Psychoneuroimmunology and male infertility: A possible link between stress,coping and male immunological infertility

Abstract

This current study investigated a link between stress and coping with some male infertility problems via psychoneuroimmunological theories. The study was carried out on 77 males who came to a fertility clinic for sperm diagnosis. Appraisal and coping with stress reaction to negative life events and to infertility were related to non-sperm cells within the seminal plasma. Those men who had felt strained from external events and from problems of infertility, and had used emotional escape coping strategies, were more prone to have an immunosuppressed reaction, indicated by bacteria within their plasma. Those using task focused control strategies were more prone to have an immunostimulatory reaction, indicated by white blood cells, including in some cases, sperm destroying phagocytes suggesting a possible auto-immunity reaction. When the analyses were done separately on patients with known male fertility problems in comparison with those with unexplained infertility, the two opposing psychoneuroimmunological processes became more pronounced.     

Personal mastery predicts pain,stress, fatigue,and blood pressure in adults with rheumatoid arthritis

Among individuals with rheumatoid arthritis (RA), stress-associated disease flare can severely impact well-being. Psychological factors such as personal mastery may buffer an individual from the negative effects of those flares. We tested the hypothesis that a high sense of personal mastery would prospectively predict stress reactivity. Measures of pain, perceived stress, fatigue, and mean arterial pressure (MAP) were collected before, during, and after two interpersonal stressors conducted on 73 individuals with RA. Factor analysis of the personal mastery scale yielded two independent factors: a 5-item “fatalism” component and a 2-item “control” component. Individuals with high fatalism scores reported overall greater joint pain at baseline and those scoring high on control exhibited lower MAP, and reported less stress and fatigue at baseline. After controlling for baseline differences, those high in control exhibited greater MAP increase during stress, and less drop in pain when compared to those low in control. These results suggest that individuals high in control may be more susceptible to the effects of acute stress; however, the overall beneficial aspects of high control outweigh the acute negative effects. Personal mastery may play a role in the experience of pain, stress, and fatigue for people with RA.     

Examining the effects of perceived social support on momentary mood and symptom reports in asthma and arthritis patients

Objective: Social support has been linked to beneficial effects on health directly (main effect) and as a buffer to stress. Most research, however, has examined these relationships using global and retrospective assessments of health and stress, which may be subject to recall biases. This study used ambulatory ecological momentary assessment (EMA) methods to test the main and stress-buffering effects of social support on the daily health and well-being of asthma and rheumatoid arthritis (RA) patients.

Design: Community volunteers with asthma (n?=?97) or RA (n?=?31) responded to EMA prompts five times daily for one week.

Main outcomes: Baseline perceived social support was obtained, and then, participants reported mood, stress and symptoms using EMA. Multilevel mixed-modelling examined whether social support predicted mood and symptoms directly or via stress-reducing effects.

Results: Supporting a main effect, more perceived social support predicted decreased negative mood and stress severity. Supporting a stress-buffering effect, more perceived social support resulted in fewer reported symptoms when stress was present.

Conclusion: Results suggest perceived social support directly relates to better ambulatory status and dynamically buffers individuals against the negative effects of stressors, and highlight the importance of studying social support across different temporal and contextual levels.     

The relationship between self-reported oral symptoms and life-events

Abstract

This paper investigates whether eight specific life-events were related to self-reported chronic (persistent trouble over the last 12 months) and acute (trouble in the last 14 days) oral symptoms in a sample of 3861 civil servants aged 35-44 years. The results of a logistic regression analysis taking age, social class and gender into account showed that a range of life-events—marital or family problems other than divorce, death of a relative, personal serious illness, serious illness of a close relative, major financial difficulty and mugging and robbery—were significantly associated with either acute or chronic oral symptoms. Further analysis showed that marital or family problems other than divorce was found to be the most important life event studied. The results support the argument that marital dissatisfaction leads to poorer physical and psychological health.     

The role of attitudes towards the targets of behaviour in predicting and informing prenatal testing choices

Research considering the role of attitudes in prenatal testing choices has commonly focused on the relationship between the attitude towards undergoing testing and actual testing behaviour. In contrast, this study focused on the relationship between testing behaviour and attitudes towards the targets of the behaviour (in this case people with Down syndrome (DS) and having a baby with DS). A cross-sectional, prospective survey of 197 pregnant women measured attitudes towards the targets of prenatal testing along with intentions to use screening and diagnostic testing, and the termination of an affected pregnancy. Screening uptake was established via patient records. Although attitudes towards DS and having a baby with DS were significantly associated with screening uptake and testing and termination intentions, unfavourable attitudes were better than favourable ones at predicting these outcomes. For example, in the quartile of women with the ‘most favourable’ attitude towards people with DS 67% used screening although only 8% said they would terminate an affected pregnancy. Qualitative data suggested that not all women considered personal attitudes towards DS to be relevant to their screening decisions. This finding has implications for the way in which informed choice is currently understood and measured in the prenatal testing context.     

Perfectionism and health: A mediational analysis of the roles of stress,social support and health-related behaviours

This study tested a model derived from personality theory in which perceived stress, perceived social support, health-risk and health-promotion behaviours mediate the relationship between perfectionism and perceived physical health. A sample of 538 undergraduate students completed a web-based survey assessing multi-dimensional perfectionism, perceived stress, perceived social support, health behaviours, physical health and a scale tapping elements of the five-factor model of personality. Analyses that account for the effects of traits from the five-factor model (e.g., neuroticism, conscientiousness and extraversion) indicated that socially prescribed perfectionism was associated with poorer physical health and this association was fully mediated by higher levels of perceived stress and lower levels of perceived social support. Self-oriented perfectionism was related complexly to health such that it was related to poorer health via higher levels of perceived stress, but was also related to better health via higher levels of perceived social support. Our findings illustrate the need for considering key mediators of the link between perfectionism and poor health outcomes.     

General analytical solution for stress intensity factor of a hypocycloid hole with many cusps in an infinite plate

In this article, the problem for the determination of the displacement functions and the stress intensity factors (SIFs) around a boundary of a hypocycloid hole with cusps in an infinite elastic plate subject to normal and shear stresses are presented. A hole with cusps (hypocycloid) is mapped onto a unit circle and the modified complex potential is used for solving the relevant boundary value problems. An analytical solution for the SIF of a hypocycloid hole is obtained. For a special case, our results agree with others.     

The role of stress and area‐specific self‐esteem in adolescent smoking

Stress and self‐esteem have been shown to be important risk factors for adolescent cigarette smoking, and self‐esteem has previously been implicated as a stress‐moderating and a stress‐mediating variable. This study aimed to examine the associations between stress, area‐specific self‐esteem, and adolescent smoking, and to investigate whether specific areas of self‐esteem moderate or mediate the relationship between stress and smoking. Four hundred and ninety‐five adolescents (aged 14–19) responded to a questionnaire that examined these variables. Results showed that self‐esteem in the areas of school subjects and parent relations were related to smoking. Adolescents with low self‐esteem in these areas were more likely to smoke than their high self‐esteem counterparts. Highly stressed adolescents were more likely to smoke than those with low stress. However, the relationship between stress and smoking was completely mediated by self‐esteem in the area of school subjects. No moderation was revealed. Thus, high global self‐esteem may not be sufficient to reduce the risk of smoking. To maximise benefit, prevention and intervention efforts should target self‐esteem in the areas of school subjects and parent relations. Initiatives focusing on stress are only likely to decrease smoking to the extent that they influence self‐esteem in the area of school subjects.     

A randomised controlled trial of a brief online mindfulness-based intervention

ObjectivesThere is growing evidence that mindfulness has positive consequences for both psychological and physical health in both clinical and non-clinical populations. The potential benefits of mindfulness underpin a range of therapeutic intervention approaches designed to increase mindfulness in both clinical and community contexts. Self-guided mindfulness-based interventions may be a way to increase access to the benefits of mindfulness. This study explored whether a brief, online, mindfulness-based intervention can increase mindfulness and reduce perceived stress and anxiety/depression symptoms within a student population.MethodOne hundred and four students were randomly allocated to either immediately start a two-week, self-guided, online, mindfulness-based intervention or a wait-list control. Measures of mindfulness, perceived stress and anxiety/depression were administered before and after the intervention period.ResultsIntention to treat analysis identified significant group by time interactions for mindfulness skills, perceived stress and anxiety/depression symptoms. Participation in the intervention was associated with significant improvements in all measured domains, where no significant changes on these measures were found for the control group.ConclusionsThis provides evidence in support of the feasibility and effectiveness of shorter self-guided mindfulness-based interventions. The limitations and implications of this study for clinical practice are discussed.     

Implementation of Cognitive Therapy for PTSD in routine clinical care: Effectiveness and moderators of outcome in a consecutive sample

ObjectiveTrauma-focused psychological treatments are recommended as first-line treatments for Posttraumatic Stress Disorder (PTSD), but clinicians may be concerned that the good outcomes observed in randomized controlled trials (RCTs) may not generalize to the wide range of traumas and presentations seen in clinical practice. This study investigated whether Cognitive Therapy for PTSD (CT-PTSD) can be effectively implemented into a UK National Health Service Outpatient Clinic serving a defined ethnically mixed urban catchment area.MethodA consecutive sample of 330 patients with PTSD (age 17–83) following a wide range of traumas were treated by 34 therapists, who received training and supervision in CT-PTSD. Pre and post treatment data (PTSD symptoms, anxiety, depression) were collected for all patients, including dropouts. Hierarchical linear modeling investigated candidate moderators of outcome and therapist effects.ResultsCT-PTSD was well tolerated and led to very large improvement in PTSD symptoms, depression and anxiety. The majority of patients showed reliable improvement/clinically significant change: intent-to-treat: 78.8%/57.3%; completer: 84.5%/65.1%. Dropouts and unreliable attenders had worse outcome. Statistically reliable symptom exacerbation with treatment was observed in only 1.2% of patients. Treatment gains were maintained during follow-up (M = 280 days, n = 220). Few of the selection criteria used in some RCTs, demographic, diagnostic and trauma characteristics moderated treatment outcome, and only social problems and needing treatment for multiple traumas showed unique moderation effects. There were no random effects of therapist on symptom improvement, but therapists who were inexperienced in CT-PTSD had more dropouts than those with greater experience.ConclusionsThe results support the effectiveness of CT-PTSD and suggest that trauma-focused cognitive behavior therapy can be successfully implemented in routine clinical services treating patients with a wide range of traumas.