Effects of psychological stress and cortisol on decision making and modulating factors: A systematic review.

Evidence suggests that psychological stress has effects on decision making, but the results are inconsistent, and the influence of cortisol and other modulating factors remains unclear. Based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria, 18 studies carried out between 2015 and 2020 that examined the effects of psychological stress on decision making and measured cortisol levels were selected. Eight studies employed uncertainty-based economic tasks, five studies used decision-making tasks in hypothetical situations that can be encountered in real life or in a specific setting and five studies employed prosocial decision tasks. Seventeen studies assessed acute stress, and two assessed chronic stress; eight evaluated the influence of sex. Most of the studies that explored the association between stress and decision making using uncertainty-based economic tasks found statistically significant differences as a function of stress exposure and the cortisol response to stress, whereas most of the studies that employed non-economic decision-making tasks in hypothetical situations did not find statistically significant differences. When prosocial decision making was evaluated, more altruistic decisions were found after acute stress, and these decisions were positively associated with cortisol. Half of the studies that assessed the role of sex observed a greater impact on decision making after stress in women. Results suggest that it is important to consider modulating factors-the type of decision-making task, the cortisol response to stress, the characteristics of the psychological stressor or the subject's sex-when trying to understand psychosocial stress phenomena.

Optimism as a protective factor against the psychological impact of COVID-19 pandemic through its effects on perceived stress and infection stress anticipation.

The 2019 coronavirus disease (COVID-19) and the recommended social isolation presented a challenge to people's mental health status. Optimism is a psychological factor that plays a key role in the evaluation of stressful situations. The purpose of this study was to investigate the mediating role of perceived stress and Covid-19-related stress anticipation in the relationship between optimism and post-traumatic stress symptoms. Our sample included 1015 participants ranging in age from 18 to 79 years, 80% of whom were Spaniards. At the beginning of the worldwide pandemic, participants were confined to their homes for at least seven days and completed an online survey measuring various sociodemographic and psychological variables. We found an indirect effect of optimism on intrusion and hyperarousal through perceived stress and stress anticipation. In addition, we observed an indirect effect of optimism on avoidance through perceived stress. Finally, the results showed a significant indirect effect of optimism on the total post-traumatic stress symptoms score through perceived stress and stress anticipation. Our results indicate that positive beliefs inherent to optimism are related to less psychological impact of the COVID-19 outbreak.

Educational level as a protective factor against the influence of depressive symptoms on cognition in older adults: implications for functional independence during a 10-year follow-up.

OBJECTIVES: To examine whether the educational level moderates the relationship between baseline depressive symptoms and cognitive functioning at 5- and 10-year follow-ups in older adults, considering the association between cognitive functioning and difficulty with activities of daily living (ADL). DESIGN: Using a prospective design, a path analysis was performed. SETTING: In-home, face-to-face interviews and self-administered questionnaires, within the National Social Life, Health, and Aging Project. PARTICIPANTS: In total, 1,461 participants (mean age = 66.62) were followed up from Wave 1 (baseline) to Wave 2 (at 5 years) and Wave 3 (at 10 years). MEASUREMENTS: Depressive symptoms were assessed at baseline. Cognitive functioning and difficulty with ADL were assessed at baseline and at 5 and 10 years. RESULTS: Educational level moderates the relationship between depressive symptoms and cognitive functioning at 5 years (ß = 0.07, SE = 0.03, p = 0.04, Cohen's f2 = 0.02), being depressive symptoms related to poor cognitive functioning only at low educational levels. Cognitive functioning predicts difficulty with ADL at 5 and 10 years (ß = -0.08, SE = 0.03, p = 0.008, Cohen's f2 = 0.01; ß = -0.09, SE = 0.03, p = 0.006, Cohen's f2 = 0.02). The proposed model yielded excellent fit (CFI = 1.00, RMSEA = 0.0001, 90% CI 0.0001-0.03, SRMR = 0.004, and χ2(8) = 7.16, p = 0.52). CONCLUSIONS: Cognitive reserve may act as a protective factor against the effect of depressive symptoms on cognition in older adults, which, in turn, is relevant to their functional independence.

Differential Effects of Alcohol on Memory Performance in Adolescent Men and Women with a Binge Drinking History.

AIMS: Binge drinking (BD) is characterized by intermittent consumption of large quantities of alcohol in short periods. This pattern of drinking is prevalent among adolescents, and has been associated with undermined learning and memory ability. This study investigates the relationships between a history of BD and the effects of acute exposure to alcohol on learning and memory performance in adolescent men and women. METHODS: A high, acute dose of alcohol or control refreshment was administered to a sample of 172 adolescent undergraduate students, some of which had a history of BD and others of which had refrained from alcohol consumption. Subsequently, immediate visual memory (IVM) and working memory (WM) was measured according to the Wechsler Memory Scale in females and males with different BAC (Experiment 1) and similar BAC (Experiment 2). RESULTS: In both experiments, IVM was reduced after acute alcohol consumption and there was no significant main effect of Drinking Pattern. Furthermore, an effect of cognitive alcohol tolerance on IVM was observed in women but not in men. WM was not affected by alcohol, but a gender difference was evident in that performance was superior in men than in women. CONCLUSIONS: In adolescents, IVM is more sensitive than WM to impairment by alcohol, and women are more vulnerable to the neurotoxic effects of alcohol than men, since the cognitive tolerance effect of alcohol on IVM develops in BD women but not in BD men. These findings emphasize the need to investigate the neurotoxic effects of alcohol in adolescent women. SHORT SUMMARY: In adolescents, immediate visual memory (IVM) is more sensitive than working memory to impairment by alcohol, and women are more vulnerable to the neurotoxic effects of alcohol than men, because the cognitive tolerance effect of alcohol on IVM develops in binge drinking (BD) women but not in BD men.

EEG frequency bands in subjective cognitive decline: A systematic review of resting state studies.

As the older population continues to expand, there is a growing prevalence of individuals who experience subjective cognitive decline (SCD), characterized by self-reported failures in cognitive function and an increased risk of cognitive impairment. Recognizing that preventive interventions are typically more effective in preclinical stages, current research endeavors to focus on identifying early biological markers of SCD using resting-state electroencephalogram (rsEEG) methods. To do so, a systematic literature review covering the past 20 years was conducted following PRISMA guidelines, in order to consolidate findings on rsEEG frequency bands in individuals with SCD. Pubmed and Web of Science databases were searched for rsEEG studies of people with SCD. Quality assessments were completed using a modified Newcastle-Ottawa scale. A total of 564 articles published from December 2003 to December 2023 were reviewed, and significant aspects of these papers were analyzed to provide a general overview of the research on this technique. After removing unrelated articles, nine articles were selected for the present study. The review emphasizes patterns in frequency band activity, revealing that individuals classified as SCD exhibited increased theta power than healthy controls, but decreased than MCI. However, findings for the alpha, delta, and beta bands were inconsistent, demonstrating variability across studies and highlighting the need for further research. Although the rsEEG of frequency bands emerges as a promising early biomarker, there is a noteworthy need to establish uniform standards and consistent measurement approaches in order to ensure the reliability and comparability of the results obtained in the research.

Effects of binge drinking and the anti-inflammatory drug indomethacin on spatial memory and cognitive flexibility in mice.

In previous research, we found that chronic-intermittent ethanol administration (CIEA), a model of binge drinking, impaired emotional memory in mice, and this impairment was counteracted by the anti-inflammatory drug indomethacin. In the present study, we evaluated the effects of CIEA on spatial memory and cognitive flexibility in adolescent mice of both sexes. Animals were randomly assigned to one of four groups for each sex: SS (saline + saline), SA (saline + alcohol), SI (saline + indomethacin), and AI (alcohol + indomethacin). They were injected with saline, ethanol (3 g/kg) or indomethacin (10 mg/kg) for the first three days of each week, throughout three weeks. 96 h after treatment, subjects learnt a standard water maze task on five consecutive days (4-day training and 1-day probe trial). One day later, mice underwent a reversal task for evaluating spatial cognitive flexibility. Animals receiving alcohol (SA and AI groups) did not differ from controls (SS groups) during the standard task, but animals treated with indomethacin performed better than controls, both in the acquisition trials and the probe trial. During the reversal task, no significant differences between alcohol groups and controls were observed, but the indomethacin group showed significant lower escape latencies than controls. No sex differences were found in either task. In conclusion, binge drinking does not impair spatial memory or spatial cognitive flexibility, while the anti-inflammatory indomethacin improves both, showing that the effects of alcohol and indomethacin on spatial memory (dependent on hippocampus) are different to those they exert on emotional memory (dependent on amygdala).

Online consultations in mental healthcare: Modelling determinants of use and experience based on an international survey study at the onset of the pandemic.

Introduction: While online consultations have shown promise to be a means for the effective delivery of high-quality mental healthcare and the first implementations of these digital therapeutic contacts go back nearly two decades, uptake has remained limited over the years. The onset of the COVID-19 pandemic dramatically altered this relative standstill and created a unique turning point, with a massive amount of both professionals and clients having first hands-on experiences with technology in mental healthcare. Objective: The current study aimed to document the uptake of online consultations and explore if specific characteristics of mental health professionals across and beyond Europe could predict this. Methods: An international survey was designed to assess mental health professionals' (initial) experiences with online consultations at the onset of the pandemic: their willingness to make use of them and their prior and current experiences, alongside several personal characteristics. Logistic mixed-effects models were used to identify predictors of the use of online consultations, personal experience with this modality, and the sense of telepresence. Results: A total of 9115 healthcare professionals from 73 countries participated of which about two-thirds used online consultations during the initial COVID-19 outbreak. The current study identifies multiple determinants relating to the use and experience of online consultations, including the professionals' age, experience with the technology before the outbreak, the professional context, and training. Conclusions: Despite strong evidence supporting the relevance of training in digital mental health, this is clearly still lacking. Nevertheless, the COVID-19 pandemic presented a first, and potentially transformative, experience with online consultations for many healthcare professionals. The insights from this study can help support professionals and, importantly, (mental) healthcare organisations to create optimal circumstances for selective and high-quality continued use of online consultations.

Online consultations in mental healthcare during the COVID-19 outbreak: An international survey study on professionals' motivations and perceived barriers.

INTRODUCTION: While the general uptake of e-mental health interventions remained low over the past years, physical distancing and lockdown measures relating to the COVID-19 pandemic created a need and demand for online consultations in only a matter of weeks. OBJECTIVE: This study investigates the uptake of online consultations provided by mental health professionals during lockdown measures in the first wave of the COVID-19 pandemic in the participating countries, with a specific focus on professionals' motivations and perceived barriers regarding online consultations. METHODS: An online survey on the use of online consultations was set up in March 2020. The Unified Theory of Acceptance and Use of Technology (UTAUT) guided the deductive qualitative analysis of the results. RESULTS: In total, 2082 mental health professionals from Austria, Belgium, Cyprus, France, Germany, Italy, Lebanon, Lithuania, the Netherlands, Norway, Portugal, Spain, and Sweden were included. The results showed a high uptake of online consultations during the COVID-19 pandemic but limited previous training on this topic undergone by mental health professionals. Most professionals reported positive experiences with online consultations, but concerns about the performance of online consultations in a mental health context (e.g., in terms of relational aspects) and practical considerations (e.g., relating to privacy and security of software) appear to be major barriers that hinder implementation. CONCLUSIONS: This study provides an overview of the mental health professionals' actual needs and concerns regarding the use of online consultations in order to highlight areas of possible intervention and allow the implementation of necessary governmental, educational, and instrumental support so that online consultations can become a feasible and stable option in mental healthcare.

Emotional memory impairment produced by binge drinking in mice is counteracted by the anti-inflammatory indomethacin.

The Binge Drinking (BD) pattern of alcohol consumption, prevalent in adolescents and young adults, has been associated with memory impairment. In addition, evidence shows that alcohol abuse causes neuroinflammation, which may contribute to the brain damage produced by alcohol and explain its cognitive consequences. In this study, we evaluated the effectiveness of the anti-inflammatory indomethacin in counteracting the memory impairment produced by alcohol (ethanol) in adolescent mice of both sexes. Animals were randomly assigned to one of four groups for each sex: SS (saline + saline), SA (saline + alcohol), SI (saline + indomethacin) and AI (alcohol + indomethacin). They were injected acutely (Experiment 1) or chronically intermittent (Experiment 2) with saline, ethanol (3 g/kg) and indomethacin (10 mg/kg). All subjects were evaluated in an inhibitory avoidance task 96 h after treatment. With acute administration, SA groups showed significantly lower Test latencies than SS groups, while AI groups had similar latencies to controls. The chronic-intermittent administration of alcohol, an animal model of BD, produced significant emotional memory impairment -blocking learning in males- which was counteracted by indomethacin, as the AI groups had similar latencies to the SS groups. No significant differences were observed in locomotor activity or analgesia. In conclusion, alcohol BD (one or several episodes) impairs emotional memory in mice. This impairment is not secondary to the effects of alcohol BD on locomotor activity or pain sensitivity, and it is counteracted by indomethacin. Therefore, the memory impairment produced by alcohol BD seems to be mediated, in part, by neuroinflammatory processes. These findings open a window for new treatments for alcohol use disorders.

Methods for Evaluating the Interaction Between Social Stress and Environmental Enrichment in Animal Models of Nicotine Addiction.

The environmental enrichment (EE) paradigm has been evaluated as a means of counteracting some of the consequences of chronic stress in rodents as well as a model of protective environment against drug abuse development. In the present chapter, our main aim is to describe the models of EE and chronic social stress and how they can be applied jointly in order to evaluate the effects of early psychosocial stress in animals exposed of different environments (enriched environment or standard environment). Furthermore, both paradigms could be applied in animal models of nicotine addiction, so the guidelines for the application of a chronic oral nicotine treatment in mice will be described. The heterogeneity of the procedures carried out in different laboratories makes it interesting to specify their characteristics in order to obtain replicable and valid animal models.

An Animal Model of Alcohol Binge Drinking: Chronic-Intermittent Ethanol Administration in Rodents.

Binge drinking (BD), characterized by intermittent consumption of large quantities of alcohol in short periods of time, is the main alcohol consumption pattern in adolescents and young adults. BD has serious biomedical consequences, and it is a prominent risk factor for later development of alcohol use disorders. Rodent models offer exceptional power to study these negative consequences of BD. This chapter focuses on one of these BD models: the chronic-intermittent ethanol administration (CIEA) paradigm. Essentially, CIEA consists of the administration in rats or mice of i.p. injections of ethanol (doses: 3-4 g/kg) for several consecutive days each week, in alternation with several days without injections, during several weeks. Due to our interest in the neurobehavioral effects of BD, a combination of the CIEA model with a battery of behavioral tests is described, with emphasis on the effects of alcohol BD on different kinds of memory. The CIEA model, in combination with behavioral tasks, seems to be a useful tool for studying the neurobehavioral effects of BD as well as for developing potential prevention and treatment strategies.

Indomethacin counteracts the effects of chronic social defeat stress on emotional but not recognition memory in mice.

We have previously observed the impairing effects of chronic social defeat stress (CSDS) on emotional memory in mice. Given the relation between stress and inflammatory processes, we sought to study the effectiveness of the anti-inflammatory indomethacin in reversing the detrimental effects of CSDS on emotional memory in mice. The effects of CSDS and indomethacin on recognition memory were also evaluated. Male CD1 mice were randomly divided into four groups: non-stressed + saline (NS+SAL); non-stressed + indomethacin (NS+IND); stressed + saline (S+SAL); and stressed + indomethacin (S+IND). Stressed animals were exposed to a daily 10 min agonistic confrontation (CSDS) for 20 days. All subjects were treated daily with saline or indomethacin (10 mg/kg, i.p.). 24 h after the CSDS period, all the mice were evaluated in a social interaction test to distinguish between those that were resilient or susceptible to social stress. All subjects (n = 10-12 per group) were then evaluated in inhibitory avoidance (IA), novel object recognition (NOR), elevated plus maze and hot plate tests. As in control animals (NS+SAL group), IA learning was observed in the resilient groups, as well as in the susceptible mice treated with indomethacin (S+IND group). Recognition memory was observed in the non-stressed and the resilient mice, but not in the susceptible animals. Also, stressed mice exhibited higher anxiety levels. No significant differences were observed in locomotor activity or analgesia. In conclusion, CSDS induces anxiety in post-pubertal mice and impairs emotional and recognition memory in the susceptible subjects. The effects of CSDS on emotional memory, but not on recognition memory and anxiety, are reversed by indomethacin. Moreover, memory impairment is not secondary to the effects of CSDS on locomotor activity, emotionality or pain sensitivity.

Blood Alcohol Concentration-Related Lower Performance in Immediate Visual Memory and Working Memory in Adolescent Binge Drinkers.

The binge drinking (BD) pattern of alcohol consumption is prevalent during adolescence, a period characterized by critical changes to the structural and functional development of brain areas related with memory and cognition. There is considerable evidence of the cognitive dysfunctions caused by the neurotoxic effects of BD in the not-yet-adult brain. Thus, the aim of the present study was to evaluate the effects of different blood alcohol concentrations (BAC) on memory during late adolescence (18-19 years old) in males and females with a history of BD. The sample consisted of 154 adolescents (67 males and 87 females) that were classified as refrainers if they had never previously drunk alcoholic drinks and as binge drinkers if they had drunk six or more standard drink units in a row for men or five or more for women at a minimum frequency of three occasions in a month, throughout the previous 12 months. After intake of a high acute dose of alcohol by binge drinkers or a control refreshment by refrainers and binge drinkers, subjects were distributed into four groups for each gender according to their BAC: BAC0-R (0 g/L, in refrainers), BAC0-BD (0 g/L, in binge drinkers), BAC1 (0.3 - 0.5 g/L, in binge drinkers) or BAC2 (0.54 - 1.1 g/L, in binge drinkers). The subjects' immediate visual memory and working memory were then measured according to the Wechsler Memory Scale (WMS-III). The BAC1 group showed lower scores of immediate visual memory but not of working memory, while lower performance in both memories were found in the BAC2 group. Therefore, the brain of binge drinkers with moderate BAC could be employing compensatory mechanisms from additional brain areas to perform a working memory task adequately, but these resources would be undermined when BAC is higher (>0.5 g/L). No gender differences were found in BAC-related lower performance in immediate visual memory and working memory. In conclusion, immediate visual memory is more sensitive than working memory to the neurotoxic effects of alcohol in adolescent binge drinkers of both genders, being a BAC-related lower performance, and without obvious differences between males and females.

Hierarchical Status Predicts Behavioral Vulnerability and Nucleus Accumbens Metabolic Profile Following Chronic Social Defeat Stress.

Extensive data highlight the existence of major differences in individuals' susceptibility to stress [1-4]. While genetic factors [5, 6] and exposure to early life stress [7, 8] are key components for such neurobehavioral diversity, intriguing observations revealed individual differences in response to stress in inbred mice [9-12]. This raised the possibility that other factors might be critical in stress vulnerability. A key challenge in the field is to identify non-invasively risk factors for vulnerability to stress. Here, we investigated whether behavioral factors, emerging from preexisting dominance hierarchies, could predict vulnerability to chronic stress [9, 13-16]. We applied a chronic social defeat stress (CSDS) model of depression in C57BL/6J mice to investigate the predictive power of hierarchical status to pinpoint which individuals will exhibit susceptibility to CSDS. Given that the high social status of dominant mice would be the one particularly challenged by CSDS, we predicted and found that dominant individuals were the ones showing a strong susceptibility profile as indicated by strong social avoidance following CSDS, while subordinate mice were not affected. Data from 1H-NMR spectroscopy revealed that the metabolic profile in the nucleus accumbens (NAc) relates to social status and vulnerability to stress. Under basal conditions, subordinates show lower levels of energy-related metabolites compared to dominants. In subordinates, but not dominants, levels of these metabolites were increased after exposure to CSDS. To the best of our knowledge, this is the first study that identifies non-invasively the origin of behavioral risk factors predictive of stress-induced depression-like behaviors associated with metabolic changes.

Effects of social stress and clomipramine on emotional memory in mice.

We have previously observed impairing effects of social defeat stress (CSDS) on inhibitory avoidance (IA) in mice. Given the similarity between changes produced by social stress in animals and symptoms of certain human psychopathologies such as depression and anxiety, the effects of the antidepressant clomipramine on IA impairment produced by CSDS were evaluated in the present study. Male CD1 mice were randomly assigned to the groups: non-stressed+saline, non-stressed+clomipramine, stressed+saline and stressed+clomipramine. Stressed animals were subjected to daily agonistic encounters (10 min) in the home cage of the aggressor over a 20-day period. Just before each encounter, non-stressed and stressed mice were injected i.p. with saline or clomipramine (10 mg/kg) according to their experimental condition. 24 hours after the last CSDS session, all the mice were tested in a step-through IA task. In the IA training phase, animals were punished by a shock to the paw when they entered the dark compartment of the apparatus. In the IA test phase (one week later) the same procedure took place, but without shock. Complementary measures were obtained by evaluating all the animals in an elevated plus maze (locomotor activity and emotionality) and on a hot plate (analgesia). IA learning was confirmed in all groups except the stressed+saline group, which was the only one that exhibited higher anxiety levels. No variations were observed in either locomotor activity or analgesia. In conclusion, CSDS induces anxiety and impairs emotional memory in mice; the negative effects of CSDS on memory appear to be attenuated by clomipramine, and these detrimental effects do not seem to be secondary to the effects of CSDS on locomotor activity, emotionality or pain sensitivity.

Effects of several degrees of chronic social defeat stress on emotional and spatial memory in CD1 mice.

In the present study, the effects of several degrees of CSDS (Chronic Social Defeat Stress) on emotional and spatial memory in mice were evaluated in separate experiments. Male CD1 mice were randomly assigned to four experimental groups (n=10-12) for each experiment: NS (non-stressed), S5, S10 and S20 (5, 10 and 20 sessions of CSDS, respectively). The S groups underwent the corresponding number of agonistic encounters (10min each) over a 20-day period. 24h after the last session of CSDS, mice performed the inhibitory avoidance (Experiment 1) or the Morris water maze test (Experiment 2). In both experiments, animals were also evaluated in the elevated plus maze for 5min to obtain complementary measures of locomotor activity and emotionality. The results showed that the highest degree of CSDS had impairing effects on inhibitory avoidance, while there were no significant differences between groups in the water maze. The S20 group exhibited higher anxiety levels in the elevated plus maze. No variations in locomotor activity were observed in any experiment. In conclusion, CSDS has a greater impact on emotional memory than on spatial memory. These negative effects of CSDS on memory do not seem to be secondary to the motor or emotional effects of stress.

Inhibitory avoidance learning in CD1 mice: Effects of chronic social defeat stress.

Chronic social defeat stress (CSDS) is an animal model widely used to determine the neurobiological mechanisms of stress and its associated pathologies. In this study, the effects of CSDS on inhibitory avoidance (IA) were evaluated in post-pubertal and adult male CD1 mice, instead of the C57BL/6J strain used in the CSDS standard protocol. CSDS consisted of daily 5-min (experiments 1 and 2) or 10-min (experiment 3) agonistic encounters on 21 consecutive days. Twenty four hours after the last session of CSDS, all the mice were tested for IA. They were also evaluated in an elevated plus-maze, obtaining complementary measures of locomotor activity and emotionality. In experiments 1 and 2, IA learning was confirmed in both non-stressed and stressed groups, showing stressed post-pubertal mice higher test latencies than controls. In experiment 3, IA was confirmed in the non-stressed but not in the stressed group. In conclusion, a moderate degree of CSDS (5-min encounters) enhances memory in post-pubertal but not in adult mice, while a high degree (10-min encounters) prevents the memory formation of IA in mice. These effects of CSDS on memory are not secondary to motor or emotional effects of stress. Furthermore, CD1 has been shown to be a valid strain for the stressed mice in the CSDS model.