Self-reported Health Measures Research Articles

Evaluating the factor structure of the pregnancy-related anxiety scale: implications for maternal and infant wellbeing

ABSTRACT Aims/Background Although the Pregnancy-Related Anxiety Scale – also referred to as the Pregnancy-Related Thoughts Scale (PRT) – is one of the most widely utilised measures of pregnancy-related anxiety (PrA), there is limited research exploring its factor structure and psychometric properties. The present study sought to (a) explore the factor structure of the PRT and (b) examine whether specific dimensions of PrA differentially predict postpartum outcomes. Design/Methods A community sample of pregnant women (N = 159) was recruited from a Midwestern city in the United States and completed the PRT alongside other self-report measures of stress and maternal health and mood during pregnancy. Participants also completed measures of maternal health and mood, as well as parenting/infant outcomes, at 1- and 6-months postpartum. Results Results provided support for a bifactor model with two unique dimensions of the PRT capturing baby- and self-focused concerns, respectively. Maternal self-focused PrA uniquely predicted postpartum internalising problems (β = .22), worse physical health (β = -.27), and impaired mother-infant bonding (β = .19) when controlling for baby-focused and general PrA. Conclusion Findings highlight the utility of screening for specific dimensions of PrA to promote both maternal and infant wellbeing following childbirth. Specifically, evidence suggests that screening for self-focused PrA, above and beyond baby-focused PrA, might facilitate prevention and intervention efforts and allow researchers to better understand antecedents and consequences of unique facets of PrA.

Psychometric Properties of Telugu Version of Scale of Oral Health Outcomes for 5-year-old Children.

Only a finite number of standard oral health-related quality of life (OHRQoL) measures are available for young children. However, instead of using parents as proxies to report a child's oral health status, children's self-reported oral health measures would be more accurate in providing their own perceptions of oral impacts. The study aimed to evaluate the psychometric properties of the Telugu version of the scale of oral health outcomes (SOHO-5T) for 5-year-old children in Telangana. The forward-backward translated SOHO-5T was pilot-tested among thirty children. The tested questionnaire was administered to 419 children, followed by a clinical oral examination using dentition status to evaluate dental caries (DC). Children (n = 30) were readministered the same questionnaire after a 2-week interval to test reliability. Internal consistency and test-retest reliability were determined by Cronbach's α and intraclass correlation. Correlation with global ratings of oral health questions was done to assess construct validity. Discriminant validity was evaluated based on the presence or absence of DC. A p < 0.05 was considered statistically significant. The mean SOHO-5T score was 4.70, and the mean decayed teeth score was 2.48, with 49.16% of children having DC. Cronbach's α scores and the intraclass correlation (ICC) coefficient for overall SOHO-5T were 0.90 and 0.91, respectively. SOHO-5T also demonstrated good construct validity with a significant positive correlation with global ratings of oral health. SOHO-5T showed good discrimination between the presence (9.43 ± 3.10), or absence (0.14 ± 1.01) of DC. This study shows good internal consistency and test-retest reliability. It also exhibited good construct and discriminant validity. Meghana D, Sukhabogi JR, Doshi D, et al. Psychometric Properties of Telugu Version of Scale of Oral Health Outcomes for 5-year-old Children. Int J Clin Pediatr Dent 2024;17(8):933-937.

Coping patterns associations with cognitive function in older adults.

Cognitive function may contribute to variability in older adults' ability to cope with chronic stress; however, limited research has evaluated this relationship. This study investigated the relationship between theoretically derived coping domains and cognitive function in 165 middle-to-older adults during the Omicron stage of COVID-19. Participants completed a clinical interview and self-report measures of health. The National Alzheimer's Coordinating Center Uniform Data Set neuropsychological battery was used to evaluate memory, language, executive function/speed, and working memory. Structural equation modeling evaluated the underlying factor structure of the Brief COPE adapted for COVID-19. The data supported the proposed second-order Approach factor comprised of Problem-Solving and Emotion Regulation (ER) strategies and a first-order Avoidance factor. Higher Avoidance was associated with greater depression symptoms, lower income and worse memory, executive function, working memory, and verbal fluency performance. Higher Problem-Solving was associated with better verbal fluency performance. ER strategies were not significantly associated with cognitive function. The use of Problem-Solving was not associated with less Avoidance. Greater use of Problem-Solving, ER, and Avoidance were all associated with higher levels of stress. Post-hoc analyses found that higher Acceptance was the only coping strategy associated with less stress. These findings demonstrate that older adults with worse cognitive function were more likely to use Avoidance during the pandemic, which could result in prolonged stress and adverse health consequences. Future research is warranted to investigate whether acceptance-based interventions reduce the avoidance and impact of stress on health in vulnerable older adults.

Expecting Relocation to a Nursing Home: Longitudinal Links with Functional Limitations, Self-Rated Health, and Life Satisfaction

Introduction: Developing realistic expectations of future old age constitutes an adaptational process which facilitates the anticipation of and adjustment to challenges, such as relocation to a nursing home. Developing such expectations might minimize the negative impacts of relocation. This pre-registered study examined (1) to which extent lower levels and declines in health (i.e., functional limitations and self-rated health) and life satisfaction before relocation were associated with higher levels and increases in expectations to relocate and (2) to which extent higher expectations to relocate were associated with more positive changes in health and life satisfaction after relocation. Methods: Using data from the Health and Retirement Study (HRS; 2006–2018), we selected older adults (aged 65 years and older) who relocated to a nursing home. We used latent growth curve models to assess the longitudinal links between self-reported measures of health, life satisfaction, and expectations to relocate to a nursing home from up to 7 years before (n = 1,048) until up to 5 years after relocation (n = 307). Results: As hypothesized, more functional limitations and lower self-rated health were related to higher expectations of relocation. Surprisingly, changes in expectations to relocate were not related to changes in health and life satisfaction before relocation. Moreover, expectations to relocate were not associated with changes in health and life satisfaction after relocation. Conclusion: The absence of a link between expectations to relocate to a nursing home with changes in health and well-being suggests that these expectations did not constitute adaptational processes before or after this transition.

Improving sleep health in paramedics through an app-based intervention: a randomised waitlist control pilot trial

BackgroundDue to work commitments, shiftworkers often obtain inadequate sleep, consequently experiencing negative health, wellbeing, and safety outcomes. Given shiftworkers may have limited control over their work commitments, lifestyle and environmental factors within their control may present an intervention opportunity. However, such interventions require tailoring to ensure applicability for this sleep-vulnerable population.MethodsA randomised waitlist control pilot trial investigated the effectiveness of mobile health application Sleepfit, which delivered a tailored sleep health intervention aimed at improving sleep health and sleep hygiene outcomes amongst paramedic shiftworkers. Outcome measures of self-reported sleep health (sleep need, duration, and quality, fatigue, Insomnia Severity Index, Fatigue Severity Scale, and Epworth Sleepiness Scale scores) and sleep hygiene (Sleep Hygiene Index score) were collected at baseline, post-intervention, and 3-month follow-up.ResultsFifty-eight paramedics (aged 33.4 ± 8.0 years; 50% male) were recruited, and trialed Sleepfit for a 14-day intervention period between August 2021–January 2022. For all participants, there was a significant reduction in Insomnia Severity Index and Sleep Hygiene index scores after intervention engagement. Regression models demonstrated no significant intervention effect on sleep health or sleep hygiene outcomes (intervention versus waitlist control group). A high study drop-out rate (91.4%) prevented assessment of outcomes at 3-month follow-up.ConclusionsPilot trial findings demonstrate that Sleepfit may elicit improvements in sleep health and sleep hygiene outcomes amongst paramedic shiftworkers. However, low enrolment and retention means that findings should be interpreted with caution, further highlighting potential engagement challenges, especially among paramedics who are particularly in need of support for improved sleep.Trial registrationProspectively registered with the Australian New Zealand Clinical Trial Registry 24/01/2020 (reference no. ACTRN12620000059965).

Optimism, pessimism, and physical health among youth: a scoping review.

High levels of optimism (and low levels of pessimism) are associated with improved physical health in adults. However, relatively less is known about these relations in youth. The present study aimed to review the literature investigating optimism, pessimism, and physical health in children and adolescents from populations with and without health conditions. We conducted a scoping review up until February 2024. Studies were included if they sampled youth (average age ≤18 years) and treated optimism or pessimism as predictors of health behaviors or outcomes. Data on study and sample characteristics, health outcome, optimism construct, and findings were extracted from eligible papers and results were synthesized. Sixty studies were retained. Most studies were conducted in North America, with adolescents, and used cross-sectional designs and self-reported measures of health. Measures of optimism and pessimism differed across studies. Roughly one-third of studies sampled medical populations. Health categories included substance use, diet and physical activity, sexual health practices, medical adherence, other health behaviors, cardiometabolic health, subjective health/health-related quality of life, pain, sleep, and oral health. Generally, we observed adaptive associations between optimism and health. Higher optimism and lower pessimism were most consistently associated with lower rates of substance use and lower cardiometabolic risk. The presence of optimism or the absence of pessimism appears to be associated with various adaptive health outcomes among youth with and without health conditions. Developmental, methodological, and clinical considerations for future research are discussed, such as conducting longitudinal studies with objective measures of health and psychometrically validated instruments.

Exploring Older Adults' Subjective Views on Aging Positively: Development and Validation of the Positive Aging Scale.

Historically, aging research has focused primarily on health deterioration and negative aspects associated with aging. This has limited the scope of our understanding of the experience of aging and the relationships between aging and well-being from an integrative biopsychosocial perspective. In the same vein, there is a lack of reliable and valid assessments of aging that capture the positive aspects that characterize and improve the subjective experience of this period of life, particularly one that focuses on psychosocial well-being, including meaningful experiences and activities, group memberships, and general abilities. This study presents the development and validation of the Positive Aging Scale (PAS), a novel self-report assessment. This was an online cross-sectional study conducted on 501 UK residents aged ≥60 years. A number of self-reported items and measures of positive aging, general health, well-being, and cognitive functioning were administered to the sample. We used exploratory and confirmatory factor analyses and assessed the dimensionality, reliability, and concurrent criterion-related validity of the PAS. The results suggested that a unidimensional solution represents the data well, with the positive aging factor adequately loading on 8 items, and the solution showing factorial invariance between young-old and old participants (i.e., ≥75 years). Total PAS scores positively correlate with general health, well-being, and cognitive functioning. The PAS demonstrated strong psychometric properties and the findings highlight correlations between the PAS and key outcomes of positive aging, including general health. Implications for research and interventions are discussed.

A longitudinal examination of appraisal, coping, stress, and mental health in students: A cross-lagged panel network analysis.

In their seminal Transactional Theory of Stress, Lazarus and Folkman described a complex adaptation mechanism that involves appraisal and coping processes that lead to the subjective experience of stress. In this study, we examined the temporal order of all components of this theory using a cross-lagged panel analysis. A sample of 354 students (62.10% female, mean age=20.63y.o.) participated in a 5-week study and completed weekly self-reported measures of prospective appraisal, coping, core burnout, and mental health (i.e. depression, anxiety, and stress). Using cross-lagged panel network analyses, we analyzed how each measured variable is predicted by all variables from the previous measurement moment. Convergent with the transactional stress theory, we found that threat appraisals and negative self-perception predicted future anxiety and depression. Contrary to expectations, core burnout and somatization emerged as significant predictors of poor mental health outcomes, suggesting a self-perpetuating spiral. Furthermore, our study highlighted the importance of recognizing the bidirectional connections between appraisals, coping strategies, and mental well-being.

The Ambiguous Cue Task: Measurement reliability of an experimental paradigm for the assessment of interpretation bias and associations with mental health

Interpretation biases in the processing of ambiguous affective information are assumed to play an important role in the onset and maintenance of emotional disorders. Reports of low reliability for experimental measures of cognitive biases have called into question previous findings on the association of these measures with markers of mental health and demonstrated the need to systematically evaluate measurement reliability for measures of cognitive biases. We evaluated reliability and correlations with self-report measures of mental health for interpretation bias scores derived from the Ambiguous Cue Task (ACT), an experimental paradigm for the assessment of approach-avoidance behavior towards ambiguous affective stimuli. For a non-clinical sample, the measurement of an interpretation bias with the ACT showed high internal consistency (rSB = .91 – .96, N = 354) and acceptable 2-week test–retest correlations (rPearson = .61 – .65, n = 109). Correlations between the ACT interpretation bias scores and mental health-related self-report measures of personality and well-being were generally small (r ≤ |.11|) and statistically not significant when correcting for multiple comparisons. These findings suggest that in non-clinical populations, individual differences in the interpretation of ambiguous affective information as assessed with the ACT do not show a clear association with self-report markers of mental health. However, in allowing for a highly reliable measurement of interpretation bias, the ACT provides a valuable tool for studies considering potentially small effect sizes in non-clinical populations by studying bigger samples as well as for work on clinical populations, for which potentially greater effects can be expected.

Sleep quality mediates the association between chronotype and mental health in young Indian adults

There is increasing recognition of ‘higher preference for eveningness’ as a potential independent risk factor for poor mental health. To examine the chronotype-mental health relationship while also quantifying the potential roles of poor sleep quality, relevant personality traits, and childhood trauma, we assessed 282 young adults (18–40 years; 195 females) residing in North India, between January and March 2023 (to control for seasonal variation), using self-report measures of diurnal preference, sleep patterns, mental health (depression, anxiety, and stress), personality traits (extraversion, neuroticism, schizotypy, and impulsivity), and childhood trauma. The results showed a significant association between eveningness and poor mental health but this association was fully mediated by poor sleep quality. Neuroticism, emotional abuse and cognitive disorganisation were correlated with eveningness as well as with poor mental health and sleep quality. Neuroticism and emotional abuse, but not cognitive disorganisation, also had indirect effects on mental health via sleep quality. Our findings highlight the crucial role played by sleep quality in the chronotype-mental health relationship.

Cognitive reserve and well-being in migraine patients: a multidimensional approach to migraine assessment in an Italian tertiary headache center

Background: Migraine is a painful neurological condition affecting emotional, cognitive, and daily life functioning. Cognitive reserve (CR) is a protective factor against neurological damage and deterioration, but its proxies have been under-investigated in migraine. The present crosssectional study aims to investigate the relationship between CR and several self-reported health measures in migraine; and how these health measures differ between CR grades. Methods: Data were collected from an Italian tertiary center between 2022 and 2023. One hundred and eighty eligible outpatients aged from 18 to 75 years were administered a protocol consisting of: the Migraine Disability Assessment; Brief Pain Inventory (BPI); Numeric Rating Scale; Short Form-36; Self-Rating Anxiety Scale; Self-rating Depression Scale (SDS). In addition, years of illness, frequency and intensity of migraine attacks, and Cognitive Reserve Index as a gradable measure of CR, were also collected. Spearman correlation and ANOVAs were performed, setting p significance at &lt;0.05. Results: A negative correlation between perceived pain intensity, attacks, and socio-behavioral proxies of CR emerged. Higher CR was also associated with fewer headache attacks (rs=-0.176; p=0.019). Lower intensity was found to be specifically related to leisure time (rs=-0.084; p=0.049). ANOVAs highlighted differences across graded CR levels in headache-related indices, including psychological and functional status (BPI-interference: F=4.302; p=0.026; SDS: F=3.887; p=0.033; enjoyment of life: F=3.672; p=0.043), also post-hoc confirmed. Conclusions: Overall, our results suggest a link between CR levels and headache-related measures, emphasizing the importance of life-long coping strategies and healthy habits to decrease pain perception. In particular, individuals with low CR reporting higher levels of pain may benefit from integrated assessment and tailored treatment options to experience. Further studies may delve into the CR threshold hypothesis in the context of headache to identify high-risk categories of patients and foster their symptom management.

Oral microbial dysbiosis in patients with oral cavity cancers

ObjectivesThe pathogenesis of oral cavity cancers is complex. We tested the hypothesis that oral microbiota dysbiosis is associated with oral cavity cancer.Materials and methodsPatients with primary oral cavity cancer who met the inclusion and exclusion criteria were included in the study. Matching healthy individuals were recruited as controls. Data on socio-demographic and behavioral factors, self-reported periodontal measures and habits, and current dental status were collected using a structured questionnaire and periodontal chartings. In addition to self-reported oral health measures, each participant received a standard and detailed clinical examination. DNA was extracted from saliva samples from patients and healthy controls. Next-generation sequencing was performed by targeting V3-V4 gene regions of the 16 S rRNA with subsequent bioinformatic analyses.ResultsPatients with oral cavity cancers had a lower quality of oral health than healthy controls. Proteobacteria, Aggregatibacter, Haemophilus, and Neisseria decreased, while Firmicutes, Bacteroidetes, Actinobacteria, Lactobacillus, Gemella, and Fusobacteria increased in oral cancer patients. At the species level, C. durum, L. umeaens, N. subflava, A. massiliensis, and V. dispar were significantly lower, while G. haemolysans was significantly increased (p < 0.05). Major periodontopathogens associated with periodontal disease (P. gingivalis and F.nucleatum) increased 6.5- and 2.8-fold, respectively.ConclusionThese data suggested that patients with oral cancer had worse oral health conditions and a distinct oral microbiome composition that is affected by personal daily habits and may be associated with the pathogenicity of the disease and interspecies interactions.Clinical relevanceThis paper demonstrates the link between oral bacteria and oral cancers, identifying mechanistic interactions between species of oral microbiome.

The dynamics of emotion expression on Twitter and mental health in a UK longitudinal study

Introduction &amp; BackgroundAn estimated 4.95 billion people used social media in 2023, with the average user active on around seven platforms for over two hours per day. This widespread use leads to abundant digital footprint data around interactions with social media. These data can be collected continuously and reflect real behaviour of users in naturalistic settings. These strengths have led researchers to propose the use of social media data in digital phenotyping, where digital footprints can be used to quantify and predict health conditions. Mental health assessment in particular could benefit, as existing approaches, such as self-report questionnaires and inpatient assessment, are unable to perform the real-time monitoring that digital phenotyping could potentially achieve. Digital phenotyping models for mental health require careful consideration of what aspects of social media data to include. Including all data users generate could result in models that are overfitted and difficult to explain. Studies are required that explore the relationship between specific aspects of social media data, such as the time course of expressed emotion, and gold-standard measures of mental health. Objectives &amp; ApproachWith participants’ consent, we linked Twitter data to self-reported measures of mental health from the Avon Longitudinal Study of Parents and Children. We performed sentiment analysis using three different approaches—LIWC, VADER and RoBERTa—to estimate the amount, variability and instability of positive and negative emotional content in each participant’s Tweets over a one-year period. We explored the association between these measures of emotion expression and self-reported scores of depressive symptoms, anxiety symptoms and wellbeing. These mental health measures are the Short Mood and Feelings Questionnaire, the Generalized Anxiety 7 and the Warwick Edinburgh Mental Wellbeing Scale. Relevance to Digital FootprintsOur research is highly relevant to digital footprint research, as it involves the use of digital footprint data (i.e. Twitter data) to predict mental health outcomes. Conclusions &amp; ImplicationsThe results of our analysis will inform the development of digital footprint based phenotyping for mental health that could one day provide information to supplement clinical assessments.

An Examination into the Effects of a Nutraceutical Supplement on Cognition, Stress, Eye Health, and Skin Satisfaction in Adults with Self-Reported Cognitive Complaints: A Randomized, Double-Blind, Placebo-Controlled Trial.

Background: Dietary quality and the consumption of antioxidant-rich foods have been shown to protect against memory decline. Therefore, this double-blind, randomized, placebo-controlled study aimed to investigate the effects of a nutritional supplement on changes in cognitive performance. Methods: In adults aged 40 to 70 years with subjective memory complaints, participants were randomly allocated to take a supplement containing vitamin E, astaxanthin, and grape juice extract daily for 12 weeks or a matching placebo. The primary outcomes comprised changes in cognitive tasks assessing episodic memory, working memory, and verbal memory. Secondary and exploratory measures included changes in the speed of information processing, attention, and self-report measures of memory, stress, and eye and skin health. Moreover, changes in plasma concentrations of brain-derived neurotrophic factor, malondialdehyde, tumor-necrosis factor-α, and interleukin-6 were measured, along with changes in skin carotenoid concentrations. Results: Compared to the placebo, nutritional supplementation was associated with larger improvements in one primary outcome measure comprising episodic memory (p = 0.037), but not for working memory (p = 0.418) or verbal learning (p = 0.841). Findings from secondary and exploratory outcomes demonstrated that the nutraceutical intake was associated with larger improvements in the Everyday Memory Questionnaire (p = 0.022), increased plasma brain-derived neurotrophic factor (p = 0.030), decreased plasma malondialdehyde (p = 0.040), and increased skin carotenoid concentrations (p = 0.006). However, there were no group differences in changes in the remaining outcome measures. Conclusions: Twelve weeks of supplementation with a nutritional supplement was associated with improvements in episodic memory and several biological markers associated with cognitive health. Future research will be essential to extend and validate the current findings.

Exploring associations between eating habits, gastrointestinal health and perceived stress and anxiety symptoms in adults

Gastrointestinal (GI) disorders are becoming increasingly common in young people in India and globally (1). Diet (eating habits, nutrient intake, and dietary diversity) and mental health (stress and anxiety levels) factors can independently and synergistically regulate gut health through dietary modulation of gut microbiota composition and gut-brain axis-related mechanistic pathways (2-3). However, few studies have investigated the associations between diet, mental health, and GI-related disturbances. Hence, this observational study was conducted to explore the possible effects of eating behaviors and stress and anxiety symptoms on self-reported measures of gastrointestinal health among 18-45-year-old adults in India.A purposive cluster sampling method guided the recruitment of participants (n=407). Two non- consecutive day 24-hour diet recalls were conducted to estimate nutrient intakes and calculate Individual Diet Diversity (IDD) and Food Variety Scores (FVS). Gastrointestinal health was assessed using a validated instrument comprising 35 items related to gastric, small intestine, and colon function, and GI inflammation. Perceived Stress Scale (PSS-10 scores 0 to 40 with higher scores representing higher levels of stress), and Generalized Anxiety Disorder Scale (GAD-7 scores &gt;5 (mild), &gt;10 (moderate), and &gt;15 (severe)) were used to evaluate perceived stress and anxiety (4-5). Socioeconomic status and eating habits were self-reported and the anthropometry measurements were recorded. Multivariable logistic regression analysis was performed using sociodemographic characteristics, anthropometry measurements, eating habits, and stress and anxiety levels as independent (predictor) variables, and composite gastrointestinal health risk scores as the dependent variables.Participants reported mild anxiety (mean (M) = 7.09, standard deviation (SD)= 3.25) and moderate stress (M=18.44; SD= 9.89) with preponderance among females, higher age groups (&gt; 35 years), and lower socioeconomic status. Overall, 38.8% and 45.3% were at high-risk score categories for gastric function and GI inflammation respectively. Higher energy and fat consumption, frequent breakfast skipping, and lower IDDS and FVS scores were associated with higher scores for stress and anxiety. Moreover, participants having moderate to severe anxiety reported a higher frequency of GI symptoms such as indigestion (M= 3.23 SD= 2.1-4.6, p= 0.023), excessive belching (M= 2.36 SD =1.21, p=0.043), and post-meal lower abdominal discomfort and cramps (M= 3.07, SD = 2.22, p &lt; 0.001) as compared to those having nominal/mild anxiety. Age-adjusted regression models showed higher waist circumference (OR= 4.69, 95% CI =1.33- 7.28, p= 0.034), and stress scores (OR= 1.66, 95% CI= 1.32-1.90, p = 0.042), lower IDDS (OR= 2.34, 95% CI=1.80- 2.91, p &lt;0.001) and presence of &gt; 2 co-morbid conditions (OR= 8.12, 95% CI = 5.34- 11.21, p &lt; 0.001) as predictors of higher GI disorder risk scores.The preliminary findings of the study highlight associations between diet, stress, and GI health, presenting opportunities to modulate diet and optimize mental health to prevent and reduce the severity of GI disorders.

Work-, lifestyle-, and health-related factors among women and men working in the emergency medical services

Objectives. This study aimed to describe work-, lifestyle-, and health-related factors among ambulance personnel, and to analyse differences between women and men. Methods. The cross-sectional study (N = 106) included self-reported and objective measures of work, lifestyle, and health in 10 Swedish ambulance stations. The data collection comprised clinical health examination, blood samples, tests of physical capacity, and questionnaires. Results. A high proportion of the ambulance personnel reported heavy lifting, risk of accidents, threats and violence at work. A low level of smoking and alcohol use, and a high level of leisure-time physical activity were reported. The ambulance personnel had, on average, good self-rated health, high work ability and high physical capacity. However, the results also showed high proportions with risk factors for cardiovascular disease (CVD), e.g., high blood pressure, and high levels of blood lipids. More women than men reported high work demands. Furthermore, women performed better in tests of physical capacity and had a lower level of CVD risk factors. Conclusions. Exposure to work-related factors that might affect health was common among ambulance personnel. Lifestyle- and health-related factors were somewhat contradictory, with a low proportion reporting lifestyle-related risk factors, but a high proportion having risk factors for CVD.

Objective and subjective sleep patterns and biomarkers of stress among women with a history of sexual abuse in childhood.

Childhood sexual abuse (CSA) is associated with posttraumatic stress symptoms (PTSSs) and sleep disturbance into adulthood. The latter is thought to emerge from dysregulation in biobehavioral systems, including nighttime hyperarousal; however, studies investigating specific mechanisms to explain these long-term sleep problems are limited. The present study examined presleep arousal, fear of sleep, and the cortisol awakening response (CAR) as putative mediators between PTSS and sleep disturbance in women with a history of CSA. N = 64 cis-gendered women with a self-reported history of CSA completed a baseline diagnostic interview, self-reported mental health and sleep measures, 7 days of actigraphy monitoring with concurrent sleep diary, and 2 days of saliva sampling. PTSSs were not significantly associated with actigraphy-estimated sleep variables but were positively associated with self-reported sleep onset latency (SOL) and negatively associated with self-reported sleep quality. Similarly, PTSSs were not significantly associated with CAR but were associated with higher presleep arousal and fear of sleep ratings. Mediational models identified greater presleep cognitive arousal to partially explain the PTSS-SOL relationship. Specific features of CSA (i.e., age at time of abuse, location of abuse, relationship to the perpetrator) did not moderate this association. Findings suggest that targeting maladaptive cognitions (e.g., worries, rumination) that occur during the presleep period may be a potential intervention target in mitigating sleep disturbance and PTSSs in this population. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Quality of mother-infant interaction, breastfeeding, and perinatal mental health

IntroductionThe quality of mother-infant interactions is crucial for child development. Studies show that breastfeeding contributes to maternal sensitivity and the development of a positive mother-infant bond. Maternal mental health difficulties negatively impact both maternal sensitivity and breastfeeding. Thus, it is unclear whether breastfeeding contributes to the quality of mother-infant interactions independent from mental health. The purpose of this study is to examine the contribution of exclusive breastfeeding at 3 months postpartum to the quality of the mother-infant relationship at 6 months postpartum, controlling for maternal mental health in a community sample of mothers in Chile. Materials and methodEighty women completed self-report measures of mental health and breastfeeding during the third trimester of pregnancy and 3 and 6 months postpartum. At 6 months after childbirth, the mother-infant interaction was assessed by coding a free-play session between mothers and infants. Logistic regression analysis was used to examine the contribution of breastfeeding practices and mental health to the quality of mother-infant interactions. ResultsExclusive breastfeeding at 3 months postpartum increased the likelihood of displaying positive mother-infant interactions controlling for maternal mental health. Mothers who continued to breastfeed at 6 months postpartum reported less symptoms of antenatal depression and anxiety and higher levels of sensitivity and cooperation towards their infants. ConclusionBreastfeeding contributes to maternal sensitivity and cooperation even when controlling for maternal mental health. Implications for health practitioners and limitations due to the sample characteristics are discussed.

Patient-reported outcome measures in early psychosis: A cross-cultural, longitudinal examination of the self-reported health and self-reported mental health measures in Chennai, India and Montreal, Canada

ObjectiveDespite their acknowledged value, patient-reported outcome measures (PROMs) are infrequently used in psychosis, particularly in low-and middle-income countries. We compared ratings on two single-item PROMs, Self-Rated Health (SRH) and Self-Rated Mental Health (SRMH), of persons receiving similar early psychosis services in Chennai, India and Montreal, Canada. We hypothesized greater improvements in SRH and SRMH in the Chennai (compared to the Montreal) sample. MethodsParticipants (Chennai N = 159/168 who participated in the larger study; Montreal N = 74/165 who participated in the larger study) completed the SRH and SRMH during at least two out of three timepoints (entry, months 12 and 24). Repeated measures proportional odds logistic regressions examined the effects of time (baseline to month 24), site, and relevant baseline (e.g., gender) and time-varying covariates (i.e., symptoms) on SRH and SRMH scores. ResultsSRH (but not SRMH) scores significantly differed between the sites at baseline, with Chennai patients reporting poorer health (OR: 0.33; CI: 0.18, 0.63). While Chennai patients reported similar significant improvements in their SRH (OR: 7.03; CI: 3.13; 15.78) and SRMH (OR: 2.29, CI: 1.03, 5.11) over time, Montreal patients only reported significant improvements in their SRMH. Women in Chennai (but not Montreal) reported lower mental health than men. Higher anxiety and longer durations of untreated psychosis were associated with poorer SRH and SRMH, while negative symptoms were associated with SRH. ConclusionsAs hypothesized, Chennai patients reported greater improvements in health and mental health. The marked differences between health and mental health in Montreal, in contrast to the overlap between the two in Chennai, aligns with previous findings of clearer distinctions between mind and body in Western societies. Cross-context (e.g., anxiety) and context-specific (e.g., gender) factors influence patients' health perceptions. Our results highlight the value of integrating simple PROMs in early psychosis.

Early-Life Exposure to War and Later-Life Physical Functional Health.

A growing body of research shows that early-life exposure to war has adverse effects on later-life health. Research has emphasized the importance of exposure timing implicating domain-specific developmental processes and associated critical/sensitive periods. This study looks at the impacts of early childhood war exposure and the repercussions for later-life physical and functional health, with a focus on time of exposure as a source of variability. We use residential histories from the Survey of Health Ageing, and Retirement in Europe linked to external data on the location and timing of hostilities to examine the impact of early-life exposure to World War II on later-life physical and functional health. Exposure to war increases the risk of objective (grip strength, chair rise, and peak expiratory flow) and self-reported (mobility limitations and activities of daily living) measures of functional health. Effects are especially pronounced for those born during the war and for those with more prolonged exposures. There is little evidence that the impact of war is mediated by war-related hardships, socioeconomic conditions, health behaviors, or adult chronic disease. Our results suggest early-life exposure to war has a lasting impact on physical functional health. Exposure appears to largely operate via direct effects, indicative of altered initial development of physical capacity in early life. Because exposure was so pervasive among some cohorts of older individuals, understanding the health of present older European populations requires wrestling with the residual consequences of wartime exposure at the start of their lives.