Life Change Events

Background: Suicide is a major global concern, causing over 700,000 deaths annually and ranking as the fourth leading cause of death among 15-29-year-olds. Medical students are at heightened risk, with thoughts of suicide often emerging at the beginning of their medical education. Identifying and addressing this issue by finding out the prevalence of suicidal ideation and associated factors among medical undergraduates was the main aim of our study. Methodology: A Cross-sectional study was conducted in medical colleges of Kozhikode district, North Kerala using World Mental Health survey initiative version of the World Health Organization Composite International Diagnostic Interview (WHO-CIDI). Students from all academic years who were willing to participate were included through consecutive sampling. Results: The study found that 28.9% of medical students experienced suicidal ideation after enrolling in medical school. Substance abuse, h/o psychiatric illnesses in students, comorbidities, sleeping difficulties, psychiatric illnesses in family, suicides in family and experiencing stressful events during the course were factors significantly associated with suicidal ideation. Conclusions: This study observed a high prevalence of suicidal ideation among medical students. And the factors associated were joining MBBS without selfinterest, substance abuse, history of psychiatric illness, psychiatric illness in the family, stressful events, co-morbidities and sleeping difficulties.

Objective: When counseling women experiencing intimate partner violence (IPV), healthcare providers can benefit from understanding the factors contributing to a women's motivation to change her situation. We wished to examine the various factors and situations associated with turning points and change seeking in the IPV situation. Methods: We performed qualitative analysis on data from 7 focus groups and 20 individual interviews with women (61 participants) with past and=or current histories of IPV. Results: The turning points women identified fell into 5 major themes: (1) protecting others from the abuse=abuser; (2) increased severity=humiliation with abuse; (3) increased awareness of options=access to support and resources; (4) fatigue=recognition that the abuser was not going to change; and (5) partner betrayal=infidelity. Conclusions: Women experiencing IPV can identify specific factors and events constituting turning points or catalyst to change in their IPV situation. These turning points are dramatic shifts in beliefs and perceptions of themselves, their partners, and=or their situation that alter the women's willingness to tolerate the situation and motivate them to consider change. When counseling women experiencing IPV, health providers can incorporate understanding of turning points to motivate women to move forward in their process of changing their IPV situation.

Objectives. The current study examined the types of borderline personality profiles, associated psychological disorders and stressful life‐events.Design. Data from the British Psychiatric Morbidity Survey were used to examine homogeneous subtypes of participants based on their responses to nine borderline personality disorder (BPD) criteria.Methods. Latent class analysis (LCA) was used to identify homogeneous groups, or classes, of individuals. A multinomial logistic regression model was used to estimate the association between classes and associated psychological disorders and stressful life‐events.Results. A 4‐class solution provided the best fit, ranging from a class with a low probability of showing any BPD symptoms to a class whose members had a relatively high probability of endorsing all criteria. Severity of BPD was associated with higher co‐morbidity and higher stressful life‐events.Conclusions. Results suggest that four discrete classes make up the borderline continuum.

Impulsivity appears to play an important role in suicidal behavior. The aim of this cross-sectional study was to compare the impulsivity, substance abuse, and family/friends history of suicide attempt between suicide-ideated and non suicide-ideated university students. The research population consisted of all the students of the University of Isfahan in the academic year of 2009-2010. Three hundred and forty students (136 boys and 204 girls) were selected randomly through cluster sampling, of whom 53 participants were suicide-ideated and the rest were non suicide-ideated. The instruments used in this study were the 11(th) version of Barratt Impulsivity Scale, Suicide Ideation Questionnaire, and the demographic questionnaire. Descriptive statistics and multivariate analysis of variance were used to examine hypothesis. There was a significant difference between suicide ideated and non-suicide ideated subjects in impulsivity (F=3.83, p< 0.001). Accordingly, significant differences w...

The present study aimed to investigate the effects of spiritual well-being and family protective factors on the family strength in a propositional structural model. The research population consisted of all the married people of the Isfahan, Iran, in 2012 with preschool-aged children and in the first decade of marriage with at least eight grades of educational level. Three hundred and ninety five voluntary and unpaid participants were selected randomly through multi-stage sampling from seven regions of the city. The instruments used were the Spiritual Well-being Scale, Inventory of Family Protective Factors, and Family Strength Scale. Descriptive statistics and a structural equation modeling analytic approach were used. The analytic model predicted 82% of the variance of the family strength. The total effect of the spiritual well-being on the family strength was higher compared to the family protective factors. Furthermore, spiritual well-being predicted 43% of the distribution of th...

Objective-Summarize and evaluate the state of knowledge regarding the role of measured gene by environment interactions in relation to ADHD. Method-A selective review of methodological issues is followed by a systematic search for relevant articles on measured GxE; the search yielded 16 studies, which are discussed in qualitative fashion. Results-Relatively consistent evidence points to the interaction of genotype with psychosocial factors in the development of ADHD. The next step is to identify the mechanisms on the environment side and the gene combinations on the genetic side accounting for this effect. By contrast, evidence for gene-environment interactions involving pre-and peri-natal risk factors is generally negative or unreplicated. The aggregate effect size for psychosocial interaction with genotype is more than double that for the interaction of pre-and perinatal risks with genotype. Only a small fraction of candidate environments and gene markers have been studied, and multivariate methods to integrate multiple gene or environment markers have yet to be implemented. Conclusions-GxE appears likely to prove fruitful in understanding the etiology of ADHD. Findings to date already suggest new avenues of investigation particularly involving psychosocial mechanisms and their interplay with genotype. Further pursuit of theoretically promising leads is recommended.

BackgroundThere is some evidence that early sexual abuse is an aetiological factor for eating disorder. However, there is sparse information from large-scale, non-clinical studies.AimsThis study was designed to explore which early experiences, recalled during pregnancy, were associated with both lifetime and antenatal eating disorder symptoms in a community sample.MethodUnivariate and multivariate analyses were conducted of data from questionnaires administered during pregnancy to a community sample of pregnant women.ResultsRecall of parental mental health problems and of early unwanted sexual experiences were independently associated with both lifetime eating problems, laxative use and vomiting during pregnancy, and marked concern during pregnancy over shape and weight.ConclusionsThere are public health implications for these results. Eating disorders in mothers represent a risk for child development. It may be important to enquire during pregnancy about a history of eating problem...

BackgroundEvidence for an effect of work stressors on common mental disorders (CMD) has increased over the past decade. However, studies have not considered whether the effects of work stressors on CMD remain after taking co-occurring non-work stressors into account.MethodData were from the 2007 Adult Psychiatric Morbidity Survey, a national population survey of participants ⩾16 years living in private households in England. This paper analyses data from employed working age participants (N=3383: 1804 males; 1579 females). ICD-10 diagnoses for depressive episode, generalized anxiety disorder, obsessive compulsive disorder, agoraphobia, social phobia, panic or mixed anxiety and depression in the past week were derived using a structured diagnostic interview. Questionnaires assessed self-reported work stressors and non-work stressors.ResultsThe effects of work stressors on CMD were not explained by co-existing non-work stressors. We found independent effects of work and non-work stres...

There is consensus that supporting fathers' involvement in their children's care is essential and that nurses can play an important role, facilitating this process. There is little evidence about how nurses' education as family nurses enable them to work with fathers. This study aimed to explore undergraduate nursing students' perceptions of their experience with fathers during family nursing clinical practicum. An exploratory descriptive qualitative study allowed twelve nursing students to participate in a one-hour interview, at a university of Central Canada. The critical incident technique was used for data collection and analysis was done with N Vivo7. Four themes reflected students' experiences: Experiencing critical events with fathers; Perceiving fathers and father involvement as important; Building a relationship with fathers and Reflecting upon formal education and clinical practicum. Family nurses need to revisit their attitudes towards fathers and make space for this important member of the family in health care situations.

Background: Since the late 1980s, the Lord's Resistance Army (LRA), a spiritualist rebel group in northern Uganda, has killed and mutilated thousands of civilians and abducted an estimated 52,000 to 75,000 people to serve as soldiers, porters, and sex slaves for its commanders. This study examines the types of violence to which former abductees have been exposed and the extent to which these acts have affected their psychological well-being. Methods: This is a cross-sectional study of 2,875 individuals selected through a multi-stage stratified cluster sampling design conducted in 8 districts of northern Uganda. Multivariate logistic regressions were performed with symptoms for Post-traumatic Stress Disorder (PTSD) and depression as the main outcome measures. Results: One-third of the respondents (33%) self-reported having experienced abduction (49% among the Acholi, the largest tribal group in northern Uganda). Over half (56%) of all the respondents and over twothirds of those who experienced abduction met the criteria for symptoms of post-traumatic stress disorder (PTSD). Multivariate analysis shows that several factors increased the risk of former LRA abductees developing symptoms of PTSD. These factors included gender (females were more susceptible than males), being a member of the Acholi ethnic group, participating in or witnessing a cumulative number of traumatic events, and encountering difficulties re-integrating into communities after abduction. Factors associated with increased risk of meeting criteria for symptoms of depression included older age of males at the time of abduction, lower score on social relationship scale, high incidence of general traumatic event exposure, high incidence of forced acts of violence, and problems reintegrating into communities after abduction. Abduction and forced conscription of civilians has affected the psychological well-being of a significant number of northern Ugandans. The sources of psychological trauma are multiple, ranging from witnessing to being forced to commit violent acts, and compounded by prolonged exposure to violence, often for months or years. Community-based mental health care services and reintegration programs are needed to facilitate the reintegration of former abductees back into their communities.

Most of the characteristics differentiating between adolescent attempters and nonattempters do not have discriminative power in comparing 48 adolescents who recently attempted suicide with 66 depressed adolescents. These characteristics may probably be attributed to an affective disorder that is present in most of the suicide attempters. However, suicide attempters, compared with the depressed group, live in more problematic circumstances (such as family disruption or sexual abuse) and have a cognitive style that promotes a more negative evaluation of events and situations. Their depressive symptoms are distinguished from the depressed group by withdrawal and isolation, besides maintaining a hopeless and negative expectation of the future. Furthermore, there are reasons to accept the idea that suicidal behavior is a serious alternative within their behavioral repertoire. Based on these findings, a psychological interpretation is given concerning the dynamics leading to a suicide att...

This thesis focuses on a national sample of Swedish-speaking women's expectations and experience of antenatal care and women's opinions of Caesarean section, homebirth and birth centre care. Paper (I): The aim was to describe women's expectations on antenatal care. The majority of the 3,061 women, who completed the first questionnaire, wanted to follow the standard visiting schedule, while 23 per cent preferred more visits and seven per cent preferred fewer visits. The continuity of caregiver was highly valued. "Checking the baby's health" was the most important aspect of the content of antenatal care, followed by "checking the mother's health" and "making the partner feel involved". The lowest ranking was given to the importance of information about breast-feeding and infant care and the ability to participate in parent education classes. Paper (II): The aim was to follow up the number of antenatal visits and women's opinions of the number of visits and satisfaction with antenatal care. In all, 2,421 women with full-term pregnancies completed two questionnaires, in early pregnancy and two months after birth. Only 25 per cent of the women followed the standard visiting schedule recommended for an uncomplicated pregnancy, while 57 per cent had more visits and 17 per cent fewer visits. The majority of the women were satisfied with antenatal care in overall terms. No association was found between the number of visits made and satisfaction, but the women's own opinion that the number of visits was too low was associated with dissatisfaction with the medical and emotional aspects of care, while their feeling that the number of visits was too high was associated with dissatisfaction with the emotional aspects of care. Paper (III) The aim of this study was to investigate how many women, when asked in early pregnancy, wish to have a Caesarean section at the time of birth, and to identify background variables associated with such a wish. The result showed that 8.2 per cent of the 3,061 women wanted to be delivered by Caesarean section. A previous Caesarean section, fear of giving birth and a previous negative birth experience were the strongest factors in predicting a wish for an operative birth. Paper (IV): The aim of this study was to establish women's interest in homebirth and birth centre care and to describe the characteristics of these women. One per cent of the 2,563 women consistently expressed an interest in home birth, while the figure for birth center care was eight per cent , when these women were asked in early pregnancy, two months and one year after birth. Five factors were associated with an interest in home birth; having the baby's sibling and a female friend present at birth, not wanting pharmacological pain relief, a low level of education and dissatisfaction with the medical aspects of birth. An interest in birth centre care was associated with the experience of being in control during labour and birth, not wanting pharmacological pain relief and a wish to have a known midwife present at birth. Keywords: Antenatal care, number of visits, continuity of caregiver, content of care, desire for Caesarean section, alternative models of care, home birth, birth centre care.

Although the aging literature suggests that there are many paths to later life adjustment, there have been few empirical attempts to identify different patterns of adaptation, or their relation to adaptive outcome. As a way to identify patterns of socioemotional functioning in later life associated with physical hardiness, a cluster analysis was applied to 11 measures of socioemotional functioning in a large sample (N 5 1,085) of older adults (65-86 years). Ten subgroups were extracted, with clusters of individuals being primarily defined by social network variables, religious characteristics, and emotion profiles. Groups were then compared on a measure of physical hardiness. Patterns of adaptation characterized by high levels of negative emotions tended to represent less hardy adaptation, although there were nonetheless some patterns of noteworthy exception. In contrast, however, patterns of adaptation characterized by religiosity were typically associated with greater hardiness. Finally, physical hardiness was not exclusively the province of individuals exhibiting close social networks, with some groups high in connectedness being less likely to report high hardiness.

Background: Previous research showed that driving cessation is significantly related to depressive symptoms (Ragland et al., 2005). However, limited studies have considered gender and cross-national differences. This study aims to investigate (1) gender differences in the association between driving cessation and depressive symptoms, and (2) whether there is a cross-national variation between Korean and U.S older adults. Methods: Using data from the 2014 National Elderly Survey (KIHASA) in the Korea and the Health and Retirement Study (HRS) in the US, a total of 4,274 older adults (2,062 Korean citizens and 2,212 U.S residents) aged ≥65 years were selected. Geriatric Depression Scale-15 and Center for Epidemiologic Studies Depression Scale-10 were used to measure depressive symptoms in Korean and U.S sample, respectively. Demographic characteristics, disease burden, and cognitive functioning were included as covariates. Results: Significant differences were found in the prevalence of driving cessation between nations. Korean elderly was more likely to stop driving than elderly in the U.S (34% vs. 9.5%). Women were more likely to cease to drive in both countries. In the U.S, driving cessation was significantly related to higher levels of depressive symptoms in both gender. However, in Korean older adults, driving cessation was associated with higher levels of depressive symptoms only in men. Conclusions: The results indicate that the relationship between driving cessation and depressive symptoms differs across gender and nations, suggesting that driving cessation may increase depressive symptoms, especially for the U.S residents. Future research is more needed to examine underlying mechanisms.

Abstract: The coping responses of 251 Australian high school students involved in outdoor education programs were examined using a modified version of the Adolescent Coping Scale (ACS). Coping includes all strategies, whether cognitive, emotional, or physical, that a person uses to negotiate a stable balance between the internal psychological state and external stressors. The students, aged 14-15, participated in a 9-or 10-day Outward Bound program as a school requirement and later indicated which of the 79 coping strategies on ...

Background: Recurrent respiratory infections (RRI), such as the presence of at least one of the following criteria: i) >6 RI per year; ii) >1 RI per month involving upper airways from September to April; iii) >3 RI involving lower airways, constitute a social problem for both their pharmaco-economic impact and the burden for the family. However, several treatment have been proposed with controversial results. Objective: As resveratrol plus carboxymethyl-β-glucan is presently available as solution for aerosol, the aim of this study was to evaluate the effects of this compound, compared to saline solution, whether it is able to prevent RRI in children. The study was designed as real-life, randomized. Globally, 82 children (49 males, mean age 8.1 ± 2.6 years) with acute rhinopharyngitis and RRI were enrolled. Resveratrol plus carboxymethyl-β-glucan or saline isotonic solution was randomly (ratio 1:1) administered immediately after an anti-infective and anti-inflammatory 10-day treatment (tiamphenicol associated with acetylcisteine plus beclomethasone dipropionate) for the acute rhinopharyngitis. Investigated treatments lasted 20 days. Days with respiratory symptoms, fever, medication use, medical visits, and school absences were evaluated. Children were visited 30, 60, and 90 days after starting treatments. The active compound was able to significantly reduce the number of days with nasal obstruction (p < 0.001), rhinorrhea (p < 0.001), sneezing (p < 0.001), cough (p = 0.002), fever (p < 0.001), medication use (p < 0.001), medical visits (p < 0.001), and school absence (p < 0.001). Conclusions: This preliminary and real-life study could suggest that an aerosolized solution containing resveratrol plus carboxymethyl-β-glucan might exert preventive effects in children with RRI.

Background: Recurrent respiratory infections (RRI), such as the presence of at least one of the following criteria: i) >6 RI per year; ii) >1 RI per month involving upper airways from September to April; iii) >3 RI involving lower airways, constitute a social problem for both their pharmaco-economic impact and the burden for the family. However, several treatment have been proposed with controversial results. Objective: As resveratrol plus carboxymethyl-β-glucan is presently available as solution for aerosol, the aim of this study was to evaluate the effects of this compound, compared to saline solution, whether it is able to prevent RRI in children. The study was designed as real-life, randomized. Globally, 82 children (49 males, mean age 8.1 ± 2.6 years) with acute rhinopharyngitis and RRI were enrolled. Resveratrol plus carboxymethyl-β-glucan or saline isotonic solution was randomly (ratio 1:1) administered immediately after an anti-infective and anti-inflammatory 10-day treatment (tiamphenicol associated with acetylcisteine plus beclomethasone dipropionate) for the acute rhinopharyngitis. Investigated treatments lasted 20 days. Days with respiratory symptoms, fever, medication use, medical visits, and school absences were evaluated. Children were visited 30, 60, and 90 days after starting treatments. The active compound was able to significantly reduce the number of days with nasal obstruction (p < 0.001), rhinorrhea (p < 0.001), sneezing (p < 0.001), cough (p = 0.002), fever (p < 0.001), medication use (p < 0.001), medical visits (p < 0.001), and school absence (p < 0.001). Conclusions: This preliminary and real-life study could suggest that an aerosolized solution containing resveratrol plus carboxymethyl-β-glucan might exert preventive effects in children with RRI.

To identify the most prevalent worries and fears of women diagnosed with ovarian cancer. Research Approach: Online survey design was used to elicit qualitative data. Examination of worry was a single question extracted from a broader investigation. Setting: A "virtual interview" enabled women from 12 countries and 44 states to participate in this study. Participants: 360 English-speaking women aged 19-82 years with a diagnosis of ovarian cancer. Ninety-one percent of the women were partnered, were Caucasian, and had received at least some college education. The sample was equally stratified on income, geographic location (rural versus urban), and distance to healthcare services. Methodologic Approach: A descriptive survey was used to investigate "worry" among women with ovarian cancer. Colaizzi's qualitative method was used to analyze the narrative responses. Main Research Variables: Worries and fears of women with ovarian cancer stratified by age and development stage. Findings: Consistent with previously published studies, worry about recurrence and fear of death were expressed by most women, regardless of age, ethnicity, or stage of life. Other worries expressed by study participants varied by age and development and were found to correlate with the last three stages of life as described in Erikson's Theory of Psychosocial Development. Conclusions: Age and development stage are key determinants of the needs and concerns of women with ovarian cancer. Interpretation: Age and development stage should be considered when developing an individualized plan of care. Because recurrence is common among this population, the fear of death exists regardless of age and should be explored by nurses, particularly during periods of remission.

Background: Anomalous self-experiences (ASEs) are viewed as core features of schizophrenia. Childhood trauma (CT) has been postulated as a risk factor for developing schizophrenia. Aim: The aim of this study is to investigate the relationships between CT, depression and ASEs in schizophrenia. Method: ASEs were assessed in 55 patients in the early treated phases of schizophrenia using the Examination of Anomalous Self-Experience (EASE) instrument. Data on CT were collected using the Childhood Trauma Questionnaire, short form (CTQ-SF). This consists of 5 subscales: physical abuse, sexual abuse, emotional abuse, emotional neglect, and physical neglect. Assessment of depression was based on the Calgary Depression Scale for Schizophrenia (CDSS). Results: We found significant associations between EASE total score and CTQ total score and between EASE total score and emotional neglect subscore in women, but not men. We also found significant associations between CDSS total score and CTQ total score and between CDSS total score and emotional abuse, emotional neglect, and physical neglect subscores in women, but not men. In men we did not find any significant associations between EASE total score, CDSS total score and any CTQ scores. Conclusion: CT was significantly associated with higher levels of ASEs in women in the early treated phases of schizophrenia, but not in men. This again associated with an increase in depressive symptoms.

New neurons are generated in the hippocampus each day and their survival is greatly enhanced through effortful learning . The numbers of cells produced can be increased by physical exercise . These findings inspired us to develop a clinical intervention for humans known as Mental and Physical Training, or MAP Training. Each session consists of 30 min of mental training with focused attention meditation (20 min sitting and 10 min walking). Meditation is an effortful training practice that involves learning about the transient nature of thoughts and thought patterns, and acquiring skills to recognize them without necessarily attaching meaning and/or emotions to them. The mental training component is followed by physical training with 30 min of aerobic exercise performed at moderate intensity. During this component, participants learn choreographed dance routines while engaging in aerobic exercise. In a pilot ''proof-of-concept'' study, we provided supervised MAP Training (2 sessions per week for 8 weeks) to a group of young mothers in the local community who were recently homeless, most of them having previously suffered from physical and sexual abuse, addiction, and depression. Preliminary data suggest that MAP Training improves dependent measures of aerobic fitness (as assessed by maximal rate of oxygen consumed) while decreasing symptoms of depression and anxiety. Similar changes were not observed in a group of recently homeless women who did not participate in MAP Training. It is not currently possible to determine whether new neurons in the human brain increase in number as a result of MAP Training. Rather these preliminary results of MAP Training illustrate how neuroscientific research can be translated into novel clinical interventions that benefit human health and wellness.

Objective: Undergraduates at a university in the United States were exposed -directly and indirectly -to 14 peer deaths during one academic year. We examined how individual and social factors were associated with psychological (e.g., anxiety, depression, somatization) and physiological (i.e., cortisol) distress responses following this unexpected and repeated experience with loss. Method: Two to three months after the final peer death, respondents (N = 122, 61% female, 18-23 years, M = 20.13, SD = 1.14) reported prior adverse experiences, degree of closeness with the deceased, acute responses to the peer deaths, ongoing distress responses, social support, support seeking, and media viewing. A subset (n = 24) returned hair samples for evaluation of cortisol responses during the previous 3 months. Results: Ongoing psychological distress was associated with a) prior interpersonal trauma, b) fewer social supports, and c) media exposure to news of the deaths (p's,.05). Participants who had no prior bereavements showed, on average, high cortisol (.25 p/mg) compared to individuals with one or two prior bereavement experiences (who were, on average, within the normal range, 10 to 25 p/mg) (p,.05). Only 8% of the sample utilized available university psychological or physical health resources and support groups. Conclusions: Limited research has examined the psychological and physiological impact of exposure to chronic, repeated peer loss, despite the fact that there are groups of individuals (e.g., police, military soldiers) that routinely face such exposures. Prior adversity appears to play a role in shaping psychological and physiological responses to repeated loss. This topic warrants further research given the health implications of repeated loss for individuals in high-risk occupations and university settings.

Research conducted in the aftermath of the September 11th terrorist attacks (9/11) suggests that, except for those who directly witnessed or suffered loss from the attacks, for most children the emotional impact was relatively transitory. We review this literature as well as consider other ways in which the attacks may have played a role in the development of adolescents and young adults as they came of age in the shadow of 9/11 in the United States. Specifically, we discuss the potential impact of the collective trauma of 9/11 on children's coping and emotional regulation, their sociopolitical attitudes, and their general beliefs about the world. Developmental issues and the role of parents in shaping their children's responses to 9/11 are also addressed. Researchers interested in children's social, emotional, and psychological development have much to learn about children's reactions to events like 9/11 and factors that might mitigate the negative consequences of such events on children's development.

Diverse social contacts are generally associated with better health. However, diverse contacts can increase exposure to infectious agents. This should increase risk for disease, particularly among those whose host resistance is otherwise compromised (e.g., stressed individuals). In this prospective study, healthy college students who completed questionnaires assessing social network diversity and stressful life events were subsequently interviewed weekly for 12 weeks to track incidence of upper respiratory infections (URIs). URI episodes were defined by a symptom criterion and by clinically verified self-reported illness. Stress and diversity of social contacts interacted; diversity was associated with more illnesses among those with more stressful life events and slightly fewer illnesses among those with fewer stressful life events. Associations remained after controlling for neuroticism.

Rationale: Critical periods for programming early wheeze risk may include pregnancy and infancy. Effects of timing remain poorly understood. Objectives: Associations among prenatal and postnatal maternal stress and children's wheeze were prospectively examined in 653 families. Effect modification by maternal sensitization was also examined. Methods: Stress was indexed by a maternal negative life events (NLEs) score (range, 0-9) ascertained during pregnancy and between 1 and 2 years postpartum. Mothers reported child wheeze every 3 months up to age 2 years. Relationships of prenatal and postnatal maternal NLEs with repeated wheeze (>2 episodes) were examined using logistic regression adjusting for covariates. Penalized splines were implemented to explore possible nonlinear associations. We also examined the interaction between prenatal stress and maternal sensitization indexed by allergen-specific IgE from maternal prenatal serum. Measurements and Main Results: Adjusted models considering prenatal or postnatal NLEs alone both showed an exposure-response relationship between higher stress and child wheeze. When considering prenatal and postnatal stress concurrently, only children of mothers with high stress in both periods were significantly more likely to wheeze (adjusted odds ratio, 3.04; 95% confidence interval, 1.67-5.53) than children of mothers reporting low stress in both periods. Associations between high prenatal stress and wheeze were significant in children born to nonsensitized mothers (any IgE ,0.35 kU/L) but not in the sensitized group (P for interaction ¼ 0.03). Conclusions: Although children have heightened sensitivity to maternal stress in utero and in early childhood, those with higher stress in both periods were particularly at risk for wheeze. The prenatal maternal immune milieu modified effects.

Survivors of intimate partner violence often suffer from a number of serious aftereffects, but current prevalent treatments lack effectiveness for this population. Along with typical trauma symptoms such as avoidance and constriction, other common challenges unique to survivors include a loss of sense of self, negative self-appraisal, and a lack of selfefficacy. Therapeutic Assessment is well-suited to this population due to its potential for helping clients to replace distorted beliefs about the self with more adaptive ones, engaging clients as equals, and helping clients to form cohesive life narratives. The proposed study will measure the effectiveness of this approach with three to five subjects using a time-series design. Subjects will provide daily ratings of their personal experiences evaluating five areas of concern, three to be shared across subjects and two tailored to the priorities of each specific participant. The resulting indices will be tested using Simulation Modeling Analysis (SMA), controlling for autocorrelation using the Lag 1 correlation, to see whether statistically significant changes occur in the desired directions.

College student-athletes are at risk for heavy alcohol consumption and related consequences. The present study evaluated the influence of college student and college athlete descriptive norms and levels of athletic identity on drinking and related consequences among incoming college students attending two universities (N = 1119). Prior to the beginning of their first year of college, students indicating high school athletic participation completed assessments of athletic identity, alcohol consumption, drinking-related consequences, and normative perceptions of alcohol use. Estimations of drinking by college students and student-athletes were significantly greater than self-reported drinking. Athletic identity moderated associations among gender, perceived norms, drinking, and related consequences. Athlete-specific norms had a stronger effect on drinking among those reporting higher levels of athletic identity, and higher levels of athletic identity exclusively protected males from experiencing drinking-related consequences. Implications of the role of athletic identity in the development of social norms interventions targeted at high school athletes transitioning to college are discussed.

The present study attempted to assess childhood trauma events and dissociative symptoms in patients with obsessive compulsive disorder (OCD). The study included all patients who were admitted for the first time to the psychiatric outpatient unit over a 24-month period. Seventy-eight patients were diagnosed as having OCD during the twoyear study period. Childhood traumatic events were assessed with a Childhood Trauma Questionnaire (CTQ). Obsessive compulsive disorder symptoms were assessed with the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). A Dissociation Questionnaire (DIS-Q) was also used to measure dissociative symptoms. The mean of Y-BOCS points were 23.37 ± 7.27. Dissociation questionnaire scores were between 0.40 and 3.87 and the mean was 2.23 ± 0.76. Childhood trauma points were 1.27-4.77 and the mean was 2.38 ± 0.56. There was no statistically significant relationship between Y-BOCS points and childhood trauma points (p > 0.05). There was a statistically significant positive relationship between Y-BOCS points and DIS-Q points. There was no statistically significant relationship between DIS-Q points and childhood trauma points (p > 0.05). Conclusion: Childhood trauma questionnaire points might be significant clinically, although there was not a statistically significant correlation in our study. We also conclude that dissociative symptoms among patients with OCD should alert clinicians to treatment of the disorder.

The PCLO rs2522833 candidate polymorphism for depression has been associated to monoaminergic neurotransmission. In healthy and currently depressed individuals, the polymorphism has been found to affect activation of brain areas during memory processing, but no direct association of PCLO with memory bias was found. We hypothesized that the absence of this association might have been obscured by current depressive symptoms or genetically driven individual differences in reactivity to stressful events. Experiencing stressful childhood events fosters dysfunctional assumptions that are related to cognitive biases, and may modulate the predisposition for depression via epigenetic effects. The association between PCLO and memory bias, as well as interaction between PCLO and childhood events was studied in patients remitted from depression (N = 299), as well as a sample of healthy individuals (N = 157). The participants performed an emotional verbal memory task after a sad mood induction. Childhood trauma and adversity were measured with a questionnaire. The Genotype main effect, and Genotype by Childhood Events interaction were analyzed for memory bias in both samples. PCLO risk allele carrying remitted depressed patients did not show more negatively biased memory than non-risk allele carriers, not even patients with stressful childhood events. A similar pattern of results was found in healthy individuals. Memory bias may not be strongly associated with the PCLO rs2522833 polymorphism. We did not find any support for the PCLO-childhood events interaction, but the power of our study was insufficient to exclude this possibility.

The PCLO rs2522833 candidate polymorphism for depression has been associated to monoaminergic neurotransmission. In healthy and currently depressed individuals, the polymorphism has been found to affect activation of brain areas during memory processing, but no direct association of PCLO with memory bias was found. We hypothesized that the absence of this association might have been obscured by current depressive symptoms or genetically driven individual differences in reactivity to stressful events. Experiencing stressful childhood events fosters dysfunctional assumptions that are related to cognitive biases, and may modulate the predisposition for depression via epigenetic effects. The association between PCLO and memory bias, as well as interaction between PCLO and childhood events was studied in patients remitted from depression (N = 299), as well as a sample of healthy individuals (N = 157). The participants performed an emotional verbal memory task after a sad mood induction. Childhood trauma and adversity were measured with a questionnaire. The Genotype main effect, and Genotype by Childhood Events interaction were analyzed for memory bias in both samples. PCLO risk allele carrying remitted depressed patients did not show more negatively biased memory than non-risk allele carriers, not even patients with stressful childhood events. A similar pattern of results was found in healthy individuals. Memory bias may not be strongly associated with the PCLO rs2522833 polymorphism. We did not find any support for the PCLO-childhood events interaction, but the power of our study was insufficient to exclude this possibility.

Recent work in human geography has begun to explore the fluidity of bodily boundaries and to foreground the connectedness of bodies to other bodies/objects/places. Across multiple subdisciplinary areas, including health, children's and feminist geographies, geographers have begun to challenge the notion of a singular, bounded body by highlighting the importance of, for example, relations of care and intergenerationality to everyday embodied experiences; remembered past/anticipated future bodies to self-perception and body image; affect/emotion to the production of embodied collectives; and connections to distant and proximate others to understandings of embodied rights and responsibility. In this paper we will review these areas of work in order to explore the ways in which this geographical work on embodied connections might contribute to recent debates concerning public health pedagogy and the production of embodied and emotional collectives in education. This will involve an analysis of the recent anti-obesity change4life campaign in the UK; used in this context as a way to explore how the campaign attempts to produce healthy bodies through a form of pedagogy which is centred upon notions of embodied connectivities and collectives.

Study Objectives: Although reports of sleep disturbances are common among individuals with posttraumatic stress disorder (PTSD), results of polysomnographic (PSG) studies have inconsistently documented abnormalities and have therefore suggested "sleep state misperception." The authors' study objectives were to compare sleep parameters measured objectively and subjectively in the laboratory and at home in civilians with and without trauma exposure and PTSD. Design: Cross-sectional study. Setting: PSG recordings in a sleep laboratory and actigraphic recordings in participants' homes. Participants: One hundred three urban-residing African Americans with and without trauma exposure and PTSD who participated in a larger study. Interventions: N/A. Measurements: Sleep parameters (total sleep time [TST], sleep onset latency [SOL], and wake after sleep onset [WASO]) were assessed using laboratory PSG and home actigraphy. A sleep diary was completed in the morning after PSG and actigraphy recordings. Habitual TST, SOL, and WASO were assessed using a sleep questionnaire. The Clinician Administered PTSD Scale was administered to assess participants' trauma exposure and PTSD diagnostic status. Results: Participants, regardless of their trauma exposure/PTSD status, underestimated WASO in the diary and questionnaire relative to actigraphy and overestimated SOL in the diary relative to PSG. Among participants with current PTSD, TST diary estimates did not differ from the actigraphy measure in contrast with those without current PTSD who overestimated TST. No other significant group differences in discrepancies between subjective and objective sleep measures were found. Conclusions: Discrepancies between subjectively and objectively measured sleep parameters were not associated with trauma exposure or PTSD. This challenges prior assertions that individuals with PTSD overreport their sleep disturbances.

Narratives are important in psychiatric rehabilitation. People with a psychiatric diagnosis find it difficult to recall specific autobiographical memories of events that lasted less than a day. Although personal narratives play a central role in personal recovery, the factors influencing personal and clinical recovery, such as psychiatric symptoms and cognitive function, have not been fully explored. Therefore, this study examined the associations between personal recovery and autobiographical memory, age, psychiatric symptoms, and neurocognitive function. Method: The Self-Identified Stage of Recovery, Parts A and B (SISR-A, SISR-B), Autobiographical Memory Test (AMT), Japanese version of the Brief Assessment Scale of Schizophrenia Cognitive Function, and Brief Psychiatric Symptom Rating Scale were administered to 40 individuals with psychiatric disorders who were undergoing psychiatric rehabilitation. Results: A significant positive correlation was found between the total number of specific memories in the AMT and total SISR-B scores. A binary logistic regression analysis revealed that the total number of specific memories, especially high responsiveness to negative cue words, significantly predicted greater personal recovery. Age, psychiatric symptoms, and neurocognitive function did not significantly predict higher personal recovery. Conclusion: In psychiatric rehabilitation, negative episodes should be treated with caution; however, they may also facilitate personal recovery.

Objective: Fibromyalgia (FM) syndrome is a chronic pain condition characterized by diffuse muscle pain, increased negative mood, and sleep disturbance. Until recently, sleep disturbance in persons with FM has been modeled as the result of the disease process or its associated pain. The current study examined sleep disturbance (i.e., sleep duration and sleep quality) as a predictor of daily affect, stress reactivity, and stress recovery. Design and Measures: A hybrid of daily diary and ecological momentary assessment methodology was used to evaluate the psychosocial functioning of 89 women with FM. Participants recorded numeric ratings of pain, fatigue, and positive and negative affect 3 times throughout the day for 30 consecutive days. At the end of each day, participants completed daily diary records of positive and negative life events. In addition, participants reported on their sleep duration and sleep quality each morning. Results: After accounting for the effects of positive events, negative events, and pain on daily affect scores, it was found that sleep duration and quality were prospectively related to affect and fatigue. Furthermore, the effects of inadequate sleep on negative affect were cumulative. In addition, an inadequate amount of sleep prevented affective recovery from days with a high number of negative events. Conclusions: These results lend support to the hypothesis that sleep is a component of allostatic load and has an upstream role in daily functioning.

Approximately 160,000 grandparents experience the death of a grandchild each year; this represents a permanent, irrevocable loss for the grandparent resulting in physical and emotional responses. Grandparents who lose a grandchild experience increased alcohol and drug use, thoughts of suicide, and pain for their adult child who is also grieving. Supportive resources available to grieving grandparents, the effects of the grandchild's death on the grandparent-parent relationship and the influence of race/ethnicity on grandparent grieving are discussed. Despite about 40,000 child and infant deaths each year, knowledge about grandparent health and functioning following the death of a grandchild is limited. In 2002, 40,000 infants and children -28,034 infants (less than 1 year old), 4,858 children from 1-4 years old, and 7,150 children from 5-14 years of age -died in the United States (National Center for Health Statistics, 2005). Leading causes of death were congenital malformations, prematurity and its complications, and sudden infant death syndrome (SIDS) for infants; unintentional injuries and malformations for children from 1-4 years old; and unintentional injuries and cancer for children 5-14 years old (National Center for Health Statistics, 2005). Grandparents describe the devastation of a grandchild's death as: "like a part of you has been not just lost, but torn out of you… " . The limited research to date in this area indicates grandparents experience physical symptoms, anxiety, bitterness, exhaustion, depression, helplessness, and disbelief that the grandchild died before the grandparent, increased alcohol and drug use, thoughts of suicide, and pain for their child (grandchild's parent) . And while the deaths of 40,000 infants and children annually in the United States (National Center for Health Statistics, 2005) affect a minimum of two parents (not including step-parents), they affect a minimum of four grandparents (not including step-grandparents) at a stage in life when they are more vulnerable to health problems. Despite the changing racial/ethnic mix of the US population, even less is known about this phenomenon in diverse cultural groups. Such data are important in understanding health and functional effects for grandparents and are basic to identifying those at greatest risk for adverse outcomes and developing interventions to minimize health problems and maximize functioning.

Many people live with pets and most of them are considered as family members. So, when a pet dies, people experience grief and mourning. Despite the recent increase in research interest in human-pet relationships, as far as I know there is no review that answers this question: are grief and mourning for a pet and for a family member the same thing? The present narrative review can be a rst step in answering this question. This review was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) statement in the PubMed database. After removal of duplicates and examination of titles and abstracts, 50 papers were included in the review. The retrieved articles were selected and evaluated by reading each of them in full text. In order to reduce the likelihood of bias in the selection process, the process was repeated after three months. Only one study among those examined directly compared the severity of grief over human death and the death of a pet. In this study, no signi cant differences were found between pain severity levels. However, since grief is a subjective experience, this work has the limitation that the same person did not experience the loss of a family member and a pet. It also presents other critical issues since it does not examine the factors that can in uence the response to the loss. Furthermore, three other research articles dealt in depth with the topic of mourning following the loss of a pet, although their main objective was not the analysis of the comparison between the pain of losing a pet to that of a human family member. Cervantes (2023) developed a systematic review whose objectives were to better understand the grieving process and experience in humans after the loss of a pet to promote mental health well-being in the workplace. The second research identi ed is that of whose objective was to validate the HHHHMM quality of life scale in the Italian context . The third paper, (Uccheddu et al. 2019) had the objective to validate a new tool, the Mourning Dog Questionnaire, but was limited to the pain and mourning resulting from the loss of a dog. The present review was not intended to be a qualitative and quantitative assessment of the intensity of grief over the loss of an animal companion compared to grief over the loss of a human. However, in examining the literature collected in this study, we can highlight some signi cant recurring themes: The evaluation of the relationship between the owner/handler and his animal Qeios qeios.com

Many people live with pets and most of them are considered as family members. So, when a pet dies, people experience grief and mourning. Despite the recent increase in research interest in human-pet relationships, as far as I know there is no review that answers this question: are grief and mourning for a pet and for a family member the same thing? The present narrative review can be a rst step in answering this question. Methods

This article allows readers to look at racial and ethnic disparities in school readiness from a neuroscience perspective. Although researchers have traditionally measured gaps in school readiness using broad achievement tests, they can now assess readiness in terms of more specific brain-based cognitive functions. Three neurocognitive systems-cognitive control, learning and memory, and reading-are essential for success in school. Thanks to recent advances in brain imaging, it is now possible to examine these three systems, each located in specific areas of the brain, by observing them in action as children engage in particular tasks. Socioeconomic status-already linked with how well children do on skills tests generally-is particularly closely linked with how well they perform on tasks involving these crucial neurocognitive systems. Moreover, children's life experiences can influence their neurocognitive development and lead to functional and anatomical changes in their brains. Noting that chronic stress or abuse in childhood can impair development of the brain region involved in learning and memory, the authors show how the extreme stress of being placed in an orphanage leads to abnormal brain development and decreased cognitive functioning. More optimistically, the authors explain that children's brains remain plastic and capable of growth and development. Targeted educational interventions thus have the promise of improving both brain function and behavior. Several such interventions, for example, both raise children's scores in tests of reading and increase activity in the brain regions most closely linked with reading. The brain regions most crucial for school readiness may prove quite responsive to effective therapeutic interventions-even making it possible to tailor particular interventions for individual children. The authors look ahead to the day when effective educational interventions can begin to close racial and socioeconomic gaps in readiness and achievement.

Throughout its history Pakistani citizens are bearing the losses resulting from terrorism. After 9/11, 2001, there is a rise in suicide attacks on public places in Pakistan especially in major cities. Media give massive coverage to these attacks and highlight all aspects in detail which create a great sense of fear in general public particularly in youth. These threats and fears can become serious psychological problems if not met with proper treatment. In this experimental study of media exposure regarding terrorist events and posttraumatic stress disorder in youth, depression level and posttraumatic stress disorder are assessed by using intervention among the 150 undergraduate students of three universities of Faisalabad, using the technique of cluster sampling. "Self-rating Inventory Posttraumatic Stress Disorder of 22 items" and Beck's Inventory Depression were used to measure the posttraumatic Stress Disorder in students. It showed 79% reliability while inter-items reliability was observed .807. Before using the intervention Mean score of Total Pretest Posttraumatic Stress Disorder was 14.31 which increased after intervention (14.86-14.32) = .54. It means there was significant psychological effect of exposure of terrorist events , which is really a sign of contemplate for media policy makers, owners and practitioners for telecasting terrorist event on screen because the psychiatrists recommend the prescription and coping strategies if the person score 10 on the Self-rating Inventory for Posttraumatic Stress Disorder. The findings also reveals that the total mean score of Posttraumatic Stress Disorder after intervention was 15.89 in female students which was higher than male students 13.96. Beck's Inventory Depression finds that the depression among female undergraduate students was higher than male undergraduate students after the usage of intervention. Both posttraumatic Stress Disorder and depression increase after the exposure of terrorist events which is a point of serious concern for media monitors in Pakistan.

This introductory review explores the interplay between chronic pain and comorbid psychological conditions, highlighting how these conditions change the way patients understand their pain and suffering. I also explore whether meaning-based therapies, with or without pharmacological treatment, can improve patient outcomes.

Diagnosis is integral part of the way medicine organises illness: it is important for identifying treatment options, predicting outcomes and providing an explanatory framework for clinicians. Previous research has shown that during a medical visit not only the clinician but also patients provide explanations for the causes of their symptoms and health problems. Patients&#39; lifeworld explanations are often differentiated from the diagnostic explanations provided by clinicians. However, while previous conversation analytic research has elaborated the ways in which diagnostic and lifeworld explanations are interactionally structured in somatic medicine, there is little research on how these explanations are organised in psychiatry. Psychiatric diagnosis is particularly interesting because in mental disorders illness itself is not determined by any objective measurement. Understanding of the patient&#39;s problem is constructed in interaction between the patient and clinician. The foc...

Trauma comes in many forms, including interpersonal, community, and institutional trauma. The adverse childhood event (ACE) studies demonstrated that adverse experiences in childhood can have a profound, cumulative impact on the course of health and development over a lifetime. It is critical for healthcare providers, such as nurse practitioners (NPs), working in primary care to screen adolescents and emerging adults for a history of ACEs and trauma. A review of current assessment tools used in assessing this population in health settings is needed to determine how screening for ACEs is being performed. Clinically efficient tools for screening and assessment of high-ACE youth in primary care settings are lacking.  Developing a process to assess ACEs, risk behaviors, and physical and mental health status that is efficient to use during a time limited clinical visit is an important step in providing holistic care to a challenging population. Primary care NPs are in the perfect positio...

Background-Serotonin transporter promoter (5-HTTLPR) genotype appears to increase risk for depression in the context of stressful life events. However, the effects of this genotype on measures of stress sensitivity are poorly understood. Therefore, this study examined whether 5-HTTLPR genotype was associated with negative information processing biases in early childhood. Method-Thirty-nine unselected seven-year-old children completed a negative mood induction procedure and a self-referent encoding task designed to measure positive and negative schematic processing. Children were also genotyped for the 5-HTTLPR gene. Results-Children who were homozygous for the short allele of the 5-HTTLPR gene showed greater negative schematic processing following a negative mood prime than those with other genotypes. 5-HTTLPR genotype was not significantly associated with positive schematic processing.

Objective: This study examines the effectiveness of a life story work program (LSWp) in older adults with mild-to-moderate levels of intellectual disability (ID). Methods: Using a quasiexperimental design, this study assigned 60 older adults who were between 50-90 years old with mild-to-moderate levels of ID to receive either the LSWp (intervention group, N=32) or usual activities (control group, N=28) during a period of 6 months. Evaluation was made based on the outcomes assessed by the Mood Interest and Pleasure Questionnaire, the Vineland Adaptive Behavior Scales, and the Personal Wellbeing Index -ID. Results and conclusion: LSWp shows potential for improving the quality of life and preventing the loss of interest and pleasure in older adults with ID. It also shows promise in enhancing their socialization skills. Patients with better communication abilities seemed to benefit more from the LSWp.