RESUMO
Bereavement is one of the most intense, distressing, and traumatic events an elderly person will experience. The symptom responses to bereavement vary, particularly during the first year. However, the neurobiology underlying the symptom variance in grief is poorly understood. The endocannabinoid signaling (ECS) system is stress-responsive; mounting evidence implicates the central ECS in psychopathology. The current study aimed to investigate the hypothesis that the ECS is abnormal in grief, using circulating eCB concentrations as a biomarker of central ECS. A predominantly older sample of grief participants, within 13 months following the death of a loved one, and healthy comparison (HC) participants were studied. Associations of circulating eCBs with symptom variance in grievers were also examined. A total of 61 (grief: n = 44; HC: n = 17) adults completed cross-sectional clinical assessments and a fasting blood draw. Assessments included the Inventory of Complicated Grief scale; the 17-item Hamilton Depression Rating Scale; and the Hamilton Anxiety scale. Serum eCB concentrations (i.e., N-arachidonoylethanolamine [AEA] and 2-arachidonoylglycerol [2-AG]) were quantified using isotope dilution, liquid chromatography-mass spectrometry. Relative to HC participants, grievers had significantly elevated serum AEA but similar 2-AG concentrations. In grievers, serum AEA concentrations were positively associated with depressive and anxiety symptoms, but only in those with low grief symptoms. These novel findings indicate that elevated circulating eCB concentrations are found following bereavement. The eCB signaling response varies based on the degree of grief severity. Circulating eCB measures may have the potential to serve as biomarkers of prolonged grief disorder.
Assuntos
Endocanabinoides/análise , Pesar , Idoso , Idoso de 80 Anos ou mais , Ansiedade/metabolismo , Ansiedade/fisiopatologia , Ácidos Araquidônicos/análise , Ácidos Araquidônicos/sangue , Luto , Biomarcadores/sangue , Estudos Transversais , Depressão/metabolismo , Depressão/fisiopatologia , Endocanabinoides/sangue , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Alcamidas Poli-Insaturadas/análise , Alcamidas Poli-Insaturadas/sangueRESUMO
The value of assessing health-related quality of life (HRQoL) in traumatic brain injury (TBI) patients has been increasingly recognized in recent years. Yet, research examining generic and TBI-specific quality of life (QOL) methodologies within this population has been limited, rendering decisions to use one alternative over another difficult and based largely on conceptual grounds. The current study compared widely used generic QoL/HRQOL measures (Satisfaction With Life Scale, 36-item Short Form Survey) and newer population-specific HRQoL measures (Quality of Life after Brain Injury [QOLIBRI], Trauma-Quality of Life [TQoL]) among 77 TBI and 23 orthopedically injured trauma control patients. The QOLIBRI Cognition and Physical Problems subscales were the only HRQoL scores across the four instruments administered that differentiated between patient groups: participants with TBI reported being significantly less satisfied with their cognitive abilities and more bothered by physical problems. Analyses of the unique population-specific QOLIBRI content revealed that 12.2-31.5% of TBI patients endorsed dissatisfaction and 28.8-51.4% endorsed being bothered by items unique to the QOLIBRI. Endorsement rates for unique TQoL items ranged from 1.4-75.7%. Overall, the QOLIBRI and TQoL appear to capture important information pertinent to patients with TBI and trauma. Inclusion of these disease-specific HRQoL measures is recommended over the use of only generic measures among TBI populations.
Assuntos
Lesões Encefálicas Traumáticas/epidemiologia , Lesões Encefálicas Traumáticas/psicologia , Qualidade de Vida/psicologia , Recuperação de Função Fisiológica/fisiologia , Adulto , Lesões Encefálicas Traumáticas/diagnóstico , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados da Assistência ao Paciente , Estudos Prospectivos , Ferimentos e Lesões/diagnóstico , Ferimentos e Lesões/epidemiologia , Ferimentos e Lesões/psicologiaRESUMO
BACKGROUND: Although cognitive inhibition deficits and attentional biases have been associated with suicidality, these findings have not been consistently reported across samples. The aim of the current study was to further investigate these variables among participants with differing suicidal risk. METHODS: We compared affective go/no-go performance in 100 depressed individuals with both current suicidal ideation and a prior history of attempted suicide, 100 depressed individuals with current suicidal ideation, but no history of attempted suicide, 100 suicide attempters without current depression or suicidal ideation, and 100 healthy controls. RESULTS: Suicide ideators with a history of attempted suicide committed more commission errors during negative word trials than any other group. Additionally, suicide ideators with no attempt history made more commission errors than did controls and previous attempters. An interaction for group status and emotional word valence revealed that suicide ideators with a history of attempted suicide responded fastest to negative words and slowest to positive words. Suicide ideators without an attempt history displayed a similar, but less pronounced pattern. Whereas, controls and previous attempters responded more quickly to positively valenced words. LIMITATIONS: The use of cross-sectional self-report data and inclusion of only female participants limits generalizability. CONCLUSIONS: Cognitive dysfunctions were apparent in all suicide vulnerable subjects, but significantly greater in suicide ideators with a history of attempted suicide. Suicidal ideation may be associated with a processing bias and inhibitory deficit for negative, mood-congruent information. These findings increase our knowledge of cognitive impairment in suicidality and may potentially help improve intervention strategies.