Diminished cortisol responses to psychosocial stress associated with lifetime adverse events a study among healthy young subjects

BACKGROUND: Animal and human studies have found that prior stressful events can result in an altered reactivity in the HPA axis. The aim of the present study was to investigate the role of adverse events in childhood on cortisol reactivity to psychosocial stress in young healthy subjects (n=80). METHODS: Salivary cortisol levels were measured before, during and after exposure to a psychosocial stress task in healthy men and women with high (n=33) and low (n=47) exposure to adverse childhood events. RESULTS: A significant blunted cortisol response was found in individuals with a history of adverse events compared to individuals with no adverse life events, with no differences in baseline cortisol levels. This finding appeared to be primarily driven by men. The groups did not differ on any other physiological or subjective stress measure, including heart rate, blood pressure, and subjective tension. CONCLUSIONS: These findings suggest that, at least in healthy young males, adverse childhood events are associated with changes in HPA-axis functioning. Longitudinal studies are needed to investigate whether the blunted cortisol response is a risk factor in the etiology of psychiatric disorders or rather reflects resiliency with regard to the development of psychopathology.     

Roots and routes to resilience and its role in psychotherapy: a selective,attachment-informed review

Developmental research on resilience is summarised and illustrated with a case example. Self-reflection, positive relationships, and agency foster resilience in the face of adversity. Attachment and resilience are related categories. The different patterns of attachment – secure, insecure-organised and insecure-disorganised – are manifest in different patterns of resilience, depending on prevailing environmental conditions. However, the greater the environmental adversity, the less will the resilience factors emerge. Clients tend to present for psychotherapy when resilience strategies have failed. The therapeutic relationship has neurochemical and relational characteristic mirroring the secure mother–infant bond. These foster mentalising, stress innoculation, affect co-regulation, self-esteem, and agency, forming the basis for enduring and more flexible resilience strategies.     

Supporting community participation in a pandemic

The invariable governmental approach to the impact of the COVID-19 pandemic has been to effect the White Knight stance of Don Quixote, defending the population from the “Virus Dragon” and dedicating its knight-errantry to the damsel Dulcinea. Though essential, new therapeutics, vaccines, physical distancing, rigorous hygiene standards and efficient health systems are not sufficient to counter the effects of the virus. Individual compliance to public health guidelines also matters, while remaining similarly insufficient to diminish the threat. Earthier, citizen-led, community participation strategies, however, lead to innovative, tailored solutions that better fulfil the needs of diverse neighbourhoods and assures greater virus resistance and increase in population health compared to a top-down, knightly approach or isolated individual efforts. The challenge of COVID-19 offers communities a moment to build more resilient, antifragile communities that not only survive the current crisis, but that thrive after it, and that are better equipped for the next challenge. This is not the time for the singular heroics of the White Knight, or the antics of Don Quixote, tilting at windmills. It is the time of Sancho Panza, which is to say of regular non-credentialed citizens, and their collective efforts, who up to now have largely been considered pawns in this contest. Asset-based community development (ABCD) rejects both the individual as an island and the institutional, knightly emphasis on assessing needs and deficits within communities. It favours identifying and mobilising available and latent assets within a community to forge closer connections among all people, the better to collectivise problem-solving efforts. Community-driven initiatives are assisted in this by localised not-for-profit agencies that practice subsidiarity.     

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.     

Traumatisme et résilience associés à la pandémie de la COVID-19 dans les villes de Bafoussam et de Dschang au Cameroun

IntroductionThe emergence of the Covid-19 pandemic in Cameroon, as in Africa and around the world, was marked by a suddenness and unpredictability that fascinated the imagination. The considerable psychic and social repercussions of the pandemic mobilized a significant anguish of death. The sudden onset of the pandemic was followed by spectacular, high-profile deaths that fascinated the imagination, listing it in the order of traumatic events, provoking reactions of astonishment, flight and avoidance.GoalThe objective of this study is to determine the symptomatology of post-traumatic stress disorder, as well as the resilience, associated with the Covid-19 pandemic in the Western Region of Cameroon.MethodologyThe research was carried out following the model of general population mental health surveys. The availability of area frames (sampling) made it possible to opt for probabilistic calculations. First and second year master's students in clinical psychology from Dschang University were involved in data collection. They benefited from a two-day seminar on data collection techniques in the general population. The calculated sample size is 384 households. The anticipated response rate, set at 90%, made it possible to increase robustness and to anticipate a total sample of 424 households, spread over 3 districts of Bafoussam and Dschang, according to the choice previously made. The study followed the ethical provisions of the Helsinki Protocol. The data collection tools used are: the Impact of Event Scale-Revised and the Connor-Davidson Resilience Scale.Results409 subjects were recruited, representing a completion rate of 106.5%. 70.7% of subjects exhibited symptoms of PTSD. These symptoms are more often mild (40.9%) or moderate (25.6%). Women are more affected (73.7%) by PTSD than men (67.9%). In addition to sex and age, area of residence and marital status, appear to be significantly associated with symptoms of PTSD: subjects under 35 years of age have a significantly higher prevalence rate than those over 35; the rate of PTSD is significantly higher in subjects living in urban areas than in those living in rural areas; single subjects are more affected by PTSD (40.1%) than married subjects (26.7%). The average score recorded on the CD-RISC is 64.3, the standard deviation is 15.3 and the coefficient of variation is 24%. This average falls into the second quartile of the distribution, indicating average resilience. CD-RISC scores are not affected by gender, age, marital status, level of education, or occupational status. These characteristics are therefore not factors of resilience.ConclusionThe Covid-19 pandemic has had a psychological impact in Cameroon which has made it a major psychosocial stressor. More than 6 in 10 people have symptoms of PTSD. But this symptomatology is often weak or moderate, testifying to an effective resilience, to balance the traumatic effects of the pandemic.     

From liability to challenge: Complex environments are associated with favorable psychosocial outcomes in adolescent sport participants

This study aimed to identify different groups of adolescents who have distinct profiles based upon their perceptions of interpersonal and activity-based dimensions of the sport environment. A sample of 310 adolescents from Eastern Canada (M_age = 14.69 ± 1.60 years; 54.8% girls) completed questionnaires assessing selected interpersonal, activity-based, demographic and sport-specific variables. Using TwoStep Cluster Analysis, we identified three groupings of adolescent sport participants. Consistent with the literature, we labeled these groups ‘negative context,’ ‘positive context,’ and ‘complex context,’ respectively. As expected, participants in the last two groups reported greater enjoyment, perceived competence, and commitment to sport. Further, participants in the ‘complex context’ group showed the highest levels of sport commitment. We draw on insights from Csikszentmihalyi's theory of complexity and relational conceptions of compensation and resilience to interpret the findings, and offer an alternative account of contextual conditions suitable for adolescents involved in competitive sport.     

Les tuteurs de résilience dans un univers juif orthodoxe. Partie I

This reflection comes from interviews with survivors of the Holocaust. Some survivors arise from a profoundly religious environment. We noticed that the environment, the tools set up to take (bring) out there were different (because of the context) from what we had met until now. The concept of resilience is dynamic and must inevitably consider the environment and the context of their life. We hypothesize that for each micro society must be found its own strength, which induce its way of being resilient.ObjectivesWe hypothesis that this microsociety developed in itself the way to get out of its traumatic events. To showcase these resilience factors (part II) we try to define the salient features of those members (les “marqueur”).MethodWe had about twenty semi-directed interviews on the subject of the WWII and its transmission to the children of survivors. Working on this population is innovative. This microsystem is not interested in university, and Holocaust is not either a matter of subject. At first, we propose five defining criterias for this microsystem: (1) god's place and faith (2) exiles and sufferings (3) the strength of the law, (4) ancestry and filiation (5) grouping around a “Rebbe”. Then, we will discuss about the “resilience's tutors” for this microsociety.ResultsWe propose four resilience's tutors, and each of them is conceptual, not ingrown: (1) the silent of the spouse, (2) law, (3) filiation, (4) daily rite.DiscussionThe notion of “concept-tuteur de resilience” refers not in human being who could palliate lack of figure of attachment but to an absolute figure of faith which would give to this microsystem the ways of resilience.ConclusionWe should, to validate this notion, diply study the relation between faith and resilience. It makes sens for the microsystem because faith and Jewish identity are exactly the reason, which officially put them in danger.     

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.