Child and family predictors of insomnia from early childhood to adolescence

BackgroundInsomnia is prevalent among children and adolescents and is associated with a wide range of negative outcomes. Knowledge about its determinants is therefore important, but due to the lack of longitudinal studies, such knowledge is limited. The aim of the present inquiry is to identify child and family predictors of future pediatric insomnia within a psycho-bio-behavioral framework.MethodsA representative community sample (n = 1,037) was followed biennially from 4 to 14 years of age (2007–2017). Insomnia was defined based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria and was diagnosed by a semistructured clinical interview of children (from age eight years of age) and parents (all ages). Predictors included parent ratings of child emotional reactivity, family functioning, and marital conflict; self-reports of personality; and teacher-rated emotion regulation skills.ResultsRandom intercept cross-lagged analyses revealed that within-person increases (ie, relative to the child's typical levels across childhood) in emotional reactivity and decreases in emotion regulation skills predicted insomnia diagnosis two years later from ages 4 to 14 after adjusting for previous insomnia and all unmeasured time-invariant factors. Previous insomnia was the strongest predictor of later insomnia, whereas family functioning and marital conflict did not predict insomnia.ConclusionsIncreases in emotional reactivity and decreases in emotion regulation skills predicted insomnia above and beyond all unmeasured time-invariant factors and could be targets for interventions. Previous insomnia predicted later insomnia, thereby underscoring the importance of detecting, preventing, and treating insomnia at an early age.     

Personality Traits and Common Psychiatric Conditions in Adult Patients with Acne Vulgaris

Background

We believe that instances of neuroticism and common psychiatric disorders are higher in adults with acne vulgaris than the normal population.

Objective

Instances of acne in adults have been increasing in frequency in recent years. The aim of this study was to investigate personality traits and common psychiatric conditions in patients with adult acne vulgaris.

Methods

Patients who visited the dermatology outpatient clinic at Bozok University Medical School with a complaint of acne and who volunteered for this study were included. The Symptom Checklist 90-Revised (SCL 90-R) Global Symptom Index (GSI), somatization, depression, and anxiety subscales and the Eysenck Personality Questionnaire-Revised Short Form (EPQ-RSF) were administered to 40 patients who fulfilled the inclusion criteria before treatment. The results were compared with those of a control group.

Results

Of the 40 patients included in this study, 34 were female and 6 were male. The GSI and the somatization, depression, and anxiety subscales of the SCL 90-R were evaluated. Patients with adult acne had statistically significant higher scores than the control group on all of these subscales. In addition, patients with adult acne had statistically significantly higher scores on the neuroticism subscale of the EPQ-RSF.

Conclusion

Our results show that common psychiatric conditions are frequent in adult patients with acne. More importantly, neurotic personality characteristics are observed more frequently in these patients. These findings suggest that acne in adults is a disorder that has both medical and psychosomatic characteristics and requires a multi-disciplinary approach.     

Is personality associated with dementia risk? A meta-analytic investigation

This study provides a quantitative synthesis of the prospective associations between personality traits (neuroticism, extraversion, openness, agreeableness, conscientiousness) and the risk of incident Alzheimer’s disease and related dementias. We conducted five separate meta-analyses with 8–12 samples (N = 30,036 to 33,054) that were identified through a systematic literature search following the MOOSE guidelines. Higher neuroticism (HR = 1.24, 95% CI [1.17, 1.31]) and lower conscientiousness (HR = 0.77, 95% CI [0.73, 0.81]) were associated with increased dementia risk, even after accounting for covariates such as depressive symptoms. Lower extraversion (HR = 0.92, 95% CI [0.86, 0.97]), openness (HR = 0.91, 95% CI [0.86, 0.96]), and agreeableness (HR = 0.90, 95% CI [0.83, 0.98]) were also associated with increased risk, but these associations were less robust and not significant in fully adjusted models. No evidence of publication bias was found. The strength of associations was unrelated to publication year (i.e., no evidence of winner’s curse). Meta-regressions indicated consistent effects for neuroticism, openness, and conscientiousness across methods to assess dementia, dementia type, follow-up length, sample age, minority, country, and personality measures. The association of extraversion and agreeableness varied by country. Our findings indicate robust associations of neuroticism and conscientiousness with dementia risk.     

Childhood trauma as a risk factor for psychosis: A sib-pair study

BackgroundChildhood trauma, cannabis use and certain personality traits have been related to the development of psychosis. This study uses a sib-pair design to examine the association between childhood trauma and psychosis controlling for cannabis use and neuroticism.MethodsWe evaluated 60 patient-sibling pairs, conformed by patients with functional psychosis in the first five years of their illness matched with a non-psychotic sibling. In univariate analyses, patients and siblings were compared with McNemar tests and paired-sample t tests. A conditional logistic regression model of the risk of developing psychosis was built. The dependent variable of this model was the patient-sibling status (patient = 1, sibling = 0).ResultsAfter controlling for cannabis use and neuroticism, the odds of suffering psychosis for subjects who experienced a childhood trauma were 7.3 times higher than the odds for subjects who did not experience a childhood trauma [95% CI, (1.06–50.01); P = 0.04]. Also, after controlling for experiencing childhood trauma and neuroticism, subjects who were heavy cannabis users had odds of suffering psychosis that were 6.4 times higher than the odds of the remaining subjects [95% CI, (1.2–35.2); P = 0.03].ConclusionBoth childhood trauma and cannabis use were significantly associated with an increased risk of suffering functional psychosis. A neurotic personality also contributed independently to this risk. These findings might help improve the prevention of psychosis and the development of specific treatment strategies on this specific population.     

Depressogenic vulnerability and gender-specific patterns of neuro-immune dysregulation: What the ratio of cortisol to C-reactive protein can tell us about loss of normal regulatory control

We examined whether the ratio of cortisol (CORT) to high-sensitivity C-reactive protein (hsCRP), an index that captures the integrity of homeostatic regulation between the hypothalamic–pituitary–adrenal (HPA) axis and inflammatory processes, is associated with vulnerability to depression in a gender specific manner and whether glucocorticoid receptor (GR) sensitivity plays a role in these associations. Fasting blood samples were collected between 08:45 and 09:15 and assayed for CORT, hsCRP, and leukocyte count in 213 healthy, medication-free men and women. The NEO-Personality Inventory was used to assess neuroticism, extraversion and anxiety. We used the Hamilton Depression Interview to assess depressive symptoms, the Buss–Perry anger subscale to measure anger, and the Pittsburgh Sleep Quality Index to evaluate subjective sleep quality and its components. Log-transformed CORT/CRP values were analyzed using multiple regression with Holms’ adjusted p-values and age, body mass index (BMI), and race as covariates. GR sensitivity was estimated using the log-transformed ratio of neutrophils (N)-to-monocytes (M). The log-transformed ratio of CORT/CRP did not differ between men and women but was significantly and negatively associated with age and BMI. Severity of depressive symptoms, extraversion, anxiety, and sleep quality were associated with the CORT/CRP ratio in a gender-specific manner. For women, decreasing CORT/CRP ratios, suggestive of an insufficient release of CORT coupled with a heightened inflammatory state, were associated with increasing severity of depressive symptoms, decreasing quality of sleep, increasing frequency of sleep disturbance, and decreasing extraversion. For men, increasing frequency of daytime disturbance and levels of anxiety were associated with increasing CORT/CRP ratio, suggestive of an enhanced release of CORT relative to attenuated levels of hsCRP. For both genders, increasing anger was associated with decreasing CORT/CRP ratios. Although results suggested GR downregulation in women but not men, such differences did not mediate the observed associations. With the use of the CORT/CRP ratio, we showed that vulnerability factors for depression are associated with a loss of normal regulatory controls resulting in gender-specific patterns of neuro-immune dysregulation. That GR downregulation did not influence these associations suggests that the loss of regulatory controls in at risk individuals is primarily at the level of the hormone. Beyond the individual contribution of each component of the CORT/CRP ratio, disruption of normal neuroimmune regulatory feedback provides a plausible biological framework useful in understanding biobehavioral vulnerabilities to depression in a gender specific manner. The CORT/CRP ratio may be a viable biomarker not only for delineating risk for MDD but also progression and treatment responses among patients with MDD; possibilities that are testable in future studies.     

Noise and somatic symptoms: A role for personality traits?

ObjectivesWe investigated the role of a stress-sensitive personality on relations between noise, noise annoyance and somatic symptom reporting. First, we investigated the cross-sectional association of road traffic noise exposure and somatic symptoms, and its modification by hostility and vulnerability to stress. Second, we investigated the cross-sectional association of noise annoyance from eight sources (e.g. road traffic, aircraft, neighbours) and somatic symptoms, and it's confounding by hostility and vulnerability to stress.MethodsData were obtained from LifeLines, a general population cohort from the Netherlands. Road traffic noise was estimated using the Common Noise Assessment Methods in Europe (CNOSSOS-EU) noise model. Noise annoyance, hostility, vulnerability to stress, and somatic symptoms were assessed with validated questionnaires.ResultsPoisson regression models adjusted for demographic and socioeconomic variables indicated no association of noise exposure and somatic symptoms (incidence rate ratio (IRR) 1.001; 95% confidence interval (CI) 1.000–1.001; n = 56,937). Interactions of noise exposure and hostility and vulnerability to stress were not statistically significant. Small positive associations were found for noise annoyance from each of the eight sources and somatic symptoms, when adjusted for demographic and socioeconomic variables (e.g. for road traffic noise annoyance IRR 1.014, 95% CI 1.011–1.018; n = 6177). Additional adjustment for hostility and vulnerability to stress resulted in small decreases of the IRRs for noise annoyance from each of the eight sources, but the associations remained statistically significant.ConclusionsPersonality facets hostility and vulnerability to stress did not modify the relation between road traffic noise exposure and somatic symptom reporting, or confound relations between noise annoyance and symptoms.     

Cognitive behavioral approach to understanding irritable bowel syndrome

Irritable bowel syndrome(IBS)is considered a biopsychosocial disorder,whose onset and precipitation are a consequence of interaction among multiple factors which include motility disturbances,abnormalities of gastrointestinal sensation,gut inflammation and infection,altered processing of afferent sensory information,psychological distress,and affective disturbances.Several models have been proposed in order to describe and explain IBS,each of them focusing on specific aspects or mechanisms of the disorder.This review attempts to present and discuss different determinants of IBS and its symptoms,from a cognitive behavioral therapy framework,distinguishing between the developmental predispositions and precipitants of the disorder,and its perpetuating cognitive,behavioral,affective and physiological factors.The main focus in understanding IBS will be placed on the numerouspsychosocial factors,such as personality traits,early experiences,affective disturbances,altered attention and cognitions,avoidance behavior,stress,coping and social support.In conclusion,a symptom perpetuation model is proposed.     

Role of negative affects in pathophysiology and clinical expression of irritable bowel syndrome

Irritable bowel syndrome(IBS)is regarded as a multifactorial disease in which alterations in the brain-gut axis signaling play a major role.The biopsychosocial model applied to the understanding of IBS pathophysiology assumes that psychosocial factors,interacting with peripheral/central neuroendocrine and immune changes,may induce symptoms of IBS,modulate symptom severity,influence illness experience and quality of life,and affect outcome.The present review focuses on the role of negative affects,including depression,anxiety,and anger,on pathogenesis and clinical expression of IBS.The potential role of the autonomic nervous system,stress-hormone system,and immune system in the pathophysiology of both negative affects and IBS are taken into account.Psychiatric comorbidity and subclinical variations in levels of depression,anxiety,and anger are further discussed in relation to the main pathophysiological and symptomatic correlates of IBS,such as sensorimotor functions,gut microbiota,inflammation/immunity,and symptom reporting.     

Electrophysiological evidence for early perceptual facilitation and efficient categorization of self‐related stimuli during an Implicit Association Test measuring neuroticism

The Implicit Association Test (IAT) is a widely used latency‐based categorization task that indirectly measures the strength of automatic associations between target and attribute concepts. So far, little is known about the perceptual and cognitive processes underlying personality IATs. Thus, the present study examined event‐related potential indices during the execution of an IAT measuring neuroticism (N = 70). The IAT effect was strongly modulated by the P1 component indicating early facilitation of relevant visual input and by a P3b‐like late positive component reflecting the efficacy of stimulus categorization. Both components covaried, and larger amplitudes led to faster responses. The results suggest a relationship between early perceptual and semantic processes operating at a more automatic, implicit level and later decision‐related categorization of self‐relevant stimuli contributing to the IAT effect.