Resilience Predicts Lower Anxiety and Depression and Greater Recovery after a Vicarious Trauma.
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ABSTRACT:
SUBMITTER: Leys C
PROVIDER: S-EPMC8656954 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Anxiety and depression are often associated with strong beliefs that entering specific situations will lead to aversive outcomes - even when these situations are objectively safe and avoiding them reduces well-being. A possible mechanism underlying this maladaptive avoidance behavior is a failure to reflect on: (1) appropriate levels of uncertainty about the situation, and (2) how this uncertainty could be reduced by seeking further information (i.e., exploration). To test this hypothesis, we asked a community sample of 416 individuals to complete measures of reflective cognition, exploration, and symptoms of anxiety and depression. Consistent with our hypotheses, we found significant associations between each of these measures in expected directions (i.e., positive relationships between reflective cognition and strategic information-seeking behavior or "directed exploration", and negative relationships between these measures and anxiety/depression symptoms). Further analyses suggested that the relationship between directed exploration and depression/anxiety was due in part to an ambiguity aversion promoting exploration in conditions where information-seeking was not beneficial (as opposed to only being due to under-exploration when more information would aid future choices). In contrast, reflectiveness was associated with greater exploration in appropriate settings and separately accounted for differences in reaction times, decision noise, and choice accuracy in expected directions. These results shed light on the mechanisms underlying information-seeking behavior and how they may contribute to symptoms of emotional disorders. They also highlight the potential clinical relevance of individual differences in reflectiveness and exploration and should motivate future research on their possible contributions to vulnerability and/or maintenance of affective disorders.
| S-EPMC8808291 | biostudies-literature
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| S-EPMC8320852 | biostudies-literature
Project description:ObjectiveApproximately 225,000 children sustain injuries requiring hospitalization annually. Posttraumatic stress disorder (PTSD) and depression are prevalent among pediatric patients and caregivers post-injury. Most U.S. trauma centers do not address patients' mental health needs. Better models of care are needed to address emotional recovery. This article describes the engagement and recovery trajectories of pediatric patients enrolled in the Trauma Resilience and Recovery Program (TRRP), a stepped-care model to accelerate emotional recovery following hospitalization.MethodsTRRP is designed to (a) provide in-hospital education about post-injury emotional recovery and assess child and caregiver distress; (b) track mental health symptoms via a 30-day text-messaging program; (c) complete 30-day PTSD and depression phone screens; and (d) provide evidence-based treatment via telehealth or in-person services or referrals, if needed. All 154 families approached were offered TRRP services, 96% of whom agreed to enroll in TRRP. Most patients were boys (59.8%), and average age was 9.12 years [standard deviation (SD) = 5.42]. Most injuries (45.8%) were sustained from motor vehicle accidents.ResultsIn hospital, 68.5% of caregivers and 78.3% of children reported clinically significant distress levels. Over 60% of families enrolled in the texting service. TRRP re-engaged 40.1% of families for the 30-day screen, 35.5% of whom reported clinically significant PTSD (M = 13.90, SD = 11.42) and/or depression (M = 13.35, SD = 11.16). Most (76%) patients with clinically significant symptomology agreed to treatment.ConclusionsOur intervention model was feasible and increased reach to families who needed services. Efforts to improve follow-up engagement are discussed, as are initial successes in implementing this model in other pediatric trauma centers.
| S-EPMC9432141 | biostudies-literature
Project description:We identified hyper- and hypo-methylated cytosine sites and genes genome-wide using bisulfite sequencing in comparison between PTSD and control group, and between Major Depressive Disorder (MDD) and control group,
2021-09-21 | GSE178128 | GEO
Project description:ObjectiveDepression and anxiety are comorbid conditions that are disproportionately high among American Indians (AIs) or Alaska Natives. The purpose of this study was to identify potential risk (e.g., low income, intimate partner violence [IPV], adverse childhood experiences [ACEs]) and protective factors (e.g., family resilience, social and community support) related to symptoms of depression and anxiety among AI adults.MethodAs part of larger exploratory sequential mixed-methods research, the study focused on survey data with 127 AI adults from two Southeastern tribes (n = 117 when missing data were removed). We used the following three-stage hierarchical regression to understand factors related to depressive and anxiety symptoms: (a) demographics, including income; (b) ACEs and IPV; and (c) family resilience, along with family and community support.ResultsMany participants experienced elevated levels of clinically significant symptoms of depression and anxiety (15% and 20%, respectively). Results indicated lower income was associated with higher depressive and anxiety symptoms. IPV and ACE variables were positively associated with depressive and anxiety symptoms. Family resilience was negatively associated with symptoms of anxiety and depression. Social and community support were associated with symptoms of anxiety.ConclusionsThe findings provide strong preliminary support for the role of family protective and promotive factors in offsetting symptoms of anxiety and depression. This is contrary to most models of interventions for anxiety and depression focusing on individual psychotherapy rather than promoting family resilience or involvement. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
| S-EPMC7814695 | biostudies-literature
Project description:ObjectivesWith the world population rapidly aging, it is increasingly important to identify sociodemographic, cognitive, and clinical features that predict poor outcome in geriatric depression. Self-report measures of resilience-ie, the ability to adapt and thrive in the face of adversity-may identify those depressed older adults with more favorable prognoses.MethodsWe investigated the utility of baseline variables including 4 factors of resilience (grit, active coping self-efficacy, accommodative coping self-efficacy, and spirituality) for predicting treatment response and remission in a 16-week randomized controlled trial of methylphenidate, citalopram, or their combination in 143 adults over the age of 60 with MDD.ResultsFinal logistic regression models revealed that greater total baseline resilience (Wald χ2 = 3.8, P = 0.05) significantly predicted both treatment response and remission. Specifically, a 20% increase in total resilience predicted nearly 2 times greater likelihood of remission (OR = 1.98, 95% CI = [1.01, 3.91]). Examining the individual factors of resilience, only accommodative coping self-efficacy (Wald χ2 = 3.7, P = 0.05; OR = 1.41 [1.00-2.01]) was significantly associated with remission. We found no relation between baseline sociodemographic factors (age, sex, race, education level) or measures of cognitive performance and posttreatment depressive symptoms.ConclusionsSelf-reported resilience may predict greater responsivity to antidepressant medication in older adults with MDD. Future research should investigate the potential for resilience training-and in particular, interventions designed to increase accommodative coping-to promote sustained remission of geriatric depression.
| S-EPMC6246780 | biostudies-literature
Project description:Experiencing childhood trauma (CT) can create barriers for developing relationships and is a risk factor for anxiety and depression. Expressive suppression (ES; i.e., reducing expression associated with experiencing emotions) might explain the link between CT and relationship formation difficulties. We examined the association between (1) CT and ES during a dyadic paradigm intended to facilitate connectedness between unacquainted partners and (2) ES and desire for future interaction (DFI). Individuals with an anxiety or depressive disorder diagnosis (N = 77) interacted with a trained confederate; partners answered a series of increasingly intimate questions about themselves. Participant ES for positive and negative emotions, and participant and confederate DFI were collected during the task. Participants completed global anxiety, depression, and CT measures. CT correlated with positive (r = .35, p = .002), but not negative, ES (r = .13, p = .273). In a multiple linear regression model, CT predicted positive ES beyond symptom variables and gender, β = .318, t = 2.59, p = .012. Positive ES correlated with participant (r = -.38, p = .001) and confederate DFI (r = -.40, p<.01); and predicted participant DFI beyond symptom variables and ethnicity, β = -.358, t = -3.18, p = .002, and confederate DFI, β = -.390, t = -3.51, p = .001, beyond symptom variables. Mediation analyses suggested positive ES accounted for the relationship between greater CT severity and less desire for future interaction from participants, 95%CI [-0.26, -0.02], and confederates, [-0.38, -0.01]. Positive ES may be an important factor in the reduced capacity to form new social relationships for individuals with a history of CT, anxiety, and depression.
| S-EPMC10911195 | biostudies-literature
Project description:Depression and anxiety are highly prevalent psychological disorders in end-stage renal disease (ESRD) that have a negative clinical impact. The purpose of our study was to identify factors associated with the presence of depression and anxiety, in a sample of ESRD patients treated with hemodialysis. We included 187 patients from two dialysis facilities, age 18-65 years. Beck's depression and anxiety inventories, KDQOL36 questionnaire, the cognitive distortion scale and the Mexican scale of resilience were used. Socio-demographic and clinical information was obtained from medical records. Depression was present in 143 (76.4%) patients. Patient with depression were older (33 (26-52) years vs. 30 (24.43) years, p = 0.025), had a lower education level (36% vs. 9%, p = 0.001), used more medications (67% vs. 36%, p = 0.001), had a comorbidity (75% vs. 41%, p = 0.001), and a higher proportion were waiting for a kidney transplant. Anxiety was present in 112 (59.8%) cases. By multivariate analysis, depression was independently associated with lower education, absence of previous kidney transplant, anxiety, higher cognitive distortion, lower psychological resilience, and lower quality of life scores. In conclusion, lower psychological resilience, lower education level, and higher cognitive distortions are factors associated with depression and anxiety in ESRD patients.
| S-EPMC8620979 | biostudies-literature
Project description:Antidepressants are among the most widely prescribed medications, yet only 35-45% of patients achieve remission following an initial antidepressant trial. The financial burden of treatment failures in direct treatment costs, disability claims, decreased productivity, and missed work may, in part, derive from a mismatch between optimal and actual prescribed medications. The present 1 year blinded and retrospective study evaluated eight direct or indirect health care utilization measures for 96 patients with a DSM-IV-TR diagnosis of depressive or anxiety disorder. The eight measures were evaluated in relation to an interpretive pharmacogenomic test and reporting system, designed to predict antidepressant responses based on DNA variations in cytochrome P450 genes (CYP2D6, CYP2C19, CYP2C9 and CYP1A2), the serotonin transporter gene (SLC6A4) and the serotonin 2A receptor gene (5HTR2A). All subjects had been prescribed at least one of 26 commonly prescribed antidepressant or antipsychotic medications. Subjects whose medication regimen included a medication identified by the gene-based interpretive report as most problematic for that patient and are in the 'red bin' (medication status of 'use with caution and frequent monitoring'), had 69% more total health care visits, 67% more general medical visits, greater than three-fold more medical absence days, and greater than four-fold more disability claims than subjects taking drugs categorized by the report as in the green bin ('use as directed') or yellow bin ('use with caution'). There were no correlations between the number of medications taken and any of the eight healthcare utilization measures. These results demonstrate that retrospective psychiatric pharmacogenomic testing can identify past inappropriate medication selection, which led to increased healthcare utilization and cost.
| S-EPMC3625917 | biostudies-other
Project description:BackgroundChronic exposure to socioeconomic or environmental stressors associates with greater stress-related neurobiological activity (ie, higher amygdalar activity [AmygA]) and higher risk of major adverse cardiovascular events (MACE). However, among individuals exposed to such stressors, it is unknown whether neurobiological resilience (NBResilience, defined as lower AmygA despite stress exposure) lowers MACE risk. We tested the hypotheses that NBResilience protects against MACE, and that it does so through decreased bone marrow activity and arterial inflammation.MethodsIndividuals underwent 18F-fluorodeoxyglucose positron emission tomography/computed tomography; AmygA, bone marrow activity, and arterial inflammation were quantified. Chronic socioeconomic and environmental stressors known to associate with AmygA and MACE (ie, transportation noise exposure, neighborhood median household income, and crime rate) were quantified. Heightened stress exposure was defined as exposure to at least one chronic stressor (ie, the highest tertile of noise exposure or crime or lowest tertile of income). MACE within 5 years of imaging was adjudicated. Relationships were evaluated using linear and Cox regression, Kaplan-Meier survival, and mediation analyses.ResultsOf 254 individuals studied (median age [interquartile range]: 57 years [46-67], 36.7% male), 166 were exposed to at least one chronic stressor. Among stress-exposed individuals, 12 experienced MACE over a median follow-up of 3.75 years. Among this group, higher AmygA (ie, lower resilience) associated with higher bone marrow activity (standardized β [95% CI]: 0.192 [0.030-0.353], P=0.020), arterial inflammation (0.203 [0.055-0.351], P=0.007), and MACE risk (standardized hazard ratio [95% CI]: 1.927 [1.370-2.711], P=0.001). The effect of NBResilience on MACE risk was significantly mediated by lower arterial inflammation (P<0.05).ConclusionsAmong individuals who are chronically exposed to socioeconomic or environmental stressors, NBResilience (AmygA <1 SD above the mean) associates with a >50% reduction in MACE risk, potentially via reduced arterial inflammation. These data raise the possibility that enhancing NBResilience may decrease the burden of cardiovascular disease.
| S-EPMC7820711 | biostudies-literature