Impaired Coping Research Articles

Developing a Pilot Curriculum to Enhance Undergraduate Student Well-Being.

The purpose of this article is to describe the development and implementation of a program to improve well-being in undergraduate students and promote positive transitions into the workplace. College students experience anxiety, depression, and impaired coping, which were exacerbated during the COVID-19 (coronavirus disease 2019) pandemic. As students transition into their career, it is imperative they develop positive coping strategies and resiliency to manage workplace stress. The Personal Leadership Collective (PLC) is designed as a four-semester series for third- and fourth-year nursing and business students. Four themes guided the activities: awareness, connection, agility, and growth. Students participated in asynchronous online learning modules and in-person activities. Fourth-year students who completed the series served as peer mentors to third-year students. The program is undergoing formal evaluation. Anecdotal feedback from participants is positive. The PLC is a program that could enhance professional development in undergraduate students. [J Nurs Educ. 2024;63(X):XXX-XXX.].

Depression, higher level of tension induction, and impaired coping strategies in response to stress in women with PCOS correlate with clinical and laboratory indices of hyperandrogenism and not with central obesity and insulin resistance.

to examine the mental condition, self-esteem, and ways of coping with stress in women with PCOS compared to age and BMI-matched healthy controls and to correlate them with clinical and laboratory hyperandrogenism, central obesity, and IR. 42 women with PCOS and 39 controls were assessed for the above-mentioned psychological measures and correlated with serum hormonal and metabolic parameters. Compared to controls, women with PCOS had more symptoms of depression (p = 0.026), a higher level of tension induction (p = 0.032), were more prone to alcohol consumption (p = 0.015), and were less likely to use the strategy of active coping in stressful situations (p = 0.014) and to seek instrumental (p = 0.048) and emotional support (p = 0.043). The presence of hirsutism correlated negatively with the level of emotional induction (R = -0.32, p < 0.05), and androgenic alopecia positively with the hedonistic tone (R = 0.36, p < 0.05). Serumtestosterone (TST) correlated positively with the likelihood of seeking instrumental support in stressful situations (R = 0.31, p < 0.05) and with emotional focus (R = 0.34, p < 0.05). Serum androstenedione (A4-dione) correlated negatively with the escape behavior (R = -0.32, p < 0.05). No correlations were found between waist circumference and IR with the studied psychological measures. Women with PCOS are characterized by depression, higher levels of tension induction, and impaired coping strategies in stressful situations, which correlate with clinical and laboratory indices of hyperandrogenism and not with central obesity and IR.

Individuals with genetic high-risk for psychosis experience impaired coping styles compared with healthy controls.

Individuals with schizophrenia tend to have negative coping styles and low levels of self-esteem, but it is unclear whether coping styles and self-esteem levels are altered in people in the prodromal phase of psychosis. The study was designed to assess the role of coping style and self-esteem in the context of different phases of schizophrenia. Recurrent Schizophrenia (ReSch), first-episode schizophrenia patients (FEP), genetic-high risk for psychosis (GHR) patients, and healthy controls (HC) (40 per group) were subjected to in-person clinical interviews. The results of these interviews were then used to gauge coping style and self-esteem using the Coping Styles Questionnaire (CSQ) and the Rosenberg's Self-Esteem Scale (RSES). Data were analyzed through ANCOVAs and logistic regression analyses. The results found that positive coping style (CSQ problem-solving and CSQ seeking for help) generally decline with progression through the HC, GHR, and FEP groups, while negative coping style (CSQ fantasy, CSQ repression and CSQ self-blame) generally increase with progression through the HC, GHR, and FEP groups (except that GHR group was slightly lower than HC group in CSQ self-blame). Results for members of ReSch group were in line with those of members of the FEP group in coping style. At the level of self-esteem, the GHR group was similar to the HC group and significantly higher than the FEP group and the ReSch group. Logistic regression analyses indicated that GHR group patients exhibited increased negative coping styles (CSQ fantasy) relative to members of the HC group, but had greater Positive coping style (CSQ problem-solving) than did members of the FEP group. These findings suggest that both GHR individuals experience impaired negative coping styles which expands the understanding of the psychological characteristics of the prodromal group. Further explorations are warranted to develop optimal psychosocial interventions.

Development of social functioning in preadolescent children at familial high-risk of schizophrenia or bipolar disorder – a 4-year follow-up study from age 7 to 11

Social functioning is a major indicator of psychosis risk and evidence is lacking regarding social functioning development during preadolescence in children at familial high risk of schizophrenia (FHR-SZ) or bipolar disorder (FHR-BP). We aimed to investigate development of social functioning from age 7 to 11 in children at FHR-SZ or FHR-BP compared with population-based controls. At 4-year follow-up, 179 children at FHR-SZ (mean age 12.0 y, SD 0.3), 105 children at FHR-BP (mean age 11.9 y, SD 0.2), and 181 controls (mean age 11.9 y, SD 0.2) participated. We used the Vineland-II to measure social functioning. Development of social functioning was non-significantly different across groups on the Socialization Composite score as well as the subscales Interpersonal Relations, Play and Leisure, and Coping Skills. At 4-year follow-up, children at FHR-SZ demonstrated impaired social functioning, whereas children at FHR-BP displayed social functioning comparable to controls except from impaired coping skills. From age 7 to 11, the maturational pace of social functioning in children at FHR-SZ and FHR-BP is parallel to that of controls. Children at FHR-SZ show stable social functioning deficits, whereas children at FHR-BP show normal social functioning except from emergence of discretely impaired coping skills at age 11.

Coping and sleep quality in youth: An Experience Sampling study.

Sleep quality is closely linked with mental health. Two factors that influence sleep are coping style and locus of control, yet these have not been investigated in daily life. In this study, we examined associations between coping styles and sleep quality in daily lifeand the potential mediating effect of daily locus of control in a sample of youth, a group particularly vulnerable to developing psychopathology. Three hundred and seventy-nineyouths from the TwinssCan study participated in an Experience Sampling study, assessing sleep quality as well as state locus of control over the most negative event from the previous day. Participants also completed the Utrecht Coping List, which assessed engagement, disengagement, and emotion-focused coping. Disengagement, "passive reaction,"and emotion-focused coping were associated with lower daily sleep quality. State locus of control did not mediate any effects of coping styles on quality of sleep. Disengagement, "passive reaction," and emotion-focused coping were associated with decreased sleep quality during several consecutive days, which may put youths at risk for developing future insomnia, and strain their mental well-being over time. Thus, there may be value in asking about coping when a young individual presents with sleep problems; however, impaired coping when sleeping poorly should also be considered.

Prolactin-Releasing Peptide Contributes to Stress-Related Mood Disorders and Inhibits Sleep/Mood Regulatory Melanin-Concentrating Hormone Neurons in Rats.

Stress disorders impair sleep and quality of life; however, their pathomechanisms are unknown. Prolactin-releasing peptide (PrRP) is a stress mediator; we therefore hypothesized that PrRP may be involved in the development of stress disorders. PrRP is produced by the medullary A1/A2 noradrenaline (NA) cells, which transmit stress signals to forebrain centers, and by non-NA cells in the hypothalamic dorsomedial nucleus. We found in male rats that both PrRP and PrRP-NA cells innervate melanin-concentrating hormone (MCH) producing neurons in the dorsolateral hypothalamus (DLH). These cells serve as a key hub for regulating sleep and affective states. Ex vivo, PrRP hyperpolarized MCH neurons and further increased the hyperpolarization caused by NA. Following sleep deprivation, intracerebroventricular PrRP injection reduced the number of REM sleep-active MCH cells. PrRP expression in the dorsomedial nucleus was upregulated by sleep deprivation, while downregulated by REM sleep rebound. Both in learned helplessness paradigm and after peripheral inflammation, impaired coping with sustained stress was associated with (1) overactivation of PrRP cells, (2) PrRP protein and receptor depletion in the DLH, and (3) dysregulation of MCH expression. Exposure to stress in the PrRP-insensitive period led to increased passive coping with stress. Normal PrRP signaling, therefore, seems to protect animals against stress-related disorders. PrRP signaling in the DLH is an important component of the PrRP's action, which may be mediated by MCH neurons. Moreover, PrRP receptors were downregulated in the DLH of human suicidal victims. As stress-related mental disorders are the leading cause of suicide, our findings may have particular translational relevance.SIGNIFICANCE STATEMENT Treatment resistance to monoaminergic antidepressants is a major problem. Neuropeptides that modulate the central monoaminergic signaling are promising targets for developing alternative therapeutic strategies. We found that stress-responsive prolactin-releasing peptide (PrRP) cells innervated melanin-concentrating hormone (MCH) neurons that are crucial in the regulation of sleep and mood. PrRP inhibited MCH cell activity and enhanced the inhibitory effect evoked by noradrenaline, a classic monoamine, on MCH neurons. We observed that impaired PrRP signaling led to failure in coping with chronic/repeated stress and was associated with altered MCH expression. We found alterations of the PrRP system also in suicidal human subjects. PrRP dysfunction may underlie stress disorders, and fine-tuning MCH activity by PrRP may be an important part of the mechanism.

Error-prone protein synthesis recapitulates early symptoms of Alzheimer disease in aging mice.

Age-related neurodegenerative diseases (NDDs) are associated with the aggregation and propagation of specific pathogenic protein species (e.g., Aβ, α-synuclein). However, whether disruption of synaptic homeostasis results from protein misfolding per se rather than accumulation of a specific rogue protein is an unexplored question. Here, we show that error-prone translation, with its frequent outcome of random protein misfolding, is sufficient to recapitulate many early features of NDDs, including perturbed Ca2+ signaling, neuronal hyperexcitability, and mitochondrial dysfunction. Mice expressing the ribosomal ambiguity mutation Rps9 D95N exhibited disrupted synaptic homeostasis resulting in behavioral changes reminiscent of early Alzheimer disease (AD), such as learning and memory deficits, maladaptive emotional responses, epileptiform discharges, suppressed circadian rhythmicity, and sleep fragmentation, accompanied by hippocampal NPY expression and cerebral glucose hypometabolism. Collectively, our findings suggest that random protein misfolding may contribute to the pathogenesis of age-related NDDs, providing an alternative framework for understanding the initiation of AD.

Exploring the physical activity level and sleep quality among a cohort of healthy females in Egypt: a cross-sectional survey.

In healthy adults, the short-term effects of sleep disruption include disorders of mood, impaired coping ability, deficits in cognition, and reduced quality of life. Increased physical activity may improve sleep duration and quality. The aim was to investigate the physical activity level and sleep quality and their relationship among a cohort of healthy females in Egypt. We conducted a cross-sectional, self-reported survey. 688 healthy young adult females aged 18-45 years without a prior history of chronic disease were recruited for this study. Demographic data as well as physical activity (International Physical Activity Questionnaire) and sleep quality (Pittsburgh Sleep Quality Index) were collected. 73.5% reported poor sleep quality, which was worse for housewives. 50.4% of participants were either obese or overweight. Approximately 29.7% of the participants were physically inactive. High physical activity levels were associated with higher sleep efficiency compared to moderate physical activity (p=0.01). However, high physical activity resulted in poorer sleep quality overall (p=0.001). The majority of participants reported poor sleep quality and high levels of physical activity, but the relationship between physical activity and sleep quality was not clear. Poor sleep quality in our study is one of, if not the highest, reported in the literature for a similar age range in females.

Psychological Impact of COVID-19 Patient Care on Families of Healthcare Workers.

Objective: The Coronavirus‑19 (COVID‑19) pandemic has perpetrated a significant mental health burden amongst health care workers (HCWs) and their families. Families of HCWs are at significant risk of various mental health problems due to concerns regarding the wellbeing of the HCW, fear of contacting the virus from HCWs, staying isolated during periods of quarantine and being the passive recipient of public stigma directed towards HCWs.The objective of this study was to assess the perceived stress, resilience and coping tendencies of families of HCWs managing the COVID 19 crisis. Method : A cross sectional study was conducted at a tertiary care hospital in India, where close relatives of 150 HCWs managing COVID-19 patients (directly or indirectly involved in patient care) were selected using systematic random sampling. They were evaluated using the Perceived Stress Scale, Brief Resilience Coping Scale, and the Hospital Anxiety and Depression Scale. Pearson’s correlation and Independent t-test were used for statistical analysis using the SPSS software. Results: Majority (75%) of the family members associated with frontline HCWs had moderate to high level of perceived stress, while23% and 17% had clinically significant anxiety and depressive symptoms, respectively. More than 50% had low resilience and coping scores. High levels of stress, anxiety and depression were seen in female respondents, those less than 40 years old, having a child or an elderly family member and when the HCW had direct involvement in COVID-19 patient care. Conclusion: Families of HCWs suffer from significant psychological burden due to the COVID-19 crisis. They face significant risk of depression and anxiety associated problems, which are augmented by low resilience and impaired coping. Mental health of HCWs and their family members should be given due attention with a focus on early identification, providing psychological support and improving resilience.

Benzodiazepines and Z-drugs Prescriptions Trends over time among the Aberdeen Children of the 1950s and Associated Characteristics with Chronic prescriptions.

BackgroundThere are ongoing concerns worldwide about prescribing benzodiazepines and Z-drugs (BZDs) due to the risks associated with these medicines. Despite guidance to limit their prescribing, in Scotland, the sustained level of prescribing over the last decade suggests chronic prescribing of BZDs. Although prescribing decisions is a complex process that is influenced by patient-related factors, little is known about the characteristics of those who are on chronic BZDs prescriptions, including childhood and adulthood characteristics. Therefore, this study aims to describe the trend of BZDs prescriptions over seven years and to characterise those who were on chronic/recurrent BZDs prescriptions. MethodsThis is a prospective longitudinal cohort study using data linkage technique, in which a birth cohort was linked to the Prescribing Information System, the Scottish Morbidity Database. Simple descriptive analysis was used to describe the incidence trends. To characterise individuals with chronic/recurrent prescriptions, multivariable Poisson regression models were constructed using a stepwise regression, the calculated risk ratios were reported with a 95% confidence interval. FindingsThe incidence of BZDs prescription declined from 3.4% [3.0-3.7] in 2010 to 2.0% [1.7%-2.3%] in 2015. While, within those receiving any prescriptions, the incidence of chronic/recurrent prescriptions was relatively constant around 7%. The study showed that those who had a history of behavioural disturbance in childhood were at increased risk of chronic/recurrent BZDs prescriptions compared with those who had not (risk ratio: 1.18 [95%CI: 1.03-1.35]). Similarly, those who had an IQ score &lt; 100 were also more likely to be on chronic/recurrent BZDs prescriptions than those &gt;100 (1.09 [0.99-1.21]). Chronic/recurrent BZDs prescriptions were more common among individuals in receipt of psychotropic prescriptions (1.77 [1.55-2.02]) or who had been hospitalised with depression/schizophrenia (1.28 [1.13-1.46]). Multimorbidity was also important: a dose-risk relationship was evident, such that, compared to participants reporting no morbidity, those reporting one, or five or more morbidities, experienced a 116% and 451% increase in risk (2.16 [1.47-3.18] and 5.51 [3.98-7.62], respectively). Finally, those who had taken early retirement (1.65 [1.36-1.99]) and those looking after family (1.35 [1.11-1.65]) were more likely to receive chronic/recurrent BZDs, compared to employed individuals. ConclusionsChronic/recurrent BZDs prescriptions are common. Careful interpretation for the decline in incidence as this is a close cohort where incidence might be diluted after a long follow-up. The need for these drugs might be an indication of an impaired coping system. Childhood is a sensitive age period for individuals’ development. And behavioural disturbance and/or lower IQ score might be a manifestation of a disadvantaged childhood which, in turn, might affect individuals’ ability to cope with life in adulthood. Also, the accumulation of trajectory events such as impact physical and mental health or lacking socioeconomic opportunity could impact individuals’ ability to cope, although, for factors in adulthood, one must be wary of reverse causation.

Development and initial validation of the Styles of Emotion Regulation Questionnaire

BackgroundIn cognitive behavioral therapies, patients work to develop or strengthen various emotion regulation skills. Understanding the role of such skills in treatment and how focusing on different skills might be used to effectively personalize treatments requires a measure suited to these purposes. With this goal in mind, we developed the Styles of Emotion Regulation Questionnaire (SERQ) to capture individual differences in the broad range of emotion regulation skills taught in these therapies, suited for assessing skills among treatment naïve participants and those participating in treatment. MethodsIn this study, 512 participants completed the SERQ. We conducted separate factor analyses of items assessing frequency of skill use and the extent to which skills were impaired when upset. ResultsAnalyses suggested four skill factors and one emotionally impaired coping factor. In 17 of 20 tests, SERQ scores were related to anxiety, depression, stress, and features of borderline personality disorder. DiscussionInitial results suggest the potential of the SERQ as a measure of emotion regulation strategies taught in cognitive behavioral therapy. We encourage future research using the SERQ in clinical contexts.

Irritable Bowel Syndrome and Coping Strategies: A Cross-sectional Study for Identifying Psychological Alarms and Factors Related to Coping in Riyadh, Saudi Arabia.

Psychological alarms including severity of pain, functional impairment, depression, and impaired coping strategies have been correlated with (IBS); however, these attributes, particularly coping strategies, have not been well studied. The aim of this study was to assess psychological alarms, life stressors, and coping strategies of adults diagnosed with IBS. A total of 806 participants completed a self-administered survey consisting of socio-demographic data and life stressors, the Rome IV criteria to diagnose IBS, the Psychological Alarm Questionnaire, and the Coping Strategies Questionnaire (CSQ 24). IBS diagnosis was established among 372 (46.15%) participants. Anxiety (OR = 1.81; 95% CI: 1.35-2.45), severe pain (OR = 1.92; 95% CI: 1.42-2.63), financial life stressors (OR = 1.98; 95% CI: 1.33-2.40), and coping strategies such as reinterpretation (OR = 1.92; 95% CI: 1.39-2.68) and diversion (OR = 2.01; 95% CI: 1.05-3.89) were all significantly and independently associated with IBS diagnosis. Giving the chronic nature of IBS, future research should focus on coping as a potential treatment goal for IBS patients.

Skin-brain axis signaling mediates behavioral changes after skin wounding

Patients with chronic wounds often have associated cognitive dysfunction and depression with an as yet unknown mechanism for this association. To address the possible causality of skin wounding inducing these changes, behavior and cognitive functions of female C57BL/6 mice with an excisional skin wound were compared to unwounded animals. At six days post wounding, animals exhibited anxiety-like behaviors, impaired recognition memory, and impaired coping behavior. Wounded animals also had concomitant increased hippocampal expression of Tnfa, the pattern recognition receptor (PRR) Nod2, the glucocorticoid receptors GR/Nr3c1 and Nr3c2. Prefrontal cortex serotonin and dopamine turnover were increased on day six post-wounding. In contrast to the central nervous system (CNS) findings, day six post -wounding serum catecholamines did not differ between wounded and unwounded animals, nor did levels of the stress hormone corticosterone, TNFα, or TGFβ. Serum IL6 levels were, however elevated in the wounded animals. These findings provide evidence of skin-to-brain signaling, mediated either by elevated serum IL6 or a direct neuronal signaling from the periphery to the CNS, independent of systemic mediators. Wounding in the periphery is associated with an altered expression of inflammatory mediators and PRR genes in the hippocampus, which may be responsible for the observed behavioral deficits.

Perceived academic-related sources of stress among graduate nursing students in a Jamaican University

BackgroundGraduate education is essential for the improvement of professions by facilitating advancements in career paths, personal growth and enhancing a country's economy. Graduate students frequently view graduate education as moderate to very stressful and this can have a negative impact on their lives. Stress can result in impaired coping, poor academic performance and reduction in cognitive functioning, resulting in the antithesis of academic success. ObjectiveA qualitative study was done to gain insight into the perception and sources of academic- related stress among graduate nursing students at an urban school of nursing in Jamaica. DesignA purposive sample of Master of Science in Nursing students in their penultimate semester for the academic year 2017/ 2018 were invited to participate in the study. MethodsNine students participated and each was assigned a selected pseudonym. Data were collected using one- to-one semi-structured interviews and interviews were transcribed verbatim. Thematic content analysis was used to determine emerging themes and coding was done manually. ResultsThe themes that emerged were: (1) Workload (2) Research (3) Prioritization (4) Lack of support (5) Lack of feedback (6) Balancing school life (7) Very stressful (8) Expectations of lecturers. Participants perceived that graduate education was very stressful to overwhelming. Academic-related stress was multi-factorial and predominantly due to the rigid curriculum structure. Contributing factors included increased workload; time constraints; the research course itself; lack of support and timely response from research supervisors and delayed responses from the Ethics Committee. ConclusionIt is very important for educators and curriculum developers to implement innovative strategies that are essential in providing an environment that will facilitate learning and to mitigate stress faced by graduate students.

Impaired Learning From Errors and Punishments and Maladaptive Avoidance-General Mechanisms Underlying Self-Regulation Disorders?

Self-regulation (SR) is an important human function that relates to quality of life in multiple domains including mental health. Previous studies have found important correlates of low SR including impulsivity and poor emotional regulation; however, underpinnings of low SR are incompletely understood. Individuals low in SR frequently engage in maladaptive behaviors (substance abuse, procrastination, etc.) despite negative consequences. This phenomenon suggests that impaired learning from errors and punishments may be important mechanisms underlying low SR. Consistently, previous studies observed impaired error processing in a wide spectrum of individuals with low SR and impaired learning from errors and punishments in SR-related disorders. We also note a possible role for poor emotional regulation and refer to concepts suggesting that engaging in maladaptive behaviors may serve as short term emotion regulation strategies aimed at avoiding or alleviating negative affect. We speculate on transdiagnostic factors underlying poor SR. We propose that impaired error processing (possibly related to striatal functioning) may prevent subjects with low SR from learning from errors and punishments and thus learning better SR skills or tendencies. Additionally, impaired coping in emotionally challenging situations, possibly related to prefrontal-cortical functioning, may lead to maladaptive avoidance. Moreover, maladaptive behaviors may be reinforced by the temporary decreases in negative affect and rewarding values of behaviors. Given existing knowledge gaps, we call for more extensive research and describe possible directions and challenges for future studies.

Concept analysis: Resilience in young women with chronic pain.

The aim of this article is to define the concept of resilience in the context of chronic pain, while presenting a historical background of resilience. Resilience in young women with chronic pain is discussed where findings exist. Chronic pain places a considerable burden on individual and societal health; resilience is critical to chronic pain management. Enhancing understanding of the concept of resilience can promote resilience and aid in early recognition of impaired coping. Rodgers's evolutionary method of concept analysis was used. Using CINAHL, PubMed, and Google Scholar databases, articles published from 1979 to 2020 were analyzed to identify conceptual components of resilience. We reviewed included articles to determine surrogate terms, relevant uses of the concept, attributes, references of the concept, antecedents, consequences, and related concepts. Resilience in the context of chronic pain is a lifelong process of positive adaption and thriving despite adversity. Components of Rodgers's evolutionary method are identified for the concept. Further research on resilience in young women with chronic pain is needed, given the current lack of literature. Developing nursing interventions to foster resilience is important to promote long-term, effective self-management of individuals living with chronic pain.

Avaliação da resiliência em escolares do ensino médio e sua relação com a prevalência de sintomas depressivos e ansiosos

Introdução: A resiliência é um processo interativo, em que as características individuais e as relações interpessoais são determinantes para o enfrentamento dos eventos adversos. Adolescentes resilientes, além de menos vulneráveis a riscos, são mais bem sucedidos às adaptações em situações de estresse. Em contrapartida, indivíduos pouco resilientes apresentam enfrentamento prejudicado face às adversidades, podendo gerar sintomas ansiosos e depressivos. Objetivo: Investigar a relação entre a resiliência e a prevalência de sintomas depressivos e ansiosos em estudantes do ensino médio. Método: Realizou-se um estudo transversal, com amostra composta de 80 matriculados no ensino médio de uma escola pública da cidade de Presidente Prudente (SP). Os instrumentos utilizados foram: Inventário de Depressão Infantil; Escala de Ansiedade de Hamilton; scala de Resiliência de Wagnild &amp; Young; e questionário sociodemográfico elaborado pelos autores. Resultados: A baixa resiliência foi 2,02 vezes mais prevalente em adolescentes com sintomatologia depressiva; no entanto, a prevalência de baixa resiliência foi 2,54 vezes maior em pessoas com renda familiar mais baixa. Estar namorando reduziu em 45% a prevalência de baixa resiliência e demonstrou ser um fator de proteção para promoção de resiliência. A razão de prevalência de baixa resiliência foi 50% maior em adolescentes com forte grau de ansiedade, porém não houve diferença estatística significativa. Conclusões: Com base nas constatações deste estudo, adolescentes com baixa resiliência apresentaram mais indicativos de sintomas depressivos. A resiliência mostrou-se como fator protetor para sintomas de depressão, assim como maior renda familiar e estar namorando demonstraram serem bons preditivos para o desenvolvimento de indivíduos resilientes.

Impact of COVID 19 on Health Care Personnel

The outbreak of COVID 19 is highly challenging for the frontline worker that is health care personnel.This novel virus originated from Wuhan China, December 2020, as this deadly virus is highly contagious itaffected all globally. WHO declared pandemic on March 2020, and also published guidelines to be followedby the HCP while providing patient care. HCP face multiples issues continuously which develop whileproviding patient care such as occupational burnout due to shortage of manpower. HCP also faced physicaland psychological violence during delivering patient care which is again too stressful. Many HCP worksovertime of 12 to 13 hrs due to shortage of manpower and also many patients got admitted daily. Thosehealth workers who got contacted without proper PPE, they used to keep quarantine. Due to this HCP arekept separation from family members and this is again stressful for the concern person especially lady HCPhaving small children at home. Apart from these many issues, HCP also faced imbalance nutrition, deprivesleeping pattern, racism issues especially to north east Indian HCP, transports issue due to lock down, lackof PPE, impaired coping mechanism with children.

Diabetes und depressive Störungen

AbstractDepressive disorders are highly prevalent in patients with diabetes. While depressive disorders themselves require therapy, they also contribute negatively to diabetes-related medical, social and psychological outcomes, and therefore need to be addressed. Disease burden is very high for both diabetes and depression, even more so in case of comorbidity. Comorbid depressive symptoms in patients with diabetes are associated with a reduced quality of life and adherence to treatment regimes, impaired coping abilities, as well as increased morbidity and mortality rates, diabetes-related distress, and economic burden.The interactions between diabetes and depression are bidirectional. Both diseases appear to have a variety of shared bio-psychosocial, as well as biological risk factors. Recent research implies that the interaction between diabetes and depression cannot be understood as a simple cause-effect relationship but might rather be explained by being part of a disturbed homeostasis of biological and psychological circuits.Regular depression screenings should be applied to identify depressive symptoms in patients with diabetes. To verify positive screening results, treating physicians have a key role in targeting depression by actively asking patients for depressive symptoms within the last 14 days. If symptoms are present, further diagnostics, and the exploration of psychosocial problems are necessary. In case of a depressive disorder, varieties of effective antidepressant treatments (psychotherapy, psychopharmacological medications) are available. Physical activation and diabetes education programs can be offered additionally. The current paper offers insights on epidemiology, symptoms, interactions, diagnostics, treatments as well as the relationship between physician and patient.

Intermittent Absence of Control during Reinforcement Learning Interferes with Pavlovian Bias in Action Selection.

The ability to control the occurrence of rewarding and punishing events is crucial for our well-being. Two ways to optimize performance are to follow heuristics like Pavlovian biases to approach reward and avoid loss or to rely more on slowly accumulated stimulus-action associations. Although reduced control over outcomes has been linked to suboptimal decision-making in clinical conditions associated with learned helplessness, it is unclear how uncontrollability of the environment is related to the arbitration between different response strategies. This study directly tested whether a behavioral manipulation designed to induce learned helplessness in healthy adults (intermittent loss of control over feedback in a reinforcement learning task; "yoking") would modulate the magnitude of Pavlovian bias and the neurophysiological signature of cognitive control (frontal midline theta power) in healthy adults. Using statistical analysis and computational modeling of behavioral data and electroencephalographic signals, we found stronger Pavlovian influences and alterations in frontal theta activity in the yoked group. However, these effects were not accompanied by reduced performance in experimental blocks with regained control, indicating that our behavioral manipulation was not potent enough for inducing helplessness and impaired coping ability with task demands. We conclude that the level of contingency between instrumental choices and rewards/punishments modulates Pavlovian bias during value-based decision-making, probably via interfering with the implementation of cognitive control. These findings might have implications for understanding the mechanisms underlying helplessness in various psychiatric conditions.