Effects of mental stressors on mitogen induced lymphocyte responses in the laboratory

Abstract

There is considerable evidence from naturalistic studies that psychosocial stressors affect human immune function. To achieve control over factors that could bias naturalistic studies, laboratory stressors developed by cardiovascular researchers were tested to determine if they affected immune function. Thirty volunteer students were exposed to 20 minutes of mental tasks. Psychophysiological indices (heart rate, blood pressure, skin conductance) and subjective responses were monitored prior to, during, and 1-hour after the tasks, blood, samples for immunological analyses were also drawn at these times. Thirteen subjects who were not exposed to the tasks served as controls. Subjects exposed to the tasks showed increased levels of subjective distress and increased psychophysiologic responses (except diastolic blood pressure) during the tasks. Relative to controls, stressed subjects had reduced lymphocyte proliferative responses to classic T cell mitogens both immediately after and 1-hour after the tasks were found in whole blood cultures, although responses of isolated lymphocytes were not significantly affected. There were only marginal differences in whole blood mitogen responses for stressed subjects with low versus high autonomic reactions to the stressor. These results support an emerging view that the immune system is sensitive to brief stressors and that laboratory models may be useful for exploring stress-induced changes in immune function.     

The differential effects of acute marital distress on emotional,physiological and immune functions in maritally distressed men and women

Abstract

We examined the impact of acute marital conflict on emotion, cardiovascular arousal, and immune function in men and women. Subjects were 10 heterosexual, distressed couples, who panicipated in exchange for marital therapy. Each couple participated in a 40 minute conflict induction regarding an area of difficulty in their relationship. During this induction, blood pressure and heart rate were monitored and blood samples were drawn pre- and post-induction for analysis of immune change. Women responded to the experimental induction with significantly greater increases in depression and hostility, and with significantly greater increases in SBP than men. Women also responded to the acute marital distress with slight decreases in lymphocyte proliferative response to PHA, while men displayed an increase in PHA response. The sex by time interaction was significant Change in PHA was associated with change in hostility and SBP.     

Network-level dynamics underlying a combined rTMS and psychotherapy treatment for major depressive disorder: An exploratory network analysis

BackgroundDespite the growing use of repetitive transcranial magnetic stimulation (rTMS) as a treatment for depression, there is a limited understanding of the mechanisms of action and how potential treatment-related brain changes help to characterize treatment response. To address this gap in understanding we investigated the effects of an approach combining rTMS with simultaneous psychotherapy on global functional connectivity.MethodWe compared task-related functional connectomes based on an idiographic goal priming task tied to emotional regulation acquired before and after simultaneous rTMS/psychotherapy treatment for patients with major depressive disorders and compared these changes to normative connectivity patterns from a set of healthy volunteers (HV) performing the same task.ResultsAt baseline, compared to HVs, patients demonstrated hyperconnectivity of the DMN, cerebellum and limbic system, and hypoconnectivity of the fronto-parietal dorsal-attention network and visual cortex. Simultaneous rTMS/psychotherapy helped to normalize these differences, which were reduced after treatment. This finding suggests that the rTMS/therapy treatment regularizes connectivity patterns in both hyperactive and hypoactive brain networks.ConclusionsThese results help to link treatment to a comprehensive model of the neurocircuitry underlying depression and pave the way for future studies using network-guided principles to significantly improve rTMS efficacy for depression.     

Psychosocial mediators of a lifestyle physical activity intervention in women

ObjectivesA lifestyle physical activity intervention in women based on the transtheoretical model and social–cognitive theory effectively increased physical activity. The aim of the present study was to examine possible mediators (perceived benefits and barriers of physical activity, self-efficacy, processes of change, and social support) of these physical activity changes.MethodsMembers of four units of a women's organization followed a six-month minimal-contact physical activity program. The intervention program included one group meeting, a self-help booklet and five monthly reminder letters. Members of two other units served as control group. Physical activity (accelerometer counts), and psychosocial constructs (self-report questionnaires) were assessed at baseline (pretest) and directly after the intervention (posttest). Women who completed all measurements (n = 101) were included in the mediation analyses.ResultsParticipants in the intervention group reported significantly greater increases in the use of behavioral processes from pretest to posttest than participants in the control group. None of the proposed psychosocial constructs showed a mediating effect on changes in physical activity.ConclusionsThe mechanisms proposed by the transtheoretical model and social–cognitive theory could not explain the positive effect of the intervention on physical activity. Identifying the working components of an intervention remains a challenging and necessary step in the development of effective low-cost and high-reach physical activity interventions.     

An experimental test to reveal negative side-effects of high treatability information on preventative health behaviour

Objectives: When the course of a disease can be positively changed by health professionals the disease can be indicated as ‘highly treatable’. This ‘high treatability information’ (HTI) may have negative side-effects on people’s preventative motivation. This study examined the effects of HTI regarding skin cancer on preventative motivation.

Design: This study employed a 2 (high treatability (HTI) versus low treatability (LTI)) × 2 (high versus low susceptibility)?experiment with a hanging control group. (family) History and self-efficacy were assessed as moderators. Participants (N = 309) were randomly assigned to one of the five conditions.

Main outcome measures: The main outcome was intention to engage in preventative actions regarding skin cancer.

Results: HTI significantly lowered the intention compared to LTI, under the condition of high susceptibility in people with low self-efficacy. In addition, in people with a (family) history of skin cancer, HTI significantly lowered the intention compared to the no-information group.

Conclusion: HTI regarding skin cancer can cause a drop in the preventative motivation. The effects can be conceptualised as negative side-effects of HTI. As substantial proportions of the general population have a (family) history of skin cancer or low self-efficacy, the side-effects may be widespread, possibly increasing the incidence of skin cancer.     

Cardiovascular reactions to psychological stress and abuse history: the role of occurrence,frequency, and type of abuse

Background and objectives: Extreme cardiovascular reactions to psychological stress have been associated with traumatic life experiences. Previous studies have focused on the occurrence or frequency of abuse rather than type of abuse. We examined how occurrence, frequency, and the type of abuse history are related to cardiovascular reactivity (CVR) to acute psychological stress. Design: The study consisted of between group and continuous analyses to examine the association between occurrence, type, and frequency of abuse with cardiovascular reactions to acute psychological stress. Methods: Data from 64 participants were collected. Heart rate, systolic blood pressure, and diastolic blood pressure were measured at baseline and during a standard mental arithmetic stress task. Results: Individuals who experienced abuse showed diminished CVR to acute psychological stress; this was driven specifically by the history of sexual abuse. Frequency of abuse did not relate to stress reactions. Conclusions: These findings accord with previous work suggesting a relationship between traumatic life experience and hypoarousal in physiological reactivity and extend previous findings by suggesting the relationship may be driven by sexual abuse.     

A preliminary exploration of predictors of outcome and cognitive mechanisms of change in cognitive behaviour therapy for psychosis in people not taking antipsychotic medication

BackgroundCognitive behaviour therapy (CBT) has been shown to be effective in an open trial for people with psychotic disorders who have not been taking antipsychotic medication. There is little known about predictors of outcome in CBT for psychosis and even less about hypothesised mechanisms of change.Method20 participants with schizophrenia spectrum disorders received CBT in an exploratory trial. Our primary outcome was psychiatric symptoms measured using the PANSS. Secondary outcomes were dimensions of hallucinations and delusions, self-rated recovery and social functioning, and hypothesised mechanisms of change included appraisals of psychotic experiences, dysfunctional attitudes and cognitive insight. We also measured patient characteristics that may be associated with outcome.ResultsT-tests revealed that several of the hypothesised mechanisms did significantly change over the treatment and follow-up periods. Correlational analyses showed that reductions in negative appraisals of psychotic experiences were related to improvements on outcome measures and that shorter duration of psychosis and younger age were associated with greater changes in symptoms.ConclusionsCBT based on a specific cognitive model appears to change the hypothesised cognitive mechanisms, and these changes are associated with good outcomes. CBT may be more effective for those who are younger with shorter histories of psychosis.     

The impact of group leaders' behaviour on parents acquisition of key parenting skills during parent training

BackgroundParent training (PT) is identified as the most effective intervention for the treatment of conduct disorder (CD). Intervention observational outcomes are often reported as summarised composite scores, providing an overview of overall construct change.Methods and aimsParents of children aged 3–5 years identified ‘at risk’ of developing CD were randomly allocated to either PT intervention or waiting list control group. Parent and child behaviours were assessed before and after the intervention period. The current paper aims to establish which individual observed parenting categories change as a result of PT, and which specific observed leader categories predict these changes.ResultsControlling for baseline scores, ANCOVA demonstrated changes in parent praise and reflective behaviours as significant post-intervention. One-way ANOVAs demonstrated higher levels of leader praise and reflective behaviours resulted in greater change in parental praise and reflective behaviours respectively. Regression analyses indicated these leader behaviours predict positive change in parental praise and reflective behaviours for intervention families.ConclusionsComposite observational scores provide an account of behaviour constructs, whereas individual behaviour categories provide an insight into the core components of these constructs. The results suggest praise and reflection as key leader behaviours that influence the mechanisms of change in parenting behaviours as a result of PT.     

Ascription of Maturity to Human Figure Drawings by Preschool Children

Summary

Forty-five preschool children, shown outline human figure drawings (all arbitrarily drawn to the same stature) whose overall body proportions were typical of individuals aged 0, 2, 6, 12, and 25 years, generally distinguished more maturely from less maturely proportioned figures, the absence of nonproportion cues to maturity notwithstanding. This is noteworthy, since agerelated changes in stature and in proportion are confounded in nature, and since our culture emphasizes stature cues and neglects proportion cues to maturity. Although Ss generally distinguished more mature from less mature figures on the basis of body proportions, the proportions of immature individuals nonetheless tended to be assimilated to those of the mature individual.     

Formation of a 'splitting pattern' associated with L1 2 precipitates in Ir-Nb alloys

A cuboidal L1 2 phase forms in the fcc matrix of an Ir-Nb alloy. Under some conditions, a rod- or plate-like fcc structure can be observed in this phase. This is similar to the 'splitting pattern' observed in some Ni-based alloys. To understand the formation mechanism of this structure, samples were heated under different conditions. Microstructure evolution during ageing was observed by transmission electron microscopy. We observed a splitting pattern only when the L1 2 precipitates were already formed in the as-cast condition after additional heat treatment at the ageing temperature. In this case, the composition of the L1 2 phase was not equilibrated. We conclude that the splitting pattern appears owing to a kinetic phenomenon when the L1 2 phase changes to the equilibrium composition.     

From intentions via planning and behavior to physical exercise habits

ObjectivesIndividuals who enact a health behavior effortlessly with minimal conscious deliberation can be assumed to have formed a healthy habit. This can be reflected by increases in self-reported habit strength of a behavior. We examined whether physical exercise intentions facilitate changes in exercise habit strength by increasing the use of action planning and exercise.DesignTwo field studies investigated the effect of behavioral intentions on changes in habit strength through a sequential path from action planning to exercise.MethodExercise intentions, action planning, habit strength, and exercise were assessed at two measurement points in time in 231 university students (Study 1), and at four points in time in 134 rehabilitation patients (Study 2).ResultsIn multiple-step mediation models in both samples, there were indirect effects of intentions on habit strength through action planning and behavior.ConclusionAction planning and behavior operated as sequential mediators to bridge the gap between intentions and habit strength. Exercise habit strength may increase as a result of conscious action planning and frequent behavior enactment. Including these constructs jointly into behavior change models may improve the understanding of the mechanisms involved in behavior maintenance.     

Epidemiological considerations in transgender health: A systematic review with focus on higher quality data

Abstract

Background: High quality data pertaining to the size of the transgender and gender diverse (TGD) population are scant, however, several recently published studies may provide more reliable contemporary estimates.

Aims: To summarize the estimated number and proportion of TGD individuals overall and across age groups, based on most accurate data.

Methods: This systematic review focused on recent studies (published from 2009 through 2019) that utilized sound methodology in assessing the proportion of TGD people in the general population. Publications were included if they used clear definitions of TGD status, and calculated proportions based on a well-defined sampling frame. Nineteen eligible publications represented two broad categories of studies: those that used data from large health care systems; and those that identified TGD individuals from population surveys.

Results: Among health system-based studies, TGD persons were identified using relevant diagnostic codes or clinical notes. The proportions of individuals with a TGD-relevant diagnosis or other recorded evidence ranged between 17 and 33 per 100,000 enrollees. In population surveys TGD status was ascertained based on self-report with either narrow or broad definitions. The survey-based estimates were orders of magnitude higher and consistent across studies using similar definitions. When the surveys specifically inquired about ‘transgender’ identity, the estimates ranged from 0.3% to 0.5% among adults, and from 1.2% to 2.7% among children and adolescents. When the definition was expanded to include broader manifestations of ‘gender diversity’, the corresponding proportions increased to 0.5-4.5% among adults and 2.5-8.4% among children and adolescents. Upward temporal trends in the proportion of TGD people were consistently observed.

Conclusions: Current data indicate that people who self-identify as TGD represent a sizable and increasing proportion of the general population. This proportion may differ, depending on inclusion criteria, age, and geographic location, but well-conducted studies of similar type and design tend to produce comparable results.     

Forward blocking in human learning sometimes reflects the failure to encode a cue–outcome relationship

In two “allergist” causal judgement experiments, participants were trained with a blocking design (A?+?|AB+). The procedure allowed different food cues to be paired with different fictitious allergic reactions. On test, participants were asked to rate the causal efficacy of the target cues and to recall the particular allergic reaction (outcome) that had followed each cue during training. Forward blocking was observed on the causal judgement measure and on the outcome recall measure in both Experiment 1 and Experiment 2. A backward blocking contingency was also trained in Experiment 2 (AB?+?|A+). Backward blocking was not observed either on the causal judgement or on the outcome recall measure. The evidence from the recall measure suggests that forward blocking in this task results from a failure to encode the B–outcome relationship during training. Associative and nonassociative mechanisms of forward blocking are discussed.     

Retirement from sport and the loss of athletic identity

Abstract

The purpose of this study was to examine how a sample of elite athletes coped with distressful reactions to retirement from sport. As part of a larger research project, 15 former elite athletes were identified as having experienced severe emotional difficulties upon athletic career termination. Through use of a micronarrative methodology, it was determined that account making can be a significant moderator of distress during the career transition process. In addition, the quality of the account making was found to be related to present affect and overall success in coping with athletic retirement. Finally, changes in athletic identity were found to be significant determinants of adjustment for athletes upon career termination. Suggestions are presented for future research on treatment strategies for distressful reactions to retirement from sport.     

Associations between beliefs about and reactions toward people who stutter

PurposeThis study sought to assess whether beliefs about people who stutter (PWS) predict intended behavioral and affective reactions toward them in a large and varied sample of respondents while taking into account familiarity with PWS and the demographic variables of age, education, and gender.MethodsAnalyses were based on 2206 residents of the United States of America. The seemingly unrelated regression (SUR) technique was used to test the relationship between beliefs about PWS and behavioral and affective reactions toward PWS. Variables such as familiarity with PWS and demographic data were also controlled in the statistical model.ResultsFindings indicated that, when demographic variables and familiarity were taken into account, the accuracy of participants’ beliefs about PWS significantly predicted their intended behavioral and affective reactions toward PWS. The participants’ gender and familiarity with PWS were also associated with these reactions toward PWS.ConclusionThe finding of an association between beliefs and intended reactions validates attempts to improve public treatment of PWS through improving the accuracy of beliefs about PWS. Additionally, because familiarity with PWS is a significant predictor of helpful and positive reactions toward PWS, interventions involving PWS educating others through direct interpersonal interactions may be one effective way to improve public reactions toward individuals who stutter.     

The role of meaning in gastric cancer patients: relationships among meaning structures,coping, and psychological well-being

ABSTRACT

Background and Objectives: Research demonstrates that the experience of cancer invariably violates patients’ meaning structures, prompting them to use coping strategies to alleviate stress and enhance well-being. The current study aimed to examine the mediating effects of coping strategies in the relationship between global and situational meaning and psychological well-being in gastric cancer patients.

Design and Method: One hundred eighty-seven patients (96 women and 91 men) with gastric cancer completed questionnaires measuring meaning in life, changes of beliefs and goals, coping, and psychological well-being. Participants were between 27 and 82 years of age. They were diagnosed with gastric cancer from 1 to 3.2 years ago. Using Structural Equation Modeling, both the direct and indirect associations between meaning structures, coping, and psychological well-being were examined.

Results: Meaning in life exerted significant indirect effects on psychological well-being through three coping strategies: problem-, emotion-, and meaning-focused. The relationship between changes of beliefs and goals and psychological well-being was also mediated by coping.

Conclusions: Findings suggest that coping strategies are mediators in the relationship between global and situational meaning and psychological well-being. They also provide empirical evidence that in severe cancer-related stress conditions both meaning structures and coping strategies influence patients’ psychological well-being.     

Sudden gains as a long-term predictor of treatment improvement among children in community mental health organizations

ObjectiveSudden gains have been described as rapid, sizeable changes observed between treatment sessions and have been associated with improved treatment outcome in adults. The current study examined weekly sudden gains among children seeking treatment in the community mental health setting.MethodParticipants were 161 children (age M = 10.58, SD = 1.73; 69.6% male; 47.8% Caucasian) and their parents who were randomized to one of three treatment modalities and were administered weekly and quarterly assessments throughout treatment.ResultsWhen idiographic (youth- and parent-identified “top problems”) and nomothetic measures (standardized checklists) were used to calculate sudden gains (i.e., gain must be large: in absolute terms, relative to prior session, and relative to changes in prior and subsequent sessions), 20–42% of participants experienced at least one sudden gain during treatment. Most sudden gains occurred early in treatment, and session content of relaxation was associated with sudden gain presence. Using a modified Bonferonni correction, sudden gains predicted overall symptom levels at final assessment (i.e., last assessment obtained following post-treatment) even after controlling for pre-treatment symptom levels and magnitude of the overall gain from pre- to post-treatment.ConclusionsSuddenness of gains may have a direct effect on long-term treatment outcome among children in the community.     

Negative affectivity,coping, immune status,and disease progression in hiv iwected individuals

Abstract

The primary goal of the study was to assess the relationship between personality dispositions, coping styles, immune markers, clinical status, and subjective somatic symptoms in a mixed sample of HIV positive individuals. Specifically, the prognostic value of psychological and immunological measures in HIV progression was emphasized. Subjects (n = 104) were recruited from a cohort of 422 HIV positive individuals enrolled in the Oslo HIV Cohort Study. The partkipants were given self-administered questionnaires assessing behavioral, psychological, and psychdal variables. Clinical assessment and immunological tests were performed at regular follow-up visits. Clinical status was assessed according to the Centers for Disurse Control criteria. The immune markers used were CD4 T cell counts, beta2-microglobulin concentration, sewn levels of HIV-1 p24 core protein, and levels of antibodies to core protein. In addition, subjective somatic symptoms were assessed.

The results showed that measure-s of negative affectivity (NA; e.g. anxiety, distress, tension) were consistently related to subjective somatic symptoms and passivedefensive coping style. However, no amistent association between NA measures and immune markers was found. Individuals who developed AIDS in the study period had significantly lower initial CD4 cell counts as well as lower scores on measures of active-pmblem related wping (e.g. Positive reappraisal, Seeking social support) and passivedefensive coping (i.e. Escape-Avoidance, Self-control).

The results suggest (1) that coping styles may merit a specific focus in future research of psychological factors and medical outcomes in HIV infection, and (2) because of associations of NA measures with symptom reports studies of the relationship between e.g. stress, depression and HIV outcome should consider these variables as confounders.     

Exploring the experience of adhering to a prescribed pre-surgical exercise program for patients with advanced rectal cancer: A phenomenological study

ObjectivesThe aim of this study was to explore the lived experience of patients with advanced rectal cancer as they attempted to adhere to a prescribed, hospital-based pre-surgical exercise program.Design/MethodsTen patients took part in three semi-structured in-depth interviews prior to (week 0), midway (week 3), and at completion (week 6) of the exercise program. Data were analysed using a phenomenological approach.ResultsMain themes that were deemed important for remaining enrolled in the program included: (1) building camaraderie and peer support, (2) experiencing a sense of structure and control, and (3) feeling safe and encouraged. Patients also reported engaging in further exercise outside the program and feeling motivated to continue exercising in the future.ConclusionsThis study shows the potential to integrate exercise prior to surgery as it was viewed as acceptable and feasible by patients with advanced rectal cancer. Moreover, it provides much needed information into the possible mechanisms that underpin patient's continued participation in exercise programs during treatment for advanced rectal cancer. Prescribed, hospital-based program should be implemented to promote opportunities for exercise and provide on-going supportive care options for patients awaiting surgery.