Resilience Trajectories Research Articles

Corrigendum to “Contributions of Coping Flexibility and Associated Functional Brain Connectivity to Resilient Trajectories of Mental Health During the COVID-19 Pandemic”

Corrigendum to “Contributions of Coping Flexibility and Associated Functional Brain Connectivity to Resilient Trajectories of Mental Health During the COVID-19 Pandemic”

Exploring the developmental changes in and the relationship between resilience and anxiety and depression in older gastric cancer survivors: A latent growth mixture model and random intercept cross-lagged panel model analysis.

This study aims to investigate the independent and joint trajectories of resilience, anxiety, and depression symptoms and research the interaction between older gastric cancer survivors' resilience and anxiety-depression during the period of 1 year after surgery. The participants were 381 older gastric cancer survivors, with a mean age of 69 years. Resilience, anxiety, and depression symptoms were assessed immediately after surgery, and at 3, 6, and 12 months post-surgery, respectively. A longitudinal design was employed to capture the dynamic changes in resilience, anxiety, and depression levels among older gastric cancer survivors post-surgery. Latent growth mixture model and random intercept cross-lagged panel model were used to analyse the trajectories of resilience and anxiety-depression and the interaction between them. Two latent trajectories were identified for the resilience, four latent trajectories were identified for the anxiety, and five latent trajectories were identified for the depression, respectively, with three joint trajectories identified: gradual-increasing resilience, gradual-decreasing anxiety, and depression group (10.0%); gradual-decreasing resilience, gradual-increasing anxiety, and depression group (21.2%); and rapid-growth resilience, rapid-decline anxiety, and depression group (68.8%). Resilience among older gastric cancer survivors exhibits significant bidirectional and negative predictive effects on anxiety and depression. Individual differences in resilience, anxiety, and depression trajectories exist among older gastric cancer survivors, with heterogeneous joint progression patterns, and the relationship between resilience and anxiety-depression appears bidirectional. More sophisticated intervention programmes tailored to the unique characteristics of the relevant trajectories are necessary to enhance resilience and mitigate the risk of anxiety and depression.

6.M. Scientific session: Risk And Resilience Factors Of Mental Health During COVID: European Multi-country Data Findings

Abstract The COVID-19 pandemic significantly affected mental health. It worsened the mental health and well-being of those already vulnerable or exposed to excess pandemic-related stress. In addition, lockdowns and other measures created additional obstacles to mental health support access. In response, the European Commission funded the RESPOND project in 2020, aimed at enhancing the preparedness of mental health systems for pandemics and global crises. As part of the RESPOND project, (meta-)analyses were conducted on prospective cohort datasets, national health register data, and multi-country individual participant data (IPD). The aim was to examine whether there was a change in prevalence rates of mental health conditions (e.g., anxiety and depression) in the general adult population of the EU during, compared to before and in between, the COVID-19 pandemic waves. Analyses on risk factors (e.g. sociodemographic- and economic factors, severity of COVID-19 infection, (lack of) social activity and support, and loneliness) associated with psychological distress and mental disorders as well as resilience and well-being (coping strategies and core value orientations) in the general population or specific vulnerable groups were conducted as well. This workshop will feature five talks covering various aspects of the RESPOND epidemiological analyses. First, an introduction and rationale of the RESPOND study on short- and long-term impacts of the COVID-19 pandemic and outbreak response, will be provided. Subsequently, findings from the multi-country longitudinal COvid MEntal healTh Survey (COMET) on forecasting psychological distress throughout the pandemic will be presented. Second, findings from the French TEMPO (Trajectoires EpideMiologiques en POpulation) cohort and merged datasets will be presented indicating associations and interactions between socioeconomic factors, mental health, and public health behaviours during the pandemic. Third, using data of a large Belgian prospective cohort, fluctuations in risk of psychological distress across study waves and the factors associated with individual trajectories of psychological distress during the COVID-19 pandemic will be presented. Fourth, the risk of SARS-CoV-2 infection, severe COVID-19 outcomes, and death among individuals with various mental disorders, based on Spanish health records, will be presented with specific attention to sex differences. Finally, based on the IPD meta-analyses of 9 European cohorts, findings on stressor reactivity, resilience trajectories, and factors associated with resilient outcomes and vulnerability are presented. By presenting a selection of findings from large datasets together, we aim to facilitate discussions on critical topics such as vulnerability and resilience to mitigate mental health impacts in future public health crises. Key messages • Targeting specific individual vulnerabilities appears to be more effective in reducing the pandemics’ mental health impact than solely responding to pandemic-related fluctuations. • Research and harmonised data on vulnerability and resilience factors are essential for guiding the development of targeted interventions and support systems for vulnerable populations during crises.

Stress Resilience And Resilience Factors Across 9 European Samples During The COVID-19 Pandemic

Abstract While many describe changes in mental health over the pandemic, we investigate change in resilience over time during the pandemic. Stress resilience can be operationalised as stressor reactivity, that is, how much a person’s mental health is affected by the stressors that they experience. Utilising the individual participant data (IPD) meta-analyses megadataset available we first define and quantify how many stressors individuals. We then regress this stressor exposure on mental health within each sample to compute each sample’s normative stressor reactivity. Each person’s individual stressor reactivity is then calculated as the residual to this line at each time points. Resilient outcomes can be understood as lower reactivity as this indicates lower susceptibility to stressors. Stressor reactivity (SR) scores control for individual stressor exposure, therefore allowing us to investigate resilience factors during a time in which exposure to macro and micro stressors varied greatly between individuals. Further, SR scores are a harmonised outcome that can easily compared across different samples in the IPD dataset. Using this outcome, we present findings on resilience trajectories and identify factors that are associated with resilient outcomes. We also disentangle the role of current stressor exposure and prior stressors, showing that prior exposure to stressors increases vulnerability in subsequent exposures. Our findings show that stressor reactivity over time was more stable than mental health symptoms during the pandemic, therefore indicating that SR as an outcome offers new insights into the impact of the pandemic.

Bouncing back from life's perturbations: Formalizing psychological resilience from a complex systems perspective.

Experiencing stressful or traumatic events can lead to a range of responses, from mild disruptions to severe and persistent mental health issues. Understanding the various trajectories of response to adversity is crucial for developing effective interventions and support systems. Researchers have identified four commonly observed response trajectories to adversity, from which the resilient is the most common one. Resilience refers to the maintenance of healthy psychological functioning despite facing adversity. However, it remains an open question how to understand and anticipate resilience, due to its dynamic and multifactorial nature. This article presents a novel formalized framework to conceptualize resilience from a complex systems perspective. We use the network theory of psychopathology, which states that mental disorders are self-sustaining endpoints of direct symptom-symptom interactions organized in a network system. The internal structure of the network determines the most likely trajectory of symptom development. We introduce the resilience quadrant, which organizes the state of symptom networks on two domains: (1) healthy versus dysfunctional and (2) stable versus unstable. The quadrant captures the four commonly observed response trajectories to adversity along those dimensions: resilient trajectories in the face of adversity, as well as persistent symptoms despite treatment interventions. Subsequently, an empirical illustration, by means of a proof-of-principle, shows how simulated observations from four different network architectures lead to the four commonly observed responses to adversity. As such, we present a novel outlook on resilience by combining existing statistical symptom network models with simulation techniques. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The spatial-temporal evolution patterns of landslide-oriented resilience in mountainous city: A case study of Chongqing, China

Cities, as complex systems with multi-interconnected subsystems, face significant challenges from both rapid urbanization and climate change. Ensuring high resilience in urban areas is essential for managing these dynamic risks effectively. This study introduces an innovative, data-driven approach to quantitatively analyze the spatial-temporal evolution patterns of urban resilience, validated through a case study of Chongqing, a representative mountainous city in China. Based on historical landslide data from Chongqing (2010–2020), which includes 4464 events, along with indicator data from the Chongqing Statistical Yearbook, we developed a comprehensive assessment framework. This framework incorporates 33 variables, covering indicators of physical-environmental resilience (PER) and socio-economic resilience (SER). The model integrates the Random Forest (RF) algorithm, Analytic Hierarchy Process (AHP), and Coupling Coordination Degree (CCD) model. Key findings include: (1) Social development in mountainous cities like Chongqing follows a point-to-area pattern. Although there is an overall increase in SER, the CCD in more developed areas (Chongqing urban circle) was generally higher than in less developed areas (northeastern and southeastern Chongqing) (2) The PER model demonstrated exceptional performance (AUC values consistently above 0.95). Spatiotemporal evolution models reveal that Chongqing maintains a high overall PER. Notably, from 2019 to 2020, the proportion of administrative units classified as highly resilient peaked at 24.5%, marking a historical high. (3) Multi-year average rainfall primarily impacts PER (ranked first), while Gross Domestic Product (GDP) significantly affect SER. The development of multi-dimensional recovery indicators provides a robust framework for assessing resilience against landslides in mountainous cities. The CCD model illustrates the importance of regional dynamic coordinated development in resilience trajectories. This study provides a detailed blueprint for the scientific development of resilient mountainous cities, emphasizing the need for a spatial-temporal perspective on resilience and the benefits of coordinated regional development.

Trajectories of Short-Term Post-Traumatic Stress Disorder Symptoms in Patients with Post-Intensive Care Syndrome: A Longitudinal Observational Study.

Post-traumatic stress disorder (PTSD) is a major psychiatric health issue among intensive care unit (ICU) survivors with post-intensive care syndrome (PICS). Although early PTSD intervention has been demonstrated to decrease the risk of progression from acute to chronic PTSD, information on the progression trajectory of short-term PTSD symptoms and modifiable risk factors in PICS patients is limited. This study aimed to explore the clinical progression trajectories of short-term PTSD symptoms and the associated factors in PICS patients by conducting a prospective longitudinal observational study. This study was conducted at a tertiary hospital in China. The impact of event scale-revised was used to collect data on the PTSD symptoms of patients at 1, 2, 3, and 4 months post-discharge from the ICU. The latent growth mixture model was used to construct trajectory models for PTSD symptoms and multivariate logistic regression was used to determine the factors associated with the trajectories. A total of 130 ICU survivors with PICS completed the 4-month short-term follow-up. Our results showed that PTSD symptoms in PICS patients manifested as three trajectories, namely, moderate chronic (n = 17, 13.1%), recovery (n = 25, 19.2%), and resilience (n = 88, 67.7%). Compared with the resilience trajectory, age and female were identified as risk factors for the moderate chronic trajectory, while prolonged ICU stay was a risk factor for the recovery trajectory. Our study showed that short-term PTSD symptoms in PICS patients manifested as moderate chronic, recovery, and resilience trajectories. Additionally, our results showed that PTSD screening should be conducted for critically ill patients, especially younger, female, or long-term ICU patients, immediately after their discharge from the ICU.

Translating disaster resilience: How values, world views and politics complicate interpretation and implementation

Globalized climate change and ecological collapse discourses have created a universally relatable conceptual arena within which institutional actors’ debate, design and implement interventions to create ‘disaster resilient cities’ in the Global South. The implications of resilience ideologies and practices adopted from the Global North can have detrimental and counterproductive effects when translated into interventions in postcolonial countries like Pakistan. In this research paper, we use interviews and discourse analysis to underscore the techniques, rationalities, and framings mobilized by governmental and non-governmental actors in the name of ‘reducing risks’ and building ‘disaster resilience’. Within this arena, Pakistani institutional actors create, mimic, and adapt normative resilience trajectories influenced by international resilience standards that do not align, or worse, conflict with the spiritual, cultural, and postcolonial contexts and values of communities they engage with. Imposition of international resilience standards may result in disconnected top-down interventions that overlook the vulnerabilities of local communities deemed as ‘beneficiaries’ and misallocate funds in favor of ineffective projects and programmes, ultimately missing opportunities for meaningful change. While building upon existing urban resilience efforts in Pakistan is important, it is critical to recognize that merely pursuing resilience as an outcome is not enough. Fulfilling basic needs should take precedence over resilience efforts, particularly when the goal is not only the survival of local communities in the face of escalating climate and disaster risks but also their overall well-being.

Flexibility predicts chronic anxiety and depression during the first year of the COVID-19 pandemic-A longitudinal investigation of mental health trajectories.

The COVID-19 pandemic is a significant stressor, potentially putting the well-being of the general population at risk. However, a significant proportion of the population exhibits resilience, raising questions regarding psychological constructs that could contribute to resilient coping. Studies indicate that flexibility, defined as the ability to adapt to changing contextual demands by employing various emotional, cognitive, and behavioral strategies, may significantly contribute to coping with long-term stressors such as COVID-19. Cognitive and coping flexibility domains and longitudinal trajectories of anxiety and depression were assessed at three-time points across 13 months in 571 Israelis. Analyses revealed four different trajectories for anxiety: resilient (66%), chronic (22%), emerging (7%), and improving (6%), and two trajectories for depression: resilient (87%) and chronic (13%). Individuals in the chronic trajectory group (for both anxiety and depression) exhibited lower cognitive flexibility and coping flexibility levels than individuals in the resilient trajectory group. Across time, anxiety and depression were linked to clinically significant posttraumatic stress disorder-like symptoms. Low cognitive and coping flexibility are linked to the probability of experiencing chronic mental health problems, making them a potential target for prevention and treatment. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Trajectories and influencing factors of psychological resilience among Chinese patients with maintenance hemodialysis

ObjectiveTo identify distinct trajectories of psychological resilience among Chinese patients with maintenance hemodialysis, explore influencing factors and inform the formulation of corresponding interventions. MethodsThis was a multi-center longitudinal study with a 6-month follow-up. With convenience sampling, a total of 231 patients with maintenance hemodialysis were recruited between September 2020 and July 2021. Patients’ characteristics, including sociodemographic information, social support and family resilience was collected through structured questionnaires as potential baseline influencing factors of psychological resilience trajectories. Psychological resilience was evaluated using the 25-item Chinese version of the Conner and Davidson resilience scale. Latent class growth modeling was conducted to identify homogeneous subgroups with distinct trajectories of psychological resilience. Univariable and multinomial logistic regression analysis were used to examine whether baseline influencing factors were associated with trajectories in patients with maintenance hemodialysis. ResultsFive distinct psychological resilience trajectory groups were identified: declining group (n = 20, 8.7 %), rising group (n = 17, 7.4 %), moderate-stable group (n = 128, 55.4 %), high-stable group (n = 7, 3.0 %) and low-stable group (n = 59, 25.5 %). High-stable group and moderate-stable group were combined into the well-psychological resilience group for multinomial logistic regression analysis. The multinomial logistic regression analysis showed that influencing factors associated with trajectories of psychological resilience were age, religion, monthly household income per capita, and baseline family resilience. ConclusionsThe results highlight the heterogeneity in the development of psychological resilience among Chinese patients with maintenance hemodialysis. There is a need for healthcare professionals to screen for trajectories of psychological resilience in Chinese maintenance hemodialysis patients and prepare individual mental healthcare interventions.

The Role of War-Related Marketing Activism Actions in Community Resilience: From the Ground in Ukraine

Extant literature considers marketing activities as instrumental for postwar recovery and peace-building. However, war is an ongoing lived experience for numerous societies across the world. Focusing on the role of marketing during war, this article presents a study examining how and why people living in war adversity deploy, perceive, and respond to war-related marketing activism actions (MAA). War-related MAA are acts through which brands/organizations and consumers create or draw on marketing meanings to convey and to enact stances and experiences related to war. This study adopts a multimodal qualitative methodology integrating photo elicitation and in-depth interviews with consumers and with marketing and management professionals in Ukraine, the country enduring invasion and war by Russia at the time of this article’s publication. Analyses through a community resilience theoretical lens generate a conceptualization that demonstrates how war-related MAA are harnessed and serve as a medium in community dialogues concerning envisaged resilience trajectories (survival, creativity and growth, and recovery). The article advances understanding of marketing activism during war by illuminating its potential and boundary conditions for serving as a community resilience resource. It also offers public policy development directions for marketing practice, organizations, and governments.

Neighborhood Resources Associated With Psychological Trajectories and Neural Reactivity to Reward After Trauma

Research on resilience after trauma has often focused on individual-level factors (eg, ability to cope with adversity) and overlooked influential neighborhood-level factors that may help mitigate the development of posttraumatic stress disorder (PTSD). To investigate whether an interaction between residential greenspace and self-reported individual resources was associated with a resilient PTSD trajectory (ie, low/no symptoms) and to test if the association between greenspace and PTSD trajectory was mediated by neural reactivity to reward. As part of a longitudinal cohort study, trauma survivors were recruited from emergency departments across the US. Two weeks after trauma, a subset of participants underwent functional magnetic resonance imaging during a monetary reward task. Study data were analyzed from January to November 2023. Residential greenspace within a 100-m buffer of each participant's home address was derived from satellite imagery and quantified using the Normalized Difference Vegetation Index and perceived individual resources measured by the Connor-Davidson Resilience Scale (CD-RISC). PTSD symptom severity measured at 2 weeks, 8 weeks, 3 months, and 6 months after trauma. Neural responses to monetary reward in reward-related regions (ie, amygdala, nucleus accumbens, orbitofrontal cortex) was a secondary outcome. Covariates included both geocoded (eg, area deprivation index) and self-reported characteristics (eg, childhood maltreatment, income). In 2597 trauma survivors (mean [SD] age, 36.5 [13.4] years; 1637 female [63%]; 1304 non-Hispanic Black [50.2%], 289 Hispanic [11.1%], 901 non-Hispanic White [34.7%], 93 non-Hispanic other race [3.6%], and 10 missing/unreported [0.4%]), 6 PTSD trajectories (resilient, nonremitting high, nonremitting moderate, slow recovery, rapid recovery, delayed) were identified through latent-class mixed-effect modeling. Multinominal logistic regressions revealed that for individuals with higher CD-RISC scores, greenspace was associated with a greater likelihood of assignment in a resilient trajectory compared with nonremitting high (Wald z test = -3.92; P < .001), nonremitting moderate (Wald z test = -2.24; P = .03), or slow recovery (Wald z test = -2.27; P = .02) classes. Greenspace was also associated with greater neural reactivity to reward in the amygdala (n = 288; t277 = 2.83; adjusted P value = 0.02); however, reward reactivity did not differ by PTSD trajectory. In this cohort study, greenspace and self-reported individual resources were significantly associated with PTSD trajectories. These findings suggest that factors at multiple ecological levels may contribute to the likelihood of resiliency to PTSD after trauma.

Longitudinal Trajectories of Identity Formation and Resilience Development in Adolescents Living in Under-Resourced Communities

Identity and resilience are critical during adolescence, especially when facing contextual challenges. This longitudinal study explored the trajectories of identity and resilience in adolescents (n = 546; MAge = 16.22) living in an under-resourced South African community. Associations between identity and resilience were analyzed across three time points using repeated measures ANOVA’s. The dimensions of identity did not vary substantially across time, but resilience scores fluctuated significantly. Participants with high resilience showed a substantial decrease in Exploration in Depth over time, while participants with low resilience showed an increase. The findings provide insights into how to foster resilience in adolescents living in under-resourced communities.

“It’s Time to see What I Can Do”: A Mixed-Methods Investigation into Trajectories of Resilience in Adolescents during the COVID-19 Pandemic

AbstractThere is a concern that adolescent mental well-being and resilience has been adversely affected by the COVID-19 pandemic. Consequently, the aim of the current investigation was to track adolescents’ resilience from the initial months of the pandemic (T1) to approximately two years later (T2) using both qualitative and quantitative methods. Through interviews, thirty-one adolescents narrated their COVID-19 experiences and reflected on their mental well-being across this timespan. Using these accounts, we identified four groups of adolescents exhibiting one of the following trajectories of resilience: (1) Enduring resilience, (2) Reaching resilience, (3) Declining resilience and (4) Enduring non-resilience. Our findings revealed that most adolescents were able to maintain or develop good resilience on prolonged exposure to COVID-19 adversity (trajectories 1 and 2). This finding is contrary to the prevailing notion that the majority of adolescents’ mental well-being and hence resilience was adversely impacted by COVID-19 in the short and long term. Further qualitative analysis identified key factors that contributed to maintaining and developing greater levels of resilience during the pandemic: quality of friendships, quality of family relationships and regaining a sense of control. Lastly, we found a lack of congruence between quantitative and qualitative measures of mental well-being and resilience, suggesting that they might tap into different constructs/experiences. Significantly, our findings highlight that the majority of teens showed adaptive resilience during the pandemic and highlight the need for further longitudinal qualitative and quantitative research to assess both adaptive and maladaptive impacts of adversity on the adolescents’ mental well-being and resilience.

Patterns of Adverse Childhood Experiences and Neurocognitive Development

Early life adversity is associated with higher risk of many adult health problems, including mental illness, substance abuse, suicide attempt, and chronic diseases. Many previous studies investigated adversities one at a time or investigated the health toll associated with the cumulative number of adversities. To examine the co-occurrence of adversities among children and how specific patterns of adversities are associated with neurocognitive development. This cohort study used data from the Collaborative Perinatal Project (CPP), which enrolled a national sample of women during pregnancy and followed their offspring to ages 7 to 8 years, between 1959 and 1974. The CPP was a community-based study conducted in 12 US medical centers. The CPP sample was ascertained through prenatal clinics and is diverse with respect to race and socioeconomic status. Data analysis was performed from August 2023 to March 2024. A latent class analysis was conducted of 12 adverse childhood experiences that occurred between birth and 7 years to identify common patterns of childhood adversities. Five neurocognitive tests were used to measure children's visual-motor, sensory-motor, auditory-vocal, intelligence quotient, and academic skills. The analysis sample included 49 853 offspring (25 226 boys [50.6%]); 24 436 children (49.0%) had low probability of experiencing any adversity, whereas the remaining half were classified into 5 groups reflecting distinct patterns of childhood adversities: parental harshness and neglect, 1625 children (3.3%); parental separation and poverty, 8731 children (17.5%); family instability, 3655 children (7.3%); family loss, instability, and poverty, 1505 children (3.0%); and crowded housing and poverty, 9901 children (19.9%). Children in 4 of these groups had lower neurocognitive scores than children with a low probability of experiencing adversity, with standardized mean differences ranging from -0.07 (95% CI, -0.11 to -0.03) to -0.86 (95% CI, -1.06 to -0.65). These findings suggest that adverse childhood experiences are associated with deficits in children's neurocognitive functions. It is important to understand the complexity in children's exposure to adversity and the resulting developmental consequences, as well as the underlying mechanisms, to help support children exposed to adversity and foster healthier and resilient trajectories of development.

Contributions of Coping Flexibility and Associated Functional Brain Connectivity to Resilient Trajectories of Mental Health During the COVID-19 Pandemic

The COVID-19 pandemic has presented an unprecedented challenge for individual mental health. In this study, we examined the lasting impact of the pandemic on mental health among Chinese college students and tested whether different coping dimensions contributed to resilience. Using a 2-year longitudinal design with four waves, we identified four common trajectories for individuals’ levels of depression and anxiety: resilient, recovered, delayed, and chronic. With prepandemic coping and resting-state neuroimaging data as predictors, we found that coping flexibility and corresponding connectivity patterns significantly predicted increased odds ratios of resilient trajectories for depression and anxiety. However, use of specific emotion-regulation strategies (i.e., cognitive reappraisal and expressive suppression) did not predict resilient trajectories. Overall, findings help to identify heterogeneity in emotional trajectories during the pandemic and indicate that coping flexibility plays a critical role in resilience. This work has implications for clinical-risk identification and developing mental-health interventions for the current pandemic and future crises.

The learner identity of adolescents with trajectories of resilience: the role of risk, academic experience, and gender

In at-risk areas of social exclusion, a higher number of adolescents drop out of school. Dropout from compulsory education and early school leaving are associated with unemployment, poverty, and greater health problems, posing a significant threat to the youth’s development and wellbeing. Nevertheless, some students manage to pursue formal education even in high-risk areas, exhibiting resilience. Interwoven between the processes of risk and resilience, the students’ identity development plays a vital role. The present study aimed to analyze the learner identity of students who exhibit a resilience trajectory in areas at risk of social exclusion, and its relation to the degree of risk they face, their academic experience, and their gender. The sample consisted of 132 students from at-risk neighborhoods in Spain who successfully completed compulsory secondary education and continued beyond that level. To measure their academic selves, a modified version of the Twenty Statement Test (TST) was used, which was analyzed using a category system that included four dimensions: organization of the self, emotional valence, plane of action, and thematic reference. The results indicate the participants primarily used personal, positive, evaluative self-descriptions related to the academic world, mostly based on effort. A higher degree of risk was associated to more self-descriptions referring good relationships with others and class attendance, while higher academic experience was associated to more independent selves. The study also found several gender differences. The implications of these findings for research and social intervention in at-risk contexts are discussed.

Trajectories of risk and resilience: The role of empathy and perceived social support in the context of early adversity

BackgroundEvidence overwhelmingly suggests that adverse childhood experiences (ACEs) is a risk factor for poor mental health outcomes. However, the specific mechanisms via which ACEs confer an increased risk of psychopathology are less well understood. ObjectiveThe study modelled the effect of empathy and perceived social support (PSS) on mental health outcomes in a mixed clinical and non-clinical population, within the context of exposure to ACEs. Participants and settingA total of 575 participants (comprising a treatment-receiving and community-based sample), aged 18 to 65 completed self-report measures assessing early adversity, PSS, empathy, and mental health outcomes. MethodsMultiple mediation analyses were used to investigate whether empathy and PSS mediated the relationship between self-reported ACEs and mental health outcomes, and whether affective and cognitive empathy affected differentially the link between emotional neglect and psychological distress. ResultsResults revealed a statistically significant indirect effect of ACEs on adult mental health through affective empathy and PSS. Emotional neglect was the only type of adversity significantly correlated with both dimensions of empathy. The indirect effect of emotional neglect on mental health outcomes via cognitive and affective empathy was also statistically significant. ConclusionsStudy results highlight the role of affective empathy and PSS as transdiagnostic mechanisms influencing the pathway between early adversity and adult mental health, and the importance of taking these into account when designing interventions aiming to promote well-being among those who have experienced childhood adversity.

Trajectories of anhedonia symptoms after traumatic injury

Anhedonia describes the inability or difficulty of experiencing or seeking pleasure. Previous research has demonstrated a relationship between posttraumatic stress disorder (PTSD) or experiencing trauma and anhedonia symptoms; however, little to no work has been done to understand the evolution of anhedonia symptoms after trauma. We aimed to identify anhedonia trajectories following traumatic injury. One hundred ninety-five participants were recruited from the emergency department of a Level-1 Trauma Center after experiencing a traumatic injury. To measure anhedonia symptoms, participants completed the Snaith-Hamilton Pleasure Scale (SHAPS) at 2-weeks, 3-months, and 6-months post-injury. Using latent class mixture modeling, we ran a trajectory analysis with three timepoints of SHAPS scores and compared mental and physical health outcomes across trajectories. Most of the sample fell in the resilient trajectory (85 %), while the remainder were in a remitting trajectory (7 %) where symptoms decreased over time, and a delayed (6 %) trajectory where symptoms did not emerge until 3-months after injury. In the resilient trajectory, there was consistently low levels of PTSD, pain, depression, and anxiety relative to the other trajectories. In the delayed trajectory, depression and PTSD were chronically elevated and pain levels were consistent but mild. In the remitting trajectory, PTSD and depression symptoms decreased over time. Identified anhedonia trajectories mirrored trajectories commonly reported for PTSD symptoms after injury. Evaluating anhedonia trajectories and how they relate to mental health outcomes may inform targeted interventions for traumatic injury patients.

Racial discrimination increases the risk for nonremitting posttraumatic stress disorder symptoms in traumatically injured Black individuals living in the United States.

Traumatic, life-threatening events are experienced commonly among the general U.S. population, yet Black individuals in the United States (i.e., Black Americans) exhibit higher prevalence rates of posttraumatic stress disorder (PTSD) and more severe symptoms than other populations. Although empirical research has noted a range of symptom patterns that follow traumatic injury, minimal work has examined the role of racial discrimination in relation to PTSD symptom trajectories. The current study assessed racial discrimination and PTSD symptom trajectories at 6 months postinjury across two separate samples of traumatically injured Black Americans (i.e. emergency department (ED)-discharged and hospitalized). Identified PTSD symptom trajectories largely reflect those previously reported (i.e., ED: nonremitting, moderate, remitting, and resilient; hospitalized: nonremitting, delayed, and resilient), although the resilient trajectory was less represented than expected given past research (ED: 55.8%, n = 62; hospitalized: 46.9%, n = 38). Finally, higher racial discrimination was associated with nonremitting, ED: relative risk ratio (RR) = 1.32, hospitalized: RR = 1.23; moderate, ED: RR = 1.18; and delayed, hospitalized: RR = 1.26, PTSD symptom trajectories. Overall, the current findings not only emphasize the inimical effects of racial discrimination but also demonstrate the unique ways in which race-related negative events can impact PTSD symptom levels and recovery across time.