Personality changes related to presence and treatment of substance use (disorders): a systematic review.

Heavy substance use (SU) and substance use disorders (SUD) have complex etiologies and often severe consequences. Certain personality traits have been associated with an increased risk for SU(D), but far less is known about personality changes related to SU(D). This review aims to synthesize the existing literature on this research question. A systematic literature search was conducted from November 2022 to February 2023 in PubMed, EbscoHost, and Web of Science. Peer-reviewed original papers on SU(D)-related personality changes were included. Of 55 included studies, 38 were observational population-based studies and 17 were intervention studies. Overall, personality and SU measures, samples, study designs, and statistical approaches were highly heterogenous. In observational studies, higher SU was most consistently related to increases in impulsivity-related traits and (less so) neuroticism, while interventions in the context of SU(D) were mostly associated with increases in conscientiousness and self-efficacy and lasting decreases in neuroticism. Findings for traits related to extraversion, openness, conscientiousness, and agreeableness were mixed and depended on SU measure and age. Studies on bidirectional associations suggest that personality and SU(D) both influence each other over time. Due to their strong association with SU(D), impulsivity-related traits may be important target points for interventions. Future work may investigate the mechanisms underlying personality changes related to SU(D), distinguishing substance-specific effects from general SU(D)-related processes like withdrawal, craving, and loss of control. Furthermore, more research is needed to examine whether SU(D)-related personality changes vary by developmental stage and clinical features (e.g. initial use, onset, remission, and relapse).

Working life as a double-edged sword: Opposing changes in subjective well-being surrounding the transition to work and retirement.

The work role is crucial for one's identity and subjective well-being. From a role enhancement perspective, subjective well-being might increase after the transition to work and decrease after retirement. From a role strain perspective, the opposite might be true. Thus, entering and leaving working life might have benefits and costs, leading to improvements in some but impairments in other well-being indicators. To test these assumptions, we examined short- and long-term changes in life satisfaction, happiness, sadness, anxiety, and anger in the 5 years before and 5 years after the transition to work and retirement, respectively. Between 2007 and 2019, each facet of subjective well-being was repeatedly assessed in 2,720 (expectant) career starters and 2,007 (expectant) retirees from the German Socio-Economic-Panel Study. Multilevel analyses adjusted for time-dependent confounders indicated that young adults were more satisfied with their lives in (but not beyond) the first year of working life compared to before, which is in line with set-point theory. In the first 5 years of working life, career starters became happier but also angrier, supporting both the role enhancement and the role strain perspective. Older adults became less satisfied, less happy, sadder, and more anxious in the 5 years before retirement. However, in and after the first year of retirement, they were more satisfied, happier, less anxious, and less angry than before, supporting the role strain perspective. Our findings show that working life is a double-edged sword that influences individual well-being indicators in partially opposing ways. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Ecological momentary assessment and applied relaxation: Results of a randomized indicated preventive trial in individuals at increased risk for mental disorders.

Applied Relaxation (AR) is an established behavioral mental health intervention, but its efficacy in real life contexts remains unclear. Using randomized controlled trial data, we examined whether AR can effectively reduce mental health problems in daily life. A sample of 277 adults with increased psychopathological symptoms but without 12-month DSM-5 mental disorders at study entry was randomly assigned to an intervention group receiving AR training (n = 139) and an assessment-only control group (n = 138). Ecological momentary assessments were used to assess psychological outcomes in daily life over a period of seven days at baseline, post, and 12-month follow-up, respectively. Multilevel analyses indicated that all psychopathological symptoms decreased more in the intervention group than in the control group from baseline to post (range ß = -0.31 for DASS-depression to ß = -0.06 for PROMIS-anger). However, from post to follow-up, psychopathological symptoms decreased more in the control group than in the intervention group, so that only the intervention effects for PROMIS-depression (ß = -0.10) and PROMIS-anger (ß = -0.09) remained until follow-up. Moreover, positive affect (ß = 0.19), internal control beliefs (ß = 0.15), favorable coping (ß = 0.60), and unfavorable coping (ß = -0.41) improved more in the intervention group than in the control group, and these effects were mostly maintained in the long term. Some effects were stronger among women, older individuals, and individuals with higher initial symptoms. These findings suggest that AR can effectively reduce mental health problems in daily life. Trial registration. The trial has been registered at ClinicalTrials.gov (NCT03311529).

Illness anxiety predicts higher mental strain and vaccine willingness-A nine-wave longitudinal study during the first 1.5 years of the COVID-19 pandemic in Germany.

Illness anxiety may amplify vulnerability to psychopathological symptoms during the COVID-19-pandemic-perhaps especially at the beginning of the pandemic and during high infection waves, but empirical evidence on this is lacking. In addition, considering a potentially functional facet of it, illness anxiety might be associated with higher vaccine willingness. We analyzed data of a nine-wave longitudinal online-survey (March 2020-October 2021) with 8148 non-probability sampled adults of the general population in Germany (clinicaltrials.gov: NCT04331106). Using multilevel analysis, we investigated longitudinal associations of dimensionally assessed illness anxiety (worry about illness, bodily preoccupation) with mental strain and vaccine willingness and considered the dynamic of the pandemic (i.e., duration and infection rates). Higher worry about illness and bodily preoccupation were associated with higher COVID-19-related fears, unspecific anxiety, depressive symptoms, and vaccine willingness. Vaccine willingness increased over time and in parallel to higher infection rates. Symptoms of mental strain decreased with continuing duration of the pandemic but increased when infection rates inclined. This decrease and increase, respectively, was steeper in individuals with higher illness anxiety. Our findings suggest that individuals with higher illness anxiety are more vulnerable to experience psychopathological symptoms during the ongoing pandemic, particularly at its beginning and during times of high infection rates. Thus, illness anxiety and associated symptoms should be targeted by adaptive measures. The fluctuation of symptoms parallel to the pandemic situation implies that support should be particularly issued at the beginning of extraordinary situations as well as during phases of high infection rates.

The impact of mode of delivery on parent-infant-bonding and the mediating role of birth experience: a comparison of mothers and fathers within the longitudinal cohort study DREAM.

BACKGROUND: The association between mode of delivery (MOD) and parent-infant-bonding has only been studied in mothers and findings have been inconclusive. The aim of this study was to prospectively investigate how MOD relates to postpartum parent-infant-bonding in both mothers and fathers and whether these associations are mediated by birth experience. METHODS: This study is part of the prospective cohort study "Dresden Study on Parenting, Work, and Mental Health" (DREAM). Our sample comprised N = 1,780 participants who completed quantitative questionnaires during pregnancy as well as 8 weeks and 14 months postpartum. MOD was dummy coded, contrasting spontaneous vaginal delivery against vaginal delivery induced by drugs, operative vaginal delivery, planned, and unplanned cesarean section. Parent-infant bonding and birth experience were assessed using validated scales. A moderated mediation analysis based on ordinary least square (OLS) regression and bootstrapped estimates was conducted, considering relevant confounding variables. RESULTS: Compared to spontaneous vaginal delivery, all categories of MOD predicted more negative birth experiences in both parents. A more positive birth experience predicted stronger parent-infant-bonding at 8 weeks, but not at 14 months postpartum. Mothers who delivered via cesarean section (planned or unplanned) reported stronger parent-infant-bonding at 8 weeks and 14 months postpartum. In fathers, only unplanned cesarean section was associated with stronger parent-infant-bonding at 8 weeks postpartum. At 8 weeks postpartum, birth experience mediated the association between a vaginal delivery induced by drugs and a planned cesarean section and mother-infant-bonding and between a vaginal delivery induced by drugs, an operative vaginal delivery, and planned cesarean section and father-infant-bonding. At 14 months postpartum, birth experience mediated the association between a vaginal delivery induced by drugs, operative vaginal delivery, and planned cesarean section and parent-infant-bonding in both parents. CONCLUSIONS: The results emphasize the importance of the birth experience for parent-infant-bonding in both mothers and fathers. Further research should address the mechanisms by which parents with an unplanned cesarean section establish stronger parent-infant-bonding compared to parents whose baby was delivered via spontaneous vaginal delivery, despite their overall more negative birth experiences.

Baby bliss: Longitudinal evidence for set-point theory around childbirth for cognitive and affective well-being.

BACKGROUND: Becoming a parent relates not only to joy but also to new challenges. Consistent with set-point theory, previous research found that life satisfaction increased around childbirth but decreased back to baseline in the following years. However, it remains unresolved whether individual facets of affective well-being show lasting or temporary changes around childbirth. METHOD: In 5,532 first-time parents from the German Socio-Economic Panel (SOEP), we tested how life satisfaction, happiness, sadness, anxiety, and anger changed in the five years before and five years after becoming a parent. RESULTS: Parents experienced a large increase in life satisfaction and happiness in the years surrounding the birth of their first child. This increase was most pronounced in the first year of parenthood. Sadness and anger decreased in the years before childbirth, reached their lowest point in the first year of parenthood, and increased in the following years. Anxiety slightly increased in the five years before childbirth but was lower thereafter. Most well-being changes bounced back in the long run, resulting in comparable well-being levels five years after versus five years before becoming a parent. CONCLUSIONS: These findings suggest that set-point theory also applies to different facets of affective well-being across the transition to parenthood. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Anxiety sensitivity elevates the risk of mental health problems in employees with higher probability of contacting COVID-19 at work.

Individuals with increased risk of being in contact with COVID-19 cases at work have been reported to suffer from higher fear of infection and associated mental health problems. The present study examines whether this risk is further increased by higher anxiety sensitivity (AS, i.e., fear of bodily symptoms such as breathlessness, which also are core symptoms of COVID-19) that is also known to be associated with an increased risk of psychopathology. In spring 2020, 783 German health care and social workers participated in a cross-sectional online-survey, in which anxiety sensitivity, depression, anxiety, health anxiety, fear of a COVID-19 infection as well as panic symptoms were assessed. Of these participants, 28.7% affirmed contact with COVID-19 cases, which was associated with greater fear of the virus. Individuals with high AS reported more severe anxiety, health anxiety, depressive symptoms, as well as incident and recurrent panic symptoms. Moreover, the risk association of exposure to COVID-19 cases at work with health anxiety, general anxiety, and panic symptoms was further increased by higher levels of AS. These findings suggest that especially employees with contact to COVID-19 cases who also are high in AS might profit from targeted interventions to prevent excessive fear and associated mental health problems.

Dramatic effects but fast adaptation: Changes in life satisfaction and different facets of affective well-being around the death of a partner and death of a child.

Although everyone would agree that bereavement is extremely stressful, surprisingly little is known about changes in different facets of affective well-being in the years surrounding the death of a loved one. On the basis of the Socio-Economic Panel Study, we examined changes in cognitive well-being (life satisfaction) and different facets of affective well-being (happiness, sadness, anxiety, and anger) in the years around the death of a partner (N = 989) and child (N = 276). Data on the death of a partner and child as well as cognitive and affective well-being were assessed yearly since 2007. Multilevel analyses revealed that both events were associated with very large well-being impairments (>1 SD) that were most pronounced for sadness, happiness, and life satisfaction in the first year of bereavement. Afterwards, bereaved individuals managed to recover impressively well: Levels of life satisfaction, happiness, and sadness were on average similar 5 years after losing a partner or child compared with 5 years before the respective loss. Our findings suggest (a) that many individuals tend to be capable to even cope with highly stressful loss experiences and (b) that Set-Point Theory not only applies to life satisfaction but also different facets of affective well-being around the death of a loved one.

One year after the COVID-19 outbreak in Germany: long-term changes in depression, anxiety, loneliness, distress and life satisfaction.

Several studies have linked the COVID-19 pandemic to unfavorable mental health outcomes. However, we know little about long-term changes in mental health due to the pandemic so far. Here, we used longitudinal data from a general population sample of 1388 adults from Germany, who were initially assessed between April and May 2020 (i.e., at the beginning of the COVID-19 pandemic in Germany) and prospectively followed up after 6 (n = 1082) and 12 months (n = 945). Depressive and anxiety symptoms as well as loneliness did not change from baseline to 6-month follow-up. While anxiety symptoms did not change in the long run, depressive symptoms and loneliness increased and life satisfaction decreased from baseline to 12-month follow-up. Moreover, vulnerable groups such as younger individuals or those with a history of mental disorders exhibited an overall higher level of psychopathological symptoms across all assessment waves. Our findings suggest a deterioration in mental health during the course of the COVID-19 pandemic, which emphasizes the importance to implement targeted health promotions to prevent a further symptom escalation especially in vulnerable groups.

Longitudinal bidirectional associations between personality and becoming a leader.

OBJECTIVE: Leaders differ in their personalities from non-leaders. However, when do these differences emerge? Are leaders "born to be leaders" or does their personality change in preparation for a leadership role and due to increasing leadership experience? METHOD: Using data from the German Socio-Economic Panel Study, we examined personality differences between leaders (N = 2683 leaders, women: n = 967; 36.04%) and non-leaders (N = 33,663) as well as personality changes before and after becoming a leader. RESULTS: Already in the years before starting a leadership position, leaders-to-be were more extraverted, open, emotionally stable, conscientious, and willing to take risks, felt to have greater control, and trusted others more than non-leaders. Moreover, personality changed in emergent leaders: While approaching a leadership position, leaders-to-be (especially men) became gradually more extraverted, open, and willing to take risks and felt to have more control over their life. After becoming a leader, they became less extraverted, less willing to take risks, and less conscientious but gained self-esteem. CONCLUSIONS: Our findings suggest that people are not simply "born to be leaders" but that their personalities change considerably in preparation for a leadership role and due to leadership experience. Some changes are transient, but others last for a long time.

Changes in happiness, sadness, anxiety, and anger around romantic relationship events.

Most people agree that romantic relationships greatly affect how we feel. For example, we typically feel happier when getting married but sadder when breaking up. However, previous research primarily focused on changes in cognitive but less so affective well-being around positive and negative relationship events. Set-point theory suggests that subjective well-being might change shortly around such experiences but bounce back in the long run. Using data from the Socio-Economic Panel study (SOEP), we examined changes in life satisfaction, happiness, sadness, anxiety, and anger in the 5 years before and 5 years after moving in with a partner (N = 4,399), marriage (N = 3,731), separation (N = 3,538), and divorce (N = 1,103). Life satisfaction and happiness increased slightly in the years before moving in and marriage. For marriage, these effects were short-lived and diminished after 1 year. Separation and divorce were associated with much larger well-being impairments (especially a strong increase of sadness) that were most pronounced shortly before and after the event and attenuated in the following years. Changes in anxiety and anger were much smaller. Our findings suggest that romantic relationship events not only relate to substantial changes in life satisfaction but also affective well-being. These changes vary for different well-being facets, are most pronounced for happiness and sadness at the time of the event, and bounce back in the long run. As one of the first studies, we demonstrate that set-point theory not only applies to cognitive but also affective well-being around romantic relationship events. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The role of pre-pandemic depression for changes in depression, anxiety, and loneliness during the COVID-19 pandemic: Results from a longitudinal probability sample of adults from Germany.

BACKGROUND: The present study aims to delineate the role of preexisting depression for changes in common mental health problems during the COVID-19 pandemic. METHODS: Using mixed-effects linear regression models, we analyzed data on the course of depressive (Patient Health Questionnaire-2) and anxiety (Generalized Anxiety Disorder-2) symptoms as well as loneliness (three-item UCLA Loneliness Scale) in a subset of the Socio-Economic Panel Study, a large and nationally representative household panel study from Germany. Participants were assessed during the first COVID-19 wave in Germany (March 31 to July 4, 2020; n = 6,694) and prospectively followed up at the peak of the second COVID-19 wave (January 18 to February 15, 2021; n = 6,038). RESULTS: Overall, anxiety and depressive symptoms decreased, whereas loneliness increased from the first to the second COVID-19 wave. However, depressive symptoms increased and the surge in loneliness was steeper in those with versus without clinically relevant depressive symptoms in 2019 or a history of a depressive disorder before the COVID-19 pandemic. Anxiety symptoms remained stable throughout the pandemic in individuals with versus without clinically relevant depressive symptoms in 2019. Pre-pandemic depression was associated with overall higher depressive and anxiety symptoms and loneliness across both assessments. The stringency of lockdown measures did not affect the results. CONCLUSIONS: Our findings suggest that individuals with a history of depressive symptoms before the COVID-19 pandemic are at increased risk to experience an escalation of mental health problems due to the COVID-19 pandemic. Therefore, they might particularly profit from targeted prevention and early intervention programs.

The impact of postpartum obsessive-compulsive symptoms on child development and the mediating role of the parent-child relationship: A prospective longitudinal study.

Background: The first 2 years of life are a particularly sensitive period for the parent-child relationship as well as a healthy, age-appropriate child development. Both have been shown to be linked to postpartum depressive and anxiety symptoms, while the role of obsessive-compulsive symptoms, which are also common, is still largely understudied. In addition, fathers have been neglected in this area of research. This study, which includes both mothers and fathers, aims to investigate the longitudinal associations between postpartum obsessive-compulsive symptoms and different domains of child development, as well as the mediating role of the parent-child relationship. Methods: Data were drawn from the prospective longitudinal study DREAM, with 674 mothers and 442 fathers from the general population completing self-report questionnaires at four measurement points. Longitudinal associations between parental postpartum obsessive-compulsive symptoms 8 weeks postpartum, the parent-child relationship 14 months postpartum, and child development 24 months postpartum were investigated using regression and mediation analyses. A number of potential confounding variables were considered, i.e., age, academic degree, postpartum depressive and anxiety symptoms of the parents, preterm birth and temperament of the child, as well as COVID-19 pandemic-driven adversities. Results: When adjusting for confounders, neither maternal nor paternal postpartum obsessive-compulsive symptoms had adverse effects on the respective parent-child relationship and child development. Further, no mediating role of the parent-child relationship between parental postpartum obsessive-compulsive symptoms and child development could be confirmed. Instead, we found that the mother- and father-child relationship were differentially related to specific child developmental domains. For mothers, a poorer mother-child relationship was prospectively related to poorer fine motor development. For fathers, a poorer father-child relationship prospectively predicted a poorer overall development as well as poorer gross motor, fine motor, problem-solving, and personal-social development. Conclusion: Our results suggest that negative effects on the parent-child relationship and child development may only become apparent in full-blown postpartum obsessive-compulsive disorder. Given the differential impact on specific developmental domains, our findings also suggest that it is crucial to consider both parents in clinical practice as well as in future research, rather than focusing only on the mother-child dyad.

1.5 years pandemic - Psychological burden over the course of the COVID-19 pandemic in Germany: A nine-wave longitudinal community study.

BACKGROUND: The dynamic COVID-19 pandemic has been associated with mental strain. However, most studies focused primarily on the beginning of the pandemic and rarely took into account the long-term course. The aim of this prospective-longitudinal study was to investigate levels and changes of pandemic-related fears, unspecific anxiety, depressive symptoms, and psychosocial-behavioral factors over the first 1.5 years of the pandemic. METHODS: We conducted a nine-wave longitudinal online-survey from March 2020 to October 2021 with a total of 8148 participants of the adult general population in Germany. Descriptive examination and multilevel analysis were carried out to assess psychological burden, risk-bearing and protective psychosocial-behavioral factors, and associations with sociodemographics and the pandemic's duration and severity over the course of the pandemic. RESULTS: Symptoms of mental strain fluctuated across the pandemic and displayed a relative maximum at the pandemic's early beginning and during the second and third COVID-19 waves. Most participants (approximately 67.4 %-82.1 %) reported mild and transient symptoms, but a substantial portion (approximately 17.9 %-32.6 %) experienced pronounced mental health problems during the pandemic. Symptom severity was negatively associated with the duration of the pandemic and positively associated with the rate of new infections. LIMITATIONS: The observational study design, non-probability-sampling methods, and online self-report assessments limit the generalizability of our results. CONCLUSIONS: The fluctuating course of psychological burden during the pandemic emphasizes the relevance of continuous monitoring during this challenging time. Particularly individuals with pronounced subclinical symptoms or manifesting mental disorders should be targeted with adequate prevention and early intervention programs.

Personality growth after relationship losses: Changes of perceived control in the years around separation, divorce, and the death of a partner.

BACKGROUND: Previous research suggests that romantic relationships play a crucial role for perceived control. However, we know surprisingly little about changes in perceived control before and after the end of romantic relationships. METHODS: Based on data from the Socio-Economic Panel Study (SOEP), a nationally representative household panel study from Germany, we examined changes of perceived control in the years around separation from a partner (N = 1,235), divorce (N = 423), and the death of a partner (N = 437). RESULTS: Multilevel analyses revealed that external control beliefs were higher in but not beyond the first year after separation from a partner. Internal and total control beliefs increased gradually in the years after separation. Moreover, internal control beliefs were higher in and especially beyond the first year after the death of a partner compared to the years before. No evidence was found that perceived control already changed in the years before relationship losses or in the years around a divorce. CONCLUSION: Taken together, these findings point toward stress-related growth of perceived control after some relationship losses-especially separation and the death of a partner.

Efficacy of Applied Relaxation as indicated preventive intervention in individuals at increased risk for mental disorders: A randomized controlled trial.

The objective was to examine the efficacy of Applied Relaxation (AR) as indicated preventive intervention to reduce psychopathological symptoms and prevent incident mental disorders. In a parallel-group randomized controlled trial, N = 277 adults with elevated tension/distress, anxiety, or depressive symptomatology (Depression-Anxiety-Stress Scale, DASS-21) but no 12-month DSM-5 diagnosis of any mental disorder assessed via standardized interview (DIA-X-5) were randomized to an intervention group (IG; n = 139) receiving group-based AR training, or an assessment-only control group (CG, n = 138). Self-report questionnaires at baseline, post (immediately after the 10 week intervention or a similar time frame in CG) and 12-month follow-up included the DASS-21 as primary outcome measure of intervention efficacy. Incident subthreshold and threshold mental disorders were assessed via DIA-X-5 at 12-month follow-up as primary outcome of prevention efficacy. Intervention and prevention effects were examined on an intent-to-treat basis with missing data replaced using chained multiple imputation. Mixed-model analyses revealed accelerated symptom improvement in IG versus CG with a medium baseline-to-post between-group effect size (d = 0.59, 95%CI: 0.36-0.82). Logistic regression analysis revealed a significantly lower incidence rate for (sub-)threshold mental disorders until 12-month follow-up in IG (34.7%) versus CG (49.3%; Odds Ratio: 0.54, 95%CI: 0.31-0.92, Risk Ratio: 0.70, 95%CI: 0.51-0.96, Risk Difference = -0.15, 95%CI: -0.28 to -0.02). Group-based AR as a promising indicative preventive intervention should be tested in long-term studies and relative to a credible alternative intervention to assure that the intervention effects are not entirely due to demand characteristics, expectancies, or non-specific effects.

Prospective Associations of Lifetime Post-traumatic Stress Disorder and Birth-Related Traumatization With Maternal and Infant Outcomes.

Objective: Many women experience traumatic events already prior to or during pregnancy, and delivery of a child may also be perceived as a traumatic event, especially in women with prior post-traumatic stress disorder (PTSD). Birth-related PTSD might be unique in several ways, and it seems important to distinguish between lifetime PTSD and birth-related traumatization in order to examine specific consequences for mother and child. This post-hoc analysis aims to prospectively examine the relation of both, lifetime PTSD (with/without interpersonal trauma) and birth-related traumatization (with/without postpartum depression) with specific maternal and infant outcomes. Methods: In the prospective-longitudinal Maternal in Relation to Infants' Development (MARI) study, N = 306 women were repeatedly assessed across the peripartum period. Maternal lifetime PTSD and birth-related traumatization were assessed with the Composite International Diagnostic Interview for women. Maternal health during the peripartum period (incl. birth experience, breastfeeding, anxiety, and depression) and infant outcomes (e.g., gestational age, birth weight, neuropsychological development, and regulatory disorders) were assessed via standardized diagnostic interviews, questionnaires, medical records, and standardized observations. Results: A history of lifetime PTSD prior to or during pregnancy was reported by 25 women who indicated a less favorable psycho-social situation (lower educational level, less social support, a higher rate of nicotine consumption during pregnancy). Lifetime PTSD was associated with pregnancy-related anxieties, traumatic birth experience, and anxiety and depressive disorders after delivery (and in case of interpersonal trauma additionally associated with infant feeding disorder). Compared to the reference group, women with birth-related traumatization (N = 35) indicated numerous adverse maternal and infant outcomes (e.g., child-related fears, sexual problems, impaired bonding). Birth-related traumatization and postpartum depression was additionally associated with infant feeding and sleeping problems. Conclusion: Findings suggest that both lifetime PTSD and birth-related traumatization are important for maternal and infant health outcomes across the peripartum period. Larger prospective studies are warranted. Implications: Women with lifetime PTSD and/or birth related traumatization should be closely monitored and supported. They may benefit from early targeted interventions to prevent traumatic birth experience, an escalation of psychopathology during the peripartum period, and adverse infant outcomes, which in turn may prevent transgenerational transmission of trauma in the long term.

Applied relaxation and cortisol secretion: findings from a randomized controlled indicated prevention trial in adults with stress, anxiety, or depressive symptoms.

Previous research has shown that relaxation interventions can reduce distress, anxiety, and depression. The exact mechanisms that underlie the efficacy of relaxation interventions remain unresolved. This study aimed to investigate whether applied relaxation (AR) leads to changes in cortisol secretion and whether these effects mediate fewer symptoms due to AR. Data come from a randomized controlled preventive interventional trial (N = 277) with elevated tension/distress, anxiety, or depressive symptomatology. Participants were randomized to an intervention group (IG; n = 139, received AR training), or a non-interventional control group (CG, n = 138). Psychopathological symptoms were assessed with DASS-21 and diagnoses of mental disorders via DIA-X-5. Cortisol was measured as short-term index in saliva (six times/d for 2 d at pre-, post-, and follow-up [FU] assessment) and long-term index in hair samples (once at pre-assessment and FU, respectively). Data were analyzed as pre-specified secondary analyses of the randomized controlled trial (RCT) on completer basis (n = 134 CG, n = 102 IG), using multivariable-adjusted linear regression models and mediation analyses (the DASS-21 change in the IG vs. CG with cortisol (area under the curve [AUC]) as mediator). From pre- to post-assessment, total daily salivary cortisol (AUC) decreased more strongly in the IG vs. CG (ß-coefficient: -13.83, 95% confidence interval [CI]: -26.85 to -0.81), but was rendered non-significant when adjusting for pre-assessment AUC. This effect was not found for the cortisol awakening response (CAR) or hair cortisol. There was no evidence for a mediation of cortisol (AUC). These findings provide little support for the idea that cortisol reductions explain the beneficial effects of AR on mental health.

Physical and mental health changes in the five years before and five years after childbirth: A population-based panel study in first-time mothers and fathers from Germany.

BACKGROUND: The transition to parenthood is characterized by far-reaching changes in life. However, little prospective-longitudinal evidence from general population samples exists on changes of general physical and mental health in the years around the birth of a child among mothers and fathers. METHODS: Using data from the German Socio-Economic Panel Study (SOEP), this study examined continuous and discontinuous short- and long-term changes of general physical and mental health from five years before until five years after the birth of the first child in women (N = 1,912) and men (N = 1,742). Whether a child was born was assessed annually throughout the study. Physical and mental health was assessed biannually from 2002 to 2018 with the SF-12v2. RESULTS: Multilevel analyses revealed that women experienced a considerable decrease of physical health during pregnancy, which remitted after delivery. On average, women's mental health increased in the last year before and first year after delivery. These mental health improvements were stronger in older vs. younger mothers and remained largely stable in the years after childbirth. In contrast, little evidence for changes of general physical or mental health in (expectant) fathers was found. LIMITATIONS: Physical and mental health was assessed with a short questionnaire only (SF-12v2). CONCLUSIONS: On average, women's mental health tends to improve before and after the birth of the first child. Men seem to be much less affected by the birth of a child than many previous studies suggest.