Symptoms Of Emotional Disorders Research Articles

HUBUNGAN STRATEGI COPING DENGAN KECEMASAN MENGHADAPI PERSALINAN PADA IBU HAMIL PRE EKLAMPSIA BERAT DI RSUD SYARIFAH AMBAMI RATO EBHU BANGKALAN

Anxiety is something that afflicts almost everyone at a certain time in his life. Anxiety is a normal reaction to a situation that is very pressing for one's life. Anxiety can arise alone or join with other symptoms of various emotional disorders (Savitri Ramaiah, 2003: 10). Based on the results of the preliminary study, it is known that there are still mothers who experience anxiety about facing labor in PEB pregnant women, which is 29%. The purpose of this study was to determine the relationship between coping strategies and the anxiety of facing labor in PEB pregnant women at Syarifah Ambami Hospital Rato Ebhu Bangkalan. This research method is Analytical, while the research design uses cross sectional. Independent variables are coping strategies, and the dependent variable is anxiety. Population, namely all pregnant women with PEB as many as 33 pregnant women with an average of each month. Samples taken as many as 30 pregnant women with simple random sampling technique. Data collection using questionnaires and HARS scale were processed using cross tabulation and lambda statistical tests. From the results of the study, almost half of 45.8% of PEB pregnant women with mild anxiety with adaptive coping strategies were obtained. Based on the lambda statistical test, get pValue = 0.045 and a = 0.05. Thus the results obtained p = 0.045 <a = 0.05, which means that H0 is rejected and H1 is accepted, namely there is a significant relationship between Coping and Anxiety Strategy in Facing Labor in PEB Pregnant Women at Syarifah Ambami Hospital Rato Ebhu Bangkalan. The results of this study are expected to be a reference for midwives that a high-risk pregnant woman also has excessive anxiety that can affect the delivery process. By doing so, health workers should be able to provide detailed information to pregnant women about the high risks they experience.

Emotional disorder symptoms, anhedonia, and negative urgency as predictors of hedonic hunger in adolescents

Affect and reward are associated with unhealthy eating and weight; however, less research has examined affective predictors of hedonic hunger (i.e., extreme reward responsivity, pleasure toward, and drive for food), particularly among adolescents. Whether symptoms indicative of emotional disturbance increase risk of adverse reward-based eating-related symptoms such as hedonic hunger, is unknown. Such evidence could explain why emotional problems increase risk of eating and weight problems among adolescents, when eating-related health problems often originate. This report examined baseline emotional disorder symptoms, negative urgency (i.e., tendency to act impulsively in response to negative affect), and anhedonia (i.e., loss of interest in activities and decreased pleasure) as prospective predictors of increases in hedonic hunger in adolescents; associations between changes in emotional disturbance problems and hedonic hunger were also examined. Ninth-grade students (N = 2598) from high schools completed paper-and-pencil surveys at baseline and a 1-year follow-up. In a multivariable model controlling for the covariance of emotional problems, higher negative urgency, general anxiety, and obsessive-compulsive symptoms, and lower anhedonia at baseline independently predicted increases in hedonic hunger one year later. Also, increases in negative urgency, general anxiety, and obsessive-compulsive symptoms and decreases in anhedonia independently predicted increases in hedonic hunger. Affect- and reward-related variables may be important contributors to risk of hedonic hunger in adolescence.

Efficacy of online Memory Specificity Training in adults with a history of depression, using a multiple baseline across participants design

Background and objectivesMemory Specificity Training (MeST), a group training protocol, is effective in improving autobiographical memory specificity (AMS), and in so doing, reducing emotional disorder symptoms amongst clinical groups. We examined MeST's effectiveness when the core component (memory specificity trials) is offered online and individually (c-MeST). MethodsA multiple-baseline across-participants design with a randomization-to-baseline length (14 to 33 days) was used. Participants were twenty adults (16 female; Mage = 50, SD = 12) experiencing reduced AMS, at least one lifetime depressive episode and who currently reported at least minimal depressive symptoms. During baseline, the training phase (nine sessions across 17 days) and a three-month follow-up assessment, AMS, depressive symptoms and related processes were measured. ResultsAMS improved significantly by three months follow-up. Session-to-session scores indicated that AMS improved most from baseline to the first online session, with no further improvement thereafter. In contrast to studies with clinical participants, no significant change in symptoms or secondary processes such as rumination was found. ConclusionsTranslating MeST into an online, individual version is a feasible, low-cost intervention for reduced AMS. Future research should examine c-MeST's potential for preventing increases in symptoms in at-risk samples with longer follow-ups as well as its potential for reducing symptoms in clinical groups.

Parents' Personality-Disorder Symptoms Predict Children's Symptoms of Anxiety and Depressive Disorders - a Prospective Cohort Study.

Personality disorder (PD) symptomatology is characterized by interpersonal problems and emotional dysregulation, which may affect offspring of parents with PD symptoms. Notably though, studies are needed to discern (i) whether parental PDs forecast symptoms of psychiatric disorders in offspring during their childhood years and (ii) whether such prospective relations obtain after accounting for common causes (e.g., genetics, common methods). To address these issues, we followed up a community sample of Norwegian children biennially from ages 4 to 8 (n = 594), using a semi-structured psychiatric interview (PAPA/CAPA) to capture DSM-IV defined symptoms of emotional disorders. Parental symptoms of personality disorders were captured by the DSM-IV and ICD-10 Personality Questionnaire (DIP-Q), whereas depression and anxiety in caregivers were measured using the Beck Depression Inventory -II and Beck Anxiety Inventory, respectively. Upon applying a hybrid fixed and random effects method that takes into account all unmeasured time-invariant confounders, we found that: (i) Parental symptoms of DSM-IV defined Cluster A and C were related to symptoms of anxiety disorders in offspring two years later, even after accounting for children's initial levels of anxiety and parental anxiety, whereas (ii) Parental DSM-IV Cluster B predicted symptoms of depressive disorders in children, adjusted for children's initial levels of depression and parental depression. Clinical implications of the results are discussed.

Indirect Associations of Anxiety Sensitivity with Tobacco, Alcohol, and Other Drug Use Problems Through Emotional Disorder Symptoms in Adolescents

Theoretically, anxiety sensitivity—fear of anxiety symptoms—enhances perception of and emotional reactivity to autonomic arousal and mental distress, thereby increasing negative affect and motivation to use substances for negative reinforcement. Because no prior study of adolescents has tested if anxiety sensitivity is indirectly associated with substance use problems through symptoms of emotional disorders (i.e., disorders involving high levels of negative affect), the current cross-sectional study examined this theoretical pathway. Participants included ninth-grade students from 10 different high schools in the Los Angeles metropolitan area (N = 3005; 54.3% female). Self-report measures of anxiety sensitivity, emotional disorder symptoms, tobacco dependence, and alcohol and other drug problems were administered. Controlling for sex, race/ethnicity, parental education, school, and impulsiveness, we tested the associations of anxiety sensitivity with tobacco, alcohol, and other drug use problems as well as the indirect effects of anxiety sensitivity on each domain of substance use problems through emotional disorder symptoms. Anxiety sensitivity was associated with more severe tobacco dependence and greater alcohol problems and other drug problems, and anxiety sensitivity further was indirectly associated with all three domains of substance use problems through emotional disorder symptoms. Current findings suggest that adolescents high in anxiety sensitivity tend to experience emotional disorder symptoms, which may increase risk for substance use problems. Interventions that target anxiety sensitivity and enhance negative-affect coping skills may assist in preventing and reducing adolescent substance use problems.

A meta-analysis and systematic review of Memory Specificity Training (MeST) in the treatment of emotional disorders

The tendency to recall events from one's past in a non-specific and overgeneral way has been found to predict the onset and severity of a range of emotional disorders. Memory Specificity Training (MeST) was devised a decade ago in order to target and modify this tendency so as to reduce the symptoms of emotional disorder or to reduce the risk that such disorders might emerge over time. We present a meta-analytical review of research into the effects of MeST on autobiographical memory specificity in the context of emotional disorders (k = 13). MeST was associated with substantial improvement in memory specificity (d = −1.21) and depressive symptoms (d = 0.47) and MeST groups outperformed control groups at post-intervention in terms of specificity (d = 1.08) and depressive symptoms (d = −0.29). However, these effects were transitory and the benefit of MeST over control groups was mostly lost by follow-up assessment. There was mixed evidence in terms of MeST's effects on other processes associated with reduced specificity but MeST showed evidence of improving problem solving abilities and hopelessness. MeST holds promise as a novel intervention targeting reduced specificity but future studies are warranted with control groups that enable the investigation of MeST's mechanism of action and in studies with larger and more varied samples.

Reciprocal associations between screen time and emotional disorder symptoms during adolescence.

Screen-based sedentary behaviors and emotional disorders are associated with one another in youth. Yet, the direction of the association is unclear, as is whether specific types of screen-based sedentary behaviors and emotional disorder symptoms are more closely linked. This study estimated the bi-directional associations between two types of screen-based sedentary behaviors and four types of self-reported emotional disorder symptoms, and tested whether physical activity buffered these associations in a Los Angeles high school student cohort (N = 2525, baseline Mage = 14.6 years). Participants completed baseline (9th Grade, 2013) and 12-month follow-up (10th grade, 2014) surveys reporting on: television viewing and computer/videogame use (≥4 h/day; yes/no), physical activity (≥60 min/day for ≥5 days/week), and Major Depressive Disorder (MDD), Generalized Anxiety Disorder (GAD), Panic Disorder (PD), and Social Phobia (SP) symptoms (meet/exceed [sub]clinical symptom threshold; yes/no). After adjusting for baseline screen-based sedentary behavior and covariates, students with (sub)clinical baseline MDD and GAD were at increased odds of high computer/videogame use one year later (OR = 1.36[95%CI, 1.07–1.73]; OR = 1.36[95%CI,1.09–1.71], respectively). Baseline SP was marginally related to increased computer/videogame use at follow-up (OR = 1.33[95%CI,1.04–1.69]). Greater baseline computer/videogame use was associated with increased odds of (sub)clinical GAD (OR = 1.54[95%CI,1.23–1.94]) and (sub)clinical SP (OR = 1.64[95%CI 1.27–2.12]) at follow-up; these associations were suppressed among baseline physically active students. Television viewing was unrelated to emotional disorder symptoms and PD was not associated with screen-based sedentary behaviors. Thus, only reciprocal associations between computer/videogame use, SP, and GAD during a one-year period of adolescence were observed. Interventions reducing computer/videogame use and increasing physical activity may improve adolescent emotional health.

The mediating role of emotion dysregulation as a transdiagnostic factor in the relationship between pathological personality dimensions and emotional disorders symptoms severity

The present study aims to investigate the mediating role of emotional dysregulation as a transdiagnostic factor in the relationship between pathological personality dimensions and emotional disorder symptoms severity. A total of 440 university students were selected randomly from two universities, and were assessed through Personality Inventory for DSM 5 Brief Form (PID-5-BF)-Adult, Depression, Anxiety and stress Scales (DASS-21), and Difficulties in Emotion Regulation Scale (DERs). The results obtained from the correlation revealed that there is a direct and significant relationship between pathological personality dimensions and emotional disorders (anxiety and depression). In addition, Structural Equation Modeling (SEM) depicted that emotional dysregulation, as a transdiagnostic factor, can mediate the relationship between pathological personality and emotional disorders (anxiety, depression, and stress). The current findings illustrate how emotional dysregulation can increase the influenceability of pathological personality dimensions on emotional disorders.

Efficacy of the Unified Protocol for transdiagnostic treatment of comorbid psychopathology accompanying emotional disorders compared to treatments targeting single disorders

ObjectiveThis study aimed to examine whether the Unified Protocol (UP), a transdiagnostic cognitive-behavioral therapy for emotional disorders (i.e., anxiety, mood, and related disorders), is efficacious in the treatment of co-occurring emotional disorders compared to established single disorder protocols (SDPs) that target specific disorders (e.g., panic disorder). MethodParticipants included 179 adults seeking outpatient psychotherapy. Participant age ranged from 18 to 66 years, with an average of 30.66 years (SD = 10.77). The sample was 55% female and mostly Caucasian (83%). Diagnostic assessments were completed with the Anxiety Disorder Interview Schedule (ADIS), and disorder-specific, clinician-rated measures for the comorbid diagnoses of interest. ResultsIn both treatment conditions, participants' mean number of diagnoses dropped significantly from baseline to posttreatment, and baseline to 12-month follow-up. Additionally, large effects were observed for changes in comorbid generalized anxiety (ESSG: UP = −1.72; SDP = −1.98), social anxiety (ESSG: UP = −1.33, −0.86; SDP = −1.60, −1.54), and depression (ESSG: UP = −0.83; SDP = −0.84). Significant differences were not observed in between-group comparisons. ConclusionsResults suggest that both the UP and SDPs are efficacious in reducing symptoms of comorbid emotional disorders. The clinical, practical, and cost-effective advantages of transdiagnostic CBT are discussed.

Neurotic Personality Traits and Risk for Adverse Alcohol Outcomes: Chained Mediation through Emotional Disorder Symptoms and Drinking to Cope

ABSTRACTBackground: Rates of alcohol abuse are high on Canadian postsecondary campuses. Individual trait differences have been linked to indices of alcohol use/misuse, including neurotic traits like anxiety sensitivity (AS) and hopelessness (HOP). We know little, though, about how these traits confer vulnerability. AS and HOP are related to anxiety and depression, respectively, and to drinking to cope with symptoms of those disorders. Neurotic personality may therefore increase risk of alcohol use/abuse via (1) emotional disorder symptoms and/or (2) coping drinking motives. Objectives: Allan and colleagues (2014) found chained mediation through AS-generalized anxiety-coping motives-alcohol problems and AS-depression-coping motives-alcohol problems. We sought to expand their research by investigating how emotional disorder symptoms (anxiety, depression) and specific coping motives (drinking to cope with anxiety, depression) may sequentially mediate the AS/HOP-to-hazardous alcohol use/drinking harms relationships among university students. Methods: This study used cross-sectional data collected in Fall 2014 as part of the Movember-funded Caring Campus Project (N = 1,883). The survey included the SURPS, adapted DMQ-R SF, and AUDIT-3. Results: AS and HOP were both related to hazardous alcohol and drinking harms via emotional disorder symptoms and, in turn, coping drinking motives. All indirect pathways incorporating both mediators were statistically significant, and additional evidence of partial specificity was found. Conclusions/Importance: The study's results have important implications for personality-matched interventions for addictive disorders.

Targeting Comorbid Anxiety and Depression Using the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents

This article presents the use of an emotion-focused, transdiagnostic therapy approach designed for adolescents with a range of anxiety, obsessive-compulsive, depressive, and related disorders, referred to here as emotional disorders. Preliminary work suggests that emotional disorders share underlying temperament factors, such as high neuroticism and low extroversion in adults and adolescents, possibly influencing the development and maintenance of emotional disorders across the life span. The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A) and similar core dysfunction-focused, transdiagnostic therapy approaches may lead to successful treatment by targeting higher order factors that cut across an array of emotional disorders The utility of UP-A for adolescents experiencing a variety of emotional disorder symptoms is demonstrated here through the case illustration of Tony, a 15-year-old adolescent male with severe social and generalized anxiety and mild levels of depression. After 16 individual treatment sessions, Tony demonstrated significant reductions in anxiety and depressive symptoms, as well as an ability to respond more adaptively to a range of emotional experiences. This case study illustrates how short-term, transdiagnostic treatment using the UP-A can effectively ameliorate a wide range of emotional disorder symptoms in adolescents and may also lead to changes in core features of neuroticism, potentially preventing development of further emotional difficulties over time.

Hierarchical structure of emotional disorders: From individual symptoms to the spectrum.

Classification of emotional disorders faces challenges of within-disorder heterogeneity and between-disorder comorbidity. The current study addressed these issues by analyzing all emotional disorder symptoms to identify homogeneous dimensions that characterize this domain. These dimensions were, in turn, used to define coherent syndromes and higher order factors. All of the emotional disorder symptoms specified in diagnostic manuals were assessed by interview in 2 treatment-seeking samples (N = 426 and 305), alongside clinical diagnoses and functioning measures. Exploratory and confirmatory factor analyses were employed to elucidate replicable lower and higher order structures. We found 31 homogenous symptom dimensions that clustered, at different levels of generality, into 8 syndromes (Vegetative Symptoms, Cognitive Depression, Posttraumatic Stress Disorder, Panic, Social Anxiety, Phobia, Obsessive-Compulsive Disorder [OCD], and Mania), 3 subfactors (Distress, Fear, and OCD/Mania), and a single Internalizing spectrum. This structure replicated in both samples. Identified dimensions showed considerable convergence with categorical diagnoses, but provided more information about global functioning than diagnoses. Overall, current results propose a novel comprehensive description of the lower order structure of emotional disorders. The empirical syndromes generally paralleled disorders listed in diagnostic manuals, although several differences were notable. The higher order results also confirmed previously reported Distress, Fear, and Mania subfactors of the Internalizing spectrum using homogeneous dimensional markers. Taken together, results highlight a bottom-up approach to constructing an empirical nosology that does not rely on analysis of diagnostic categories. The resulting hierarchical system can be used clinically and to facilitate research on the pathophysiology of emotional disorders, which, in turn, can inform intervention and prevention. (PsycINFO Database Record

Core dimensions of anxiety and depression change independently during adolescence.

The developmental trajectories of emotional disorder symptoms during adolescence remain elusive, owing in part to a shortage of intensive longitudinal data. In the present study, we charted the temporal course of the tripartite model of anxiety and depression-which posits an overarching negative affect dimension and specific anhedonia and anxious arousal dimensions-over adolescence and emerging adulthood to construct a developmental map of the core dimensions of emotional disorders. We recruited 604 high school juniors, overselecting those at high risk for emotional disorders, and assessed the tripartite symptom domains 5 times annually. Latent curve modeling revealed that negative affect and anxious arousal declined over follow up, whereas anhedonia did not. Moreover, the correlation in rate of change varied across pairs of symptom domains. Change in negative affect was moderately correlated with change in anxious arousal, but change in anhedonia was not significantly related to change in any other domain. Symptom trajectories, and the pattern of covariation among trajectories, were equivalent across gender and comorbidity status. We discuss implications of these findings for developmental models of anxiety and depression, as well as transdiagnostic frameworks for emotional disorders. (PsycINFO Database Record

The conditional process model of mindfulness and emotion regulation: An empirical test

BackgroundThe conditional process model (CPM) of mindfulness and emotion regulation posits that specific mediators and moderators link these constructs to mental health outcomes. The current study empirically examined the central tenets of the CPM, which posit that nonreactivity moderates the indirect effect of observation on symptoms of emotional disorders through cognitive emotion regulation strategies. MethodsA clinical sample (n=1667) of individuals from Japan completed a battery of self-report instruments. Several path analyses were conducted to determine whether cognitive emotion regulation strategies mediate the relationship between observation and symptoms of individual emotional disorders, and to determine whether nonreactivity moderated these indirect effects. ResultsResults provided support the CPM. Specifically, nonreactivity moderated the indirect effect of observation on symptoms through reappraisal, but it did not moderate the indirect effect of observation on symptoms through suppression. LimitationsCausal interpretations are limited, and cultural considerations must be acknowledged given the Japanese sample ConclusionsThese results underscore the potential importance of nonreactivity and emotion regulation as targets for interventions.

Classroom Management Affects Literacy Development of Students With Emotional and Behavioral Disorders

Many children with behavior problems perform poorly academically and can disrupt regular classroom instruction. Although good classroom management strategies can benefit children with behavior problems, it is not clear whether these students need consistently good classroom management across the early elementary school years to improve their academic performance. The current study examined the quality of classroom management from kindergarten through third grade experienced by children who were rated as exhibiting symptoms of emotional and behavioral disorders (EBD) in the classroom to understand the cumulative effects in relationship to third-grade reading performance. Results indicated that higher-quality classroom management in the first 4 years of school was significantly related to higher scores on standardized measures of reading achievement in third grade for boys exhibiting EBD, but girls exhibiting EBD appeared unaffected by the quality of teachers’ classroom management during this same time. Practitioner implications and future research needs are discussed.

Prenatal anxiety, maternal stroking in infancy, and symptoms of emotional and behavioral disorders at 3.5\xa0years

Animal findings of long-term effects of maternal behaviors mediated via altered GR gene expression will, if translated into humans, have far reaching implications for our understanding of child and adolescent psychopathology. We have previously shown that mothers’ self-reported stroking of their infants modifies associations between prenatal depression and anxiety and child outcomes at 29 weeks and 2.5 years. Here, we examine whether the effect of early maternal stroking is evident at 3.5 years, and in a much larger sample than in previous publications. A general population sample of 1233 first-time mothers completed anxiety measures at 20 weeks gestation, 865 reported on infant stroking at 9 weeks, and 813 on child symptoms at 3.5 years. Maternal stroking moderated the association between pregnancy-specific anxiety and internalizing (p = 0.010) and externalizing (p = 0.004) scores, such that an effect of PSA to increase symptoms was markedly reduced for mothers who reported high levels of stroking. There was no effect of maternal stroking on general anxiety. The findings confirm the previously reported effect of maternal stroking, and in a much larger sample. They indicate that there are long-term effects of early maternal stroking, modifying associations between prenatal anxiety and child emotional and behavioral symptoms.

Adolescent Emotional Pathology and Lifetime History of Alcohol or Drug Use With and Without Comorbid Tobacco Use

abstractObjective: Use of drugs and alcohol, including tobacco, is linked to adolescent emotional psychopathology. Given that tobacco use is becoming less common over recent years, its co-use with drugs/alcohol may mark a more severe profile of emotional symptomatology. However, it is unclear whether teens with a lifetime history of using drug/alcohol and tobacco exhibit additional elevations in emotional psychopathology and/or multiple forms of emotional psychopathology compared to teens with lifetime drug/alcohol use without comorbid tobacco use. This cross-sectional study compared emotional disorder symptoms and emotional vulnerability traits among adolescents with varying histories of substance use. Methods: Ninth-grade students enrolled at two schools in Los Angeles, California, were recruited; 575 met eligibility criteria and provided both student assent and parental consent. Students completed self-report measures of emotional pathology, transdiagnostic, and lifetime substance use. Participants were classified into three groupings: (a) no history of substance use (n = 294); (b) lifetime history of drug/alcohol use without tobacco use (n = 166); and (c) lifetime history of drug/alcohol use with concomitant tobacco use (n = 115). Results: Chi-square results showed that teens with lifetime alcohol/drug use with (vs. without) comorbid tobacco use were more likely to have used 10 of 16 substances assessed in the study. Post-ANOVA pairwise tests revealed that, compared to students with no history of substance use, those with any history of use (alcohol/drugs with and without tobacco use) had higher major depression symptoms and negative affect. Those with lifetime alcohol/drug use with comorbid tobacco use had higher generalized anxiety symptoms and distress, and those with lifetime alcohol/drug use without comorbid tobacco use had higher panic disorder symptoms and anhedonia. There were no significant differences between adolescents with lifetime drug/alcohol use with comorbid tobacco use versus those without tobacco use. Conclusions: Adolescents with (vs. without) a lifetime history of drug/alcohol use endorse greater emotional symptomatology and trait vulnerabilities, regardless of comorbid lifetime tobacco use. Thus, the extent to which tobacco serves as a gateway to, correlate of, or consequence of other substance use may have little bearing on adolescent emotional health. This study's findings further suggest that emotional vulnerability (in addition to manifest psychopathology) should be considered in adolescent substance use and mental illness prevention.

Attachment to God moderates the relation between sociocultural pressure and eating disorder symptoms as mediated by emotional eating

Research suggests that secure attachment to God protects against eating disorder risk factors, but studies have not examined how attachment to God might moderate the effects of sociocultural pressure on eating disorder symptoms. Moreover, models testing moderation in combination with mediation by eating in response to negative emotions have not been tested. Questionnaires collected from 102 women (19–57 years) recruited from Amazon's Mechanical Turk were analysed. Participants had diverse religious affiliations and beliefs. Insecure-anxious attachment to God moderated the effect of sociocultural pressure on eating disorder symptoms; women with higher anxious attachment were more susceptible to the effects of sociocultural pressures. Eating in response to negative emotions mediated the relation between sociocultural pressure and eating disorder symptoms, and moderated mediation analyses revealed that participants with average or above-average levels of anxious God attachment had an increase in emotional eating and consequent eating disorder symptoms as a result of sociocultural pressure.

Heart rate variability and serum level of insulin-like growth factor-1 are correlated with symptoms of emotional disorders in patients suffering a mild traumatic brain injury

ObjectivePatients who have experienced a mild traumatic brain injury (mTBI) are susceptible to symptoms of anxiety or depression. To explore the potential biomarkers for emotional disorders in mTBI patients, we analyzed the frequency domain of heart rate variability (HRV) and serum concentrations of four neurohormones. MethodsWe assessed mTBI patients on their first visit and follow-up. Symptoms were evaluated by the Beck Anxiety Inventory and the Beck Depression Inventory, respectively. Serum levels of adrenocorticotropic hormone (ACTH), melatonin, cortisol, and insulin-like growth factor (IGF)-1 and HRV follow-ups were measured and compared. ResultsmTBI patients were more vulnerable to symptoms of anxiety or depression than healthy controls. Reduced HRV was noted in mTBI patients compared to healthy controls. The mTBI patients demonstrated higher serum levels of ACTH, lower IGF-1 compared to healthy controls. In correlation analysis, only IGF-1 was positively correlated with HRV in mTBI patients. Both HRV and IGF-1 were correlated with symptom of depression while only HRV was correlated with symptom of anxiety in mTBI patients. ConclusionsWe infer that HRV may be more significantly correlated with emotional disorders than is IGF-1 in mTBI patients. SignificanceThe study is relevant for specific diagnostic markers in mTBI patients.

Smoking to Regulate Negative Affect: Disentangling the Relationship Between Posttraumatic Stress and Emotional Disorder Symptoms, Nicotine Dependence, and Cessation-Related Problems

Posttraumatic stress disorder (PTSD) is associated with various aspects of cigarette smoking, including higher levels of nicotine dependence and cessation difficulties. Affect-regulatory smoking motives are thought to, in part, underlie the association between emotional disorders such as PTSD and smoking maintenance, although few studies have empirically tested this possibility. Data were analyzed from 135 treatment-seeking smokers who were directly exposed to the World Trade Center disaster on September 11, 2001. We modeled the direct effect of 9/11 PTSD symptom severity on nicotine dependence, perceived barriers to smoking cessation, and severity of problematic symptoms experienced during prior cessation attempts. We also examined the indirect effect of PTSD on these outcomes via negative affect reduction smoking motives. Parallel models were constructed for additional emotional disorder symptoms, including panic and depressive symptoms. PTSD symptom severity was associated with nicotine dependence and perceived barriers to cessation, but not problems during prior quit attempts indirectly via negative affect reduction smoking motives. Panic and depressive symptoms both had significant indirect effects, via negative affect reduction smoking motives, on all three criterion variables. Affect-regulatory smoking motives appear to underlie associations between the symptoms of emotional disorders such as PTSD, panic, and depression in terms of smoking dependence and certain cessation-related criterion variables. Overall, this investigation suggests negative affect reduction smoking motives help to explain the relationship of PTSD, depression, and panic symptoms to nicotine dependence, severity of problems experienced during prior quit attempts and perceived barriers to cessation. These results highlight the importance of assessing motivations for smoking in the context of cessation treatment, especially among those with emotional disorder symptoms. Future interventions might seek to utilize motivational interviewing and cognitive restructuring techniques to address coping-oriented motives for smoking, in addition to skills for managing negative affect, as a means of improving quit outcomes.