Interaction of Stress, Lead Burden, and Age on Cognition in Older Men: The VA Normative Aging Study

BACKGROUND. Low-level exposure to lead and to chronic stress may independently influence cognition. However, the modifying potential of psychosocial stress on the neurotoxicity of lead and their combined relationship to aging-associated decline have not been fully examined. OBJECTIVES. We examined the cross-sectional interaction between stress and lead exposure on Mini-Mental State Examination (MMSE) scores among 811 participants in the Normative Aging Study, a cohort of older U.S. men. METHODS. We used two self-reported measures of stress appraisal-a self-report of stress related to their most severe problem and the Perceived Stress Scale (PSS). Indices of lead exposure were blood lead and bone (tibia and patella) lead. RESULTS. Participants with higher self-reported stress had lower MMSE scores, which were adjusted for age, education, computer experience, English as a first language, smoking, and alcohol intake. In multivariable-adjusted tests for interaction, those with higher PSS scores had a 0.57-point lower (95% confidence interval, -0.90 to 0.24) MMSE score for a 2-fold increase in blood lead than did those with lower PSS scores. In addition, the combination of high PSS scores and high blood lead categories on one or both was associated with a 0.05-0.08 reduction on the MMSE for each year of age compared with those with low PSS score and blood lead level (p < 0.05). CONCLUSIONS. Psychological stress had an independent inverse association with cognition and also modified the relationship between lead exposure and cognitive performance among older men. Furthermore, high stress and lead together modified the association between age and cognition.National Institutes of Health (R01ES07821, R01HL080674, R01HL080674-02S1, R01ES013744, ES05257-06A1, P20MD000501, P42ES05947, ES03918-02); National Center for Research Resources General Clinical Research Center (M01RR02635); Leaves of Grass Foundation; United States Department of Veterans Affair

Short Term Psychodynamic Psychotherapy (STPP) for Clients with Complex and Enduring Difficulties within NHS Mental Health Services:A Case Series

Short Term Psychodynamic Psychotherapy (STPP) has been demonstrated as an effective treatment for several mental health difficulties. However, its implementation in secondary mental health services in the National Health Service (NHS) is scarce. The aim of this study was to bridge the gap between controlled trials and practice-based evidence, by exploring an initial estimate of the therapeutic effects of this intervention as well as its safety in a secondary care NHS community mental health setting. Method: The study followed a quantitative case series design. Eight clients with complex, enduring mental health difficulties, supported by a community secondary mental health service received a course of STPP. They completed outcome measures at the start, at the end and eight-weeks following completion of therapy. Results: All participants but one completed the therapy and attendance rates were high (>75%). No adverse effects were reported. All participants but two reported improvement in the CORE-OM, BSI and the PHQ-9 and these were maintained at follow-up. Conclusions: The results suggested that STPP was a safe and acceptable intervention, that may have contributed to clinical and reliable improvement for 4 participants, non-reliable improvement for 2 and non-reliable deterioration for one participant who finished the treatment

An integrative perspective on the interplay between early maladaptive schemas and mental health: The role of self-compassion and emotion regulation

Objectives We aimed to test whether negative emotion regulation difficulties and self-compassion mediate the relationship between early maladaptive schemas (EMSs) and symptoms of psychopathology and life satisfaction. Methods Data were collected from 296 adults (179 females, 117 males), whose age ranged from 17 to 52 years. The mediating roles of self-compassion and negative emotion regulation were examined via Hayes' procedure (PROCESS) for multiple mediation. Results Negative emotion regulation was the only mediator to psychopathological symptoms, with no additional role for self-compassion, whereas self-compassion mediated only to life satisfaction, with no additional role for negative emotion regulation. Conclusions The results provide evidence for unique mediating roles of negative emotion regulation and self-compassion, depending on the outcome variable. That helps to understand how problems that may be identified in terms of positive and negative domains are related to EMSs, and allows to put forward potential strategies within the frame of schema therapy

The dose-response effect in routinely delivered psychological therapies: A systematic review

The dose-response effect refers to the relationship between the dose (e.g., length, frequency) of treatment and the subsequent probability of improvement. This systematic review aimed to synthesise the literature on the dose-response effect in routine psychological therapies delivered to adult patients with mental health problems. Twenty-six studies were eligible for inclusion. Different methodological approaches have been used to examine the dose-response effect; including survival analysis, multilevel modelling and descriptive cluster analyses. Replicated and consistent support was found for a curvilinear (log-linear or cubic) relationship between treatment length and outcomes, with few exceptions such as eating disorders and severe psychiatric populations. Optimal doses of psychotherapy in routine settings range between 4 – 26 sessions (4 – 6 for low intensity guided self-help) and vary according to setting, clinical population and outcome measures. Weekly therapy appears to accelerate the rate of improvement compared to less frequent schedules. Most of the reviewed evidence is from university counselling centres and outpatient psychotherapy clinics for common mental health problems. There is scarce and inconclusive evidence in clinical samples with chronic and severe mental disorders

Levels and variables associated with psychological distress during confinement due to the coronavirus pandemic in a community sample of Spanish adults

Due to the COVID-19 pandemic's consequences and the state of alarm, literature has shown that people worldwide have experienced severe stressors that have been associated with increased prevalence of emotional distress. In this study, we explored psychological distress (depression, anxiety, and somatization symptoms) using an online survey platform in a sample of 1,781 Spanish adults during the confinement due to COVID-19, relationships between distress and sleep problems, affect, pain, sleep, emotional regulation, gender, type of housing, history of psychopathology, and living alone during the confinement, and differences depending on demographic and psychological variables. Results showed that between 25% and 39% of the sample referred to clinically significant levels of distress. In addition, women showed higher levels of distress, negative affect, perception of pain, and cognitive reappraisal and lower levels of emotional suppression and sleep quality than men. A history of psychopathology, being younger, living alone or in a flat was associated with higher distress. Finally, the variables most strongly related to distress were negative and positive affect, levels of pain, sleep quality, and emotional suppression. Our results highlight the important role of emotional suppression, cognitive reappraisal, and loneliness and the impact of being a woman and younger in Spain during the COVID-19 pandemic. Therefore, it would be necessary to provide assessments of distress levels in these population groups and focus psychological preventive and therapeutic online interventions on expressing emotions and preventing loneliness

Predicting sexual risk behavior in British and European Union university students in the United Kingdom

Drawing on the Health Adversity Risk Model, this study examines the relationship between mental health and sexual risk behaviors in British and European Union (EU) university students in the United Kingdom. Four hundred and thirty-one undergraduate students completed a cross-sectional survey. Data were analyzed using independent samples t-tests, multiple regression and structural equation modeling. Results showed that female students and British students exhibited higher levels of psychological distress, self-harm and sexual risk behaviors than males and EU students; and that female and EU students were more likely to adopt adaptive coping styles than male and British students, respectively. The structural equation model suggests that the relationship between gender and citizenship and sexual risk-taking is mediated by identity threat, psychological distress, coping styles and self-harm. Adaptive coping styles are not necessarily protective against sexual risk-taking but rather determine the type of sexual risk behavior: re-thinking/planning is associated with volitional risk behaviors and social engagement with non-volitional behaviors. Social and cultural norms may shed light on mental health outcomes and sexual risk-taking in university students

Flow on the Internet: a longitudinal study of Internet addiction symptoms during adolescence

Internet Addiction (IA) constitutes an excessive Internet use behavior with a significant impact on the user’s well-being. Online flow describes the users’ level of being absorbed by their online activity. The present study investigated age-related, gender, and flow effects on IA in adolescence. The sample comprised 648 adolescents who were assessed twice at age 16 and 18 years. IA was assessed using the Internet Addiction Test and online flow was assessed using the Online Flow Questionnaire. A three-level hierarchical model estimated age-related, gender, and online flow effects on IA symptoms and controlled for clustered random effects. IA symptoms decreased over time (for both genders) with a slower rate in males. Online flow was associated with IA symptoms and this remained consistent over time. Findings expand upon the available literature suggesting that IA symptoms could function as a development-related manifestation at the age of 16 years, while IA-related gender differences gradually increase between 16 and 18 years. Finally, the association between online flow and IA symptoms remained stable independent of age-related effects. The study highlights individual differences and provides directions for more targeted prevention and intervention initiatives for IA

Dysfunctions in brain networks supporting empathy: An fMRI study in adults with autism spectrum disorders

The present study aimed at identifying dysfunctions in brain networks that may underlie disturbed empathic behavior in autism spectrum disorders (ASD). During functional magnetic resonance imaging, subjects were asked to identify the emotional state observed in a facial stimulus (other-task) or to evaluate their own emotional response (self-task). Behaviorally, ASD subjects performed equally to the control group during the other-task, but showed less emotionally congruent responses in the self-task. Activations in brain regions related to theory of mind were observed in both groups. Activations of the medial prefrontal cortex (MPFC) were located in dorsal subregions in ASD subjects and in ventral areas in control subjects. During the self-task, ASD subjects activated an additional network of frontal and inferior temporal areas. Frontal areas previously associated with the human mirror system were activated in both tasks in control subjects, while ASD subjects recruited these areas during the self-task only. Activations in the ventral MPFC may provide the basis for one's “emotional bond” with other persons’ emotions. Such atypical patterns of activation may underlie disturbed empathy in individuals with ASD. Subjects with ASD may use an atypical cognitive strategy to gain access to their own emotional state in response to other people's emotions