of negative affect. Neuroticism has been found to exacerbate this effect. So far, most research used single-item measures for the assessment of daily hassles or relied on daily diary studies. This study aimed to examine the interrelations of daily hassles, negative affect reactivity, and neuroticism in daily life employing an extensive inventory of daily hassles. Seventy participants (18-30 years; M = 23.9 years, 59% female) completed a 4-week smartphone-based ecological momentary assessment study reporting the occurrence and perceived strain of daily hassles as well as negative affect at five semi-random signals between 9 a.m. and 8 p.m. Multilevel analyses revealed significant associations between elevated levels of negative affect and higher cumulative daily hassle strain ratings per signal in concurrent and time-lagged analyses. Contrary to our expectations, there was no moderation by neuroticism on these associations. The results suggest that daily hassles can accumulate in their impact on mood in daily life and exert a prolonged effect on negative affect. The absence of a significant moderation by neuroticism may be interpreted in the light of methodological specifics of this study.
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Affiliation(s)
| | - Andrea Chmitorz
- Department of Psychiatry and Psychotherapy, Johannes Gutenberg University Medical Center, Mainz, Germany.,Faculty of Social Work, Health Care and Nursing Sciences, Esslingen University of Applied Sciences, Esslingen, Germany
| | - Karolina Kurth
- Leibniz Institute for Resilience Research, Mainz, Germany
| | - Mario Wenzel
- Health Psychology, Institute for Psychology, Johannes Gutenberg University, Mainz, Germany
| | - Raffael Kalisch
- Leibniz Institute for Resilience Research, Mainz, Germany.,Neuroimaging Center, Focus Program Translational Neuroscience, Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Oliver Tüscher
- Leibniz Institute for Resilience Research, Mainz, Germany.,Department of Psychiatry and Psychotherapy, Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Thomas Kubiak
- Health Psychology, Institute for Psychology, Johannes Gutenberg University, Mainz, Germany
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35
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Marciniak MA, Shanahan L, Rohde J, Schulz A, Wackerhagen C, Kobylińska D, Tuescher O, Binder H, Walter H, Kalisch R, Kleim B. Standalone Smartphone Cognitive Behavioral Therapy-Based Ecological Momentary Interventions to Increase Mental Health: Narrative Review. JMIR Mhealth Uhealth 2020; 8:e19836. [PMID: 33180027 PMCID: PMC7691088 DOI: 10.2196/19836] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 08/25/2020] [Accepted: 09/14/2020] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND A growing number of psychological interventions are delivered via smartphones with the aim of increasing the efficacy and effectiveness of these treatments and providing scalable access to interventions for improving mental health. Most of the scientifically tested apps are based on cognitive behavioral therapy (CBT) principles, which are considered the gold standard for the treatment of most mental health problems. OBJECTIVE This review investigates standalone smartphone-based ecological momentary interventions (EMIs) built on principles derived from CBT that aim to improve mental health. METHODS We searched the MEDLINE, PsycINFO, EMBASE, and PubMed databases for peer-reviewed studies published between January 1, 2007, and January 15, 2020. We included studies focusing on standalone app-based approaches to improve mental health and their feasibility, efficacy, or effectiveness. Both within- and between-group designs and studies with both healthy and clinical samples were included. Blended interventions, for example, app-based treatments in combination with psychotherapy, were not included. Selected studies were evaluated in terms of their design, that is, choice of the control condition, sample characteristics, EMI content, EMI delivery characteristics, feasibility, efficacy, and effectiveness. The latter was defined in terms of improvement in the primary outcomes used in the studies. RESULTS A total of 26 studies were selected. The results show that EMIs based on CBT principles can be successfully delivered, significantly increase well-being among users, and reduce mental health symptoms. Standalone EMIs were rated as helpful (mean 70.8%, SD 15.3; n=4 studies) and satisfying for users (mean 72.6%, SD 17.2; n=7 studies). CONCLUSIONS Study quality was heterogeneous, and feasibility was often not reported in the reviewed studies, thus limiting the conclusions that can be drawn from the existing data. Together, the studies show that EMIs may help increase mental health and thus support individuals in their daily lives. Such EMIs provide readily available, scalable, and evidence-based mental health support. These characteristics appear crucial in the context of a global crisis such as the COVID-19 pandemic but may also help reduce personal and economic costs of mental health impairment beyond this situation or in the context of potential future pandemics.
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Affiliation(s)
| | - Lilly Shanahan
- Jacobs Centre of Productive Youth Development, University of Zurich, Zurich, Switzerland
| | - Judith Rohde
- University of Zurich, Psychiatric University Hospital, Zurich, Switzerland
| | - Ava Schulz
- University of Zurich, Psychiatric University Hospital, Zurich, Switzerland
| | | | | | | | - Harald Binder
- Institute for Medical Biometry and Statistics, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | | | | | - Birgit Kleim
- University of Zurich, Psychiatric University Hospital, Zurich, Switzerland
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36
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Berking AC, Thiel C, Schiele MA, Baumann C, Kalisch R, Notzen S, Zwanzger P, Pané-Farré CA, Hamm A, Alpers GW, Fydrich T, Fehm L, Gerlach AL, Straube B, Kircher T, Rief W, Plag J, Ströhle A, Lang T, Wittchen HU, Arolt V, Romanos M, Pauli P, Reif A, Deckert J, Domschke K, Weber H. An investigation of genetic variability of DNA methyltransferases DNMT3A and 3B does not provide evidence for a major role in the pathogenesis of panic disorder and dimensional anxiety phenotypes. J Neural Transm (Vienna) 2020; 127:1527-1537. [PMID: 32468273 DOI: 10.1007/s00702-020-02206-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 05/08/2020] [Indexed: 10/24/2022]
Abstract
While DNA methylation patterns have been studied for a role in the pathogenesis of anxiety disorders, the role of the enzymes establishing DNA methylation-DNA methyltransferases (DNMTs)-has yet to be investigated. In an effort to investigate DNMT genotype-specific effects on dimensional anxiety traits in addition to the categorical phenotype of panic disorder, 506 panic disorder patients and 3112 healthy participants were assessed for anxiety related cognition [Agoraphobic Cognitions Questionnaire (ACQ)], anxiety sensitivity [Anxiety Sensitivity Index (ASI)] as well as pathological worry [Penn State Worry Questionnaire (PSWQ)] and genotyped for five single nucleotide polymorphisms (SNPs) in the DNMT3A (rs11683424, rs1465764, rs1465825) and DNMT3B (rs2424932, rs4911259) genes, which have previously been found associated with clinical and trait-related phenotypes. There was no association with the categorical phenotype panic disorder. However, a significant association was discerned between DNMT3A rs1465764 and PSWQ scores in healthy participants, with the minor allele conveying a protective effect. In addition, a marginally significant association between questionnaire scores (PSWQ, ASI) in healthy participants and DNMT3B rs2424932 was detected, again with the minor allele conveying a protective effect. The present results suggest a possible minor role of DNMT3A and DNMT3B gene variation in conveying resilience towards anxiety disorders. As the observed associations indicated a protective effect of two SNPs particularly with pathological worry, future studies are proposed to explore these variants in generalized anxiety disorder rather than panic disorder.
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Affiliation(s)
- Ann-Cathrine Berking
- Department of Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of Würzburg, Margarete-Höppel Platz 1, 97080, Würzburg, Germany
- Department of Human Genetics, Hannover Medical School, Hannover, Germany
| | - Christiane Thiel
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany
| | - Miriam A Schiele
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany
| | - Christian Baumann
- Department of Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of Würzburg, Margarete-Höppel Platz 1, 97080, Würzburg, Germany
- Department of Psychology (Biological Psychology, Clinical Psychology, and Psychotherapy), Center of Mental Health, University of Würzburg, Würzburg, Germany
| | - Raffael Kalisch
- Neuroimaging Center (NIC), Johannes Gutenberg University Medical Center, Mainz, Germany
- Leibniz Institute for Resilience Research, Mainz, Germany
- Catholic University of Applied Science Münster, Münster, Germany
| | - Swantje Notzen
- Catholic University of Applied Science Münster, Münster, Germany
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Peter Zwanzger
- Department of Psychiatry and Psychotherapy, District Hospital Gabersee, Wasserburg am Inn, Germany
- Department of Psychiatry, University of Münster, Münster, Germany
- Department of Psychiatry and Psychotherapy LMU, Munich, Germany
| | - Christiane A Pané-Farré
- Institute of Psychology, University of Greifswald, Greifswald, Germany
- Institute of Psychology, Philipps University Marburg, Marburg, Germany
| | - Alfons Hamm
- Institute of Psychology, University of Greifswald, Greifswald, Germany
| | - Georg W Alpers
- Department of Psychology, School of Social Sciences, University of Mannheim, Mannheim, Germany
| | - Thomas Fydrich
- Institute of Psychology, Humboldt University, Berlin, Germany
| | - Lydia Fehm
- Institute of Psychology, Humboldt University, Berlin, Germany
| | - Alexander L Gerlach
- Institute of Clinical Psychology and Psychotherapy, University of Cologne, Cologne, Germany
| | - Benjamin Straube
- Department of Psychiatry and Psychotherapy, University Hospital of Marburg, Marburg, Germany
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, University Hospital of Marburg, Marburg, Germany
| | - Winfried Rief
- Institute of Psychology, Philipps University Marburg, Marburg, Germany
| | - Jens Plag
- Department of Psychiatry and Psychotherapy, Charité University Medicine, Campus Charité Mitte, Berlin, Germany
| | - Andreas Ströhle
- Department of Psychiatry and Psychotherapy, Charité University Medicine, Campus Charité Mitte, Berlin, Germany
| | - Thomas Lang
- Christoph-Dornier-Foundation for Clinical Psychology, Bremen, Germany
- Department of Psychology and Methods, Jacobs University Bremen, Bremen, Germany
| | - Hans-Ulrich Wittchen
- Institute of Clinical Psychology and Psychotherapy, TU Dresden, Dresden, Germany
- Department of Psychiatry and Psychotherapy LMU, Munich, Germany
| | - Volker Arolt
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Marcel Romanos
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of Würzburg, Würzburg, Germany
| | - Paul Pauli
- Department of Psychology (Biological Psychology, Clinical Psychology, and Psychotherapy), Center of Mental Health, University of Würzburg, Würzburg, Germany
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital of Frankfurt, Frankfurt, Germany
| | - Jürgen Deckert
- Department of Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of Würzburg, Margarete-Höppel Platz 1, 97080, Würzburg, Germany
| | - Katharina Domschke
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany
- Center for Basics in NeuroModulation, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Heike Weber
- Department of Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of Würzburg, Margarete-Höppel Platz 1, 97080, Würzburg, Germany.
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37
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Leukel C, Schümann D, Kalisch R, Sommer T, Bunzeck N. Dopamine Related Genes Differentially Affect Declarative Long-Term Memory in Healthy Humans. Front Behav Neurosci 2020; 14:539725. [PMID: 33328916 PMCID: PMC7673390 DOI: 10.3389/fnbeh.2020.539725] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 09/04/2020] [Indexed: 11/22/2022] Open
Abstract
In humans, monetary reward can promote behavioral performance including response times, accuracy, and subsequent recognition memory. Recent studies have shown that the dopaminergic system plays an essential role here, but the link to interindividual differences remains unclear. To further investigate this issue, we focused on previously described polymorphisms of genes affecting dopaminergic neurotransmission: DAT1 40 base pair (bp), DAT1 30 bp, DRD4 48 bp, and cannabinoid receptor type 1 (CNR1). Specifically, 669 healthy humans participated in a delayed recognition memory paradigm on two consecutive days. On the first day, male vs. female faces served as cues predicting an immediate monetary reward upon correct button presses. Subsequently, participants performed a remember/know recognition memory task on the same day and 1 day later. As predicted, reward increased accuracy and accelerated response times, which were modulated by DAT 30 bp. However, reward did not promote subsequent recognition memory performance and there was no interaction with any genotype tested here. Importantly, there were differential effects of genotype on declarative long-term memory independent of reward: (a) DAT1 40 bp was linked to the quality of memory with a more pronounced difference between recollection and familiarity in the heterozygous and homozygous 10-R as compared to homozygous 9-R; (b) DAT1 30 bp was linked to memory decay, which was most pronounced in homozygous 4-R; (c) DRD4 48 bp was linked to overall recognition memory with higher performance in the short allele group; and (d) CNR1 was linked to overall memory with reduced performance in the homozygous short group. These findings give new insights into how polymorphisms, which are related to dopaminergic neuromodulation, differentially affect long-term recognition memory performance.
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Affiliation(s)
- Carla Leukel
- Department of Psychology, University of Lübeck, Lübeck, Germany
| | - Dirk Schümann
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Raffael Kalisch
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Neuroimaging Center (NIC), Focus Program Translational Neuroscience, Johannes Gutenberg University Medical Center, Mainz, Germany.,Leibniz Institute for Resilience Research (LIR), Mainz, Germany
| | - Tobias Sommer
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Nico Bunzeck
- Department of Psychology, University of Lübeck, Lübeck, Germany.,Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Center of Brain, Behavior and Metabolism (CBBM), University of Lübeck, Lübeck, Germany
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38
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Meyer B, Yuen KSL, Saase V, Kalisch R. The Functional Role of Large-scale Brain Network Coordination in Placebo-induced Anxiolysis. Cereb Cortex 2020; 29:3201-3210. [PMID: 30124792 DOI: 10.1093/cercor/bhy188] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 07/06/2018] [Accepted: 07/20/2018] [Indexed: 12/22/2022] Open
Abstract
Anxiety reduction through mere expectation of anxiolytic treatment effects (placebo anxiolysis) has enormous clinical importance. Recent behavioral and electrophysiological data suggest that placebo anxiolysis involves reduced vigilance and enhanced internalization of attention; however, the underlying neurobiological mechanisms are not yet clear. Given the fundamental function of intrinsic connectivity networks (ICNs) in basic cognitive processes, we investigated ICN activity patterns associated with externally and internally directed mental states under the influence of an anxiolytic placebo medication. Based on recent findings, we specifically analyzed the functional role of the rostral anterior cingulate cortex (rACC) in coordinating placebo-dependent cue-related (phasic) and cue-unrelated (sustained) network activity. Under placebo, we observed a down-regulation of the entire salience network (SN), particularly in response to threatening cues. The rACC exhibited enhanced cue-unrelated functional connectivity (FC) with the SN, which correlated with reductions in tonic arousal and anxiety. Hence, apart from the frequently reported modulation of aversive cue responses, the rACC appears to be crucially involved in exerting a tonically dampening control over salience-responsive structures. In line with a more internally directed mental state, we also found enhanced FC within the default mode network (DMN), again predicting reductions in anxiety under placebo.
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Affiliation(s)
- Benjamin Meyer
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Mainz, Germany.,Deutsches Resilienz Zentrum (DRZ), Johannes Gutenberg University Medical Center Mainz, Germany
| | - Kenneth S L Yuen
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Mainz, Germany.,Deutsches Resilienz Zentrum (DRZ), Johannes Gutenberg University Medical Center Mainz, Germany
| | - Victor Saase
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Mainz, Germany.,Deutsches Resilienz Zentrum (DRZ), Johannes Gutenberg University Medical Center Mainz, Germany
| | - Raffael Kalisch
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Mainz, Germany.,Deutsches Resilienz Zentrum (DRZ), Johannes Gutenberg University Medical Center Mainz, Germany
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Chmitorz A, Kurth K, Mey LK, Wenzel M, Lieb K, Tüscher O, Kubiak T, Kalisch R. Correction: Assessment of Microstressors in Adults: Questionnaire Development and Ecological Validation of the Mainz Inventory of Microstressors. JMIR Ment Health 2020; 7:e18626. [PMID: 32365047 PMCID: PMC7235810 DOI: 10.2196/18626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 03/16/2020] [Indexed: 11/13/2022] Open
Abstract
[This corrects the article DOI: 10.2196/14566.].
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Affiliation(s)
- Andrea Chmitorz
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany.,Faculty of Social Work, Health Care and Nursing Sciences, Esslingen University of Applied Sciences, Esslingen, Germany
| | - Karolina Kurth
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany.,Health Psychology, Institute for Psychology, Johannes Gutenberg University, Mainz, Germany.,Leibniz Institute for Resilience Research, Mainz, Germany
| | - Lara K Mey
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany.,Health Psychology, Institute for Psychology, Johannes Gutenberg University, Mainz, Germany.,Leibniz Institute for Resilience Research, Mainz, Germany
| | - Mario Wenzel
- Health Psychology, Institute for Psychology, Johannes Gutenberg University, Mainz, Germany.,Leibniz Institute for Resilience Research, Mainz, Germany
| | - Klaus Lieb
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany.,Leibniz Institute for Resilience Research, Mainz, Germany
| | - Oliver Tüscher
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany.,Leibniz Institute for Resilience Research, Mainz, Germany
| | - Thomas Kubiak
- Health Psychology, Institute for Psychology, Johannes Gutenberg University, Mainz, Germany.,Leibniz Institute for Resilience Research, Mainz, Germany
| | - Raffael Kalisch
- Leibniz Institute for Resilience Research, Mainz, Germany.,Neuroimaging Center, University Medical Center, Mainz, Germany
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Varatheeswaran R, Hassan U, Pillen S, Lang P, Yuen K, Meyer B, Kalisch R, Bergmann T. P12 Connectivity-informed concurrent TMS-fMRI for indirect stimulation of the ventromedial prefrontal cortex. Clin Neurophysiol 2020. [DOI: 10.1016/j.clinph.2019.12.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Chmitorz A, Kurth K, Mey LK, Wenzel M, Lieb K, Tüscher O, Kubiak T, Kalisch R. Assessment of Microstressors in Adults: Questionnaire Development and Ecological Validation of the Mainz Inventory of Microstressors. JMIR Ment Health 2020; 7:e14566. [PMID: 32130154 PMCID: PMC7063526 DOI: 10.2196/14566] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 09/25/2019] [Accepted: 11/02/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Many existing scales for microstressor assessment do not differentiate between objective (ie, observable) stressor events and stressful cognitions or concerns. They often mix items assessing objective stressor events with items measuring other aspects of stress, such as perceived stressor severity, the evoked stress reaction, or further consequences on health, which may result in spurious associations in studies that include other questionnaires that measure such constructs. Most scales were developed several decades ago; therefore, modern life stressors may not be represented. Ecological momentary assessment (EMA) allows for sampling of current behaviors and experiences in real time and in the natural habitat, thereby maximizing the generalization of the findings to real-life situations (ie, ecological validity) and minimizing recall bias. However, it has not been used for the validation of microstressor questionnaires so far. OBJECTIVE The aim is to develop a questionnaire that (1) allows for retrospective assessment of microstressors over one week, (2) focuses on objective (ie, observable) microstressors, (3) includes stressors of modern life, and (4) separates stressor occurrence from perceived stressor severity. METHODS Cross-sectional (N=108) and longitudinal studies (N=10 and N=70) were conducted to evaluate the Mainz Inventory of Microstressors (MIMIS). In the longitudinal studies, EMA was used to compare stressor data, which was collected five times per day for 7 or 30 days with retrospective reports (end-of-day, end-of-week). Pearson correlations and multilevel modeling were used in the analyses. RESULTS High correlations were found between end-of-week, end-of-day, and EMA data for microstressor occurrence (counts) (r≥.69 for comparisons per week, r≥.83 for cumulated data) and for mean perceived microstressor severity (r≥.74 for comparisons per week, r≥.85 for cumulated data). The end-of-week questionnaire predicted the EMA assessments sufficiently (counts: beta=.03, 95% CI .02-.03, P<.001; severity: beta=.73, 95% CI .59-.88, P<.001) and the association did not change significantly over four subsequent weeks. CONCLUSIONS Our results provide evidence for the ecological validity of the MIMIS questionnaire.
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Affiliation(s)
- Andrea Chmitorz
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany.,Faculty of Social Work, Health Care and Nursing Sciences, Esslingen University of Applied Sciences, Esslingen, Germany
| | - Karolina Kurth
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany.,Health Psychology, Institute for Psychology, Johannes Gutenberg University, Mainz, Germany.,Leibniz Institute for Resilience Research, Mainz, Germany
| | - Lara K Mey
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany.,Health Psychology, Institute for Psychology, Johannes Gutenberg University, Mainz, Germany.,Leibniz Institute for Resilience Research, Mainz, Germany
| | - Mario Wenzel
- Health Psychology, Institute for Psychology, Johannes Gutenberg University, Mainz, Germany.,Leibniz Institute for Resilience Research, Mainz, Germany
| | - Klaus Lieb
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany.,Leibniz Institute for Resilience Research, Mainz, Germany
| | - Oliver Tüscher
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany.,Leibniz Institute for Resilience Research, Mainz, Germany
| | - Thomas Kubiak
- Health Psychology, Institute for Psychology, Johannes Gutenberg University, Mainz, Germany.,Leibniz Institute for Resilience Research, Mainz, Germany
| | - Raffael Kalisch
- Leibniz Institute for Resilience Research, Mainz, Germany.,Neuroimaging Center, University Medical Center, Mainz, Germany
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Kampa M, Schick A, Sebastian A, Wessa M, Tüscher O, Kalisch R, Yuen K. Replication of fMRI group activations in the neuroimaging battery for the Mainz Resilience Project (MARP). Neuroimage 2020; 204:116223. [DOI: 10.1016/j.neuroimage.2019.116223] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 09/16/2019] [Accepted: 09/23/2019] [Indexed: 01/25/2023] Open
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Abstract
BACKGROUND According to current research concepts resilience can be defined as adaptation to past and ongoing exposure. Accordingly, adaptation to exposure is a dynamic process, which can be different in different population groups. Prospective longitudinal studies provide unique opportunities to investigate resilience processes. OBJECTIVES The aim of this article is to define the concept of resilience, describe examples of longitudinal studies investigating resilience in children, adults and older individuals, exemplary describe four ongoing longitudinal resilience studies in which the authors of the article are participating and identify and analyze methodological challenges in empirical resilience research. MATERIAL AND METHODS This study was based on a qualitative literature review of published prospective studies investigating resilience listed in PubMed and study protocols of the four longitudinal studies. RESULTS The exemplarily described studies have shown that resilience processes are changeable in all age groups and subject to a variety of influencing factors. The specific and potentially age-associated types of alterations have so far been difficult to determine and need further clarification. DISCUSSION In view of the dynamic course of resilience, prospective longitudinal studies are urgently needed. Prospective longitudinal studies have the potential to identify resilience mechanisms and predictors of the course of resilience in different population groups, such as children, adolescents, adults and older individuals. Furthermore, resilience research needs to develop an improved and precise assessment of exposure to stressors.
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Affiliation(s)
- J Lindert
- Fachbereich Soziale Arbeit und Gesundheit, Hochschule Emden/Leer, Constantiaplatz 4, 26723, Emden, Deutschland.
| | - A Schick
- Deutsches Resilienz Zentrum (DRZ) Mainz, Mainz, Deutschland.,Neuroimaging Center (NIC), Forschungszentrum Translationale Neurowissenschaften (FTN), Universitätsmedizin Mainz, Mainz, Deutschland
| | - A Reif
- Klinik für Psychiatrie, Psychosomatik und Psychotherapie, Universitätsklinikum Frankfurt, Frankfurt, Deutschland
| | - R Kalisch
- Deutsches Resilienz Zentrum (DRZ) Mainz, Mainz, Deutschland.,Neuroimaging Center (NIC), Forschungszentrum Translationale Neurowissenschaften (FTN), Universitätsmedizin Mainz, Mainz, Deutschland
| | - O Tüscher
- Deutsches Resilienz Zentrum (DRZ) Mainz, Mainz, Deutschland.,Klinik für Psychiatrie und Psychotherapie, Universitätsmedizin Mainz, Mainz, Deutschland
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Abstract
BACKGROUND Resilience is a complex construct commonly defined as a dynamic process of maintenance or rapid restoration of mental health during and following exposure to stress and trauma. Resilient individuals show no or only minimal disruption in their overall functioning following trauma. Predictors of individual resilience are currently unclear. OBJECTIVE Are there significant and reliable predictors of resilience? MATERIAL AND METHODS Analysis and summary of recent studies on psychosocial and neurobiological resilience predictors derived from longitudinal studies. RESULTS Less than half of the studies on psychosocial and neurobiological predictors reviewed indexed predictors for resilience prior to exposure to the traumatic event. The results are heterogeneous and often not replicated across studies. Even significant predictors often explain only a relatively small or clinically insignificant amount of variance in resilience. CONCLUSION The results are not yet ready for direct implementation into practice and the development of appropriate prevention programs on the basis of significant predictors.
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Affiliation(s)
- B Kleim
- Dept. Experimentelle Psychopathologie und Psychotherapie, Universität Zürich, Lenggstraße 31, 8008, Zürich, Schweiz. .,Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Universität Zürich, Zürich, Schweiz.
| | - R Kalisch
- Deutsches Resilienz Zentrum (DRZ) Mainz, Mainz, Deutschland.,Neuroimaging Center (NIC), Forschungszentrum Translationale Neurowissenschaften (FTN), Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Mainz, Deutschland
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Kalisch R, Cramer AOJ, Binder H, Fritz J, Leertouwer IJ, Lunansky G, Meyer B, Timmer J, Veer IM, van Harmelen AL. Deconstructing and Reconstructing Resilience: A Dynamic Network Approach. Perspect Psychol Sci 2019; 14:765-777. [PMID: 31365841 DOI: 10.1177/1745691619855637] [Citation(s) in RCA: 100] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Resilience is still often viewed as a unitary personality construct that, as a kind of antinosological entity, protects individuals against stress-related mental problems. However, increasing evidence indicates that maintaining mental health in the face of adversity results from complex and dynamic processes of adaptation to stressors that involve the activation of several separable protective factors. Such resilience factors can reside at biological, psychological, and social levels and may include stable predispositions (such as genotype or personality traits) and malleable properties, skills, capacities, or external circumstances (such as gene-expression patterns, emotion-regulation abilities, appraisal styles, or social support). We abandon the notion of resilience as an entity here. Starting from a conceptualization of psychiatric disorders as dynamic networks of interacting symptoms that may be driven by stressors into stable maladaptive states of disease, we deconstruct the maintenance of mental health during stressor exposure into time-variant dampening influences of resilience factors onto these symptom networks. Resilience factors are separate additional network nodes that weaken symptom-symptom interconnections or symptom autoconnections, thereby preventing maladaptive system transitions. We argue that these hybrid symptom-and-resilience-factor networks provide a promising new way of unraveling the complex dynamics of mental health.
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Affiliation(s)
- Raffael Kalisch
- 1 Deutsches Resilienz Zentrum, Mainz, Germany.,2 Neuroimaging Center, Focus Program Translational Neuroscience, University Medical Center, Johannes Gutenberg University, Mainz
| | - Angélique O J Cramer
- 3 Department of Methodology and Statistics, School of Social and Behavioral Sciences, Tilburg University
| | - Harald Binder
- 4 Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg
| | | | - IJsbrand Leertouwer
- 3 Department of Methodology and Statistics, School of Social and Behavioral Sciences, Tilburg University
| | | | - Benjamin Meyer
- 1 Deutsches Resilienz Zentrum, Mainz, Germany.,2 Neuroimaging Center, Focus Program Translational Neuroscience, University Medical Center, Johannes Gutenberg University, Mainz
| | - Jens Timmer
- 7 Institute of Physics, University of Freiburg.,8 Center for Data Analysis and Modelling, University of Freiburg.,9 Signalling Research Centres BIOSS and CIBSS, University of Freiburg
| | - Ilya M Veer
- 10 Division of Mind and Brain Research, Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin
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Abstract
It is a joyous relief when an event we dread fails to materialize. In fear extinction, the appetitive nature of an omitted aversive event is not a mere epiphenomenon but drives the reduction of fear responses and the formation of long-term extinction memories. Dopamine emerges as key neurobiological mediator of these related processes.
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Affiliation(s)
- Raffael Kalisch
- Deutsches Resilienz Zentrum (DRZ), Johannes Gutenberg University Medical Center, Mainz, Germany; Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany.
| | - Anna M V Gerlicher
- Department of Clinical Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Sevil Duvarci
- Institute of Neurophysiology, Neuroscience Center, Goethe University, Frankfurt, Germany
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Gottschalk MG, Richter J, Ziegler C, Schiele MA, Mann J, Geiger MJ, Schartner C, Homola GA, Alpers GW, Büchel C, Fehm L, Fydrich T, Gerlach AL, Gloster AT, Helbig-Lang S, Kalisch R, Kircher T, Lang T, Lonsdorf TB, Pané-Farré CA, Ströhle A, Weber H, Zwanzger P, Arolt V, Romanos M, Wittchen HU, Hamm A, Pauli P, Reif A, Deckert J, Neufang S, Höfler M, Domschke K. Orexin in the anxiety spectrum: association of a HCRTR1 polymorphism with panic disorder/agoraphobia, CBT treatment response and fear-related intermediate phenotypes. Transl Psychiatry 2019; 9:75. [PMID: 30718541 PMCID: PMC6361931 DOI: 10.1038/s41398-019-0415-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Revised: 01/06/2019] [Accepted: 01/17/2019] [Indexed: 12/23/2022] Open
Abstract
Preclinical studies point to a pivotal role of the orexin 1 (OX1) receptor in arousal and fear learning and therefore suggest the HCRTR1 gene as a prime candidate in panic disorder (PD) with/without agoraphobia (AG), PD/AG treatment response, and PD/AG-related intermediate phenotypes. Here, a multilevel approach was applied to test the non-synonymous HCRTR1 C/T Ile408Val gene variant (rs2271933) for association with PD/AG in two independent case-control samples (total n = 613 cases, 1839 healthy subjects), as an outcome predictor of a six-weeks exposure-based cognitive behavioral therapy (CBT) in PD/AG patients (n = 189), as well as with respect to agoraphobic cognitions (ACQ) (n = 483 patients, n = 2382 healthy subjects), fMRI alerting network activation in healthy subjects (n = 94), and a behavioral avoidance task in PD/AG pre- and post-CBT (n = 271). The HCRTR1 rs2271933 T allele was associated with PD/AG in both samples independently, and in their meta-analysis (p = 4.2 × 10-7), particularly in the female subsample (p = 9.8 × 10-9). T allele carriers displayed a significantly poorer CBT outcome (e.g., Hamilton anxiety rating scale: p = 7.5 × 10-4). The T allele count was linked to higher ACQ sores in PD/AG and healthy subjects, decreased inferior frontal gyrus and increased locus coeruleus activation in the alerting network. Finally, the T allele count was associated with increased pre-CBT exposure avoidance and autonomic arousal as well as decreased post-CBT improvement. In sum, the present results provide converging evidence for an involvement of HCRTR1 gene variation in the etiology of PD/AG and PD/AG-related traits as well as treatment response to CBT, supporting future therapeutic approaches targeting the orexin-related arousal system.
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Affiliation(s)
- Michael G. Gottschalk
- Department of Psychiatry and Psychotherapy, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany ,0000 0001 1378 7891grid.411760.5Department of Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of Würzburg, Würzburg, Germany
| | - Jan Richter
- grid.5603.0Department of Biological and Clinical Psychology/Psychotherapy, University of Greifswald, Greifswald, Germany
| | - Christiane Ziegler
- Department of Psychiatry and Psychotherapy, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Miriam A. Schiele
- Department of Psychiatry and Psychotherapy, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Julia Mann
- 0000 0001 1378 7891grid.411760.5Department of Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of Würzburg, Würzburg, Germany
| | - Maximilian J. Geiger
- 0000 0001 1378 7891grid.411760.5Department of Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of Würzburg, Würzburg, Germany ,grid.5963.9Epilepsy Center, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Christoph Schartner
- 0000 0001 1378 7891grid.411760.5Department of Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of Würzburg, Würzburg, Germany ,0000 0001 2297 6811grid.266102.1Department of Physiology, University of California San Francisco, San Francisco, CA USA
| | - György A. Homola
- 0000 0001 1958 8658grid.8379.5Department of Neuroradiology, University of Würzburg, Würzburg, Germany
| | - Georg W. Alpers
- 0000 0001 0943 599Xgrid.5601.2Department of Psychology, School of Social Sciences, University of Mannheim, Mannheim, Germany
| | - Christian Büchel
- 0000 0001 2180 3484grid.13648.38Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lydia Fehm
- 0000 0001 2248 7639grid.7468.dDepartment of Psychology, Humboldt University, Berlin, Germany
| | - Thomas Fydrich
- 0000 0001 2248 7639grid.7468.dDepartment of Psychology, Humboldt University, Berlin, Germany
| | - Alexander L. Gerlach
- 0000 0000 8580 3777grid.6190.eDepartment of Clinical Psychology and Psychotherapy, University of Cologne, Cologne, Germany
| | - Andrew T. Gloster
- 0000 0001 2111 7257grid.4488.0Department of Psychology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany ,0000 0004 1937 0642grid.6612.3Division of Clinical Psychology and Intervention Science, University of Basel, Basel, Switzerland
| | - Sylvia Helbig-Lang
- 0000 0001 2111 7257grid.4488.0Department of Psychology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany ,0000 0001 2287 2617grid.9026.dDepartment of Psychology and Psychotherapy, University of Hamburg, Hamburg, Germany
| | - Raffael Kalisch
- grid.410607.4Neuroimaging Center (NIC) und Deutsches Resilienz-Zentrum (DRZ), Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Tilo Kircher
- 0000 0004 1936 9756grid.10253.35Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Thomas Lang
- 0000 0001 2111 7257grid.4488.0Department of Psychology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany ,0000 0001 2287 2617grid.9026.dDepartment of Psychology and Psychotherapy, University of Hamburg, Hamburg, Germany ,Christoph-Dornier-Foundation for Clinical Psychology, Bremen, Germany
| | - Tina B. Lonsdorf
- 0000 0001 2180 3484grid.13648.38Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christiane A. Pané-Farré
- grid.5603.0Department of Biological and Clinical Psychology/Psychotherapy, University of Greifswald, Greifswald, Germany
| | - Andreas Ströhle
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité – Universitätsmedizin Berlin, corporate member of the Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Heike Weber
- 0000 0001 1378 7891grid.411760.5Department of Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of Würzburg, Würzburg, Germany ,0000 0004 0578 8220grid.411088.4Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital of Frankfurt, Frankfurt, Germany
| | - Peter Zwanzger
- 0000 0004 0551 4246grid.16149.3bDepartment of Psychiatry and Psychotherapy, University Hospital of Münster, Münster, Germany ,kbo-Inn-Salzach-Hospital, Wasserburg, Germany ,0000 0004 1936 973Xgrid.5252.0Department of Psychiatry und Psychotherapy, Ludwig Maximilians University, Munich, Germany
| | - Volker Arolt
- 0000 0004 0551 4246grid.16149.3bDepartment of Psychiatry and Psychotherapy, University Hospital of Münster, Münster, Germany
| | - Marcel Romanos
- 0000 0001 1378 7891grid.411760.5Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of Würzburg, Würzburg, Germany
| | - Hans-Ulrich Wittchen
- 0000 0001 2111 7257grid.4488.0Department of Psychology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany ,0000 0004 1936 973Xgrid.5252.0Department of Psychiatry und Psychotherapy, Ludwig Maximilians University, Munich, Germany
| | - Alfons Hamm
- grid.5603.0Department of Biological and Clinical Psychology/Psychotherapy, University of Greifswald, Greifswald, Germany
| | - Paul Pauli
- 0000 0001 1958 8658grid.8379.5Department of Psychology, Center of Mental Health, University of Würzburg, Würzburg, Germany
| | - Andreas Reif
- 0000 0004 0578 8220grid.411088.4Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital of Frankfurt, Frankfurt, Germany
| | - Jürgen Deckert
- 0000 0001 1378 7891grid.411760.5Department of Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of Würzburg, Würzburg, Germany
| | - Susanne Neufang
- 0000 0001 1378 7891grid.411760.5Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of Würzburg, Würzburg, Germany ,0000 0001 2176 9917grid.411327.2Department of Psychiatry and Psychotherapy, Medical Faculty Heinrich-Heine University, Duesseldorf, Germany
| | - Michael Höfler
- 0000 0001 2111 7257grid.4488.0Department of Psychology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Katharina Domschke
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany. .,Center for NeuroModulation, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
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Gerlicher AMV, Tüscher O, Kalisch R. L-DOPA improves extinction memory retrieval after successful fear extinction. Psychopharmacology (Berl) 2019; 236:3401-3412. [PMID: 31243481 PMCID: PMC6892771 DOI: 10.1007/s00213-019-05301-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 06/05/2019] [Indexed: 11/30/2022]
Abstract
RATIONALE A promising strategy to prevent a return of fear after exposure-based therapy in anxiety disorders is to pharmacologically enhance the extinction memory consolidation presumed to occur after exposure. Accumulating evidence suggests that the effect of a number of pharmacological consolidation enhancers depends on a successful fear reduction during exposure. Here, we employed the dopamine precursor L-DOPA to clarify whether its documented potential to enhance extinction memory consolidation is dependent on successful fear extinction. METHODS In two double-blind, randomized and placebo-controlled experiments (experiment 1: N = 79, experiment 2: N = 32) comprising fear conditioning (day 1), extinction followed by administration of 150 mg L-DOPA or placebo (day 2) and a memory test (day 3) in healthy male adults, conditioned responses were assessed as differential skin conductance responses. We tested whether the effect of L-DOPA on conditioned responses at test depended on conditioned responses at the end of extinction in an experiment with a short (10 trials, experiment 1) and long (25 trials, experiment 2) extinction session. RESULTS In both experiments, the effect of L-DOPA was dependent on conditioned responses at the end of extinction. That is, post-extinction L-DOPA compared to placebo administration reduced conditioned responses at test only in participants showing a complete reduction of conditioned fear at the end of extinction. CONCLUSION The results support the potential use of L-DOPA as a pharmacological adjunct to exposure treatment, but point towards a common boundary condition for pharmacological consolidation enhancers: a successful reduction of fear in the exposure session.
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Affiliation(s)
- A. M. V. Gerlicher
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Langenbeckstr. 1, 55131 Mainz, Germany ,Deutsches Resilienz Zentrum (DRZ), Johannes Gutenberg University Medical Center, Untere Zahlbacher Str. 8, 55131 Mainz, Germany ,Present Address: Department of Clinical Psychology, University of Amsterdam, Nieuwe Achtergracht 129B, 1018 WS Amsterdam, The Netherlands
| | - O. Tüscher
- Deutsches Resilienz Zentrum (DRZ), Johannes Gutenberg University Medical Center, Untere Zahlbacher Str. 8, 55131 Mainz, Germany ,Department of Psychiatry and Psychotherapy, Johannes Gutenberg University Medical Center, Untere Zahlbacher Str. 8, 55131 Mainz, Germany
| | - R. Kalisch
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Langenbeckstr. 1, 55131 Mainz, Germany ,Deutsches Resilienz Zentrum (DRZ), Johannes Gutenberg University Medical Center, Untere Zahlbacher Str. 8, 55131 Mainz, Germany
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Kunzler AM, Chmitorz A, Bagusat C, Kaluza AJ, Hoffmann I, Schäfer M, Quiring O, Rigotti T, Kalisch R, Tüscher O, Franke AG, van Dick R, Lieb K. Construct Validity and Population-Based Norms of the German Brief Resilience Scale (BRS). Eur J Health Psychol 2018; 25:107-117. [PMID: 32671321 PMCID: PMC7357822 DOI: 10.1027/2512-8442/a000016] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 10/25/2018] [Accepted: 11/01/2018] [Indexed: 01/02/2023]
Abstract
Abstract. The Brief Resilience Scale (BRS) measures the ability to
recover from stress. To provide further evidence for construct validity of the
German BRS and to determine population-based norms, a large sample
(N = 1,128) representative of the German
adult population completed a survey including the BRS and instruments measuring
perceived stress and the resilience factors optimism, self-efficacy, and locus
of control. Confirmatory factor analyses showed best model fit for a five-factor
model differentiating the ability to recover from stress from the three
resilience factors. On the basis of latent and manifest correlations, convergent
and discriminant validity of the BRS were fair to good. Female sex, older age,
lower weekly working time, higher perceived stress, lower optimism, and
self-efficacy as well as higher external locus of control predicted lower BRS
scores, that is, lower ability to recover from stress.
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Affiliation(s)
- Angela M Kunzler
- Deutsches Resilienz Zentrum (DRZ) Mainz, Germany.,Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Germany
| | - Andrea Chmitorz
- Deutsches Resilienz Zentrum (DRZ) Mainz, Germany.,Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Germany
| | - Christiana Bagusat
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Germany
| | - Antonia J Kaluza
- Department of Social Psychology, Institute for Psychology, Goethe University Frankfurt, Germany
| | - Isabell Hoffmann
- Institute for Medical Biostatistics, Epidemiology, and Informatics (IMBEI), University Medical Center Mainz, Germany
| | - Markus Schäfer
- Department of Communication, Johannes Gutenberg University Mainz, Germany
| | - Oliver Quiring
- Department of Communication, Johannes Gutenberg University Mainz, Germany
| | - Thomas Rigotti
- Deutsches Resilienz Zentrum (DRZ) Mainz, Germany.,Department of Work, Organizational, and Business Psychology, Institute for Psychology, Johannes Gutenberg University Mainz, Germany
| | - Raffael Kalisch
- Deutsches Resilienz Zentrum (DRZ) Mainz, Germany.,Neuroimaging Center Mainz (NIC), Focus Program Translational Neuroscience (FTN), University Medical Center Mainz, Germany
| | - Oliver Tüscher
- Deutsches Resilienz Zentrum (DRZ) Mainz, Germany.,Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Germany
| | | | - Rolf van Dick
- Department of Social Psychology, Institute for Psychology, Goethe University Frankfurt, Germany
| | - Klaus Lieb
- Deutsches Resilienz Zentrum (DRZ) Mainz, Germany.,Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Germany
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50
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Salinas-Hernández XI, Vogel P, Betz S, Kalisch R, Sigurdsson T, Duvarci S. Dopamine neurons drive fear extinction learning by signaling the omission of expected aversive outcomes. eLife 2018; 7:38818. [PMID: 30421719 PMCID: PMC6257816 DOI: 10.7554/elife.38818] [Citation(s) in RCA: 84] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 11/08/2018] [Indexed: 01/15/2023] Open
Abstract
Extinction of fear responses is critical for adaptive behavior and deficits in this form of safety learning are hallmark of anxiety disorders. However, the neuronal mechanisms that initiate extinction learning are largely unknown. Here we show, using single-unit electrophysiology and cell-type specific fiber photometry, that dopamine neurons in the ventral tegmental area (VTA) are activated by the omission of the aversive unconditioned stimulus (US) during fear extinction. This dopamine signal occurred specifically during the beginning of extinction when the US omission is unexpected, and correlated strongly with extinction learning. Furthermore, temporally-specific optogenetic inhibition or excitation of dopamine neurons at the time of the US omission revealed that this dopamine signal is both necessary for, and sufficient to accelerate, normal fear extinction learning. These results identify a prediction error-like neuronal signal that is necessary to initiate fear extinction and reveal a crucial role of DA neurons in this form of safety learning. To survive, animals must identify and react to stimuli in their environment that signal danger. But they must also adapt their behavior when those stimuli no longer signal danger – hiding whenever you hear a loud noise might keep you safe, but it also prevents you from searching for food. In the laboratory, we can study this form of learning using procedures called fear conditioning and extinction. During fear conditioning, animals learn that a stimulus, such as a tone, signals that an unpleasant event is about to occur. That event might involve receiving a mild shock to the foot, for example. After experiencing the tone and shock paired together multiple times, animals will initially show signs of fear – such as freezing – when they hear the tone. But if later the tone occurs without being followed by the shock, these fear responses fade. This fading process is called extinction. Extinction does not involve erasing the old memory about the tone-shock relationship. That is, it is not a form of forgetting. Instead, the animals learn that the tone no longer signals an impending shock. By monitoring brain activity in mice trained to associate a shock with a tone, Salinas-Hernández et al. reveal how the brain begins to learn that the shock no longer follows the tone. When the mice do not receive the anticipated shock to the foot, a group of brain cells that produce the chemical dopamine increase their activity. These neurons also fire whenever animals receive a reward, particularly one that exceeds their expectations. The more the dopamine neurons fire, the faster the mice reduce their fear responses to the tone. Preventing the neurons from increasing their activity prevents the mice from extinguishing their fear memory. By contrast, activating the neurons speeds up the extinction process. Understanding how the brain extinguishes learned fear responses has therapeutic implications. Many anxiety disorders, such as post-traumatic stress disorder, involve impaired fear extinction learning. Indeed, exposure therapy – used to treat anxiety disorders such as phobias – is a form of fear extinction. Manipulating the activity of dopamine neurons during extinction could therefore help to treat anxiety disorders.
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Affiliation(s)
| | - Pascal Vogel
- Institute of Neurophysiology, Neuroscience Center, Goethe University, Frankfurt, Germany
| | - Sebastian Betz
- Institute of Neurophysiology, Neuroscience Center, Goethe University, Frankfurt, Germany
| | - Raffael Kalisch
- Deutsches Resilienz Zentrum, University Medical Center of the Johannes Gutenberg University, Mainz, Germany.,Neuroimaging Center, Focus Program Translational Neuroscience, Johannes Gutenberg University, Mainz, Germany
| | - Torfi Sigurdsson
- Institute of Neurophysiology, Neuroscience Center, Goethe University, Frankfurt, Germany
| | - Sevil Duvarci
- Institute of Neurophysiology, Neuroscience Center, Goethe University, Frankfurt, Germany
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