Number Of Negative Life Events Research Articles

The Compounding Effects of Negative Life Events and Peer Victimization on Internalizing Symptoms in Middle School

ABSTRACT Middle school is a time of transition associated with increases in peer victimization (PV) and stress that warrant additional attention. Middle school students (N = 256; 54.7% male; M age = 12.24, SD age = .94) completed measures of PV, negative life events (NLEs), anxiety, and depression. Students were assessed across 6 time points to examine if PV and the number of NLEs at baseline (Time 1; T1) had a unique and interactive effect on symptoms of depression and anxiety concurrently and over three school years. Results suggest that T1 PV, T1 NLEs, and their interactions were significantly associated with concurrent depression. Moreover, the association between T1 PV and the trajectory of depression was moderated by T1 NLEs. Associations with anxiety were not as substantial; nonetheless, T1 PV was significantly associated with concurrent anxiety. Findings clarify the cross-sectional and longitudinal association between PV and NLEs on internalizing symptoms in middle school with an emphasis on the substantial risk of depression symptomatology.

Psychogenic non-epileptic (functional) seizures in adults with intellectual disability and epilepsy: A matched case-control study.

To describe the characteristics of psychogenic non-epileptic (functional) seizures (PNES) in adults with epilepsy and intellectual disability (ID) and to establish differences and risk factors regarding psychosocial functioning between individuals with and without PNES. Adults with ID and epilepsy living in epilepsy care facilities in The Netherlands were screened for PNES by a neurologist. A control group consisting of people with epilepsy and ID, without PNES, was matched according to age, sex, and level of ID. Objective data were retrieved retrospectively from clinical notes of the resident. Standardized questionnaires and tests, adjusted for people with ID, were obtained from participants and their nursing staff. Differences were analyzed using paired t tests, Wilcoxon signed-rank tests, or McNemar's tests, appropriate for matched case-control studies. Conditional logistic regression identified PNES risk factors. Five hundred forty individuals were screened, of which 42 had PNES (point prevalence 7.8%). In total, 35 cases and 35 controls gave consent. Proxy reports indicated that PNES impacted daily life in 79% by adjusting the individual's schedule, and caused minor injuries in one-third. Those with PNES were mainly female (69%); had a mild (46%) or moderate (37%) level of ID; showed more symptoms of depression (p = .024), anxiety (p = .030), self-injurious behavior (p = .015); and experienced more negative life events (p < .001). Clinically relevant predictors of PNES were the number of negative life events (odds ratio [OR] 1.71, 95% confidence interval [CI] 1.12-2.53) and self-injurious behaviors (OR 5.27, 95% CI .97-28.81). Previously, PNES in individuals with ID and epilepsy were described mainly as a reinforced behavioral pattern, due to limited associations with psychiatric disorders. Our results demonstrate that this population does show individual psychosocial vulnerabilities when measured with instruments adjusted for this population, as indicated by proxy reports from daily caregivers. Viewing PNES as an involuntary response, especially for stress-prone individuals with ID, could reduce stigma and improve treatment.

A Discrepancy in the Reports on Life Events Between Parents and Their Depressed Children Is Associated with Lower Responsiveness to SSRI Treatment.

Introduction: Exposure to a range of stressful life events (SLE) is implicated in youth psychopathology. Previous studies point to a discrepancy between parents'/children's reports regarding stressful life events. No study systematically assessed the correlation between such discrepancies and psychopathology in depressed youth. This study was designed to assess parent-youth discrepancies regarding stressful life events and its association with severity of psychopathology at baseline and response to selective serotonin reuptake inhibitor (SSRI) treatment in depressed youth. Methods: Reports regarding stressful life events were assessed in children/adolescents suffering from depressive/anxiety disorders using the life events checklist (LEC), a self-report questionnaire measuring the impact of negative life events (NLE) and positive life events (PLE), as reported by the children and their parents. The severity of depression/anxiety disorders and response to antidepressant treatment were evaluated and correlated with both measures of LEC. Results: Participants were 96 parent-child dyads (39 boys, 57 girls) aged 6-18 years (mean = 13.90 years, SD = 2.41). Parents reported more NLE and higher severity of NLE events than their children (number of NLE: 7.51 ± 4.17 vs. 6.04 ± 5.32; Cumulative severity of NLE: 24.95 ± 14.83 vs. 17.24 ± 12.94). Discrepancy in PLE, but not NLE, was associated with more severe psychopathology and reduced response to treatment. Discussion: Discrepancy in informant reports regarding life events in depressed/anxious youth, especially regarding PLE, is associated with more severe psychopathology and reduced response to pharmacotherapy. It is essential to use multiple reporters in assessing stressful life events in children.

Validation of the Arabic version of the resilience scale for adolescents (READ)

IntroductionAdolescents react differently to challenging negative life events. Resilience, a dynamic characteristic of individuals, was studied to be a protective factor against such events. In order to study the resilience among Arabic-speaking adolescent populations, age-appropriate measures that are fully apprehended by younger respondents are needed. In this context, the present study aimed to examine the psychometric properties of an Arabic translation of the Resilience Scale for Adolescents (READ) in a community sample of native Arabic–speaking adolescents aged 13–18 years.MethodsA sample of 546 community Arabic-speaking adolescents from Lebanon was recruited (n = 328 females, with a mean age of 15.76 ± 1.65 years). Through an online questionnaire, participants were requested to complete the READ, Depression, Anxiety and Stress Scale (DASS-8) and the 13-item Children’s Impact of Event Scale (CRIES-13).ResultsFollowing the exploratory and confirmatory factor analysis (EFA-to-CFA) strategy, a unidimensional model of the Arabic version of the READ was met after 10 items were removed from the scale, and showed strong internal consistency (Cronbach’s alpha of 0.943). Additionally, the one-factor solution of the Arabic version of the READ was identical across male and female adolescents at the three levels of invariance (Configural, Metric and Scalar). Finally, higher resilience scores were significantly correlated with lower levels of psychopathology, namely depression, anxiety, stress and PTSD, thus attesting to the concurrent validity of the Arabic READ.ConclusionFindings lend support to the psychometric reliability and validity of the Arabic version of the READ, and therefore its suitability for use among Arabic-speaking adolescents. The availability of this tool facilitates the implementation of interventions that foster resilience, especially in adolescents who have faced a number of negative life events.

0324 Protective and Risk Factors for Insomnia Over 5 Years in a Population-Based Sample of Adults

Abstract Introduction Insomnia is a major public health concern and one of the most prevalent health issues among adults. Identifying protective and risk factors for insomnia could help identify vulnerable populations and design public health interventions to prevent some adverse medical and mental health consequences. The study objective was to identify protective and risk factors for insomnia in a population-based sample of adults. Methods Data is from a large epidemiological cohort study on the natural course of insomnia conducted in Canada before the COVID-19 pandemic. Insomnia and potential protective and risk factors for insomnia were measured annually over 5 years with validated questionnaires (e.g., Insomnia Severity Index, Pittsburgh Sleep Quality Index, State-Trait Anxiety Inventory, Beck Depression Inventory, Perceived Stress Scale, Coping Inventory for Stressful Situations, Ford Insomnia Response to Stress Test, Arousal Predisposition Scale, Life Experiences Survey). Risk factors for insomnia were divided as predisposing or precipitating factors. Results From a cohort of 3,413 participants 1,709 adults were identified as good sleepers at baseline and were included in the analyses. A total of 202 people developed an insomnia syndrome during the 5-year follow-up. Using survival analysis for discrete events, the following variables were significant predisposing factors for insomnia: anxiety (HR=1.037; p=0.018), depression (HR=1.082; p&amp;lt; 0.001), perceived stress (HR=1.073; p&amp;lt; 0.001), number of negative life events (HR=1.478; p=0.02), perceived worse general health (HR=1.606; p=0.006), pain (HR=1.475; p=0.002), vulnerability to stress (HR=1.089; p&amp;lt; 0.001), and maladaptive emotional coping (HR=1.044; p&amp;lt; 0.001). The following variables were identified as precipitating factors for insomnia: loss of income (HR=1.346; p=0.03), increased anxiety (HR=1.070, p&amp;lt; 0.001), depression (HR=1.119; p&amp;lt; 0.001) and perceived stress (HR=1.083; p=0.001), decline in perceived general health (HR=2.061; p=0.006), and increased pain (HR=1.353; p=0.013). Physical activity was not a significant protective factor for insomnia (p=0.54). Conclusion These results provide new information that could be helpful to prevent the onset and chronicity of insomnia by targeting specific precipitating factors, and people with predisposing factors for insomnia. This is important as insomnia tends to be a persistent condition and is known to increase adverse medical and mental health outcomes. Support (if any) This study was funded by the Canadian Institutes of Health Research.

A mediated moderation model of negative life events, self-esteem, rumination and parental divorce on depression among Chinese juvenile delinquents

Little attention was paid to the prevalence of depression in Chinese juvenile delinquents who are studied in correctional work-study schools. Hence, the present study aimed to test the unique, mediating and moderating effects of negative life events, self-esteem, rumination and parental divorce on depression among Chinese juvenile delinquents. A total of 236 juvenile delinquents aged between 12 and 17 years old (M = 14.68 SD = 1.30) were recruited to accomplish a battery of self-report questionnaires concerning their negative life events, self-esteem, rumination, depression and demographic profile. The descriptive analysis showed that there was a positive correlation between negative life events and depression in Chinese juvenile delinquents. Moreover, the results from the structural model indicated that self-esteem and rumination played separate and sequential mediating roles between negative life events and depression. In addition, parental divorce had a moderating effect between negative life events and self-esteem in the model. These results suggest that the prevalence of depression among Chinese juvenile delinquents can be reduced through modification of the ruminative way of thinking, improving their self-esteem when they encounter a number of negative life events. Furthermore, more attention should be paid to the juvenile delinquents who experienced parental divorce.

Suicidal attempts and ideations in Kenyan adults with psychotic disorders: An observational study of frequency and associated risk factors.

Psychotic disorders increase the risk for premature mortality with up to 40% of this mortality attributable to suicide. Although suicidal ideation (SI) and suicidal behavior (SB) are high in persons with psychotic disorders in sub-Saharan Africa, there is limited data on the risk of suicide and associated factors among persons with psychotic disorders. We assessed SI and SB in persons with psychotic disorders, drawn from a large case-control study examining the genetics of psychotic disorders in a Kenyan population. Participants with psychotic disorders were identified using a clinical review of records, and the diagnosis was confirmed with the Mini-International Neuropsychiatric Interview (MINI). We conducted bivariate and multivariate logistic (for binary suicide outcomes) or linear regression (for suicide risk score) analysis for each of the suicide variables, with demographic and clinical variables as determinants. Out of 619 participants, any current SI or lifetime suicidal attempts was reported by 203 (32.8%) with psychotic disorders, of which 181 (29.2%) had a lifetime suicidal attempt, 60 (9.7%) had SI in the past month, and 38 (20.9%) had both. Family history of suicidality was significantly associated with an increased risk of suicidality across all the following four outcomes: SI [OR = 2.56 (95% CI: 1.34-4.88)], suicidal attempts [OR = 2.01 (95% CI: 1.31-3.06)], SI and SB [OR = 2.00 (95% CI: 1.31-3.04)], and suicide risk score [beta coefficient = 7.04 (2.72; 11.36), p = 0.001]. Compared to persons aged <25 years, there were reduced odds for SI for persons aged ≥ 25 years [OR = 0.30 (95% CI: 0.14-0.62)] and ≥ 45 years [OR = 0.32 (95% CI: 0.12-0.89)]. The number of negative life events experienced increased the risk of SI and SB [OR = 2.91 (95% CI: 1.43-5.94)] for 4 or more life events. Higher negative symptoms were associated with more suicidal attempts [OR = 2.02 (95%CI: 1.15-3.54)]. Unemployment was also associated with an increased risk for suicidal attempts [OR = 1.58 (95%CI: 1.08-2.33)] and SI and SB [OR = 1.68 (95% CI: 1.15-2.46)]. Suicidal ideation and SB are common in persons with psychotic disorders in this African setting and are associated with sociodemographic factors, such as young age and unemployment, and clinical factors, such as family history of suicidality. Interventions targeted at the community (e.g., economic empowerment) or at increasing access to care and treatment for persons with psychotic disorders may reduce the risk of suicide in this vulnerable population group.

The Relationship Between Early Life Adversity and Academic Competence in Early Childhood.

It is well-documented that early life adversity negatively affects children academically and that these impacts magnify as the number of negative life events (NLEs) they experience increases. However, it is unclear whether the types of NLEs children are exposed to differentially relate to their levels of academic competence, a component of educational functioning. The present study addressed this question by assessing the relationships between different types of early life adversity and academic competence in 4- to 6-year-olds (N = 111) using secondary data analyses of parent reports in which respondents indicated children's levels of academic competence and exposure to NLEs. The results showed that family turmoil (b = -2.31, 95% CI [-4.05, -0.57], p = .01, f2 = .07), poverty (b = -2.92, 95% CI [-4.31, -1.53], p < .001, f2 = .16), and violence (b = -3.43, 95% CI [-5.14, -1.73], p < .001, f2 = .15) negatively predicted academic competence, whereas family separation and death/illness did not relate to academic competence. Additionally, poverty negatively predicted academic competence above and beyond family turmoil and violence (b = -2.36, 95% CI [-0.49, 0.72], p = .03, f2 = .04). These findings demonstrate that some, but not all, types of NLEs negatively predict preschoolers' academic competence, illustrating the differential relationship between different types of early life adversity and academic performance. Moreover, these findings reveal the deleterious impacts of certain types of NLEs on children's academics prior to beginning formal education, suggesting the importance of early intervention targeting family turmoil, poverty, and violence from a young age.

Associations among negative life events, changes in cortico-limbic connectivity, and psychopathology in the ABCD Study

Adversity exposure is a risk factor for psychopathology, which most frequently onsets during adolescence, and prior research has demonstrated that alterations in cortico-limbic connectivity may account in part for this association. In a sample of youth from the Adolescent Brain Cognitive Development (ABCD) Study (N = 4006), we tested a longitudinal structural equation model to examine the indirect effect of adversity exposure (negative life events) on later psychopathology via changes in cortico-limbic resting-state functional connectivity (rsFC). We also examined the potential protective effects of parental acceptance. Generally, cortico-limbic connectivity became more strongly negative between baseline and year 2 follow-up, suggesting that stronger negative correlations within these cortico-limbic networks may reflect a more mature phenotype. Exposure to a greater number of negative life events was associated with stronger negative cortico-limbic rsFC which, in turn, was associated with lower internalizing (but not externalizing) symptoms. The indirect effect of negative life events on internalizing symptoms via cortico-limbic rsFC was significant. Parental acceptance did not moderate the association between negative life events and rsFC. Our findings highlight how stressful childhood experiences may accelerate neurobiological maturation in specific cortico-limbic connections, potentially reflecting an adaptive process that protects against internalizing problems in the context of adversity.

Cultural and interpersonal risk factors for suicide ideation and suicide attempts among Muslim college students from 11 nations

BackgroundResearch on suicidality in low to middle-income countries is scarce. We addressed this issue by investigating suicidality in a cross-national college student samples from 11 predominantly low to middle-income majority Muslim countries. MethodsThe sample consisted of 7427 college students (56% female) who reported to be affiliated with Islam. Data on self-construal, social support, negative life-events, acceptability of suicide, suicidal ideation, and suicide attempts were collected with self-administered questionnaires. ResultsAcceptability of suicide and the experience of negative life-events were positively, and perceived social support was negatively associated with suicidal ideation. Interdependent self-construal was negatively related to the acceptability of suicide and positively associated with perceived social support, implying a negative indirect effect on suicidal ideation although its direct effect was positive. The number of negative life-events was the strongest positive predictor of ever attempting suicide. The interdependent self-construal moderated the association of negative life-events with suicide attempts. LimitationsCross-sectional and self-report nature of the study were its major limitations. Participants may have suppressed their responses about suicide because of religious and legal reasons. ConclusionRemarkable similarities across 11 country samples emerged in the linkages between cultural and interpersonal factors with suicidality. Our findings highlight the value of a nuanced approach to suicidality, that can recognize the differences in the processes associated with suicidal ideation and suicide attempts, as well as the need to consider the interplay of a broad range of personal, interpersonal, and cultural influences.

The role of perceived negative childhood experiences in the context of recent stress: Testing competing theoretical models

The present study evaluated the assumptions of stress sensitization and stress immunization hypotheses about the role of perceived negative childhood experiences on adult adjustment. The study used a longitudinal design with three waves spaced six months apart. The final sample consisted of 293 undergraduate students aged 19 to 30 years. We examined the linear and nonlinear main and moderating effects of perceived negative childhood experiences in the relationship between recent stressful events and both ability to bounce back and subjective well-being. The results yielded nonlinear moderating effects of negative childhood experiences on life satisfaction and the ability to bounce back, whereas a main effect was found for negative affect. A significant drop in the ability to bounce back in the context of high recent life stress was found only among individuals with a very high level of negative childhood experiences. We also found that an increase in the number of negative life events leads to a decrease in life satisfaction among individuals with both low- and high-intensity levels of negative childhood experiences. The present study offers the possibility of integrating different models of additive and interactive effects of perceived negative childhood experiences in the relationship between recent stressors and psychological adjustment.

Vulnerability to interrogative suggestibility from negative life events. A comparison of separated asylum-seeking youth and age-matched peers.

The consistency of young asylum-seeker's verbal testimony is often critical in determining the outcome of their claims. It is well established that an interviewee may change their answers to appease an interviewer or in response to suggestions. Experiencing adversity during childhood may increase vulnerability in such interview situations. Here, the vulnerability to interview pressure of asylum-seeking youth separated from their caregivers as minors was compared with age-matched peers. Thirty participants (16–23 years) completed the Gudjonsson Suggestibility Scale (GSS2, measures of negative life events (NLEs) and non-verbal cognitive functioning measures. Vulnerability to interrogative suggestibility, non-verbal cognitive functioning and number of NLEs was compared between two groups. This preliminary data showed asylum-seeking youth as significantly more vulnerable to Shift; changes in response to interviewer feedback. NLEs and lower non-verbal cognitive functioning were significantly more common among the separated youth increasing vulnerability to Shift. The implications are discussed.

Negative Life Events and Time Perspective Among Adolescents

We examined negative life events and time perspective in adolescents. Negative life events were nonnormative experiences including school suspension, running away from home, or the death of a family member. Time perspective referred to thoughts and feelings about the past, present, and future. We assessed multiple dimensions including orientations and positive and negative feelings about time. Participants were 790 adolescents and data were self-reported. Findings indicated that (a) adolescents who experienced the highest number of negative life events were oriented toward the past, whereas adolescents who experienced the fewest negative life events were oriented toward the three time periods equally, and (b) negative life events were positively associated with negative feelings and inversely associated with positive feelings about time.

Bereavement and Physiological Dysregulations in African American Adults

This study uses data from National Survey of Midlife in the U.S. (MIDUS) to examine the effect of bereavement on physiological dysregulations in African American adults, with moderating effects of gender. Models were estimated using data from 210 Non-Hispanic African American respondents who participated in MIDUS 2 (M2: 2004-2005) and the biomarker data collection (2004-2009). We analyzed data from two groups, respondents who experienced the death of an individual(s) close to them, either family or friends (97 women, 40 men) and respondents who did not experience any deaths of close individuals during the same period (46 women, 27 men), controlling for age, education, marital status, prior family bereavement, number of negative life events since M2, and physical health prior to bereavement. Physiological dysregulations were assessed for 7 systems: HPA axis, glucose metabolism, lipids metabolism, sympathetic system, parasympathetic system, inflammation, and cardiovascular functioning. The results show that African American men and women who experienced bereavement were at higher risk of dysregulation of glucose metabolism (assessed by HbA1c, HOMA-IR, and fasting glucose) than the non-bereaved, even after adjusting prior diabetes diagnosis. In addition, African American women (but not men) who experienced recent bereavement were at higher risk of dysregulation of HPA axis functioning (assessed by urinary cortisol and blood DHEA-S) than their counterparts. The other physiological systems were not significantly associated with bereavement experience in African American adults. The findings suggest that bereavement has adverse impacts on health in African American adults via dysregulations in glucose metabolism and HPA axis functioning.

Life events and adolescent depressive symptoms: Protective factors associated with resilience.

Depression is a public health concern among youth, and it is pertinent to identify factors that can help prevent development of depressive symptoms in adolescence. This study aimed to investigate the association between negative life events and depressive symptoms among adolescents, and to examine the influence and relative contributions of personal, social and family protective factors related to resilience. Data stem from the cross-sectional youth@hordaland-survey, conducted in Hordaland, Norway. In all, 9,546 adolescents, aged 16-19 years old (52.8% girls) provided self-report information on depressive symptoms, negative life events and protective factors related to resilience. Experiencing a higher number of negative life events was related to increases in depressive symptoms, while the potential protective factors goal orientation, self-confidence, social competence, social support, and family cohesion individually were associated with fewer symptoms. Although there were small moderating effects of goal orientation and self-confidence, the results mainly supported a compensatory resilience model. When considering the potential protective factors jointly, only self-confidence and family cohesion were significantly associated with fewer depressive symptoms for both genders, with the addition of social support for girls. There were significant interactions between all the potential protective factors and gender, indicating a greater reduction of depressive symptoms with higher levels of protective factors among girls. Interventions aimed at fostering self-confidence and family cohesion could be effective in preventing depressive symptoms for adolescent boys and girls, regardless of their exposure to negative events. Results further indicate that preventive interventions targeting these potential protective factors could be especially beneficial for adolescent girls.

4288 Identifying Predictive Variables of High-Intensity Binge Drinking Through the Use of a Machine Learning Algorithm

OBJECTIVES/GOALS: To test if a machine learning algorithm could predict a person’s capacity to binge drink and explore what measures might be important for identifying individuals at risk for high-intensity binge drinking behaviors. METHODS/STUDY POPULATION: The sample included 1177 (474 female) non-treatment-seeking drinkers (age: 18-91 years), that were assigned to a group based on their heaviest drinking day reported in a 90-Day Alcohol Timeline Followback questionnaire. The groups were Non-Bingers (female: 12 drinks, male:&gt;15 drinks). The sample was divided into a training sample (N = 884) and a testing sample (N = 293). A machine learning algorithm called random forest was then used to generate a predictive model based on measures of substance use, personality traits, and trauma. The model was applied to the testing sample to determine accuracy. RESULTS/ANTICIPATED RESULTS: The first model correctly assigned 190 out of 293 subjects, giving it a total error rate of 0.35, with lowest rates for non-binge (0.19) and high-intensity (0.18), while medium-intensity had the highest error rate (0.86). The most important variables for the accuracy of the model included: total score on the Alcohol Use Disorder Identification Test, first five sub-score of the Self-Reported Effects of Alcohol, Compulsive Drinking subscale, and presence of a current psychiatric diagnosis. As a follow-up analysis, we built and tested another random forest model without the use of drinking dependence measures. This model had a total error rate of 0.39, and introduced other important variables such as smoking behaviors, perceived stress, IQ, and number of negative life events. DISCUSSION/SIGNIFICANCE OF IMPACT: Our study showed that it was possible for a machine learning algorithm to predict binge drinking intensity better than chance. Drinking patterns were the most robust predictors, and stress, IQ, and psychiatric diagnoses were also useful in predicting binge drinking intensity.

Decision-making in major depressive disorder: Subjective complaint, objective performance, and discrepancy between both.

BackgroundStudies comparing objective and subjective cognition in major depressive disorder (MDD) are scarce, and available data concern different cognitive functions but not decision-making specifically. This cross-sectional study aimed to explore objective (O-DMI) and subjective decision-making impairment (S-DMI) as well as the discrepancy between both in people with MDD. Secondly, we assessed the association between S-DMI and O-DMI. Finally, we explored sociodemographic, clinical, and psychosocial factors related to decision-making impairment status. MethodOne hundred and nine people with MDD were assessed with the Iowa Gambling Task to identify “O-DMI”. The item 9 of the Beck Depression Inventory was used to compose the variable “S-DMI”. Psychiatric history, medication adherence, childhood trauma, physical and psychological pain, and negative life experiences were also collected. ResultsForty-six percent of participants have O-DMI and 65.1% S-DMI. From 49.5% showing a discrepancy between both, 68,6% have positive discrepancy and 31,4% negative (i.e. under and overestimation respectively). O-DMI and S-DMI were not associated. Binary logistic regressions showed that the number of negative life events in the past 6 months was predictor of O-DMI, while depression severity and medication adherence predicted S-DMI. Finally, medication adherence and depression severity predicted the type of discrepancy. LimitationsThe variable S-DMI was obtained through a single item. ConclusionThese results confirm the lack of association between objective and subjective measures of cognition in MDD, and for the first-time concerning decision-making. This suggest that both assessments should be done in order to have a deeper knowledge of the cognitive functioning of each patient.

Lifestyle Factors and Subjective Cognitive Impairment in Patients Seeking Help at a Memory Disorder Clinic: The Role of Negative Life Events

Background/Aims: A large proportion of patients at memory disorders clinics are classified as having subjective cognitive impairment (SCI). Previous research has investigated whether particular lifestyle factors known to affect cognition can be useful in differentiating patients who do not show objective evidence of memory decline. There may also exist subgroups of patients with respect to lifestyle factors that could help clinicians to understand the patient group that presents to memory clinics. These may differ in diagnostic outcome. Very little is known about potential subgroups; however, but such information may help guide interventions and potentially eliminate unnecessary diagnostic procedures. The current study investigated patterns of lifestyle-related variables, including stress, sleep, sensory sensitivity, depression, and negative life events in patients presenting to a memory disorders clinic. The aim was to determine whether subgroups existed and whether it was possible to distinguish those with objectively impaired cognition. Methods: One hundred and seventy-eight patients (mean age 58 years) from a University Hospital Memory Disorders Clinic. Results: Cluster analysis identified three groups of lifestyle-related variables. Strong determinants of clusters were negative life events and age. Patients with a high number of negative life events also tended to have highest self-reported memory complaint, higher levels of stress, depression, and sensory sensitivity. However, they did not perform the worst on memory testing. In contrast, individuals who performed the worst on memory tests were older, tended to have the least memory complaints, and less negative lifestyle factors; this group also included the highest proportion of patients with mild cognitive impairment and had the lowest median amyloid A-beta 42 (Aβ₄₂). The group with the best cognitive performance were younger, included the highest proportion of patients with SCI and the highest median Aβ₄₂. On lifestyle variables, their ratings fell in between the other groups. Conclusions: Lifestyle subgroups of patients were determined by stress, emotional problems, and age. The groups were significantly associated with Aβ₄₂ and diagnostic outcome. This pattern may confound the differentiation between objective and subjective memory problems. Asking about lifestyle variables, in conjunction with neuropsychological testing, could potentially identify individuals who are not likely to have objective memory impairment and guide interventions.

Negative life events and major depressive disorder among HIV-positive individuals in Guangdong, China: A cross-sectional study.

HIV-positive individuals encounter a number of negative life events (NLEs). This cross-sectional study aimed to evaluate the association between NLEs and major depressive disorder (MDD) among HIV-positive individuals in Guangdong, China, about which little is known.HIV-positive individuals were recruited from the Centers for Disease Prevention and Control of Guangzhou, Zhongshan, and Yangjiang from September 2007 to September 2008. Data on NLEs were collected using a questionnaire. The Structured Clinical Interview for DSM-IV-TR Axis I Disorders-Patient Edition (SCID-I/P) based on the DSM-IV criteria was used to diagnose MDD. Multiple logistic regression analyses were conducted to evaluate the association between NLEs and MDD.Among the 339 participants, 306 (90.27%) reported that one or more NLEs had ever occurred. Participants who reported NLEs that included HIV infection, financial problems, AIDS diagnosis, HIV/AIDS discrimination, conflict with spouse or lover, conflict with other family members, problems in childbearing, and conflict with nonfamily were at a higher risk of MDD. Participants who reported more NLEs in the last year had a higher risk of MDD (OR = 2.86, 95%CI: 1.76–4.65) than individuals who reported fewer NLEs. Individuals with higher chronic stress scores had a higher risk of MDD (OR = 4.36, 95%CI: 2.44–7.78) than individuals with lower chronic stress scores. However, acute stress was not associated with MDD.NLEs were common among HIV-positive individuals. MDD was associated with a greater number of NLEs and the increased chronic stress caused by the NLEs. Interventions should be tailored to those who reported NLEs to help reduce the risk of MDD and increase the quality of life among HIV-positive individuals.

Do negative childhood conditions increase the risk of somatic symptoms in adolescence? \u2013 a prospective cohort study

BackgroundIn order to prevent health and social problems later in life, it is important to identify childhood conditions related to the development of somatic symptoms. This prospective study expands on previous research by investigating whether negative childhood conditions are related to somatization later in life, taking other risk factors into account.This study aims to investigate whether somatic symptoms of the participants’ parents, poor family functioning, or negative life events during childhood result in somatic symptoms in early or late adolescence.MethodsThe study population includes participants from the West Jutland Cohort Study who responded to the survey on their somatic symptoms at age 15 (n = 2963) and/or age 18 (n = 2341). The study also includes additional questionnaire information about the participants’ poor family functioning, number of negative life events, and parental reports of somatic symptoms as well as register information about parental socioeconomic background. Generalized linear models for the binomial family were used and the results were presented as relative risks (RR) and risk differences (RD) with 95% confidence intervals (95%-CI).ResultsExperiencing poor family functioning at age 15 showed associations with somatic symptoms at age 15 (RR 1.75, 95%-CI, 1.43–2.14 and RD 18, 95%-CI, 11–25%) and 18 (RR 1.32, 95%-CI, 1.00–1.75 and RD 7, 95%-CI, 0.2–14%). The relative risks between poor family functioning and somatic symptoms were 2.5 for the boys at age 15 and 1.71 for the girls at age 18. Having experienced two or more negative life events up to the age of 15 was associated with reporting somatic symptoms at age 15 (RR 1.73, 95%-CI, 1.31–2.28 and RD 24, 95%-CI, 11–37%). No relative risks above 1.35 were found between parents reporting somatic symptoms and participants reporting somatic symptoms at ages 15 or 18.ConclusionsAn increased awareness of the association between a poor social climate in the family and somatic symptoms may help professionals in health and educational systems prevent the development of such symptoms among adolescents.