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Background Excessive processing of aversive life events is a major pathology in stress-related anxiety and depressive disorders. Current pharmacological treatments have rather non-specific mechanisms of action. Somatostatin is synthesized and released as an inhibitory co-neurotransmitter by specific GABA interneurons and one of its receptors, SSTR4, is localized in brain regions involved in adaptive aversion processing and implicated in negative valence neuropathology, including the amygdala. Methods Rat and mouse experiments were conducted to investigate effects of specific SSTR4 agonism on neurobehavioral aversion processing including any normalization of stress-related hyper-responsiveness. A mouse experiment to investigate stress and SSTR4 agonism effects on reward processing was also conducted. Results In male rats (N=5-10/group) fitted with glutamate biosensors in basolateral amygdala, SSTR4 agonism attenuated glutamate release to restraint stress in control rats and particularly in rats previously exposed to chronic corticosterone. In male mice (N=10-18/group), SSTR4 agonism dose-dependently attenuated Pavlovian tone-footshock learning and memory measured as freezing behavior, both in controls (CON) and following exposure to chronic social stress (CSS) which induces excessive Pavlovian aversion learning-memory. Specificity of SSTR4 agonism effects to aversion learning-memory was demonstrated by absence of effects on discriminative reward (sucrose) learning-memory in both CON and CSS mice; SSTR4 agonism did increase reward-to-effort valuation in a dose-dependent manner, and in both CON mice and mice exposed to CSS which attenuates reward motivation. Conclusions These neuropsychopharmacological findings add substantially to the preclinical proof-of-concept evidence for SSTR4 agonism as a treatment in anxiety and depressive disorders.

Introduction : The COVID-19 pandemic has led to an increase of social stressors and mental health issues in the general population as well as among mentally ill patients. A COVID-19- related “infodemic”, including too much information in digital and physical environments, has been recognized globally. Aim : This study aimed to describe the impact of COVID-19 infodemic (exposure to news related to COVID-19) in terms of depressive symptoms in the Paraguayan general population. Methods : This was a descriptive and cross-sectional study. An online survey, designed in Google Forms, has been launched nationwide through the most popular social networks (Facebook, Twitter, Instagram) and messaging applications (WhatsApp, Telegram) in April (1st-30th) 2021. The Mental Health Inventory-5 (MHI-5) was employed for detecting depressive symptoms. Results : The survey included 1102 responders aged 35.4 ± 12.9 years old, 74.9% were women. MHI-5 mean score was 44.07 ± 14.16 in the general population with 34.4% (n = 379) of responders suffering from severe symptoms of depression (>52, as cut-off point). 53.5% of sample reported to have been exposed between 1 and 3 h to COVID-19 news, daily. An OR 1.933 (95% CI 1.48 - 2.52) was found between the exposure to news and depressive symptoms. Conclusions : This study suggests that people exposed to a higher number of hours of COVID-19 news were 93.3% more likely to develop depressive symptoms.

The field of Obstetrics and Gynecology is one that provides intersections between one's most private and intimate moments with scenarios that could potentially trigger significant emotional trauma. As providers, one must balance providing appropriate care with the respect and autonomy of the patient. The perioperative and operative space presents many ethical dilemmas in navigating these boundaries, particularly among individuals with a history of sexual trauma. In our commentary, we present one case of an adolescent patient, with a history of sexual trauma and pelvic pain, who underwent laparoscopic surgery. We explore the interplay of delegating autonomy during amnesia, chronic pelvic pain, post-traumatic stress disorder, and hyperarousal within this period. There is knowledge to be gained amongst Obstetrics and Gynecology providers in navigating perioperative services in individuals with complex history of social stress and trauma so that we can better understand the landscape of providing competent care.

Contains fulltext : 291750.pdf (Publisher’s version ) (Open Access) Childhood adversity might impair corticolimbic brain regions, which play a crucial role in emotion processing and the acute stress response. The dimensional model of childhood adversity proposed that deprivation and threat dimensions might associated with individuals' development through different mechanisms. However, few studies have explored the relationship between different dimensions of childhood stress, emotion processing, and acute stress reactivity despite the overlapping brain regions of the last two. With the aid of the event-related potentials technique, we explore whether negative emotion processing, which might be particularly relevant for adaptive stress responding among individuals with adverse childhood experience, mediates the relationship between dimensional childhood stress and acute stress response. Fifty-one young adults completed a free-viewing task to evaluate neural response to negative stimuli measured by late positive potential (LPP) of ERPs (Event-related potentials). On a separate day, heart rate and salivary cortisol were collected during a social-evaluative stress challenge (i.e. TSST, Trier Social Stress Test). After the TSST, the childhood trauma questionnaire was measured to indicate the level of abuse (as a proxy of threat) and neglect (as a proxy of deprivation) dimensions. Multiple linear regression and mediation analysis were used to explore the relationship among childhood stress, emotion processing, and acute stress response. Higher level of childhood abuse (but not neglect) was distinctly related to smaller LPP amplitudes to negative stimuli, as well as smaller heart rate reactivity to acute stress. For these participants, smaller LPP amplitudes were linked with smaller heart rate reactivity to acute stress. Furthermore, decreased LPP amplitudes to negative stimuli mediated the relationship between higher level of childhood abuse and blunted heart rate reactivity to stress. Consistent with the dimensional model of childhood stress, our study showed that childhood abuse is distinctly associated with neural as well as physiological response to threat. Furthermore, the blunted neural response to negative stimuli might be the underlying mechanism in which childhood abuse leads to the blunted acute stress response. Considering that all the participants are healthy in the present study, the blunted processing of negative stimuli might rather reflect adaptation instead of vulnerability, in order to prevent stress overshooting in the face of early-life threatening experiences. 01 januari 2023

Background: Epilepsy is one of the most common chronic neurological disorders in children that have a negative impact on the children's psychosocial development, cognition, behaviors, schooling, finally resulting to high stressors experiencing. Aim: The aim of this study was to assess the psychosocial stressors of epileptic children. Research design: A descriptive study design was conducted. Setting: This study was conducted at Neurological clinic of Children's University Hospital at Ain Shams University. Sample: Convenience sample was selected which included (100) epileptic children. Tools of data collection: Interviewing questionnaire tool for children was used which included two parts: Socio- demographic characteristics and medical history of the epileptic children and their parents, and the psychosocial stressors inventory. Results: More than three fifths of studied epileptic children had high psychological stressors and more than three quarter of studied epileptic children had high social stressors. Moreover, there were statistically significant relation between psychosocial stressors and socio-demographic features and medical history such as their age, area of residence, and medications compliance. Conclusion: The epileptic children have high psychosocial stressors in relation to their socio-demographic data and medical history. Furthermore, the majority of these stressors are due to illness precautions, medications side effects, epileptic fits, and the school. Recommendation: Develop and apply nursing intervention programs for epileptic children, their parents, and teachers to improve the knowledge, awareness, and attitudes towards epilepsy

Introducción: Las personas con diagnóstico de cáncer y que reciben tratamiento manifiestan factores estresantes, físicos, emocionales y sociales, que inciden en la salud mental del paciente, por lo tanto, se reconoce la importancia de las prácticas de automanejo para aliviar la carga de estos factores. Objetivo: Identificar factores emocionales que puedan ser útiles para predecir la práctica de automanejo. Método: Diseño transversal, predictivo, muestreo no probabilístico intencional conformado por 160 personas con diagnóstico de cáncer. Se emplearon los instrumentos: Partners in Health (PIH), Self-rated Health, Escala de depresión del Cuestionario de Salud del Paciente (PHQ-8P), Escala Visual Análoga para valorar el estrés e insomnio. Se aplicó el modelo de regresión lineal múltiple; se calculó el efecto de la diferencia y la potencia estadística utilizando el método de escalonado. Resultados: Se identificaron dos variables predictoras con significancia estadística (p

BackgroundThe prevalence of serious psychological distress (SPD) was elevated during the COVID-19 pandemic in the USA, but the relationships of SPD during the pandemic with pre-pandemic SPD, pre-pandemic socioeconomic status, and pandemic-related social stressors remain unexamined.MethodsA probability-based sample (N = 1751) of the US population age 20 and over was followed prospectively from February 2019 (T1), with subsequent interviews in May 2020 (T2) and August 2020 (T3). Multinomial logistic regression was used to assess prospective relationships between T1 SPD with experiences of disruption of employment, health care, and childcare at T2. Binary logistic regression was then used to assess relationships of T1 SPD, and socioeconomic status and T2 pandemic-related stressors with T3 SPD.ResultsAt T1, SPD was associated with age, race/ethnicity, and household income. SPD at T1 predicted disruption of employment (OR 4.5, 95% CI 1.4–3.8) and health care (OR 3.2, 95% CI 1.4–7.1) at T2. SPD at T1 (OR 10.2, 95% CI 4.5–23.3), low household income at T1 (OR 2.6, 95% CI 1.1–6.4), disruption of employment at T2 (OR 3.2, 95% CI 1.4–7.6), and disruption of healthcare at T2 (OR 3.3, 95% CI 1.5–7.2) were all significantly associated with elevated risk for SPD at T3.ConclusionsElevated risk for SPD during the COVID-19 pandemic is related to multiple psychological and social pathways that are likely to interact over the life course. Policies and interventions that target individuals with pre-existing mental health conditions as well as those experiencing persistent unemployment should be high priorities in the mental health response to the pandemic.

The creation of universally effective and safe correctors of biliary secretion disorders is becoming more timely. There is an urgent need for scientists to find drugs that would correct blood cholesterol levels and metabolism in liver effectively and without limiting side effects. The purpose of the study was to investigate the possibility of using corvitin to correct stress-induced biliary disorders of the liver of male rats. Materials and methods. The article looks at recent research dealing with changes in the bile acid composition of outbred male rats’ bile under chronic social stress (social defeat in daily male confrontations, 14 days) when using Corvitin (1 mg/kg, intragastrically, 7 days). Chronic social stress was created by daily agonistic interactions between animals. The state of memory and the level of research activity in the object recognition test (cognitive test) were also studied. The main fractions of conjugated bile acids (taurocholic, taurohenodeoxycholic and taurodeoxycholic, glycocholic, glycochenodeoxycholic and glycodeoxycholic and free ones – cholic, chenodeoxycholic and deoxycholic) were determined by the method of thin layer chromatography of bile. Results and discussion. Chronic social stress leads to a slight increase in the overall activity of the experimental animals, but significantly impairs the processes of recognition and memory. Social stress significantly inhibits the processes that ensure the synthesis, biotransformation and transport of bile acids in the bile. Also, chronic social stress causes changes in bile production, which reduce the solubilization properties of bile and increase the risk of lithogenesis. Conclusion. The use of Corvitin simultaneously with the simulation of experimental social stress normalized the biliary secretory function of the liver, which indicates a high potential for the use of Corvitin as a corrective factor in chronic social stress. Corvitin used by us in the conditions of experimental social stress to some extent corrected the content of bile acids in the liver of male rats, which indicates the ability of this drug to interfere with the metabolism of cholate in liver cells, in the mechanisms of bile acid transport. Correction of stress-induced pathologies of liver bile-secretory function by Corvitin requires further thorough experimental studies

Background Both parental and neighbourhood socio-economic status (SES) are linked to poorer health independently of personal SES measures, but the biological mechanisms are unclear. Our objective was to examine these influences via epigenetic age acceleration (EAA)—the discrepancy between chronological and epigenetic ages. Methods We examined three USA-based [Coronary Artery Risk Disease in Adults (CARDIA) study, Fragile Families and Child Wellbeing Study (FFCWS) and Programming Research in Obesity, Growth, Environment and Social Stressors (PROGRESS)] and one Mexico-based (Project Viva) cohort. DNA methylation was measured using Illumina arrays, personal/parental SES by questionnaire and neighbourhood disadvantage from geocoded address. In CARDIA, we examined the most strongly associated personal, parental and neighbourhood SES measures with EAA (Hannum’s method) at study years 15 and 20 separately and combined using a generalized estimating equation (GEE) and compared with other EAA measures (Horvath’s EAA, PhenoAge and GrimAge calculators, and DunedinPoAm). Results EAA was associated with paternal education in CARDIA [GEEs: βsome college = −1.01 years (−1.91, −0.11) and β Conclusions These findings suggest that EAA captures epigenetic impacts of paternal education independently of personal SES later in life. Longitudinal studies should explore these associations at different life stages and link them to health outcomes. EAA could be a useful biomarker of SES-associated health and provide important insight into the pathogenesis and prevention of chronic disease.

Aims: Prenatal maternal stress and anxiety affect the offspring causing low birth weight, decreased motor activity, and developmental delays. Ocimum sanctum is cherished as the holiest herb in India and possesses strong adaptogenic, memory enhancer, and anti-stress properties. This study aimed to assess the effect of O. sanctum leaf aqueous extract on preventing pregnancy related stress impact on the mice offspring. Methodology: Pregnant female mice were treated with O. sanctum leaf aqueous extract throughout the gestation period at 100 mg/kg, p.o, while exposed to resident–intruder social stress paradigm. Physiological, morphological, and behavioral aspects of offspring were observed for 6 weeks. Results: Pups of O. sanctum treated mothers showed significantly (P < 0.05) improved body weight, body length, and head length. O. sanctum treatment has significantly reduced eye opening and pinna detachment period (P < 0.05-0.01), and duration for gaining surface righting and mid-air righting refluxes (P < 0.05). O. Sanctum has significantly increased (P < 0.05-0.01) number of correct entries in radial arm maze and line crossing in open field performance. Conclusion: The study outcome proves the beneficial role of O. Sanctum in ameliorating prenatal stress and anxiety induced deleterious effect on offspring.

BackgroundThe serotonin 1A (5-HT1A) receptor has been implicated in depression and suicidal behavior. Lower resting cortisol levels are associated with higher 5-HT1A receptor binding, and both differentiate suicide attempters with depression. However, it is not clear whether 5-HT1A receptor binding and cortisol responses to stress are related to familial risk and resilience for suicidal behavior.Methods[11C]CUMI-101 positron emission tomography imaging to quantify regional brain 5-HT1A receptor binding was conducted in individuals considered to be at high risk for mood disorder or suicidal behavior on the basis of having a first- or second-degree relative(s) with an early onset mood disorder and history of suicidal behavior. These high-risk individuals were subdivided into the following groups: high risk resilient having no mood disorder or suicidal behavior (n = 29); high risk with mood disorder and no suicidal behavior history (n = 31); and high risk with mood disorder and suicidal behavior (n = 25). Groups were compared with healthy volunteers without a family history of mood disorder or suicidal behavior (n = 34). Participants underwent the Trier Social Stress Task (TSST). All participants were free from psychotropic medications at the time of the TSST and PET scanning.ResultsWe observed no group differences in 5-HT1A receptor binding considering all regions simultaneously, nor did we observe heterogeneity of the effect of group across regions. These results were similar across outcome measures (BPND for all participants and BPp in a subset of the sample) and definitions of regions of interest (ROIs; standard or serotonin system-specific ROIs). We also found no group differences on TSST outcomes. Within the high risk with mood disorder and suicidal behavior group, lower BPp binding (β = −0.084, SE = 0.038, P = .048) and higher cortisol reactivity to stress (β = 9.25, 95% CI [3.27,15.23], P = .004) were associated with higher lethality attempts. There were no significant relationships between 5-HT1A binding and cortisol outcomes.Conclusions5-HT1A receptor binding in ROIs was not linked to familial risk or resilience protecting against suicidal behavior or mood disorder although it may be related to lethality of suicide attempt. Future studies are needed to better understand the biological mechanisms implicated in familial risk for suicidal behavior and how hypothalamic-pituitary-adrenal axis function influences such risk.

BackgroundFatigue is a prevalent symptom in patients with coronary heart disease (CHD). Individual differences in chronic stress may affect the experience and persistence of fatigue, and this may vary between the sexes. Therefore, we studied the effect of chronic stress on the course of fatigue over a 2-year period after percutaneous coronary intervention (PCI), and examined the moderating effects of sex.Methods1682 patients (78% men, age = 67.1 ± 10.6) were recruited and filled out multiple self-report questionnaires at baseline, one, 12, and 24 months post-PCI, including questions on demographics, fatigue (HCS). Multiple chronic stressors were assessed at baseline: work stress (ERI16), marital stress (MMQ-6), early life events (Life Events Questionnaire) and social stress. Latent class factor analysis (LatentGOLD) was used to construct a comprehensive chronic stress index. Linear mixed modeling examined the predictive quality of predictors and covariates.ResultsFatigue was found to substantially decrease over the first month post-PCI, then stabilized at a moderate level. Chronic stress impacted both the level and course of fatigue by increasing its level and delaying recovery. Overall and across time, women reported more fatigue than men. The level and course effects of chronic stress and sex were independent of demographic, health behavioral, and medical covariates.ConclusionsIndividual differences in chronic stress impact both the level and course of fatigue post-PCI, with women being affected most. Future research could further explain the mechanisms underlying the observed relationships. Developing and testing interventions focusing on exercise and stress-reduction could be used to alleviate fatigue.

Ketamine has been demonstrated to be a rapid-onset and long-lasting antidepressant, but its underlying molecular mechanisms remain unclear. Recent studies have emerged microRNAs as important modulators for depression treatment. In this study, we report that miR-98-5p is downregulated in the prefrontal cortex and hippocampus of mice subjected to chronic social stress, while overexpressing it by its agonist alleviates depression-like behaviors. More importantly, we demonstrate that miR-98-5p is upregulated by ketamine administration, while inhibition of it by its antagonist blocks the antidepressant effect of ketamine. Our data implicate a novel molecular mechanism underlying the antidepressant effect of ketamine, and that therapeutic strategies targeting miR-98-5p could exert beneficial effects for depression treatment.

Adoption of certain behavioral and social routines that organize and structure the home environment may help families navigate the challenges presented by the COVID-19 pandemic. The current cross-sectional study aimed to assess family routines prior to and during the COVID-19 pandemic and examine associations with individual and family well-being. Using a national sample, 300 caregivers of children ages 6-18 were surveyed using Amazon Mechanical Turk platform during the first three months of COVID-19 pandemic in the United States. Caregivers reported on family demographics, COVID-19-related stress, engagement in family routines (prior to and during the COVID-19 pandemic), stress mindset, self-efficacy, and family resiliency. Overall, families reported engaging in fewer routines during the COVID-19 pandemic compared to prior to the pandemic. COVID-19-related stress was highest in low-income families, families of healthcare workers, and among caregivers who had experienced the COVID-19 virus. Moreover, COVID-19-related stress was negatively related to self-efficacy, positively related to an enhancing stress mindset, and negatively related to family resilience. Engagement in family routines buffered relations between COVID-19-related stress and family resilience, such that COVID-19-related stress was not associated with lower family resilience among families that engaged in high levels of family routines. Results suggest that family routines were challenging to maintain in the context of the COVID-19 pandemic, but were associated with better individual and family well-being during this period of acute health, economic, and social stress., Highlights Families reported engaging in fewer routines during the COVID-19 pandemic, when compared to prior to the pandemic.Families reported significant reductions in child bedtime routines and screen time limitations during the COVID-19 pandemic, when compared to prior to the pandemic.Engagement in family routines buffered the impact of stress on family resilience during the COVID-19 pandemic.

Context Caregiving during advanced cancer presents many physical and psychological challenges, especially for caregivers who are coping with their own history of cancer or their own chronic health conditions. There is growing recognition that caregiver health and patient health are interdependent. Objectives The objective of this study was to use quantitative and interview data to examine and explore the impact of a caregiver's personal cancer history and chronic health conditions on the psychosocial well-being of both the caregiver and patient. Methods This was a secondary analysis of data from 88 patients with advanced lung/gastrointestinal cancer and their spouse-caregivers. Participants self-reported subjective health, chronic health conditions (including cancer), anxiety and depression symptoms, and social support and social stress. Caregivers self-reported caregiving burden and preparedness for caregiving. Caregivers also completed semistructured interviews. Results Participants were mostly white, non-Hispanic, and in their mid-60s. Caregivers reported 1.40 (SD = 1.14) chronic conditions on average; 11 reported a personal history of cancer (“survivor-caregivers”). The number of caregiver chronic health conditions was positively associated with patient depression symptoms. Patients of survivor-caregivers also reported more depression symptoms than patients of caregivers without cancer (t(85) = −2.35, P = 0.021). Survivor-caregivers reported higher preparedness for caregiving than caregivers without cancer (t(85) = −2.48, P = 0.015). Interview data enriched quantitative findings and identified factors that may drive patient depression, including emotions such as resentment or guilt. Experiencing cancer personally may provide caregivers unique insight into the patient experience. Conclusion Providers should be aware of caregiver chronic conditions and cancer history, given the potential negative effects on patient psychosocial well-being.

Objective Determine the proportion and characteristics of traumatic injury survivors who perceive a negative impact of the COVID-19 pandemic on their recovery and to define post-injury outcomes for this cohort. Background The COVID-19 pandemic has precipitated physical, psychological, and social stressors that may create a uniquely difficult recovery and reintegration environment for injured patients. Methods Adult (≥18 years) survivors of moderate-to-severe injury completed a survey 6-14 months post-injury during the COVID-19 pandemic. This survey queried individuals about the perceived impact of the COVID-19 pandemic on injury recovery and assessed post-injury functional and mental health outcomes. Regression models were built to identify factors associated with a perceived negative impact of the pandemic on injury recovery, and to define the relationship between these perceptions and long-term outcomes. Results Of 597 eligible trauma survivors who were contacted, 403 (67.5%) completed the survey. Twenty-nine percent reported that the COVID-19 pandemic negatively impacted their recovery and 24% reported difficulty accessing needed healthcare. Younger age, lower perceived-socioeconomic status (SES), extremity injury, and prior psychiatric illness were independently associated with negative perceived impact of the COVID-19 pandemic on injury recovery. In adjusted analyses, patients who reported a negative impact of the pandemic on their recovery were more likely to have new functional limitations, daily pain, lower physical and mental component scores of the SF-12 and to screen positive for PTSD and depression. Conclusions The COVID-19 pandemic is negatively impacting the recovery of trauma survivors. It is essential that we recognize the impact of the pandemic on injured patients while focusing on directed efforts to improve the long-term outcomes of this already at-risk population.

PurposeThe purpose of this paper is to explore the relationship between cultural diversity in teams and team members' individual well-being. The paper further explores the relationship between social resources, social stressors, team member well-being and the influence of the type of team individuals are working in (mono- vs. multicultural), gender and individualism/collectivism (IC).Design/methodology/approachUsing data collected via an online survey, the authors analyzed 659 responses from individuals working in mono- and multicultural work teams. A theoretical model explaining the influence of social stressors, social resources, and social and demographic variables was proposed and tested using structural equation modeling.FindingsThe results indicate that members of multicultural work teams perceive significantly more social stressors and lower levels of social resources than do members of monocultural teams. Higher levels of social stressors suggest decreased psychological well-being, while social resources have an indirect positive effect on psychological well-being. Furthermore, personal characteristics, namely, individualism and gender, have direct effects on the perception of social stressors and indirect effects on team member well-being.Originality/valueThis paper demonstrates that cultural diversity in teams can influence the social stressors and resources that individual team members experience. Moreover, the pivotal role of social resources in the facilitation of team member well-being is highlighted primarily through its direct effect on social stressors and its concomitant indirect effect on well-being.

Prospective momentary psychological and biological measures of real-time daily life stress experiences have been examined in several psychiatric disorders, but not in adults with an autism spectrum disorder (ASD). The current electronic self-monitoring study examined associations between momentary daily life stressors and (i) negative affect (NA; emotional stress reactivity) and (ii) cortisol levels (biological stress reactivity) in males and females with ASD (N = 50) and without ASD (N = 51). The Experience Sampling Method, including saliva sampling, was used to measure three types of daily life stress (activity-related, event-related, and social stress), NA, and cortisol. Multilevel regression analyses demonstrated significant interactions between group and stress (i.e., activity-related and event-related stress) in the model of NA, indicating stronger emotional stress reactivity in the ASD than in the control group. In the model of cortisol, none of the group × stress interactions were significant. Male/female sex had no moderating effect on either emotional or biological stress reactivity. In conclusion, adults with ASD showed a stronger emotional stress (but not cortisol) reactivity in response to unpleasant daily life events and activities. The findings highlight the feasibility of electronic self-monitoring in individuals with ASD, which may contribute to the development of more personalized stress-management approaches. ispartof: SCIENTIFIC REPORTS vol:11 issue:1 ispartof: location:England status: published

Patients with serious mental illness are a high-risk category of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Patients with schizophrenia are not participatory and have increased mortality and morbidity, patients with dementia cannot be cared for while depression, anxiety, bipolar tubing are associated with low immune status. Social stress is amplified by social isolation, amplifying depression and the mechanisms of decreased immunity. Hygiene measures and prophylactic behavior are impossible to put into practice in conditions of chronic mental illness. In coronavirus disease 2019 (COVID-19), the risk for severe development is associated with the presence of comorbidities and immune system deficiency. Prothrombotic status, cytokine storm and alveolar destruction are mechanisms that aggravate the evolution of patients, especially in the context in which they have dysfunction of the autonomic system. The activity of proinflammatory cytokines is accentuated by hyperglutamatergia, which potentiates oxidative stress and triggers the mechanisms of neural apoptosis by stimulating microglial activation. Activation of M1-type microglia has an important role in pathogenesis of major psychiatric disorders, such as major depression, schizophrenia or bipolar disorder, and may associate hippocampal atrophy and disconnection of cognitive structures. Memantine and Amantadine, N-methyl-D-aspartate (NMDA) glutamate receptor inhibitors, have demonstrated, through their pharmacological profile, psychotropic effects but also antiviral properties. In the conditions of the COVID-19 pandemic, based on these arguments, we suggest that they can be associated with the therapy with the basic psychotropics, Memantine or Amantadine, for the control of neuropsychiatric symptoms but also as adjuvants with antiviral action.

Objectives Several studies show that severe social stressors, e.g., in the form of exposure to workplace bullying in humans, is associated with negative mental health effects such as depression and anxiety among those targeted. However, the understanding of the underlying biological mechanisms that may explain the relationship between exposure to bullying and such negative health outcomes is scarce. The analyses presented here focus on understanding the role of the β2-adrenergic receptors (ADRB2) on this association. Methods First, a resident-intruder paradigm was used to investigate changes in circulating norepinephrine (NE) in rat serum induced by repeated social defeat and its relationship with subsequent social behavior. Second, the direct effects of the stress-hormones NE and cortisol, i.e., synthetic dexamethasone (DEX), on the ADRB2 expression (qPCR) and monocyte chemoattractant protein-1 (MCP-1) release (immunoassay) was examined in cultured EL-1 cells. Third, in a probability sample of 1052 Norwegian employees, the 9-item short version of the Negative Acts Questionnaire—Revised (S-NAQ) inventory, Hopkins Symptom Checklist and genotyping (SNP TaqMan assay) were used to examine the association between social stress in the form of workplace bullying and anxiety moderated by the ADRB2 genotype (rs1042714) in humans. Results The present study showed a clear association between reduced social interaction and increased level of circulating NE in rats previously exposed to repeated social defeat. Parallel cell culture work, which was performed to examine the direct effects of NE and DEX on ADRB2, demonstrated ADRB2 downregulation and MCP-1 upregulation in cultured EL-1 cells. Genotyping with regard to the ADRB2 genotype; rs1042714 CC vs CG/GG, on human saliva samples, showed that individuals with CC reported more anxiety following exposure to bullying behaviors as compared to the G carriers. Conclusion We conclude that workplace bullying promotes anxiety and threaten well-being through an ADRB2 associated mechanism.

BackgroundThe biological consequences of stress from the social environment pattern health outcomes. This study investigated whether social stress is prospectively associated with fracture incidence among racially and ethnically diverse, postmenopausal women.MethodsData from 160 709 postmenopausal women in the Women’s Health Initiative was analysed using Cox proportional hazards regression models to examine prospective associations of social stress with time to total and hip fracture incidence. Self-reported questionnaires measuring social strain, social functioning and social support were used to assess social stress.ResultsAge and race/ethnicity modified associations between social stress and total and hip fractures. HRs for the associations between higher social support (indicating lower social stress) and total fractures among those age 50–59 years were 0.92 (95% CI: 0.90 to 0.94); HR=0.94 (95% CI: 0.93 to 0.95) for those age 60–69 years and HR=0.96 (95% CI: 0.95 to 0.98) for those age 70–79 years. Higher social strain was associated with greater hip fracture incidence among Native American women (HR=1.84, 95% CI: 1.10 to 3.10), Asian women (HR=1.37, 95% CI: 1.01 to 1.86) and white women (HR=1.04, 95% CI: 1.01 to 1.08).ConclusionIdentifying population patterns of fracture incidence as biological expressions of social environments reveals how race/ethnic specific social environmental factors influence disparities in fractures.

Objective Lesbian, gay, and bisexual (LGB) individuals who report greater minority stress (e.g., discrimination) are at an elevated risk for multiple health problems. However, few studies have examined physiological mechanisms that might link minority stress to health. This study tested how cardiovascular and cortisol responses to a laboratory-induced social stressor differed when that stressor contained an additional minority stress component. Method LGB adults (n = 141; 51% male, 49% female) participated in a social stress task in which they were interviewed by a prerecorded confederate. Participants were randomized to receive information that their interviewer held either antigay or progay social/political beliefs. Cardiovascular reactivity and salivary cortisol were assessed at baseline, during the task, and during recovery. Results All participants experienced significant task-related increases in heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP). However, participants in the antigay condition had greater increases in HR and SBP during the task and smaller decreases in SBP during recovery. Salivary cortisol increased significantly only in the antigay condition. High frequency heart rate variability (hfHRV) was constant throughout the stress task for participants in the progay condition but decreased significantly during the task for participants in the antigay condition. Conclusions Minority stress has the potential to affect LGB individuals' health through cardiovascular and endocrine mechanisms. Moreover, its physiological signature may differ from other social stress in ways that have implications for health and emotion regulation more broadly. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Background Prenatal exposure to per- and poly-fluoroalkyl substances (PFAS) and psychosocial stressors has been associated with adverse pregnancy outcomes, including preterm birth. Previous studies have suggested that joint exposure to environmental chemical and social stressors may be contributing to disparities observed in preterm birth. Elevated corticotropin-releasing hormone (CRH) during mid-gestation may represent one biologic mechanism linking chemical and nonchemical stress exposures to preterm birth. Methods Using data from a prospective birth cohort (N = 497), we examined the cross-sectional associations between five individual PFAS (ng/mL; PFNA, PFOA, PFOS, PFHxS, and Me-PFOSA-AcOH) and CRH (pg/mL) using linear regression. PFAS and CRH were measured during the second trimester in serum and plasma, respectively. Coefficients were standardized to reflect change in CRH associated with an interquartile range (IQR) increase in natural log-transformed PFAS. We additionally examined if the relationship between PFAS and CRH was modified by psychosocial stress using stratified models. Self-reported depression, stressful life events, perceived stress, food insecurity, and financial strain were assessed using validated questionnaires during the second trimester and included as binary indicators of psychosocial stress. Results An IQR increase in PFNA was associated with elevated CRH (β = 5.17, 95% confidence interval [CI] = 1.79, 8.55). Increased concentrations of PFOA were also moderately associated with CRH (β = 3.62, 95% CI = −0.42, 7.66). The relationship between PFNA and CRH was stronger among women who experienced stressful life events, depression, food insecurity, and financial strain compared to women who did not experience these stressors. Conclusions This cross-sectional study is the first to examine the relationship between PFAS exposure and CRH levels in mid-gestation. We found that these associations were stronger among women who experienced stress, which aligns with previous findings that chemical and nonchemical stressor exposures can have joint effects on health outcomes.

La exposición al sismo del 19-Septiembre (19S) de 2017 en Ciudad de México fue percibido como un estresor. En personas con vulnerabilidad biopsicosocial a desarrollar trastorno de estrés agudo y postraumático se presenta una elevada actividad simpática. Una medida no invasiva para evaluar el tono simpático es la temperatura nasal. Estudios recientes sugieren que en personas con estrés postraumático un estresor induce un prolongado descenso térmico nasal; mientras que la estimulación térmica no nociva puede mejorar el estado anímico. El presente estudio propone un proceso de termorregulación afectiva: el decremento térmico nasal durante una tarea de estrés social agudo y el incremento térmico nasal durante la relajación en estudiantes universitarios expuestos al sismo del 19-S mientras sostuvieron en manos un estímulo térmico no nocivo. Se utilizó un diseño cuasiexperimental de medidas repetidas de temperatura nasal, mediante un sensor infrarrojo, en 21 estudiantes, 20 días después del 19S. También se evaluó, mediante escalas psicométricas, el nivel de ansiedad, depresión, estrés postraumático, alexitimia, apoyo social, y percepción de estrés. Los resultados indicaron que la temperatura nasal disminuyó con el estresor (p0.05). Al analizar las diferencias psicosociales, el estrés percibido fue menor en quienes incrementaron su temperatura nasal (p

Autonomic nervous system (ANS) activity is a core and central component of emotion. The myriad social and cognitive challenges faced by humans require flexible modulation of ANS activity for different contexts. In this study, simultaneous activity of the parasympathetic and sympathetic nervous system was measured using respiratory sinus arrhythmia (RSA) and pre-ejection period (PEP), respectively. Samples combined four previous studies (N=325) in which RSA and PEP were collected continuously during a resting baseline and an acute stressor, the Trier Social Stress Task. The concurrent relation between RSA and PEP responses was modeled in order to determine the extent to which SNS and PNS activity is coordinated at rest, in response to a stressor, and during recovery, and whether this coordination was moderated by age, race, sex, or baseline RSA and PEP. Overall, RSA and PEP were reciprocally coupled within task periods, perhaps reflecting shared regulatory mechanisms in the brain, independent of reciprocal responses to environmental demands. However, recovery from a stressor was characterized by uncorrelated activity and coactivation on average. Individuals also vary in the extent to which their SNS and PNS are reciprocally coupled; women, younger adults, and individuals with higher baseline RSA showed more reciprocal coupling than men, older adults, and those with lower baseline RSA, respectively, perhaps reflecting a greater range of physiological responding in the former group.

Stress has a major impact on the modulation of metabolism, as previously evidenced by hyperglycemia following chronic social defeat (CSD) stress in mice. Although CSD-triggered metabolic dysregulation might predispose to pre-diabetic conditions, insulin sensitivity remained intact, and obesity did not develop, when animals were fed with a standard diet (SD). Here, we investigated whether a nutritional challenge, a high-fat diet (HFD), aggravates the metabolic phenotype and whether there are particularly sensitive time windows for the negative consequences of HFD exposure. Chronically stressed male mice and controls (CTRL) were kept under (i) SD-conditions, (ii) with HFD commencing post-CSD, or (iii) provided with HFD lasting throughout and after CSD. Under SD conditions, stress increased glucose levels early post-CSD. Both HFD regimens increased glucose levels in non-stressed mice but not in stressed mice. Nonetheless, when HFD was provided after CSD, stressed mice did not differ from controls in long-term body weight gain, fat tissue mass and plasma insulin, and leptin levels. In contrast, when HFD was continuously available, stressed mice displayed reduced body weight gain, lowered plasma levels of insulin and leptin, and reduced white adipose tissue weights as compared to their HFD-treated non-stressed controls. Interestingly, stress-induced adrenal hyperplasia and hypercortisolemia were observed in mice treated with SD and with HFD after CSD but not in stressed mice exposed to a continuous HFD treatment. The present work demonstrates that CSD can reduce HFD-induced metabolic dysregulation. Hence, HFD during stress may act beneficially, as comfort food, by decreasing stress-induced metabolic demands.

Quarantine is known as one of the strategies to minimize the spread of Covid-19. This study aims to seek scientific evidence regarding the impact of centralized quarantine on the mental health of people affected by Covid-19. We conducted a systematic search for articles evaluating the mental health conditions of Covid-19 sufferers and suspected cases who were undergoing quarantine. The search for articles was carried out on December 31, 2020, through the Science Direct, PubMed, and Springer databases. Among 704 articles, only seven reviews met our criteria. One study evaluating the mental condition of quarantine Covid-19 patients in hospital compared to a non-quarantine control group found that patients experienced higher rates of depression, anxiety, and post-traumatic stress symptoms. Depression and anxiety were reported to be health problems experienced by participants in all studies. Factors related to mental health conditions, namely female gender, lower education level, lower-income, and married status. Social stressors in the form of negative stigma from the community, lack of adequate information, and poor quarantine facilities worsen mental health conditions. Centralized quarantine has negative consequences for the mental health of sufferers of Covid-19. More attention needs to be paid to the mental health well-being of patients undergoing in centralized quarantine. The right strategy to minimize the negative impact of quarantine needs to be implemented in order to achieve individual mental health and prevent long-term complications.

Purpose Psychological distress is common in patients with cancer and is associated with lower quality-of-life (QOL). Although distress among oncology outpatients undergoing standard therapy has been widely studied, few studies have evaluated distress among patients enrolling on Phase I therapeutic clinical trials. Thus, we aimed to characterize levels of distress and types of stressors in patients enrolling on Phase I clinical trials. Methods Participants completed the National Comprehensive Cancer Network Distress Thermometer (NCCN DT) and Problem list and measures of anxiety and depression at the time of Phase I clinical trial initiation. Results We enrolled 87 patients (95% with metastatic/incurable disease) who were initiating a Phase I clinical trial. Analyses revealed a high prevalence of distress (51%) and anxiety (28%). There were significant correlations between overall distress and practical problems (r = 0.31, p = 0.016), family problems (r = 0.35, p = 0.006), and emotional problems (r = 0.64, p < 0.001), but not physical problems (r = 0.17, p = 0.206). Conclusions Patients may be better prepared to manage physical stressors but not practical, emotional, or family stressors at the time of Phase I trial enrollment. Implications for Cancer Survivors Phase I trial patients experience high levels of distress which may be due to the rigors of previous therapies therapy and related emotional and social stressors related to the poor prognosis of their advanced cancer diagnosis. Distress may go unidentified without screening which is not standard practice at the time of Phase I trial consideration. Future studies should evaluate strategies to routinely identify and intervene upon addressable stressors in patients participating in Phase I clinical trials.

The cortisol response to social evaluative stress has been well characterized. However, data regarding changes in gonadal hormones after stress are still scarce and inconsistent. The majority of studies have focused on testosterone reactivity to stress in men, while estradiol responses or gonadal stress responses in women have hardly been investigated. Furthermore, it has not been evaluated whether sex hormone reactivity to stress differs between men and women and the relationship between cortisol and gonadal reactivity to stress is still unclear. To address these questions, we re-analyzed saliva samples collected from 37 men and 30 women in their luteal cycle phase before and repeatedly after social-evaluative stress. Both, testosterone and estradiol levels were assessed. In both men and women, testosterone was significantly reduced after stress. Testosterone levels were at their lowest after 20 minutes, but did not return to baseline until 35 minutes after stress. Across the whole sample, estradiol was significantly increased after stress with two separate peaks after 15 and 30 minutes. Follow-up analyses revealed that 41 participants actually responded with a decrease in estradiol levels to stress, with lowest levels after 20 min, while the remaining participants responded with an increase in estradiol levels. These gonadal stress responses appear to be largely independent of the cortisol response to stress. These results demonstrate that the endocrinological stress response is not restricted to the HPA axis and stress responsivity of gonadal hormones is not simply driven by cortisol. Accordingly, the stress responsivity of gonadal hormones and their association to psychological variables is an additional avenue to explore in both men and women.

Introduction Healthcare workers (HCWs) are often exposed to mistreatment by patients, which has negative effects on both staff and institutions. To take appropriate action to help HCWs in this context, patient-related social stressors (PSS) should be explored. The purpose of the research was to identify the most pronounced patient behaviour contributing to the social stress (SS) of HCWs, and compare PSS between different HCWs and different types of healthcare institutions. Methods 750 HCWs from Slovenian public health centres and hospitals participated in the online survey. Although the non-probability sampling was used, the sample was representative according to gender and HCW type (doctors, nurses and other HCWs). Results The results show that the most pronounced patient behaviour contributing to the SS of HCWs are attitudes and behaviour of patients that are challenging in terms of what is – from the HCWs’ point of view – considered as acceptable and reasonable (disproportionate patient expectations), and unpleasant, humourless, and hostile patients. HCWs in primary institutions meet less verbally aggressive and unpleasant patients than in tertiary ones. Although among all HCWs less educated ones are more exposed to inappropriate behaviour, doctors are those HCWs who experience more inappropriate behaviour. Conclusion Managers should enable HCWs to get comprehensive patient service training, oriented towards improving relationship management and patient-HCW relationships.

Background Previous studies have reported a negative psychological and mental health impact of the COVID-19 pandemic. This impact is likely to be stronger for people with autism as they are at heightened risk of mental health problems and because the pandemic directly affects social functioning and everyday routines. We therefore examined COVID-19 pandemic-related changes in mental health, the impact of the pandemic on their social life and routines, satisfaction with pandemic-related information and tips, and participants’ wishes for guidance. Methods We used a mixed-method approach, collecting quantitative and qualitative survey data from adults with and without autism across three European countries: Belgium, the Netherlands, and the UK (N = 1044). Results We found an increase in depression and anxiety symptoms in response to the pandemic for both the non-autism and the autism group, which was greater for adults with autism. Furthermore, adults with autism showed a greater increase in worries about their pets, work, getting medication and food, and their own safety/security. They felt more relieved from social stress, yet experienced the loss of social contact as difficult. Adults with autism also felt more stressed about the loss of routines. Pleasant changes noted by adults with autism were the increase in solidarity and reduced sensory and social overload. Adults with autism frequently reported problems with cancellation of guidance due to the pandemic and expressed their wish for (more) autism-specific information and advice. Limitations Our sample is likely to reflect some degree of selection bias, and longitudinal studies are needed to determine long-term effects. Conclusions Results highlight the psychological burden of the pandemic on adults with autism and shed light on how to support them during this COVID-19 pandemic, which is especially important now that the pandemic is likely to have a prolonged course. There is a need for accessible, affordable (continued) support from health services. Guidance may focus on the maintenance of a social network, and adjusting routines to the rapid ongoing changes. Finally, we may learn from the COVID-19 pandemic-related changes experienced as pleasant by adults with autism to build a more autism-friendly society post-pandemic.

In social mammalian species, such as human and mouse, social stress can arise from different social interactions; for example, from encounters with aggressive strangers (whether they be mice or men). Repeated exposure to such stress can lead to various conditions, including depression and anxiety, but different individuals show varying degrees of resilience to such stress. To explore the mechanisms underlying such differential response to stress, Sakamoto et al. from Johns Hopkins University and University of Alabama at Birmingham used a mouse model of chronic 'social defeat' stress (CSDS) to examine molecular changes in the blood following stress. In an article published in this issue of FEBS Open Bio, the authors report how molecular alterations in circulating extracellular vesicles (EVs) influence social behaviours and resilience to chronic social stress. Test mice were classified as resilient or susceptible to social stress and their blood samples were analysed. Their data demonstrated that mice susceptible to CSDS have alterations in the miRNA content of circulating EVs, and these EVs in turn influence the expression of pro-inflammatory cytokines in microglia cells, thereby resulting in social avoidance phenotypes. Since low resilience to social stress may be linked to the progression of several psychiatric disorders, it may ultimately be possible to determine prognosis or likely response to therapy for individuals susceptible to or suffering from such conditions by profiling pro-inflammatory cytokines and EV-associated miRNAs in blood samples.

Heart rate variability (HRV) is an important biomarker for parasympathetic function and future health outcomes. The present study examined how the structure of regions in a neural network thought to maintain top-down control of parasympathetic function is associated with HRV during both rest and social stress. Participants were 127 young women (90 Black American), who completed a structural MRI scan and the Trier Social Stress Test (TSST), during which heart rate was recorded. Regression analyses were used to evaluate associations between cortical thickness in five regions of the Central Autonomic Network (CAN; anterior midcingulate cortex [aMCC], pregenual and subgenual anterior cingulate cortex [pgACC, sgACC], orbitofrontal cortex [OFC], and anterior insula) and high-frequency HRV during rest and stress. Results indicated that cortical thickness in CAN regions did not predict average HRV during rest or stress. Greater cortical thickness in the right pgACC was associated with greater peak HRV reactivity during the TSST, and survived correction for multiple comparisons, but not sensitivity analyses with outliers removed. The positive association between cortical thickness in the pgACC and peak HRV reactivity is consistent with the direction of previous findings from studies that examined tonic HRV in adolescents, but inconsistent with findings in adults, which suggests a possible neurodevelopmental shift in the relation between brain structure and autonomic function with age. Future research on age-related changes in brain structure and autonomic function would allow a more thorough understanding of how brain structure may contribute to parasympathetic function across neurodevelopment.

Background: Aspects of the canonical stress response differ in stimulant, opioid, and alcohol users relative to controls, and dysregulated responses to stress may contribute to continued use of these drugs. Little prior research has focused on stress responses in regular cannabis smokers. We assessed responses to a standardized laboratory social stress assay (the Trier Social Stress Task; TSST) in regular cannabis smokers (CANs) compared with controls (CONs). Methods: Healthy, non-treatment-seeking adult CANs (⩾4×/week; smoking cannabis as usual) and demographically matched CONs completed the TSST. Outcome measures were subjective mood, heart rate, and salivary cortisol. Results: Nineteen CANs (1 female) and 20 CONs (2 female) participated; groups were matched on trauma exposure, sex, race, and age. CANs smoked cannabis 6.4 ± 1.1 days/week. Eight CANs and one CON smoked tobacco cigarettes daily. Overall, the TSST produced expected increases in anxiety, negative mood states, cortisol, and heart rate. CANs had blunted subjective response to stress relative to CONs, but they did not differ in physiological (cortisol and cardiovascular) stress responding. Conclusion: These results indicate that CANs have blunted mood responses to social stress, but normative physiological stress responding. Observed differences could be due to residual effects of cannabis, reluctance to endorse negative mood states, or to issues related to identifying (i.e., emotional identification) or feeling (i.e., interoception) stress-related affective states. Further research is warranted to characterize the mechanisms of these differences and assess implications for daily functioning and treatment outcomes.

The current coronavirus disease 2019 (COVID-19) pandemic represents a severe, life-changing event for people across the world. Life changes may involve job loss, income reduction due to furlough, death of a beloved one, or social stress due to life habit changes. Many people suffer from social isolation due to lockdown or physical distancing, especially those living alone and without family. This article reviews the association of life events and social isolation with cardiovascular disease, assembling the current state of knowledge for stroke and coronary heart disease. Possible mechanisms underlying the links between life events, social isolation, and cardiovascular disease are outlined. Furthermore, groups with increased vulnerability for cardiovascular disease following life events and social isolation are identified, and clinical implications of results are presented.

Background: Uncontrolled hypertension is a significant risk factor for cardiovascu­lar morbidity and mortality. In the United States, many patients remain uncontrolled, in part, due to poor medication adherence. Efforts to improve hypertension control include not only attending to medical management of the disease but also the social determinants of health, which impact medication adherence, and ultimately blood pressure control.Purpose: To determine which social deter­minants – health care access or community and social stressors - explain medication adherence.Methods: In this cross-sectional analysis, we used baseline data (N=1820, col­lected August 2017 to October 2019) from a pragmatic trial, which compares the effectiveness of a multi-level intervention including collaborative care and a stepped approach with enhanced standard of care for improving blood pressure. We used logistic regression analyses to examine the association between patient experiences of care and community and social stressors with medication adherence.Results: The participants represented a diverse sample: mean age of 60 years; 59% female; 57.3% Black, 9.6% Hispanic, and 33.2% White. All participants had a blood pressure reading ≥140/90 mm Hg (mean blood pressure – 152/85 mm Hg). Half of the participants reported some level of non-adherence to medication. Regression analy­sis showed that, compared with Whites, Blacks (AOR .47; 95% CIs: .37-.60, P

Background Burnout is a negative workplace syndrome of emotional exhaustion, cynicism, and perceived professional inefficacy that risks the patient-provider relationship, patient care, and physician well-being. Objective To assimilate the neurosurgical burnout literature in order to classify burnout among domestic and international neurosurgeons and trainees, identify contributory factors, and appraise the impact of wellness programs. Methods A scoping review identified the available literature, which was reviewed for key factors related to burnout among neurosurgeons. Two researchers queried PubMed, Embase, Google Scholar, Cochrane, and Web of Science for articles on burnout in neurosurgery and reduced 1610 results to 32 articles. Results A total of 32 studies examined burnout in neurosurgery. A total of 26 studies examined prevalence and 8 studies detailed impact of wellness programs. All were published after 2011. Burnout prevalence was measured mostly through the Maslach Burnout Inventory (n = 21). In 4 studies, participants defined their own understanding of "burnout." Domestically, burnout prevalence was 11.2% to 67% among residents and 15% to 57% among attendings. Among trainees, poor operative experience, poor faculty relationships, and social stressors were burnout risks but not age, sex, or marital status. Among attendings, the literature identified financial or legal concerns, lack of intellectual stimulation, and poor work-life balance as risks. The impact of wellness programs on trainees is unclear but group exercises may offer the most benefit. Conclusion Noticeable methodological differences in studies on trainee and attending burnout contribute to a wide range of neurosurgery burnout estimates and yield significant knowledge gaps. Environment may have greater impact on trainee burnout than demographics. Wellness programs should emphasize solidarity.

Although various governmental entities in the USA are required to consider environmental justice (EJ) impacts of their actions during decision-making, socially vulnerable groups continue to be disproportionately exposed to environmental hazards. Tools and programs to quantify and mitigate environmental injustices are limited by existing data, which may not capture the full range of health disparities exacerbated by the complex interactions between environmental exposures and social stressors. In this study, we analyzed how the scientific literature approaches EJ issues in the USA. We searched PubMed for journal articles discussing at least one sociodemographic or environmental variable in the context of cumulative impacts and analyzed the relative frequency with which various EJ topics were studied. Our findings indicate that demographic variables are commonly used in epidemiologic studies, though some areas (e.g., age) are better studied than others. Similarly, occupational exposure and ambient air pollution were more studied than other types of exposures. Word frequency analyses revealed which toxicants and health outcomes are the most frequently studied. In addition, temporality analyses showed that the rate of occupational publications rose rapidly in the 1970-1980s and has since plateaued, while other publication rates increased two decades later and are still on the rise. Cumulative impacts are considered in a relatively small portion of journal articles across all topics; nevertheless, they have seen an exponential climb in the last decade. A more equitable distribution of scientific efforts might be needed for a better distribution of funding, policy-making efforts, and other resources to socially and environmentally vulnerable communities.

We aimed to conduct a systematic review of studies exploring the relationship between prenatal alcohol exposure (PAE) and hypothalamic-pituitary-adrenal (HPA) axis functioning in the offspring in humans. Animal studies have demonstrated that PAE has long-term consequences in HPA axis activity in the offspring. Fewer studies have been conducted in humans. Our systematic review identified 9 studies including infants/toddlers (n = 6) and children/adolescents (n = 3). Cortisol responses to stress were only studied in infants/toddlers (3 studies: painful stressors; 3 studies: social stressors). In infants/toddlers, PAE seems to be associated with a blunted response to painful stressors whereas an enhanced cortisol response to social stress is observed (only in boys). In children/adolescents, the normal cortisol circadian rhythm is altered in PAE participants with a FASD diagnosis, who show increased evening cortisol levels. These findings support the programming effects of alcohol on the HPA stress system.

The coronavirus disease 19 (COVID-19) pandemic has negatively affected people's day-to-day lives, especially those with mental illness. We present a case of a manic episode with psychotic features induced by dexamethasone administered as part of COVID-19 treatment. The patient had underlying depression, anxiety, and posttraumatic stress disorder, but was stable before contracting COVID-19. The implications of quarantine and social stress on mood stability are also discussed. We call for better patient education on the risks of steroid-induced mania and psychosis as well as increased attention to mental illness screening and treatment during this unprecedented pandemic time.

Stress and ethanol consumption are known to affect the immune system, interfering in individual health, and resistance to opportunistic diseases. When experienced together, stress and ethanol seem to interact uniquely, altering each other effects depending on the exposure schedule. However, the effects of social stress on chronic ethanol exposure effects on the immune system are not well elucidated. To study this interaction, we chronically treated male swiss mice with ethanol after repeated social defeat stress (SDS) exposure. Some animals were tested in the elevated plus-maze (EPM) and open field (OF) while another cohort had plasmatic TNF-α, TGF-β1, CXCL-1, CCL-2, and VEGF quantified. Mice exposed to SDS or ethanol withdrawal showed increased anxiety-like behaviors in the EPM, while ethanol withdrawal decreased locomotor activity. Both alterations were attenuated in the groups exposed to SDS and ethanol withdrawal. Ethanol and stress alone increased plasmatic CXCL-1, while only stress affected CCL-2 and VEGF. Our results suggest that SDS exposure and ethanol withdrawal attenuated the increase in anxiety-like behaviors, but did not alter each other effects on cytokine content.

Objective: The aim of the current study was to investigate cardiovascular responses to a brief social exclusion stressor, the Cyberball task, and to determine whether individual differences in depression, anxiety, and perceived social isolation moderate physiological stress responses. Methods: Sixty-four participants engaged in the Cyberball task while heart rate, blood pressure, and respiratory rate were continuously measured. Results: Systolic (M = 121.61, SD = 13.34) and diastolic (M = 77.34, SD = 7.56) blood pressure increased significantly during the exclusion condition compared with the rest condition (M = 117.81, SD = 12.71, M = 75.63, SD = 7.39, respectively). Significant correlations were also found between social anxiety (r = −0.25) and depression (r = −0.25) scores with systolic blood pressure from the exclusion condition. Further, participants who reported high depression scores had attenuated cardiovascular responses to social exclusion. Conclusions: Overall, cardiovascular activity were elevated after a brief social stressor, but those with clinically relevant cut off scores on the CES-D had attenuated cardiovascular responses These findings support the growing body of literature surrounding cardiovascular stress reactivity to stress induced from social exclusion.

Nicotine use and social stress have a complex interplay, which has been shown to be mediated by cholinergic neurons in the ventral tegmental area (VTA). Social stress is often comorbid with nicotine consumption, and the presence of either stress or nicotine use significantly increasesthe riskof developing the other. In fact, it has been shown in mice that nicotine injection is sufficient to increase susceptibility to social defeat, a reliable model for stress and anxiety-like behavior. Stressful events can molecularly remodel cholinergic synapses, inducing the production of more cholinergic transporters and increasing the number of nicotinic receptor binding sites. One way stress and nicotine remodel cholinergic synapses are through long-term potentiation (LTP) in cholinergic pathways in the VTA, enhancing the experience of stress and the effects of addiction. Despite both primarily acting on the alpha7subtype nicotine receptor, nicotine and stress induce LTP in vastly different ways: nicotine acts quickly via ligand-gated ion channels while stress activates a slower hormonal-induced G-protein coupled receptor pathway. These findings suggest that dopaminergic VTA neurons may be a useful therapeutic target for depression, anxiety, and other stress-related disorders. Deep brain stimulation has preliminarily shown to be a potential therapeutic treatment for untreatable depression, especially when it targets the medial forebrain bundle within the VTA-NAc pathway. Sleep patterns are also partially regulated by dopaminergic VTA neurons, and sleep deficits may contribute to social stress and other depressive symptoms. The role of nicotine dependence in stress-related mental illnesses is especially important to consider given the recent increase in adolescent nicotine use with the advent of vaping. Adolescents already have an increased risk for developing mental illnesses, and it is important that young people are made aware of the potential psychological harms of nicotine use.

Objective: Individual differences in long-term cardiovascular disease risk are related to physiological responses to psychological stress. However, little is known about specific physiological response profiles in young adults that may set the stage for long-term increased cardiovascular disease risk. We investigated individual differences in profiles of resting cardiovascular physiology and stress reactivity, combining parasympathetic, sympathetic, and hemodynamic measures.Methods: Participants (n = 744, 71% women, mean [standard deviation] age = 20.1 [2.4] years) underwent the Trier Social Stress Test, while blood pressure (systolic blood pressure, diastolic blood pressure), electrocardiograms (interbeat interval), and impedance cardiograms (preejection period, left ventricular ejection time) were recorded. Respiratory sinus arrhythmia was derived from the combination of the electrocardiogram and the impedance cardiogram. A three-step latent profile analysis (LPA) was performed on resting and reactivity values to derive clusters of individual physiological profiles. We also explored demographic and health behavioral correlates of the observed latent clusters.Results: For resting physiology, LPA revealed five different resting physiology profiles, which were related to sex, usual physical activity levels, and body mass index. Five cardiovascular stress reactivity profiles were identified: a reciprocal/moderate stress response (Cr1; 29%), and clusters characterized by high blood pressure reactivity (Cr2: 22%), high vagal withdrawal (Cr3; 22%), autonomic coactivation (parasympathetic nervous system and sympathetic nervous system; Cr4; 13%), and overall high reactivity (Cr5; 12%). Men were more likely to belong to the high reactivity (Cr5) cluster, whereas women were more likely to have autonomic coactivation (Cr4).Conclusions: We identified five cardiovascular physiological reactivity profiles, with individuals displaying generalized hyperreactivity, predominant vagal withdrawal, autonomic coactivation, or blood pressure-specific hyperreactivity. Longitudinal studies are needed to determine whether these profiles are useful in early detection of individuals at high risk for cardiovascular disease.

Background: The first COVID-19 cases were diagnosed in Russia on 31 January 2020. By the end of March, many hospitals cancelled all scheduled procedures and started receiving patients with COVID-19. Large group of healthcare workers were involved in the treatment of patients with the novel virus. The mental health of medical workers treating patients with COVID-19 is now becoming an issue of increasing concern worldwide. However, the available data on stress and anxiety symptoms among healthcare workers during the COVID-19 are relatively limited and have not been evaluated in Russia yet. This study had two objectives: first, we aimed to evaluate stress and anxiety symptoms among healthcare workers directly involved in the diagnosis and treatment of patients with COVID-19 during the outbreak in Russia. A second objective was to validate the Russian version of new Stress and Anxiety to Viral Epidemics – 9 (SAVE-9) scale. Methods: The study was a cross-sectional hospital-based anonymous on-line survey between May 12th and May 26th, 2020 of 1,090 healthcare workers - 548 physicians [50.2%] and 542 nurses [49.8%] directly involved in the diagnosis and treatment of patients with COVID-19 . All the participants were directly involved in the treatment of such patients. Stress and anxiety symptoms were assessed using the Russian versions of SAVE-9 and GAD-7 scales. Logistic regression, Kaiser-Meyer-Olkin two component factor model, Cronbach's alpha and ROC-analysis were performed to determine the influence of different variables, internal structure and consistency, sensitivity and specificity of SAVE-9 compared with Generalized Anxiety Disorder – 7 (GAD-7). Findings: The median scores on the GAD-7 and SAVE-9 were 5 and 14, respectively. 535 [49.1%] respondents had moderate and 239 [21.9%] had severe anxiety according to selected SAVE-9 total score interpretation by percentiles. 134 participants [12.3%] had severe anxiety, 144 [13.2%] had moderate according to GAD-7. 707 [64.9%] participants often or always have been worried about their family or friends getting infected because of them, 387 [35.5%] – have been more sensitive towards minor physical symptoms. The component model (Kaiser-Meyer-Olkin adequacy criterion = 0.847, Barletts' sphericity criterion, p

Introduction: Infertility is not only a gynecological illness but also a bio-psycho-social health problem including a lower Quality of Life (QOL), psychiatric problems, marital conflicts and sexual dissatisfaction. Women in India are facing the burden of infertility treatment because of cultural and social stress, lack of knowledge and which can lead to other mental health problems. Objectives: The study aimed to assess the psychological status including the anxiety and depression, level of social support by family spouse and peer, and to assess the level of health system support by doctors, nurses and any health care provider to the women who are diagnosed with primary infertility. Methodology: Quantitative (non-experimental) approach was used. The data was collected from select 80 women who were undergoing infertility treatment at National Institute of Health and Family Welfare, New Delhi. A standardized scale (BAI and BDI) was used to assess the psychological status and structured questionnaire to assess the social support and health system support among the women in view of getting infertility treatment support for data collection and later data was analyzed using descriptive statistics. Result: The findings revealed that 28.75% were normal and 28.75% had moderate level and10% had severe level of depression, 93.75% had low level of anxiety, 5% had moderate level of anxiety and 1.25% had extreme level of anxiety, the 80% were getting average, 11.25% getting poor and 8.75% were getting good social support. 96.25% women were getting good support, 1.25% were getting average support and 2.5% were getting poor support from the health system. Conclusion: The study concluded that women who are undergoing infertility treatment had faced moderate mood disturbances as well less support from the family and spouse in their life. Further research must be undertaken to investigate better management for psychological and emotional support techniques to surpass their problem and you are valuable with or without a baby. How to cite this article:Pawar D, Shaiju B, Khan F. A Study to Assess the Psychological Status, Social and Health System Support to the Women who are Undergoing Infertility Treatment. Int J Nurs Midwif Res 2020; 7(2): 11-15. DOI: https://doi.org/10.24321/2455.9318.202012