Life Events Research Articles

Social connectedness in older adults: The potential of social internet use to maintain a strong and stable personal network.

Maintaining a strong social network in later life can be challenging due to limited resources, life events, and changes in health. Social internet use provides an accessible way for communication that is less susceptible to age-related challenges. Although social internet use is increasingly used by older adults, we do not know how social internet use shapes older adults' offline networks. The purpose of this study is to examine whether social internet use can help maintain strong social relationships. We used data from three waves (2012-2013, 2015-2016, and 2018-2019) of the Longitudinal Aging Study Amsterdam. Our sample included 2,266 older adults aged 55-99 (mean = 68.2 years, 54% female). We included the frequency of social internet use and computed personal network size, contact frequency, and the number of continued, gained, and lost ties over time. Hybrid models were applied to disentangle between within- and between-person associations. More frequent social internet users had significantly larger personal networks and, relative to the previous wave, more continued and gained network ties, compared to less frequent social internet users. A within-person increase in social internet use over time was associated with more continued and gained ties. Social internet use may help maintain a strong and stable network, which is important for social connectedness in later life. It allows for additional interaction opportunities, as well as network maintenance and growth. Social internet use thus proves to be a valuable addition to the social interaction resources of older adults.

Patient Perceptions of an Intervention for Cancer Distress and Traumatic Stress Symptoms: A Qualitative Analysis.

This study aimed to explore contextual elements of the cancer experience that are consistently distressing and/or psychologically traumatic, as well as explore perceptions of Accelerated Resolution Therapy® (ART®) and its influence on the cancer experience. Using a qualitative descriptive design, semi-structured interviews were completed by 12 participants following the completion of ART. Interview data were analyzed using content analysis to identify major themes and patterns. Four themes included: (a) Cancer as the straw that broke the camel's back, (b) ART® is different from previous therapy, (c) Don't need to always be looking in the rearview mirror, and (d) Importance of early psychological intervention. Participants perceived that ART® was different and potentially more effective than other types of therapy they had previously received. Results support the diagnosis of cancer and the cumulative effects of previous life events and cancer-related stressors as traumatic events.

Evaluating sex and line differences in successive negative contrast and ethanol consumption using alcohol preferring and high alcohol drinking rats.

The loss of a job or relationship are a couple of examples of unexpected reward loss. Life events, such as these can induce negative emotional reactions (e.g., anxiety and stress), which have been associated with increased alcohol consumption and in turn, an increased risk of developing an alcohol use disorder (AUD). The present study analyzed consummatory successive negative contrast (SNC) for the first time in alcohol preferring (P) and high alcohol drinking (HAD) rats that have been selectively bred to consume high amounts of ethanol. Following reward loss, animals were given free access to ethanol to determine whether consumption would increase as a possible indication of any negative emotional reaction. Male and female P and HAD rats were split into shifted and unshifted groups receiving either 32% or 4% sucrose for 5 min across 10 preshift days. Subsequently, all animals received 4% sucrose for four postshift days, across which, animals were given access to 20% ethanol for 30 min after access to 4% sucrose. Male and female P rats demonstrated a longer contrast effect than HAD rats, indicated by a longer recovery time following the downshift in reward. Conversely, HAD males did not demonstrate a contrast effect following this downshift in reward unlike their female counterparts. Surprisingly, P rats who experienced a loss of reward consumed significantly less ethanol than animals who did not. Lastly, individual measure of contrast size, or shift ratio, was significantly associated with greater ethanol consumption in HAD males only, who did not display a contrast effect. These data indicate different reactivity to SNC between these two lines and sexes, suggesting different genetic and sex-related mechanisms underlying sensitivity to an unexpected loss of reward and ethanol consumption following this loss.

Significance of birth in the maintenance of quiescent neural stem cells.

Birth is one of the most important life events for animals. However, its significance in the developmental process is not fully understood. Here, we found that birth-induced alteration of glutamine metabolism in radial glia (RG), the embryonic neural stem cells (NSCs), is required for the acquisition of quiescence and long-term maintenance of postnatal NSCs. Preterm birth impairs this cellular process, leading to transient hyperactivation of RG. Consequently, in the postnatal brain, the NSC pool is depleted and neurogenesis is decreased. We also found that the maintenance of quiescent RG after preterm birth improves postnatal neurogenesis. This study demonstrates the significance of birth in the maintenance of quiescent NSCs.

The effect of stressful life events on depressive symptoms in Chinese university students: Moderated mediating effect of interpersonal relationship and gender.

This study aimed to examine the impact of stressful life events on the depressive symptoms of Chinese first-year university students, while considering the influence of interpersonal relationships and gender on this association. A total of 8079 first-year Chinese university students were surveyed using the Adolescent Self-Rating Life Events Check List (ASLEC), Beck Depression Inventory (BDI), and Comprehensive Diagnostic Scale of Interpersonal Relationship (CDSIR). Stressful life event were positively correlated with interpersonal relationships, depressive symptoms, and gender (r = 0.385, 0.264, 0.055, p < 0.001); there was a significant positive correlation between depressive symptoms and interpersonal relationships (r = 0.473, p < 0.001). Stressful life events partially predict depressive symptoms through the mediation of interpersonal relationships, and the proportion of indirect total effect was 63.26 %. The effect of stressful life events on depressive symptoms was moderated by gender. Stressful life events had a positive effect on depressive symptoms in both male and female individuals. Compared with male individuals (simple slope = 0.070, t = 3.467, p < 0.001), female individuals were more susceptible to stressful life events (simple slope = 0.185, t = 9.652, p < 0.001). The generalizability of the findings is constrained by the composition of the sample. The study's utilization of questionnaire methodology and cross-sectional design poses limitations in establishing definitive causality. The effect of stressful life events on depressive symptoms might be mediated by interpersonal relationships and moderated by gender.

Neuroimaging stratification reveals the striatal vulnerability to stress as a risk for schizophrenia

The striatum, a core brain structure relevant for schizophrenia, exhibits heterogeneous volumetric changes in this illness. Due to this heterogeneity, its role in the risk of developing schizophrenia following exposure to environmental stress remains poorly understood. Using the putamen (a subnucleus of the striatum) as an indicator for convergent genetic risk of schizophrenia, 63 unaffected first-degree relatives of patients (22.08 ± 4.80 years) with schizophrenia (UFR-SZ) were stratified into two groups. Compared with healthy controls (HC; n = 59), voxel-based and brain-wide volumetric changes and their associations with stressful life events (SLE) were tested. These stratified associations were validated using two large population-based cohorts (the ABCD study; n = 1680, 11.92 ± 0.62 years; and UK Biobank, n = 20547, 55.38 ± 7.43 years). Transcriptomic analysis of brain tissues was used to identify the biological processes associated with the brain mediation effects on the SLE-psychosis relationship. The stratified UFR-SZ subgroup with smaller right putamen had a smaller volume in the left caudate when compared to HC; this caudate volume was associated with both a higher level of SLE and more psychotic symptoms. This caudate-SLE association was replicated in two independent large-scale cohorts, when individuals were stratified by both a higher polygenic burden for schizophrenia and smaller right putamen. In UFR-SZ, the caudate cluster mediated the relationship between SLE and more psychotic symptoms. This mediation was associated with the genes enriched in both glutamatergic synapses and response to oxidative stress. The stratified association between the striatum and stress highlights the differential vulnerability to stress, contributing to the complexity of the gene-by-environment etiology of schizophrenia.

Facing migration under adverse conditions: challenges and resilience in the Colombo-Venezuelan border area

BackgroundInternal displacement and cross-country migration are an increasing global phenomenon drawing the attention of politicians and the public. Causes and effects on the migrants and receptor populations are varied and often shaped by immigration laws and how migrants and refugees are being dealt with by local conditions, policy frameworks and by the host population (receptors). The massive influx of Venezuelan migrants into Colombia for more than a decade has characteristics which warrant a systematic analysis to identify contextual and individual factors favouring and hindering the well-being of migrants and their new Colombian neighbours of the receptor population.MethodsA household interview survey was conducted in two cities of the Colombo-Venezuelan border: Cucuta and Valledupar. The survey included 412 migrant families, comprising 1656 individuals, and 317 Colombian neighbour families, totalling 1077 individuals. Only migrants staying in the border area for more than 6 months and excluding “short term migrants” who cross the border only for getting treatment or schooling for their children. We used systematic sampling in neighbourhoods with the highest concentration of migrants. The sampling interval was set at every 7 and 6 migrant households. Ethical approval was obtained by the ethics committees of the three participating universities and the local health authority.ResultsVenezuelan migrants were younger than their Colombian neighbours (22.04 and 28.69 years respectively). The primary reason for migration among these individuals was economic (84.1%) and much less for political reasons (< 10%); about half of them had entered the country through an irregular crossings, known locally as “trochas”. Within this group, around 28% reported experiencing various forms of violence, particularly physical or verbal aggression, much less sexual assault. Following their arrival, irregular migrants had to go through a regulation (legalization) process in Colombia, with 48.1% having either initiated or completed this process. The target migrants have been living in Colombia for an average of 4.3 years, mostly in poor shelters, just as their Colombian neighbours (64.8% and 53% respectively). Both groups, but particularly the migrants, belonged to the lower socioeconomic strata according to their educational levels and occupations (street vendors including street musicians and entertainers; 21.6% of migrants and 10.6% of Colombian neighbours). They all had stressful life events recently, with economic hardship being the most significant one, especially among migrants. In terms of exposure to physical violence, the rates were almost equal for both groups. However, specific incidents such as theft, assault and intended homicide were more often experienced by the Colombian receptor population. Legal services were often sought by migrants, mostly in a special advice centre for migrants or from international organizations while their Colombian neighbours resorted mainly to national institutions including the police. For health issues migrants had often to go to private services with out-of-pocket payment while the Colombians accessed the health system through the subsidized or pre-paid health insurance. Emotional and psychological symptoms were frequent in both groups but more among migrants. The Colombian respondents had more frequently negative comments about migrants but acknowledged that they were exploited in Colombia and that they contribute to community activities and the local economy.ConclusionBoth Venezuelan migrants and their Colombian neighbours suffer significantly from the consequences of poverty and stressful living conditions. As such, they require equal attention from policymakers and public services. This attention should encompass enhanced security in the public spaces, accessible legal advice, and comprehensive health support.

How trait mindfulness protects late adolescents from stress-induced sleep problems: the unique role of mindfulness facets and gender differences

BackgroundUnderstanding sleep problems in late adolescents caused by daily stress is essential due to their increased vulnerability to stress-related sleep issues. While previous research has demonstrated the potential protective effect of trait mindfulness, facets of mindfulness were found to have unique functions against the negative impact of stress, and the unique impact of each facet of mindfulness on the sleep problems caused by the negative impact of stress remains unclear. Thus, this longitudinal study aimed to assess the impact of stressful life events on sleep problems a year later among late adolescents and to explore the moderating effects of the five trait mindfulness facets. Gender differences have been observed in mindfulness’s protective effects, yet how gender influences each mindfulness facet remains unclear. This study also examines how gender moderates the effects of individual mindfulness facets.MethodsThe study tracked 1,926 Chinese vocational high school students (Mage = 18.49) over a year, assessing them for their sleep problems, perceived impact of stressful life events, and mindfulness facets through self-reported questionnaires. Multivariate analysis was used to investigate the moderating effects of each mindfulness facet on the relationship between stressful life events and sleep problems one year later. Then, gender differences were examined through multi-group comparison.ResultsA higher impact from stressful life events predicted more sleep problems a year later. Notably, among all five facets of mindfulness, only Observing significantly buffered the negative impact of stressful life events on sleep problems, in females but not in males, thus gender moderated the impact of Observing.ConclusionsThis study suggested that Observing uniquely protected young females from the negative impact of stressful life events on their sleep problems a year later. Since the measurement tool for the Observing facet only had 1 question tested on observing inner feelings, and other questions are all about observing bodily sensations and outer environments, this study implies that insomnia therapies focus on enhancing the ability to anchor attention in the present moment, especially towards bodily sensations and the outer environment, may be particularly effective in buffering the long-term impact of daily stressors on sleep for young females.Trial registrationNot applicable.

Neighborhood opportunity and residential instability: associations with mental health in middle childhood.

Neighborhood quality may contribute to child mental health, but families with young children often move, and residential instability has also been tied to adverse mental health. This study's primary goal was to disentangle the effects of neighborhood quality from those of residential instability on mental health in middle childhood. 1,946 children from 1,652 families in the Upstate KIDS cohort from New York state, US, were followed prospectively from birth to age 10. Residential addresses were linked at the census tract level to the Child Opportunity Index 2.0, a multidimensional indicator of neighborhood quality. The number of different addresses reported from birth to age 10 was counted to indicate residential instability, and the change in COI quintile indicated social mobility. Parents completed three assessments of attention-deficit/hyperactivity disorder, problematic behavior, and internalizing psychopathology symptoms at ages 7, 8, and 10. Child and family covariates were selected a priori to adjust sample characteristics, increase estimate precision, and account for potential confounding. In unadjusted models, higher neighborhood quality at birth was associated with fewer psychopathology symptoms in middle childhood, but associations were largely mediated by residential instability. In adjusted models, residential instability was associated with more psychopathology symptoms, even accounting for social mobility. Neighborhood quality at birth had indirect effects on child mental health symptoms through residential instability. Children born into lower-quality neighborhoods moved more, and moving more was associated with higher psychopathology symptoms. Findings were similar across different timings of residential moves, for girls and boys, and for children who did not experience a major life event. Additional research is needed to better understand which aspects of moving are most disruptive to young children.

Association of childhood maltreatment and adverse lifetime experiences with post-injury psychopathology: evidence from the China Severe Trauma Cohort

BackgroundAdverse life experiences have been associated with increased susceptibilities to psychopathology in later life. However, their impact on psychological responses following physical trauma remains largely unexplored.MethodsBased on the China Severe Trauma Cohort, we conducted a cohort study of 2937 patients who were admitted to the Trauma Medical Center of West China Hospital between June 2020 and August 2023. Adverse life experiences, including childhood maltreatment (5 subtypes, measured by Childhood Trauma Questionnaire-Short Form) and adverse lifetime experiences (17 subtypes, by Life Events Checklist) were assessed. Generalized linear mixed models were used to examine the associations of childhood maltreatment and adverse lifetime experiences with symptoms of psychopathology measured at multiple time-points after the index injury (i.e., at recruitment, 1-, 3-, 6-, and 12-month follow-ups), adjusted for important confounders. We further stratified the analyses by level of genetic predisposition to a given psychological symptom quantified by polygenic risk score (PRS) based on publicly available GWAS summary statistics. Mediation analyses were performed to assess the role of adverse lifetime experiences in connecting childhood maltreatment and post-injury psychopathology.ResultsThe mean age of participants was 47.95 years with a predominance of males (61.39%). During the whole follow-up period, the incidence of symptoms of stress-related disorders, anxiety, and depression was 13.86%, 29.89%, and 36.57%, respectively. We observed associations between the cumulative number of those studied adversities and increased risk of post-injury psychopathology, particularly stress-related disorder (odds ratio [OR] = 2.78, 95% confidence interval [CI] 1.87–4.12 for ≥ 2 vs no childhood maltreatment; 2.65 [1.67–4.20] for ≥ 4 vs 0–1 adverse lifetime experiences). By subtype, positive associations were observed for most studied life adversities, with the most pronounced estimates for childhood emotional abuse (ORs = 1.71–2.52) and lifetime life-threatening illness/injury (ORs = 1.87–2.89). We found basically comparable estimates among traumatized individuals with different PRSs for studied psychopathology. Moreover, adverse lifetime experiences may partially (mediation proportion: 22.52–27.48%) explain the associations between various childhood maltreatment and post-injury psychopathology.ConclusionsBoth childhood maltreatment and adverse lifetime experiences were associated with post-injury psychopathology, irrespective of genetic susceptibility. Such findings highlight the importance of close surveillance and timely psychological interventions for injury patients with adverse life experiences.

Prenatal maternal stress: triangulating evidence for intrauterine exposure effects on birth and early childhood outcomes across multiple approaches

BackgroundMaternal stress during pregnancy may impact offspring development via changes in the intrauterine environment. However, genetic and environmental factors shared between mothers and children might skew our understanding of this pathway. This study assesses whether prenatal maternal stress has causal links to offspring outcomes: birthweight, gestational age, or emotional and behavioral difficulties, triangulating across methods that account for various measured and unmeasured confounders.MethodsWe used data from the Norwegian Mother, Father, and Child Cohort Study (MoBa), including maternal reports on prenatal stress at work, at home, and via stressful life events as exposures. Outcomes were children’s birthweight and gestational age, from the Medical Birth Registry of Norway, and maternal reports on early offspring emotional and behavioral difficulties. We assessed associations using four approaches: sibling control analyses, gene-environment interaction analyses, intergenerational Mendelian randomization (MR), and negative control (i.e., postnatal stress) analyses.ResultsMaternal prenatal stress was observationally associated with offspring lower birthweight (e.g., βwork = − 0.01 [95%CI: − 0.02, − 0.01]), earlier birth (e.g., βwork = − 0.04 [95%CI: − 0.04, − 0.03])), and more emotional (e.g., βevents = 0.08 [95%CI: 0.07, 0.09]) and behavioral difficulties (e.g., βrelationship = 0.08 [95%CI: 0.07, 0.09]) in the full sample (N = 112,784). However, sibling control analyses (N = 36,511) revealed substantial attenuation of all associations after accounting for familial factors. Gene-environment interaction models (N = 76,288) showed no clear evidence of moderation of associations by mothers’ polygenic scores for traits linked to stress sensitivity. Intergenerational MR analyses (N = 29,288) showed no clear evidence of causal effects of maternal plasma cortisol on any offspring outcomes. Negative control exposure analyses revealed similar effect sizes whether exposures were measured prenatally or postnatally.ConclusionsOur results indicate that links between prenatal maternal stress and variation in early offspring outcomes are more likely to be confounded than causal. While no observational study can rule out causality, the consistency of our findings across different approaches is striking. Other sources of prenatal stress or more extreme levels may represent intrauterine causal risk factors for offspring development. Nonetheless, our research contributes to identifying boundary conditions of the fetal programming and developmental origins of health and disease hypotheses, which may not be as universal as sometimes assumed.

Navigating life’s twists and turns: characteristics of life events across adulthood

This study examines whether there are age-related differences in the experience of life events across adulthood. We hypothesized that older adults would report life events that are less anticipated, less normative, less controllable, less positive, and more strenuous than younger adults due to increasing developmental losses and decreasing gains. We investigated how age (linear, quadratic, and cubic) relates to life-event characteristics by comparing different events and analyzing the same events across individuals, to distinguish between the effects observed across life events and those that emerge after accounting for the specific life event in question. Additionally, we hypothesized that older adults would cope better with less favorable events due to their life experience and emotion regulation skills. Analyses of 6,688 participants (18–90 years) showed that while older adults reported less favorable life events, they coped better with the same events than younger adults. The results underscore the importance of distinguishing between age and life event effects. They also show that life-event characteristics are consistently linked to well-being throughout adulthood.

Addressing unmet mental health needs of older adults in Turbo, Colombia: a multi-component psychosocial intervention feasibility study

BackgroundOlder adults have lived through extreme and stressful live events in Colombia, including during the armed conflict. Without adequate mental health resources in place, the aim of this study was to feasibility test a co-produced community-integrated intervention for older adults to improve their mental health and well-being in Turbo, Colombia.MethodsBased on a systematic review and meta-analysis of community-based mental health interventions for older adults in LMICs, qualitative interviews with older adults and local stakeholders, as well as a mental health needs assessment survey of the local older adult population in Turbo, Colombia, we consulted older adults in the region to co-produce a community-based intervention. The co-produced intervention ran for three months in 2023, with two sessions provided per week in a community centre (26 sessions in total). The multi-component intervention included social engagement, educational interventions, physical activities, and peer support. Older adults were recruited from the local community. Twelve participants were interviewed about their experiences of the intervention and its feasibility.ResultsEighteen older adults participated in the intervention, with 13 completing the 12 weeks. Attendance rate was high, with 10 participants attending between 90 to 100% of all 26 sessions. Qualitative interviews with 12 participants showed that participants valued the intervention and the activities it offered, that the intervention was feasible, and expressed a keen interest for the intervention to be continued.ConclusionsThis co-produced and evidence-based intervention for older victims of ‘La Violencia’ in Colombia has the potential to provide affordable, acceptable and relevant community-based resources supporting mental health and wellbeing within the community; providing care and support with trained facilitation. Normally, this group would not be able to access services to address their social and psychological isolation and distress. In light of limited mental health support across LMICs, this intervention could provide mental health for older adults in other communities in Colombia and elsewhere developed through co-production, cultural adaptation, subject to further evaluation.

Correlation between anxiety, depression, and social stress in young patients with thoracolumbar spine fractures.

Traumatic injuries, such as falling, car accidents, and crushing mostly cause spinal fractures in young and middle-aged people, and > 50% of them are thoracolumbar fractures. This kind of fracture is easily combined with serious injuries to peripheral nerves and soft tissues, which causes paralysis of the lower limbs if there is no timely rehabilitation treatment. Young patients with thoracolumbar fractures find it difficult to recover after the operation, and they are prone to depression, low self-esteem, and other negative emotions. To investigate the association between anxiety, depression, and social stress in young patients with thoracolumbar spine fractures and the effect on rehabilitation outcomes. This study retrospectively analyzed 100 patients admitted to the orthopedic department of Honghui Hospital, Xi'an Jiaotong University who underwent thoracolumbar spine fracture surgery from January 2022 to June 2023. The general data of the patients were assessed with the Hamilton anxiety scale (HAMA), Hamilton depression scale (HAMD), life events scale, and social support rating scale (SSRS) to identify the correlation between anxiety, depression scores, and social stress and social support. The Japanese Orthopedic Association (JOA) was utilized to evaluate the rehabilitation outcomes of the patients and to analyze the effects of anxiety and depression scores on rehabilitation. According to the scores of HAMD and HAMA in all patients, the prevalence of depression in patients was 39% (39/100), and the prevalence of anxiety was 49% (49/100). Patients were categorized into non-depression (n = 61) and depression (n = 39), non-anxiety (n = 51), and anxiety (n = 49) groups. Statistically significant differences in gender, occupation, Pittsburgh Sleep Quality Index (PSQI) score, and monthly family income were observed between the non-depression and depression groups (P < 0.05). A significant difference in occupation and PSQI score was found between the non-anxiety and anxiety groups. Both depression (r = 0.207, P = 0.038) and anxiety scores (r = 0.473, P < 0.001) were significantly and positively correlated with negative life events. The difference in negative life event scores as well as SSRS total and item scores was statistically significant between patients in the non-depression and depression groups (P < 0.05). The difference between the non-anxiety and anxiety groups was statistically significant (P < 0.05) in the negative life event scores as well as the total SSRS scores. Additionally, JOA scores were significantly lower in both anxious and depressed patients. Young patients with thoracolumbar fractures are prone to anxiety and depression. Patients' anxiety and depression are closely associated with social pressure, which reduces the life pressure of young patients with thoracolumbar fractures, enhances social support, and improves the psychology of anxiety and depression., which affects patients' recovery.

Body mass index trajectories from birth to adolescence and associated factors in the PARIS cohort.

Development of body mass index (BMI) trajectories is essential for understanding childhood overweight, a public health concern. This study aimed to identify BMI trajectories from birth to adolescence and examine associated factors in the Pollution and Asthma Risk: an Infant Study (PARIS) birth cohort. Data on height, weight, birth parameters, lifestyle, parental weight status and stress were collected via questionnaires and health check-ups. BMI z-score (BMIz) trajectories were developed using group-based trajectory modelling on anthropometric data collected at least six times. Associated factors were investigated in multivariable multinomial logistic regression models, adjusted for confounders. Five BMIz trajectories were identified in 540 adolescents. The early high stable BMI trajectory grouped participants who reached overweight status in early childhood. Four trajectories remained within the normal weight status: low stable BMI, continuous decrease BMI, continuous increase BMI, and early increase and slight decrease BMI trajectories. Compared with low stable BMI, high BMI trajectories were associated with higher parental weight status, early rebound age, excessive TV watching, lower food avoidance score, stressful events in early life and parent-child relationship stress. High BMI trajectories shared several modifiable factors, emphasising the need for multifactorial interventions to tackle the childhood overweight epidemic.

Joint Spatial Analysis of Low Birth Weight and Stunting in West African Countries

Introduction: The burden of childhood morbidity and mortality are still huge in most sub-Saharan African countries with West African sub-region contributing largely to the burden. Previous findings have demonstrated strong link between early life events such as low birth weight (LBW) with later events particularly malnutrition. We aim at estimating the specific and shared spatial patterns of LBW and stunting among under-five children in multiple West African countries. Methods: Data set for the study was sourced from the Demographic and Health Surveys conducted in fourteen West African countries. We used a Bayesian shared component model allows us to split the spatial surface into those specific to each of the outcomes and one shared by the two, with inference based on a Bayesian approximation procedure through the integrated nested Laplace approximation. Results: The findings show spatial clustering in the shared and specific effects of the health outcomes, demonstrating high likelihood in northern Nigeria spanning through Niger and that the spatial pattern for the shared effects are similar to those of the specific effects of stunting. Furthermore, mother’s level of education, attendance in antenatal care and household wealth index are strongly associated with the shared health outcomes. Conclusion: The study provides insight into the spatial pattern of LBW and stunting among West African children and can be useful in targeted interventions in regions with high burden of LBW and malnutrition which may include more advocacy that promote the use of antenatal care services during pregnancy.

A Retrospective Study of the Influence of Life Events and Social Support on Relapses and Recurrences in Older Patients with Bipolar Disorder.

Background/Objectives: Life events and lack of social support are risk factors for a relapse or recurrence in patients with a bipolar disorder, yet studies focusing on older adults remain limited. Our aim was to investigate the influence of life events and social support on the course of bipolar disorder in older adults. Methods: A retrospective cohort study included patients aged 55 years and older in treatment for bipolar disorder and who used lithium. During a follow-up of maximum 5 years, relapses and recurrences, life events and six social support variables were constructed based on patients' electronic medical files. Results: We included 100 older patients with a mean age of 68.1 (SD 8.6) years; 69% were female. At least one relapse or recurrence was observed within the 5 years of observation in 52% of our patients. Life events were noted in the medical files in 24 out of these 52 (46.2%) patients. Living alone, a lower quality of social support and having at least two children was significantly associated with the onset of a relapse or recurrence (p = 0.024, p < 0.001, p = 0.022, respectively). Conclusions: Older adults with bipolar disorder have a high rate of relapses or recurrences within 5 years of observation, and half of the relapses or recurrences were preceded by life events. Social factors may also play a significant role in the onset of relapses and recurrences. Our results underline the necessity for incorporating social and environmental factors into prevention of relapses or recurrences for older bipolar patients.

Relationship of negative life events with depression and anxiety in nursing students: a moderated mediation model of resilience and gender

BackgroundCompared to ordinary student in the same age group, nursing students experience notably higher rates of depression and anxiety. Negative life events (NLEs) and resilience were recognized as risk factors and protective factors, respectively. There is little literature on the complex interaction of these factors among nursing students.ObjectivesThe study aims to explore the potential relationship of NLEs, resilience, and gender with symptoms of depression and anxiety among nursing students.MethodsA cross-sectional design was used for this study. A total of 568 participants from three universities in East, South and North China were recruited. Data collection instruments included socio-demographic characteristics, the Patient Health Questionnaire-9, the Generalized Anxiety Disorder Scale, the 10-item Connor-Davidson Resilience Scale, the Adolescent Life Events Self-Rating Scale, and The Pittsburgh Sleep Quality Index. A moderated mediation model was used to analyze the data.ResultsNLEs and resilience significantly related to depression and anxiety (r = -0.289 ~ 0.454, all ps < 0.01). NLEs had a direct effect on depression (B = 0.251, p < 0.001) and anxiety (B = 0.307, p < 0.001). Analysis of mediating effects revealed that NLEs influenced depression (B = 0.02, 95% CI : 0.004–0.041) and anxiety (B = 0.019, 95% CI : 0.004–0.040) through resilience pathways. Additionally, gender was found to have a moderating effect on the direct association of NLEs with anxiety (B = -0.031, p < 0.05), with males showing a greater association.ConclusionsThe findings suggest that improving resilience may help break the relationship of NLEs with depression and anxiety in nursing students. Additionally, the mental health of male nursing students needs more attention.

Recent life events and adverse childhood experiences in predicting antenatal depression and anxiety: cross-sectional study.

Antenatal depression and anxiety are associated with preterm labour, low birth weight, and postpartum depression, and can impact the emotional and mental development of the child. Both adverse childhood experiences and recent stressful events are linked to negative health outcomes. However, certain events may be more impactful than others. This study aims to investigate the most important types of adverse childhood events and recent stressors that may help in identifying pregnant women in most need of psychological support. This observational study examines data from the FamilieTrivsel trial, in which women between 6 and 10 weeks gestation were recruited by general practitioners. All participants were asked to complete questionnaires. Mental health was assessed with the Hospital Anxiety and Depression Score (HADS). Potential contributory risk factors were identified using the Recent Life Events Questionnaire and the Adverse Childhood Experiences questionnaire. The relative importance of the various types of events was analysed in a dominance analysis, and the direction of their association was determined by a multivariable linear regression analysis. Of specific recent life events, serious problems with a friend, divorce, racial harassment, unemployment, financial difficulties, and moving house had the strongest associations with poor mental health, along with childhood experience of mental illness in the household. Growing up with an experience of physical neglect and parental divorce were, paradoxically, associated with lower HADS scores. Recent stressful life events have a stronger association with postnatal mental health than adverse childhood events, implying that it might be useful for clinicians providing routine antenatal care to gather information on recent stressors.

Changes in mood states during inpatient rehabilitation after spinal cord injury

Design Retrospective observational study. Objective To analyze changes in mood states during the acute phase of inpatient rehabilitation for spinal cord injury (SCI) and the factors associated with worse mood states and less improvement. Setting Spinal unit in Italy. Participants The study included people with SCI admitted between 2014 and 2019 and treated for psychological problems with a focus on ‘emotion processing’ and ‘emotional adjustment’. The sample included 170 patients (71.8% male, mean age 47.1 ± 16, range 17–78), 46.5% with tetraplegia and 50% with comorbidities. Outcome Measures The Profile of Mood States (POMS) questionnaire was used to assess mood states at baseline and at the end of treatment. Multiple linear regression models were used to identify factors associated with changes in mood states during treatment. Results At baseline, patients with distress related to SCI diagnosis reported lower levels of vigor, whereas those with distressing life events reported higher levels of anger and confusion-bewilderment. POMS subscales improved significantly by at least 4 points. ASIA Impairment Scale (AIS) C score, living with family of origin, comorbidities and critical events during hospitalization were associated with greater improvements, whereas higher education was associated with less improvement in depressive mood. In tetraplegic patients, higher improvements in depressive mood were associated with greater independence at discharge, whereas in patients with paraplegia, higher improvements in anxiety and vitality were associated with better mobility. Conclusion Our results indicate that mood states improved in people with SCI receiving a psychological treatment. Socio-demographic and SCI-related characteristics associated with a greater effect of psychological treatment should be considered in order to tailor the intervention.