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Youth with a family history of bipolar disorder (At-Risk) have a higher risk of developing psychiatric disorders and experiencing environmental stressors than youth without such family history (Control). We studied the differential associations of familial and environmental factors on developing psychiatric diagnoses and symptoms, in At-Risk and Control youth. At-Risk and Control youth (N = 466, ages 9–22) were systematically assessed for severity of symptoms, psychiatric diagnoses, and self-reported measures of stress and social support. We tested the association of family history and measures of stress or support with symptom severity and diagnoses. At-Risk youth had higher symptom severity scores and were more frequently diagnosed with psychiatric disorders (all p values < 0.001). When predicting mood symptom severity, family history had an interaction effect with stressful life events (p < 0.001) and number of distinct traumatic events (p = 0.001). In multivariate models, At-Risk status predicted anxiety disorders (OR = 2.7, CI 1.3–5.4, p = 0.005) and anxiety severity (Coefficient = 0.4, CI 0.2–0.7, p < 0.001) but not mood or behavioral disorder diagnoses or severity. Measures of stress and social support were based on self-report. Not all participants had passed through the period of risk for developing the outcomes under study and the follow up period was variable. We could not fully study the differential impact of physical or sexual abuse due to low frequency of occurrence in controls. At-Risk youth exhibit more severe mood symptoms compared to Controls when exposed to similar levels of stress or trauma. At-Risk youth are also more prone to develop anxiety which may be a precursor for bipolar disorder. • Youth at risk for bipolar disorder had more mood, anxiety, behavior and substance use diagnoses or symptoms than controls. • At risk youth had higher levels of mood symptoms compared to controls when exposed to similar levels of stress and trauma. • Controlling for several environmental factors, at risk status was more predictive of anxiety disorders and symptoms. [ABSTRACT FROM AUTHOR]

Strategies of prevention for psychiatric disorders need a deep understanding of the aetiological factors involved in the psychopathological processes. Our twin study aims at disentangling the contributions of genes and environment to schizotypal and hypomanic dimensions, considering the role of stressful life events (LEs) and the quality of family relationships. The Magical Ideation Scale (MIS) and Perceptual Aberration Scale (PAS) were used to assess positive schizotypy, while Hypomanic Personality Scale (HPS) and its sub-scales were used to investigate proneness to affective disorders. 268 twins (54.5 % female; aged 18.0 ± 6.68) were included. Participants filled out a questionnaire on LEs and their parents provided an evaluation of intra-family relationship (Relationship Quality Index, RQI). Classic univariate twin models for quantitative traits were fitted for scales, and the effects of covariates (LEs and RQI) were assessed. For MIS, HPS and its sub-scales, significant common and unique environmental effects were detected, with genetic factors affecting only HPS Social Vitality sub-scale. Unique environment was the only source of variance of PAS score. The number of recent LEs influenced MIS and PAS models, while RQI score affected MIS model. The main limitation of the study is the small sample size, which reduces statistical power and may potentially lead to an underestimation of heritability. Additionally, the cross-sectional design limits the possibility to draw causal considerations. Findings provide preliminary evidence for a significant environmental role in modulating states of vulnerability. Moreover, the expression of positive schizotypy resulted influenced by recent stressors and intra-family relationships. • Twin studies aid at inferring the role of gene and environment on phenotypes. • Findings showed a crucial role of environment in modulating states of vulnerability; • Genetic factors affected only Social Vitality; • Expression of positive schizotypy was influenced by recent stressors; • The intra-family relationship showed an important role for MIS. [ABSTRACT FROM AUTHOR]

The impacts of prenatal maternal affective symptoms on the placental structure are not well-established. Employing Geographic Information System (GIS) spatial autocorrelation, Moran's I, can help characterize placental thickness uniformity/variability and evaluate the impacts of maternal distress on placental topography. This study (N = 126) utilized cohort data on prenatal maternal affective symptoms and placental 2D and 3D morphology. Prenatal maternal depression, stress, anxiety and sleep quality were scored for each trimester using the Edinburgh Postnatal Depression Scale (EPDS), Stressful Life Event Scale (SLE), Penn State Worry Questionnaire (PSWQ), and Pittsburgh Sleep Quality Index (PSQI), respectively. Placental shape was divided into Voronoi cells and thickness variability among these cells was computed using Moran's I for 4-nearest neighbors and neighbors within a 10 cm radius. Sex-stratified Spearman correlations and linear regression were used to study associations between mean placental thickness, placental GIS variables, placental weight and the average score of each maternal variable. For mothers carrying boys, poor sleep was associated with higher mean thickness (r = 0.308, p = 0.035) and lower placental thickness uniformity (r = −0.36, p = 0.012). Lower placental weight (r = 0.395, p = 0.003), higher maternal depression (r = −0.318, p = 0.019) and worry/anxiety (r = −0.362, p = 0.007) were associated with lower placental thickness uniformity for mothers carrying girls. The study is exploratory and not all GIS models were developed. Excluding high-risk pregnancies prevented investigating pregnancy complications related hypotheses. A larger sample size is needed for greater confidence for clinical application. Placental topography can be studied using GIS theory and has shown that prenatal maternal affective symptoms and sleep have sex-specific associations with placental thickness. • GIS theory can be used to study placental topography. • Spatial autocorrelation describes placental thickness variability. • Prenatal maternal depression symptoms linked to varying placental depth in girls. • Prenatal maternal anxiety symptoms linked to variable placental thickness in girls. • Poor prenatal maternal sleep linked to greater placental thickness variation in boys. [ABSTRACT FROM AUTHOR]

Women may be vulnerable to elevated depressive symptoms during the menopause transition (MT). Studies generally have not considered premenopausal depressive symptom history or examined symptoms in relation to the final menstrual period (FMP). To identify specific time points in relation to the FMP when depressive symptoms increase or decrease. Participants were 1582 multiracial/ethnic women from the longitudinal Study of Women's Health Across the Nation (SWAN). Biological, psychosocial, and depressive symptom data were collected approximately annually. Depressive symptoms were measured by the Center for Epidemiological Studies-Depression (CES D) scale. Women with high baseline depressive symptoms (CES-D ≥ 16) declined in symptoms (M = −1.04/yr., 95 % CI = −1.58, −0.50) until 4 years before the FMP, followed by a smaller decrease (M = −0.50/yr., 95 % CI = −0.72, −0.28) until 18 months after the FMP. Depressive symptoms increased (M = 0.21/yr., 95 % CI = 0.11, 0.30) in those with low baseline symptoms until 1 year before the FMP, and decreased (M = −0.06/yr., 95 % CI = −0.11, −0.008) going forward. Greater social support, higher levels of follicle stimulating hormone and estradiol, and less sleep disturbance contributed to greater decline in depressive symptoms among those with high baseline depressive symptoms. Anxiety, experiencing stressful life events, lower body mass index, and poor role-physical function contributed to an increase in depressive symptoms among those with low baseline symptoms. Excluded women had higher baseline CES-D scores. Lacked pre-MT depression for pre/early perimenopausal women at baseline. Accounting for baseline depressive symptom level and focusing on the FMP more precisely characterize depressive symptom change over the MT. • Examined depressive symptoms over 10 years before and after the final menstrual period (FMP). • Examined specific time points when depressive symptoms increase or decrease around the FMP. • Pattern of symptoms varied according to level of pre/early perimenopasusal depressive symptoms. • Factors contributing to change in depressive symptoms varied by pre/early perimenopausal level. [ABSTRACT FROM AUTHOR]

There is scarce data concerning the relationship between negative life events (NLEs)* and current and new depressive episodes by age. Cross-sectional (baseline) and prospective analyses (4-year/8-year follow-ups) were performed in 15,105 civil servants in 6 cities in Brazil classified according to age strata at baseline: 1st(35–44), 2nd(45–54), 3rd(55–64), and 4th(65–74) years. The independent variable was NLEs in the last year (robbery, hospitalization, death of a relative, financial hardship, and rupture of a love relationship) collected at baseline. The dependent variable was depressive episodes assessed at baseline (current), and 4-year/8-year follow-ups (new). We built logistic (Odds Ratio[OR];95 % Confidence Interval[CI]) in the cross-sectional analysis and Poisson regression models (Relative Risk[RR], [CI]) in the prospective analysis. Robbery, hospitalization, financial hardship, rupture of a relationship were associated with current depressive episodes concentrated in the 35–44 age range, while for new depressive episodes, the association of hospitalization, death of a relative, and financial hardship were concentrated in the 45–54 age stratum. Financial hardship was associated with current depressive episodes in all age-strata: 1st: OR, 2.77(CI, 1.83–4.19); 2nd: OR, 1.71(CI, 1.26–2.34); 3rd: OR, 1.68(CI,1.15–2.46); 4th, OR, 4.07(CI, 1.24–13.34), and new depressive episodes: 1st: RR, 1.45(CI, 1.09–1.93); 2nd RR, 1.46(CI: 1.15–1.84); 3rd: RR, 1.97(CI, 1.38–2.82). Rupture of a relationship was associated only with current depressive episode, while death of a relative only with new depressive episode. We cannot rule out the possibility of recall bias, since NLEs' information was self-reported. The association between NLEs with depressive episodes was concentrated in youngers. • The association between negative life events with prevalent and incident depression was concentrated in the youngers. • The association of negative life events with prevalent and incident depression decreases with ageing. • Financial hardship was the negative life event most associated do prevalent and incident depression. [ABSTRACT FROM AUTHOR]

The Chinese government has enacted the "Double Reduction" Policy, which aims to reduce students' academic burden and promote their mental health, but there is limited research examining the policy's impact on students' well-being. This study aims to evaluate changes in students' mental health problems before and after the "Double Reduction" Policy and explore relevant influential factors. A total of 101,976 elementary and junior high school students were recruited before the "Double Reduction" Policy, and 91,832 students were recruited one year later. Through data integration, a total of 36,637 students participated in both web-based surveys and provided complete data on all measures. As a whole, we found that the prevalence of students' depression (12.1 % to 9.2 %) and anxiety (8.9 % to 6.2 %) tended to decline after the "Double Reduction" Policy. Attending private school, reduced homework, more extracurricular activities, more time with parents, reduced academic stress, and sleep duration ≥8 h/n were associated with the decrease in the likelihood of mental health problems in students. Female gender, negative life events, and negative impact of COVID-19 as risk factors for mental health. These findings indicated that the "Double Reduction" Policy has improved the well-being of Chinese students. Reducing students' homework burden and alleviating their academic pressure are beneficial for their mental health. Increasing time for extracurricular activities and interaction with parents, as well as ensuring sufficient sleep for students, are also effective ways to prevent the onset and exacerbation of mental health symptoms in adolescents. • This study is a longitudinal study to evaluate changes in Chinese students' mental health problems before and after the "Double Reduction" Policy. • Prevalence of students' depression (12.1% to 9.2%) and anxiety (8.9% to 6.2%) tended to decline after the "Double Reduction" Policy. • The influences of demographic characteristics, "Double Reduction" policy related factors, and pandemic related factors was both considered. [ABSTRACT FROM AUTHOR]

Prenatal negative life events (NLEs) have been linked to adverse health outcomes in children. However, few studies examine this relationship during late childhood using trajectory analyses. Additionally, the impact of specific NLEs domains on child development remains unclear. This study aims to longitudinally explore the association between NLEs (cumulative score and specific NLEs domains) and child outcomes from birth to late childhood. 1135 mother-child pairs from the French EDEN cohort were followed from 24 to 28 weeks of pregnancy up to 11 years of age. Maternal self-reports of prenatal NLEs were collected immediately after birth, then analyzed as a cumulative score and by NLEs domain. Children's emotional and behavioral symptoms were assessed at 4 timepoints through the Strengths and Difficulties Questionnaire. Children of mothers exposed to ≥3 NLEs were more likely to follow trajectories of high levels of peer relationship problems (aOR [95 % CI] = 5.69 [1.74–18.69]), emotional symptoms (aOR [95 % CI] = 3.05 [1.08–8.63]), and conduct problems (aOR [95 %] = 3.53 [1.20–10.42]). Among the domains of NLEs, only events related to housing, finance, and living conditions were significantly associated with high emotional and behavioral difficulties trajectories (aOR [95%CI] = 2.71[1.26–5.81]). Potential attrition bias due to a higher dropout rate for children experiencing early indications of emotional and behavioral difficulties. Findings support the relationship between prenatal NLEs and child outcomes, underscoring the importance of assessing prenatal stressors across life domains to identify mothers who might be in need of support. • Children exposed to 3+ prenatal negative life events (NLEs) face higher emotional, conduct, and peer problems. • Events related to housing, finance, and living conditions significantly influence total child difficulties. • Assessing NLEs during prenatal follow-up may help identify high-risk individuals for appropriate multidisciplinary care. [ABSTRACT FROM AUTHOR]

Assisted reproductive technologies (ARTs) have become the main treatment for infertility. ART treatment can be a stressful life event for infertile females. Whether there is an association between ARTs and postpartum depressive symptoms (PDS) has not been established. PubMed, MEDLINE, EMBASE, PsycINFO, and CNKI were searched. The pooled outcome was the difference in incidence of PDS within 1 year postpartum between ARTs and the spontaneous pregnancy group. A total of 12 cohort studies, which were conducted in eight developed countries and two developing countries, were involved. In total, 106,338 pregnant women, including 4990 infertile females with ARTs treatment and 101,348 women with spontaneous pregnancy, were enrolled in our final analysis. ARTs women had a lower incidence of PDS compared to the spontaneous pregnancy group according to a random effect model (OR = 0.83, 95 % CI: 0.71–0.97, p = 0.022, I 2 = 62.0 %). Subgroup analyses indicated that studies on late PDS (follow-up: 3–12 months postpartum) were more heterogeneous than those on early PDS (follow-up: <3 months postpartum) (I 2 = 24.3 % vs. I 2 = 0 %, interaction p -value < 0.001). There was a strong relationship between ARTs and late PDS (OR = 0.65, 95 % CI: 0.55–0.77, p < 0.001). Therefore, the possible source of heterogeneity was the postpartum evaluation time, which was confirmed by post-hoc meta-regression. Some underlying confounders, such as previous psychiatric illness, the limited availability of ARTs, and ethnic disparities, cannot be ignored and may have biased interpretation of the results. The available data suggested that ARTs were associated with lower incidence of PDS, especially when follow-up lasted over 3 months. However, these findings should be interpreted with caution. Better-designed trials are needed to confirm this association. • The association between ARTs and PDS was clarified for the first time. • Twelve cohort studies with a total of 106,338 pregnant women were considered in our analysis. • ARTs were associated with lower incidence of PDS compared to the spontaneous pregnancy group. [ABSTRACT FROM AUTHOR]

Neuroticism has been identified as a significant predictor for depression within the adolescent population However, few longitudinal studies have investigated this association and explored the mediation effect of the negative life events. This study aimed to examine the longitudinal association between neuroticism, negative life events, and depression in a large sample of Chinese adolescents. Data on Five Factor Inventory-Neuroticism Subscale (FFI-N) was collected from 1150 participants aged 14–19 years old at baseline, and data on Adolescent Life Event Questionnaire (ALEQ) and Center of Epidemiological Study-Depression (CES-D) were collected both at baseline and 6-month follow-up. Multilevel modelings were used to analyze the longitudinal associations among neuroticism, negative life events and depression. Through a longitudinal study design, results from multilevel regression analyses indicated a direct correlation between increased levels of neuroticism and the aggregation of negative life events with the prediction of more severe depressive symptoms. Further, results of multilevel mediations suggested that the negative life events served to partially mediate the relationship between neuroticism and each dimension of depression. The results cannot be used to make a clinical diagnosis. The current findings suggest the negative life events as a cross-dimensional mediator in the relationship between neuroticism and each dimension of depression. Regulating neuroticism levels and implementing strategies to coping stress derived from daily life events could be integral approaches to reducing the prevalence of depression within the adolescent population. • Neuroticism and negative life events positively predict depression. • Negative life events mediate the effect of neuroticism on all the dimensions of depression. • Negative life events may be the cross-dimensional mediator between neuroticism and each dimension of depression. [ABSTRACT FROM AUTHOR]

Depressive symptoms seem to be interrelated in a complex and self-reinforcing way. To gain a better understanding of this complexity, the inclusion of theoretically relevant constructs (such as risk and protective factors) offers a comprehensive view into the complex mechanisms underlying depression. Cross-sectional data from individuals diagnosed with a major depressive disorder (N = 986) and healthy controls (N = 1049) were analyzed. Participants self-reported their depressive symptoms, as well as several risk factors and protective factors. Regularized partial correlation networks were estimated for each group and compared using a network comparison test. Symptoms of depression were more strongly connected in the network of depressed patients than in healthy controls. Among the risk factors, perceived stress, the experience of negative life events, emotional neglect, and emotional abuse were the most centrally embedded in both networks. However, the centrality of risk factors did not significantly differ between the two groups. Among the protective factors, social support, personal competence, and acceptance were the most central in both networks, where the latter was significantly more strongly associated with the symptom of self-hate in depressed patients. The network analysis revealed that key symptoms of depression were more strongly connected for depressed patients than for healthy controls, and that risk and protective factors play an important role, particularly perceived stress in both groups and an accepting attitude for depressed patients. However, the purpose of this study is hypothesis generating and assisting in the potential selection of non-symptom nodes for future research. • Symptoms of depression are interrelated in a complex and self-reinforcing way. • The inclusion of risk and protective factors offers a more comprehensive view into depression. • Key symptoms of depression were indecisiveness and lack of satisfaction. • Perceived stress plays an important role in healthy controls and depressed patients. • An accepting attitude seems especially beneficial for depressed patients. [ABSTRACT FROM AUTHOR]

Military missions, especially those involving combat exposure, are associated with an increased risk of depression. Understanding the long-term course of depressive symptoms post-deployment is important to improve decision-making regarding deployment and mental health policies in the military. This study investigates trajectories of depressive symptoms in the Dutch army, exploring the influence of factors such as demographics, early-life trauma, posttraumatic stress disorder (PTSD) symptoms, and deployment stressors. A cohort of 1032 military men and women deployed to Afghanistan (2005–2008) was studied from pre- to 10 years post-deployment. Depressive and PTSD symptoms were assessed using the Symptom CheckList-90 and the Self-Rating Inventory for PTSD. Demographics, early trauma, and deployment experiences were collected at baseline and after deployment, respectively. Latent Class Growth Analysis was used to explore heterogeneity in trajectories of depressive symptoms over time. Four trajectories were found: resilient (65%), intermediate-stable (20%), symptomatic-chronic (9%), and late-onset-increasing (6%). The resilient group experienced fewer deployment stressors, while the symptomatic-chronic group reported more early life traumas. Trajectories with elevated depressive symptoms consistently demonstrated higher PTSD symptoms. Potential nonresponse bias and missing information due to the longitudinal design and extensive follow-up times. This study identified multiple trajectories of depressive symptoms in military personnel up to 10 years post-deployment, associated with early trauma, deployment stressors, adverse life events and PTSD symptoms. The prevalence of the resilient trajectory suggests a substantial level of resilience among deployed military personnel. These findings provide valuable insights and a foundation for further research. • Four depression trajectories were observed in deployed military personnel. • Healthy trajectories included resilient (65%) and intermediate-stable (20%). • Depression trajectories included symptomatic-chronic (9%) and late-onset-increasing. • Trajectories were associated with deployment stressors, life events and PTSD symptoms. [ABSTRACT FROM AUTHOR]

Although genetic and environmental factors are involved in the aetiology of bipolar disorder [BD], studies focused on their interplay are lacking. The current investigation examines interactions and correlations between polygenic risk scores [PRS] for BD and major depressive disorder [MDD] with stressful life events [SLEs] in liability for BD. This study used data from 1715 participants (862 bipolar cases and 853 controls) taken from UK and Canadian samples. The List of Threatening Experiences Questionnaire recorded SLEs that occurred 6 months before interview for controls and 6 months prior to the first (Canadian sample) and worst (UK sample) depressive and manic episodes for bipolar cases. PRS-BD and PRS-MDD were calculated from the Psychiatric Genomics Consortium. For the worst depressive episode, the PRS-MDD was significantly correlated with total number of SLEs (β = 0.13, 95 % CI:0.04–0.22, p = 0.003) and dependent SLEs (β = 0.09, 95 % CI:0.02–0.16, p = 0.007). After correction for multiple testing nominally significant correlations were detected for PRS-BD with total number of SLEs (β = 0.11, 95 % CI:0.02–0.20, p = 0.015) and dependent SLEs (β = 0.08, 95 % CI:0.01–0.15, p = 0.019). Among bipolar cases, these associations were slightly stronger but were only of nominal significance for total number of SLEs (PRS-MDD: β = 0.19, 95 % CI:0.04–0.35, p = 0.015; PRS-BD: β = 0.16, 95 % CI:0.01–0.32, p = 0.042) and dependent SLEs (PRS-MDD: β = 0.14, 95 % CI:0.03–0.26, p = 0.015; PRS-BD: β = 0.12, 95 % CI:0.004–0.24, p = 0.043). No other significant gene-environment correlations or interactions were found. Use of a larger sample size would be beneficial. The relationship between SLEs and genetic risk for mood disorders may be best explained through correlations rather than interactions. • Bipolar studies focused on the gene-stressful life event interplay use candidate genes but bipolar disorder is polygenic. • This study examined the relationship between stressful life events and polygenic risk for mood disorders using 2 samples • The polygenic risk score for bipolar disorder (PRS-BD) and major depressive disorder (PRS-MDD) were used in this study • Stressful life events experienced before the worst depressive episodes were found to significantly correlate with PRS-MDD • No evidence for significant interactions between stressful life events and the PRS-BD or PRS-MDD were observed [ABSTRACT FROM AUTHOR]

Stressful life events (SLEs) constitute key risk factors for depression. However, previous studies examining associations between SLEs and depression have been limited by focusing on single events, combining events into broad categories, and/or ignoring interrelationships between events in statistical analyses. Network analysis comprises a set of statistical methods well-suited for assessing relationships between multiple variables and can help surpass several limitations of previous studies. We applied network analysis using mixed graphical models combining two large-scale population-based samples and >34,600 randomly sampled adults to investigate the associations between SLEs and current depressive symptoms in the general population. Numerous SLEs were uniquely associated with specific symptoms. Strong pairwise links were observed between SLEs during the past year and individual symptoms, e.g., between having experienced illness or injury and sleeping problems, having been degraded or humiliated and feeling blue, and between financial problems and hopelessness and being worried and anxious. Several SLEs, such as financial problems, sexual abuse, and having been degraded or humiliated, were associated with symptoms across more than one timepoint. More recent SLEs were generally more strongly associated with depressive symptoms. Several life events were strongly interrelated, such as multiple forms of abuse, and financial problems, unemployment, divorce, and serious illness or injury. Limitations include a retrospective SLE measure, cross-sectional data, a brief self-report measure of depressive symptoms, and possible attrition bias in the sample. Our findings may have implications for public health efforts seeking to improve population mental health. • Stressful life events were associated with depressive symptoms in the general population using a network analysis approach. • Numerous stressful life events were uniquely associated with specific symptoms. • Several stressful life events were strongly interrelated. • More recent SLEs were more strongly associated with depressive symptoms. [ABSTRACT FROM AUTHOR]

Stressful life events are a significant public health issue worldwide. Despite its mental, psychological, and social problems, important questions about the prevalence and risk factors remained unanswered. Therefore, this study aimed to show major life events and help-seeking behaviors among women in the reproductive-age group. A community-based cross-sectional study design was conducted using a multistage cluster sampling technique to get a total of 845 study participants from March 20 to April 29, 2021. Exposure to stressful life events and help-seeking behavior was collected using Women's Exposure to the Stressful Life Events Test, and General Help-Seeking Questionnaire (GHQ) respectively. Data were cleaned, coded, and entered into EPI-Info version 3.1 and analyzed using SPSS version 20. The prevalence of stressful life events and help-seeking behaviors was 47.9 % and 38.7 % respectively. Reproductive-age women with poor social support (AOR = 2.392, 95 % CI: 1.422, 4.026), moderate social support (AOR = 1.861, 95 % CI: 1.341, 2.583), husband alcohol users (AOR = 1.496, 95 % CI: 1.027, 2.178), husband chat users (AOR = 2.962, 95 % CI: 1.140, 7.696), and having ever suicidal attempt (AOR = 8.702, CI: 1.719, 44.049), were positively associated with stressful life events. Nearly half of reproductive-age women had stressful life events. Thus, it is important to give serious attention to addressing those identified factors to increase public awareness, especially among husbands, their families, and elected authorities. • Half of the internal-conflict-affected individuals develop PTSD. • The prevalence of help-seeking behaviors was 38.7 %. • Poor and moderate social support, suicidal attempts, and husband substance users were the risk factors. [ABSTRACT FROM AUTHOR]

Adversity in childhood increases the risk of psychopathology, perhaps by influencing sensitivity to recent stressful life events (SLEs). However, little is known about the stress-sensitizing effect of childhood adversity on nonsuicidal self-injury (NSSI), whether stress sensitization exists in specific types of SLEs, and the stress-buffering effect of self-esteem. This study aimed to investigate whether exposure to child maltreatment increases adolescent's vulnerability to the effects of dependent and independent SLEs on later NSSI and whether self-esteem buffers this risk. We conducted a two-wave study with 18-month intervals. 601 Chinese adolescents completed self-report measures of child maltreatment, SLEs, self-esteem, and NSSI. Results supported the stress sensitization hypothesis for child maltreatment regarding dependent SLEs, with dependent SLEs significantly predicting later NSSI only in maltreated adolescents. Moreover, self-esteem buffered the relationship between dependent SLEs and NSSI in maltreated adolescents but amplified the relationship in non-maltreated adolescents. In the maltreated group, dependent SLEs predicted increased NSSI only in those with low self-esteem. In contrast, in the control group, dependent SLEs were significantly associated with NSSI in individuals with high self-esteem. We did not collect information on the timing of exposure to child maltreatment. Future studies that assess child maltreatment during critical periods of development may be able to identify sensitive period in which maltreatment sensitizes individuals to stress in adolescents. Findings provide preliminary evidence that child maltreatment has a stress-sensitizing effect on adolescent NSSI. Improving self-esteem may mitigate the associations between SLEs and NSSI in adolescents exposed to child maltreatment. • Child maltreatment has a stress-sensitizing effect on NSSI in adolescence. • The stress-sensitizing effect of childhood maltreatment was found only in dependent stressful life events (SLEs). • Self-esteem is protective against NSSI in maltreated adolescents following SLEs. • Maltreated adolescents may benefit from interventions aimed at increasing self-esteem. [ABSTRACT FROM AUTHOR]

Obsessive-compulsive symptom fluctuations may be contingent on the number of stressful pandemic-related events and the resilience characterizing different cultures. We investigated the influence of the pandemic on symptom changes in a sample of obsessive-compulsive disorder (OCD) patients from Brazil and Italy, two countries that were highly affected by the outbreak. Ninety-one OCD outpatients were evaluated at baseline and about one year later. Thirty of them were assessed in Brazil and 61 in Italy. Socio-demographic variables, symptoms' severity and the number of stressful pandemic-related events were collected. Comparisons between countries' samples were performed, and a linear regression examined whether the country of origin, demographic features and the number of stressful events were able to predict the symptoms' severity at the follow-up. Brazilian patients experienced more stressful pandemic-related events than Italian patients (p = 0.018). However, along with higher age (p < 0.01) and increased severity of symptoms at baseline (p < 0.01), lower number of events predicted increased symptoms' severity after one year (p < 0.01). Country of origin was not a significant predictor of severity. Small number of subjects; lack of information regarding duration of illness; and potential sample differences between countries. During the pandemic, the occurrence of more stressful pandemic-related events was associated with decreased severity of patients' OCD symptoms. Nevertheless, older patients and those with more severe symptoms seemed prone to exhibit increased OCD severity at follow-up. • Both Brazil and Italy were highly affected by COVID-19. • Yet, country of origin did not predict long term OCD severity. • Having more stressful pandemic-related events decreased OCD severity. [ABSTRACT FROM AUTHOR]

Offspring of depressed mothers have elevated risk of developing depression because they are exposed to greater stress. While generally assumed that youth's increased exposure to stress is due to the environmental effects of living with a depressed parent, youth's genes may influence stress exposure through gene-environment correlations (rGEs). To understand the relationship between risk for depression and stress, we examined the effects of polygenic risk for depression on youth stress exposure. We examined the relations of a polygenic risk score (PRS) for depression (DEP-PRS), as well as PRSs for 5 other disorders, with youth stress exposure. Data were from a longitudinal study of a community sample of youth and their parents (n = 377) focusing on data collected at youth's aged 12 and 15 assessments. Elevated youth DEP-PRS was robustly associated with increased dependent stress, particularly interpersonal events. Exploratory analyses indicated that findings were driven by major stress and were not moderated by maternal nor paternal history of depression, and of the 5 additional PRSs tested, only elevated genetic liability for bipolar I was associated with increased dependent stress—particularly non-interpersonal events. Like other PRS studies, we focused on those of European ancestry thus, generalizability of findings is limited. Polygenic risk contributes to youth experiencing stressful life events which are dependent on their behavior. This rGE appears to be specific to genetic risk for mood disorders. • Youth elevated polygenic risk for depression is robustly associated with elevated youth stress exposure, supporting a stress generation model. • Of the 5 additional PRSs tested, only bipolar I disorder was associated with elevated youth stress exposure. • Findings suggest that there are gene-environment correlations that are specific to mood disorders--depression and bipolar 1. [ABSTRACT FROM AUTHOR]

Repetitive nonsuicidal self-injury (R-NSSI) is a growing concern in adolescents and is associated with various mental health problems. However, little is known about the potential psychology and addiction mechanisms of R-NSSI in adolescents. This study aimed to examine the mediating effects of emotion dysregulation and maladaptive cognitive schemas based on the Interaction of Person-Affect-Cognition-Execution (I-PACE) model and the integrated model of NSSI among adolescents who repeatedly engage in NSSI. This longitudinal study was conducted in two waves with 6-month lags. A total of 3925 adolescents (M age = 13.22 ± 0.86 years, 42 % female) were recruited from three middle schools. Relevant questionnaires were used to evaluate stressful life events, emotion dysregulation, maladaptive cognitive schemas, NSSI, and NSSI addictive features. The structural equation modeling approach was conducted separately for adolescents who engaged in occasional NSSI (O–NSSI) and those who engaged in R-NSSI. Results showed that emotion dysregulation played a significant mediating role in the associations between stressful life events and NSSI frequency, and both maladaptive cognitive schemas and emotion dysregulation played a significant mediating role in the associations between stressful life events and NSSI addictive features in adolescents who engaged in R-NSSI but not in those who engaged in O–NSSI. The main limiting factor is self-reported data. These findings contribute to the understanding of the psychological and addictive mechanisms involved in R-NSSI. Both emotion dysregulation and maladaptive cognitive schemas could be a suitable therapeutic target to reduce R-NSSI in the context of stress during adolescence. • The study explores underlying psychological mechanisms among adolescents with repetitive NSSI. • Emotion dysregulation played mediating role in the stressful life events (SLE)-NSSI frequency link. • Both emotion dysregulation and maladaptive cognitive schemas played mediating role in the SLE-NSSI addictive features link. • Both emotion dysregulation and maladaptive cognitive schemas could be therapeutic targets to reduce repetitive NSSI. [ABSTRACT FROM AUTHOR]

Negative life events are major triggers for depression. How individual physical qualities and psychological resources affect the relationship between negative life events and depression in college students remains to be studied. Therefore, we constructed a structural equation model to explore the mediating effect of trait anxiety and the moderating effect of self-esteem in the relationship between negative life events and depression among college students. A total of 6224 Chinese college students (aged 16–25) in Jiangxi Province in the central area of China completed the online survey. A moderated mediation model was tested to verify the hypothesis. The mediation analysis showed a significant indirect effect of negative life events on depression through trait-anxiety. Mediation was moderated by self-esteem, which significantly interacted with negative life events to reduce their effect on both anxiety and depression. All measures were self-reported. The cross-sectional design only provides evidence of correlation. The results in this study revealed that self-esteem as a component of psychological defense mechanism to reduce the harm of environmental threats to individuals. Low self-esteem college students are more likely to have adverse effects when experiencing low-level life events. University mental health education reduces the effects of negative life events on trait anxiety and depression of college students by raising their self-esteem levels. [ABSTRACT FROM AUTHOR]

It has been suggested that gender differences in anxiety and depressive symptoms characterize panic disorder (PD) in terms of vulnerability to stressful life events, anxiety, depressive symptom patterns, and brain structure. However, few studies have investigated the gender differences in PD using a network approach. This study included 619 participants with PD (313 men). The Panic Disorder Severity Scale, Albany Panic and Phobia Questionnaire, and Beck Depression Inventory-II were used to evaluate symptomatology. To investigate the PD-related white matter (WM) neural correlates, tract-based spatial statistics were used. The PD-related clinical scales and WM neural correlates were included in the network analysis to identify associations between variables. To evaluate network differences between genders, network comparison tests were conducted. Our findings revealed that agoraphobia in men was the strongest central symptom. In addition, loss of pleasure, and not anxiety or panic symptoms, was the strongest central symptom in women with PD. The network comparison test revealed that the bridge strength score was higher in agoraphobia and tiredness in men and in self-criticalness in women. Furthermore, in the network that includes neural correlates of WM, the bridge strength score was higher in the cingulate gyrus WM in men and the cingulum hippocampus in women. Since this is a cross-sectional network study of PD patients, the causal relationship between interactions in this network analysis for both genders may not be accurately determined. Network structures of anxiety and depressive symptomatology and related WM neural correlates can differ according to gender in PD patients. • Agoraphobia in male panic disorder (PD) and loss of pleasure in female PD are central symptoms. • The bridge strength was higher in the agoraphobia and tiredness in male, and higher in the self-criticalness in female. • Cingulate gyrus white matter in male PD showed higher bridge centrality with psychopathology than in female PD. • Cingulum hippocampus in female PD showed higher bridge centrality with psychopathology than in male PD. [ABSTRACT FROM AUTHOR]

There has been widespread interest in the implications of COVID-19 containment measures on the mental health of parents. Most of this research has focused on risk. Much less is known about resilience; yet such studies are key to protecting populations during major crises. Here we map precursors of resilience using life course data spanning three decades. The Australian Temperament Project commenced in 1983 and now follows three generations. Parents (N = 574, 59 % mothers) raising young children completed a COVID-19 specific module in the early (May–September 2020) and/or later (October–December, 2021) phases of the pandemic. Decades prior, parents had been assessed across a broad range of individual, relational and contextual risk and promotive factors during childhood (7–8 years to 11–12 years), adolescence (13–14 years to 17–18 years) and young adulthood (19–20 years to 27–28 years). Regressions examined the extent to which these factors predicted mental health resilience, operationalised as lower than expected anxiety and depressive symptoms during the pandemic relative to pre-pandemic symptoms. Parent mental health resilience during the COVID-19 pandemic was consistently predicted by several factors assessed decades before the pandemic. These included lower ratings of internalizing difficulties, less difficult temperament/personality traits and stressful life events, and higher ratings of relational health. The study included 37–39-year-old Australian parents with children age between 1 and 10 years. Results identified psychosocial indicators across the early life course that, if replicated, could constitute targets for long-term investment to maximise mental health resilience during future pandemics and crises. • Prospective, multi-wave studies of parent mental health resilience are rare. • We assessed risk and promotive factors decades before the COVID-19 pandemic. • A range of factors predicted parent mental health resilience during COVID-19. • Findings may assist in long-term preparation for future pandemics or crises. [ABSTRACT FROM AUTHOR]

It is unclear to what extent mental health and negative life events (NLEs) contribute to weight change in patients with overweight. This study aimed to evaluate the association of anxiety, depression, NLEs and quality of life (QoL) with weight change over ten years in middle-aged individuals with overweight. Population-based cohort study of 2889 middle-aged men and women with a body mass index ≥27 kg/m2. Relative weight change over ten years was defined as weight loss (≤− 5 %), stable weight (between >− 5 % and <5 %) or weight gain (≥5 %). At baseline, participants reported anxiety symptoms, depressive symptoms, recent (last year) and distant (lifetime) NLEs, and a mental component summary of QoL. With multinomial logistic regression adjusting for potential confounding, we examined the association of mental health and NLEs with weight change after a median (25th, 75th percentiles) follow-up of 9.7 (9.0–10.5) years. In 51 % participants weight was stable, 33 % participants lost weight and 17 % gained weight. Mild (odds ratio 1.36; 95 % confidence interval 1.05–1.75), and moderate to very severe depressive symptoms (1.43; 0.97–2.12) and four or more distant NLEs (1.35; 1.10–1.67) were associated with weight gain. Anxiety symptoms, the mental component summary of QoL were not associated with either weight gain or weight loss. Due to the observational design residual confounding cannot be excluded. Our study suggests that depressive symptoms or having experienced distant NLEs are associated with weight gain over time in middle-aged individuals with overweight. These subgroups might benefit from proactive attention from their health care providers. • To what extent mental health and negative life events in patients with overweight contribute to weight change over time is unclear. • Depressive symptoms and distant (lifetime) negative life events are associated with weight gain over ten years follow-up in patients with overweight. • Proactive attention to these subgroup of patients by primary care physicians and mental health professionals might help to prevent weight gain. • Optimized cooperation between psychosocial and somatic health care providers might be beneficial for patients with overweight and mental health problems. [ABSTRACT FROM AUTHOR]

Half of women with postnatal depression (PND) are not identified in routine care. We aimed to estimate the cost-effectiveness of PND case-finding in women with risk factors for PND. A decision tree was developed to represent the one-year costs and health outcomes associated with case-finding and treatment for PND. The sensitivity and specificity of case-finding instruments, and prevalence and severity of PND, for women with ≥1 PND risk factor were estimated from a cohort of postnatal women. Risk factors were history of anxiety/depression, age < 20 years, and adverse life events. Other model parameters were derived from published literature and expert consultation. Case-finding for high-risk women only was compared with no case-finding and universal case-finding. More than half of the cohort had one or more PND risk factor (57.8 %; 95 % CI 52.7 %–62.7 %). The most cost-effective case-finding strategy was the Edinburgh Postnatal Depression Scale with a cut-off of ≥10 (EPDS-10). Among high-risk women, there is a high probability that EPDS-10 case-finding for PND is cost-effective compared to no case-finding (78.5 % at a threshold of £20,000/QALY), with an ICER of £8146/QALY gained. Universal case-finding is even more cost-effective at £2945/QALY gained (versus no case-finding). There is a greater health improvement with universal rather than targeted case-finding. The model includes costs and health benefits for mothers in the first year postpartum, the broader (e.g. families, societal) and long-term impacts are also important. Universal PND case-finding is more cost-effective than targeted case-finding which itself is more cost-effective than not case-finding. • The sensitivity of case-finding instruments is greater in women at high-risk for PND. • The Edinburgh Postnatal Depression Scale is a cost-effective case-finding tool. • Universal case-finding for PND is more cost-effective than a targeted approach. [ABSTRACT FROM AUTHOR]

Traumatic life events are associated with the development of psychiatric and chronic medical illnesses. This exploratory study examined the relationship between traumatic life events and the gut microbiota among adult psychiatric inpatients. 105 adult psychiatric inpatients provided clinical data and a single fecal sample shortly after admission. A modified version of the Stressful Life Events Screening Questionnaire was used to quantify history of traumatic life events. 16S rRNA gene sequencing was used to analyze the gut microbial community. Gut microbiota diversity was not associated with overall trauma score or any of the three trauma factor scores. Upon item-level analysis, history of childhood physical abuse was uniquely associated with beta diversity. Linear Discriminant Analysis Effect Size (LefSe) analyses revealed that childhood physical abuse was associated with abundance of distinct bacterial taxa associated with inflammation. This study did not account for dietary differences, though diet was highly restricted as all participants were psychiatric inpatients. Absolute variance accounted for by the taxa was small though practically meaningful. The study was not powered for full subgroup analysis based on race and ethnicity. This study is among the first to demonstrate a relationship between childhood physical abuse and gut microbiota composition among adult psychiatric patients. These findings suggest that early childhood adverse events may have long-conferred systemic consequences. Future efforts may target the gut microbiota for the prevention and/or treatment of psychiatric and medical risk associated with traumatic life events. • Traumatic events were examined as variables of interest in the prediction of gut biodiversity in psychiatric inpatients. • A composite trauma score was not a significant predictor of gut biodiversity in psychiatric inpatients. • When trauma types were examined separately, only childhood physical abuse was uniquely associated with gut diversity. • It is theorized that chronic inflammation secondary to physical abuse may lead to gut microbiota differences in adulthood. • This study is the first to suggest that childhood physical abuse may have long-term impact on the gut microbiota. [ABSTRACT FROM AUTHOR]

Stressful life events (SLE) impact psychosocial functioning. However, the psychological mechanism underlying the association between SLE and functional disability (FD) has not been fully elucidated. This study focused on whether depressive symptoms (DS) and subjective cognitive dysfunction (SCD) mediated the influence of SLE, comprising negative SLE (NSLE) and positive SLE (PSLE), on FD. A total of 514 adults from Tokyo, Japan, completed the self-administered questionnaires to evaluate DS, SCD, SLE, and FD. We investigated the relationships among the variables using path analysis. Path analyses showed that NSLE positively affected FD directly (β = 0.253, p <.001), and indirectly via DS and SCD (β = 0.192, p <.001). PSLE negatively affected FD indirectly via DS and SCD (β = −0.068, p =.010), although PSLE did not affect FD directly (β = −0.049, p =.163). Causal relationships could not be determined owing to the cross-sectional design. All participants were recruited in Japan, which limits the generalization of findings to other countries. DS and SCD, in this order, may partially mediate the positive effect of NSLE on FD. DS and SCD may fully mediate the negative effect of PSLE on FD. When considering the impact of SLE on FD, evaluating the mediating role of DS and SCD could be useful. Our findings may elucidate how perceived life stress affects daily functioning via depressive and cognitive symptoms. In the future, it is desirable to conduct a longitudinal study based on our results. • NSLE is positively associated with FD, and PSLE is negatively associated with FD. • DS and SCD mediated the influences of NSLE and PSLE on FD. • DS and SCD partially mediated the positive effect of NSLE on FD. • DS and SCD fully mediated the negative effect of PSLE on FD. • Our findings help elucidate how life stresses affect FD via DS and SCD. [ABSTRACT FROM AUTHOR]

This review systematically examined the associations between chronic stress and hair cortisol concentration (HCC) in children, and the potential modification effects of type, measurement period and scales of chronic stress, child age and sex, hair length and HCC measurement method, characteristics of study site, and congruence between time periods measured for chronic stress and HCC. Pubmed, Wed of Science, and APA PsycINFO were systematically searched for articles examining the association between chronic stress and HCC. Thirteen studies from five countries with 1,455 participants were included in the systematic review and nine studies were included in the meta-analysis. Meta-analysis revealed that chronic stress was associated with HCC (pooled- r = 0.09, 95 % CI: 0.03, 0.16). Stratified analyses revealed that type, measurement time and scales of chronic stress, hair length and measurement method of HCC, and the congruence between time periods measured for chronic stress and HCC modified such correlations. The positive correlations between chronic stress and HCC were significant for studies measuring chronic stress as stressful life events, assessing chronic stress within the past six months, extracting HCC from 1 cm, 3 cm, or 6 cm of hair, measuring HCC by LC-MS/MS, or having congruence between time periods measured for chronic stress and HCC. The potential modifying effects of sex and country developmental status could not be concluded due to the limited number of studies included. Chronic stress was positively correlated with HCC, varying by characteristics and measurements of chronic stress and HCC. HCC could be a biomarker for chronic stress among children. • Chronic stress was positively correlated with hair cortisol concentration (HCC). • Characteristics and measurements of chronic stress and HCC modified the correlations. • Stressful life events and stress within the past 6 months were correlated with HCC. • HCC measured by LC-MS/MS and 1, 3, or 6 cm of hair was correlated with chronic stress. • Studies with congruent time of stress and HCC had a stronger pooled correlation. [ABSTRACT FROM AUTHOR]

Stress generation theory suggests that people engage in certain behaviors that causally generate "dependent" stressful life events. Stress generation has primarily been studied in the context of depression with limited consideration of anxiety. People with social anxiety exhibit maladaptive social and regulatory behaviors that may uniquely generate stress. Across two studies, we examined if people with elevated social anxiety experienced more dependent stressful life events than those lower in social anxiety. On an exploratory basis, we examined differences in perceived intensity, chronicity, and self-blame of stressful life events. As a conservative test, we examined whether observed relationships held after covarying depression symptoms. Community adults (N s = 303; 87) completed semi-structured interviews about recent stressful life events. Participants with higher social anxiety symptoms (Study 1) and social anxiety disorder (SAD; Study 2) reported more dependent stressful life events than those with lower social anxiety. In Study 2, healthy controls rated dependent events as less impactful than independent events; those with SAD rated dependent and independent events as equally impactful. Regardless of social anxiety symptoms, participants placed greater blame on themselves for the occurrence of dependent than independent events. Life events interviews are retrospective and preclude conclusions about short-term changes. Mechanisms of stress generation were not assessed. Results provide initial evidence for the role of stress generation in social anxiety that may be distinct from depression. Implications for assessing and treating unique and shared features of affective disorders are discussed. • People high in social anxiety and depression experience more dependent stressors. • Social anxiety is associated with stress generation above and beyond depression. • People with SAD are similarly impacted by dependent and independent events. • Social anxiety is associated with greater self-blame for stressful events. [ABSTRACT FROM AUTHOR]

Stress and marital dissatisfaction have been identified as risk factors for depression in separate lines of research. However, the interaction between stress and marital satisfaction in predicting depression over time has rarely been examined, despite the fact that marital satisfaction may weaken (i.e., buffer) the impact of stress on depression. This longitudinal study evaluated marital satisfaction as a moderator of the association between stress and depressive symptoms in a probability sample of American married adults. Married respondents from Wave I and Wave II of the Americans' Changing Lives (ACL) study (N = 1392) completed measures of marital satisfaction, stressful life events, and depressive symptoms at baseline and three-year follow-up. Marital satisfaction and stressful life events were significantly associated with depressive symptoms in cross-sectional analyses and uniquely predicted depressive symptoms three years later, controlling for prior depressive symptoms. However, marital satisfaction did not moderate the association between stressful life events and depression. A sensitivity analysis of data from Wave IV and Wave V of the ACL yielded similar findings, supporting the replicability of the results. Broader assessment on stressful life events and assessment of perceived stress would provide a stronger test of the association between stress and depression as well as the degree to which this association is moderated by marital satisfaction. Attending to both stress and marital satisfaction may provide a more comprehensive understanding of risk for depression than exclusive focusing on either stress or marital satisfaction, which may have beneficial implications for preventing and treating depression. • Examined marital satisfaction as a buffer of the stress-depression association • Marital satisfaction and stress were cross-sectionally associated with depression. • Both variables were uniquely associated with depression at follow-up. • Marital satisfaction did not buffer the stress-depression association at follow-up. • Attending to both risk factors may improve understanding & treatment of depression. [ABSTRACT FROM AUTHOR]

Stressful life events (SLEs) are high-risk factors for subthreshold depressive symptoms (SDS) and major depressive disorder (MDD). This study sought to assess the association of SLEs with SDS and MDD, with a focus on gender effects. A total of 4132 participants were recruited from 34 primary health care settings. The Stressful Life Events Screening Questionnaire (SLESQ) was used to measure SLEs that participants had experienced in the past time. The Patient Health Questionnaire 9 (PHQ-9) was used to assess SDS, and the Mini-International Neuropsychiatry Interview (MINI) depression module was used to assess the diagnosis of MDD by trained psychiatrists. In our sample (N = 4132), exposure to any SLEs was more common in individuals with SDS and MDD than in non-depressed population, and the proportion of emotional abuse was relatively high (SDS: 10.6 %; MDD: 33.9 %). After adjusting for control variables, people who experienced SLEs were at a higher risk of SDS and MDD. For males, those experiencing only one event were not at a higher risk of SDS (P = 0.061). For individuals who had experienced multiple SLEs, the association between SLEs and SDS was stronger in females than males. However, the association between SLEs and MDD was stronger in males than females. The cross-sectional study design and self-reported SLEs. SLEs were associated with the increased risks of SDS and MDD. The associations of SLEs with SDS were more robust for females than males. In contrast, the association between SLEs and MDD was stronger in males than females. • Our results suggest that an increase in SLEs experienced is associated with a higher risk of developing SDS and MDD. • Males who experienced only one SLE were not at a higher risk to develop into SDS, however, in females, at least one SLE was associated with SDS. Moreover, experiencing two or more SLEs was significantly associated with SDS, and the associations was greater in females than males. • The association between the number of SLEs and MDD was stronger in males than females. [ABSTRACT FROM AUTHOR]

Adolescents' exposure to stressful life events (SLEs) is highly prevalent and increases their risk of developing depression considerably. A small number of studies have addressed the extent to which resilience factors, such as the ability to emotionally regulate, mediate the relationship between SLEs and depression. This study examined whether emotion regulation mediates and significantly attenuates the direct path between SLEs and depressive symptoms in a nonclinical sample of adolescents. A sample of 235 first- and second-year high-school students completed the Depression Anxiety Stress Scale, the Risk Factor Questionnaire, and the Difficulties in Emotion Regulation Scale. Mean age was 16.9 (SD = 1.8) years, and 65 % (n = 152) of the participants were female. To assess for mediation, a regression-based path analysis approach was used. SLEs were significantly (t = 5.13, p < 0.001) associated with depressive symptoms, explaining 59.1 % of the total variance. Controlling for the mediation variable (emotion regulation), we found a reduced but statistically significant direct effect (t = 2.87, p = 0.005) between SLEs and depressive symptoms. A statistically significant indirect effect explaining 64.6 % of the total effect demonstrated partial mediation from stressful life events to depressive symptoms via emotion regulation. Our analyses are based on correlational and cross-sectional data and thus exclude statistical examination of temporal causal relationships, and assessments of whether reported affects are stable over time. Our results indicate that interventions that can modify the ability to regulate emotions may help reduce depressive symptoms in at-risk adolescents. • Adolescents' exposure to stressful life events (SLEs) is highly prevalent. • To assess for mediation, a regression-based path analysis approach was used. • A significant indirect effect was observed, demonstrating a mediation from SLEs to depressive symptoms via emotion regulation. • Interventions that can modify the ability to emotionally regulate may help reduce depressive symptoms in at-risk adolescents. [ABSTRACT FROM AUTHOR]

Suicide is the second most common cause of death among young people. Structural brain alterations, rumination, and recent stressful experiences contribute to suicidal thoughts and behaviors (STBs). Here, we employed structural equation modeling (SEM) to examine the unique and combined relationships of these risk factors with STBs in a sample of young people with major depressive disorder (MDD) from the Magnetic Resonance-Improving Mood with Psychoanalytic and Cognitive Therapies (MR-IMPACT) study (N = 67, mean age = 15.90; standard deviation ± 1.32). Whereas increased rumination and lower surface area of brain regions, that have been previously reported to be involved in both STBs and rumination, were associated with each other (Beta = −0.268, standard error (SE) = 0.114, Z = −2.346, p = 0.019), only increased rumination was related to greater severity of suicidal ideation (Beta = 0.281, SE = 0.132, Z = 2.134, p = 0.033). In addition, we observed that recent stress was associated with lower surface area in the suicidal ideation model without covariate only (Beta = −0.312, SE = 0.149, Z = −2.089, p = 0.037). For the attempt models, no associations were found between any of the risk factors and suicide attempts. We emphasize that these findings from this secondary analysis are hypothesis-forming and preliminary in nature given the small sample size for SEM analyses. Our findings suggest that neither lower surface area nor recent stress are directly associated with youth suicidal ideation or attempt. However, lower surface area is related to recent stress and increased rumination, which predicted greater severity of suicidal ideation in young people with MDD. • Cognitive rumination was associated with suicidal ideation. • Rumination was related to brain regions involved in both suicide and rumination. • Findings are hypothesis-forming and preliminary based on secondary analyses. [ABSTRACT FROM AUTHOR]

Abortion is a stressful life event associated with wide variability in women's perceptions and adjustment. There is scarce evidence on interventions to help women cope with abortion and achieve positive psychological health outcomes. This study tested the effect of a stress and coping theory-formed intervention (START) on depression and coping of Chinese women undergoing a first-trimester abortion. A randomized controlled trial was conducted at a Chinese metropolitan hospital. 110 participants were recruited and randomized to intervention group (START + standard care) or control group (standard care) with a 1:1 allocation ratio. The primary outcome was depression at two-week post-abortion. Surveys were completed by participants when they sought abortion services (baseline), two and six-week post-abortion. At two-week post-abortion, women allocated to the intervention group compared to the control group, had significantly lower depression scores (aOR −2.81 [−4.12 to −1.50]), higher problem-focused coping (aOR 1.64 [0.36–2.93]), lower dysfunctional coping (aOR −2.29 [−3.69 to −0.89]), higher self-efficacy (aOR 3.17 [−0.42–5.94]), and higher personal growth scores (aOR 4.41 [0.30–8.53]). Lower depression scores at two-weeks were mediated by lower dysfunctional coping (mediated effect 0.96 [0.25, 1.74]; proportion of overall effect 36 % [9 %, 65 %]). Chinese women allocated to receive START had lower depression and better coping at two-week post-abortion. This brief, online intervention contributed to women's self-efficacy and positive perceptions of social support, abortion experience, and personal growth. Maintenance of the effects need further research. • Evidence on psychological interventions to help women cope with abortion is scarce. • A theory-in formed intervention (START) is effective in mitigating depression and improving coping at two-week post-abortion. • The effect of START on reducing depression was mediated by the decreased dysfunctional coping behaviours. • An adequately powered RCT with longer follow-up and multi-center involvement is necessary to draw definite conclusions. [ABSTRACT FROM AUTHOR]

Dyssomnias, are the most common parent-reported sleep complaints in young children. The present study investigated the prevalence, one-year development (incidence and persistence) of dyssomnia in early childhood, and the parent, child, and family factors associated with dyssomnia. Longitudinal data of 700 children aged 0–8, gathered in the CIKEO cohort study in the Netherlands were analyzed. Dyssomnias were defined as the presence of night awakenings ≥3 times per night or sleep-onset latency of >30 min. Least absolute shrinkage and selection operator (LASSO) was used to identify the parental, child, and family factors associated with the incidence and persistence of dyssomnias in children. The mean age of the children (47 % girls) was 3.2 ± 1.9 years at baseline and 4.4 ± 1.8 years at follow-up. The prevalence of dyssomnias was 13.3 % and 15.4 % at baseline and follow-up, respectively. The incidence and persistence rates of dyssomnias at follow-up were 12.0 % and 37.6 %, respectively. New incidence of insomnia was associated with being a girl, having medical conditions, experiencing stressful life events, and lower parenting self-efficacy at baseline (P < 0.05). Higher levels of parental psychological distress were associated with the persistence of dyssomnias in children (P < 0.05). Dyssomnias are common with a moderate persistent rate in young children. Several parental, child, and family factors in relation to the incidence and persistence of dyssomnias were identified. Preventive programs and interventions targeting modifiable factors, particularly parental psychological distress, parenting self-efficacy, and resilience to stressful life events, might benefit child sleep. • Dyssomnias, which were assessed by night awakenings and sleep onset latency, are common with a moderate persistent rate in young children age 0–8 years. • We identified several parental (i.e., lower parenting self-efficacy), child (i.e., female sex, medical conditions), family factors (i.e., stressful life events) associated with the incidence of dyssomnias in children; and one parental factor (i.e., parental psychological distress) that is associated with the persistence of dyssomnias. • Interventions targeting the modifiable factors (e.g. parenting self-efficacy, parental psychological distress and resilience to stressful life events) might benefit child sleep. [ABSTRACT FROM AUTHOR]

Introduction: Understanding how Bipolar Disorder (BD) affects employment is limited by cross-sectional or short-term longitudinal designs. The aims for this study are to examine condition-related and other clinical predictors of longitudinal employment status and stability in those with BD compared to healthy controls (HC).Methods: Participants were 358 individuals with BD and HC who were enrolled in the Heinz C. Prechter Longitudinal Study of BD. Participants completed self-report measurements of employment, symptoms, health, personality, life events, and neuropsychological tests at study enrollment, yearly and/or every two months. Repeated measures logistic regression was used to predict employment status and stability.Results: Those with BD were less likely to be employed than HC. Significant predictors of unemployment in BD include having BD type I, younger age, less years with BD, higher depression, worse processing speed, and worse mental and physical health. Of those with BD, 64 % demonstrated greater employment instability compared to 37 % of HC. History of psychosis, worse memory, physical health, and greater disruption of negative life events significantly predicted employment instability.Limitations: The limitations of this study include the generalizability of this sample, a large reliance of self-report measures, and a lack of employment-related factors such as job-type, functioning, performance, and satisfaction. Lastly, the effects of medication, treatment adherence, and treatment optimization were not assessed in this study.Conclusions: These findings highlight that different aspects of BD are important for being employed versus maintaining stable employment. These findings indicate the need for more effective treatment strategies beyond symptom management. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has negatively impacted parental and child mental health; however, it is critical to examine this impact in the context of parental histories of adversity. We hypothesized that maternal adverse childhood experiences (ACEs) and pandemic-related negative life events would predict child traumatic stress symptoms (TSS) and tested potential mediating pathways through maternal pandemic-related TSS and/or poorer maternal sensitivity during the pandemic.Methods: Data were collected from a longitudinal sample of low-income, racially/ethnically diverse mothers and their children. Between May and November 2020, mothers (n = 111) of young children (M age = 7.42 years, SD = 0.45) completed questionnaires to assess their own and their child's pandemic-related TSS, exposure to pandemic-related negative events, and parent-child relationship quality. Maternal ACEs, maternal depression, parent-child relationship quality, and child internalizing symptoms had been assessed approximately 1-3 years prior.Results: Structural equation analyses revealed that pandemic negative life events were indirectly associated with child TSS via greater maternal TSS. For mothers, recent pandemic-related negative events were associated with their own TSS, whereas maternal ACEs were not. Maternal ACEs directly predicted greater child TSS, with no evidence of mediation by either maternal TSS or maternal sensitivity.Limitations: All measures were parent report, and pandemic-related measures were collected at the same time point.Conclusions: Findings underscore the long reach of mothers' own adverse childhood experiences, highlighting the negative consequences of these prior traumatic exposures alongside current pandemic-related maternal trauma symptoms for children's adjustment during the pandemic. [ABSTRACT FROM AUTHOR]

Background: Previous studies have identified a set of variables associated with depression during the COVID-19 pandemic. However, the existing antecedents in Mexico, in addition to being limited to the beginning of the health emergency, made use of small and unrepresentative samples. Therefore, the aim of the present study was to identify the prevalence and factors associated with clinically significant depressive symptomatology (CSDS) in a representative Mexican sample of 2021.Methods: A secondary cross-sectional analysis of the Encuesta Nacional de Bienestar Autorreportado (ENBIARE) was conducted. For the present study, the effective sample was 30,901. Univariate and bivariate anaylses were followed by a multiple Poisson regression, which served to obtain adjusted prevalence ratios of each variable under study.Results: The prevalence of CSDS in the year 2021 was 15.3 %. In the multivariable analysis, the factors associated with CSDS were the number of recent stressful events, having a major functional limitation, not having social support from family or friends, being female, having suffered recent discrimination, alcohol or other drug use (by oneself or someone at home), not being married or cohabiting, living in a rural area, having had a diagnosis of COVID-19, having lost a job, living with a chronic patient, not doing physical exercise, and having a low educational level.Limitations: The main limitations were the cross-sectional nature of the data, the use of self-report measures, as well as the fact that this was a secondary analysis that did not allow consideration of additional variables.Conclusions: A set of personal and contextual variables were identified that can help focus prevention and intervention efforts on the phenomenon of depression. [ABSTRACT FROM AUTHOR]

Background: Questionnaires for the screening of paternal perinatal psychological distress are based on clinical manifestations expressed by women, showing limitations in capturing the wide array of signs and symptoms exhibited by men. The current study aimed to validate the Perinatal Assessment of Paternal Affectivity, a new self-report tool for the screening of paternal depressive and affective disorder.Method: This study used a cross-sectional design with a 3-month test-retest, involving respectively 385 (T1) and a sub-sample of 111(T2) fathers. Confirmatory factor analysis (CFA) was performed to test structural validity and concurrent validity was assessed by Spearman correlations. We assessed reliability using McDonald's ω and ordinal alpha. Group differences in PAPA scores based on sociodemographic were also tested.Results: The CFA reported a one factor structure as the optimal solution. The PAPA also showed adequate reliability and internal consistency as well as acceptable test-retest indices. Concurrent validity was confirmed by significant correlations between PAPA total score and standardized test scores. Non-Italian fathers and fathers who experienced recent stressful life events reported higher PAPA scores.Limitations: Our sample was not homogeneous in terms of nationality and most of the participants, were from Northern Italy. Some risk factors associated with paternal parental psychological distress (e.g., unplanned pregnancy) have not been considered.Conclusion: This study provides initial evidence of validity and reliability of the PAPA as a brief and sensitive screening tool to detect signs and symptoms of paternal affective disorder during both prenatal and postnatal period. [ABSTRACT FROM AUTHOR]

Background: In treatment studies of major depressive disorder (MDD), exposure to major life events predicts less symptom improvement and greater likelihood of relapse. In contrast, the impact of minor life events has received less attention. We hypothesized that the impact of minor events on symptom improvement and risk of relapse would be heightened in the presence of concurrent chronic stress. We also hypothesized that major events would predict less symptom improvement and greater risk of relapse independently of chronic stress.Methods: Adult patients experiencing an episode of MDD were enrolled into a 16-week trial with antidepressant treatments (n = 156). Forty-three fully remitted patients agreed to participate in a naturalistic 18-month follow-up, and 30 had full data for analyses. Life events and chronic stressors were assessed using a contextual life stress interview.Results: Greater exposure to minor events predicted greater improvement in symptoms during acute treatment, but this relation was specific to those who reported greater severity of chronic stress. During follow-up, however, major life events predicted increased risk of relapse, and this effect was not moderated by chronic stress.Limitation: High attrition rates led to a small sample size for the follow-up analyses.Conclusions: Exposure to minor events may provide an opportunity to practice problem-solving skills, thereby facilitating symptom improvement. Nevertheless, acute treatment did not protect patients from relapse when they subsequently faced major events during follow-up. Therefore, adjunctive strategies may be needed to enhance outcomes during pharmacotherapy, consolidating benefits from acute treatment and providing skills to prevent relapse. [ABSTRACT FROM AUTHOR]

Background: The diathesis-stress model of major depressive disorder (MDD) predicts interactions of recent stressful life events (SLEs) in adulthood and early developmental risk factors. We tested, for the first time, the diathesis stress model on brain structure in a large group of MDD patients.Methods: Structural magnetic resonance imaging data of 1465 participants (656 with lifetime diagnosis MDD; 809 healthy controls) were analyzed using voxel-based morphometry to identify clusters associated with recent SLEs (Life Events Questionnaire). Those clusters were then examined for group (healthy/MDD) × early developmental risk (operationalized as childhood abuse [Childhood Trauma Questionnaire] and a major psychiatric disorder [i.e., MDD, bipolar disorder, schizophrenia, and schizoaffective disorder] in a first-degree relative) × recent SLEs three-way interactions on grey matter volume.Results: There was a group × childhood abuse × recent SLEs interaction on left medial orbitofrontal cortex grey matter volume. This three-way interaction arose because childhood abuse and recent SLEs interacted in MDD subjects but not in healthy subjects.Limitations: We are not able to draw conclusions about the cause and effect relationship due to our cross-sectional study design.Conclusions: Our data provides evidence for an interplay between orbitofrontal cortex structure, childhood abuse and recent SLEs. These factors have previously been linked to MDD and their complex interaction contributes to the pathogenesis of MDD. [ABSTRACT FROM AUTHOR]

Background: Given the high prevalence of depressive symptoms reported by adolescents and associated risk of experiencing psychiatric disorders as adults, differentiating the trajectories of the symptoms related to negative valence at an individual level could be crucial in gaining a better understanding of their effects later in life.Methods: A longitudinal deep learning framework is presented, identifying self-reported and behavioral measurements that detect the depressive symptoms associated with the Negative Valence System domain of the NIMH Research Domain Criteria (RDoC).Results: Applied to the annual records of 621 participants (age range: 12 to 17 years) of the National Consortium on Alcohol and Neurodevelopment in Adolescence (NCANDA), the deep learning framework identifies predictors of negative valence symptoms, which include lower extraversion, poorer sleep quality, impaired executive control function and factors related to substance use.Limitations: The results rely mainly on self-reported measures and do not provide information about the underlying neural correlates. Also, a larger sample is required to understand the role of sex and other demographics related to the risk of experiencing symptoms of negative valence.Conclusions: These results provide new information about predictors of negative valence symptoms in individuals during adolescence that could be critical in understanding the development of depression and identifying targets for intervention. Importantly, findings can inform preventive and treatment approaches for depression in adolescents, focusing on a unique predictor set of modifiable modulators to include factors such as sleep hygiene training, cognitive-emotional therapy enhancing coping and controllability experience and/or substance use interventions. [ABSTRACT FROM AUTHOR]

Background: Social support is a robust predictor of post-traumatic stress disorder (PTSD). Although the inverse relationship between perceived social support and PTSD (social causation model) is supported, less is understood about the antecedents of the social causation model. Further, there is limited research in non-Western psychiatric populations that experience elevated rates of trauma and PTSD (e.g., mood disorders). The present study evaluated whether cumulative traumatic life events influenced current PTSD symptoms through maladaptive personality traits and perceptions of social support among Asian patients with mood disorders., Methods: A total of 200 Asian patients (77.5 % Chinese) with mood disorders were assessed for maladaptive personality traits, perceptions of social support, cumulative traumatic life events, PTSD, and depressive symptoms. Structural equation modelling was conducted to evaluate the extended social causation model., Results: The extended social causation model demonstrated acceptable fit to the data (Comparative Fit Index [CFI] = 0.90; absolute Root Mean Square Error of Approximation [RMSEA] = 0.08). There were significant indirect effects of cumulative traumatic life events on current PTSD symptoms (β = 0.29, p < .001; 85 % variance explained) and depressive symptoms (β = 0.28, p < .001; 69 % variance explained)., Limitations: Results may not be generalizable beyond the Singapore population due to the socio-cultural and environmental context., Conclusions: The present findings provide conceptual support for a maladaptive personality-informed model of social support and PTSD, which could better inform trauma-focused interventions in preventing and treating the debilitating effects of PTSD in psychiatric populations., Competing Interests: Declaration of competing interest None., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: Exposure to stressors increases the risk of mental health disorders. People living with HIV (PLWH) are particularly affected by poor mental health which can contribute to adverse HIV treatment outcomes.Methods: We estimated the prevalence of recent stressful life events (modified Life Events Survey) among a cohort of PLWH entering HIV care at three public health care facilities in Cameroon and quantified the association of seven types of stressful life events with symptoms of depression (Patient Health Questionnaire-9 scores>9), anxiety (General Anxiety Disorder-7 scores>9), and PTSD (PTSD Checklist for DSM-5 scores>30) using separate log-binomial regression models.Results: Of 426 PLWH enrolling in care, a majority were women (59%), in relationships (58%), and aged 21 to 39 years (58%). Recent death of a family member (39%) and severe illness of a family member (34%) were the most commonly reported stressful life events. In multivariable analyses, more stressful life event types, a negative relationship change, death or illness of a friend/family member, experience of violence, work-related difficulties, and feeling unsafe in one's neighborhood were independently associated with at least one of the mental health outcomes assessed. The greatest magnitude of association was observed between work-related difficulties and PTSD (adjusted prevalence ratio: 3.1; 95% confidence interval: 2.0-4.8).Limitations: Given the design of our study, findings are subject to recall and social desirability bias.Conclusions: Stressful life events were common among this population of PLWH entering care in Cameroon. Evidence-based interventions that improve coping, stress management, and mental health are needed. [ABSTRACT FROM AUTHOR]

Background: Depression and anxiety are both prevalent among university students. They frequently co-occur and share risk factors. Yet few studies have focused on identifying students at highest risk of first-onset and persistence of either of these conditions.Methods: Multicenter cohort study among Spanish first-year university students. At baseline, students were assessed for lifetime and 12-month Major Depressive Episode and/or Generalized Anxiety Disorder (MDE-GAD), other mental disorders, childhood-adolescent adversities, stressful life events, social support, socio-demographics, and psychological factors using web-based surveys; 12-month MDE-GAD was again assessed at 12-month follow-up.Results: A total of 1253 students participated in both surveys (59.2% of baseline respondents; mean age = 18.7 (SD = 1.3); 56.0% female). First-onset of MDE-GAD at follow-up was 13.3%. Also 46.7% of those with baseline MDE-GAD showed persistence at follow-up. Childhood/Adolescence emotional abuse or neglect (OR= 4.33), prior bipolar spectrum disorder (OR= 4.34), prior suicidal ideation (OR=4.85) and prior lifetime symptoms of MDE (ORs=2.33-3.63) and GAD (ORs=2.15-3.75) were strongest predictors of first-onset MDE-GAD. Prior suicidal ideation (OR=3.17) and prior lifetime GAD symptoms (ORs=2.38-4.02) were strongest predictors of MDE-GAD persistence. Multivariable predictions from baseline showed AUCs of 0.76 for first-onset and 0.81 for persistence. 74.9% of first-onset MDE-GAD cases occurred among 30% students with highest predicted risk at baseline.Limitations: Self-report data were used; external validation of the multivariable prediction models is needed.Conclusion: MDE-GAD among university students is frequent, suggesting the need to implement web-based screening at university entrance that identify those students with highest risk. [ABSTRACT FROM AUTHOR]

Background: Previous studies on the prevalence and predictors of postpartum depression (PPD) in China were mostly hospital-based with relatively small study samples. Basing on a routine screening programme, this study assessed the prevalence and factors associated with PPD at community level.Methods: A cross-sectional study was conducted with all the women who delivered in a hospital and were screened for depression during routine postpartum home visits in Shenzhen between 2015 August and 2017 April. The Edinburgh Postnatal Depression Scale was used as the screening tool with a cut-off score of 10. Predictors of PPD were determined by Chi-square test and stepwise logistic regression.Results: Approximately 300,000 puerperal women were included in the study with a PPD prevalence of 4.3%. Prenatal anxiety and depression were associated with 4.55 and 3.80 times of PPD risk, respectively. Stressful life events, family history of mental illness, poor economic status, low Apgar scores and birth defects of the infants, bottle and mixed feeding, as well as living with parents-in-low after childbirth were related to moderate risk. Higher gravidity and parity, larger gestation age, prenatal education, and living with the women's own parents were associated with lower risk.Limitations: The large sample size might have suggested statistically significant differences which were not practical.Conclusions: The prevalence of PPD at community level is significantly lower than the rates detected within hospitals. Prenatal anxiety and depression are the most important predictors of PPD. Integrating depression screening into routine postpartum home visits facilitates achievement of universal coverage. [ABSTRACT FROM AUTHOR]

Background: Studies investigating the patterns or predictors of psychological distress in expecting and postpartum mothers affected by previous prenatal loss, are limited. The study objectives were to explore longitudinal trajectory patterns of depressive and anxiety symptoms in mothers affected by previous prenatal loss from early in a subsequent pregnancy up to pre-adolescence, and to identify early factors predictive of elevated symptom trajectory patterns.Methods: A total of 2854 mothers from the Avon Longitudinal Study of Parents and Children self-identified as having experienced a previous prenatal loss. A latent class analysis identified trajectory patterns of symptoms across 10 timepoints from 18-weeks' gestation up to 134-months postpartum, multivariate regression analysis identified predictors of elevated symptom trajectories, and hierarchical regression analysis determined predictive accuracy between predictors and elevated trajectory patterns.Results: Three distinct longitudinal trajectory patterns of depressive and anxiety symptoms reflected low (54%), sub-clinical (34%), and clinical symptoms (12%). Key factors that predicted elevated symptom trajectory patterns better than increased symptom scores early in subsequent pregnancy include history of severe depression or other psychiatric problem, experiencing three or more stressful events from mid-pregnancy, inadequate social support, history of induced abortion, and history of abuse. Predictive accuracy of elevated trajectories was 0.542 (depression) and 0.432 (anxiety).Limitations: Generalizability may be compromised by attrition, under-reporting, and recall bias.Conclusion: Including factors predictive of long-term sub-clinical or clinical depressive and anxiety symptoms in early assessments will improve clinician's ability to identify mothers who may benefit from immediate and/or ongoing monitoring, and psychotherapeutic intervention after prenatal loss. [ABSTRACT FROM AUTHOR]

Background: Stressful life events (SLEs) are well-established proximal predictors of the onset of depression. However, the fundamental causes of interindividual differences in depression outcomes are poorly understood. This study addressed this depression susceptibility mechanism using a well-powered sample of adults living in China.Methods: Healthy participants with SLEs (n = 185; mean = 47.51 years, 49.73% female), drawn from a longitudinal study on the development of depression, underwent diffusion tensor imaging, interleukin-6 (IL-6) level measurement, and trimonthly standardized clinical and scale evaluations within a two-year period.Results: Receiver operating characteristic analyses indicated that reduced feeder connection and HIP.R nodal efficiency improved the predictive accuracy of post-SLEs depression (ORfeeder = 0.623, AUC = 0.869, P < 0.001; ORHIP = 0.459, AUC = 0.855, P < 0.001). The successfully established path analysis model confirmed the significant partial effect of SLEs-IL-6-white matter (WM) network differences-depression (onset and severity) (x2/8 = 1.453, goodness-of-fit [GFI] = 0.935, standard root-mean-square error of approximation [SRMR] = 0.024). Females, individuals with lower exercise frequency (EF) or annual household income (AHI) were more likely to have higher IL-6 level after SLEs (βint-female⁎SLEs = -0.420, P < 0.001; βint-exercise⁎SLEs = -0.412, P < 0.001; βint-income⁎SLEs = -0.302, P = 0.005).Limitations: The sample size was restricted due to the limited incidence rate and prospective follow-up design.Conclusions: Our results suggested that among healthy adults after SLEs, those who exhibited abnormal IL-6-WM differences were susceptible to developing depression. Females, lower AHI or EF might account for an increased risk of developing these abnormal IL-6-WM differences. [ABSTRACT FROM AUTHOR]

Objective: The microbiota-gut-brain axis is a key pathway perturbed by prolonged stressors to produce brain and behavioral disorders. Frontline healthcare workers (FHWs) fighting against COVID-19 typically experience stressful event sequences and manifest some mental symptoms; however, the role of gut microbiota in such stress-induced mental problems remains unclear. We investigated the association between the psychological stress of FHW and gut microbiota.Methods: We used full-length 16S rRNA gene sequencing to characterize the longitudinal changes in gut microbiota and investigated the impact of microbial changes on FHWs' mental status.Results: Stressful events induced significant depression, anxiety, and stress in FHWs and disrupted the gut microbiome; gut dysbiosis persisted for at least half a year. Different microbes followed discrete trajectories during the half-year of follow-up. Microbes associated with mental health were mainly Faecalibacterium spp. and [Eubacterium] eligens group spp. with anti-inflammatory effects. Of note, the prediction model indicated that low abundance of [Eubacterium] hallii group uncultured bacterium and high abundance of Bacteroides eggerthii at Day 0 (immediately after the two-month frontline work) were significant determinants of the reappearance of post-traumatic stress symptoms in FHWs.Limitations: The lack of metabolomic evidence and animal experiments result in the unclear mechanism of gut dysbiosis-related stress symptoms.Conclusion: The stressful event sequences of fighting against COVID-19 induce characteristic longitudinal changes in gut microbiota, which underlies dynamic mental state changes. [ABSTRACT FROM AUTHOR]

Background: The present study explored the interrelations between cognitive emotion regulation strategies (CERS) and depressive symptoms to better understand how young adults with childhood maltreatment (CM) are more prone to depression after recent stressful events.Methods: The sample consisted of 342 young adults (M = 19.51 years, range = 17-28 years, 64% female) who had experienced stressful events in the last six months. Network analysis was used to examine the interrelations between nine CERS and four depressive symptom clusters in exposed ('CM'; n = 182) and not exposed to CM groups ('non-CM'; n = 160).Results: We found that somatic symptoms, rumination, putting into perspective, and catastrophizing had high expected influence (EI) in the whole sample network. Global and local connectivity differed between the CM and non-CM groups. More specifically, the structure of the CM network had higher overall connectivity than the structure of the non-CM network. Considering local connectivity, depressed affect, rumination, positive refocusing, and putting into perspective had marginally significantly higher levels of EI in the CM network. We found some significant differences in partial correlations among CERS, such as stronger positive correlations between positive refocusing-catastrophizing, rumination-refocus on planning, and putting into perspective-blaming others in the CM group.Limitations: This study was cross-sectional and limited by the use of retrospective self-report tools.Conclusions: The findings shed light on the complex interrelations between CERS and depressive symptoms in the context of recent stressful events. Additionally, they highlight potential directions for population-based interventions. [ABSTRACT FROM AUTHOR]

Background: Stressors at the population level affect women more than men. The influence of prolonged stressors on mental disorders in women is yet unknown, especially when social movements and pandemics coexist.Methods: This study analysed data from an online mental health self-help service for women in Hong Kong between May and September 2020. We collected demographic data, PTSD symptoms, and exposure to social unrest-related traumatic events (TEs), pandemic-related traumatic events (PEs), and personal stressful life experiences (SLEs). Multiple logistic regression was performed to examine the links between TEs, PEs, and SLEs and PTSD.Results: The study found that 38.4% of 751 women had moderate-to-severe depressive symptoms and 23.8% had probable PTSD. The most common TEs, PEs, and SLEs were violence via media, major physical health concerns, and plans thwarted due to COVID-19, respectively. Younger age, less education, unemployment, and more stressors (individually or collectively, except for high TEs and PEs) were linked to increased odds of moderate-to-severe depressive symptoms. TEs and PEs increased the risk of probable PTSD only when SLEs were present.Limitation: The non-random samplinging procedure reduced the generalisability to the entire women population.Conclusions: Exposure to social conflicts and pandemics may increase depressive and PTSD symptoms in women. Developing mental health services for women should consider the impact of concurrent major events. [ABSTRACT FROM AUTHOR]