Global Prevalence of Psychological Distress and Comorbidity With Disorders of Gut-Brain Interactions.

INTRODUCTION: This study focused on defining the global prevalence of clinically relevant levels of psychological distress and somatic symptoms and the prevalence of coexistence between these symptoms and disorders of gut-brain interaction (DGBI). We also analyzed how clinically relevant psychological distress and somatic symptoms and coexistent DGBI are associated with health-related outcomes. METHODS: We included a representative sample of 54,127 adult participants (49.1% women; mean age of 44.3 years) from 26 countries worldwide. Participants completed an Internet survey (the Rome Foundation Global Epidemiology Study) with validated self-report questionnaires. RESULTS: Clinically relevant psychological distress and/or somatic symptom severity was reported by 37.5% of the sample. These participants had 4.45 times higher odds to have at least one DGBI than individuals without psychological distress and/or somatic symptoms. Compared with participants with psychological distress and/or somatic symptoms with vs without DGBI, participants with a DGBI reported increased healthcare and medication utilization (with OR from 1.6 to 2.8). Coexistent DGBI in participants with psychological distress and/or somatic symptoms was the variable most strongly associated with reduced mental (ß = -0.77; confidence interval [-0.86 to -0.68]) and physical (ß = -1.17; confidence interval [-1.24 to -1.10]) quality of life. DISCUSSION: This global study shows that psychological distress, somatic symptoms, and DGBI are very common and frequently overlap. The coexistence between psychological distress/somatic symptoms and DGBI seems to be especially detrimental to quality of life and healthcare utilization. Individuals with psychological distress/somatic symptoms and DGBI coexistence seem to be a group vulnerable to psychosocial problems that should be studied further and would likely benefit from psychological/psychiatric interventions.

Paramagnetic NMR to study iron sulfur proteins: 13C detected experiments illuminate the vicinity of the metal center.

The robustness of NMR coherence transfer in proximity of a paramagnetic center depends on the relaxation properties of the nuclei involved. In the case of Iron-Sulfur Proteins, different pulse schemes or different parameter sets often provide complementary results. Tailored versions of HCACO and CACO experiments significantly increase the number of observed Cα/C' connectivities in highly paramagnetic systems, by recovering many resonances that were lost due to paramagnetic relaxation. Optimized 13C direct detected experiments can significantly extend the available assignments, improving the overall knowledge of these systems. The different relaxation properties of Cα and C' nuclei are exploited in CACO vs COCA experiments and the complementarity of the two experiments is used to obtain structural information. The two [Fe2S2]+ clusters containing NEET protein CISD3 and the one [Fe4S4]2+ cluster containing HiPIP protein PioC have been taken as model systems. We show that tailored experiments contribute to decrease the blind sphere around the cluster, to extend resonance assignment of cluster bound cysteine residues and to retrieve details on the topology of the iron-bound ligand residues.

Protein Interactions in Rhodopseudomonas palustris TIE-1 Reveal the Molecular Basis for Resilient Photoferrotrophic Iron Oxidation.

Rhodopseudomonas palustris is an alphaproteobacterium with impressive metabolic versatility, capable of oxidizing ferrous iron to fix carbon dioxide using light energy. Photoferrotrophic iron oxidation is one of the most ancient metabolisms, sustained by the pio operon coding for three proteins: PioB and PioA, which form an outer-membrane porin-cytochrome complex that oxidizes iron outside of the cell and transfers the electrons to the periplasmic high potential iron-sulfur protein (HIPIP) PioC, which delivers them to the light-harvesting reaction center (LH-RC). Previous studies have shown that PioA deletion is the most detrimental for iron oxidation, while, the deletion of PioC resulted in only a partial loss. The expression of another periplasmic HiPIP, designated Rpal_4085, is strongly upregulated in photoferrotrophic conditions, making it a strong candidate for a PioC substitute. However, it is unable to reduce the LH-RC. In this work we used NMR spectroscopy to map the interactions between PioC, PioA, and the LH-RC, identifying the key amino acid residues involved. We also observed that PioA directly reduces the LH-RC, and this is the most likely substitute upon PioC deletion. By contrast, Rpal_4085 demontrated significant electronic and structural differences from PioC. These differences likely explain its inability to reduce the LH-RC and highlight its distinct functional role. Overall, this work reveals the functional resilience of the pio operon pathway and further highlights the use of paramagnetic NMR for understanding key biological processes.

Exploring the Impact of Covid-19-Related Perceptions on Psychological Distress and Quality of Life in an International Gastrointestinal Cohort Over Time Guided by the Common Sense Model.

The aim of this longitudinal study was to examine changes in COVID-19 and illness-related perceptions, gastrointestinal symptoms, coping, catastrophising, psychological distress, and QoL during the COVID-19 pandemic. A total of 831 adults with a gastrointestinal condition completed an online questionnaire at baseline (May-October 2020). Of those, 270 (32.5%) participants (85.2% female, mean age = 47.3 years) provided follow-up data (March-May 2021). Repeated-measures multiple analysis of variance and a cross-lagged panel model were used to test the study hypotheses. Gastrointestinal symptoms and COVID-19 perceptions at follow-up were strongly predicted by their baseline values, while illness perceptions were predicted by baseline gastrointestinal symptoms. Cross-lagged relationships indicated a reciprocal relationship between gastrointestinal symptoms and psychological distress. Moreover, gastrointestinal symptoms had substantial predictive utility, strongly predicting future gastrointestinal symptoms, and to a lesser extent, more negative illness perceptions, greater psychological distress, and greater use of adaptive coping strategies across time.

Relationship Between Abuse History and Gastrointestinal and Extraintestinal Symptom Severity in Irritable Bowel Syndrome.

OBJECTIVE: This study aimed to investigate the associations between the different abuse types, and gastrointestinal (GI) and extraintestinal symptom severity in irritable bowel syndrome (IBS), and possible mediators of these relationships. METHODS: We assessed sexual and physical abuse in childhood and adulthood with the Drossman and Leserman abuse questionnaire, whereas GI and extraintestinal symptoms were assessed with the Gastrointestinal Symptom Rating Scale and the Symptom Check List-90 Revised. General linear models with bootstrapping tested the mediating role of depressive symptoms, anxiety symptoms, and GI-specific anxiety and rectal pain threshold. A path model analysis testing all relationships simultaneously was also performed. RESULTS: Among our 186 patients with IBS, an overall history of abuse (i.e., at least one type) was found in 37%. The effects of child and adult sexual abuse on GI symptom severity were fully mediated by GI-specific anxiety and rectal pain threshold (F = 21.540, R2 = 0.43, and F = 22.330, R2 = 0.44, respectively; p < .001 for both). The effect of adult sexual abuse and child physical abuse on extraintestinal symptom severity was fully mediated by GI-specific anxiety, depressive symptoms, and rectal pain threshold, whereas the effect of child sexual abuse was partially mediated (F = 14.992, R2 = 0.28; F = 15.065, R2 = 0.30; and F = 18.037, R2 = 0.32, respectively; p < .001 for all). When analyzed in a single path model, child sexual abuse and adult physical abuse only had a direct effect on extraintestinal symptom severity, whereas child physical abuse had an indirect effect through depressive symptoms. CONCLUSIONS: Abuse is associated with increased GI and extraintestinal symptom severity in IBS. These associations are mediated by levels of GI-specific anxiety, depressive symptoms, and rectal sensitivity.

Internal and External Shame in Healthy and Chronically Ill Samples: Exploring Links to Psychological Health.

This study aimed to examine the role of decentering and committed action as mediators of the link of external and internal shame with psychological health, in people with a chronic disease diagnosis (n = 223) and without chronic disease (n = 230). Participants with chronic disease presented higher levels of both external and internal shame. Path analysis results showed that these variables seem to be negatively linked to psychological health and that their effects on this outcome seem to be reduced by the mechanisms of decentering and committed action. The tested model explained 56% of psychological health's variance and was invariant across groups. This study emphasizes the importance of taking a decentered stance towards internal experiences and behaving accordingly to one's personal values on psychosocial functioning, independently of disease status. These results may have particular relevance to individuals with high levels of shame.

Exploring the Relationship Between Self-Isolation and Distress Among People with Gastrointestinal Disorders During the COVID-19 Pandemic.

This study aimed to explore the association between perceived isolation and symptoms of distress in people with GI disorders at the time of the pandemic; and to examine factors which moderate this relationship. This online cross-sectional survey was advertised in May-September 2020 via patient organisations and associated social media. Overall, 831 people (82% female, mean age 49 years) from 27 countries participated. A significant relationship between social isolation and psychological distress was noted (r = .525, p < .001). GI symptoms moderated the association between isolation and distress (B = .047, t = 2.47, p = .015). Interventions targeting these factors may help to reduce distress in people with GI disorders at the time of major stressors such as the COVID-19 pandemic.

Extending the Common Sense Model to Explore the Impact of the Fear of COVID-19 on Quality of Life in an International Inflammatory Bowel Disease Cohort.

The aim of this cross-sectional study was to use an extended common sense model (CSM) to evaluate the impact of fear of COVID-19 on quality of life (QoL) in an international inflammatory bowel disease cohort. An online study involving 319 adults (75% female, mean (SD) 14.06 (15.57) years of symptoms) completed the Gastrointestinal Symptom Rating Scale, Brief Illness Perceptions Questionnaire, Fear of Contracting COVID-19 Scale, Brief-COPE, Depression, Anxiety and Stress Scale, and the EUROHIS-QOL. The extended CSM had an excellent fit (χ2 (9) = 17.06, p = .05, χ2/N = 1.90, RMSEA = 0.05, SRMR = 0.04, CFI = .99, TLI = .97, GFI = 0.99), indicating the influence of gastrointestinal symptoms on QoL was mediated by illness perceptions, fear of COVID-19, adaptive and maladaptive coping, and psychological distress. Interventions targeting the fear of COVID-19 in the context of an individual's perceptions will likely enhance QoL during the pandemic.

A pilot randomized controlled trial of online acceptance and commitment therapy versus compassion-focused therapy for chronic illness.

Literature suggests that acceptance and commitment therapy (ACT) is effective in improving well-being and in reducing psychopathological symptoms commonly experienced by people with chronic illness (CI). Compassion-focused therapy (CFT) reduces psychological distress, especially in individuals with high levels of shame and self-criticism, but few studies have explored CFT in CI. Additionally, studies almost exclusively compared ACT and CFT with inactive controls (wait-list; treatment as usual). Also, there is an interest in developing cost-effective mental health solutions, such as low-intensity online psychological interventions. This randomized controlled trial (RCT) aimed to assess the acceptability and compare the efficacy of four-session online ACT (n = 25) and CFT (n = 24) interventions in a sample of people with CI. Results showed both interventions were acceptable, with attrition rates at post-intervention comparable to those found in similar studies (around 50%). Intention-to-treat analyses showed that participants presented significantly less illness-related shame, less uncompassionate self-responding and more valued living after the intervention, although no difference was found between conditions. Results were sustained at 3- and 6-month follow-up. Results did not find statistical differences between conditions through reliable change index (RCI). Correlation between demographics and RCI showed that, at post-intervention, younger participants presented more behavioural awareness, men presented more valued action, and participants with CI for shorter periods presented less uncompassionate self-responding and less anxiety. Results suggest that low-intensity (four sessions) online ACT and CFT are cost-effective approaches to promote mental health of individuals with CI. Results and limitations are thoroughly discussed.

Structure and reactivity of a siderophore-interacting protein from the marine bacterium Shewanella reveals unanticipated functional versatility.

Siderophores make iron accessible under iron-limited conditions and play a crucial role in the survival of microorganisms. Because of their remarkable metal-scavenging properties and ease in crossing cellular envelopes, siderophores hold great potential in biotechnological applications, raising the need for a deeper knowledge of the molecular mechanisms underpinning the siderophore pathway. Here, we report the structural and functional characterization of a siderophore-interacting protein from the marine bacterium Shewanella frigidimarina NCIBM400 (SfSIP). SfSIP is a flavin-containing ferric-siderophore reductase with FAD- and NAD(P)H-binding domains that have high homology with other characterized SIPs. However, we found here that it mechanistically departs from what has been described for this family of proteins. Unlike other FAD-containing SIPs, SfSIP did not discriminate between NADH and NADPH. Furthermore, SfSIP required the presence of the Fe2+-scavenger, ferrozine, to use NAD(P)H to drive the reduction of Shewanella-produced hydroxamate ferric-siderophores. Additionally, this is the first SIP reported that also uses a ferredoxin as electron donor, and in contrast to NAD(P)H, its utilization did not require the mediation of ferrozine, and electron transfer occurred at fast rates. Finally, FAD oxidation was thermodynamically coupled to deprotonation at physiological pH values, enhancing the solubility of ferrous iron. On the basis of these results and the location of the SfSIP gene downstream of a sequence for putative binding of aerobic respiration control protein A (ArcA), we propose that SfSIP contributes an additional layer of regulation that maintains cellular iron homeostasis according to environmental cues of oxygen availability and cellular iron demand.

Measuring transverse relaxation in highly paramagnetic systems.

The enhancement of nuclear relaxation rates due to the interaction with a paramagnetic center (known as Paramagnetic Relaxation Enhancement) is a powerful source of structural and dynamics information, widely used in structural biology. However, many signals affected by the hyperfine interaction relax faster than the evolution periods of common NMR experiments and therefore they are broadened beyond detection. This gives rise to a so-called blind sphere around the paramagnetic center, which is a major limitation in the use of PREs. Reducing the blind sphere is extremely important in paramagnetic metalloproteins. The identification, characterization, and proper structural restraining of the first coordination sphere of the metal ion(s) and its immediate neighboring regions is key to understand their biological function. The novel HSQC scheme we propose here, that we termed R2-weighted, HSQC-AP, achieves this aim by detecting signals that escaped detection in a conventional HSQC experiment and provides fully reliable R2 values in the range of 1H R2 rates ca. 50-400 s-1. Independently on the type of paramagnetic center and on the size of the molecule, this experiment decreases the radius of the blind sphere and increases the number of detectable PREs. Here, we report the validation of this approach for the case of PioC, a small protein containing a high potential 4Fe-4S cluster in the reduced [Fe4S4]2+ form. The blind sphere was contracted to a minimal extent, enabling the measurement of R2 rates for the cluster coordinating residues.

Chromatin regulation of somatic abiotic stress memory.

In nature, plants are often subjected to periods of recurrent environmental stress that can strongly affect their development and productivity. To cope with these conditions, plants can remember a previous stress, which allows them to respond more efficiently to a subsequent stress, a phenomenon known as priming. This ability can be maintained at the somatic level for a few days or weeks after the stress is perceived, suggesting that plants can store information of a past stress during this recovery phase. While the immediate responses to a single stress event have been extensively studied, knowledge on priming effects and how stress memory is stored is still scarce. At the molecular level, memory of a past condition often involves changes in chromatin structure and organization, which may be maintained independently from transcription. In this review, we will summarize the most recent developments in the field and discuss how different levels of chromatin regulation contribute to priming and plant abiotic stress memory.

Influence of fears of compassion on body image shame and disordered eating.

PURPOSE: The current study tested a path model examining the impact of fears of compassion in the adoption of disordered eating and whether social safeness and body shame would mediate this relationship. METHODS: Participants were 645 women (aged between 18 and 55) from the general community, who completed an online survey. RESULTS: Results indicated that fears of compassion were negatively associated with one's ability to feel secure and safe within close relationships, and positively linked with higher levels of body shame and disordered eating. The tested model accounted for 62% of the variance of disordered eating. Path analyses results revealed that the three dimensions of fears of compassion impacted on disordered eating. Particularly, fear of expressing compassion for others presented a direct impact on disordered eating. Moreover, fears of self-compassion and fears of receiving compassion from others partially impacted on disordered eating attitudes and behaviours, through the mechanisms of social safeness and body image-focused shame. These findings suggested that women who present higher levels of fear of self-compassion and of receiving signs of affection and compassion from others tend to feel more insecure in their social group, which seem explain body shame and the engagement in disordered eating behaviours. CONCLUSIONS: This study highlights the pathogenic impact of fears of compassion on body image and eating attitudes and behaviours. The current data seem to offer relevant insights for research and clinical practice, by supporting the relevance of developing compassionate abilities and attitudes to target body image and eating-related difficulties.

Cognitive fusion and depressive symptoms in women with chronic pain: A longitudinal growth curve modelling study over 12 months.

This study aims to (a) explore individual differences in women with chronic pain (CP) in regard to pain intensity, functional impairment, cognitive fusion, and depressive symptoms and (b) longitudinally test whether cognitive fusion is a significant predictor of depression symptoms, while controlling for pain intensity and functional impairment, over a 12-month period. This study follows a longitudinal design and was conducted in a sample of 86 women with CP who responded to an online battery of questionnaires in three equally spaced assessment moments. In order to explore the growth trajectory of variables of interest, latent growth curve models were examined. Also, correlation analyses were conducted between demographic and illness-related variables and depressive symptoms, as well as between all variables in all assessment moments. Cognitive fusion and functional impairment (but not pain intensity) were significantly associated with baseline levels of depressive symptoms. Cognitive fusion significantly predicted the growth trajectory of depressive symptoms, whereas pain intensity and functional impairment did not. No demographic (age, marital status, education, socio-economic) nor illness-related variables (number of CP diagnoses, duration of CP, taking medication) were associated with depressive symptoms at any point. These results suggest that the trajectory of depressive symptoms in women with CP is not predicted by the intensity of pain nor pain-related functional impairment, but rather by the tendency to get entangled with internal experiences (e.g., thoughts, emotions, and physical sensations), which may or may not be related to pain-specific contents. Clinical implications are discussed.

The influence of self-criticism on depression symptoms among ambulatory patients with inflammatory bowel disease.

Considering that self-criticism is an important process in the development and maintenance of depression, and taking into account the stigma associated with inflammatory bowel disease (IBD), the present study aimed to analyse whether self-criticism exacerbates the relationships of depression symptoms with IBD symptomatology and chronic illness-related shame. The sample included 53 ambulatory IBD patients (66% females) with ages from 18 to 65. Moderation analyses were conducted using structural equation modelling. Self-criticism exacerbated the associations of depression with IBD symptoms (b = 0.01; standard error [SE] = 0.00; Z = 3.73; P < .001) and illness shame (b = 0.02; SE = 0.01; Z = 2.40; P = .016). For the same level of IBD symptomatology or chronic illness-related shame, those individuals who present more feelings of inadequacy towards the self, experience more symptoms of depression. This exacerbation effect is stronger when IBD symptomatology and chronic illness-related shame are more intense. A high self-critical IBD patient may view the illness and/or symptomatology as a flaw or error that should be self-corrected. Physicians and other health professionals should be attentive to these pathological mechanisms and should attempt to alleviate them. It may be beneficial to refer high self-critical patients to psychological care.

The central role of self-reassurance to explain body and eating attitudes.

Literature has emphasized the significant role of social acceptance and connectedness in well-being and the benefits of cultivating a positive body image in the prevention and treatment of body and eating-related difficulties. The current study aims to examine whether strategies of self-reassurance and body-image appreciation mediate the association of feelings of social safeness and acceptance with the "core" dimensions of body and eating-related psychopathology (restraint, eating concern, weight concern, and shape concern), while controlling the effects of body mass index (BMI). Participants were 309 Portuguese women, aged between 18 and 50 years that completed self-report measures. Results from the performed path analysis revealed that self-reassurance and body-image appreciation mediated the impact of feelings of social safeness and acceptance on eating psychopathology-related dimensions. Results seem to suggest that women who perceive the self as acceptable and desirable tend to adopt self-reassurance strategies. These strategies in turn seem to predict a protective and caring relationship with one's own body and decreased severity of eating psychopathology symptoms. This path model explained 22%, 27%, 51%, and 47% of restraint, eating concern, weight concern, and shape concern, respectively, and showed an excellent model fit. Our findings appear to offer significant insights in the field of body and eating-related psychopathology and seem to support the pertinence of creating intervention programs for women from the general community with body and eating-related difficulties that encourage the adoption of self-reassurance strategies and promote a positive and respectful relationship with one's own body image.Level of evidence V, cross-sectional descriptive study.

The buffer effect of body compassion on the association between shame and body and eating difficulties.

Body compassion is a new construct which incorporates two multidimensional concepts: body image and self-compassion. Self-compassion has been revealed as a protective mechanism against body image and eating-related-related disturbances, including eating disorders. However, the study of this compassionate competence specifically focused on the domain of the body is still largely unexplored. This study aims to test whether body compassion moderate the impact of external shame on body image shame and disordered eating, in a sample of 354 women from the Portuguese general population. Correlation analyses showed that body compassion was negatively associated with experiences of shame and disordered eating. Path analysis results demonstrated the existence of a moderator effect of body compassion on the relationship between general feelings of shame and both body image shame and related behaviours, and disordered eating symptomatology. In fact, results suggested that body compassion buffered the impact of general feelings of shame on these psychopathological indices, with the tested model accounting for 46% and 39% of the variance of body image shame and disordered eating, respectively. This study contributes to a better understanding of the role of body compassion in body image and eating difficulties. Body compassion seems to be an important protector of these difficulties in women by buffering the effects of general shame on body image shame and related body concealment behaviours, as well as disordered eating. The findings from this study thus appear to offer important research and clinical implications, supporting the relevance of promoting body compassion in prevention and treatment programs for body image difficulties and disordered eating.

Roles of body image-related experiential avoidance and uncommitted living in the link between body image and women's quality of life.

The current study aimed to test whether the associations of body mass index, body image discrepancy, and social comparison based on physical appearance with women's psychological quality of life (QoL) would be explained by the mechanisms of body image-related experiential avoidance and patterns of uncommitted living. The sample was collected from October 2014 to March 2015 and included 737 female college students (aged between 18 and 25 years) who completed validated self-report measures. Results demonstrated that the final path model explained 43% of psychological QoL and revealed an excellent fit. Body image-related experiential avoidance had a meditational role in the association between body image discrepancy and psychological QoL. Further, the link between social comparison based on physical appearance and psychological QoL was partially mediated by body image-related experiential avoidance and uncommitted living. These findings indicate that the key mechanisms of the relationship between body image and young women's QoL were those related to maladaptive emotion regulation. It thus seems that interventions aiming to promote mental health in this population should promote acceptance of internal experiences related to physical appearance (e.g., sensations, thoughts, or emotions) and the engagement in behaviors committed to life values.

Do shame and perfectionistic self-presentation explain the link between early affiliative memories and eating psychopathology?

This study tested a model examining the impact that early affiliative memories (both with family and peers) on eating psychopathology, and whether these links are carried by the mechanisms of external shame and body image-related perfectionistic self-presentation, in a sample of 480 female college students. Path analyses' results revealed that this model accounted for 48% of disordered eating's variance and suggests that the lack of early positive emotional memories is associated with higher levels of shame (feelings of inferiority and unattractiveness), and with higher tendency to adopt body image-related perfectionistic strategies, that seem to explain excessive eating concern and rigid control of one's eating behaviors. This study offers important insights for future research and for the development of intervention programs, by revealing the importance of assessing and targeting shame and perfectionistic strategies and suggesting the importance of promoting adaptive emotion regulation strategies.

Going beyond social support: Fear of receiving compassion from others predicts depression symptoms in breast cancer patients.

BACKGROUND: Recent studies have highlighted the importance of being able to receive compassion and affiliative signals from others. The main aim of the present study was to explore whether social support and fear of receiving compassion from others are predictors of depression symptoms in a sample of breast cancer patients. METHODS: The sample included 86 female patients with non-metastatic breast cancer. Participants were recruited at a Radiotherapy Service in central Portugal and completed validated self-report instruments. Multiple regression analysis were conducted to examine the predictive effects of clinical (cancer stage, comorbidities) and demographic variables (age, education), social support, and fear of receiving compassion from others on depressive symptoms. RESULTS: Fear of receiving compassion from others was the only significant predictor of the model, with a positive effect on depression symptomatology (ß = 0.44; p < 0.001). These results suggest that the amount of supportive social contacts and networks may not be as important as cancer patients' ability to receive compassion from others. CONCLUSIONS: This is the first study to focus on fear of receiving compassion from others in cancer patients and seems to be a significant contribution for the study of the social factors that may be associated with depression in breast cancer. Psychological screening interviews in breast cancer, besides assessing patients' level of depression and social support, ought to also evaluate the ability to receive empathy and emotional help and support from other people.