Protection or Vulnerability? A Meta‐Analysis of the Relations Between the Positive and Negative Components of Self‐Compassion and Psychopathology

Self‐compassion is increasingly explored as a protective factor in relation to psychopathology. The Self‐Compassion Scale (SCS) and its Short Form variant (SCS‐SF) are the most widely used instruments for measuring this psychological construct, and previous studies have indeed shown that the total score of this scale is negatively associated with psychopathology. In this article, we point out that half of the items of the SCS and SCS‐SF are positive indicators of self‐compassion and directly refer to the three key components of self‐kindness, common humanity and mindfulness, while the other half of the items are negative indicators of the construct and reflect the precise opposite of the key components, namely self‐judgment, isolation and over‐identification. A meta‐analysis was conducted including 18 studies that reported on the positive and negative indicators of self‐compassion as indexed by the SCS/SCS‐SF and their relations to various types of psychopathology. Results showed that positive indicators of self‐compassion were negatively associated with psychopathology, which confirms their hypothesized protective influence. However, the negative indicators were positively linked to psychopathology, suggesting that these scales tap increased vulnerability to mental health problems. Moreover, tests comparing the strength of the relations between various SCS/SCS‐SF counterparts (i.e., self‐kindness versus self‐judgment, common humanity versus isolation and mindfulness versus over‐identification) and psychopathology showed that the negative indicators were significantly stronger linked to mental health problems than the positive indicators. This provides support for the idea that the use of a total self‐compassion score of the SCS or SCS‐SF, which typically includes the reversely scored negative subscales, will probably result in an inflated relationship with symptoms of psychopathology. Copyright © 2016 John Wiley & Sons, Ltd.     

Three‐year stability of cardiovascular and autonomic nervous system responses to psychological stress

Chronically heightened physiological reactivity to or delayed recovery from stress may contribute to cardiovascular (CV) risk and mortality. Long‐term stability of physiological stress responses has received little attention. Our objectives were to evaluate the 3‐year stability of reactivity and recovery change scores across CV and autonomic parameters and assess whether sex and age moderate stability. A total of 134 healthy participants underwent two laboratory stress protocols, including four 5‐min interpersonal stressors, each followed by a 5‐min recovery period. Heart rate (HR), blood pressure (BP), and HR variability (high frequency, low frequency, very low frequency [VLF]) were obtained. Spearman rank correlations and linear regressions were performed. Significant correlations emerged for all physiological measures except diastolic BP and VLF recovery. No significant sex or age differences were found. Stress responses represent stable individual traits little affected by sex or age.     

Meta‐analysis of chest CT features of patients with COVID‐19 pneumonia

The objective of this paper is to perform a meta‐analysis regarding the chest computed tomography (CT) manifestations of coronavirus disease‐2019 (COVID‐19) pneumonia patients. PubMed, Embase, and Cochrane Library databases were searched from 1 December 2019 to 1 May 2020 using the keywords of “COVID‐19 virus,” “the 2019 novel coronavirus,” “novel coronavirus,” and “COVID‐19.” Studies that evaluated the CT manifestations of common and severe COVID‐19 pneumonia were included. Among the 9736 searched results, 15 articles describing 1453 common patients and 697 severe patients met the inclusion criteria. Based on the CT images, the common patients were less frequent to exhibit consolidation (odds ratio [OR] = 0.31), pleural effusion (OR = 0.19), lymphadenopathy (OR = 0.17), crazy‐paving pattern (OR = 0.22), interlobular septal thickening (OR = 0.27), reticulation (OR = 0.20), traction bronchiectasis (OR = 0.40) with over two lobes involved (OR = 0.07) and central distribution (OR = 0.18) while more frequent to bear unilateral pneumonia (OR = 4.65) involving one lobe (OR = 13.84) or two lobes (OR = 6.95) when compared with severe patients. Other CT features including ground‐glass opacities (P = .404), air bronchogram (P = .070), nodule (P = .093), bronchial wall thickening (P = .15), subpleural band (P = .983), vascular enlargement (P = .207), and peripheral distribution (P = .668) did not have a significant association with the severity of the disease. No publication bias among the selected studies was suggested (Harbord's tests, P > .05 for all.) We obtained reliable estimates of the chest CT manifestations of COVID‐19 pneumonia patients, which might provide an important clue for the diagnosis and classification of COVID‐19 pneumonia.     

Meta‐analysis of genotype‐phenotype associations in Bardet‐Biedl syndrome uncovers differences among causative genes

Bardet‐Biedl syndrome (BBS) is a recessive genetic disease causing multiple organ anomalies. Most patients carry mutations in genes encoding for the subunits of the BBSome, an octameric ciliary transport complex, or accessory proteins involved in the BBSome assembly or function. BBS proteins have been extensively studied using in vitro, cellular, and animal models. However, the molecular functions of particular BBS proteins and the etiology of the BBS symptoms are still largely elusive. In this study, we applied a meta‐analysis approach to study the genotype‐phenotype association in humans using our database of all reported BBS patients. The analysis revealed that the identity of the causative gene and the character of the mutation partially predict the clinical outcome of the disease. Besides their potential use for clinical prognosis, our analysis revealed functional differences of particular BBS genes in humans. Core BBSome subunits BBS2, BBS7, and BBS9 manifest as more critical for the function and development of kidneys than peripheral subunits BBS1, BBS4, and BBS8/TTC8, suggesting that incomplete BBSome retains residual function at least in the kidney.     

Antiviral therapy of symptomatic HCV‐associated mixed cryoglobulinemia: Meta‐analysis of clinical studies

Hepatitis C virus (HCV) infection may be associated with extra‐hepatic illness including mixed cryoglobulinemia. Evidence on HCV‐related mixed cryoglobulinemia in the non‐transplantation setting exists even if its appropriate management remains unclear. The cornerstone of treatment for symptomatic HCV‐associated mixed cryoglobulinemia is antiviral therapy but little is known about its activity. A systematic review of the literature with a meta‐analysis of clinical studies was performed in order to assess efficacy and safety of combination antiviral therapy for symptomatic HCV‐associated mixed cryoglobulinemia in non‐immunosuppressed individuals. The random effects model of DerSimonian and Laird was used, with heterogeneity and sensitivity analyses. The primary outcome was sustained virological response (as a measure of efficacy), and the secondary outcome was the rate of patients stopping (or dose reducing) antiviral agents (as a measure of tolerability). Ten clinical studies (300 unique patients) were identified; the rate of baseline kidney involvement ranged between 4% and 39%. The summary estimate of frequency of sustained viral response was 0.42 with a 95% confidence interval (CI) of 0.31; 0.54 (random effects model). Significant heterogeneity occurred (P = 0.00001; I² = 77.6%). Stratified analysis showed higher efficacy in those studies using combination therapy with pegylated—than conventional IFN; the summary estimate of sustained viral response being 0.52 (95% CI, 0.40; 0.63) and 0.32 (95% CI, 0.15; 0.49), respectively. There was good association between viral and clinical response, weighted K 0.634 (95% CI, 0.455; 0.814), by a meta‐analysis at individual level on a subset of reports (n = 3; 74 unique patients). The summary estimate of frequency of patients stopping (or dose reducing) antiviral agents was 0.15 (95% CI, 0.08; 0.21); no heterogeneity occurred (P = 0.05; I² = 51%). In summary, combination antiviral therapy (pegylated IFN plus ribavirin) gives satisfactory response in more than the half of patients with symptomatic mixed cryoglobulinemia associated with HCV. HCV‐related mixed cryoglobulinemia is uncommon in developed countries and this clearly hampers randomized controlled clinical trials aimed to evaluate efficacy and safety of antiviral therapy in non‐immunosuppressed individuals. J. Med. Virol. 85: 1019–1027, 2013. © 2013 Wiley Periodicals, Inc.     

Moderators of Psycho‐Oncology Therapy Effectiveness: Meta‐Analysis of Socio‐Demographic and Medical Patient Characteristics

We report a meta‐analysis seeking socio‐demographic and medical moderators of the effectiveness of psycho‐oncological interventions. The dataset comprised 146 published and unpublished prospective controlled trials where outcomes were anxiety, depression, and general distress. Analyses took into account the confounding potential of two study design features discovered in preliminary analyses, and produced a coherent pattern of moderation suggestive of the critical influence of elevated baseline distress. Being older, having lower income, being male, or having a cancer other than (early stage) breast cancer produced higher statistically significant or trend effects, and being single produced nonsignificant effects double in magnitude to effects produced by married patients. Elevated baseline distress itself produced a significantly higher effect. Implications for research and practice are discussed.     

Meta‐analysis reveals no significant correlation between breast cancer survival and ErbB3 expression

Prognostic value of ErbB3 in human breast cancer is still controversial. However, the roles of ErbB3 receptors in drug resistance are recently emerging. The objective of this study was to evaluate the relationship between ErbB3 expression and survival of breast cancer via meta‐analysis. A systematic literature search was conducted and 32 potentially relevant studies were included in the meta‐analysis. Outcomes presented in searched literatures can be classified as disease free survival (DFS), overall survival (OS), and progress free survival (PFS) values. Meta‐analysis was performed for each group. Results showed no statistically significant difference in survival. The overall hazard ratio of PFS, DFS, and OS of ErbB3 expression was 1.40 [95% confidence interval/CI (0.51, 3.83)], 1.07 [95% CI (0.82, 1.40)], and 1.15 [95% CI (0.91, 1.44)], respectively. Subgroup analysis according to ErbB2 receptor status, ErbB3 assessment methods (immunohistochemistry/IHC vs non‐IHC), and analysis type (multivariate and univariate analysis) were performed. No significant association was found. Using various assessment methods and patient populations, our results revealed that there was no significant correlation between ErbB3 expression and breast cancer survival. Further studies on heterodimers of ErbB3 and other molecular markers involved in ErbB3 related pathway are merited.     

A momentary assessment study of the relationship between affective and adrenocortical stress responses in daily life

The tendency to experience negative emotions in the face of stress may lead to repeated overactivation of the hypothalamic-pituitary-adrenal axis. In a sample of 556 women, this study used the Experience Sampling Method to assess different daily stressors, current mood, and salivary cortisol, 10 times daily for 5 days. Multilevel analyses estimated the contributions of stressors and mood states as predictors of salivary cortisol secretion. Results showed that minor stressors were associated with decreased positive affect and increased negative affect, agitation, and cortisol. Of the mood states, only negative affect was independently associated with cortisol. Negative affect also mediated effects of daily stressors on cortisol. Although further research is needed to clarify: (i) the causal pathways between daily stress, mood, and cortisol and (ii) the importance of daily stress reactivity as a prospective risk factor, these findings confirm that minor daily stressors can influence emotional and biological processes involved in subjective well-being.     

Exploring the Major Sources and Extent of Heterogeneity in a Genome‐Wide Association Meta‐Analysis

Genome‐wide association (GWA) meta‐analysis has become a popular approach for discovering genetic variants responsible for complex diseases. The between‐study heterogeneity effect is a severe issue that may complicate the interpretation of results. Aiming to improve the interpretation of meta‐analysis results, we empirically explored the extent and source of heterogeneity effect. We analyzed a previously reported GWA meta‐analysis of obesity, in which over 21,000 subjects from seven individual samples were meta‐analyzed. We first evaluated the extent and distribution of heterogeneity across the entire genome. We then studied the effects of several potentially confounding factors, including age, ethnicity, gender composition, study type, and genotype imputation on heterogeneity with a random‐effects meta‐regression model. Of the total 4,325,550 SNPs being tested, heterogeneity was moderate to very large for 25.4% of the total SNPs. Heterogeneity was more severe in SNPs with stronger association signals. Ethnicity, average age, and genotype imputation accuracy had significant effects on the heterogeneity. Exploring the effects of ethnicity can provide clues to the potential ethnic‐specific effects for two loci known to affect obesity, MC4R, and MTCH2. Our analysis can help to clarify understanding of the obesity mechanism and may provide guidance for an effective design of future GWA meta‐analysis.     

Genome‐wide association study of lncRNA polymorphisms with bone mineral density

Recent studies suggested that long noncoding RNAs (lncRNAs) were widely transcribed in the genome, but their potential roles in the genetic complexity of human disorders required further exploration. The purpose of the present study was to explore genetic polymorphisms of lncRNAs associated with bone mineral density (BMD) and its potential value. Based on the lncRNASNP database, 55,906 lncSNPs were selected to conduct a genome‐wide association study meta‐analysis among 11,140 individuals of seven independent studies for BMDs at femoral neck (FN), lumbar spine, and total hip (HIP). Promising results were replicated in Genetic Factors for Osteoporosis Consortium (GEFOS Sequencing, n = 32,965). We found two lncRNA loci that were significantly associated with BMD. MEF2C antisense RNA 1 (MEF2C‐AS1) located at 5q14.3 was significantly associated with FN‐BMD after Bonferroni correction, and the strongest association signal was detected at rs6894139 (P = 3.03 × 10^?9). LOC100506136 rs6465531 located at 7q21.3 showed significant association with HIP‐BMD (P = 7.43 × 10^?7). MEF2C‐AS1 rs6894139 was replicated in GEFOS Sequencing with P‐value of 1.43 × 10^?23. Our results illustrated the important role of polymorphisms in lncRNAs in determining variations of BMD and provided justification and evidence for subsequent functional studies.     

Cognitive‐Behavioral School‐Based Interventions for Anxious and Depressed Youth: A Meta‐Analysis of Outcomes

A meta‐analysis of school‐based interventions for anxious and depressed youth using QUORUM guidelines was conducted. Studies were located by searching electronic databases, manual effort, and contact with expert researchers. Analyses examined 63 studies with 8,225 participants receiving cognitive‐behavioral therapy (CBT) and 6,986 in comparison conditions. Mean pre–post effect sizes indicate that anxiety‐focused school‐based CBT was moderately effective in reducing anxiety (Hedge's g = 0.501) and depression‐focused school‐based CBT was mildly effective in reducing depression (Hedge's g = 0.298) for youth receiving interventions as compared to those in anxiety intervention control conditions (Hedge's g = 0.193) and depression intervention controls (Hedge's g = 0.091). Predictors of outcome were explored. School‐based CBT interventions for youth anxiety and for youth depression hold considerable promise, although investigation is still needed to identify features that optimize service delivery and outcome.     

A tale of two mechanisms: A meta‐analytic approach toward understanding the autonomic basis of cardiovascular reactivity to acute psychological stress

A series of meta‐analyses was undertaken to determine the contributions of sympathetic and parasympathetic activation to cardiovascular stress reactivity. A literature search yielded 186 studies of sufficient quality that measured indices of sympathetic (n = 113) and/or parasympathetic activity (n = 73). A range of psychological stressors perturbed blood pressure and heart rate. There were comparable aggregate effects for sympathetic activation, as indexed by increased plasma epinephrine and norepinephrine, and shortened pre‐ejection period and parasympathetic deactivation, as indexed by heart rate variability measures. Effect sizes varied with stress task, sex, and age. In contrast to alpha‐adrenergic blockade, beta‐blockade attenuated cardiovascular reactivity. Cardiovascular reactivity to acute psychological stress would appear to reflect both beta‐adrenergic activation and vagal withdrawal to a largely equal extent.     

Meta‐analysis of association between obsessive‐compulsive disorder and the 3′ region of neuronal glutamate transporter gene SLC1A1

The neuronal glutamate transporter gene SLC1A1 is a candidate gene for obsessive‐compulsive disorder (OCD) based on linkage studies and convergent evidence implicating glutamate in OCD etiology. The 3′ end of SLC1A1 is the only genomic region with consistently demonstrated OCD association, especially when analyzing male‐only probands. However, specific allele associations have not been consistently replicated, and recent OCD genome‐wide association and meta‐analysis studies have not incorporated all previously associated SLC1A1 SNPs. To clarify the nature of association between SLC1A1 and OCD, pooled analysis was performed on all available relevant raw study data, comprising a final sample of 815 trios, 306 cases and 634 controls. This revealed weak association between OCD and one of nine tested SLC1A1 polymorphisms (rs301443; uncorrected P = 0.046; non‐significant corrected P). Secondary analyses of male‐affecteds only (N = 358 trios and 133 cases) demonstrated modest association between OCD and a different SNP (rs12682807; uncorrected P = 0.012; non‐significant corrected P). Findings of this meta‐analysis are consistent with the trend of previous candidate gene studies in psychiatry and do not clarify the putative role of SLC1A1 in OCD pathophysiology. Nonetheless, it may be important to further examine the potential associations demonstrated in this amalgamated sample, especially since the SNPs with modest associations were not included in the more highly powered recent GWAS or in a past meta‐analysis including five SLC1A1 polymorphisms. This study underscores the need for much larger sample sizes in future genetic association studies and suggests that next‐generation sequencing may be beneficial in examining the potential role of rare variants in OCD. © 2013 Wiley Periodicals, Inc.