Comprehensive psychoneuroendocrinology最新文献

Association between depression and anxiety disorders with euthyroid Hashimoto's thyroiditis: A systematic review and meta-analysis. 抑郁症和焦虑症与甲状腺功能良好的桥本甲状腺炎之间的关系：一项系统综述和荟萃分析。

IF 2.1 Q3 ENDOCRINOLOGY & METABOLISM

Comprehensive psychoneuroendocrinology

Pub Date : 2024-12-02 eCollection Date: 2024-11-01 DOI: 10.1016/j.cpnec.2024.100279

Bo Wang, Jie Huang, Li Chen

Background: Hashimoto's thyroiditis (HT) affects up to 10 % of the population and is a common cause of hypothyroidism, which can lead to depression and anxiety. However, it remains unclear whether HT directly causes these conditions or if they arise due to HT-induced hypothyroidism. The present review aims to offer meta-analytic insights into the relationship between depression and anxiety in patients with euthyroid HT.

Methods: A comprehensive search was conducted in PubMed, Embase, Web of Science, Cochrane Library, CNKI, Wanfang Data, SinoMed, and VIP from their inception through May 2024. Case-control or cross-sectional studies examining the association between euthyroid HT and either depression, anxiety disorders, or both were included.

Results: For depression, 1365 patients (694 HT vs. 671 controls) from 11 articles were analyzed; for anxiety, 1009 patients (516 HT vs. 493 controls) from 8 articles were included. HT patients had 2.5 times higher odds of anxiety disorders (OR = 2.52, 95 % CI: 1.66-3.82). The Beck Depression Inventory showed a WMD of 4.26 (95 % CI: 1.28-7.24) and the Beck Anxiety Inventory a WMD of 5.10 (95 % CI: 1.55-8.66).

Limitation: The findings should be interpreted cautiously due to heterogeneity, potential publication bias, and variability in assessment tools, which may limit generalizability.

Conclusions: Euthyroid HT patients exhibit a higher prevalence of anxiety disorders compared to healthy control groups, and more susceptible to anxiety and depression symptoms based on the Beck Inventory. Thyroid antibodies themselves are also associated with depression and anxiety disorder.

桥本甲状腺炎（桥本甲状腺炎）影响高达10%的人口，是甲状腺功能减退的常见原因，可导致抑郁和焦虑。然而，目前尚不清楚是HT直接导致这些疾病，还是HT引起的甲状腺功能减退。本综述旨在对甲状腺激素治疗患者抑郁和焦虑之间的关系进行meta分析。方法：综合检索PubMed、Embase、Web of Science、Cochrane Library、CNKI、万方数据、中国医学信息网（sinmed）、维普网（VIP）自成立至2024年5月的数据库。研究甲状腺激素与抑郁症、焦虑症或两者之间关系的病例对照或横断面研究也包括在内。结果：在抑郁症方面，来自11篇文章的1365例患者（694例HT对671例对照）被分析；对于焦虑症，纳入了来自8篇文章的1009例患者（516例HT对493例对照）。HT患者出现焦虑障碍的几率是前者的2.5倍（OR = 2.52, 95% CI: 1.66-3.82）。贝克抑郁量表的WMD为4.26 (95% CI: 1.28-7.24)，贝克焦虑量表的WMD为5.10 （95% CI: 1.55-8.66）。局限性：由于异质性、潜在的发表偏倚和评估工具的可变性，研究结果应谨慎解释，这可能限制推广。结论：与健康对照组相比，甲状腺功能亢进患者表现出更高的焦虑障碍患病率，并且根据贝克量表更容易出现焦虑和抑郁症状。甲状腺抗体本身也与抑郁症和焦虑症有关。

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引用次数: 0

A Festschrift for Janice Kiecolt-Glaser: At the origin of stress and immunity. 贾尼丝·基科特-格拉泽：压力和免疫的起源。

IF 2.1 Q3 ENDOCRINOLOGY & METABOLISM

Comprehensive psychoneuroendocrinology

Pub Date : 2024-11-05 eCollection Date: 2024-11-01 DOI: 10.1016/j.cpnec.2024.100277

Robert Dantzer

引用次数: 0

Experiences of participating in cortisol awakening response research: “I was more conscious than usual, I wanted to get it right” 参与皮质醇唤醒反应研究的经历："我比平时更清醒，我想把事情做好

IF 2.1 Q3 ENDOCRINOLOGY & METABOLISM

Comprehensive psychoneuroendocrinology

Pub Date : 2024-11-01 DOI: 10.1016/j.cpnec.2024.100276

Natasha Ramachandran, Nina Smyth, Sanjay Joban, Maria Flynn, Angela Clow, Lisa Thorn

Cortisol awakening response (CAR) research relies upon self-collected saliva sampling during the post-awakening period. It is unknown how the CAR protocol is perceived and how they may affect typical routines relevant to CAR methodology. CAR assessment is sensitive to state variables, suggesting that CAR measurement may be affected by research participation. This is the first qualitative study to explore motivation and experiences of participation in CAR research.

Interviews were conducted with a sample of 20 participants (males/females: 4/16) aged 46-82 years following their participation in CAR research in the domestic setting. Responses were transcribed verbatim and thematically analysed.

Participants were motivated to take part in CAR research for altruistic reasons and the apparent convenience of undertaking the study at home. Participants experienced the study as arduous describing apprehension and the cognitive burden it placed on them leading to disruptions to sleep and morning routines. Participants also struggled to identify the moment of awakening and there was uncertainty surrounding the timing of the first awakening sample. Disruptions were lessened with habituation to sampling on repeated study days.

There was apprehension about taking part in CAR research, affecting mood, cognition, and sleep; state variables known to influence the CAR. Findings inform ways to optimise CAR ‘ecological validity’ and obtain typical CAR characteristics. The ‘moment of awakening’, was not universally understood, leading to hesitancy in deciding when to collect saliva samples. Researchers need to include a specific discussion of the commonly experienced ambiguity surrounding awakening to increase awareness, lessen anxiety and highlight its importance.

皮质醇唤醒反应（CAR）研究依赖于在唤醒后时期自采唾液样本。目前还不清楚人们如何看待 CAR 方案，也不清楚这些方案会如何影响与 CAR 方法相关的典型例行程序。CAR 评估对状态变量很敏感，这表明 CAR 测量可能会受到研究参与的影响。本研究首次对参与 CAR 研究的动机和经历进行了定性研究。研究人员对 20 名参与者（男/女：4/16）进行了访谈，他们的年龄在 46-82 岁之间，都是在国内环境中参与 CAR 研究的。参与者参与 CAR 研究的动机是出于利他主义，而且在家中进行研究显然很方便。参与者体验到了研究的艰辛，描述了研究给他们带来的忧虑和认知负担，导致他们的睡眠和晨间作息被打乱。参与者也很难确定觉醒的时刻，而且第一个觉醒样本的时间也不确定。在重复研究的日子里，随着对取样的习惯化，扰乱情况有所缓解。参加 CAR 研究的人对影响情绪、认知和睡眠（已知会影响 CAR 的状态变量）感到担忧。研究结果为优化 CAR "生态有效性 "和获得典型 CAR 特征提供了参考。唤醒时刻 "没有得到普遍理解，导致在决定何时采集唾液样本时犹豫不决。研究人员需要对唤醒过程中普遍存在的模糊认识进行具体讨论，以提高意识、减轻焦虑并强调其重要性。

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引用次数: 0

Understanding psychological symptoms among Chinese college students during the COVID-19 Omicron pandemic: Findings from a national cross-sectional survey in 2023 了解 COVID-19 Omicron 大流行期间中国大学生的心理症状：2023 年全国横断面调查的结果

IF 2.1 Q3 ENDOCRINOLOGY & METABOLISM

Comprehensive psychoneuroendocrinology

Pub Date : 2024-11-01 DOI: 10.1016/j.cpnec.2024.100278

You Xin, Tianrui Ren, Xu Chen, Xin Liu, Yijin Wu, Shu Jing, Ling Zhang, Zhenwei Dai, Ye Wang, Xiaoyou Su

During the Omicron pandemic in late 2022, this study surveyed Chinese students via an online questionnaire to assess their mental health status, prevalence of psychological symptoms, and associated factors. A nationwide cross-sectional survey of 4254 participants was conducted in seven regions of China from January 5 to February 9, 2023. Scales were utilized respectively to measure depressive symptoms, anxiety symptoms, post-traumatic stress disorder (PTSD) symptoms, and perceived social support. Descriptive, univariate, and multivariable analyses were performed to identify associated factors. Protective factors against depressive symptoms include regular exercise and robust social support networks, while risk factors involve excessive alcohol consumption, comorbidities, Omicron infection, and irregular sleep patterns. Risk factors for anxiety symptoms include comorbidities, Omicron infection, living alone, and irregular sleep patterns, while social support emerges as a protective factor. For PTSD symptoms, regular exercise and strong social support systems are identified as protective measures, with risks associated with comorbidities, Omicron infection, and poor sleep quality. Students are particularly vulnerable during the pandemic due to their lifestyle and academic pressures. It's essential to bolster their social support and promote healthier habits.

在 2022 年末的欧米茄大流行期间，本研究通过在线问卷对中国学生进行了调查，以评估他们的心理健康状况、心理症状的发生率以及相关因素。本研究于 2023 年 1 月 5 日至 2 月 9 日在中国 7 个地区开展了一项全国性横断面调查，共有 4254 人参与。调查采用量表分别测量抑郁症状、焦虑症状、创伤后应激障碍（PTSD）症状和感知社会支持。通过描述性分析、单变量分析和多变量分析来确定相关因素。抑郁症状的保护因素包括经常锻炼和强大的社会支持网络，而风险因素则包括过度饮酒、合并症、Omicron 感染和不规律的睡眠模式。焦虑症状的风险因素包括合并症、奥米克隆感染、独居和不规律的睡眠模式，而社会支持则是一个保护因素。对于创伤后应激障碍症状，经常锻炼和强大的社会支持系统被认为是保护性措施，而风险则与合并症、奥米克隆感染和睡眠质量差有关。由于生活方式和学业压力，学生在大流行期间尤其脆弱。加强他们的社会支持和促进更健康的生活习惯至关重要。

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引用次数: 0

A randomized controlled clinical trial of a Wim Hof Method intervention in women with high depressive symptoms 针对抑郁症状严重女性的 Wim Hof 方法干预随机对照临床试验

IF 2.1 Q3 ENDOCRINOLOGY & METABOLISM

Comprehensive psychoneuroendocrinology

Pub Date : 2024-11-01 DOI: 10.1016/j.cpnec.2024.100272

Robin Blades , Wendy Berry Mendes , Brian P. Don , Stefanie E. Mayer , Rebecca Dileo , Julia O'Bryan , Elena Fromer , Joanna Y. Guan , Sylvia S. Cheng , Ashley E. Mason , Aric A. Prather , Elissa S. Epel

Objective

Stress is a driver of depression, and people with depression often struggle to cope with stress and anxiety. This study directly compares the mental health effects of a Wim Hof Method intervention to an active control condition (slow breathing) in women with high stress and high depressive symptoms.

Methods

We randomized 84 healthy midlife women with high stress and high depressive symptoms to either: 1) the hormetic stress condition based on the Wim Hof Method (WHM) involving a breathing technique designed to induce intermittent hypoxia and cold showers (n = 41) or 2) an active comparison condition involving slow-paced breathing and warm showers (n = 43). We provided participants with daily audio instructions (15 min) for three weeks during the COVID-19 pandemic (2020–2021). Our primary outcomes were depressive symptoms, anxiety symptoms, and perceived stress collected at pre-intervention, post-intervention, and 3 months later. We also assessed daily stress rumination and affect with daily diary during the intervention, and participants completed a laboratory stressor, the Trier Social Stress Test, before and after the intervention, and provided samples for salivary cortisol reactivity.

Results

Participants in the active control condition perceived the intervention to be more credible and expected greater mental wellbeing benefits compared to those in the Wim Hof Method condition. Differential attrition was observed with six participants (7 %) dropping out -- all from WHM condition. Among the participants who completed the intervention, both groups improved on mental health outcomes immediately after the intervention with a 24 % reduction in depressive symptoms, a 27 % reduction in anxiety symptoms, and 20 % reduction in perceived stress. Improvements were maintained at the 3-month follow-up with 46 % of the sample reporting mild or no depressive symptoms. Participants in the WHM condition had significant reductions in rumination after daily stressful events compared to those in the active control group. Both conditions had reduced daily negative affect across the intervention and lower peak cortisol reactivity to the lab stressor post-intervention.

Conclusions

Counter to the preregistered predictions, and despite participants’ differing expectations, the interventions led to equivalent reductions in depressive symptoms, anxiety symptoms, and perceived stress, which were sustained at three months. They also produced comparable reductions in cortisol reactivity and daily negative affect. However, the WHM condition was associated with greater reduction in reported rumination after daily stressful events than the active control, a finding that needs replication with larger and more diverse samples.

目标压力是抑郁症的诱因之一，而抑郁症患者往往难以应对压力和焦虑。本研究直接比较了 Wim Hof 方法干预措施与积极对照条件（缓慢呼吸）对高压力和高抑郁症状女性的心理健康影响：1）基于 Wim Hof 方法（WHM）的荷尔蒙压力条件，包括旨在诱发间歇性缺氧的呼吸技术和冷水淋浴（n = 41）；或 2）积极的对比条件，包括慢节奏呼吸和温水淋浴（n = 43）。在 COVID-19 大流行期间（2020-2021 年），我们为参与者提供了为期三周的每日音频指导（15 分钟）。我们的主要结果是在干预前、干预后和 3 个月后收集的抑郁症状、焦虑症状和感知压力。在干预期间，我们还通过每日日记对参与者的日常压力反刍和情绪进行了评估，参与者在干预前和干预后完成了一项实验室压力测试--特里尔社会压力测试，并提供了唾液皮质醇反应性样本。观察到了不同的流失情况，有六名参与者（7%）退出了干预，他们都来自 "WHM "条件下。在完成干预的参与者中，两组人在干预后都立即改善了心理健康结果，抑郁症状减少了 24%，焦虑症状减少了 27%，感知压力减少了 20%。在 3 个月的随访中，改善效果得以保持，46% 的样本报告抑郁症状轻微或没有抑郁症状。与积极对照组的参与者相比，在日常压力事件发生后，妇女健康管理组的参与者的反刍明显减少。结论与预先登记的预测相反，尽管参与者有不同的期望，但干预措施对抑郁症状、焦虑症状和感知压力的减轻效果相当，并在三个月后得以持续。它们对皮质醇反应性和日常负面情绪也产生了类似的抑制作用。然而，与积极对照组相比，妇女健康管理组在日常压力事件后报告的反刍减少得更多，这一发现需要在更大规模和更多样化的样本中进行验证。

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引用次数: 0

Is the Mannheim Multicomponent Stress Test a viable alternative to the Trier Social Stress Test? 曼海姆多成分压力测试是特里尔社会压力测试的可行替代方案吗？

IF 2.1 Q3 ENDOCRINOLOGY & METABOLISM

Comprehensive psychoneuroendocrinology

Pub Date : 2024-11-01 DOI: 10.1016/j.cpnec.2024.100275

Daniel S. Kashi, Marianne Hunter, Jason P. Edwards, Harry Bell, Megan Robinson, Neil P. Walsh

Background

The Trier Social Stress Test (TSST) is a widely used laboratory protocol to study acute stress reactivity, a hallmark of which is a meaningful increase in saliva cortisol (>2.5 nmol/L) in most individuals, reflecting hypothalamic-pituitary-adrenal (HPA) axis activation. The Mannheim Multicomponent Stress Test (MMST) has potential as a low staff burden alternative to the TSST, with one study showing statistically significant increases in subjective stress, heart rate and saliva cortisol; however, uncertainty remains about the meaningfulness of these psychobiological responses.

Objective

To assess whether the MMST is a viable alternative to the TSST.

Methods

Using a between subjects design, 31 healthy adults were randomised to the standard TSST or the MMST using stratified block randomisation accounting for sex and trait anxiety. The standard TSST consisted of an anticipation phase, followed by a free speech and mental arithmetic task performed in front of a panel of trained actors. The MMST consisted of a computer based Paced Auditory Serial Addition Task (cognitive stressor) with additional motivational, emotional and acoustic stressors in the presence of one unresponsive observer.

Results

Group × time interactions showed that the MMST induced smaller psychobiological responses compared with the TSST (mixed model ANCOVA, P < 0.05). Post-hoc analyses revealed that the MMST induced a significant yet smaller state anxiety response (score range 20–80, MMST: 47 ± 12 vs. TSST: 57 ± 9; P < 0.01, Cohens d = 0.9) and peak heart rate response (MMST: 98 ± 17 vs. TSST: 110 ± 21 bpm; P < 0.05, Cohens d = 0.6) compared with the TSST. Despite observing stereotypical neuroendocrine responses to the TSST, the MMST did not increase saliva α-amylase or cortisol (Δ saliva cortisol, 0.1 ± 1.1 vs. TSST: 10.3 ± 12.8 nmol/L; between group difference P < 0.01, Cohens d = 1.1). Moreover, meaningful increases in saliva cortisol (>2.5 nmol/L) were observed in 80% of participants after the TSST but in no participant after the MMST.

Conclusion

The Mannheim Multicomponent Stress Test increased state anxiety and heart rate but not saliva cortisol. As such, the present results do not support the utility of the Mannheim Multicomponent Stress Test as a viable alternative to The Trier Social Stress Test.

背景特里尔社会压力测试（TSST）是一种广泛使用的实验室方案，用于研究急性压力反应性，其特点是大多数人的唾液皮质醇（2.5 nmol/L）会显著增加，反映出下丘脑-垂体-肾上腺（HPA）轴的激活。曼海姆多组分压力测试（MMST）具有替代TSST的低人员负担潜力，一项研究显示，主观压力、心率和唾液皮质醇的增加具有统计学意义；但是，这些心理生物学反应的意义仍不确定。方法采用受试者间设计，使用分层区组随机法（考虑性别和特质焦虑）将31名健康成年人随机分配到标准TSST或MMST。标准 TSST 包括一个预期阶段，然后在一组训练有素的演员面前完成自由言论和心算任务。MMST包括一项基于计算机的步调听觉连续加法任务（认知压力源）以及额外的动机、情绪和声音压力源，并有一名无反应的观察者在场。结果组×时间的交互作用表明，与TSST相比，MMST引起的心理生物反应较小（混合模型方差分析，P < 0.05）。事后分析表明，与 TSST 相比，MMST 诱导的状态焦虑反应（得分范围为 20-80，MMST：47 ± 12 vs. TSST：57 ± 9；P <；0.01，Cohens d = 0.9）和心率峰值反应（MMST：98 ± 17 vs. TSST：110 ± 21 bpm；P <；0.05，Cohens d = 0.6）显著但较小。尽管观察到了 TSST 的刻板神经内分泌反应，但 MMST 并未增加唾液中的α-淀粉酶或皮质醇（Δ唾液皮质醇：0.1 ± 1.1 vs. TSST：10.3 ± 12.8 nmol/L；组间差异 P < 0.01，Cohens d = 1.1）。结论曼海姆多组分压力测试增加了状态焦虑和心率，但没有增加唾液皮质醇。因此，目前的结果并不支持将曼海姆多成分压力测试作为特里尔社会压力测试的可行替代方法。

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引用次数: 0

Oxytocin: Not "just a female hormone": A very special issue and a very special molecule. 催产素：不仅仅是女性荷尔蒙一个非常特别的问题和一种非常特别的分子。

IF 2.1 Q3 ENDOCRINOLOGY & METABOLISM

Comprehensive psychoneuroendocrinology

Pub Date : 2024-10-31 eCollection Date: 2024-11-01 DOI: 10.1016/j.cpnec.2024.100273

C Sue Carter, Rose-Marie Bluthé, Jessica J Connelly, Marcy A Kingsbury

For decades it was believed that oxytocin was "just a female hormone." This was a mistake. In the 21st century it has become clear that oxytocin arose from ancient roots, and acquired dozens of diverse functions throughout the mammalian body. This Special Issue of Comprehensive Psychoneuroendocrinology brings together a series of fifteen papers describing different facets and functions of oxytocin. Each author was invited to describe her perspectives on oxytocin, as well as to share experiences that led them to study this remarkable molecule. Many of these stories are highly personal and set in the context of what it means to be a female and to be an academic scientist. Oxytocin is not "just" a female hormone and these articles are not "just" routine descriptions of scientific facts. The readers are invited to join us in a celebration of the molecule that made us human.

几十年来，人们一直认为催产素 "只是一种女性荷尔蒙"。这是一个错误。在 21 世纪，人们已经清楚地认识到，催产素起源于远古，在哺乳动物体内具有数十种不同的功能。本期《综合精神神经内分泌学》特刊汇集了 15 篇系列论文，介绍催产素的不同方面和功能。每位作者都应邀阐述了自己对催产素的看法，并分享了促使他们研究这种非凡分子的经历。其中许多故事都非常个人化，并以女性和学术科学家的身份为背景。催产素 "不仅仅 "是一种女性荷尔蒙，这些文章也 "不仅仅 "是对科学事实的例行描述。我们邀请读者与我们一起庆祝这一造就人类的分子。

引用次数: 0

Introduction to the special issue: A festschrift for Janice Kiecolt-Glaser - At the origin of stress and immunity. 特刊导言：贾尼斯·基科尔特-格拉泽的纪念——压力和免疫的起源。

IF 2.1 Q3 ENDOCRINOLOGY & METABOLISM

Comprehensive psychoneuroendocrinology

Pub Date : 2024-10-31 eCollection Date: 2024-11-01 DOI: 10.1016/j.cpnec.2024.100274

Christopher Fagundes

This special issue of Comprehensive Psychoneuroendocrinology pays tribute to Janice Kiecolt-Glaser's groundbreaking career and marks her well-earned retirement. As a leader in human psychoneuroimmunology (PNI), Kiecolt-Glaser transformed the domain by showing that everyday stressors, along with significant life events, can significantly affect the immune system. Her groundbreaking research on informal dementia caregivers revealed the detrimental effects of chronic psychological stress, including delayed wound healing, virus reactivation, heightened proinflammatory cytokine levels, and weakened vaccine responses. This issue features contributions from her former mentees and collaborators, reflecting the enduring influence of her mentorship and research. Few psychologists in PNI have matched her mentorship legacy, and the included works showcase the ways her guidance has shaped their scientific careers. These articles explore new frameworks for integrating affective science with immune health, interventions designed for couples managing chronic illness, and studies examining the immune consequences of relational dynamics. Personal reflections from her trainees and collaborators highlight Kiecolt-Glaser's unique ability to balance rigorous expectations with unwavering support, fostering their professional growth. Collectively, this special issue illustrates how Kiecolt-Glaser's scholarship continues to advance the field, pushing the boundaries of interdisciplinary inquiry. Her influence on the next generation of scientists ensures that her legacy will remain central to PNI, reinforcing the critical role of relationships in health and disease.

本期《综合精神神经内分泌学》特刊旨在向 Janice Kiecolt-Glaser 开创性的职业生涯表示敬意，并纪念她当之无愧的退休。作为人类心理神经免疫学（PNI）领域的领军人物，Kiecolt-Glaser 证明了日常压力和重大生活事件会对免疫系统产生重大影响，从而改变了这一领域。她对痴呆症非正规护理人员的开创性研究揭示了长期心理压力的有害影响，包括伤口愈合延迟、病毒再激活、促炎细胞因子水平升高以及疫苗反应减弱。本期刊物收录了她的前学员和合作者的文章，反映了她的指导和研究的持久影响力。PNI中很少有心理学家能与她的导师遗产相媲美，所收录的作品展示了她的指导如何塑造了他们的科学生涯。这些文章探讨了将情感科学与免疫健康相结合的新框架、为夫妻管理慢性疾病而设计的干预措施，以及对关系动态的免疫后果进行的研究。来自她的学员和合作者的个人感想突出了 Kiecolt-Glaser 在严格要求和坚定支持之间取得平衡的独特能力，促进了他们的专业成长。总之，这本特刊展示了 Kiecolt-Glaser 的学术成就如何不断推动这一领域的发展，突破跨学科研究的界限。她对下一代科学家的影响确保了她的遗产仍将是 PNI 的核心，加强了人际关系在健康和疾病中的关键作用。

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引用次数: 0

Perceived partner responsiveness alters the association between marital distress and well-being in dementia spousal caregivers 感知到的伴侣响应能力会改变痴呆症配偶照顾者的婚姻痛苦与幸福之间的关系

IF 2.1 Q3 ENDOCRINOLOGY & METABOLISM

Comprehensive psychoneuroendocrinology

Pub Date : 2024-10-18 DOI: 10.1016/j.cpnec.2024.100271

Vincent D. Lai , Jensine Paoletti-Hatcher , E. Lydia Wu-Chung , Itee Mahant , Daniel L. Argueta , Kelly N. Brice , Bryan T. Denny , Charles Green , Luis D. Medina , Paul E. Schulz , Jennifer M. Stinson , Cobi J. Heijnen , Christopher P. Fagundes

Caregivers for spouses with Alzheimer's disease and related dementias (ADRD) experience drastic changes in the marital relationship that may put them at risk for worsening well-being. Perceived partner responsiveness, or feeling cared for, understood, and appreciated by one's spouse, may help mitigate these effects. In this study, we investigated the associations between marital distress, perceived partner responsiveness, and psychological and physiological well-being indicators among ADRD spousal caregivers.

Method

A sample of 161 caregivers provided blood samples and completed self-report measures of marital distress, perceived partner responsiveness, and depressive symptoms. We tested hypotheses in our sample cross-sectionally based on two theoretical frameworks.

Results

Testing the marital discord model of depression, caregivers who reported greater marital distress also reported more depressive symptoms, and this association was stronger as participants reported lower perceived partner responsiveness. Caregivers who reported greater marital distress exhibited elevated proinflammatory cytokine production by in vitro lipopolysaccharide (LPS)-stimulated peripheral blood leukocytes at low levels of perceived partner responsiveness, but not mean or high levels. Testing the vulnerability-stress-adaptation model, caregivers who reported more depressive symptoms also reported greater marital distress. Further, caregivers who exhibited elevated LPS-stimulated proinflammatory cytokine production reported greater marital distress at mean and high levels of perceived partner responsiveness, but not low levels. These patterns of results held even when accounting for the dementia stage and reported hours of caregiving per day.

Discussion

This study's findings contribute to the body of research examining interpersonal factors that shape health and well-being among the caregiver population.

阿尔茨海默病及相关痴呆症（ADRD）患者配偶的照顾者会经历婚姻关系的急剧变化，这可能使他们面临幸福感恶化的风险。感知到的伴侣响应能力，或感觉到配偶的关心、理解和赞赏，可能有助于减轻这些影响。在这项研究中，我们调查了 ADRD 配偶照顾者的婚姻困境、感知伴侣响应度与心理和生理幸福感指标之间的关联。方法：161 名照顾者提供了血液样本，并完成了婚姻困境、感知伴侣响应度和抑郁症状的自我报告测量。我们根据两个理论框架对样本中的假设进行了横截面测试。结果在测试抑郁症的婚姻不和谐模型时，报告了较多婚姻困扰的照顾者也报告了较多抑郁症状，并且这种关联在参与者报告了较低的感知伴侣响应度时更为强烈。在感知伴侣响应度较低的情况下，体外脂多糖（LPS）刺激的外周血白细胞会分泌更多的促炎细胞因子，而在感知伴侣响应度较高或较低的情况下，这种现象则不会出现。通过检验脆弱性-压力-适应模型，发现抑郁症状较多的照顾者的婚姻问题也较严重。此外，LPS 刺激促炎细胞因子分泌增加的照顾者在感知到伴侣反应性的平均水平和高水平上报告了更大的婚姻困扰，而在低水平上则没有。即使考虑到痴呆症阶段和报告的每天护理时数，这些结果模式仍然成立。讨论这项研究的发现为研究影响护理人群健康和幸福的人际因素做出了贡献。

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引用次数: 0

Distress and inflammation are independently associated with cancer-related symptom severity 苦恼和炎症与癌症相关症状的严重程度独立相关

IF 2.1 Q3 ENDOCRINOLOGY & METABOLISM

Comprehensive psychoneuroendocrinology

Pub Date : 2024-10-11 DOI: 10.1016/j.cpnec.2024.100269

Tamara E. Lacourt , D. Tripathy , Maria C. Swartz , Emily C. LaVoy , Cobi J. Heijnen

Objective

To evaluate longitudinal associations of distress and inflammation with somatic and depressive symptom severity in breast cancer patients, from before to six months after neoadjuvant chemotherapy. We also explored feasibility and effects of an early mindfulness-based intervention for preventing or reducing somatic and depressive symptoms.

Methods

Longitudinal pilot study with a randomized waitlist-controlled intervention design. Women with breast cancer were randomized to receive access to a smartphone application offering meditation exercises, either immediately after baseline testing (intervention group) or after study completion (control group) in a 1:1 ratio. Assessments (self-report questionnaires and a blood draw when feasible) were completed before, halfway through, immediately after, and 6 months after completing neoadjuvant chemotherapy.

Results

Fifty evaluable women were enrolled. Somatic symptom severity increased during chemotherapy, whereas depressive symptom severity was at its peak before treatment and declined gradually thereafter. Distress was positively associated with depressive symptom severity. Only Distress Thermometer-results were positively associated with somatic symptom severity. Inflammation was positively associated with both types of symptoms, and distress did not moderate the associations between inflammation and symptom severity. Intervention adherence was low and no intervention effect on symptom experience was observed.

Conclusion

Inflammation and distress are independently associated with somatic and depressive symptoms experienced during breast cancer treatment.

目的评估乳腺癌患者从新辅助化疗前到化疗后六个月期间的痛苦和炎症与躯体症状和抑郁症状严重程度之间的纵向关联。我们还探讨了以正念为基础的早期干预措施在预防或减轻躯体症状和抑郁症状方面的可行性和效果。患有乳腺癌的妇女按 1:1 的比例被随机分配到提供冥想练习的智能手机应用中，或者在基线测试后立即进行冥想练习（干预组），或者在研究完成后进行冥想练习（对照组）。在完成新辅助化疗前、化疗中途、化疗后和化疗后 6 个月，分别完成评估（自我报告问卷和抽血）。躯体症状的严重程度在化疗期间有所增加，而抑郁症状的严重程度在治疗前达到高峰，之后逐渐下降。躯体不适与抑郁症状严重程度呈正相关。只有 "压力温度计 "的结果与躯体症状的严重程度呈正相关。炎症与这两类症状均呈正相关，而苦恼并不能缓和炎症与症状严重程度之间的关联。结论炎症和痛苦与乳腺癌治疗过程中出现的躯体症状和抑郁症状独立相关。

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