Self-distancing and Avoidance Mediate the Links Between Trait Mindfulness and Responses to Emotional Challenges

Objectives Mindfulness has been linked to better emotion regulation and more adaptive responses to stress across a number of studies, but the mechanisms underlying these links remain to be fully understood. The present study examines links between trait mindfulness (Five Facets of Mindfulness Questionnaire; FFMQ) and participants\u27 responses to common emotional challenges, focusing specifically on the roles of reduced avoidance and more self-distanced engagement as key potential mechanisms driving the adaptive benefits of trait mindfulness. Methods Adults (n = 305, age range: 40-72) from the Second Generation Study of the Harvard Study of Adult Development completed two laboratory-based challenges-public speaking combined with difficult math tasks (the Trier Social Stress Test) and writing about a memory of a difficult moment. State anxiety and sadness were assessed immediately before and after the two stressors. To capture different ways of engaging, measures of self-distancing, avoidance, and persistent worry were collected during the lab session. Results As predicted, individuals who scored higher on the FFMQ experienced less anxiety and persistent worry in response to the social stressors. The FFMQ was also linked to less anxiety and sadness when writing about a difficult moment. The links between mindfulness and negative emotions after the writing task were independently mediated by self-distanced engagement and lower avoidance. Conclusions Affective benefits of trait mindfulness under stress are associated with both the degree and the nature of emotional engagement. Specifically, reduced avoidance and self-distanced engagement may facilitate reflection on negative experiences that is less affectively aversive

Coherence Between Feelings and Heart Rate: Links to Early Adversity and Responses to Stress

Past research suggests that higher coherence between feelings and physiology under stress may confer regulatory advantages. Research and theory also suggest that higher resting vagal tone (rVT) may promote more adaptive responses to stress. The present study examines the roles of response system coherence (RSC; defined as the within-individual covariation between feelings and heart rate over time) and rVT in mediating the links between childhood adversity and later-life responses to acute stressors. Using data from 279 adults from the Second Generation Study of the Harvard Study of Adult Development who completed stressful public speaking and mental arithmetic tasks, we find that individuals who report more childhood adversity have lower RSC, but not lower rVT. We further find that lower RSC mediates the association between adversity and slower cardiovascular recovery. Higher rVT in the present study is linked to less intense cardiovascular reactivity to stress, but not to quicker recovery or to the subjective experience of negative affect after the stressful tasks. Additional analyses indicate links between RSC and mindfulness and replicate previous findings connecting RSC to emotion regulation and well-being outcomes. Taken together, these findings are consistent with the idea that uncoupling between physiological and emotional streams of affective experiences may be one of the mechanisms connecting early adversity to later-life affective responses. These findings also provide evidence that RSC and rVT are associated with distinct aspects of self-regulation under stress. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s42761-020-00027-5

Design and baseline characteristics of the finerenone in reducing cardiovascular mortality and morbidity in diabetic kidney disease trial

Background: Among people with diabetes, those with kidney disease have exceptionally high rates of cardiovascular (CV) morbidity and mortality and progression of their underlying kidney disease. Finerenone is a novel, nonsteroidal, selective mineralocorticoid receptor antagonist that has shown to reduce albuminuria in type 2 diabetes (T2D) patients with chronic kidney disease (CKD) while revealing only a low risk of hyperkalemia. However, the effect of finerenone on CV and renal outcomes has not yet been investigated in long-term trials. Patients and Methods: The Finerenone in Reducing CV Mortality and Morbidity in Diabetic Kidney Disease (FIGARO-DKD) trial aims to assess the efficacy and safety of finerenone compared to placebo at reducing clinically important CV and renal outcomes in T2D patients with CKD. FIGARO-DKD is a randomized, double-blind, placebo-controlled, parallel-group, event-driven trial running in 47 countries with an expected duration of approximately 6 years. FIGARO-DKD randomized 7,437 patients with an estimated glomerular filtration rate >= 25 mL/min/1.73 m(2) and albuminuria (urinary albumin-to-creatinine ratio >= 30 to <= 5,000 mg/g). The study has at least 90% power to detect a 20% reduction in the risk of the primary outcome (overall two-sided significance level alpha = 0.05), the composite of time to first occurrence of CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. Conclusions: FIGARO-DKD will determine whether an optimally treated cohort of T2D patients with CKD at high risk of CV and renal events will experience cardiorenal benefits with the addition of finerenone to their treatment regimen. Trial Registration: EudraCT number: 2015-000950-39; ClinicalTrials.gov identifier: NCT02545049

Evacetrapib and Cardiovascular Outcomes in High-Risk Vascular Disease

BACKGROUND: The cholesteryl ester transfer protein inhibitor evacetrapib substantially raises the high-density lipoprotein (HDL) cholesterol level, reduces the low-density lipoprotein (LDL) cholesterol level, and enhances cellular cholesterol efflux capacity. We sought to determine the effect of evacetrapib on major adverse cardiovascular outcomes in patients with high-risk vascular disease. METHODS: In a multicenter, randomized, double-blind, placebo-controlled phase 3 trial, we enrolled 12,092 patients who had at least one of the following conditions: an acute coronary syndrome within the previous 30 to 365 days, cerebrovascular atherosclerotic disease, peripheral vascular arterial disease, or diabetes mellitus with coronary artery disease. Patients were randomly assigned to receive either evacetrapib at a dose of 130 mg or matching placebo, administered daily, in addition to standard medical therapy. The primary efficacy end point was the first occurrence of any component of the composite of death from cardiovascular causes, myocardial infarction, stroke, coronary revascularization, or hospitalization for unstable angina. RESULTS: At 3 months, a 31.1% decrease in the mean LDL cholesterol level was observed with evacetrapib versus a 6.0% increase with placebo, and a 133.2% increase in the mean HDL cholesterol level was seen with evacetrapib versus a 1.6% increase with placebo. After 1363 of the planned 1670 primary end-point events had occurred, the data and safety monitoring board recommended that the trial be terminated early because of a lack of efficacy. After a median of 26 months of evacetrapib or placebo, a primary end-point event occurred in 12.9% of the patients in the evacetrapib group and in 12.8% of those in the placebo group (hazard ratio, 1.01; 95% confidence interval, 0.91 to 1.11; P=0.91). CONCLUSIONS: Although the cholesteryl ester transfer protein inhibitor evacetrapib had favorable effects on established lipid biomarkers, treatment with evacetrapib did not result in a lower rate of cardiovascular events than placebo among patients with high-risk vascular disease. (Funded by Eli Lilly; ACCELERATE ClinicalTrials.gov number, NCT01687998 .)

Prevalence of and risk factors associated with atherosclerosis in psittacine birds

OBJECTIVE: To estimate the prevalence of clinically relevant atherosclerotic lesions in birds and identify epidemiological variables and illness types associated with development of atherosclerosis. DESIGN: Retrospective case-control study. SAMPLE: Records of 7683 psittacine birds, including 525 with advanced atherosclerosis. PROCEDURES: 5 pathology centers provided databases and access to histopathology slides. Age and sex were collected for all birds of the Amazona, Ara, Cacatua, Nymphicus, and Psittacus genera. Databases were searched for atherosclerosis cases, and slides were reviewed for the presence of type IV through VI atherosclerotic lesions. Results were used to build several multiple logistic models to define the association between advanced atherosclerosis and age, sex, genus, illness type, and specific lesions. Prevalence was reported as a function of age, sex, and genus. RESULTS: In the first model including 7683 birds, age, female sex, and the genera Psittacus, Amazona, and Nymphicus were significantly associated with clinically relevant atherosclerosis detected via necropsy. Subsequent models of 1,050 cases revealed further associations with reproductive disease, hepatic disease, and myocardial fibrosis, controlling for age, sex, and genus. CONCLUSIONS AND CLINICAL RELEVANCE: Age, female sex, and 3 genera appeared to be positively associated with the presence of advanced atherosclerotic lesions in psittacine birds. This information may be useful in clinical assessment of the cardiovascular system and patient management. Reproductive diseases were the only potentially modifiable risk factor identified and could be a target for prevention in captive psittacine birds

Is There Intergenerational Continuity in Early Life Experiences? Findings from the Harvard Study of Adult Development

As research continues to elucidate the impact of early life experiences on later life outcomes, there has been increased interest in understanding why some individuals have optimal early life experiences, whereas others do not. Prior work has considered the correlates and impact of early life experiences within a person’s lifetime, yet we know little about whether early life experiences are sustained across generations. We use multi-generational data from 1,312 offspring and their fathers (N = 518 families), who were followed for 70+ years, to understand the extent to which there is intergenerational continuity in multiple domains of early life experience (childhood social class, childhood home atmosphere, parent-child relationship quality, childhood health); whether intergenerational continuity is greater for some domains of early life experience than others; and if there are person-level (offspring sex and birth order) and family-level factors (family size, father education level and education mobility) that strengthen (or weaken) intergenerational continuity. Multilevel models showed that, at the aggregate level, fathers who had better early life experiences overall tended to have children with better early life experiences. This intergenerational continuity was particularly robust for childhood social class, and non-significant for the other domains of early life experiences. Moreover, the intergenerational continuity of early life experiences was moderated by father education level and education mobility, such that low education level conferred risks, and upward education mobility conferred benefits, for offspring’s early life experiences. We discuss the broader theoretical and practical significance of the findings for future interventions and social policy

Is There Intergenerational Continuity in Early Experiences? Findings from the Harvard Study of Adult Development

As research continues to elucidate the impact of early life experiences on later life outcomes, there has been increased interest in understanding why some individuals have optimal early life experiences, whereas others do not. Prior work has considered the correlates and impact of early life experiences within a person’s lifetime, yet we know little about whether early life experiences are sustained across generations. We use multi-generational data from 1,312 offspring and their fathers (N = 518 families), who were followed for 70+ years, to understand the extent to which there is intergenerational continuity in multiple domains of early life experience (childhood social class, childhood home atmosphere, parent-child relationship quality, childhood health); whether intergenerational continuity is greater for some domains of early life experience than others; and if there are person-level (offspring sex and birth order) and family-level factors (family size, father education level and education mobility) that strengthen (or weaken) intergenerational continuity. Multilevel models showed that, at the aggregate level, fathers who had better early life experiences overall tended to have children with better early life experiences. This intergenerational continuity was particularly robust for childhood social class, and non-significant for the other domains of early life experiences. Moreover, the intergenerational continuity of early life experiences was moderated by father education level and education mobility, such that low education level conferred risks, and upward education mobility conferred benefits, for offspring’s early life experiences. We discuss the broader theoretical and practical significance of the findings for future interventions and social policy

Is There Intergenerational Continuity in Early Life Experiences? Findings From the Harvard Study of Adult Development

There has been longstanding and widespread interdisciplinary interest in understanding intergenerational processes, or the extent to which conditions repeat themselves across generations. However, due to the difficulty of collecting longitudinal, multigenerational data on early life conditions, less is known about the extent to which offspring experience the same early life conditions that their parents experienced in their own early lives. Using data from a socioeconomically diverse, White U.S. American cohort of 1,312 offspring (50% female) and their fathers (N = 518 families), we address three primary questions: (1) To what extent is there intergenerational continuity in early life experiences (social class, home atmosphere, parent-child relationship quality, health)? (2) Is intergenerational continuity in early life experiences greater for some domains of experience compared to others? and (3) Are there person-level (offspring sex, birth order, perceptions of marital stability) and family-level factors (family size, father education level and education mobility, marital stability) that moderate intergenerational continuity? Multilevel models indicated that intergenerational continuity was particularly robust for childhood social class, but nonsignificant for other early life experiences. Further, intergenerational continuity was moderated by several family-level factors, such that families with higher father education/mobility and marital stability, tended to have offspring with the most optimal early life experiences, regardless of what their father experienced in early life. We discuss the broader theoretical implications for family systems, as well as practical implications for individual-level and family-level interventions. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Aim 1

Aim 1 is to: • First, obtain municipal, state and federal administrative data on participants in 3 Boston-based longitudinal studies, and their siblings. From data sources including vital statistics, census, military records, and public records on lead piping and lead smelter locations, we will acquire prospective data on early-life context, including family-of-origin and neighborhood socioeconomic status (SES), family composition, lead exposure, and birth-related information (e.g., birth weight), and later-life health (e.g., mortality; siblings only). • Second, we will test hypotheses on the enduring impact of early adversity in participants and their siblings