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Associations Between Sexual Orientation Dimensions and Cardiometabolic Diseases: Data from the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III). 性取向维度与心脏代谢疾病之间的关系:来自全国酒精及相关疾病流行病学调查-III(NESARC-III)的数据。
IF 2.9 3区 医学 Q2 PSYCHIATRY Pub Date : 2024-10-16 DOI: 10.1097/PSY.0000000000001349
Christopher A Crawford, Ian W Carson, Brittanny M Polanka, Michelle K Williams, Alexis B Higgins, Matthew D Schuiling, Jesse C Stewart

Objective: Sexual orientation can be measured across identity, attraction, and behavior. Sexual minorities are at increased risk of cardiovascular disease (CVD) and diabetes; however, it is not known whether cardiometabolic disease risk varies across these dimensions.

Methods: We analyzed cross-sectional data from 36,309 adults who participated in the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III; 2012-2013). Participants were categorized as heterosexual (reference), lesbian/gay, or bisexual across identity, attraction, and behavior using structured clinical interview data. Prevalent CVD (myocardial infarction, stroke, angina, or arteriosclerosis) and diabetes were assessed by self-report.

Results: Demographics (age, sex, race/ethnicity, education, and income) adjusted logistic regression models revealed bisexual behavior (i.e., people reporting sexual activity with both man- and woman-identifying individuals), but not lesbian/gay behavior (i.e., people reporting sexual activity exclusively with same-sex individuals), was associated with an increased odds of prevalent CVD (OR = 1.44, 95% CI: 1.08-1.91, p = .013) and prevalent diabetes (OR = 1.39, 95% CI: 1.09-1.77, p = .007). Contrastingly, sexual minority identity (i.e., self-concept) and attraction (i.e., one's sexual/romantic feelings) were not associated with prevalent CVD or diabetes.

Conclusions: Our results in a nationally representative sample indicate the sexual orientation dimension of behavior is linked with prevalent CVD and diabetes. This finding suggests that assessing multiple sexual orientation dimensions may aid in identifying sexual minority subgroups in greatest need of cardiometabolic disease prevention efforts. While mechanisms such as stigma and minority stress have been proposed, future studies are required to elucidate mechanisms underlying the bisexual behavior-cardiometabolic disease relationship.

目的:性取向可以从身份、吸引力和行为三个方面进行衡量。性取向少数群体罹患心血管疾病(CVD)和糖尿病的风险较高;然而,心血管代谢疾病风险在这些方面是否存在差异尚不清楚:我们分析了 36,309 名成年人的横截面数据,他们参加了全国酒精及相关疾病流行病学调查-III(NESARC-III,2012-2013 年)。通过结构化临床访谈数据,参与者被分为异性恋(参考)、女同性恋/男同性恋或双性恋,包括身份、吸引力和行为。心血管疾病(心肌梗死、中风、心绞痛或动脉硬化)和糖尿病的患病率通过自我报告进行评估:结果:人口统计学(年龄、性别、种族/民族、教育程度和收入)调整逻辑回归模型显示了双性恋行为(即报告与男性和女性认同的个体发生性行为的人),但没有显示女同性恋/男同性恋行为(即报告只与男性和女性认同的个体发生性行为的人)、与心血管疾病(OR = 1.44,95% CI:1.08-1.91,p = .013)和糖尿病(OR = 1.39,95% CI:1.09-1.77,p = .007)患病几率增加有关。)相反,性少数群体身份(即自我概念)和吸引力(即个人的性/浪漫感觉)与心血管疾病或糖尿病的发病率无关:我们在一个具有全国代表性的样本中得出的结果表明,行为的性取向维度与心血管疾病和糖尿病的发病率有关。这一结果表明,评估多个性取向维度可能有助于识别最需要预防心血管代谢疾病的性少数亚群。虽然有人提出了污名化和少数群体压力等机制,但还需要未来的研究来阐明双性恋行为与心血管代谢疾病关系的内在机制。
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引用次数: 0
Differences in Emotion Expression, Suppression, and Cardiovascular Consequences Between Black and White Americans in the Midlife in the United States (MIDUS) Study. 美国中年(MIDUS)研究中美国黑人和白人在情绪表达、抑制和心血管后果方面的差异。
IF 2.9 3区 医学 Q2 PSYCHIATRY Pub Date : 2024-10-02 DOI: 10.1097/PSY.0000000000001348
Anna J Finley, Cassandra L Baldwin, Tia M Hebbring, Carien M van Reekum, Julian F Thayer, Richard J Davidson, Stacey M Schaefer

Objective: Recent theoretical work suggests the expression of emotions may differ among Black and White Americans, such that Black Americans engage more frequently in expressive suppression to regulate emotions and avoid conflict. Prior work has linked expressive suppression usage with increases in cardiovascular disease risk, suggesting that racialized differences in expressive suppression usage may be one mechanism by which racism "gets under the skin" and creates heath disparities.

Method: To examine racialized differences in expressive suppression and blood pressure (a measure of cardiovascular disease risk), we used self-report and facial electromyography (fEMG) data from two cohorts of Black and White Americans from the Midlife in the United States (MIDUS) longitudinal study (MIDUS 2, n = 271, 34.7% Black, collected from 2004-2009; MIDUS Refresher 1, n = 114, 31.6% Black, collected from 2012-2016; total N = 385, 33.9% Black).

Results: Black Americans reported engaging in expressive suppression more frequently than White Americans (t(260.95) = 2.18, p = .002) and showed less corrugator fEMG activity during negative images(t(969) = 2.38, pFDR = .026). Less corrugator activity during negative images was associated with higher systolic blood pressure only for Black Americans (b = -4.63, t(375) = 2.67, p = .008).

Conclusion: Overall, results are consistent with theoretical accounts that Black Americans engage more frequently in expressive suppression, which in turn is related to higher cardiovascular risk. Additional research is needed to further test this claim, particularly in real-world contexts and self-reports of in-the-moment usage of expressive suppression.

目的:最近的理论研究表明,美国黑人和白人的情绪表达方式可能有所不同,美国黑人更频繁地使用表达性抑制来调节情绪和避免冲突。先前的研究将表达性抑制的使用与心血管疾病风险的增加联系起来,这表明表达性抑制使用方面的种族差异可能是种族主义 "深入皮肤 "并造成健康差异的机制之一:为了研究表达抑制和血压(衡量心血管疾病风险的指标)的种族差异,我们使用了来自美国中年(MIDUS)纵向研究的两组美国黑人和白人的自我报告和面部肌电图(fEMG)数据(MIDUS 2,n = 271,34.7% 为黑人,收集时间为 2004-2009 年;MIDUS Refresher 1,n = 114,31.6% 为黑人,收集时间为 2012-2016 年;总人数 = 385,33.9% 为黑人):结果:美国黑人比美国白人更经常进行表达性抑制(t(260.95) = 2.18,p = .002),并且在负面图像中表现出较少的皱纹肌肌电图活动(t(969) = 2.38,pFDR = .026)。只有美国黑人在负像时较少的皱纹肌活动与较高的收缩压有关(b = -4.63,t(375) = 2.67,p = .008):总之,研究结果与理论观点一致,即美国黑人更频繁地进行表达性抑制,这反过来又与较高的心血管风险有关。还需要进行更多的研究来进一步验证这一说法,特别是在现实世界的背景下和对表达性抑制的即时使用情况的自我报告中。
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引用次数: 0
Socioeconomic Disadvantage, Neighborhood Belonging, and Inflammation Among Adolescents. 青少年的社会经济劣势、邻里归属感和炎症。
IF 2.9 3区 医学 Q2 PSYCHIATRY Pub Date : 2024-10-01 Epub Date: 2024-07-04 DOI: 10.1097/PSY.0000000000001332
Michelle A Chen, Edith Chen, Shanti U Gallivan, Elizabeth J Brody, Veronica Passarelli, Gregory E Miller

Objective: Childhood socioeconomic disadvantage is associated with a host of adverse health outcomes across the lifespan. However, there is increasing interest in identifying factors that may promote resilience to disadvantage's effects on health. One promising candidate in this regard is a sense of neighborhood belonging, which could offset health risks by providing a sense of connection to others, as well as a sense of belonging to a community larger than oneself.

Methods: In a sample of 245 adolescents (age: mean [standard deviation] = 15.98 [0.54] years; sex: 64.1% female; race: 41.6% White, 37.6% Black/African American, 9.8% Other; ethnicity: 68.6% non-Hispanic), we examined neighborhood belonging as a moderator of the relationship between socioeconomic disadvantage (measured on a 0- to 5-point scale, mean [standard deviation] = 1.21 [1.36]) and low-grade inflammation (measured via a composite of circulating inflammatory biomarkers including IL-6, IL-8, IL-10, TNF-α, CRP, and suPAR). Covariates included age, sex, race/ethnicity, and pubertal status.

Results: Neighborhood belonging buffered the relationship between socioeconomic disadvantage and low-grade inflammation, a key mechanistic pathway to multiple chronic diseases. Specifically, there was a positive relationship between socioeconomic disadvantage and low-grade inflammation among individuals with low neighborhood belonging, but not among individuals with high neighborhood belonging.

Conclusions: These findings suggest that neighborhood belonging is one type of social connection factor that can mitigate the relationship between socioeconomic disadvantage and low-grade inflammation in youth.

目的:儿童时期的社会经济劣势与人一生中的一系列不良健康后果有关。然而,越来越多的人开始关注确定哪些因素可以促进人们抵御不利条件对健康的影响。在这方面,邻里归属感是一个很有希望的候选因素,它可以通过提供与他人的联系感以及对一个比自己更大的社区的归属感来抵消健康风险:抽样调查了 245 名青少年(年龄:M = 15.98 岁,SD = 0.54;性别:64.1% 为女性;种族:41.6% 为白人,37.6% 为女性):41.6%为白人,37.6%为黑人/非裔美国人,9.8%为其他种族;种族:68.6%为非西班牙裔),我们研究了邻里归属感对社会经济劣势(以0-5分制衡量,中=1.21;标度=1.36)和低度炎症(通过循环炎症生物标志物的综合指标衡量,包括IL-6、IL-8、IL-10、TNF-a、CRP和suPAR)之间关系的调节作用。协变量包括年龄、性别、种族/民族和青春期状况:结果:邻里关系缓冲了社会经济劣势与低度炎症之间的关系,而低度炎症是导致多种慢性疾病的关键机制。具体来说,在邻里归属感低的人群中,社会经济劣势与低度炎症之间存在正相关关系,而在邻里归属感高的人群中则没有这种关系:这些研究结果表明,邻里归属感是一种社会联系因素,可以缓解青少年的社会经济劣势与低度炎症之间的关系。
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引用次数: 0
Neonatal Hair Cortisol and Birth Outcomes: An Empirical Study and Meta-Analysis. 新生儿毛发皮质醇与出生结果:实证研究和荟萃分析。
IF 2.9 3区 医学 Q2 PSYCHIATRY Pub Date : 2024-10-01 Epub Date: 2024-08-10 DOI: 10.1097/PSY.0000000000001339
LillyBelle K Deer, Catherine H Demers, Benjamin L Hankin, Jenalee R Doom, Grant S Shields, M Camille Hoffman, Elysia Poggi Davis

Objective: Prenatal stress physiology is often posited as a predictor of birth outcomes, including gestational age at birth and birthweight. However, research has predominantly relied on indicators in the maternal system, with few studies examining hormones of the fetal system. The current study focuses on fetal cortisol in the third trimester, as measured in neonatal hair, as a biological factor that might be associated with birth outcomes (gestational age at birth and birthweight). We report findings from two studies: a longitudinal cohort (Study 1), and a meta-analysis of the existing literature (Study 2).

Methodsstudy: Hair was collected for cortisol analysis from 168 neonates (55.95% female) shortly after birth. Gestational age at birth and birthweight were abstracted from medical records.

Methodsstudy: An exhaustive search of four databases was conducted, yielding 155 total studies for screening. Papers reporting neonatal hair cortisol (collection <2 weeks postpartum) and birth outcomes among human neonates were retained for analysis, including Study 1 results ( k = 9).

Resultsstudy: Higher neonatal hair cortisol was related to longer gestation ( r = 0.28, p < .001) and higher birthweight, r = 0.16, p = .040. Sex did not moderate either association.

Resultsstudy: Across the nine studies, higher neonatal hair cortisol predicted both longer gestation ( r = 0.35, p < .001, 95% confidence interval = 0.24-0.45) and higher birthweight ( r = 0.18, p = .001, 95% confidence interval = 0.07-0.28). Neonatal sex did not moderate these associations.

Conclusions: Fetal cortisol exposure in the third trimester plays a role in normative maturation of the fetus, and findings reveal that higher cortisol is associated with positive birth outcomes.

目的:产前应激生理通常被认为是预测出生结果(包括胎龄和出生体重)的一个因素。然而,研究主要依赖于母体系统的指标,很少有研究对胎儿系统的激素进行检测。目前的研究重点是通过新生儿毛发测量胎儿皮质醇,将其作为可能与出生结局(出生胎龄和出生体重)相关的生物因素。我们报告了两项研究的结果:一项纵向队列研究(研究 1)和一项对现有文献的荟萃分析(研究 2):研究方法:采集 168 名新生儿(55.95% 为女性)出生后不久的毛发进行皮质醇分析。研究方法:对 168 名新生儿(55.95% 为女性)出生后不久的毛发进行皮质醇分析:对四个数据库进行了详尽检索,共筛选出 155 项研究。结果研究:较高的新生儿毛发皮质醇与较长的妊娠期(r = .28,p < .001)和较高的出生体重(r = .16,p = .040)有关。结果研究:在九项研究中,新生儿毛发皮质醇越高,妊娠期越长,r = .35,p < .001,95% CI [0.24,0.45];出生体重越大,r = .18,p = .001,95% CI [0.07,0.28]。新生儿性别并不影响这些关联:结论:第三孕期胎儿皮质醇暴露在胎儿正常成熟过程中发挥作用,研究结果表明,较高的皮质醇与积极的出生结局相关。
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引用次数: 0
Lifetime Trauma Exposure and Arthritis in Older Adults. 老年人终生遭受的创伤与关节炎。
IF 2.9 3区 医学 Q2 PSYCHIATRY Pub Date : 2024-10-01 Epub Date: 2024-07-02 DOI: 10.1097/PSY.0000000000001331
Kristen Nishimi, Ruijia Chen, Gabriela Schmajuk, Thomas C Neylan, Aoife O'Donovan

Objective: Experiencing potentially traumatic events across one's lifecourse increases risk for poor physical health outcomes. Existing models emphasize the effects of any lifetime trauma exposure, risk accumulation (multiple traumas over time), and sensitive periods of exposure (specific exposure timepoints leading to lasting consequences). We examined how different indices of trauma exposure across the lifecourse were associated with later life arthritis, a common and debilitating health condition.

Methods: Data include 5717 Health and Retirement Study participants (age mean [standard deviation] = 65.4 [12.9] years) who reported on lifetime adversity and trauma in 2006-2008. Lifetime trauma exposure was modeled as any trauma, accumulation of traumas, and lifecourse profiles (no exposure, childhood only, adulthood only, childhood and adulthood exposure). Outcomes included prevalent arthritis at baseline and incident arthritis across 12 years of follow-up. Covariate-adjusted generalized linear models for prevalence ratios and Cox proportional hazards models for hazard ratios were conducted.

Results: Any lifetime trauma was associated with both prevalent arthritis at baseline (prevalence ratio = 1.13, 95% confidence interval = 1.05-1.22) and incident arthritis over 12 years (hazard ratio = 1.25, 95% confidence interval = 1.17-1.47). Greater trauma accumulation was significantly associated with both prevalent and incident arthritis. Childhood exposure was particularly strongly associated with prevalent and incident cases, with adulthood exposure being unassociated with incident arthritis. Across models, trauma exposure was associated with prevalent cases of both immune-related and osteoarthritis types.

Conclusions: Higher lifetime trauma burden, especially during childhood, may predispose individuals to arthritis later in life. Early intervention or prevention efforts should identify trauma as an important risk factor for musculoskeletal health across the lifecourse.

目的在人的一生中经历潜在的创伤事件会增加不良身体健康后果的风险。现有模型强调一生中任何创伤暴露的影响、风险累积(随着时间的推移发生多次创伤)和暴露敏感期(导致持久后果的特定暴露时间点)。我们研究了生命过程中不同的创伤暴露指数与晚年关节炎(一种常见的使人衰弱的健康状况)之间的关系:数据包括 5,717 名健康与退休研究(Health and Retirement Study)参与者(平均年龄 = 65.3 岁,标准差 = 12.9 岁),他们报告了 2006-2008 年期间的终生逆境和创伤情况。终生遭受创伤的情况被模拟为任何创伤、创伤累积以及生命历程概况(未遭受创伤、仅童年时期遭受创伤、仅成年时期遭受创伤、童年时期和成年时期遭受创伤)。研究结果包括基线关节炎发病率和随访 12 年的关节炎发病率。研究人员采用协变量调整的广义线性模型计算患病率比(PR),并采用考克斯比例危险模型计算危险比(HR):任何终生创伤都与基线关节炎患病率(PR = 1.13,95%CI 1.05-1.22)和 12 年内关节炎发病率(HR = 1.25,95%CI 1.17-1.47)相关。创伤累积越多与关节炎的发病率和发病率都有明显的相关性。童年时期受到的创伤与关节炎的发病率和发病率的关系尤为密切,而成年后受到的创伤与关节炎的发病率无关。在各种模型中,创伤暴露与免疫相关类型和骨关节炎类型的发病率都有关联:结论:一生中较高的创伤负担,尤其是童年时期的创伤负担,可能会使人在晚年易患关节炎。早期干预或预防工作应将创伤确定为影响一生中肌肉骨骼健康的重要风险因素。
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引用次数: 0
Article Summaries for October 2024 Psychosomatic Medicine, Volume 86, Issue 8. 2024 年 10 月文章摘要 《心身医学》第 86 卷第 8 期。
IF 2.9 3区 医学 Q2 PSYCHIATRY Pub Date : 2024-10-01 DOI: 10.1097/PSY.0000000000001347
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引用次数: 0
Stressors and Subjective Cognition in Daily Life: Tests of Physical Activity and Age as Moderators. 日常生活中的压力和主观认知:测试体育锻炼和年龄的调节作用。
IF 2.9 3区 医学 Q2 PSYCHIATRY Pub Date : 2024-10-01 Epub Date: 2024-08-10 DOI: 10.1097/PSY.0000000000001338
Nicole S Stuart, Jin H Wen, Patrick Klaiber, Eli Puterman, Anita DeLongis, Nancy L Sin

Objective: Growing research indicates that daily stress is associated with poorer same-day cognitive performance, for example, memory and attention. However, it is unclear whether this relationship holds across diverse ages and engagement in physical activity (PA), or whether these factors might buffer the relationship between daily stress and subjective cognitive function.

Methods: Ecological momentary assessment data were collected from adults aged 25 to 88 years across British Columbia, Canada. For 14 days, participants ( N = 204) wore a triaxial physical activity monitor, reported stressor occurrence in mobile surveys four times per day, and rated their subjective attention and memory at the end of each day.

Results: Multilevel models evaluated daily stressor occurrence as a predictor of subjective attention and memory, with same-day PA engagement and age as moderators. Subjective attention and memory were lower on days when a stressor had occurred, compared to stressor-free days. Neither PA nor age moderated the within-person associations of daily stressors with subjective cognition.

Conclusion: The lack of stress-buffering effects for same-day PA and age raises questions about the contexts in which PA promotes cognitive functioning and about age-related processes underlying stress and cognition. Future work could examine the mechanisms that might explain the link between daily stress and cognition function, as well as the associations of different intensity and forms of physical activity on stress across age groups.

目的越来越多的研究表明,日常压力与较差的当日认知表现有关,例如记忆力和注意力。然而,目前还不清楚这种关系是否适用于不同年龄段和参与体育锻炼(PA)的人群,也不清楚这些因素是否会缓冲日常压力与主观认知功能之间的关系:方法:我们收集了加拿大不列颠哥伦比亚省 25-88 岁成年人的生态瞬间评估数据。在14天内,参与者(N = 204)佩戴三轴身体活动监测器,每天4次在移动调查中报告压力发生情况,并在每天结束时对其主观注意力和记忆力进行评分:多层次模型评估了每天发生的压力事件对主观注意力和记忆力的预测作用,而当天的体育锻炼参与度和年龄则是调节因素。与无压力日相比,有压力日的主观注意力和记忆力较低。参与体育锻炼和年龄都不能调节日常压力与主观认知之间的人际关联:结论:当日活动量和年龄对压力没有缓冲作用,这就对活动量促进认知功能的环境以及压力和认知的年龄相关过程提出了疑问。未来的工作可以研究可能解释日常压力与认知功能之间联系的机制,以及不同强度和形式的体育活动对不同年龄组压力的影响。
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引用次数: 0
Sleep Duration, Insomnia, and Associated Factors Among Ukrainians 1 Year After Russia's Full-Scale Invasion. 俄罗斯全面入侵一年后乌克兰人的睡眠时间、失眠症及相关因素。
IF 2.9 3区 医学 Q2 PSYCHIATRY Pub Date : 2024-10-01 Epub Date: 2024-08-10 DOI: 10.1097/PSY.0000000000001337
Shanshan Wang, Madelyn Hsiao-Rei Hicks, Emily Barrett, Dmytro Martsenkovskyi, Irina Holovanova, Olga Marchak, Liudmyla Ishchenko, Nancy Fiedler, Ubydul Haque

Objective: We aimed to investigate the prevalence of sleep disturbances and associated factors among Ukrainians 1 year after Russia's full-scale invasion.

Methods: Quota sampling was used to collect online survey data from 2364 adults living in Ukraine aged 18 to 79 years from April 5, 2023, to May 15, 2023. Short sleep duration was defined as sleep duration ≤6 hours and long sleep duration as ≥9 hours. Insomnia was assessed by the Insomnia Symptom Questionnaire.

Results: The prevalences of short sleep duration, long sleep duration, and insomnia were 39.4%, 6.9%, and 38.5%, respectively. Short sleep duration and insomnia were both more likely in females (short sleep duration: adjusted odds ratio [aOR] = 1.44; insomnia: aOR = 2.17), individuals with depression (short sleep duration: aOR = 1.61; insomnia: aOR = 7.76), affected by the 2014 Russian invasion (short sleep duration: aOR = 1.37; insomnia: aOR = 1.78), and with more trauma events (short sleep duration: quartile 3 [Q3] versus Q1: aOR = 1.88; Q4 versus Q1: aOR = 1.83; insomnia: Q3 versus Q1: aOR = 2.14; Q4 versus Q1: aOR = 2.32). Insomnia was more likely in Ukrainians with posttraumatic stress disorder (aOR = 2.95), anxiety (aOR = 4.57), and loneliness (aOR = 1.67). Essential public service was associated with short sleep duration (aOR = 1.64). Short sleep duration and insomnia were associated with lower quality of life in physical, psychological, and environmental domains. Insomnia was associated with the social relationships domain.

Conclusions: Sleep health among Ukrainian adults 1 year into the war is concerning, with more than one-third reporting inadequate sleep or insomnia. More studies are needed on impacts and interventions for sleep health during and after the war.

目的我们旨在调查俄罗斯全面入侵一年后乌克兰人睡眠障碍的发生率及相关因素:方法:我们采用配额抽样调查法,从 2023 年 4 月 5 日至 2023 年 5 月 15 日期间收集了 2364 名居住在乌克兰、年龄在 18-79 岁之间的成年人的在线调查数据。睡眠时间短定义为睡眠时间≤6 小时,睡眠时间长定义为睡眠时间≥9 小时。失眠通过失眠症状问卷进行评估:结果:睡眠时间短、睡眠时间长和失眠的发生率分别为 39.4%、6.9% 和 38.5%。女性、抑郁症患者(睡眠时间短:aOR = 1.61;失眠:aOR = 7.76)、受 2014 年俄罗斯入侵影响的人(睡眠时间短:aOR = 1.37;失眠:aOR = 1.78)以及有更多创伤事件的人更容易出现睡眠时间短和失眠(睡眠时间短:aOR = 1.44;失眠:aOR = 2.17):第 3 四分位数 vs 第 1 四分位数:aOR = 1.88;第 4 四分位数 vs 第 1 四分位数:aOR = 1.83;失眠:第三四分位数与第一四分位数相比:aOR = 2.14;第四四分位数与第一四分位数相比:aOR = 2.32)。患有创伤后应激障碍(aOR = 2.95)、焦虑(aOR = 4.57)和孤独(aOR = 1.67)的乌克兰人更容易失眠。基本公共服务与睡眠时间短有关(aOR = 1.64)。睡眠时间短和失眠与身体、心理和环境方面的生活质量较低有关。失眠与社会关系领域有关:结论:战争结束一年后,乌克兰成年人的睡眠健康状况令人担忧,超过三分之一的人表示睡眠不足或失眠。需要对战时和战后睡眠健康的影响和干预措施进行更多研究。
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引用次数: 0
Habitual Caffeine Use Is Associated With Heightened Cortisol Reactivity to Lab-Based Stress in Two Samples. 在两个样本中,习惯性使用咖啡因与皮质醇对实验室压力的反应性增强有关。
IF 2.9 3区 医学 Q2 PSYCHIATRY Pub Date : 2024-10-01 Epub Date: 2024-07-15 DOI: 10.1097/PSY.0000000000001334
Elli L Cole, Alessandra R Grillo, Suzanne Vrshek-Schallhorn

Objective: Habitual caffeine consumption protects against depression but through unclear mechanisms. Although habitual caffeine use predicts cortisol release in response to other acute stressors (e.g., exercise), this is less examined with lab-based psychosocial stress in healthy adults. Furthermore, caffeine-induced cortisol increases may mask theory-predicted cortisol blunting to robust stress in people with elevated depression risk. In two samples, we tested whether acute (same-day) and habitual caffeine use would predict greater cortisol reactivity to lab-based stress, and whether caffeine would "mask" the effect of a depression risk factor, trait rumination, on blunted cortisol reactivity.

Method: In sample 1, N = 128 emerging adults completed one of three Trier Social Stress Test conditions: nonevaluative control, ambiguously evaluative intermediate, or explicit negative evaluative. In sample 2, N = 148 emerging adults completed either a control or negative evaluative condition.

Results: In both samples, multilevel growth curve modeling indicated that habitual caffeine use ( t = -1.99, p = .048; t = -2.73, p = .007, samples 1 and 2, respectively) but not acute caffeine use predicted heightened cortisol reactivity as a function of condition. In sample 1, the relationship between condition, rumination, and blunted cortisol was evident only in caffeine nonusers, which differed from users ( t = 2.82, p = .005), but in sample 2, the predicted blunting pattern was evident regardless of caffeine use.

Conclusion: The results provide evidence that habitual caffeine use is associated with greater cortisol release under psychosocial lab-based stress and may mask the influence of psychosocial variables; future research should examine whether habitual caffeine-induced cortisol release has behaviorally activating effects that protect against depression.

目的:习惯性饮用咖啡因可预防抑郁症,但其机制尚不清楚。虽然习惯性摄入咖啡因可预测皮质醇在其他急性应激源(如运动)下的释放,但在健康成年人中,这一点在实验室社会心理应激中的研究较少。此外,咖啡因诱导的皮质醇增加可能会掩盖理论预测的皮质醇对抑郁风险升高的人的强大压力的钝化作用。在两个样本中,我们测试了急性(当天)和习惯性使用咖啡因是否会预测皮质醇对实验室压力的反应性,以及咖啡因是否会 "掩盖 "抑郁风险因素特质反刍对皮质醇反应性减弱的影响:在样本 1 中,N = 128 名新成人完成了三种特里尔社会压力测试条件之一:非评价性控制、模糊评价性中间或明确的负面评价。在样本 2 中,N=148 名新成人完成了 "控制 "或 "消极评价 "条件之一:在这两个样本中,多层次生长曲线建模显示,习惯性(t = -1.99, p = .048; t = -2.73, p = .007,分别为样本 1 和样本 2)而非急性咖啡因使用可预测皮质醇反应性的升高。在样本 1 中,条件、反刍和皮质醇钝化之间的关系仅在非咖啡因使用者中明显,这与使用者不同(t = 2.82,p = .005),但在样本 2 中,无论是否使用咖啡因,预测的钝化模式都很明显:这提供了证据,证明习惯性使用咖啡因与心理社会实验室压力下皮质醇的更大释放有关,并可能掩盖心理社会变量的影响;未来的研究应探讨习惯性使用咖啡因引起的皮质醇释放是否具有行为激活效应,从而保护人们免受抑郁的影响。
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引用次数: 0
Mediators of a Mindfulness-Based Intervention for Younger Breast Cancer Survivors: Effects on Depressive Symptoms. 对年轻乳腺癌幸存者进行正念干预的中介因素:对抑郁症状的影响
IF 2.9 3区 医学 Q2 PSYCHIATRY Pub Date : 2024-10-01 Epub Date: 2024-08-10 DOI: 10.1097/PSY.0000000000001340
J Richard T Korecki, Patricia A Ganz, Ann H Partridge, Antonio C Wolff, Laura Petersen, Catherine M Crespi, Julienne E Bower

Objective: Depression is associated with poor outcomes in breast cancer patients, with higher prevalence among younger women. Although mindfulness-based interventions (MBIs) have demonstrated therapeutic effects, the mechanisms of intervention effects are poorly understood. We investigated whether rumination, self-kindness, intrusive thoughts about cancer, cancer-related worry, or a sense of meaning and peace mediated the intervention effects of an MBI, Mindful Awareness Practices (MAPs), on depressive symptoms. Additionally, we explored the same variables as mediators of a psychoeducation program, Survivorship Education (SE).

Methods: Women diagnosed with stage 0-III breast cancer at age <50 years were randomized to 6 weeks of MAPs ( n = 85), SE ( n = 81), or wait-list control (WLC; n = 81). During preintervention, postintervention, and 6-month follow-up (FU), we assessed depressive symptoms, rumination, self-kindness, intrusive thoughts, worry, and meaning and peace.

Results: MAPs and SE significantly reduced depressive symptoms at postintervention, and reductions remained through 6-month FU for MAPs. Models revealed that reductions in rumination ( β = -0.68, 95% confidence interval [CI] = -1.64 to -0.07) and intrusive thoughts ( β = 1.17, 95% CI = -2.17 to -0.37) and improvements in self-kindness ( β = -1.09, 95% CI = -2.37 to -0.28) and meaning and peace ( β = -1.09, 95% CI = -3.16 to -0.56) mediated MAPs' effects at all time points. Reductions in worry ( β = -1.34, 95% CI = -2.47 to -0.45]) mediated effects at postintervention only. Worry and intrusive thoughts mediated SE effects at postintervention and 6-month FU, respectively.

Conclusions: Findings identified depression-relevant mediators of MAPs' effects, expanding the understanding of MBI mechanisms. Results highlight pathways that could be leveraged to optimize intervention outcomes.

Trial registration: ClinicalTrials.gov identifier: NCT03025139 .

目的:抑郁症与乳腺癌患者的不良预后有关,在年轻女性中发病率更高。虽然正念干预(MBIs)已显示出治疗效果,但人们对干预效果的机制却知之甚少。我们研究了反刍、自我亲切感、对癌症的侵入性想法、与癌症相关的担忧或意义与和平是否对正念觉察练习(MAPs)这种正念干预对抑郁症状的干预效果起中介作用。此外,我们还探讨了作为心理教育计划 "幸存者教育"(SE)中介因素的相同变量:年龄小于 50 岁、被诊断为 0-III 期乳腺癌的女性被随机分配到为期 6 周的 MAPs(85 人)、SE(81 人)或候补对照组(81 人)中。在干预前、干预后和6个月的随访(FU)期间,我们对抑郁症状、反刍、自我亲切感、侵入性想法、担忧以及意义与和平进行了评估:结果:MAPs 和 SE 在干预后能明显减轻抑郁症状,MAPs 在 6 个月的随访中仍能减轻抑郁症状。模型显示,在所有时间点,反刍(β = -0.68,95% CI [-1.64,-0.07])和侵入性想法(β = 1.17,95% CI [-2.17,-0.37])的减少以及自我亲切感(β = -1.09,95% CI [-2.37,-0.28])和意义与和平(β = -1.09,95% CI [-3.16,-0.56])的改善对 MAPs 的效果起到了中介作用。担忧的减少(β = -1.34, 95% CI [-2.47, -0.45])仅在干预后的效果中起中介作用。担忧和侵入性想法分别对干预后和6个月FU的SE效应起中介作用:研究结果确定了MAPs效应的抑郁相关中介因素,拓展了对MBI机制的理解。研究结果强调了可用于优化干预结果的途径。
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Psychosomatic Medicine
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