Levels Of Anxiety Symptoms Research Articles

Vitamin C intake, psychological distress and health outcomes in patients with heart failure

Abstract Background Patients with heart failure (HF) have lower dietary vitamin C intake than healthy adults, which may increase oxidative stress and worsen important patient-reported health outcomes (functional status and quality of life [QOL]). Patients with HF are more likely to have higher levels of psychological distress (anxiety and depressive symptoms). However, it is not known whether psychological distress is a link in the association of dietary vitamin C with health outcomes. Objective To examine the inter-relationships among dietary vitamin C intake, psychological distress (anxiety and depressive symptoms), and health outcomes (functional status and QOL) in patients with HF. Method We performed a secondary analysis of baseline data from 206 adults with HF (female: 33%, age: 61±12, NYHA class III/IV: 44%) with complete data on dietary vitamin C intake, anxiety, depressive symptoms, functional status, and QOL. Dietary vitamin C intake was assessed using a 4-day food diary and analyzed using the Nutrition Data System for Research software program. Low dietary vitamin C intake was defined as averaged daily intake below the estimated average requirement (EAR) from the Institute of Medicine of 75 mg/day for men and 60 mg/day for women. Anxiety was assessed using the Brief Symptom Inventory Anxiety subscale. Depressive symptoms were assessed using the Beck Depression Inventory II. Functional status was measured using the Duke Activity Status Index. Quality of life was measured using the Minnesota Living with Heart Failure Questionnaire. Linear regression was conducted using the PROCESS macro in SPSS. Results Eighty-four patients (41%) had low dietary vitamin C intake based on the EAR standard. In bivariate analyses, patients with low dietary vitamin C intake had higher levels of anxiety, depressive symptoms, poorer functional status, and worse QOL (all p <.005). In the mediation regression model, low dietary vitamin C intake was directly associated with higher levels of anxiety, but not with depressive symptoms. Depressive symptoms were directly associated with functional status and QOL. Dietary vitamin C intake was not directly associated with functional status or QOL. Low dietary vitamin C intake was indirectly associated with poor functional status through higher levels of anxiety and depressive symptoms (Figure 1). Similarly, low dietary vitamin C intake was indirectly associated with worse QOL (Figure 2). Conclusion Anxiety and depressive symptoms link the relationship between dietary vitamin C intake and functional status and between dietary vitamin C intake and QOL. Our findings highlight the importance of including interventions to enhance diet quality and psychological well-being as part of HF treatment to improve health outcomes.Vitamin C and functional statusVitamin C and quality of life

Sociodemographic disparities in depression and anxiety symptom severity among young adults in Sweden

Abstract Background Young adults are disproportionately affected by mental health problems such as depression and anxiety. While previous studies have identified sociodemographic predictors using the four-item Patient Health Questionnaire (PHQ-4), differences in symptom severity remain less explored. This study aimed to evaluate the sociodemographic predictors of different levels of depression and anxiety symptoms among young adults in Sweden. Methods Survey data from a population-based sample of Swedish adults aged 20-21 (n = 3,226) was used. Symptom severity was categorized into three levels: normal/mild, moderate, and severe, based on established cutoff scores on the PHQ-4. Gender, parental education and birth country, and upper secondary education were assessed through linked registry information. Multinomial logistic regression was used. Results Females had a higher risk of moderate (RR = 1.8, 95% CI 1.5, 2.2) and severe (RR = 2.3, 95% CI 1.8, 3.1) symptoms (compared to no or mild symptoms) relative to males. Among males, the risk of moderate symptoms was higher without a secondary degree (RR = 1.9, 95% CI 1.0, 3.4) compared to an academic degree. Males with parents born abroad faced elevated risks of moderate (RR = 1.9, 95% CI 1.3, 2.9) and severe (RR = 2.2, 95% CI 1.3, 3.7) symptoms relative to males with Swedish-born parents. Among females, parental tertiary education was associated with a lower risk of moderate symptoms (RR = 0.7, 95% CI 0.5, 0.9) compared to lower education. Further, females having a vocational (RR = 1.5, 95% CI 1.1, 2.1) or no secondary degree (RR = 3.6, 95% CI 2.1, 6.1) had an increased risk of severe symptoms compared to females with an academic degree. Conclusions This study identified sociodemographic predictors for moderate and severe symptoms of depression and anxiety among young men and women in Sweden. Mental health promotion and prevention should specifically target young adults at elevated risk of experiencing moderate to severe symptoms. Key messages • Understanding sociodemographic predictors of depression and anxiety symptoms in young adulthood is essential for public health work. • Mental health promotion and prevention needs to include appropriate interventions for young men and women from diverse socioeconomic and cultural backgrounds.

Optimism mitigated impacts of pre-operative depression and anxiety on post-operative distress in cardiac patients

ABSTRACT Both anxiety and depression are comorbid mortality risks in middle-aged and older patients with heart diseases. Open-heart surgery (OHS), a life-altering procedure, can induce psychological distress that impedes postoperative recovery. Extensive research has shown the health benefit of optimism, an indicator of hope—a Character Strength in positive psychology. It predicts low mortality in cardiovascular disease—the number one killer of all Americans. Few studies, however, have explored whether that optimism mitigates the negative impact of preoperative depression and anxiety on postoperative general psychological distress. This interdisciplinary clinical study evaluated a hypothetical model of these relationships prior to and 1 month following OHS in 311 U.S. patients using a three-wave survey. Structural equation modeling (SEM) was performed to predict post-OHS general psychological distress. Optimism was indicated by two subscales in the Life Orientation Test (LOT). Based on the definition, general psychological distress was indicated by low symptom levels of somatization, depression, and anxiety as measured by the SCL-90 subscales. The final solution demonstrated a good fit. Optimism alleviates the negative effects of preoperative depression and anxiety, as indicators of poor mental health, on postoperative distress. Both older age and female gender were positively and directly associated with higher levels of post-OHS symptoms. The finding supports the beneficial role of optimism in mitigating the damage of poor mental health in the postoperative outcome of cardiac patients. The desirable function of character strength hope suggests that health providers should be attentive to and enhance inner strength for reducing the distress of cardiac patients in the postoperative recovery month.

Linking early emotional abuse/neglect with young adolescents’ social (versus general) anxiety symptoms: A developmental cascade through emotion regulation

Despite the widely documented implications of childhood emotional abuse/neglect for subsequent anxiety symptoms, the implicated mechanisms remain under-revealed, especially the various transdiagnostic and specific pathways related to early experiences of emotional abuse versus emotional neglect and different types of subsequent anxiety symptoms (social versus general). Using three-wave data from 844 Chinese adolescents (Meanage = 13.21 at Wave 1, SD = 0.39; 53 % Boys), we tested emotion regulation strategies (cognitive reappraisal and expressive suppression) as explanatory mechanisms underlying the links between childhood emotional abuse/neglect and subsequent social anxiety symptoms (SAS), while simultaneously considering general anxiety symptoms (GAS) for the identification of possible specificity. Results indicated that expressive suppression played a mediating role in the links between emotional neglect and both forms of anxiety symptoms, whereas cognitive reappraisal served as a linking mechanism only for the link between emotional neglect and GAS. No effects were identified for emotional abuse. All associations were identified after controlling for the baseline levels of anxiety symptoms, the baseline uses of emotion regulation strategies, and covariates (age, gender, and family socioeconomic status). Our findings re-confirm that emotion regulation is an important intermediate process accounting for anxiety-related sequelae of early emotional deprivation, suggesting that expressive suppression appears to be a more developmentally transdiagnostic process shaped particularly by early emotional neglect to contribute to different types of subsequent anxiety symptoms. Accordingly, educational and clinical practices on emotion regulation likely benefit the affective well-being of young adolescents whose childhood has been clouded with emotional neglect.

Unwanted Online Sexual Solicitation Among Young People in a Swedish Psychiatric Sample: Occurrence and Associations with Depression and Anxiety

ABSTRACT Technology-facilitated sexual violence (TFSV) is a ubiquitous societal problem with negative health consequences. Child and Adolescent Psychiatric (CAP) patients are burdened with more violence exposure than other groups, but more work is needed to chart their exposure to TFSV specifically and to understand how it relates to their mental health. In this study, we aimed to investigate the occurrence of unwanted online sexual solicitation (UOSS) in a young Swedish psychiatric sample. We also aimed to measure the associations between psychiatric symptoms and exposure to UOSS, offline sexual harassment, cyberbullying, and offline bullying. We also aimed to analyze possible differences between boys and girls. Our results show a high occurrence of UOSS (48.61%), which is higher than in the general population. UOSS was significantly higher among girls (57.31%) than boys (20.59%), but boys in the CAP group were burdened with more UOSS victimization than boys in general. Co-occurrence of UOSS with other types of offline and online harassment was substantial. UOSS, together with age and offline sexual harassment, predicted anxiety and depressive symptoms among both girls and boys. UOSS also showed a significant interaction effect with gender, suggesting that boys exposed to UOSS suffer higher levels of anxiety and depressive symptoms than girls exposed to UOSS. Preventing and treating mental health difficulties needs to consider contextual circumstances such as exposure to sexual violence online.

Predictors of treatment response trajectories to cognitive behavioral therapy for chronic fatigue syndrome: A cohort study

BackgroundThe response to cognitive behavioral therapy (CBT) for chronic fatigue syndrome (CFS) varies greatly between patients, but predictors of treatment success remain to be elucidated. We aimed to identify patient subgroups based on fatigue trajectory during CBT, identify pre-treatment predictors of subgroup membership, and disentangle the direction of predictor – outcome relationships over time. Methods297 individuals with CFS were enrolled in a standardized CBT program consisting of 17 sessions, with session timing variable between participants. Self-reported levels of fatigue, depressive, anxiety, and somatic symptoms, perceived stress, and positive affect were collected pre-treatment, and after 3, 10, and 15 sessions. Latent Class Growth Analysis (LCGA) was used to identify subgroups based on fatigue trajectories and baseline predictors of group membership. Cross-lagged structural equation models were used to disentangle predictor-outcome relationships. ResultsLCGA identified four fatigue trajectory subgroups, which were labelled as “no improvement” (23 %), “weak improvement” (45 %), “moderate improvement” (23 %), and “strong improvement” (9 %) classes. Higher pre-treatment levels of depressive, anxiety, and somatic symptoms, stress, and lower levels of positive affect predicted membership of the “no improvement” subgroup. Reductions in anxiety preceded reductions in fatigue, while the depressive symptoms – fatigue relationship was bidirectional. ConclusionsOn a group level, there were statistically significant reductions in fatigue after 15 sessions of CBT, with important individual differences in treatment response. Higher pre-treatment levels of anxious, depressive, and somatic symptoms and perceived stress are predictors of lack of response, with reductions in anxiety and stress preceding improvements in fatigue.

Evaluation of the mental health status of intensive care unit healthcare workers at the beginning of COVID-19 pandemic.

During pandemic periods, mental health issues are highly prevalent, particularly among healthcare workers who are at a higher risk of developing psychiatric disorders. The aim of this study is to evaluate the mental health status of the intensive care unit (ICU) healthcare workers, who play a vital role in managing the COVID-19 pandemic, in terms of the quality of sleep, levels of depressive and anxiety symptoms, stress and to determine the factors that affect their mental health. The research was conducted in April 2020 and incorporated a total of 79 participants working in an university hospital ICUs in Turkey. Pittsburgh Sleep Quality Index (PSQI), Depression Anxiety Stress Scale 42 (DASS-42), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) were applied. Among the participants, 58 individuals comprising 73.4% of the cohort were working in the ICUs, managing patients infected with COVID-19. Those working in ICUs with COVID-19 patients had significantly higher DASS-S, BAI, and BDI scores. Doctors' BDI scores were significantly lower compared to both nurses and other healthcare workers. Participants exhibiting COVID-19 symptoms manifested significantly higher BAI scores in compared to those without such symptoms. Healthcare workers involved in ICUs with COVID-19 patients were more significantly affected psychologically, doctors had lower depressive symptoms as compared to other healthcare workers. In addition, individuals with COVID-19 symptoms demonstrated significantly higher levels of anxiety. The findings of our study emphasize the significance of providing psychological support to healthcare workers throughout pandemics.

Performance replication of the Hospital Mental Health Risk Screen in ethnoracially diverse U.S. patients admitted through emergency care.

Patients admitted to hospitals after emergency care for injury or acute illness are at risk for later mental health problems. The American College of Surgeons Committee on Trauma Standards for care of injured patients call for mental health risk screening, and the Hospital Mental Health Risk Screen (HMHRS) accurately identified at-risk patients in a developmental study that included patients from five ethnoracial groups. Replication of these findings is essential, because initial positive results for predictive screens can fail to replicate if the items were strongly related to outcomes in the development sample but not in a new sample from the population the screen was intended for. Replication of the predictive performance of the 10-item HMHRS was studied prospectively in ethnoracially diverse patients admitted after emergency care for acute illness or injury in three hospitals across the U.S. Risk screen scores and follow-up mental health outcomes were obtained for 452 of 631 patients enrolled (72%). A cut score of 10 on the HMHRS correctly identified 79% of the patients who reported elevated levels of depression, anxiety, and PTSD symptoms two months post-admission (sensitivity) and 72% of the patients whose symptoms were not elevated (specificity). HMHRS scores also predicted well for patients with acute illness, for patients with injuries, and for patients who reported an Asian American/Pacific Islander, Black, Latinx, Multirace, or White identity. Predictive performance of the HMHRS was strong overall and within all five ethnoracial subgroups. Routine screening could reduce suffering and health care costs, increase health and mental health equity, and foster preventive care research and implementation. The performance of the HMHRS should be studied in other countries and in other populations of recent trauma survivors, such as survivors of disaster or mass violence.

B - 13 Effects of Individual and Community-Level Adverse Childhood Experiences and Current Psychopathology among Monolingual Spanish-Speaking Adult Neuropsychology Referrals

Abstract Objective The link between adverse childhood experiences (ACEs) and higher rates of psychopathology in adulthood has been well-established, though far less analogue research has examined this relationship among Latinx patients. This study assessed the relationship between ACEs and symptoms of anxiety, depression, and perceived stress among monolingual Spanish-speaking neuropsychology referrals. Method Data were culled from 27 adult neuropsychology referrals (mean age = 61.70; mean education = 8.59) neuropsychological referrals administered the ACE Questionnaire, Beck Depression Inventory (BDI-II), Geriatric Depression Scale (GDS), Beck Anxiety Inventory (BAI), and Perceived Stress Scale (PSS). Linear regression analyses examined the effect of exposure to individual (e.g., emotional, physical, sexual abuse, neglect, domestic violence) and community-level ACEs on depression, anxiety, and perceived stress symptom endorsement. Results Endorsement of more individual ACEs predicted higher levels of anxiety (R2 = 0.281; p = 0.009) and depression (R2 = 0.127; p = 0.075) symptoms, but not perceived stress levels (R2 = 0.037; p = 0.365. By contrast, endorsement of more community-level ACEs marginally predicted higher anxiety symptoms (R2 = 0.124; p = 0.071), but not depression symptoms (R2 = 0.020; p = 0.568) or perceived stress levels (R2 = 0.045; p = 0.319). Conclusions Experiencing more individual-level ACEs predicted greater anxiety and, to a lesser extent, depressive symptoms, whereas community-level ACEs did not predict similar levels of endorsement of active psychopathology among monolingual Spanish-speaking adults referred for neuropsychological evaluation. Findings emphasize the need of neuropsychologists to consider routinely assessing patient’s childhood trauma history and current psychopathology symptoms during evaluation to improve diagnostic accuracy and recommendations for Latinx patients.

Understanding depression and anxiety rates of school psychology graduate students.

School psychology graduate students experience many risk factors for problems with mental health, including high workloads, financial distress, and challenging relationships with faculty that can exacerbate feelings of anxiety and depression. Although there have been studies that have investigated depression and anxiety amongst graduate students in general (Eisenberg et al., 2007) and health service psychology students in particular (Hobaica et al., 2021), there are reasons to believe that school psychology graduate students may have different experiences. To date, no research has been found investigating the depression and anxiety symptoms of graduate students in school psychology programs. A survey was sent to 194 school psychology training programs, and 291 graduate students completed it. Approximately one in four graduate students reported moderate to severe levels of depressive symptoms, while one in three reported moderate to severe levels of anxiety symptoms. These symptoms were significantly higher in graduate students identifying as lesbian, gay, bisexual, transgender, queer/questioning, and more identities, women, or reported being from a lower socioeconomic background. There were no differences in depression or anxiety symptoms between the type of program (i.e., doctoral or specialist) or years in program. Implications for trainers of school psychology are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Effects of pain, hospitalization, and medication on depressive symptom in Syrian patients with chronic diseases

Chronic diseases and pain exacerbate depressive symptom in Syria. Limited research on hospital-induced depressive symptom among Syrian patients with chronic diseases warrants further study. A cross-sectional study in four Damascus hospitals revealed high rates of pain and depressive symptom. This study aims to investigate the prevalence and severity of chronic pain and hospital-induced depressive symptom in Syrian patients, as well as the relationship between pain, depressive symptom, and medication behavior. This study analyzes the impact of pain, hospitalization, and medication on patients with chronic diseases. The four Damascus hospitals included 453 patients from various departments. Data were collected through structured interviews and internationally recognized scales such as the PSEQ, HADS, and MMAS. These findings offer insights into pain management and psychological well-being, with implications for patient care and support strategies. The study involved 453 patients with chronic diseases, with gender distribution showing 46.6% females and 53.4% males. The age range was from 7 to 87 years, with an average of 46.87 years. Chi-square tests revealed a significant connection between gender and HADS-A scores, where 48.3% of females had abnormalities (χ2 (1, N = 453) = 7.125, p = 0.028). Marital status was significantly associated with anxiety and depressive symptom levels, particularly among widowed and divorced patients. Employment status, education, and comorbidity were linked to abnormal HADS-A scores, while education level showed a positive correlation with HADS-D scores. ANOVA tests showed significant differences in MMAS scores across income groups (F (3, 449) = 3.167, p = 0.024), with a notable difference between low-income and lower-middle-income groups (mean difference = 0.389, p = 0.031. Chronic pain and HID are prevalent among Syrian patients with chronic diseases and influenced by socio-demographic factors. Personalized interventions are needed to address psychological symptoms and medication behavior.

Identifying latent subtypes of symptom trajectories in major depressive disorder patients and their predictors.

This study aimed to identify different symptom trajectories based on the severity of depression symptoms within a 2-month follow-up, and to explore predictive factors for different symptom trajectories. Three hundred and ninety-two adults diagnosed with major depressive disorder (MDD) were recruited from two longitudinal cohorts. Patients received antidepressant treatment as usual, and the depression symptoms were evaluated by the 17-item Hamilton depression rating scale (HAMD-17) at baseline, two weeks, and eight weeks. Based on the HAMD-17 scores, different trajectories of symptom change were distinguished by applying Growth Mixture Modeling (GMM). Furthermore, the baseline sociodemographic, clinical, and cognitive characteristics were compared to identify potential predictors for different trajectories. Through GMM, three unique depressive symptom trajectories of MDD patients were identified: (1) mild-severity class with significant improvement (Mild, n = 255); (2) high-severity class with significant improvement (High, n = 39); (3) moderate-severity class with limited improvement (Limited, n = 98). Among the three trajectories, the Mild class had a relatively low level of anxiety symptoms at baseline, whereas the High class had the lowest education level and the worst cognitive performance. Additionally, participants inthe Limited class exhibited an early age of onset and experienced a higher level of emotional abuse.MDD patients could be categorised into three distinct latent subtypes through different symptom trajectories in this study, and the characteristics of these subtype patients may inform identifications for trajectory-specific intervention targets.

Identifying analogue samples of individuals with clinically significant social anxiety: Updating and combining cutoff scores on the Social Phobia Inventory and Sheehan Disability Scale.

The use of analogue samples, as opposed to clinical groups, is common in mental health research, including research on social anxiety disorder (SAD). Recent observational and statistical evidence has raised doubts about the validity of current methods for establishing analogue samples of individuals with clinically significant social anxiety. Here, we used data from large community samples of clinical and nonclinical participants to determine new cutoff scores on self-report measures of social anxiety symptoms and symptom-related impairment. We then examined whether using these newly determined cutoff scores alone or in combination improves the identification of individuals who have SAD from those who do not, revealing the most ideal cutoff combination to be 34 or above on the Social Phobia Inventory and 11 or above on the Sheehan Disability Scale. Finally, we compared the effects of our new cutoff scores with old cutoff scores by extracting analogue samples of participants with high social anxiety from historical data on seven large groups of undergraduate Psychology research participants from the authors' institution spanning the past 5 years (2018-2023). We observed that the new combined cutoff scores identified markedly fewer students as having high social anxiety, lending credibility to their utility. We also observed a striking increase in levels of social anxiety symptoms in the undergraduate population from before to after the COVID-19 pandemic. Of note, most participants were under 30 and identified as Caucasian or Asian women, indicating that future research is needed to examine whether our findings generalize to diverse populations. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Psychometric Evaluation of the Traumatic Grief Inventory-Self Report Plus (TGI-SR+) in Chinese Bereaved People.

The Traumatic Grief Inventory-Self Report Plus (TGI-SR+) measures the most recent prolonged grief disorder (PGD) symptom sets defined in the 11th edition of the International Statistical of Diseases and Related Health Problems (ICD-11) and the text revision of the fifth edition of the Diagnostical and Statistical Manual of Mental Disorders (DSM-5-TR). However, the TGI-SR+ has not yet been translated and validated in Chinese. This study aims to evaluate the psychometric properties of the Chinese translation of the TGI-SR+. We examined the Chinese TGI-SR+'s factor structure, internal consistency, convergent validity, discriminant validity, known-groups validity, and optimal clinical cut-off scores in 443 Chinese bereaved adults. Confirmatory factor analyses showed that the two-factor models showed the best fit for the Chinese TGI-SR+ items assessing ICD-11 and DSM-5-TR prolonged grief symptoms. Items assessing ICD-11 and DSM-5-TR prolonged grief symptoms demonstrated good internal consistency. Associations of TGI-SR+ scores with symptom levels of prolonged grief (assessed by the International Prolonged Grief Disorder Scale), posttraumatic stress, anxiety, and depression supported convergent and discriminant validity. Associations with background/loss-related variables provided evidence for known-groups validity. Cut-off points for probable ICD-11 PGD (liberal scoring rule), probable ICD-11 PGD (conservative scoring rule), and probable DSM-5-TR PGD were ≥67, ≥75, and ≥68, respectively. The Chinese TGI-SR+ appears to be a reliable and valid measure to assess prolonged grief symptoms per ICD-11 and DSM-5-TR among Chinese bereaved adults.

Cognitive functioning in adults with chronic insomnia disorder- A cross-sectional study

Background: Chronic insomnia, affecting 15.9% of the population, is characterized by sustained hyperarousal and heightened somatic, cognitive, and cortical activity. Despite its prevalence, the precise impact of chronic insomnia on cognitive domains, particularly attention, working memory, and executive function, remains inadequately understood. Aim: This study aims to systematically investigate the cognitive functioning of adults with chronic insomnia. Methodology: A meticulously matched cohort of 80 participants, comprising 40 with chronic insomnia and 40 controls, participated in this cross-sectional study. The diagnosis followed strict criteria outlined in the International Classification of Sleep Disorders-3. Neuropsychological assessments, including the Digit Span Test, Stroop Test, and Trail Making Test, were employed to scrutinize attention, working memory, and executive function. Robust metrics, such as the Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), Generalized Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire-9 (PHQ-9), supported the investigative approach. Results: Analysis revealed notable deficits in backward digit span, digit symbol substitution test, and Stroop Test (cards B and C) among chronic insomnia subjects compared to non-insomniac counterparts. Trail Making Test B indicated prolonged completion times in the chronic insomnia cohort. Despite comparable levels of anxiety and depressive symptoms, the chronic insomnia group exhibited higher ISI and PSQI scores, indicating the severity of their sleep disturbances. Conclusion: This cross-sectional analysis reveals cognitive deficits associated with chronic insomnia, specifically impacting attention, working memory, and executive function. Even with meticulous demographic controls, chronic insomnia leaves a discernible impact on cognitive functions. The study underscores the need for precise cognitive evaluations to reveal the latent impact of chronic insomnia, offering insights for targeted interventions.

Perinatal Intimate Partner Violence and Maternal-Infant Bonding in Women With Anxiety Symptoms in Pakistan: The Moderating Role of Breastfeeding.

Intimate partner violence (IPV) during the perinatal period can negatively affect both a woman's health and the bonding with her infant. Research on IPV among pregnant women experiencing psychological distress in South Asia is limited. We examined associations between perinatal exposure to IPV and postnatal maternal-infant bonding in Pakistani women with symptoms of anxiety and assessed if breastfeeding practices moderated these associations. Postnatal data were collected from 720 Pakistani women who reported at least mild levels of anxiety symptoms in pregnancy. We performed Poisson regression with robust variance analyses to examine the associations between IPV during pregnancy or within 6 weeks after delivery (i.e., the perinatal period) and maternal-infant bonding. Interaction terms between IPV and breastfeeding practices were included in the analytic models to examine the moderating effects. About 27% of women were exposed to at least one type of perinatal IPV. Women who were exposed to IPV were more likely to have moderate to severe postpartum anxiety (n = 57, 28.9% of IPV-exposed women), compared to those without IPV (n = 65, 12.4% of unexposed women; p value < .001). Compared to women not reporting IPV, women exposed to any IPV showed a 38% increase in Postpartum Bonding Questionnaire scores, suggesting higher likelihood of impaired bonding (risk ratio [RR] = 1.38, 95% confidence interval [CI] [1.21, 1.56]). Among women who initiated breastfeeding later than 1 hr post-delivery, IPV was associated with impaired bonding (RR = 1.09, 95% CI [1.06, 1.20]), whereas no association was present for women who initiated breastfeeding within 1 hr (RR = 1.03, 95% CI [0.98, 1.08]). In addition to the efforts to reduce IPV, encouraging IPV-exposed women to adhere to the breastfeeding guidelines (e.g., early breastfeeding) may enhance maternal-infant bonding.

Adverse childhood experiences and alexithymia intensity as predictors of temporal dynamics of functioning in individuals with irritable bowel syndrome: A three-wave latent transition analysis

ObjectiveDespite high prevalence of irritable bowel syndrome (IBS) and its significant negative impact on individuals' quality of life, its etiology remains poorly understood. This prospective study explored whether early life factors (adverse childhood experiences; ACEs) and alexithymia intensity, could explain IBS symptom severity and its effects on psychological functioning over time. We also compared the studied variables between an IBS sample and a healthy control group. MethodBased on the Rome III Diagnostic Criteria for IBS, 245 individuals with a diagnosis of IBS were recruited from a national sample of Poles. The IBS sample completed the following psychometric questionaries in three waves, one month apart: Adverse Childhood Experiences Questionnaire, Toronto Alexithymia Scale, IBS Symptom Severity Score, Short Form Perceived Stress Scale, and Ultra-Brief Patient Health Questionnaire for Anxiety and Depression. Latent transition analysis was used to identify distinct profiles of IBS symptom dynamics. ResultsThe IBS group reported a significantly higher number of ACEs, greater alexithymia severity, and more intense levels of stress, anxiety, and depressive symptoms compared to the healthy controls. Four profiles of IBS individuals with distinct dynamics of IBS symptoms, stress, anxiety, and depressive symptoms were extracted, which correlated with the baseline number of ACEs and alexithymia intensity among participants. ConclusionChildhood adversity and associated problems in emotional processing affect IBS symptom severity. ACEs should be included in IBS screening and considered in the design of individualized multidisciplinary treatment approaches for IBS patients.

Unique associations between strategies of coping with COVID-19-related stress and internalizing symptoms in a clinical sample of adolescents

AbstractYouth internalizing symptoms increased significantly during COVID-19, suggesting a need for more knowledge on how to prevent youth mental health problems during future widespread societal health crises. This cross-sectional study examined coping strategies and how these were associated with internalizing problems in a clinical sample of youth during COVID-19. Youth (13–19 years) referred to mental health treatment for internalizing problems were assessed 6–18 months into the pandemic. Participants (N = 160, mean age = 15.8 years, SD = 1.2; 80% female, 5% non-binary) completed the Response to Stress Questionnaire, assessing COVID-19 stress, coping strategies, and involuntary stress responses. Internalizing symptoms were evaluated by the Spence Children’s Anxiety Scale and the Short Mood and Feelings Questionnaire. Results showed that coping strategies were associated with internalizing symptoms, after controlling for sex, age, and COVID-19-related stress. Youth using primary control coping had lower levels of anxiety whereas those using secondary control coping strategies had fewer depressive symptoms and fewer involuntary disengagement responses. Secondary control coping (i.e., adapting to the situations) was the most frequent strategy. The highest COVID-19 stressors reported were insecurity about the future, and having to change, postpone or cancel important plans/events. Thus, in a clinical sample of youth, unique associations were found between the type of coping strategy and levels of anxiety and depressive symptoms. During future pandemics and societal health crises, measures to reduce unpredictability in everyday life and insecurity about the future should be implemented, followed by interventions to support adaptive coping strategies.

Locus of Control and Mental Health: Human Variation Complicates a Well-Established Research Finding.

Locus of control (LoC) refers to one's expectation that life outcomes and (mis)fortune are driven largely by one's own actions or abilities (internal LoC) or by external factors (e.g., powerful others, chance; external LoC). There is a large literature demonstrating an association between internal LoC and positive mental health outcomes. However, this research is conducted mostly in high-income, Global North settings, with limited consideration of cross-cultural variability. This short report explores how LoC relates to mental health when considered in a less-studied context: in a setting of stark structural violence and in relation to supernatural agents. I conducted a community-based survey in rural Haiti (n = 322) that assessed sent spirit-related locus of control (LoC-S) and mental health. Among individuals experiencing higher levels of daily stressors, depressive and anxiety symptoms were high regardless of LoC-S. However, for individuals facing low-to-moderate daily stressors, external LoC-S (believing one does not have control in relation to sent spirits) was associated with lower depressive and anxiety symptoms, though this interaction did not hold for anxiety after controlling for covariates. Though initially a nonintuitive finding, I contextualize this outcome in relation to ethnographic work in Haiti, showing that the ability to explain misfortune via the supernatural world can serve as a form of blame displacement. In a context where extreme structural violence means that individuals realistically have little control over their lives, an external LoC better reflects lived experience, helping explain the association with better mental health outcomes.

Untangling purpose: examining the nuanced influence of personal meaning and beyond-the-self orientation on youth mental health in unprecedented times

ABSTRACT This modified sequential explanatory mixed methods study explores how the components of purpose (personal meaningfulness and a beyond-the-self orientation) impact youth mental health outcomes (depressive and anxiety symptoms) in the context of COVID-19. We hypothesized that youth with higher scores on the components of purpose (goal-directedness, personal meaningfulness, and beyond-the-self orientation) would be less likely to experience anxiety and depressive symptoms during COVID-19. We also explored in what ways youths’ descriptions of their own prosocial behavior align with the relation between purpose and mental health. Data are from two waves of the Boy Scouts of America (BSA) Building Evidence in Scouting Together study. Quantitative data are from 4,896 youth and a subsample of 94 youth completed qualitative personal communication Results indicate the personal meaning component of purpose is protective against depressive and anxiety symptoms. However, the beyond-the-self orientation of purpose is associated with higher levels of depressive and anxiety symptoms. In addition, differences were found between youth who reported higher and lower levels of depressive and anxiety symptoms, and personal meaning and a beyond-the-self orientation for the following themes: 1) Empathy for others, 2) Desire to change the situation, 3) Solutions to change the situation, 4) Helping at home, 5) Following health advice, and 6) Scouting-specific examples. Taken together, this study provides useful insights into how each component of purpose can uniquely promote or provide a buffer for depression and anxiety among youth.