Longitudinal pathway from violence exposure to firearm carriage among adolescents: The role of future expectation

IntroductionExposure to violence is a risk factor for firearm carriage. Youth exposed to violence also have difficulty envisioning positive future outcomes (e.g., educational outcomes), which can increase the likelihood of firearm carriage over time. Researchers, however, have not yet examined whether changes in exposure to violence over time can influence the developmental trajectories of firearm carriage. To address this gap, we (1) examined the longitudinal association between exposure to violence and firearm carriage (grades 9 to 12) and then (2) examined whether changes in future expectations mediated this longitudinal association.MethodThe longitudinal association between exposure to violence and firearm carriage through future expectations was examined among 850 adolescents from the Flint Adolescent Study. Participants were recruited from four high schools in a midwestern city in the United States. Parallel latent growth models and latent growth mediation models were estimated.ResultsA positive association was observed between the rate of change in exposure to violence and firearm carriage. Exposure to violence also indirectly increased the risk for firearm carriage over time by decreasing future expectation in the 9th grade.ConclusionsOur results support the idea that helping youth develop positive attitude about educational success may help reduce firearm carriage. Increasing positive expectations about future may help prevent firearm carriage within the context of violence exposure.     

Qualitative evidence for Resilience,Stress, and Ethnicity (RiSE): A program to address race-based stress among Black women at risk for cardiovascular disease

ObjectiveGrowing evidence demonstrates that perceived discrimination and racism are significant contributing factors to psychological distress, low-grade chronic inflammation, and cardiovascular health disparities among minorities, particularly among Black women. Despite this evidence, there are no evidence-based complementary therapy interventions available to ameliorate chronic stress associated with racism and discrimination. The purpose of this study was to examine the feasibility and effectiveness of a novel, 8-week, group-based stress reduction program, Resilience, Stress and Ethnicity (RiSE), designed to help Black women at risk for cardiovascular disease (CVD) develop effective coping skills for dealing with chronic stress uniquely associated with being a minority.MethodsWe conducted two semi-structured focus groups with Black women (N = 22) following their participation in the 8-week RiSE program. We analyzed the data using constant comparative qualitative methods.ResultsAttrition rate was low (13%) with all participants attending at least 6 of the 8 classes. Participants reported high levels of satisfaction with the program and the majority (81%) reported practicing the skills that they learned in real-life stressful situations. In describing the participants’ response to the program, four key categories emerged from the data: (1) Increasing awareness of stressors associated with perceived discrimination and racism; (2) Coping with race-based stressors; (3) Coping with other sources of stress; and (4) Increasing sense of empowerment and emotion regulation.ConclusionsFindings suggest that RiSE is feasible and effective in helping Black women at risk for CVD cope with chronic stress associated with being a minority. Given evidence that perceived discrimination and racism are underlying factors in many inflammatory-based chronic diseases, this research may have broader implications for reducing health disparities across a wide-spectrum of chronic illnesses in which women minorities are disproportionately affected.     

癌症患者心理韧性质性研究的系统评价

目的 系统评价有关癌症患者心理韧性发展的真实体验,为更好地制定心理韧性干预方案提供理论依据。方法 计算机检索Cochrane Library、Medline、CINAHL、Embase、PubMed、Web of Science、Psyc INFO以及中国生物医学文献数据库、中国知网、维普、万方数据库从建库至2019年6月相关的质性研究。采用澳大利亚乔安娜布里格斯研究所循证卫生保健中心质性研究质量评价标准（2016）对文献进行评价,采用汇集性整合方法进行结果整合。结果 共纳入10篇文献,提炼42个明确的结果,形成8个类别,汇总成3个整合结果。①心理韧性发展是动态循环的过程：危机负性期,调节成长期,积极转化期,循环强化期;②心理韧性的阻碍因素：个体（消极应对,错误认知,症状和体象困扰）,环境（传统社会文化,医疗环境,家庭负担）;③心理韧性的保护因素：个体（积极心理与应对方式,复原经历,宗教信仰,自我表露,利他主义与行为）,环境（家庭因素,医疗照护,人际支持）。结论 心理韧性的发展是动态循环过程,受个体和环境因素影响,医护人员应根据不同阶段的影响因素给予针对性护理措施,促进患者心理韧性的形成和发展,提高患者的生活质量。     

Gestational poly(I:C) attenuates,not exacerbates,the behavioral,cytokine and mTOR changes caused by isolation rearing in a rat ‘dual-hit’ model for neurodevelopmental disorders

Many psychiatric illnesses have a multifactorial etiology involving genetic and environmental risk factors that trigger persistent neurodevelopmental impairments. Several risk factors have been individually replicated in rodents, to understand disease mechanisms and evaluate novel treatments, particularly for poorly-managed negative and cognitive symptoms. However, the complex interplay between various factors remains unclear. Rodent dual-hit neurodevelopmental models offer vital opportunities to examine this and explore new strategies for early therapeutic intervention. This study combined gestational administration of polyinosinic:polycytidylic acid (poly(I:C); PIC, to mimic viral infection during pregnancy) with post-weaning isolation of resulting offspring (to mirror adolescent social adversity). After in vitro and in vivo studies required for laboratory-specific PIC characterization and optimization, we administered 10 mg/kg i.p. PIC potassium salt to time-mated Lister hooded dams on gestational day 15. This induced transient hypothermia, sickness behavior and weight loss in the dams, and led to locomotor hyperactivity, elevated striatal cytokine levels, and increased frontal cortical JNK phosphorylation in the offspring at adulthood. Remarkably, instead of exacerbating the well-characterized isolation syndrome, gestational PIC exposure actually protected against a spectrum of isolation-induced behavioral and brain regional changes. Thus isolation reared rats exhibited locomotor hyperactivity, impaired associative memory and reversal learning, elevated hippocampal and frontal cortical cytokine levels, and increased mammalian target of rapamycin (mTOR) activation in the frontal cortex – which were not evident in isolates previously exposed to gestational PIC. Brains from adolescent littermates suggest little contribution of cytokines, mTOR or JNK to early development of the isolation syndrome, or resilience conferred by PIC. But notably hippocampal oxytocin, which can protect against stress, was higher in adolescent PIC-exposed isolates so might contribute to a more favorable outcome. These findings have implications for identifying individuals at risk for disorders like schizophrenia who may benefit from early therapeutic intervention, and justify preclinical assessment of whether adolescent oxytocin manipulations can modulate disease onset or progression.     

Feasibility and efficacy of integrating resiliency training into a pilot nurse residency program

The high stress associated with the nursing profession can negatively affect the health of nurses and the quality of patient care that they provide. This quasi-experimental study aimed to 1) assess the feasibility of integrating a Stress Management and Resiliency Training (SMART) program within a nine-month pilot nurse residency program and 2) assess the effects of the program on participants’ stress, anxiety, mindfulness, and resilience relative to a comparison group. A pre- and post-intervention survey design was used, with measurements taken at baseline and at 1, 3, 9, and 12 months after baseline. We enrolled 51 registered nurses (intervention group, n = 23; comparison group, n = 28) at a Midwestern US academic medical center. Nurses in the intervention group had a participation rate of 93%–100% with SMART program events. Despite the relatively limited adherence to the protocol by intervention group participants, significant improvements were noted for stress (P < .001), mindfulness (P < .001), and resilience (P < .001) in the intervention group compared with the comparison group. The SMART program can potentially be successfully integrated into a nurse residency program and positively impact nurse stress, mindfulness, and resilience. Further research is needed to determine the proper dose of the intervention and methods to enhance adherence.     

心理弹性在直招士官新兵人格稳定性、忧虑性与状态焦虑之间的中介作用

目的 探讨心理弹性在人格因素与状态焦虑之间的中介效应.方法 整群抽取某新兵训练基地直招士官新兵591名,采用心理弹性量表、状态-特质焦虑量表及简化版人格因素问卷进行调查,运用相关性分析、分层回归分析及建构结构方程模型分析变量间的关系.结果 共收回有效问卷579例,有效率为97.97％;相关分析结果表明状态焦虑与心理弹性及人格因素中稳定性、恃强性、有恒性、敢为性、自律性呈负相关(P均<0.01),与人格因素中忧虑性、独立性、紧张性呈正相关(P均<0.01),心理弹性与人格因素中稳定性、恃强性、有恒性、敢为性、自律性呈正相关(P均<0.01),与人格因素中忧虑性和紧张性呈负相关(P均<0.01);分层回归分析显示人格因素中稳定性、忧虑性、紧张性及心理弹性可以独立预测状态焦虑;2个结构方程模型分析提示纳入人格因素中稳定性、忧虑性、紧张性3个自变量时,心理弹性在稳定性和忧虑性与状态焦虑之间均存在中介效应(P均<0.001),而在紧张性与状态焦虑之间的中介作用不显著(P=0.117);当纳入稳定性与忧虑性2个自变量时,心理弹性的中介效应都存在(P均<0.001),其在稳定性和忧虑性与状态焦虑之间的中介效应量差异无统计学意义(P=0.706).结论 心理弹性在人格因素中稳定性、忧虑性与状态焦虑之间起着部分中介作用,提高军人心理弹性、增强稳定性特质、降低忧虑性特质有助于降低新兵状态焦虑水平.     

Neonatal experience interacts with adult social stress to alter acute and chronic Theiler’s virus infection

Previous research has shown that neonatal handling has prolonged protective effects associated with stress resilience and aging, yet little is known about its effect on stress-induced modulation of infectious disease. We have previously demonstrated that social disruption stress exacerbates the acute and chronic phases of the disease when applied prior to Theiler’s virus infection (PRE-SDR) whereas it attenuates disease severity when applied concurrently with infection (CON-SDR). Here, we asked whether neonatal handling would protect adult mice from the detrimental effects of PRE-SDR and attenuate the protective effects of CON-SDR on Theiler’s virus infection. As expected, handling alone decreased IL-6 and corticosterone levels, protected the non-stressed adult mice from motor impairment throughout infection and reduced antibodies to myelin components (PLP, MBP) during the autoimmune phase of disease. In contrast, neonatal handling X PRE/CON-SDR elevated IL-6 and reduced corticosterone as well as increased motor impairment during the acute phase of the infection. Neonatal handling X PRE/CON-SDR continued to exacerbate motor impairment during the chronic phase, whereas only neonatal handling X PRE-SDR increased in antibodies to PLP, MOG, MBP and TMEV. Together, these results imply that while handling reduced the severity of later Theiler’s virus infection in non-stressed mice, brief handling may not be protective when paired with later social stress.     

Women’s recovery,negotiation of appearance,and social reintegration following a burn

The gendered nature of postburn coping has received scant research attention in South Africa, a country that has a high rate of burns with significant concentrations among women. In this study, narratives that emerged from in-depth interviews with seven women were examined. The narratives emphasized essential needs of these burn survivors for personal support, the complexities of negotiating intimate relationships, struggles with the humiliation from family and friends, in some instances strained relationships with children, the support found through religious beliefs and institutions, and often frustratingly slow psychological acceptance of scars. These difficulties faced by women survivors of burns have highlighted the need to include religion/spirituality, intimate male partners, and women’s children into the psychological recovery process, in an attempt to assist women’s journey to psychological and emotional healing after burn.