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Once a threat no longer exists, extinction of conditioned fear becomes adaptive in order to reduce allotted resources towards cues that no longer predict the threat. In anxiety and stress disorders, fear extinction learning may be affected. Animal findings suggest that the administration of oxytocin (OT) modulates extinction learning in a timepoint-dependent manner, facilitating extinction when administered prior to fear conditioning, but impairing it when administered prior to extinction learning. The aim of the present study was to examine if these findings translate into human research. Using a randomized, double-blind, placebo-controlled, 2-day fear conditioning and extinction learning design, behavioral (self-reported anxiety), physiological (skin conductance response), neuronal (task-based and resting-state functional magnetic resonance imaging), and hormonal (cortisol) data were collected from 124 naturally cycling (taking no hormonal contraceptives) healthy females. When administered prior to conditioning (Day 1), OT, similar to rodent findings, did not affect fear conditioning, but modulated the intrinsic functional connectivity of the anterior insula immediately after fear conditioning. In contrast to animal findings, OT impaired, not facilitated, extinction learning on the next day and increased anterior insula activity. When administered prior to extinction learning (day 2), OT increased the activity in the bilateral middle temporal gyrus, and similar to animal findings, reduced extinction learning. The current findings suggest that intranasal OT impedes fear extinction learning in humans regardless of the timepoint of administration, providing new insights and directions for future translational research and clinical applications.
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BACKGROUND: A recent meta-analysis revealed that vagally mediated heart rate variability (vmHRV; a biomarker of emotion regulation capacity) significantly decreases in the luteal phase of the menstrual cycle. As two follow-up studies suggest, these vmHRV decreases are driven primarily by increased luteal progesterone (P4). However, analyses also revealed significant interindividual differences in vmHRV reactivity to the cycle, which is in line with longstanding evidence for interindividual differences in mood sensitivity to the cycle. The present study begins to investigate whether these interindividual differences in vmHRV cyclicity can explain who is at higher risk of showing premenstrual emotional changes. We expected a greater degree of midluteal vmHRV decrease to be predictive of a greater premenstrual increase in negative affect. METHODS: We conducted an observational study with a naturally cycling community sample (N = 31, M = 26.03 years). Over a span of six weeks, participants completed (a) daily ratings of negative affect and (b) counterbalanced lab visits in their ovulatory, midluteal, and perimenstrual phases. Lab visits were scheduled based on positive ovulation tests and included assessments of baseline vmHRV and salivary ovarian steroid levels. RESULTS: In line with previous research, multilevel models suggest that most of the sample shows ovulatory-to-midluteal vmHRV decreases which, however, were not associated with premenstrual emotional changes. Interestingly, it was only the subgroup with luteal increases in vmHRV whose negative affect markedly worsened premenstrually and improved postmenstrually. CONCLUSION: The present study begins to investigate cyclical changes in vmHRV as a potential biomarker of mood sensitivity to the menstrual cycle. The results demonstrate a higher level of complexity in these associations than initially expected, given that only atypical midluteal increases in vmHRV are associated with greater premenstrual negative affect. Potential underlying mechanisms are discussed, among those the possibility that luteal vmHRV increases index compensatory efforts to regulate emotion in those with greater premenstrual negative affect. However, future studies with larger and clinical samples and more granular vmHRV assessments should build on these findings and further explore associations between vmHRV cyclicity and menstrually related mood changes.
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Frecuencia Cardíaca , Fase Luteínica , Progesterona , Humanos , Femenino , Fase Luteínica/fisiología , Fase Luteínica/psicología , Frecuencia Cardíaca/fisiología , Adulto , Progesterona/sangre , Emociones/fisiología , Afecto/fisiología , Nervio Vago/fisiología , Adulto Joven , Síndrome Premenstrual/fisiopatología , Síndrome Premenstrual/psicologíaRESUMEN
Given the bidirectional association between psychopathology and relationship distress, an in-depth understanding of couples' interaction processes that contribute to psychopathology is needed. This study examined the interpersonal dynamics of vocally-encoded emotional arousal (fundamental frequency, f0) during couple conversations and their associations with depressive symptoms, anxiety symptoms, and relationship distress. Data from eight samples were pooled (N = 404 couples) to examine (a) overall trajectories of f0 across the interaction and (b) moment-by-moment intraindividual changes in and interpersonal reactivity to partners' f0. Multilevel growth models and repeated-measures actor-partner interdependence models demonstrated that individuals with more severe depression showed more synchronizing reactivity to their partners' f0 on a moment-by-moment basis, and their overall baseline level of f0 was lower. More severe relationship distress was associated with more steeply increasing trajectories of f0 and with greater synchronizing reactivity to partners' f0. Relative differences in depressive symptoms between the two members of a couple were associated with interpersonal dynamics of f0 as well. There were no associations with anxiety symptoms. Thus, depressive symptoms were associated with characteristic interpersonal dynamics of vocally-encoded emotional arousal; yet, most consistent associations emerged for relationship distress, which future studies on individual psychopathology should take into account.
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Ansiedad , Depresión , Relaciones Interpersonales , Humanos , Femenino , Masculino , Depresión/psicología , Ansiedad/psicología , Adulto , Distrés Psicológico , Adulto Joven , Persona de Mediana Edad , Nivel de Alerta , EmocionesRESUMEN
BACKGROUND: The emergence of the COVID-19 pandemic rapidly accelerated the need and implementation of digital innovations, especially in medicine. OBJECTIVE: To gain a better understanding of the stress associated with digital transformation in physicians, this study aims to identify working conditions that are stress relevant for physicians and differ in dependence on digital transformation. In addition, we examined the potential role of individual characteristics (ie, age, gender, and actual implementation of a digital innovation within the last 3 years) in digitalization-associated differences in these working conditions. METHODS: Cross-sectional web-based questionnaire data of 268 physicians (mean age 40.9, SD 12.3 y; n=150, 56% women) in Germany were analyzed. Physicians rated their chronic stress level and 11 relevant working conditions (ie, work stressors such as time pressure and work resources such as influence on sequence) both before and after either a fictional or real implementation of a relevant digital transformation at their workplace. In addition, a subsample of individuals (60; n=33, 55% women) submitted self-collected hair samples for cortisol analysis. RESULTS: The stress relevance of the selected working conditions was confirmed by significant correlations with self-rated chronic stress and hair cortisol levels (hair F) within the sample, all of them in the expected direction (P values between .01 and <.001). Multilevel modeling revealed significant differences associated with digital transformation in the rating of 8 (73%) out of 11 working conditions. More precisely, digital transformation was associated with potentially stress-enhancing effects in 6 working conditions (ie, influence on procedures and complexity of tasks) and stress-reducing effects in 2 other working conditions (ie, perceived workload and time pressure). Younger individuals, women, and individuals whose workplaces have implemented digital innovations tended to perceive digitalization-related differences in working conditions as rather stress-reducing. CONCLUSIONS: Our study lays the foundation for future hypothesis-based longitudinal research by identifying those working conditions that are stress relevant for physicians and prone to differ as a function of digital transformation and individual characteristics.
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COVID-19 , Estrés Laboral , Médicos , Humanos , Estudios Transversales , Femenino , Adulto , Masculino , Médicos/psicología , Médicos/estadística & datos numéricos , COVID-19/psicología , Estrés Laboral/psicología , Persona de Mediana Edad , Alemania , Encuestas y Cuestionarios , SARS-CoV-2 , Hidrocortisona/análisis , Lugar de Trabajo/psicología , Cabello , Estrés Psicológico/psicología , Pandemias , Carga de Trabajo/psicologíaRESUMEN
PURPOSE: Endometriosis and infertility are associated with impaired partnership and sexuality of the patients, but also of their male partners. Also, endometriosis is one of the most common causes of infertility, resulting in a large overlap of both pathologies. The aim of this study was to determine the association of different predictors of partnership and sexual satisfaction and dyadic effects in couples with endometriosis and infertility. METHODS: A cross-sectional study was conducted with n = 62 women with endometriosis and n = 46 partners, including a total of n = 44 couples, some of whom were affected by infertility. The questionnaire included items on partnership, sexuality, depression, social support, and desire for a child. Multiple linear regression and the actor-partner-interdependence-model were used for analysis. RESULTS: Significant dyadic effects only occurred in couples with both endometriosis and infertility. Depression showed a significant negative actor effect in men for partnership satisfaction and a negative actor and partner effect in women for sexuality satisfaction (p < .05). For women, social support showed a significant positive actor effect for partnership satisfaction (p < .05), age showed a significant actor and partner effect for sexuality satisfaction (p < .05). CONCLUSION: The results show a significant association of endometriosis and infertility with partnership and sexuality satisfaction. Infertility could be a decisive factor. However, the large overlapping of both endometriosis und infertility in many couples support the importance of further studies to differentiate between the both effects. TRIAL REGISTRATION: German Clinical Trials Register DRKS00014362 on the 29.03.2018.
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Endometriosis , Satisfacción Personal , Apoyo Social , Humanos , Endometriosis/psicología , Endometriosis/complicaciones , Femenino , Masculino , Estudios Transversales , Adulto , Encuestas y Cuestionarios , Infertilidad Femenina/psicología , Infertilidad Femenina/etiología , Depresión/psicología , Depresión/etiología , Parejas Sexuales/psicología , Relaciones Interpersonales , Infertilidad/psicologíaRESUMEN
Lesbian, gay, bisexual, and transgender individuals (hereafter people with minoritized sexual orientation and/or gender identities) have limited legal rights and access to resources because of their marginalized status in society. These limitations are associated with notable health disparities and increase experiences of minority stress. For those in a romantic relationship, being able to communicate and cope with one's partner-dyadic coping-can help buffer stress' deleterious effects on well-being. Given the promise of understanding how dyadic coping can mitigate experiences of sexual minority stress, the Dyadic Coping Inventory-Sexual Minority Stress (DCI-SMS) was recently created and validated with those living in the United States to assess how partners cope with sexual minority stress. Answering a global call to expand psychological science beyond a U.S. centric perspective, the purpose of this study was to validate the DCI-SMS in German and Italian using samples from Austria, Germany, Switzerland, and Italy, respectively. Confirmatory factor analysis results, along with tests of convergent and discriminant validity, and measurement invariance, suggest that the DCI-SMS is a valid measure of stress communication and dyadic coping behaviors for those in a same-gender relationship in the countries sampled. Important future directions include examining its efficacy in other countries, such as those with more adverse sociopolitical climates for people with minoritized sexual orientation and/or gender identities in a same-gender relationship. Limitations and future directions for research and clinical practice are presented. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Adaptación Psicológica , Minorías Sexuales y de Género , Estrés Psicológico , Humanos , Femenino , Masculino , Adulto , Minorías Sexuales y de Género/psicología , Italia , Estrés Psicológico/psicología , Persona de Mediana Edad , Alemania , Psicometría/instrumentación , Adulto Joven , Reproducibilidad de los Resultados , Austria , Suiza , Parejas Sexuales/psicología , Encuestas y CuestionariosRESUMEN
INTRODUCTION: Chronic back pain is a widespread medical condition associated with high socioeconomic costs and increasing prevalence. Despite the advanced implementation of multidisciplinary approaches, providing a satisfactory treatment offer for those affected is often not possible. Exposure therapy (EXP) promises to be an effective and economical form of treatment and in a previous pilot study showed to be superior to cognitive behavioral therapy (CBT) in reducing perceived limitations of movement. The current study aims to further compare the efficacy of both treatment methods and identify those patient groups that particularly benefit from EXP. METHODS: The general objective of this randomized multicenter clinical trial (targeted N = 380) is to improve and expand the range of treatments available to patients with chronic back pain. As the primary objective of the study, two different psychological treatments (EXP and CBT) will be compared. The primary outcome measure is a clinically significant improvement in pain-related impairment, measured by the QPBDS, from baseline to 6-month follow-up. Secondary outcome measures are absolute changes and clinically significant improvements in variables coping, psychological flexibility, depressiveness, catastrophizing, exercise avoidance and fear of exercise, and intensity of pain. Participants are recruited in five psychological and medical centers in Germany and receive ten sessions of manualized therapy by trained licensed CBT therapists or clinical psychologists, who are currently in their post-gradual CBT training. Potential predictors of each treatment's efficacy will be explored with a focus on avoidance and coping behavior. CONCLUSION: This study will be the first RCT to compare CBT and EXP in chronic back pain in a large sample, including patients from different care structures due to psychological and medical recruitment centers. By identifying and exploring potential predictors of symptom improvement in each treatment group, this study will contribute to enable a more individualized assignment to treatment modalities and thus improves the care situation for chronic back pain and helps to create a customized treatment program for subgroups of pain patients. If our findings confirm EXP to be an efficacious and efficient treatment concept, it should gain more attention and be further disseminated. TRIAL REGISTRATION: ClinicalTrials.gov NCT05294081. Registered on 02 March 2022.
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Dolor Crónico , Terapia Cognitivo-Conductual , Humanos , Proyectos Piloto , Dolor de Espalda/diagnóstico , Dolor de Espalda/terapia , Dolor de Espalda/psicología , Terapia Cognitivo-Conductual/métodos , Miedo , Costos y Análisis de Costo , Dolor Crónico/diagnóstico , Dolor Crónico/terapia , Dolor Crónico/psicología , Resultado del Tratamiento , Ensayos Clínicos Controlados Aleatorios como Asunto , Estudios Multicéntricos como AsuntoRESUMEN
BACKGROUND: Over- and undernutrition coexist in many African countries and pose a threat to metabolic health. This study assessed the associations between relationship satisfaction and Body Mass Index (BMI), waist circumference (WC), and glycated hemoglobin (HbA1c), in a rural population of older adults in Burkina Faso. It also explored potential gender differences and the mediating role of depressive symptoms. METHODS: Data from the "Centre de Recherche en Santé de Nouna (CRSN) Heidelberg Aging Study (CHAS)," a cross-sectional population-based study conducted in 2018 in Burkina Faso, were used in our study. Hierarchical linear regression models were applied for each of the three outcome variables. Among 2291 participants aged 40 years or older who provided data on relationship satisfaction, 2221, 2223, and 2145 participants had BMI, waist circumference (WC), and HbA1c values respectively. RESULTS: Higher relationship satisfaction (CSI-4 score) was associated with increased BMI (ß = 0.05, p = 0.031) and WC (ß = 0.12, p = 0.039). However, the association of CSI-4 and BMI became non-significant after controlling for depressive symptoms (PHQ-9 score) and physical inactivity (BMI: ß = 0.04, p = 0.073). Depressive symptoms fully mediated the relationship between relationship satisfaction and BMI (ß = -0.07, p = 0.005). There was no significant association between relationship satisfaction and HbA1c. These results were consistent across genders and age groups. CONCLUSION: Higher relationship satisfaction may lead to increased body weight among Burkinabe adults aged 40 years and older, and depressive symptoms may be a mediator in this association.
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Satisfacción Personal , Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Estudios Transversales , Hemoglobina Glucada , Índice de Masa Corporal , Circunferencia de la Cintura , Burkina Faso/epidemiología , Factores de RiesgoRESUMEN
The fact that endometriosis is one of the most frequent gynaecological disorders in women and girls is gradually attracting greater public and political attention. There is also substantial awareness of the disorder among German gynaecologists, albeit without sufficient "equipment" for discussing the condition with patients and providing psychological counselling. This article offers hands-on proposals for medical counselling and the discussion of relevant issues, as well as other practical tips and suggested verbalisations for use by women suffering from endometriosis (and their partners). These practical recommendations will certainly help to improve the doctor-patient relationship in the case of endometriosis. The resources mentioned below (guidebooks, websites) focus on German-language offerings only.
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Endometriosis , Humanos , Femenino , Endometriosis/terapia , Relaciones Médico-Paciente , Consejo , ComunicaciónRESUMEN
BACKGROUND: Studies have shown that depression and interpersonal relationships are interdependently connected and that including the intimate partner in treatment for depression has beneficial effects. Given evidence that compassion is both an interpersonal quality and a promising treatment target, the goal of this study was to examine the effects of a compassion-based, contemplative treatment for couples employing a multi-method approach for evaluation. METHODS: In a pre-post-follow-up design, n = 53 different-sex couples including women with current depression were randomly assigned to a 10-week-long CBCT®-fC (Cognitively-Based Compassion Training/intervention for couples) or treatment-as-usual (TAU) condition. Multi-level linear regression models and post-hoc contrasts were calculated to determine changes in depressive symptoms, mindfulness and self-compassion, interpersonal functioning and neuroendocrine markers collected during a partnership appreciation task (PAT) in the laboratory before and after CBCT-fC treatment. RESULTS: While CBCT-fC led to a comparable decrease of depressive symptoms as TAU, the training specifically increased self-compassion and mindfulness versus TAU. Interestingly, interpersonal functioning did not improve, which was also reflected in participants' preferred self-focus in-between-session practices, instead of practices with interpersonal focus. There were no group-specific changes in psychobiological stress-marker reactivity. CONCLUSIONS: CBCT-fC was effective in decreasing current depressive symptomatology and increasing mindfulness, and self-compassion. Especially the motivation to participate, such as improving interpersonal functioning, should be addressed and intrinsic motives of the partners to be involved. In highly burdened individuals, self-regulation may need to be improved before co-regulation can be addressed, which would requiring longer treatments. Facilitating factors for engaging in the practice between-sessions seem meaningful.
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Trastorno Depresivo , Atención Plena , Humanos , Femenino , Empatía , Atención Plena/métodos , Ansiedad , Proyectos de Investigación , Trastorno Depresivo/terapiaRESUMEN
PURPOSE: For many couples, bearing children is a common life goal; however it cannot always be fulfilled. Undergoing infertility treatment does not always guarantee pregnancies and live births. Couples experience miscarriages and even discontinue infertility treatment. Significant medical predictors for the outcome of infertility treatment have yet to be fully identified. METHODS: To further our understanding, a cross-sectional 5-year follow-up survey was undertaken, in which 95 women and 82 men that have been treated at the Women's Hospital of Heidelberg University participated. Binary logistic regressions, parametric and non-parametric methods were used for our sample to determine the relevance of biological (infertility diagnoses, maternal and paternal age) and lifestyle factors (smoking, drinking, over- and underweight) on the outcome of infertility treatment (clinical pregnancy, live birth, miscarriage, dropout rate). In addition, chi-square tests were used to examine differences in the outcome depending on the number of risk factors being present. RESULTS: In the binary logistic regression models for clinical pregnancies, live births and drop outs were statistically significant only for the maternal age, whereas the maternal and paternal BMI, smoking, infertility diagnoses and infections showed no significant predicting effect on any of the outcome variables. A correlation between the number of risk factors and the outcome of infertility treatment could not be excluded. CONCLUSION: The results confirm that maternal age has an effect on infertility treatment, whereas the relevance of other possible medical predictors remains unclear. Further large-scale studies should be considered to increase our knowledge on their predictive power.
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Aborto Espontáneo , Infertilidad , Embarazo , Masculino , Niño , Humanos , Femenino , Estudios Transversales , Estudios de Seguimiento , Infertilidad/terapia , Edad Materna , Nacimiento Vivo/epidemiología , Aborto Espontáneo/epidemiología , Técnicas Reproductivas Asistidas , Resultado del TratamientoRESUMEN
Endometriosis is currently the second most common gynecological disease and is associated with severe pain, vegetative impairment, and infertility. In association, there are considerable psychological symptoms that limit the quality of life of those affected. In this narrative review, the Research Domain Criteria (RDoC) framework was utilized to display the different transdiagnostic processes involved in disease progression and maintenance in regard to psychosocial functioning. Using the RDoC framework, it becomes clear that immune/endocrinological dysregulation is interlocked with (pelvic) pain chronification processes and psychological symptoms such as depressive mood, loss of control, higher vigilance toward the onset or worsening of symptoms, social isolation, and catastrophizing. This paper will discuss and identify promising treatment approaches, in addition to medical care, as well as further research implications. Endometriosis can come with substantial psychosomatic and social burden, requiring more research to understand the interdependence of different factors involved in its chronic development pathway. However, it is already clear that standard care should be extended with multifaceted treatments addressing pain, as well as the psychological and social burden, in order to halt the cycle of aggravation of symptoms and to improve quality of life for patients.
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Background: Affectionate touch, which is vital for mental and physical health, was restricted during the Covid-19 pandemic. This study investigated the association between momentary affectionate touch and subjective well-being, as well as salivary oxytocin and cortisol in everyday life during the pandemic. Methods: In the first step, we measured anxiety and depression symptoms, loneliness and attitudes toward social touch in a large cross-sectional online survey (N = 1050). From this sample, N = 247 participants completed ecological momentary assessments over 2 days with six daily assessments by answering smartphone-based questions on affectionate touch and momentary mental state, and providing concomitant saliva samples for cortisol and oxytocin assessment. Results: Multilevel models showed that on a within-person level, affectionate touch was associated with decreased self-reported anxiety, general burden, stress, and increased oxytocin levels. On a between-person level, affectionate touch was associated with decreased cortisol levels and higher happiness. Moreover, individuals with a positive attitude toward social touch experiencing loneliness reported more mental health problems. Conclusions: Our results suggest that affectionate touch is linked to higher endogenous oxytocin in times of pandemic and lockdown and might buffer stress on a subjective and hormonal level. These findings might have implications for preventing mental burden during social contact restrictions. Funding: The study was funded by the German Research Foundation, the German Psychological Society, and German Academic Exchange Service.
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Oxitocina , Tacto , Humanos , Control de Enfermedades Transmisibles , COVID-19/epidemiología , Estudios Transversales , Evaluación Ecológica Momentánea , Hidrocortisona , Oxitocina/sangre , PandemiasRESUMEN
Dysregulations of the hypothalamic-pituitary-adrenal (HPA) and sympatho-adrenal medullary (SAM) axis are associated with mental and somatic illness. However, there is lack of knowledge regarding the molecular mechanisms underlying these effects. Epigenetic states in the serotonin transporter gene (SLC6A4) were shown to be associated with stress in various forms. We hypothesized that levels of DNA methylation (DNAm) of SLC6A4 would be associated with altered SAM- and HPA regulation in daily life. N = 74 healthy persons participated in the study. An ecological momentary assessment (EMA) approach was used to assess indicators of stress in daily life. Each day included six concurrent assessments of saliva, to quantify cortisol (sCort; HPA axis) and alpha-amylase (sAA; SAM axis), and to assess self-reports on subjective stress. To assess SLC6A4 DNAm, peripheral blood was drawn and analyzed via bisulfite pyrosequencing. All data were assessed in two waves three months apart, each including two days of EMA and the assessment of SLC6A4 DNAm. Data were analyzed using multilevel models. On the between-person level, higher average levels of SLC6A4 DNAm were associated with higher average levels of sAA, but not with average levels of sCort. On the within-person level, higher levels of SLC6A4 DNAm were associated with lower levels of sAA and sCort. There were no associations of subjective stress with SLC6A4 DNAm. The results help to clarify the association between environmental stress and stress axes regulation, pointing towards an important role of differential within- and between-person effects of SLC6A4 DNAm, which might shape this association.
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alfa-Amilasas Salivales , Humanos , alfa-Amilasas Salivales/genética , alfa-Amilasas Salivales/metabolismo , Hidrocortisona/genética , Sistema Hipotálamo-Hipofisario/metabolismo , Proteínas de Transporte de Serotonina en la Membrana Plasmática/genética , Proteínas de Transporte de Serotonina en la Membrana Plasmática/metabolismo , Estrés Psicológico/genética , Sistema Hipófiso-Suprarrenal/metabolismo , Metilación de ADN/genética , Saliva/metabolismoRESUMEN
Self-reported pain levels have been associated with increased stress levels during the COVID-19 pandemic. Less is known about the long-term effects of stress on individuals' physical and emotional pain levels and their associations with the neuropeptide hormone oxytocin. We aimed to predict momentary pain through individual stress levels and momentary oxytocin levels at genuinely high-stress phases, namely during COVID-related lockdowns. In a cross-sectional (n = 254) and a longitudinal (n = 196) assessment during lockdowns in Germany, participants completed a 2-day ecological momentary assessment (EMA) protocol (collecting six saliva samples on two consecutive days each and simultaneously reporting on stress, physical, and emotional pain levels) in 2020, as well as one year later, in 2021. Hierarchical linear modeling revealed significant positive associations between individuals' stress levels and physical pain, both cross-sectionally (b = 0.017; t(103) = 3.345; p = 0.001) and longitudinally (b = 0.009; t(110) = 2.025; p = 0.045). Similarly, subjective stress ratings showed significant positive associations with emotional pain on a within-person (b = 0.014; t(63) = 3.594; p < 0.001) as well as on a between-person (b = 0.026; t(122) = 5.191; p < 0.001) level. Participants further displayed significantly lower salivary oxytocin when experiencing higher levels of emotional pain (b = -0.120; t(163) = -2.493; p = 0.014). In addition, high-stress levels significantly moderated the association between physical pain and salivary oxytocin (b = -0.012; t(32) = -2.150; p = 0.039). Based on mechanistic and experimental research, oxytocinergic mechanisms have long been suggested to modulate pain experiences, however, this has not yet been investigated in everyday life. Our data, which was collected from a large sample experiencing continued stress, in this case, during the COVID-19 pandemic, suggests that individuals experience more intense physical pain and elevated stress levels, as shown by particularly low salivary oxytocin concentrations.
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A physical or mental illness affects not only patients but also their family environment. The immediate (caring) relatives are of particular importance in coping with the illness. However, they are often overlooked as invisible patients in the second row. Using selected diseases such as cancer, dementia and pain as examples, the following article will illustrate the special importance of working with relatives and couples. The focus in this article is on adult relatives. The group of children as relatives requires separate consideration.
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Trastornos Mentales , Adulto , Niño , Humanos , Trastornos Mentales/terapia , Adaptación Psicológica , FamiliaRESUMEN
Mental contrasting with implementation intentions (MCII) has been successfully applied to improve health-related behaviors (e.g. exercise). We explored its effectiveness to improve sleep outcomes beyond effects of sleep hygiene (SH) information, and investigated associations with stress. Eighty university employees (mean age: 29.6, SD = 4.5) were randomized to either a MCII + SH or a SH-only condition. During a baseline-week and a post-intervention week, sleep duration (Fitbit Alta and self-report), sleep quality, and stress were assessed daily and saliva was collected to assess the cortisol awakening response (CAR). In total, self-reported sleep quality and duration increased, but there was no meaningful condition*week interaction for sleep parameters or CAR. Higher average stress was associated with shorter sleep duration and lower sleep quality. Within-person, days with higher stress were followed by nights with lower sleep quality. Despite overall improvements, effects of MCII were not confirmed. MCII might be less effective to improve behaviors which are less controllable.
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Intención , Sueño , Humanos , Adulto , Sueño/fisiología , Ejercicio Físico , Salud Mental , Duración del Sueño , Hidrocortisona , SalivaRESUMEN
The hypothalamic neuropeptide oxytocin (OT) exerts prominent analgesic effects via central and peripheral action. However, the precise analgesic pathways recruited by OT are largely elusive. Here we discovered a subset of OT neurons whose projections preferentially terminate on OT receptor (OTR)-expressing neurons in the ventrolateral periaqueductal gray (vlPAG). Using a newly generated line of transgenic rats (OTR-IRES-Cre), we determined that most of the vlPAG OTR expressing cells targeted by OT projections are GABAergic. Ex vivo stimulation of parvocellular OT axons in the vlPAG induced local OT release, as measured with OT sensor GRAB. In vivo, optogenetically-evoked axonal OT release in the vlPAG of as well as chemogenetic activation of OTR vlPAG neurons resulted in a long-lasting increase of vlPAG neuronal activity. This lead to an indirect suppression of sensory neuron activity in the spinal cord and strong analgesia in both female and male rats. Altogether, we describe an OT-vlPAG-spinal cord circuit that is critical for analgesia in both inflammatory and neuropathic pain models.
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Neuralgia , Oxitocina , Ratas , Masculino , Femenino , Animales , Oxitocina/metabolismo , Sustancia Gris Periacueductal/fisiología , Neuronas/metabolismo , Analgésicos/farmacología , Neuralgia/metabolismoRESUMEN
Love is probably the most fascinating feeling that a person ever experiences. However, little is known about what is happening in the brains of a romantic couple-the central and most salient relationship during adult age-while they are particularly tender and exchanging loving words with one another. To gain insight into nearly natural couple interaction, we collected data from N = 84 individuals (including N = 43 heterosexual couples) simultaneously in two functional magnetic resonance imaging scanners, while they sent and received compliments, i.e. short messages about what they liked about each other and their relationship. Activation patterns during compliment sharing in the individuals revealed a broad pattern of activated brain areas known to be involved in empathy and reward processing. Notably, the ventral striatum, including parts of the putamen, was activated particularly when selecting messages for the partner. This provides initial evidence that giving a verbal treat to a romantic partner seems to involve neural reward circuitry in the basal ganglia. These results can have important implications for the neurobiological mechanisms protecting and stabilizing romantic relationships, which build a highly relevant aspect of human life and health.
Asunto(s)
Emociones , Imagen por Resonancia Magnética , Adulto , Humanos , Ganglios Basales/diagnóstico por imagen , Encéfalo/diagnóstico por imagen , EmpatíaRESUMEN
BACKGROUND: Approximately seven to nine percent of couples of reproductive age do not get pregnant despite regular and unprotected sexual intercourse. Various psychosocial interventions for women and men with fertility disorders are repeatedly found in the literature. The effects of these interventions on outcomes such as anxiety and depression, as well as on the probability of pregnancy, do not currently allow for reliable generalisable statements. This review includes studies published since 2015 performing a method-critical evaluation of the studies. Furthermore, we suggest how interventions could be implemented in the future to improve anxiety, depression, and pregnancy rates. METHOD: The project was registered with Prospero (CRD42021242683 13 April 2021). The literature search was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Six databases were searched and 479 potential studies were discovered. After reviewing the full texts, ten studies were included for the synthesis. Not all studies reported the three outcomes: four studies each for depression, three for anxiety and nine studies for pregnancy rates were included in the meta-analysis, which was conducted using the Comprehensive meta-analysis (CMA) software. RESULTS: Psychosocial interventions do not significantly change women's anxiety (Hedges' g -0,006; CI: -0,667 to 0,655; p = 0,985), but they have a significant impact on depression in infertile women (Hedges' g -0,893; CI: -1,644 to -0,145; p = 0,026). Implementations of psychosocial interventions during assisted reproductive technology (ART) treatment do not increase pregnancy rates (odds ratio 1,337; 95% CI 0,983 to 1,820; p = 0,064). The methodological critical evaluation indicates heterogeneous study design and samples. The results of the studies were determined with different methods and make comparability difficult. All these factors do not allow for a uniform conclusion. METHODOLOGICAL CRITICAL EVALUATION: Study design (duration and timing of intervention, type of intervention, type of data collection) and samples (age of women, reason for infertility, duration of infertility) are very heterogeneous. The results of the studies were determined with different methods and make comparability difficult. All these factors do not allow for a uniform conclusion. CONCLUSION: In order to be able to better compare psychosocial interventions and their influence on ART treatment and thus also to achieve valid results, a standardised procedure to the mentioned factors is necessary.