Brain drawings following traumatic brain injury (TBI) and links to illness perceptions and health outcomes – Findings from a population-based study

Objective: Individuals’ illness perceptions predict health behaviours and influence functional outcomes. This study examined associations between a novel assessment of illness perceptions, in the form of adult’s brain drawings after traumatic brain injury (TBI) and questionnaire measures of illness perceptions, quality of life and post-concussive symptoms.

Design: Population-based, prospective longitudinal study examining 245 adults with predominantly mild TBI with high risk of complications.

Main outcome measures: Participants were asked to draw pictures of what they thought their brain looked like before injury and at baseline and one month post-injury. Drawing characteristics (height, width and percentage damage at one month) were examined in relation to each outcome of interest at six months.

Results: Greater damage at one month was associated with more negative illness perceptions (rs = .23), poorer mental health (rs = ?.21), and more total post-concussive symptoms (rs = .27 to r = .35) at six months. The extent of damage depicted reduced over time (p < .001). No associations were found between the amount of damage drawn and injury severity, nor the height or width of drawings and injury severity or illness perceptions.

Conclusion: Drawings post-TBI offer a simple, cost- and time-effective way to begin discussions and improve understanding of peoples’ illness perceptions.     

Pathways maintaining physical health problems from childhood to young adulthood: The role of stress and mood

Objective: Poor physical health in childhood is associated with a variety of negative health-related outcomes in adulthood. Psychosocial pathways contributing to the maintenance of physical health problems from childhood to young adulthood remain largely unexamined, despite evidence that factors such as negative mood and stress impact physical health.

Design: The current study tested the direct and indirect effects of ongoing health, chronic stress, health-related chronic stress, and depressive symptoms at age 20 on the link between health problems in childhood and young adulthood (age 21) in a longitudinal sample (n = 384).

Main Outcome Measures: The hypotheses were tested using a multiple mediation path analysis framework; the primary outcome measure was a composite index of health status markers in young adulthood.

Results: The proposed model provided an adequate fit for the data, with significant total indirect effects of the four mediators and significant specific indirect effects of health-related chronic stress and depressive symptoms in maintaining health problems from childhood into young adulthood.

Conclusions: Health problems are maintained from early childhood into young adulthood in part through psychosocial mechanisms. Depressive symptoms and health-related chronic stress have significant, unique effects on the relationship between health problems in early childhood and young adulthood.     

虐待与流动儿童对立违抗症状的关系:亲密度和冲突性的作用

以来自北京10所小学的369名有对立违抗障碍症状的流动儿童,349名无ODD症状的对照组流动儿童和94名有ODD症状的北京儿童为被试,探究了有ODD症状流动儿童的症状严重程度及影响因素,并进一步探讨了ODD症状流动儿童在家庭中所受情感虐待、躯体虐待对其情绪方面的ODD症状和行为方面的ODD症状的影响,以及亲子关系(包括亲密度和冲突性)在其中起的作用。研究结果发现:(1)对比ODD症状北京儿童和对照组流动儿童,ODD症状流动儿童受到更严重的虐待,亲子关系亲密度更差,冲突性更高;(2)对ODD症状流动儿童,虐待和亲密度显著负相关,虐待和冲突性显著正相关,躯体虐待、冲突性均和行为方面ODD症状显著正相关;(3)躯体虐待能直接预测ODD症状流动儿童的行为方面ODD症状,但无法直接预测其情绪方面ODD症状;(4)在躯体虐待对ODD症状的影响中,冲突性起着显著的中介作用,躯体虐待通过影响亲子关系冲突性,对流动儿童的行为方面ODD症状产生影响,而亲密度则显著调节了躯体虐待对流动儿童情绪方面ODD症状的影响。     

Occupational stress,job satisfaction and physical health in teachers

IntroductionChanges within the teaching profession have been blamed for the high levels of stress reported by teachers. In recent decades, Italian schools have been characterised by continuous change, as a result of profound transitions that have affected political, social and economic development.ObjectiveThis paper investigated the relationship between occupational stress, job satisfaction and physical health in Italian teachers. Specifically, our aim is to study the role of job satisfaction as a possible mediation role between work stressors and its effects on teachers’ physical health (physical symptoms). In addition, we were interested in studying the direct effects of work stressors on the hypothetical outcomes (physical symptoms).MethodData were collected via a questionnaire from a sample of 565 teachers working in different upper secondary schools in Italy. The booklet filled by the teachers consisted of 32 items that measure perceived occupational difficulties, job satisfaction and physical symptoms.ResultsThe results showed that workload, perception of work environment, teachers’ perceptions of senior management and attitude towards change are specific perceived occupational difficulties of the Italian teachers involved in our research. In particular, workload and attitude towards change have significant direct effects on physical symptoms, and indirect effects on physical symptoms through job satisfaction. Also, job satisfaction decreases physical symptoms.ConclusionThe results suggest important implications for stress prevention in teachers. In fact, the level of stress and its consequences can be reduced and prevented through an accurate identification of its sources, with a positive effect on individual and organisational health.     

Psychological well-being of patients with insomnia and its relationship with anxiety and depression

The aims of the present study are to evaluate the impact of insomnia on psychological well-being and to examine the associations of insomnia and psychological well-being with anxiety and depression. Forty-one patients attending our hospital-based Centre for sleep medicine were administered scales for the evaluation of insomnia (ISI), anxiety (STAI-Y), depression (BDI-II) and psychological well-being (PWB). The scores were compared to those of a control group of 68 subjects attending the hospital for routine examinations or as accompanying persons. Significant differences between patients and controls were detected for anxiety and depression, as well as for psychological well-being. Even if subclinical on average, anxiety and depression symptoms were significantly related to poor psychological well-being, whereas insomnia per se was not. These findings suggest that patients with insomnia report a relevant impact on their psychological well-being, and that such an impact seems to be strongly associated with concomitant subthreshold symptoms of anxiety and depression. The implications for diagnosis and treatment are discussed.     

Infant Emotion Regulation Strategy Moderates Relations between Self‐Reported Maternal Depressive Symptoms and Infant HPA Activity

Children of mothers with depressive symptoms often have high cortisol levels. Research shows that various child characteristics (e.g., attachment pattern, internalizing behaviours, and temperament) moderate this association. We suggest that these characteristics share common variance with emotion regulation strategy. Therefore, we examine infant emotion regulation strategy as a moderator of the association between maternal depressive symptoms and infant hypothalamic–pituitary–adrenal (HPA) function. We hypothesize that infants who utilize more independent emotion regulation strategies and have mothers who report higher depressive symptoms will exhibit elevated cortisol levels. Participants were 193 mothers and infants (15 months old) recruited from the community. Self‐reported maternal depressive symptoms were assessed. Infant independent regulatory behaviours (withdrawal, wandering away, distraction, scanning, orienting to another object) were coded in the context of a Toy Frustration Task. Infant cortisol was collected via saliva samples at baseline, +20, and +40 minutes. Results indicate that infant emotion regulation strategy moderates the relation between mothers' self‐reported depressive symptoms and infant total cortisol output (AUC_G) and cortisol reactivity (AUC_I). Infants who employed more independent regulatory behaviours and have mothers with higher depressive symptoms experience greater cortisol secretion. We discuss the findings in relation to parent‐infant interactions and the adaptive nature of emotion regulation strategies, as they relate to HPA regulatory capacities. Copyright © 2015 John Wiley & Sons, Ltd.     

Evidence that anticipated stigma predicts poorer depressive symptom trajectories among emerging adults living with concealable stigmatized identities

People living with concealable stigmatized identities are vulnerable to experiencing greater depressive symptoms as a result of occupying a lower social status. In the present research, we examine the effect of changes in enacted stigma and changes in anticipated stigma on trajectories of depressive symptoms over time. A sample of 192 college-aged emerging adults (81.0% female, 81.9% Caucasian, M_age = 18.82 years) living with a concealable stigmatized identity (e.g., mental illness and sexual minority status) completed measures of enacted stigma, anticipated stigma, and depressive symptoms at two time points across eight weeks. Hierarchical linear modeling analyses indicate that increases in anticipated stigma, but not enacted stigma, predicted poorer trajectories of depressive symptoms, controlling for the effect of baseline rumination and other identity-related variables. These data are among the first to demonstrate that worries about future devaluation predict poorer depressive symptom trajectories over time among college-aged emerging adults.     

Mothering under political violence: Post-traumatic symptoms,observed maternal parenting practices and child externalising behaviour

Using the family stress model as our conceptual framework, we explored whether observed maternal parenting practices (positive and coercive) account for the associations between mothers' post-traumatic stress symptoms and children's externalising behaviours. Mothers' self-reported post-traumatic stress symptoms, observed maternal practices, and reports of children's externalising behaviour were collected from 123 Israeli mothers and their children, who were exposed to ongoing rocket attacks in southern Israel. A structural equation model revealed that mothers' post-traumatic stress symptoms were linked with greater maternal coercive parenting practices, which in turn were associated with more externalising behaviours in children. The study highlights the crucial role of maternal distress and mothers' parenting skills in the development of externalising behaviours in children exposed to chronic political violence. These results suggest that prevention interventions designed to promote parenting skills for mothers exposed to political violence may be beneficial for children's healthy development.     

Borderline personality disorder level predicts change in depressiveness after short‐term group psychotherapy: A study in a daily psychiatric clinic

The project examined the comorbidity between depression symptoms and the level of borderline personality organisation among patients admitted for group psychotherapy (Study 1). It also aimed to analyse how the level of borderline personality organisation relates to the reduction in depression symptoms after short‐term psychotherapy (Study 2). The study was conducted in a day clinic where patients were receiving psychotherapy for emotional problems affecting their functioning (N = 57). The study used the Borderline Personality Inventory (BPI) and the Patient Health Questionnaire. The analysis showed that BPI was positively related to depression symptoms. The higher borderline personality organisation patients presented when entering group psychotherapy, the greater was the decrease in depression symptoms after 3 months of psychotherapy. We discuss the results in relation to the notion that the presence of depression could be a positive prognostic indicator for patients with borderline personality.     

Psychosocial correlates of health status among Asians, Caucasians, and multiracial subjects

The present study assessed the relationship between race and physical health in a multicultural sample. When controlling for a variety of health risk factors, the results revealed a significant relationship between race and recent and chronic physical symptoms (i.e., minor health problems) as well as past major health problems. Multiracial individuals reported more health problems than Asians or Caucasians. These findings may reflect the differences in diet and socioeconomic status (SES) as well as conditions associated with low SES such as decreased likelihood of seeking medical services and a variety of psychosocial variables.