Stress Symptoms Research Articles

Pregnancy during COVID 19 pandemic associated with differential gut microbiome composition as compared to pre-pandemic.

The first two years of the COVID-19 pandemic and subsequent health mandates resulted in significant disruptions to daily life, creating a period of heightened psychosocial stress in myriad aspects. Understanding the impact of this period on pregnant individuals' bacteriomes is crucial as pregnancy is a period of heightened vulnerability to stress and its sequelae, anxiety and mood disorders, which have been demonstrated to alter gut microbiome composition. In a prospective cohort study (N = 12-26) conducted from February 2019 to August 2021, we examined psychometric responses and rectal microbiome swabs from pregnant individuals. Full-length 16S rRNA sequencing followed by calculation of diversity metrics and relative abundance values were used to interrogate fecal microbiome community composition across pandemic groups. Distinct shifts in bacterial diversity and composition were observed during early to late pregnancy in the pandemic group, including lower relative abundance of pathogenic and lesser-known taxa. However, distribution of stress and depressive symptoms did not significantly differ from the pre-pandemic period while the correlation between stress and depressive symptoms dissipated during the pandemic. Our findings suggest that living through the COVID-19 pandemic altered the gut microbiome of pregnant individuals, independent of perceived stress.

The Effect of Forgiveness and Resilience on Anxiety, Depression and Stress in Nursing Students.

Purpose: To examine the effects of forgiveness and resilience on anxiety, depression, and stress in nursing students. Design: Cross-sectional correlational study. Methods: The convinient sample of the study consisted of 383 nursing students. Results: Significant predictors of nursing students' anxiety levels were experiencing an event where they could not forgive themselves or others and resilience. Significant predictors of nursing students' depression levels were gender, income level, experiencing an event where they could not forgive themselves or others, resilience, and self-forgiveness. Significant predictors of nursing students' stress levels were experiencing an event where they could not forgive themselves or others, resilience, and forgiveness of others. Conclusion: An increase in the level of self-forgiveness in nursing students reduced depression symptoms, and an increase in the level of forgiveness of others decreased stress symptoms. An increase in the level of resilience reduced symptoms of anxiety, depression, and stress. Female gender and a middle level of income reduced symptoms of depression. Interventions that increase forgiveness and resilience should be integrated into the curriculum to reduce nursing students' psychological symptoms in the context of holistic nursing.

Intergenerational Transmission of Posttraumatic Orientation to Bodily Signals Following Child Maltreatment.

Recent studies have indicated that CM (child maltreatment) may influence individuals' perception of their bodies, often resulting in a posttraumatic orientation to bodily signals (OBS). Given the intricate relationship between bodily and interpersonal experiences, it is hypothesized that posttraumatic OBS may be intergenerationally transmitted. However, knowledge regarding this phenomenon, and its underlying mechanisms, remains limited. Two studies tested (a) the link between CM and posttraumatic OBS, mediated by posttraumatic stress (PTS) symptoms and attachment security, and (b) the intergenerational transmission of a posttraumatic OBS following CM among dyads of parents and their young adult offspring. The first study included 445 young adults (mean age = 352, SD = 10.2), and the second study included 393 dyads (parents' mean age = 58, SD = 5.91; offspring's mean age = 27, SD = 3.91). The participants completed self-reported questionnaires. Study 1 found that posttraumatic OBS was associated with CM, through the mediation of PTS symptoms (indirect effect = 0.15, p = .005), and insecure attachment (indirect effects between 0.132 and 1.44, p < .006). The second study found two pathways of intergenerational transmission. The first pathway showed indirect paths between parents' CM exposure and offspring's posttraumatic OBS, through parents' reaction to CM (PTS symptoms, anxious attachment, and avoidant attachment) and posttraumatic OBS (indirect effects between 0.006 and 0.013, p < .039). The second pathway revealed indirect links between parents' CM exposure and offspring's posttraumatic OBS, through parents' and offspring's reaction to CM (indirect effects between 0.006 and 0.56, p < .015). The study's findings add empirical evidence that posttraumatic OBS is a significant implication of CM. The second study illuminates the intergenerational transmission of a posttraumatic OBS following parental CM exposure, uncovering PTS symptoms, and insecure attachment styles as potential underlying mechanisms.

The Influence of Anxiety Disorders on Dermatological Diseases: A Vicious Cycle of Stress and Skin Symptoms

The Influence of Anxiety Disorders on Dermatological Diseases: A Vicious Cycle of Stress and Skin Symptoms

The prospective impact of extradyadic stress on depressive symptoms and the mediating role of intradyadic stress in parents-an actor-partner interdependence mediation model.

Stress outside of the couple relationship (extradyadic stress) can spill over into the couple relationship, increasing stress between the partners (intradyadic stress). Extra- and intradyadic stress are furthermore associated with depressive symptoms. Due to the interdependence of romantic partners, this study aimed to investigate the influence of the person's own and their partner's extra- and intradyadic stress on the person's depressive symptoms in parents of toddlers. The second aim was to evaluate whether intradyadic stress mediates the within-person and between-partner association between extradyadic stress and depressive symptoms. Longitudinal data of a community sample of 878 opposite-sex couples, participating in the prospective cohort study DREAM, were collected two and three years after birth. Extra- and intradyadic stress were assessed by the Multidimensional Stress Questionnaire for Couples and depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale. An actor-partner interdependence mediation model was applied to the data, while controlling for the confounder academic degree. The person's own extradyadic stress predicted their depressive symptoms one year later, partially mediated by their intradyadic stress. The partner's extradyadic stress and the person's own depressive symptoms one year later were only indirectly associated through the person's own intradyadic stress. In a sensitivity analysis, between-partner effects were no longer significant after including autoregressive pathways. Our findings highlight the importance of the extradyadic-intradyadic stress spillover for the mental health of women and men with young children. Early targeted interventions could help to prevent later depressive symptoms by reducing stress inside the couple relationship that results from both partners' stress from outside the couple relationship.

Differential effects of trait-like emotion regulation use and situational emotion regulation ability across the affective and anxiety disorders spectrum: a transdiagnostic examination

Here, we investigated the association of different emotion regulation (ER) indices with symptom severity across a large transdiagnostic sample of patients with emotional disorders (cross-sectional approach) and the predictive validity these ER indices have for the outcome of routine care CBT (longitudinal approach). We assessed the trait-like use of adaptive (reappraisal) and maladaptive (suppression, externalizing behaviors) ER strategies via questionnaire as well as the situational ability to regulate emotions with an experimental ER paradigm. Psychopathology was assessed dimensionally using the depression, anxiety, and stress scale. Cross-sectionally symptom severity was predicted by less trait-like use of adaptive and more trait-like use of maladaptive ER strategies, but no associations were found for situational ER ability. This association was more pronounced for depression and stress symptoms rather than anxiety symptoms. In a striking dissociation, the longitudinal analyses revealed the reverse picture: Better situational ER ability, but not trait-like use of ER strategies was associated with less symptom severity after the CBT treatment. Our data argues in favor of a distinction between trait-like and situational ER abilities in individuals with emotional disorders, highlighting challenges in applying adaptive ER strategies in daily life despite demonstrating intact ER skills in experimental settings. Our findings also inform transdiagnostic models of psychopathology and suggest that distress/depression rather than anxiety symptomatology to be driving forces for the occurrence of ER deficits across the depression/anxiety disorders spectrum.

When the Caregivers Need Care: The Silent Stress of Human Resources Work

The aim of this study is to examine the stress and pressure experienced by individuals working in human resources, focusing on the unique challenges that this work entails. This research is therefore guided by the question: what are the characteristics of work-related stress and burnout for individuals working in human resources? This study employed a mixed-methods approach, incorporating both qualitative and quantitative research methods. Initially, semi-structured interviews were conducted with eight human resources professionals, comprising an equal number of women and men. Subsequently, a survey was administered to a broader group of human resources personnel. The quantitative analysis utilized the “Copenhagen Burnout Inventory” as a measurement tool, alongside background questions regarding the participants’ gender, age, job title, field of work, and seniority. The findings from both the qualitative and quantitative research indicate that employees in human resource roles exhibit significant stress symptoms. A majority of the interviewees reported experiencing mental and/or physical symptoms attributable to work-related stress. Specifically, the quantitative data revealed that 65.7% of the participants sometimes or often feel mentally exhausted, while 40.3% report similar levels of physical exhaustion. Notably, despite these challenges, only 8.7% of the participants identify as being burnt-out in their roles. The quantitative results also highlight gender as a significant factor affecting the mental and physical well-being of human resources employees, with women reporting lower levels of well-being compared to men.

The association between perceive social support and post-traumatic stress disorder symptoms among medical staff in Hubei, China: a chain mediating effect of resilience and positive coping

BackgroundEvidence suggests that PTSD symptoms following public health emergencies are influenced by many factors. The aim of this study was to investigate the relationship between perceived social support and Post-traumatic stress disorder symptoms and to explore the chain-mediated role of resilience and positive coping style, among medical staff in Hubei Province, China, during a public health emergency.MethodsConvenience sampling was used to select medical staff from two general hospitals in Hubei Province in July 2022 for this study. A total of 2,751 medical staff were included in the study. Multidimensional Scale of Perceived Social Support, 10- itemConnor- Davidson resilience scale, Simplified Coping Style Questionnaire and The Post-traumatic stress disorder Checklist for DSM-5 were used to assess the levels of perceived social support, resilience, coping style and Post-traumatic stress disorder symptoms of medical staff two years after the public health emergency. Statistical descriptions were conducted using SPSS, and a structural equation model was established using AMOS to analyze the chain-mediated roles of resilience and positive coping style between perceived social support and Post-traumatic stress disorder symptoms.ResultsStructural equation modeling results showed a standardized total effect of perceived social support on Post-traumatic stress disorder symptoms of -0.416 (95%CI [-0.456, -0.374], P < 0.001). Resilience mediated the effect of perceived social support and Post-traumatic stress disorder, with an indirect effect of -0.016 ( 95%CI [0.031, 0.001], P = 0.038). Positive coping mediated the effect of perceived social support and Post-traumatic stress disorder, with an indirect effect of -0.024 (95%CI [-0.035, -0.014], P < 0.001). Resilience and positive coping style chain-mediated between perceived social support and Post-traumatic stress disorder symptoms, mediating 17.1% of the total effect.ConclusionPerceived social support has significant direct and indirect effects on Post-traumatic stress disorder symptoms and resilience. In addition, positive coping style act as chain mediators between perceived social support and Post-traumatic stress disorder symptoms. We suggest that strengthening perceived social support for medical staff can enhance their resilience, encouraging them to adopt positive coping, which in turn reduces the level of post-traumatic stress symptoms among medical staff following public health emergencies.

Proximal and distal minority stressors and mental health among young gay and bisexual men and other men who have sex with men (GBMSM) in Kisumu, Kenya.

Young gay and bisexual men and other men who have sex with men (GBMSM) in Kenya experience pervasive intersectional stigma and discrimination, contributing to elevated levels of negative mental health symptoms. Grounded in the Minority Stress Model, this paper explores associations of proximal and distal minority stressors with three types of negative mental health outcomes among young HIV-negative GBMSM (n = 63) between the ages of 19-34 who participated in a pilot trial of a sexual health intervention. Using the PHQ-9, GAD-7, and PC-PTSD-5 screening measures, levels of clinically significant symptoms were reported as follows: 15.8% depressive symptoms, 12.7% anxiety symptoms, 31.7% posttraumatic stress symptoms. Results from stepwise linear regression analyses suggest that GBMSM-related stigma (distal stressor) was the strongest correlate for all three mental health outcomes, and concealment motivation (proximal stressor) was an additional significant correlate only in the depressive symptoms model. These findings should be viewed with caution and seen as initial observations given the small sample which limits our interpretations of the findings. Structural-level interventions are needed to decrease GBMSM's exposure to intersectional stigma and discrimination, such as decriminalization of same-sex sexual activity, as well as individual and group-level interventions that assist GBMSM with improving their adaptive coping strategies.

Understanding Fatigue, Insomnia, and COVID-19 PTSS Among Mainland Chinese During Initial Post-Zero-COVID Infection Wave: A Multi-Group Analysis

In early 2023, China experienced its first widespread COVID-19 outbreak after a policy shift. This study examines the relationship between fatigue and COVID-19-related post-traumatic stress symptoms (PTSS) in infected and uninfected individuals, exploring the potential mediating role of insomnia symptoms. An online survey of 5953 Chinese participants was conducted from 10 to 16 January 2023. Participants reported their COVID-19 infection status, fatigue, insomnia symptoms, and PTSS. Multi-group structural equation modeling (SEM) was used to test whether the mediation paths differed between infected and uninfected groups. The prevalence of fatigue, insomnia symptoms, and COVID-19 PTSS were 30.0%, 36.4%, and 5.8%. The SEM based on the bootstrapping showed that after controlling for demographics, chronic fatigue positively associated with COVID-19 PTSS in a significant way, with insomnia symptoms playing a mediating role. The multi-group analyses further revealed a partial mediation effect of insomnia symptoms on the relationship between fatigue and COVID-19 PTSS in the uninfected group (UG). However, for the infected group (IG), insomnia symptoms fully mediated the relationship between fatigue and COVID-19 PTSS. Infected individuals were more subject to the aforementioned mechanism than uninfected individuals. Addressing chronic fatigue, insomnia, and developing targeted interventions are crucial for supporting mental health across different infection statuses.

Patterns and relationships of prolonged grief, post-traumatic stress, and depressive symptoms in Chinese shidu parents: Latent profile and network analyses

Parents who experience the trauma of losing an only child are called “shidu” parents in China. There are individual differences in post-loss outcomes.1,061 Chinese shidu parents were asked to complete questionnaires assessing prolonged grief, post-traumatic stress, and depressive symptoms. The mean age of the sample was 59.68 (SD = 7.52), with the average time since the loss was 9.46 years (SD = 7.05). Most participants were female (62.3%). The main cause of the loss was an unnatural case (52.7%). Latent profile analysis was used to identify similar symptom patterns. Network analysis was used to explore the relationships among symptoms within different subgroups. A two-profile model based on symptom severity identified a “low symptom severity” subgroup (n = 419) and a “high symptom severity” subgroup (n = 642). In the low symptom severity subgroup network, the most central symptoms were loss of interest, feeling numb, and meaninglessness. In the high symptom severity subgroup network, the most central symptoms were physiological cue reactivity, emotional pain, and feeling easily startled. Individual differences in the post-loss outcomes of Chinese shidu parents are reflected not only in symptom patterns but also in the relationships among symptoms.

Perceived health and working life in caregivers from nursing homes that used or did not use nighttime personalized non-pharmacological therapies to address residents’ behavioral and psychological symptoms of dementia

Dementia is frequent in nursing home (NH), affecting between 40 and 50 % of the residents and is associated in 90 % of the cases with behavioral and psychological symptoms (BPSD) which are detrimental to caregivers’ working life and perceived health. We compared perceived health and working life between NHs that used or did not use nighttime personalized non-pharmacological therapies (PNPT) to address BPSD. This anonymous survey included 96 caregivers from 25 NHs which used (n = 69) or not (n = 27) nighttime PNPT. Perceived health, nursing and medical care, quality of care and internal motivation were significantly higher, stress symptoms and workload were significantly lower and there was a tendency to enhanced satisfaction with work in caregivers from NHs which used nighttime PNPT. Our present data open a new window on the benefits of PNPT.

Mobile Heart Rate Variability Biofeedback for Work-Related Stress in Employees and the Influence of Instruction Format (Digital or Live) on Training Outcome: A Non-Randomized Controlled Trial.

Work-related stress is a major health issue in most industrialized countries. Heart rate variability biofeedback (HRV-BfB) can promote resilience and stress coping capacity. Mobile HRV-BfB could contribute to stress prevention in the workplace. Little is known about whether the type of training, with digital or live instruction, has an impact on the training outcome. This study analyzes the psychophysiological effects of four-week workplace resilience training with mobile HRV-BfB and the influence of instruction format (digital or live) on training success. This was a prospective, three-arm, non-randomized controlled trial with parallel group design. 73 employees of a bearing and seal manufacturer (58.9% male, 86.3% full-time employment, 67.1% office workers) attended resilience training with HRV-BfB, live (n = 24) or digital (n = 19) format, or served as waitlist controls (n = 30). HRV-BfB training spanned four weeks. Participants applied resilience techniques to increase HRV using visual biofeedback. Data were collected at baseline (T0), post-intervention (T1), and another four weeks later (T2). Primary outcome measure was the Burnout scale of the Copenhagen Psychosocial Questionnaire (COPSOQ) at T1. Secondary outcome measures included further COPSOQ scales, self-reported sleep quality (Pittsburgh Sleep Quality Index, PSQI), and HRV parameters. Burnout parameters decreased significantly in HRV-BfB and waitlist. The decrease (T0-T1 and T0-T2) showed higher effect sizes in HRV-BfB (Cohen's d: 0.63; 0.69) than in waitlist (d: 0.27; 0.36). Sleep quality improved in HRV-BfB with small effect sizes (no change for waitlist). SDNN (standard deviation of beat-to-beat intervals) increased in HRV-BfB between T0 and T1 (d: 0.23;). In subgroup analysis, digital reached higher effect sizes for improvement in burnout (d: 0.87; 0.92) and sleep quality (d: 0.59; 0.64) than live learning (burnout: d: 0.43; 0.51; sleep quality: d: 0.28; 0.22). HRV-analysis revealed no differences between subgroups. Four-week mobile HRV-BfB resilience training reduced stress and burnout symptoms in employees. No significant differences were found between HRV-BfB digital or live. Hence, companies should choose the approach that fits their company profile or, if possible, offer both formats to accommodate the different needs of employees. However, findings were nonhomogeneous and should be verified by further studies.Trial Registration: ClinicalTrials.gov , NCT04897165, 05/18/2021, retrospectively registered.

Understanding the severity of attachment injury-related stress symptoms via the reasons for forgiveness and unforgiveness identified by injured romantic partners

IntroductionFailure to provide comfort and care to a romantic partner in a moment of need for support can result in feelings of betrayal and abandonment, and impact trust. This type of relationship trauma is referred to as an attachment injury, which can have negative psychological consequences for the injured partner and for some, it is more difficult to adjust. It appears that forgiveness favors reconciliation in couples who have experienced an attachment injury, whereas unforgiveness can prevent its resolution. But, are the reasons for forgiving or not forgiving a partner associated with adjustment to an attachment injury in injured partners? ObjectivesThis mixed-methods (qualitative and quantitative) study aimed to (1) identify the reasons for forgiving and not forgiving an attachment injury and to organize these reasons into themes, and (2) examine the associations between the forgiveness and unforgiveness themes and the severity of injury-related stress symptoms. MethodA total of 84 participants who forgave and 50 who did not forgive their partner provided reasons for their decision and completed a measure of injury-related stress symptoms. Data were analyzed using thematic content analysis and multiple regressions. ResultsSeven themes of reasons for forgiveness and eleven themes of reasons for unforgiveness were identified. The forgiveness theme Strong partner commitment to repairing the injury on the part of the injuring partner was associated with lower injury-related stress symptoms, whereas the forgiveness theme I understand my partner and/or the context in which the injury occurred was associated with higher injury-related stress symptoms. The themes of reasons for unforgiveness were not significantly associated with injury-related stress symptoms. ConclusionThis study provides a foundation for the development of a psychosocial model of forgiveness and unforgiveness among partners who experienced an attachment injury in their romantic relationship.

Risk Factors of Post-Traumatic Stress in Pediatric Solid Organ Transplant Recipients.

Life with end-stage organ failure is accompanied by an accumulation of traumatic medical or surgical experiences. Despite recovery after solid organ transplantation (SOT), many children and adolescents develop post-traumatic stress symptoms (PTSS). PTSS remain underappreciated as a major comorbidity in SOT programs, despite their association with decreased quality of life. We conducted a retrospective, cross-sectional study of 86 pediatric SOT recipients (17 heart, 44 kidney, and 25 liver) to evaluate potential determinants of PTSS. Trauma symptoms were measured by the Child Trauma Screening Questionnaire (CTSQ). Demographic, baseline, and contemporaneous factors were tested for independent association with CTSQ scores. The median post-transplant CTSQ score was 2 (IQR 1-4), and 22% were identified as high risk (score ≥5) for PTSD. Higher CTSQ scores were independently associated with the number of ICU days within the previous 12 months, the number of medications (complexity), and involvement with foster care in the primary model (R2 [adj.] = 0.26). The addition of the Family Impact Module improved the overall model (R2 [adj.] = 0.33), wherein higher family functioning was independently associated with lower CTSQ scores. An exploratory analysis of pre-transplant patients (n = 34) found a median pre-transplant CTSQ of 2 (IQR 1-6), suggesting that PTSS are onset before transplant and persist afterward. PTSS are highly prevalent in the SOT population. Risk factors include recent adverse medical experiences and complexity, whereas family stability may be protective. Additional research is needed to improve early ascertainment and support for patients at high risk of developing PTSS throughout their transplant journey.

Exploring Stressors And Their Associated Effects On Workplace Stress In The Ministry Of Interior United Arab Emirates

Stress is a psychological and physical mental disorder that occurs in situations of pressure, which requires available resources to meet organizational and individual demands. This research was about exploring stressors and their effects associated with workplace stress. A mixed method exploratory sequential approach and survey were used to describe Ministry of Interior (MOI) employees'' workplace stress and its stressors that involved two phases: qualitative (phase I) used interviews and quantitative (phase II) used surveys to explore stressors and its effects associated with the workplace stress. This study aimed to explore stress prevalence and the stressors experienced by MOI employees. Qualitative and quantitative analysis is carried out on the collected data. The result of phase I indicated that if there were more frequent stress symptoms among the participants, this would contribute to decreased productivity. Phase II of the analysis relied on the multiple regression technique, Stress Management Conflict Resolution predicts that was statistically significant, which was shown as the R-squared, the overall regression model was significant, F (3,296) =0.14, P &gt; .025, R2 =.014. Workplace stress, the multiple regression model was significant, F (3,296) =98, P &gt; .403, R2 = 98. Absenteeism, F (3,296) =.27, P &gt; .80, R2 = 84. Workload and Responsibility - NIOSH's multiple regression model was significant, F (3,296) =85, P &gt; .85, R 2 = 85 on predicting job satisfaction. The confidence level in the finding was high since the P-value was less than the maximum acceptable value of 0.05. Therefore, the F-statistic was significant.

Caregiver-Child agreement in posttraumatic symptoms and outcomes in the child and family traumatic stress intervention

BackgroundAgreement between caregiver and child reports of posttraumatic stress symptoms is often quite poor. Lack of agreement about symptoms, as well as failure of mutual recognition and understanding of symptoms, can impact treatment outcomes. ObjectiveThis study examines change in caregiver and child agreement about child posttraumatic stress symptoms (PTSS) before and after a brief and early intervention for children exposed to a traumatic event. MethodThe Child and Family Traumatic Stress Intervention (CFTSI) is a brief (5–8 session) trauma-focused mental health treatment designed to reduce trauma symptoms in the aftermath of recent traumatic experiences that involves a focus on caregiver and child recognition of and communication about the child’s PTSS. We report on results of a naturalistic treatment study of CFTSI implementation without a comparison group that includes 1,190 child-caregiver dyads from 13 community-based clinical settings. Pre- and post-treatment reports of child PTSS were assessed using caregiver and child reports on the Child Posttraumatic Symptom Scale. A mixed effects analysis was conducted to examine change in caregiver and child discrepancy from pre to post CFTSI intervention. ResultsThere was a significant discrepancy between caregiver and youth agreement in PTSS at baseline that was significantly reduced post-CFTSI treatment. Change in discrepancy was similar regardless of child age and gender. Higher caregiver PTSS at pretreatment was associated with less change in discrepancy. ConclusionThis study suggests CFTSI may reduce the discrepancy between caregiver and child reports of the child’s PTSS. Reduced discrepancy implies an increased recognition of, and communication about, children’s PTSS, which may be a mechanism through which CFTSI reduces child PTSS following a recent traumatic event.

Pre-disaster income inequality and post-disaster mental health: A natural experiment from the 2011 Great East Japan Earthquake and Tsunami

BackgroundWe sought to test the hypothesis that communities with a high degree of income inequality are ill-equipped to deal with crises. Specifically, we tested whether pre-disaster higher income inequality increases the risk of worse mental health conditions in the aftermath of disaster. MethodsWe examined the association between pre-disaster community income inequality and post-disaster mental health outcomes in a prospective cohort study of older adults (≥65 years) who survived the 2011 Great East Japan Earthquake. The baseline survey of participants (completed in 2010) predated the disaster by seven months. Survivors completed three waves of post-disaster surveys in 2013, 2016, and 2019. To assess the level of income inequality, the Gini index was calculated using individual income data in 2010 aggregated to 98 communities (range 0.05–0.50: median = 0.32) and categorized into tertiles (low, middle, high). Depressive symptoms and post-traumatic stress symptoms (PTSS) were assessed in the three post-disaster surveys using validated instruments. Multilevel analysis was conducted adjusting for pre-disaster characteristics. ResultsHigher levels of community income inequality were associated with higher PTSS scores across time (2013: β = 0.14, 95%CI = −0.01, 0.29; 2016: β = 0.16, 95%CI = 0.03, 0.29; 2019: β = 0.12, 95%CI = −0.01, 0.24). The association between income inequality and mental health was partly attenuated by adding the change in social capital to the model (2013: β = 0.14, 95%CI = -0.01, 0.29; 2016: β = 0.15, 95%CI = 0.03, 0.28; 2019: β = 0.11, 95%CI = -0.01, 0.22). ConclusionOur findings suggest that pre-disaster income inequality may explain PTSS symptoms in the aftermath of a disaster, and the relation may be mediated by disaster-related change. Further study to reveal its mechanism is needed for the policy recommendation.

Birth expectations, birth experiences and childbirth-related post-traumatic stress symptoms in mothers and birth companions: Dyadic investigation using response surface analysis.

During the perinatal period, women and their birth companions form expectations about childbirth. We aimed to examine whether a mismatch between birth expectations and experiences predict childbirth-related post-traumatic stress symptoms (CB-PTSS) for mothers and birth companions. We also explored the influence of the mismatch between mothers' and birth companions' expectations/experiences on CB-PTSS. Dyadic longitudinal data from the Self-Hypnosis IntraPartumTrial. Participants (n = 469 mothers; n = 358 birth companions) completed questionnaires at 27 and 36 weeks of gestation and 2 and 6 weeks post-partum. We used the measures of birth expectations (36 weeks gestation), birth experiences (2 weeks post-partum) and CB-PTSS (6 weeks post-partum). Correlations revealed that birth expectations were associated with experiences for both mothers and birth companions but were not consistently associated with CB-PTSS. Birth experiences related to CB-PTSS for both mothers and birth companions. The response surface analysis results showed no support for the effect of a mismatch between expectations and experiences on CB-PTSS in mothers or birth companions. Similarly, a mismatch between mothers' and birth companions' expectations or experiences was unrelated to CB-PTSS. Following previous literature, birth expectations were associated with experiences, and experiences were associated with CB-PTSS. By testing the effect of the match between birth experiences and expectations using an advanced statistical method, we found that experiences play a more substantial role than the match between experiences and expectations in CB-PTSS. The impact of birth experiences on CB-PTSS highlights the importance of respectful and supportive maternity care.

Food Consumption According to the NOVA Food Classification and Its Relationship with Symptoms of Depression, Anxiety, and Stress in Women

Background/Objectives: Depression, anxiety, and stress are highly prevalent mental disorders worldwide, and food consumption can change in individuals with these conditions. We aimed to assess the food consumption of women with depressive symptoms and compare it to a control without symptoms. Methods: A cross-sectional study was conducted with 96 women, aged 18–59, allocated into two groups: control (n = 62) or depressive symptoms (n = 34). The participants underwent an anthropometric assessment, and food consumption was evaluated using a 24 h food recall and the NOVA classification. Depressive symptoms, anxiety, and stress were measured using the DASS-21 questionnaire. Results: Anthropometric parameters did not differ between the groups. Women with depressive symptoms consumed fewer calories (p = 0.006), carbohydrates (p = 0.014), proteins (p = 0.036), and lipids (0.011) from unprocessed and minimally processed foods (UMPF) compared to the control women. A negative correlation was found between the dietary consumption energy of UMPF and symptoms of depression (r = −0.337; p = 0.001), anxiety (r = −0.262; p = 0.014), and stress (r = −0.260; p = 0.014), as well as a positive correlation between energy intake from ultra-processed foods (UPF) and symptoms of depression (r = 0.218; p = 0.042) and stress (r = 0.227; p = 0.034). Regression analysis showed that depressive symptoms accounted for 7.6% of the lower energy consumption from UMPF. Conclusions: Women with depressive symptoms displayed lower UMPF consumption, and this was negatively correlated with symptoms of depression, anxiety, and stress. Professional dietary advice can improve health status in these patients.