Internalizing Mental Health Disorders and Emotion Regulation: A Comparative and Mediational Study of Older Adults With and Without a History of Complex Trauma Exposure

Individuals with complex trauma exposure (CTE) in early life (i.e., childhood/adolescence) are at heightened risk for developing problems in various domains of functioning. As such, CTE has repeatedly been linked to internalizing mental health disorders, such as depression and anxiety, as well as emotion dysregulation across the lifespan. While these correlates of CTE are comparatively well studied up to middle adulthood, they are insufficiently studied in older adulthood. Therefore, this study aimed to (a) compare Swiss older adults with and without a CTE history regarding current and lifetime internalizing mental health disorders and emotion regulation strategies; and (b) to examine the potential mediating role of emotion regulation in the mental health disparities between these groups. A total of N = 257 participants (age = 49–95 years; 46.3% female) were assessed in a retrospective, cross-sectional study, using two face-to-face interviews. The CTE group (n = 161; M$_{age}$ = 69.66 years, 48.4% female) presented with significantly more current and lifetime internalizing mental health disorders than the non-affected (nCTE) group (n = 96; M$_{age}$ = 72.49 years, 42.7% female). The CTE group showed significantly higher emotion suppression and lower emotion reappraisal compared to the nCTE group. Mediation analysis revealed that the two emotion regulation strategies were significant mediators between CTE history and internalizing mental health disorders. Findings emphasize the relevance of emotion (dys-)regulation in understanding mental health disparities in older age and deciding about treatment strategies. Research and practice should pay more attention to the needs of this high-risk group of older individuals

Associations Between Complex Trauma Exposure in Childhood/Adolescence and Psychopathology in Older Age: The Role of Stress Coping and Coping Self-Perception

Complex trauma exposure in childhood and/or adolescence is common and has repeatedly been linked to mental ill-health across the lifespan. While the correlates of complex trauma and mental health are well-studied in individuals up to middle adulthood, correlates in older adulthood, as well as potential mediators of this relationship, such as stress coping, are insufficiently studied. Therefore, this study aimed to (a) examine the mental health of Swiss older adults affected by complex trauma exposure in childhood and/or adolescence, in comparison to non-affected individuals; and (b) to examine the potential mediating role of coping strategies and coping self-perception. Data from N = 257 participants (complex trauma [CT] group: n = 161; M age = 69.66 years, 48.4% female; non-complex trauma [nCT] group: n = 96; M age = 72.49 years, 42.7% female) were assessed using self-report questionnaires and a clinical interview. The CT group presented with significantly more current and lifetime mental health disorders, more disadvantageous coping strategies, and significantly lower coping self-perception, compared to the nCT group. Mediation analyses revealed that maladaptive coping and coping self-perception were relevant mediators of the relationship between complex trauma exposure and psychopathology. Results suggest that complex trauma exposure in childhood and/or adolescence can have a lasting impact on mental health in later life and can be negatively associated with stress coping. Findings emphasize the relevance of a lifespan perspective in research and clinical practice for addressing consequences of complex trauma exposure. Keywords: Adolescence; Childhood; Complex trauma exposure; Coping self-perception; Mental health; Older adults; Stress coping

Small-Animal PET Imaging of Amyloid-Beta Plaques with [11C]PiB and Its Multi-Modal Validation in an APP/PS1 Mouse Model of Alzheimer's Disease

In vivo imaging and quantification of amyloid-β plaque (Aβ) burden in small-animal models of Alzheimer's disease (AD) is a valuable tool for translational research such as developing specific imaging markers and monitoring new therapy approaches. Methodological constraints such as image resolution of positron emission tomography (PET) and lack of suitable AD models have limited the feasibility of PET in mice. In this study, we evaluated a feasible protocol for PET imaging of Aβ in mouse brain with [11C]PiB and specific activities commonly used in human studies. In vivo mouse brain MRI for anatomical reference was acquired with a clinical 1.5 T system. A recently characterized APP/PS1 mouse was employed to measure Aβ at different disease stages in homozygous and hemizygous animals. We performed multi-modal cross-validations for the PET results with ex vivo and in vitro methodologies, including regional brain biodistribution, multi-label digital autoradiography, protein quantification with ELISA, fluorescence microscopy, semi-automated histological quantification and radioligand binding assays. Specific [11C]PiB uptake in individual brain regions with Aβ deposition was demonstrated and validated in all animals of the study cohort including homozygous AD animals as young as nine months. Corresponding to the extent of Aβ pathology, old homozygous AD animals (21 months) showed the highest uptake followed by old hemizygous (23 months) and young homozygous mice (9 months). In all AD age groups the cerebellum was shown to be suitable as an intracerebral reference region. PET results were cross-validated and consistent with all applied ex vivo and in vitro methodologies. The results confirm that the experimental setup for non-invasive [11C]PiB imaging of Aβ in the APP/PS1 mice provides a feasible, reproducible and robust protocol for small-animal Aβ imaging. It allows longitudinal imaging studies with follow-up periods of approximately one and a half years and provides a foundation for translational Alzheimer neuroimaging in transgenic mice

Einfluss der Cochlea-Implantat-Versorgung auf Sprachverstehen, Lebensqualität, Tinnitusbelastung und Komorbiditäten von Patienten mit bilateraler CI-Versorgung

Ziel: Das Ziel dieser prospektiven Studie war es, den Einfluss der bilateralen Cochlea-Implantat (CI)-Versorgung auf Sprachverstehen, Lebensqualität, Tinnitusbelastung sowie psychische Komorbiditäten von bilateral ertaubten Patienten zu untersuchen. Besonderes Augenmerk lag dabei auf der Evaluation des zusätzlichen Nutzens eines zweiten CIs. Methodik: 22 postlingual ertaubte Erwachsene wurden zwischen 2009 und 2016 sequentiell bilateral mit einem Multichannel-CI versorgt. Die Datenerhebung erfolgte präoperativ, ein halbes Jahr nach der ersten Implantation sowie nach der kontralateralen Versorgung mit Hilfe sprachaudiometrischer Verfahren (Freiburger Einsilbertest (FE) und Oldenburger Satztest (OLSA)) und dem Einsatz validierter Fragebögen (Oldenburger-Inventar (OI), Nijmegen Cochlear Implant Questionnaire (NCIQ), Medical Outcomes Study Short Form-36 (SF-36), Tinnitus-Fragebogen nach Goebel und Hiller (TF), Perceived Stress Questionnaire (PSQ), Brief-COPE, Allgemeine Depressionsskala (ADS-L) und General Anxiety Disorder-7 (GAD-7)). Ergebnisse: Das Sprachverstehen in Ruhe und im Störgeräusch verbesserte sich sowohl nach der ersten als auch der zweiten Implantation signifikant. Die Messung der binauralen Effekte ergab signifikante Verbesserungen durch den Kopfschatteneffekt von 11,2 dB und durch den Summationseffekt von 1,4 dB. Ein Squelch-Effekt ließ sich mit einer Abnahme von -0,7 dB nach bilateraler CI-Versorgung hingegen nicht nachweisen. Die mit dem NCIQ erfasste krankheitsspezifische Lebensqualität nahm nach beiden Operationen jeweils signifikant zu. Nach der zweiten Implantation verbesserten sich sowohl die hörspezifischen Aspekte (NCIQ 1 = elementare Schallwahrnehmung; NCIQ 2 = erweiterte Schallwahrnehmung) als auch die psychische (NCIQ 4 = Selbstwertgefühl) und soziale Funktionsfähigkeit (NCIQ 5 = Aktivität; NCIQ 6 = soziale Interaktion) signifikant im Vergleich zur ersten Implantation. Die Tinnitusbelastung im TF nahm nach der ersten Operation signifikant ab und blieb nach der zweiten Operation konstant. Trotz der im PSQ unauffälligen Stressbelastung kam es nach bilateraler Implantation zu einem signifikant reduzierten Anwenden der Bewältigungsstrategien „Support Coping“ und „Focus on positive“ im Brief-COPE. Die Gesamtwerte zur Beurteilung depressiver Symptome und generalisierter Angststörungen lagen sowohl vor als auch nach den Implantationen im Referenzbereich der Normalbevölkerung und zeigten keine signifikanten Veränderungen. Schlussfolgerung: Der zusätzliche Nutzen eines zweiten CIs umfasst neben der Verbesserung des Sprachverstehens vor allem auch eine gesteigerte psychische und soziale Funktionsfähigkeit. Die vorliegende Studie zeigt, dass die bilaterale CI-Versorgung eine effektive Möglichkeit der Hörrehabilitation für bilateral ertaubte Patienten darstellt und sie in vielen Bereichen von einem zweiten CI profitieren.Objective: The objective of this prospective study was to investigate the influence of bilateral cochlear implantation on speech perception, quality of life, tinnitus burden and psychological comorbidities in bilaterally deaf patients. This study focused on the assessment of the additional benefit of a second CI. Methods: 22 postlingually deafened adults were sequentially bilaterally provided with a multichannel-CI between 2009 and 2016. Data were collected before, 6 months after the first implantation and after the contralateral implantation by performing speech audiometric tests (Freiburg Monosyllabic Test and Oldenburg Sentence Test) and using validated questionnaires (Oldenburg Inventory (OI), Nijmegen Cochlear Implant Questionnaire (NCIQ), Medical Outcomes Study Short Form-36 (SF-36), Tinnitus Questionnaire by Goebel and Hiller, Perceived Stress Questionnaire (PSQ), COPE Inventory, Depression Scale and General Anxiety Disorder-7 (GAD-7)). Results: Speech perception in quiet and in noise improved significantly both after the first and the second implantation. The measurement of binaural effects showed significant improvements by the head shadow effect of 11,2 dB as well as by the summation effect of 1,4 dB. A squelch effect couldn’t be demonstrated with a decrease of -0,7 dB after bilateral CI. The disease-specific quality of life, which was assessed with the NCIQ, significantly increased after each of the two operations. After the second implantation not only the hearing specific aspects (NCIQ 1 = Elementary sound perception; NCIQ 2 = Advanced sound perception), but in particular the psychological (NCIQ 4 = Self-esteem) and social functioning (NCIQ 5 = Activity; NCIQ 6 = Social interaction) significantly increased compared to the first implantation. A significant reduction of tinnitus burden in the TQ was observed after the first surgery and remained constant after the second one. Despite the fact, that there was no enhanced level of perceived stress in the PSQ after the second implantation, the coping strategies “Support Coping” and “Focus on positive” were used significantly less according to the Brief-COPE. The total scores for assessing depressive symptoms and generalized anxiety disorders were both before and after the implantations within reference range of the general population and didn’t show any significant changes. Conclusion: The additional benefit of a second CI comprises apart from the improvements of speech perception especially an increase of psychological and social functionality. This study shows that bilateral cochlear implantation is an effective way of hearing rehabilitation in bilaterally deaf patients and that they benefit in many fields from a second CI

Development and Psychometric Evaluation of the Reactions to Somatic Stress Questionnaire (RSSQ)

Background: Stress is a ubiquitous phenomenon in modern societies and is often accompanied by somatic sensations and symptoms, such as tension and nausea. Despite the inherent somatic component of stress, research on coping with stress has previously neglected to consider how somatic stress responses (i.e., somatic stress) may affect stress-coping behavior. Aim: To address this gap in the literature, this study introduces the concept of reactions to somatic stress (RSS). It also provides the first psychometric evaluation of the Reactions to Somatic Stress Questionnaire (RSSQ), a novel 16-item questionnaire that assesses hampering and facilitating RSS. Method: The RSSQ and a battery of questionnaires on related constructs were administered via an online survey to N = 265 participants from the general population. Results: Exploratory ( n = 133) and confirmatory ( n = 132) factor analyses yielded two dimensions of the RSSQ: Hampering RSS (RSS-H) and facilitating RSS (RSS-F). Both subscales showed good internal consistency (α = .81–.89). Correlations with body awareness, emotion regulation skills, and beliefs about stress indicated medium to high convergent and discriminant validity. The RSS-H and RSS-F scores significantly predicted maladaptive and adaptive coping behavior, respectively. This association remained stable after controlling for subjective stress and related measures. Limitations: Generalization of the obtained results is limited to healthy individuals. Conclusion: The study supports the theoretical assumptions underlying the RSS concept. The RSSQ suggests a promising way to assess reactions to somatic stress as they relate to coping with stress. The RSSQ could be used for clinical and health psychological testing or interdisciplinary research

Single-centre experience and practical considerations of the benefit of a second cochlear implant in bilaterally deaf adults

Purpose: Bilateral cochlear implant (CI) implantation is increasingly used in the auditory rehabilitation of bilaterally deafened adults. However, after successful unilateral implantation, objective patient counselling is essential. Methods: We investigated the extra benefit of a second CI in adults in terms of health-related quality of life, tinnitus, stress, anxiety, depression, quality of hearing, and speech recognition. Hearing ability was assessed by using the Freiburg monosyllable speech discrimination test (FB MS) and the Oldenburg sentence test with azimuth variations. In a prospective patient cohort, we administered validated questionnaires before a CI, after a first CI and after a second CI implantation. Results: The study included 29 patients, made up of nine women and 20 men. The median time between the first and the second implantation was 23 months. The mean total NCIQ score and TQ before a CI improved significantly after both implantations. Stress, anxiety, and depression were stable over time and were not significantly affected by CI implantations. Speech recognition with noise significantly improved after the first and again after the second CI. Correlation analysis showed a strong connection between auditory performance and HRQoL. Conclusion: We demonstrated that a unilateral CI benefitted many fields and that the second sequential CI leads again to additional improvement. Bilateral CI implantation should, therefore, be the standard form of auditory rehabilitation in deafened adults

Influence of copolymer composition of polylactide implants on cranial bone regeneration

Biodegradable polymers have become useful auxiliary materials for the functional and structural restoration of bone deficiencies. Commercial implants from poly(l/dl-lactide) 70:30 are used clinically for fracture fixation in regions of low load. Implants manufactured from poly(l/dl-lactide) 80:20 are currently being investigated experimentally. The higher degree of crystallinity results in a higher chemical strength and loading capacity which promises advantages for long-term implantation. In this study implants from these two copolymers were applied to promote bone regeneration of bilateral, full thickness, circular cranial defects in 16 adult New Zealand white rabbits. The defects were covered with melt extruded and laser cut polylactide burr hole covers epicranially and endocranially in direct contact to the dura. The defect spaces were kept open with a spacer which created a hollow chamber. Both materials were implanted in each animal. Bone seeking fluorochromes were used to assess the pattern of bone growth. After eight weeks bone regeneration in the defects was assessed radiologically, histologically and by fluorescence microscopy. During the eight weeks observation period the application of a hollow chamber design resulted in almost complete cranial defect healing, whereby the copolymer composition had no effect on the amount or the morphology of the regenerate. The dura mater showed no adverse tissue reactions during these early stages of implantation. Eight weeks is only a short period in the lifetime of the tested polymers and complete bone regeneration can only be expected after complete polymer degradation. Long-term studies or accelerated degradation studies are required to confirm the expected advantages of poly(l/dl-lactide) 80:20. textcopyright 2005 Elsevier Ltd. All rights reserved

Prevalence of mental disorders among detained asylum seekers in deportation arrest in Switzerland and validation of the Brief Jail Mental Health Screen BJMHS

Background: Though slowly growing, knowledge about prisoners detained for having violated an Alien Act is still marginal and most studies involve detained asylum seekers in the USA and Australia. Little is known about prevalence rates of mental health disorders in such a population. The Brief Jail Mental Health Screening BJMHS has been demonstrated in other prison populations as a valid screening for serious mental illness. Aim: The aims of this study were to describe prevalence rates for mental disorders according to ICD-10 and to validate the BJMHS for this population. Methods: 80 inmates at a detention center for prisoners having violated the Swiss Aliens Act were surveyed using the BJMHS at their admission. The results were cross validated with the WHO Composite International Diagnostic Interview (CIDI). Results: When omitting disorders caused by smoking tobacco, 76% of the prisoners suffered from at least one mental disorder according to CIDI. Whereas the rates for disorders due to psychoactive substance use as well as schizophrenic and affective disorders were comparable with other prison populations, we found a specific increased reporting of phobic (14%) and post-traumatic stress disorders (23%).The BJMHS detected serious mental illness defined as schizophrenic or affective disorders with a sensitivity of 81.0% and a specificity of 74.6%. Discussion: As in other prison populations prevalence rates for mental disorders were markedly above the general population. The specific pattern with high rates of phobic as well as post-traumatic stress disorders may reflect the very often traumatic backgrounds of this population. Whereas the results for the validation of the BJMHS were even better than in other similar studies and the instrument proved to be practicable and helpful to detect serious mental illness, sensitivity for a screening tool of around 80% is still too low. Additionally the fact that other serious mental disorders are not covered emphasizes the importance of other elements in the screening process, including the need to have well-trained staff, and to have a low threshold for psychiatric examinatio

Prevalence of mental disorders among detained asylum seekers in deportation arrest in Switzerland and validation of the Brief Jail Mental Health Screen BJMHS

Background: Though slowly growing, knowledge about prisoners detained for having violated an Alien Act is still marginal and most studies involve detained asylum seekers in the USA and Australia. Little is known about prevalence rates of mental health disorders in such a population. The Brief Jail Mental Health Screening BJMHS has been demonstrated in other prison populations as a valid screening for serious mental illness. Aim: The aims of this study were to describe prevalence rates for mental disorders according to ICD-10 and to validate the BJMHS for this population. Methods: 80 inmates at a detention center for prisoners having violated the Swiss Aliens Act were surveyed using the BJMHS at their admission. The results were cross validated with the WHO Composite International Diagnostic Interview (CIDI). Results: When omitting disorders caused by smoking tobacco, 76% of the prisoners suffered from at least one mental disorder according to CIDI. Whereas the rates for disorders due to psychoactive substance use as well as schizophrenic and affective disorders were comparable with other prison populations, we found a specific increased reporting of phobic (14%) and post-traumatic stress disorders (23%).The BJMHS detected serious mental illness defined as schizophrenic or affective disorders with a sensitivity of 81.0% and a specificity of 74.6%. Discussion: As in other prison populations prevalence rates for mental disorders were markedly above the general population. The specific pattern with high rates of phobic as well as post-traumatic stress disorders may reflect the very often traumatic backgrounds of this population. Whereas the results for the validation of the BJMHS were even better than in other similar studies and the instrument proved to be practicable and helpful to detect serious mental illness, sensitivity for a screening tool of around 80% is still too low. Additionally the fact that other serious mental disorders are not covered emphasizes the importance of other elements in the screening process, including the need to have well-trained staff, and to have a low threshold for psychiatric examinatio