Multiorgan involvement and circulating IgG1 predict hypocomplementaemia in IgG4-related disease.

OBJECTIVES: Hypocomplementaemia is common in patients with IgG4-related disease (IgG4-RD). We aimed to determine the IgG4-RD features associated with hypocomplementaemia and investigate mechanisms of complement activation in this disease. METHODS: We performed a single-centre cross-sectional study of 279 patients who fulfilled the IgG4-RD classification criteria, using unadjusted and multivariable-adjusted logistic regression to identify factors associated with hypocomplementaemia. RESULTS: Hypocomplementaemia was observed in 90 (32%) patients. In the unadjusted model, the number of organs involved (OR 1.42, 95% CI 1.23 to 1.63) and involvement of the lymph nodes (OR 3.87, 95% CI 2.19 to 6.86), lungs (OR 3.81, 95% CI 2.10 to 6.89), pancreas (OR 1.66, 95% CI 1.001 to 2.76), liver (OR 2.73, 95% CI 1.17 to 6.36) and kidneys (OR 2.48, 95% CI 1.47 to 4.18) were each associated with hypocomplementaemia. After adjusting for age, sex and number of organs involved, only lymph node (OR 2.59, 95% CI 1.36 to 4.91) and lung (OR 2.56, 95% CI 1.35 to 4.89) involvement remained associated with hypocomplementaemia while the association with renal involvement was attenuated (OR 1.6, 95% CI 0.92 to 2.98). Fibrotic disease manifestations (OR 0.43, 95% CI 0.21 to 0.87) and lacrimal gland involvement (OR 0.53, 95% CI 0.28 to 0.999) were inversely associated with hypocomplementaemia in the adjusted analysis. Hypocomplementaemia was associated with higher concentrations of all IgG subclasses and IgE (all p<0.05). After adjusting for serum IgG1 and IgG3, only IgG1 but not IgG4 remained strongly associated with hypocomplementaemia. CONCLUSIONS: Hypocomplementaemia in IgG4-RD is not unique to patients with renal involvement and may reflect the extent of disease. IgG1 independently correlates with hypocomplementaemia in IgG4-RD, but IgG4 does not. Complement activation is likely involved in IgG4-RD pathophysiology.

Parental Mental Health and Parenting Behaviors Following Very Preterm Birth: Associations in Mothers and Fathers and Implications for Child Cognitive Outcome.

OBJECTIVES: To investigate the longitudinal associations between parental mental health symptoms within 4 weeks of birth, parenting behaviors at 1 year, and child general cognitive ability at 4.5-5 years in a sample of children born very preterm (VP). This study also examined whether these associations differed based on level of family social risk. METHODS: Participants were 143 children born <30 weeks' gestation and their parents. Within 4 weeks of birth, mothers' and fathers' depressive and anxiety symptoms were assessed using the Center for Epidemiologic Studies Depression Scale and Hospital Anxiety Depression Scale-Anxiety Subscale. Parents' sensitive and structuring parenting behaviors were assessed at 1 year using the Emotional Availability Scales. Child general cognitive ability was assessed at 4.5-5 years using the Wechsler Preschool & Primary Scale of Intelligence-Fourth Edition. RESULTS: Higher maternal depressive symptoms were associated with lower levels of sensitive and structuring parenting behavior, while higher maternal anxiety symptoms were associated with higher levels of structuring parenting behavior. There was weak evidence for positive associations between mothers' sensitive parenting behavior and fathers' structuring parenting behavior and child general cognitive ability. There was also weak evidence for stronger associations between mothers' mental health symptoms, parenting behaviors, and child general cognitive ability, in families of higher compared with lower social risk. CONCLUSIONS: Depressive and anxiety symptoms experienced by mothers in the initial weeks following VP birth can have long-term effects on their parenting behaviors. Enquiring about parents' mental health during their child's hospitalization in the neonatal intensive care unit is crucial.

Preconception factors associated with postnatal mental health and suicidality among first-time fathers: results from an Australian Longitudinal Study of Men's Health.

PURPOSE: Prospective evidence about men at risk of postnatal difficulties is rare-particularly for postpartum suicidal ideation. This study aimed to determine the extent to which first-time fathers reported depressive symptoms and suicidal ideation and behaviours in the first postnatal year, and to identify preconception risk factors for postnatal mental health difficulties. METHODS: Secondary analysis of data from The Ten to Men Study-Australia's population-based prospective study of men's health was conducted. Participants were 205 men who became first-time fathers in the 12 months prior to wave 2 (2015/16). Regression analyses were used to ascertain preconception (mental and physical health, lifestyle) and demographic factors associated with postnatal depressive symptoms. RESULTS: Postnatally, 8.3% of fathers reported moderate to severe depressive symptoms, 5% had suicidal thoughts, 3% had plans, and less than 1% had attempted suicide. Preconception depressive symptoms was the only factor significantly associated with postnatal depressive symptoms. CONCLUSION: The transition into fatherhood is marked with significant psychological distress for some men. These results suggest that mental health screening and support in the preconception period is crucial to supporting the mental health of new fathers.

Parenting and Neurobehavioral Outcomes in Children Born Moderate-to-Late Preterm and at Term.

OBJECTIVES: To compare the parenting environment and the relationships between parenting behaviors and concurrent child neurobehavioral outcomes at 2 years of corrected age between children born moderate-to-late preterm (MLP; 32-36 weeks of gestation) and at term (≥37 weeks of gestation). STUDY DESIGN: Participants were 129 children born MLP and 110 children born at term and their mothers. Mothers' parenting behaviors (sensitivity, structuring, nonintrusiveness, nonhostility) were assessed at 2 years of corrected age using the Emotional Availability Scales. Child cognitive and language development were assessed using the Bayley Scales of Infant and Toddler Development, and social-emotional competence using the Infant Toddler Social and Emotional Assessment. RESULTS: Mothers of children born MLP and at term displayed similar parenting behaviors overall, with slightly lower nonintrusiveness in mothers of children born MLP (adjusted mean difference -0.32 [-0.60, -0.04]; P = .03). In both groups of children, greater maternal sensitivity was associated with better cognitive development (P < .001 MLP; P = .02 term), increased maternal structuring was associated with better social-emotional competence (P = .02 MLP; P = .03 term), and higher maternal nonintrusiveness was associated with better cognitive, language, and social-emotional outcomes (all P < .04). Greater maternal sensitivity and structuring were associated with better language development in children born MLP but not in children born at term. CONCLUSIONS: Parenting behaviors are important for neurobehavioral outcomes in children born MLP and at term. Language development may be more strongly influenced by select parenting behaviors in children born MLP compared with children born at term.

New group memberships formed after an acquired brain injury and posttraumatic growth: A prospective study.

Predicting positive psychosocial outcomes following an Acquired Brain Injury (ABI) remains a challenge. Considerable research demonstrates that social group memberships can have positive effects on psychological well-being, particularly during life transitions. Social group memberships are argued to help people derive a sense of self. This prospective study examined if social group memberships (number of groups and connectedness with groups) could predict posttraumatic growth (PTG) in those affected by ABI. Thirty-six participants (10 females, Mage = 46.56, SD = 11.46) engaged in community rehabilitation services completed measures at two time-points. Mediation analyses demonstrated that the number of new group memberships (groups formed post-injury) predicted greater PTG at time 2, via stronger connectedness with these new group memberships (controlling for initial PTG). The observed results suggest that a focus on developing and strengthening connections with new group memberships may promote positive adjustment after brain injury.

Mental Health Trajectories of Fathers Following Very Preterm Birth: Associations With Parenting.

OBJECTIVE: Mothers of infants born very preterm (VPT) are at high risk of mental health difficulties. However, less is known about the course of fathers' depressive and anxiety symptoms over time, and the implications this may have for early parenting behaviors. METHODS: In total, 100 fathers of 125 infants born VPT (<30 weeks' gestation) completed questionnaires assessing depressive and anxiety symptoms shortly after their infant's birth, and when their infant reached term-equivalent age, 3 months, 6 months, and 12 months' corrected age. At 12 months' corrected age, fathers' parenting behaviors were assessed using the Emotional Availability Scales. Longitudinal latent class analysis was used to identify trajectories of fathers' depressive and anxiety symptoms, and linear regression equations examined relationships between these trajectories and fathers' parenting behaviors. RESULTS: For both depressive and anxiety symptoms, two distinct trajectories were identified. For depression, most fathers were assigned to the persistently low symptom trajectory (82%), while the remainder were assigned to the persistently high symptom trajectory (18%). For anxiety, 49% of fathers were assigned to the persistently low symptom trajectory, while 51% were assigned to the trajectory characterized by moderate symptoms over the first postnatal year. There were no significant differences in parenting behaviors between fathers assigned to the different depressive and anxiety symptom trajectories. CONCLUSIONS: Fathers of infants born VPT are at risk of chronic depressive and anxiety symptoms over the first postnatal year, highlighting the need for screening and ongoing support.

Influence of Fathers' Early Parenting on the Development of Children Born Very Preterm and Full Term.

OBJECTIVES: To examine factors associated with fathers' early parenting behaviors (including very preterm [VPT] birth, familial social risk, child sex, and child medical risk), and the relationship between fathers' early parenting behaviors and later child development. STUDY DESIGN: Participants were 81 VPT (born <30 weeks of gestation) and 39 full-term father-child dyads. Parenting behaviors (sensitivity, structuring, nonintrusiveness, nonhostility) were assessed at 12 months of corrected age using the Emotional Availability Scales, with scores ranging from 1 (low) to 7 (high). At 24 months of corrected age, child cognitive, language, motor, and social-emotional development were assessed. Results are presented as (regression coefficients; 95% CIs). RESULTS: There was little evidence that VPT birth, familial social risk, or child medical risk were associated with fathers' parenting behaviors. Fathers of girls tended to be more sensitive (0.42; 0.18, 0.65), less intrusive (0.36; 0.04, 0.70), and less hostile (0.26; 0.01, 0.50) compared with fathers of boys. Higher structuring was associated with more optimal cognitive (3.29; 1.25, 5.34), and language development (4.69; 2.26, 7.14). Higher sensitivity was associated with more optimal language development 3.35 (0.95, 5.75), and more intrusive behavior was associated with more externalizing symptoms (-1.68; -3.06, -0.31). CONCLUSIONS: Early parenting did not differ between fathers with VPT and full-term children, but fathers' parenting did vary according to child sex. Fathers' early parenting was associated with future neurodevelopment, reinforcing the need to support fathers' parenting, and include fathers in early intervention programs.

New social identities in Ukrainian 'refugees': A social cure or social curse?

Experiencing traumatic events often drives profound post-traumatic stress (PTS), but trauma also has the potential to engender positive consequences, such as post-traumatic growth (PTG). Traumatic experiences may also lead to gaining new identities which can have both protective (i.e., social cure) or damaging (i.e., social curse) effects on health and well-being. This study aims to examine the role of new social identities and related social identity resources acquired after war-related experiences (i.e., identification with a new host society and identification as a refugee) in contributing to different trauma trajectories. The sample included 468 participants who left Ukraine due to the war that commenced on February 24th, 2022, and became residents of Ireland or Poland. The findings indicate that identification with the host society was associated with lower PTS and greater PTG. Whereas identification with refugees was related to higher PTS, but it was not directly associated with PTG. Further, the psychological resources derived from these new identities mediated the relationship between identification strength and PTG. This study offers practical insights for interventions targeting refugees in their new countries of residence.

Religious engagement and antibody response to the COVID-19 vaccine.

This research examined religious engagement and subsequent antibody responses to the COVID-19 vaccine. Using publicly available data from the Understanding Society survey, we employed a longitudinal design. Between January 2016 and May 2018, respondents completed measures of religious belonging, frequency of attending religious services (i.e., extrinsic religiosity), and the difference religion made to their lives (i.e., intrinsic religiosity). A COVID-19 survey wave was collected in March 2021 and measured antibody responses to the COVID-19 vaccine via blood draw. A final sample of 746 adults [462 (61.9%) females, Mage = 61.94, SD = 19.07] was achieved. Mediation analyses (PROCESS, Model 4; Hayes, Introduction to mediation, moderation, and conditional process analysis: A regression-based approach, The Guildford Press, 2022; Introduction to mediation, moderation, and conditional process analysis: A regression-based approach; The Guildford Press) revealed one pathway through which religion and antibody responses to the COVID-19 vaccine are associated, namely via extrinsic factors-attendance at religious services. In contrast, intrinsic religious factors which is the difference religion can make to one's life, was not a significant mediator. Overall, this analysis provides evidence that behavioural enactment of religion matters to the effectiveness of vaccination and the management of public health crises. It also highlights the value of social resources associated with engagement in valued social groups-and in particular religious social groups-for public health.

Pre-pandemic adversity and maternal mental health during the COVID-19 pandemic: the mediating role of pandemic stress and family relationships.

BACKGROUND: The COVID-19 pandemic was a time of increased stress for families. Parents with a history of adversity may have been at higher risk of experiencing mental health problems during this time. The current study aims to investigate the relationship between pre-pandemic adversity pandemic related stressors and maternal mental health outcomes during the pandemic. METHODS: Data was drawn from the Mothers' and Young People's Study (MYPS), a longitudinal of first time mothers and their children. Participants were 418 mothers who completed the MYPS COVID-19 sub-study. Data was collected during pregnancy, at 1, 4, 10 years postpartum, and during the COVID-19 pandemic (approximately 14 years postpartum). Path-analysis was used to test the relationship indirect relationship between pre-pandemic adversity and maternal depressive and anxiety symptoms, via family functioning and pandemic related stress. RESULTS: The hypothesised model was a good fit to the data accounting for 34 % and 33 % of the variance in maternal depressive and anxiety scores, respectively. A significant indirect effect was found between pre-pandemic adversity and both maternal anxiety and depressive systems via family relationships during the pandemic and pandemic related stress. LIMITATIONS: MYPS participants who took part in the COVID-19 sub-study were more likely to be older, have a higher level of education, and speak English as a first language, compared to the total MYPS sample. CONCLUSIONS: Family inclusive service responses which aim to strengthen family relationships may be particularly important for families where there is a history of adversity to support parental mental health.

Child sexual abuse and social identity loss: A qualitative analysis of survivors' public accounts.

Emerging evidence suggests that social identities are an important determinant of adaptation following traumatic life experiences. In this paper, we analyse accounts of people who experienced child sexual abuse. Using publicly available talk of people who waived their right to anonymity following successful conviction of perpetrators, we conducted a thematic analysis focusing on trauma-related changes in their social identities. Analysis of these accounts highlighted two themes. The first highlights the acquisition in these accounts of unwanted and damaging identity labels. The second presents child sexual abuse as a key destructive force in terms of important identity work during childhood. Discussion of this analysis centres on the pathological consequences of social identity change. Both the loss of valued identities and the acquisition of aberrant and isolating identities are experienced and constructed as devastating by those affected by child sexual abuse. This has important implications, not only for those impacted by child sexual abuse but for how abuse is discussed in society, and how it is approached by policy makers, educators and individuals working with survivors and their families.

Patterns of intimate partner violence exposure across the first 10 years of life and children's emotional-behavioural outcomes at 10 years.

BACKGROUND: Childhood exposure to intimate partner violence (IPV) is associated with emotional-behavioural problems. However, little is known about children's emotional-behavioural outcomes following exposure to different long-term patterns of IPV. OBJECTIVE: The current study aimed to investigate the emotional-behavioural functioning of children at 10 years of age following exposure to different patterns of IPV across the first 10 years of life. PARTICIPANTS AND SETTING: Data for this study was drawn from the Mothers' and Young People's Study- a longitudinal study of 1507 first time mothers and their first born child. METHODS: Women were recruited during pregnancy from six public hospitals in Victoria, Australia. Data was collected during pregnancy, and at one, four and ten years postpartum. Four patterns of IPV exposure were previously identified: (a) minimal IPV exposure; (b) early IPV; (c) Increasing IPV; and (d) persistent IPV. Logistic regression was used to assess associations between IPV exposure and emotional-behavioural outcomes. RESULTS: Exposure to early, increasing, or persistent IPV was associated with increased odds of experiencing emotional-behavioural difficulties (OR 2.15-2.97). Children exposed to a persistent pattern of IPV experienced over 6 times the odds of conduct problems (OR = 6.15 CI = 2.3-16.44). CONCLUSIONS: Children exposed to early, increasing, or persistent IPV experienced increased odds of emotional-behavioural problems at age 10, regardless of the duration or type of violence they were exposed to. However, children exposed to persistent IPV across childhood appeared to experience the highest odds of emotional-behavioural difficulties.

Sex as a predictor of clinical phenotype and determinant of immune response in IgG4-related disease: a retrospective study of patients fulfilling the American College of Rheumatology-European League Against Rheumatism classification criteria.

BACKGROUND: IgG4-related disease is a multiorgan fibroinflammatory disease considered to have an autoimmune origin. Case series describing individual organ involvement have suggested differences in phenotypic expression between males and females. We aimed to characterise differences in IgG4-related disease manifestations between male and female patients in a large single-centre cohort. METHODS: In this retrospective, single-centre cohort study, patients were recruited from the Massachusetts General Hospital Rheumatology Clinic (Boston, MA, USA) and classified according to the American College of Rheumatology-European Alliance of Associations for Rheumatology (ACR-EULAR) classification criteria. Only patients satisfying the ACR-EULAR classification criteria were included in the study. Data on age at diagnosis, organ involvement at baseline, treatment status, and pre-treatment laboratory values were collected. Circulating plasmablasts and B-cell subsets were quantitated by flow cytometry. Active disease was defined by an IgG4-related disease Responder Index score of more than 0. Laboratory values were analysed for patients who were untreated at baseline and had active IgG4-related disease. The main outcomes were assessed in all participants with available data. FINDINGS: Of the 564 participants enrolled in the Massachusetts General Hospital Rheumatology Clinic IgG4-related disease Registry, 328 fulfilled ACR-EULAR classification criteria and were included between January, 2008, and May, 2023. There was a strong male predominance (male:female ratio 2·2:1) with 226 (69%) males and 102 (31%) females, which contrasted markedly with our general rheumatology clinic population (0·4:1; p<0·001). The male predominance increased with each decade of life starting at age 40 years. On average, male patients were 5·5 years older at diagnosis than female patients (63·7 years vs 58·2 years; p=0·0031). We observed male patients to have higher ACR-EULAR classification criteria scores at baseline with a median score of 35·0 (IQR 28·0-46·0), compared with 29·5 (25·0-39·0) for females (p=0·0010). The proportion of male patients with pancreatic and renal involvement was almost double the proportion observed in female patients (50% of the male patients had pancreatic involvement, compared with about 26% of the female patients; p<0·0001). Male patients were more likely to have serological abnormalities at baseline. The distribution of IgG4 values differed significantly between male an female sexes, favouring higher values in males. We found that male patients with IgG4-related disease were more likely to have active B-cell responses in the blood as defined by plasmablast expansions. INTERPRETATION: IgG4-related disease is unusual among autoimmune diseases in that it is more likely to affect males than females and to present with a striking sex-dependent organ distribution and degree of B-cell response. These findings highlight important variation between IgG4-related disease and other conditions generally believed to have an autoimmune basis. Most autoimmune diseases, by contrast to IgG4-related disease, demonstrate pronounced predilections for affecting females more frequently than males. Hypotheses surrounding the cause and pathophysiology of this condition need to consider this unusual sex distribution among patients with IgG4-related disease. FUNDING: National Institutes of Health, National Institute of Allergy and Infectious Diseases, Rheumatology Research Foundation, and the National Institute of Arthritis and Musculoskeletal and Skin Diseases.

PROTOCOL: Group-based interventions for posttraumatic stress disorder: A systematic review and meta-analysis of the role of trauma type.

This is the protocol for a Campbell systematic review. The primary objective is to assess the effects of group-based treatments on posttraumatic stress disorder (PTSD) symptomology in people diagnosed with PTSD (by a clinician or screening instrument) or referred to a PTSD treatment group for their symptoms by a medical professional. We will also examine a range of moderators that may affect the efficacy of group-based treatments, including the nature of the trauma (interpersonal, stigmatized) and the group fit (in terms of gender and shared vs. unshared trauma). Further, we will also explore what, if any, group-based and social identity factors are recorded and how they relate to PTSD outcomes.

Early parenting behaviour is associated with complex attention outcomes in middle to late childhood in children born very preterm.

Attention deficits are common in children born very preterm (VP), especially for children with higher social risk. The aim of this study was to examine the association between parenting behavior and attention in children born VP, and whether this association is influenced by familial social risk. Two hundred and twenty-four children born <30 weeks' gestation and/or with a birth weight <1250 g were recruited at birth. At 2 years, social risk was calculated and parenting behaviors were observed during a parent-child interaction task, with children's attention skills assessed at 7 and 13 years using standardized assessments. Higher levels of sensitive parenting at 2 years were positively associated with divided attention at age 7 years, and higher levels of intrusive parenting were negatively associated with divided attention at 13 years. Children born VP with higher social risk were more positively influenced by sensitive parenting behavior for sustained attention at 7 years, selective attention at 13 years, and divided attention at 7 and 13 years than children born VP with lower social risk. Additionally, children born VP with higher social risk were more negatively influenced by intrusive parenting for sustained attention outcomes at 7 years than those with lower social risk. In summary, the evidence for a contribution of early parenting to attention outcomes in children born VP was stronger for more complex attention (divided attention) compared with basic attention domains. Our findings also suggest that early parenting behavior has a particular influence on children born VP from socially disadvantaged environments for attention outcomes.

Assessment of patient-reported symptoms and distress in IgG4-related disease (IgG4-RD): Development, clinical validation, and content validation of the IgG4-RD Symptom Severity Index.

OBJECTIVE: IgG4-related disease (IgG4-RD), a multi-organ autoimmune disease, causes diverse manifestations that can lead to symptoms and distress. We developed and validated the Symptom Severity Index (SSI) to assess symptom burden. METHODS: A pilot SSI was tested in n = 5; several gaps were identified. Twenty semi-structured qualitative interviews were performed to expand the item set and identify missing symptoms. Subsequent changes resulted in the current SSI; it was administered with quality of life (QOL) measures to n = 136. We assessed symptom burden and the construct validity of the SSI. A distress score for each symptom is calculated by multiplying symptom frequency ("Never" [0 points] to "Every Day" [3 points]) by associated distress ("None" [0 points] to "Very Much" [4 points]). Each distress score is summed to calculate a total SSI score. RESULTS: The SSI assesses the frequency and distress of 24 symptoms. Among n = 136 with ≥ 1 SSI, 90% experienced ≥ 1 symptom and 88% had distress. The median SSI score was 6.5 (IQR 3.0, 18.0). Fear of more severe disease was observed in 49%. The SSI inversely correlated with the SF-36 (r= - 0.51, p<0.001), the feeling thermometer (r= - 0.28, p<0.001), and the EQ-5D (r= - 0.28, p<0.001). The median SSI score was higher during active vs non-active disease among n = 52 who completed >1 SSI (15 [6, 26] vs. 3 [2, 14], p = 0.008). CONCLUSIONS: Symptoms and distress are common in IgG4-RD and associated with worse health-related QOL. The SSI has face, content, and construct validity; it corresponds with QOL measures.

Disruption to well-being activities and depressive symptoms during the COVID-19 pandemic: The mediational role of social connectedness and rumination.

BACKGROUND: Disruption to everyday routine during the COVID-19 pandemic has resulted in considerable implications for global mental health. The inter- and intra-personal mechanisms by which disrupted routine can contribute to elevated depressive symptoms has not been well-explored. The present study aimed to examine how feelings of social (dis)connectedness and rumination, as a maladaptive coping strategy, could explain the association between disrupted well-being activities and depressive symptoms. METHODS: Participants (N = 496) ranging in age from 18 to 73 years (M = 28.73, SD = 10.93) completed an online survey within the first 3 months of the COVID-19 pandemic, which included measures of disruption to usual psychological and physical well-being activities, social connectedness, rumination, and depressive symptoms. Social connectedness and rumination were investigated as serial mediators of the association between disrupted well-being activities and depression using Hayes' PROCESS macro. RESULTS: 39.5% of the sample reported clinically significant levels of depression. Disruption to well-being activities predicted higher depressive symptoms, and this was partially explained by feelings of social disconnectedness and subsequent rumination. Rumination, alone, was not a significant mediator between disrupted routine and depressive symptoms. LIMITATIONS: The cross-sectional survey design does not preclude the possibility of bidirectional effects. CONCLUSION: The social distancing public health measures to combat COVID-19 have contributed to widespread disrupted routine, and in turn, elevated symptoms of depression. Social disconnectedness plays a particularly important role in this association. Intervention strategies should consider social factors as a 'social cure' for mass, positive mental health promotion during COVID-19.

Social integration: Implications for the association between childhood trauma and stress responsivity.

OBJECTIVE: Childhood trauma is linked to the dysregulation of physiological responses to stress, particularly lower cardiovascular reactivity (CVR) to acute stress. The mechanisms that explain this association, however, are not yet fully understood. METHOD: Using secondary data from the Midlife in the United States (MIDUS) Biomarker Project (N = 1,148; n = 652 females), we examine whether social integration can help explain the association between childhood trauma and lower CVR. Participants completed a standardized laboratory stress paradigm which involved completing executive functioning (Stroop) and mental arithmetic (MATH) tasks. Cardiovascular measurements were continuously assessed using electrocardiogram (ECG) and Finometer equipment. The Social Well-Being Scale (Keyes, 1998) and the Childhood Trauma Questionnaire (CTQ; Bernstein et al., 2003) measured social integration and trauma, respectively. RESULTS: Regression analyses demonstrated that childhood trauma was associated with lower systolic (SBP; ß = -.14, p < .001) and diastolic (DBP; ß = -.11, p < .001) blood pressure reactivity but not heart rate (HR) reactivity. Mediation analyses, using Hayes PROCESS Model 4, showed that higher levels of trauma were associated with less social integration and in turn linked to lower reactivity across all biological indices. Moreover, sensitivity analyses showed that this indirect effect via social integration was evident for emotional and physical abuse, emotional and physical neglect, but not sexual abuse. CONCLUSION: Overall, the results indicated that dysregulated cardiovascular stress responses owing to childhood trauma may be shaped by a lack of social integration. The implications of this, as well as the findings for the individual types of trauma, are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Cardiovascular reactivity to acute stress: Attachment styles and invisible stranger support.

While the benefits of social support for physiological health are well established, the underlying pathways by which support can influence cardiovascular reactivity (CVR) are still being elucidated. In the present study, we adapted an attachment framework to further explore the support-CVR link. Specifically, we experimentally tested the effect of attachment and social support on CVR by manipulating the provision of invisible support from a stranger, across individuals with secure, anxious and avoidant attachment styles. Employing a 3 × 2 design, a sample of young adults (N = 138) from across each of the three attachment styles were randomly assigned to either an invisible support (from a stranger), or no support, condition. All participants were subject to an acute standardised stress testing protocol where cardiovascular indices were monitored throughout. Results from a factorial ANOVA showed no significant interaction between support and attachment on any cardiovascular reactivity parameter (SBP, DBP, HR) or any main effect of attachment or support. These findings suggest that, in this case, social support was not effective in buffering the effects of stress across various attachment styles. The benefits of incorporating a developmental perspective to the study of social support and health are discussed.

A meta-analysis of influenza vaccination following correspondence: Considerations for COVID-19.

BACKGROUND: High vaccination rates are needed to protect against influenza and to end the COVID-19 pandemic. Health authorities need to know if supplementing mass communications with direct correspondence to the community would increase uptake. OBJECTIVES: The primary objective is to determine if sending a single written message directly to individuals increases influenza vaccine uptake, and a secondary objective is to identify any identified content shown to increase influenza vaccine uptake. METHODS: MEDLINE, Embase, Cochrane CENTRAL, PsycINFO, and PubMed were searched for RCTs testing a single correspondence for members of the community in OECD countries to obtain influenza vaccination. A meta-analysis with inverse-variance, random-effects modelling was used to estimate a mean, weighted risk ratio effect size measure of vaccine uptake. Studies were quality assessed and analysis was undertaken to account for potential publication bias. RESULTS: Twenty-eight randomized controlled trials were included, covering 45 interventions. Of the 45 interventions, 37 (82.2%) report an increase in influenza vaccination rates. A formal meta-analysis shows that sending a single written message increased influenza vaccine uptake by 16%, relative to the no contact comparator group (RR = 1.16, 95% CI [1.13-1.20], Z = 9.25, p < .001). Analysis shows that the intervention is effective across correspondence type, age group, time, and location, and after allowing for risk of publication bias. LIMITATIONS: The generalizability of results across the OECD may be questioned. CONCLUSIONS AND IMPLICATIONS: The implication for public health authorities organizing vaccination programs for influenza, and arguably also for COVID-19, is that sending written vaccination correspondence to members of the community is likely to increase uptake. This study is pre-registered on osf.io; details can be found at https://osf.io/98mr7.