Despite the importance of daily stress to individuals' health and wellbeing, few studies have explored where stress happens in real time, that is, dynamic stress processes in different spaces. As such, stress interventions rarely account for the environment in which stress occurs. We used mobile phone based ecological momentary assessment (EMA) to collect daily stress data. Thirty-three participants utilized a mobile-phone-based EMA app to self-report stressors as they went about their daily lives. Geographic coordinates were automatically collected with each stress report. Data from thematic analysis of stressors by location (home, work, work from home, other) were used to determine whether certain stressors were more prevalent in certain environments. Nine daily stressors significantly differed by location. Work-related stress was reported more often at work. Pets, household chores, sleep, and media-related stressors were reported most at home. Physical illnesses, vehicle issues, and safety/security stressors occurred most often while participants were “working from home.” Traffic-related stress was experienced more commonly in “other” environments. Other 18 stressors were generated regardless of location, suggesting that these stressors were persistent and without respect to location. Study findings expand the understanding of environments in which specific stressors occur, providing baseline data for potential targeted “just-in-time” stress interventions tailored to unique stressors in specific environments. We also provide findings related to the “work from home” phenomenon. Further work is needed to better understand the unique stressors among the large number of individuals who transitioned to working from home during and after the COVID-19 pandemic.
Caregivers may play an essential role in buffering and/or exacerbating coronavirus disease 2019 (COVID-19) fears and behaviors in youth. However, few studies have examined these associations in children from racial or ethnic minority groups, who have been historically marginalized and may be disproportionately susceptible to psychological consequences. Here, we examined the associations among caregivers and children in COVID-19-related fears, behaviors, and impact in a majority Black (71.9%) sample of children. Children (N = 64, 24 females, ages 7–10 years) were recruited from three Detroit, Michigan-area schools during the 2019–2020 school year. Following school shutdowns in March 2020, children and their caregivers were invited to complete remote surveys in May and August 2020. We examined the associations among child and caregiver COVID-19-related fears, preventive behaviors, and perceived impact. We also examined whether aspects of the caregiver–child relationship (i.e., closeness, conflicts) moderated these associations. Caregiver–child fears about social distancing, preventive behaviors, and the perceived impact of COVID-19 were positively correlated. The positive correlation between caregiver–child preventive behaviors strengthened over time and was moderated by caregiver–child closeness. These findings suggest that caregivers may impact fear as well as preventive behaviors and perceived impact of the pandemic in marginalized youth.
Posttraumatic stress disorder (PTSD) affects many military veterans. Given limited success of and barriers to conventional treatments, increasing interest is being paid to mind-body therapy approaches. However, little evidence exists on whether these have the potential to treat traumatic stress. The aim of this study was to compare 6 months of hands-on mind-body therapy as an add-on to treatment as usual (TAU) with TAU alone. Participants with PTSD resulting from active military service were randomly assigned to the intervention group or treatment-as-usual (TAU) group. The intervention group received 24 hands-on manipulative mind-body therapy sessions during 6 months as add-on to TAU. The primary outcome was the PTSD Checklist-Military version (PCL-M) at 6 months (postintervention). Outcome measurements were obtained at four time points; baseline, 3 months (midway), 6 months (postintervention), and 12 months (follow-up). Intention-to-treat analysis was done masked to allocation. A total of 42 participants were randomized (22 control, 20 intervention). In the intervention group, two discontinued the mind-body therapy. At postintervention, participants who had received mind-body treatment demonstrated greater reduction in PTSD severity (PCL-M scores between-group mean difference: −11.1, 95% CI −17.9 to −4.2, p = 0.002, effect size d = 1.06). At follow-up, PCL-M scores were not statistically significant between groups (between-group difference: −4.65, 95% CI −11.8 to 1.50). Post hoc analysis showed that number of participants remitting from PTSD from baseline to follow-up was 25% in the intervention group and 0% in the control group. Our study showed that hands-on mind-body therapy over 6 months produced clinically significant decrease in PTSD symptoms. The large reduction in symptoms was not maintained 6 months after the intervention period. Further research on mind-body therapy as adjunctive PTSD treatment is warranted.
Sexual trauma (ST) occurs with alarming frequency in the United States in the form of both childhood sexual abuse (CSA) and adulthood sexual assault (ASA). It is well established that the effects of ST are pervasive and that ST can be a risk factor for the development of several psychiatric disorders. However, the potential for distinct psychological consequences or neural correlates between CSA and ASA has received little attention. Furthermore, despite the high prevalence of sexual revictimization, the combinatorial effects of CSA and ASA are understudied in comparison to each form of ST on its own. In the current review, we present results from both clinical psychology and neuroscience research on the impacts of CSA and ASA, describing major psychological, biopsychosocial, and neuroimaging findings for each form of ST. We further highlight limitations in the current state of the research and needed areas of future research to better understand the distinct, overlapping, and cumulative effects of ST in both childhood and adulthood. The present study summarizes the state of the literature on this critical form of trauma and provides recommendations for future clinical research practices to mitigate the deleterious outcomes of ST.
Family caregivers' role in sending their mentally ill relatives to the mental health service (MHS) has been vital in the era of community mental healthcare. They are the determinants of where mentally ill relatives are sent for care. There is currently no evidence about the motivators of MHS use among these major stakeholders in the Bolgatanga municipality. This study, therefore, sought to explore the perceived utilization and the motivating factors for the utilization of MHS in the Bolgatanga municipality. A descriptive qualitative study design was employed to conduct the study in two health facilities (Presbyterian Psychiatric Hospital and the Upper East Regional Hospital). A semi-structured interview guide was used to conduct in-depth interviews among 19 purposively sampled participants consisting of 15 family caregivers of mentally ill relatives, two MHS providers, and two MHS administrators. Audio-recorded interviews were transcribed verbatim and thematically analyzed. Two main themes emerged including perceived utilization of MHS by family caregivers and motivating factors for the utilization of MHS. The study showed that most participants sought MHS for their mentally ill relatives. The study further identified multilevel factors such as individual factors, interpersonal factors, organizational factors, and policy-level factors that motivated the utilization of MHS in the Bolgatanga municipality. There is a need to embark on activities that will further strengthen the factors that have been identified as motivators to encourage the continuous utilization of MHS in the municipality.
The prevalence of alcohol-use disorders is higher amongst adults experiencing homelessness (AEH) compared with domiciled adults. Greater exposure to heavy drinkers increases personal risk for heavy alcohol use. AEH spend substantial periods of time at shelters and report greater pressure to use alcohol when near shelter locations, as well as greater negative affect when near a shelter. It is unclear if the relationship between affect and (1) interacting with people and (2) being near someone AEH drank alcohol with before differs when AEH are at a shelter versus not. AEH reporting alcohol misuse (n = 72, Mage = 47, 85% male, 68% non-White) completed five daily smartphone-based ecological momentary assessments over 28 days. Generalized multilevel modeling revealed that when AEH were interacting with someone they drank with before, they had significantly lower positive affect when at a shelter (b = −0.17, p = 0.05) versus when not (b = 0.00, p = 0.99). AEH are likely to interact with previous drinking partners while at shelters. It may be important to deliver real-time treatment messages targeting affect in these moments, as well as deliver alcohol reduction/abstinence messages.
Catastrophizing is a transdiagnostic construct that has been suggested to precipitate and maintain a multiplicity of psychiatric disorders, including anxiety, depression, post-traumatic stress disorder, and obsessive-compulsive disorder. However, the underlying cognitive mechanisms that result in catastrophizing are unknown. Relating reinforcement learning model parameters to catastrophizing may allow us to further understand the process of catastrophizing. Using a modified four-armed bandit task, we aimed to investigate the relationship between reinforcement learning parameters and self-report catastrophizing questionnaire scores to gain a mechanistic understanding of how catastrophizing may alter learning. We recruited 211 participants to complete a computerized four-armed bandit task and tested the fit of six reinforcement learning models on our data, including two novel models which both incorporated a scaling factor related to a history of negative outcomes variable. We investigated the relationship between self-report catastrophizing scores and free parameters from the overall best-fitting model, along with the best-fitting model to include history, using Pearson's correlations. Subsequently, we reassessed these relationships using multiple regression analyses to evaluate whether any observed relationships were altered when relevant IQ and mental health covariates were applied. Model-agnostic analyses indicated there were effects of outcome history on reaction time and accuracy, and that the effects on accuracy related to catastrophizing. The overall model of best fit was the Standard Rescorla–Wagner Model and the best-fitting model to include history was a model in which learning rate was scaled by history of negative outcome. We found no effect of catastrophizing on the scaling by history of negative outcome parameter (r = 0.003, p = 0.679), the learning rate parameter (r = 0.026, p = 0.703), or the inverse temperature parameter (r = 0.086, p = 0.220). We were unable to relate catastrophizing to any of the reinforcement learning parameters we investigated. This implies that catastrophizing is not straightforwardly linked to any changes to learning after a series of negative outcomes are received. Future research could incorporate further exploration of the space of models which include a history parameter.
In 2020, the novel severe acute respiratory syndrome coronavirus outbreak emerged as a public health emergency. Three years later, we are still assessing the effects caused by the coronavirus disease (COVID-19) and by the lifestyle changes due to prevention measures, like social isolation. Here, we assessed the profile of both the anxiety screening scores and anthropometric variables in the university community, associated with the isolation due to the COVID-19 pandemic. We analyzed social and epidemiological associated factors for anxiety and weight change to address and better identify the physical and mental conditions aggravated during the pandemic. This is a cross-sectional study based on the 7-item Generalized Anxiety Disorder Scale questionnaire applied virtually to university students and professors in the State of Rio de Janeiro (n = 480). In our population cohort, we showed that the majority of individuals showed moderate to severe anxiety and increased body weight during the COVID-19 pandemic. The major demographic associated factors for higher anxiety levels were young age, female gender, and low family income. The main modifiable associated factors for both anxiety and weight gain were the negative changes in living habits. In addition, there was a trend toward severe anxiety and greater weight change in people with increased time in social isolation. In view of these results, we suggest that bad habits, adopted during the COVID-19 pandemic, were the main reason for the high anxiety levels found in the studied population.
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