RESUMO
As food addiction is being more commonly recognized within the scientific community, parallels can be drawn between it and other addictive substance use disorders, including tobacco use disorder. Given that both unhealthy diets and smoking are leading risk factors for disability and death, a greater understanding of how food addiction and tobacco use disorder overlap with one another is necessary. This narrative review aimed to highlight literature that investigated prevalence, biology, psychology, and treatment options of food addiction and tobacco use disorder. Published studies up to August 2020 and written in English were included. Using a biopsychosocial lens, each disorder was assessed together and separately, as there is emerging evidence that the two disorders can develop concurrently or sequentially within individuals. Commonalities include but are not limited to the dopaminergic neurocircuitry, gut microbiota, childhood adversity, and attachment insecurity. In addition, the authors conducted a feasibility study with the purpose of examining the association between food addiction symptoms and tobacco use disorder among individuals seeking tobacco use disorder treatment. To inform future treatment approaches, more research is necessary to identify and understand the overlap between the two disorders.
Assuntos
Dependência de Alimentos/epidemiologia , Dependência de Alimentos/psicologia , Tabagismo/epidemiologia , Tabagismo/psicologia , Adulto , Adultos Sobreviventes de Eventos Adversos na Infância/psicologia , Terapia Comportamental , Encéfalo/fisiopatologia , Comorbidade , Terapia por Estimulação Elétrica , Feminino , Dependência de Alimentos/terapia , Microbioma Gastrointestinal/fisiologia , Humanos , Masculino , Apego ao Objeto , Prevalência , Fatores de Risco , Abandono do Uso de Tabaco , Tabagismo/terapiaRESUMO
Objectives: This study examines the prevalence of exposure to adverse events and associations with stress levels among a diverse population-based sample of young people. The study further explores whether these vulnerable populations, who have the potential to benefit from the mind-body practice of yoga, engage in a regular yoga practice. Design: EAT 2018 (Eating and Activity over Time) is a population-based study in which survey data were collected from 1568 ethnically/racially diverse (81.2% nonwhite) emerging young adults (mean age: 22.0 ± 2.0 years). Results: Exposure to adverse events was highly prevalent. For example, 43.9% reported at least one adverse childhood experience (ACE) (e.g., physical, emotional, or sexual abuse before age 18), whereas 40.1% reported experiencing discrimination. Exposure to adverse events was associated with higher stress levels. Practicing yoga at least 30 min/week was reported by 12.7% of the population, with variation across sociodemographic characteristics. Young adults exposed to adverse events were either more or similarly likely to practice yoga than young adults not reporting adverse events. Conclusions: The high prevalence of exposure to adverse events and associations with higher levels of stress points to a need for public health interventions. Thus, it was promising to find that young people exposed to adverse events, who may have greater emotional burdens, practice yoga at equal or greater proportions to those without these exposures. Given the potential benefits of yoga for populations living with high stress, it is important to develop further outreach efforts and provide accessible, acceptable, and affordable opportunities for practicing yoga.
Assuntos
Adultos Sobreviventes de Eventos Adversos na Infância/psicologia , Discriminação Social/psicologia , Estresse Psicológico/terapia , Yoga , Adolescente , Adulto , Feminino , Humanos , Masculino , Prevalência , Inquéritos e Questionários , Adulto JovemRESUMO
Adverse childhood experiences (ACEs) and trauma symptoms have been linked with intimate partner violence (IPV) perpetration and victimization among men, yet the field lacks depth in several key areas hampering progress toward violence intervention. Specifically, posttraumatic stress disorder (PTSD) dominates the field's scope of trauma symptoms under study, limiting understanding of other manifestations of trauma especially among men. Furthermore, most research focuses exclusively on men's physical IPV perpetration and rarely focuses on other types of IPV, severity of violence, or men's victimization. Also, few studies examine potential protective factors grounded in the ACE framework, such as mindfulness, among clinical populations. Finally, most research has not focused on men of color, despite some racial/ethnic minority groups disproportionate rates of IPV exposure. Therefore, the relationships between IPV frequency and severity (psychological, physical, injury) and ACEs, PTSD, trauma symptomology (separate from PTSD), and mindfulness self-efficacy were examined in a sample of 67 predominantly low-income men of color in a batterer intervention program. More than half of the sample (51.5%) reported exposure to four or more ACEs, and 31.1% met the clinical cutoff for a probable PTSD diagnosis. Higher ACE scores predicted increased rates for nearly all types of self-reported IPV perpetration and victimization. PTSD symptoms and complex trauma symptom severity together explained between 13% and 40% of IPV outcomes, and each was uniquely associated with certain types of self-reported IPV victimization and perpetration frequency and severity. Mindfulness self-efficacy was associated with decreased self-report psychological IPV perpetration and victimization frequency and severity. Clinical implications relevant to marginalized men are reviewed, including screening, training, and potential therapeutic interventions.
Las experiencias adversas en la infancia (EAI) y los síntomas de trauma se han asociado con la perpetración de violencia de pareja y la victimización entre los hombres, sin embargo, el ámbito carece de profundidad en varias áreas clave que obstaculizan el avance hacia la intervención en la violencia. Específicamente, el trastorno por estrés postraumático (TEPT) domina el alcance de los síntomas de trauma del ámbito estudiado, lo cual limita la comprensión de otras manifestaciones de trauma, especialmente entre los hombres. Además, la mayoría de las investigaciones se centran exclusivamente en la perpetración de violencia física de pareja por parte de los hombres y rara vez se centra en otros tipos de violencia de pareja, en la gravedad de la violencia o en la victimización de los hombres. Además, pocos estudios analizan posibles factores protectores basados en el marco de las EAI, como la conciencia plena, entre las poblaciones clínicas. Finalmente, la mayoría de las investigaciones no se han centrado en los hombres de color, a pesar de algunos índices desmesurados de exposición a la violencia de pareja de grupos raciales/étnicos minoritarios. Por lo tanto, se analizó la relación entre la frecuencia de la violencia de pareja y la gravedad de esta (psicológica, física, lesiones) y las EAI, el TEPT, la sintomatología del trauma (aparte del TEPT), y la autoeficacia de la conciencia plena en una muestra de 67 hombres de color, predominantemente de bajos recursos, en un programa de intervención para golpeadores. Más de la mitad de la muestra (el 51, 5 %) informó exposición a cuatro o más EAI y el 31, 1 % alcanzó el umbral de decisión clínica para un diagnóstico probable de TEPT. Los puntajes más altos de EAI predijeron índices mayores de casi todos los tipos de perpetración de violencia de pareja y victimización autoinformadas. Los síntomas de TEPT y la gravedad de los síntomas de trauma complejo explicaron juntos entre el 13 % y el 40 % de los resultados de la violencia de pareja, y cada uno estuvo asociado exclusivamente con ciertos tipos de gravedad y frecuencia de la victimización y la perpetración de violencia de pareja autoinformadas. La autoeficacia de la conciencia plena estuvo asociada con una menor victimización y perpetración autoinformadas de la frecuencia y la gravedad de la violencia psicológica de pareja. Se revisan las implicancias clínicas relevantes para los hombres marginados, entre ellas, la evaluación, la capacitación y las posibles intervenciones terapéuticas.
Assuntos
Adultos Sobreviventes de Eventos Adversos na Infância/psicologia , Violência por Parceiro Íntimo/psicologia , Atenção Plena , Marginalização Social/psicologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Adolescente , Adulto , Adultos Sobreviventes de Eventos Adversos na Infância/estatística & dados numéricos , Negro ou Afro-Americano/psicologia , Negro ou Afro-Americano/estatística & dados numéricos , Idoso , Vítimas de Crime/psicologia , Estudos Transversais , Humanos , Violência por Parceiro Íntimo/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Autoeficácia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/terapia , Inquéritos e Questionários , Adulto JovemRESUMO
Objectives: The objectives of this study were to describe posttraumatic growth (PTG) levels among survivors of adolescent and young adult cancer (AYAs), and estimate relationships between PTG and medical (cancer type, age at diagnosis, time since treatment), behavioral (physical activity), and psychological (appearance evaluations, body satisfaction) variables.Methods: Eighty-eight AYAs (Mage=33 ± 4.4 years) completed a survey online that included the PTG-Inventory (PTG-I). Data were analyzed using descriptive statistics and bivariate correlations.Findings: Total and subdimension PTG-I scores indicated moderate-to-high PTG levels, with the highest and lowest scores reported for appreciation of life and spiritual change, respectively. Appearance evaluations was moderately and positively correlated with the spiritual change subdimension (r = .31, p < .001). Relationships between PTG and other variables were of weak magnitude and not statistically significant (rs = 0-.21, ps > .05).Conclusions: More research exploring variables related to PTG among AYAs is needed to better understand antecedents and outcomes of PTG.
Assuntos
Adultos Sobreviventes de Eventos Adversos na Infância/psicologia , Sobreviventes de Câncer/psicologia , Crescimento Psicológico Pós-Traumático , Adulto , Adultos Sobreviventes de Eventos Adversos na Infância/estatística & dados numéricos , Imagem Corporal/psicologia , Sobreviventes de Câncer/estatística & dados numéricos , Feminino , Humanos , Masculino , Satisfação Pessoal , Espiritualidade , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Homeless women are twice as likely to become pregnant and are less likely to receive antenatal care than women who are not homeless. Prevalent biopsychosocial complexity and comorbidities, including substance use and mental illness, increase the risk of obstetric complications, postnatal depression, and child loss to social services. AIM: To explore the perspectives of women who have experienced pregnancy and homelessness to ascertain how to improve perinatal care. DESIGN AND SETTING: A qualitative study with a purposive sample of women who had experienced pregnancy and homelessness, recruited from three community settings. METHOD: Semi-structured interviews continued to data saturation and were recorded, transcribed, and analysed thematically using a self-conscious approach, with independent verification of emergent themes. RESULTS: Eleven women, diverse in age (18-40 years) and parity (one to five children), participated. Most women had experienced childhood trauma, grief, mental illness, and substance use. Overarching themes of 'mistrust' and 'fear of child loss to social services' (CLSS) influenced their interactions with practitioners. The women experienced stigma from practitioners, and lacked effective support networks. Women who mistrusted practitioners attended appointments but concealed their needs, preventing necessary care. Further themes were being seen to do 'the best for the baby'; pregnancy-enabled access to necessary holistic biopsychosocial care; and lack of postnatal support for CLSS or parenting. CONCLUSION: Pregnancy offered a pivotal opportunity for homeless women to engage with care for their complex needs and improve self-care, despite mistrust of practitioners. Poor postnatal support and the distress of CLSS reinforced an ongoing cycle of grief, mental health crises, substance use relapse, and homelessness.
Assuntos
Adultos Sobreviventes de Eventos Adversos na Infância/psicologia , Depressão Pós-Parto/epidemiologia , Pessoas Mal Alojadas/psicologia , Transtornos Mentais/epidemiologia , Assistência Perinatal/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adulto , Escolaridade , Feminino , Pesar , Pessoas Mal Alojadas/estatística & dados numéricos , Humanos , Entrevistas como Assunto , Assistência Perinatal/normas , Gravidez , Pesquisa Qualitativa , Transtornos Relacionados ao Uso de Substâncias/psicologia , Reino Unido/epidemiologia , Adulto JovemRESUMO
BACKGROUND: Posttraumatic stress disorder (PTSD) is characterized by distressing trauma-related memories. According to the dual representation theory, intrusive memories arise from strengthened egocentric encoding and a poor contextual encoding, with spatial context requiring allocentric processing. Contextualization of mental imagery is proposed to be formed hierarchically through the ventral visual stream (VVS) to the hippocampal formation. Here, we tested this notion by investigating whether neuronal aberrations in structures of the VVS or in the hippocampus, as well as allocentric memory performance are associated with intrusive memory severity. METHODS: The sample comprised 33 women with PTSD due to childhood trauma. Allocentric memory performance was measured with the virtual Town Square Task and T1-weighted images acquired on a 3T Siemens Scanner. Intrusive memories were evoked by presenting an audio script describing parts of their trauma (script-driven imagery). RESULTS: Using hierarchical linear regression analysis, we found a significant association between lower intrusive memory severity and higher allocentric spatial memory, controlling for age, working memory, and general visuospatial ability. No significant association was found between cortical thickness of VVS structures, hippocampal volume and intrusive memory severity. Post hoc exploratory analyses revealed a negative correlation between years since index trauma and left hippocampal volume. LIMITATIONS: Our results are based on correlational analyses, causality cannot be inferred. CONCLUSION: This study supports the dual representation theory, which emphasizes the role of allocentric spatial memory for the contextualization of mental imagery in PTSD. Clinical implications are discussed.
Assuntos
Adultos Sobreviventes de Eventos Adversos na Infância/psicologia , Memória de Curto Prazo/fisiologia , Memória Espacial/fisiologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Adulto , Feminino , Hipocampo/diagnóstico por imagem , Humanos , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Testes Neuropsicológicos , Transtornos de Estresse Pós-Traumáticos/diagnóstico por imagem , Adulto JovemRESUMO
Research indicates that childhood adversity is associated with poor mental health in adulthood. The purpose of this study is to examine whether the deleterious long-term effects of childhood adversity on adult mental health are reduced for individuals who are involved in religious practices. Using longitudinal data from a representative sample of American adults ( N = 1,635), I find that religious salience and spirituality buffer the noxious effects of childhood abuse on change in positive affect over time. By contrast, these stress-buffering properties of religion fail to emerge when negative affect serves as the outcome measure. These results underscore the importance of religion as a countervailing mechanism that blunts the negative impact of childhood abuse on adult mental health over time. I discuss the theoretical implications of these findings for views about religion, childhood adversity, and mental health.
Assuntos
Adultos Sobreviventes de Eventos Adversos na Infância/psicologia , Saúde Mental , Religião e Psicologia , Adulto , Feminino , Humanos , Estudos Longitudinais , Masculino , Espiritualidade , Estados UnidosRESUMO
OBJECTIVES: Mothers with opioid use disorder are at high risk for maladaptive parenting. The present observational study aimed to measure the impact of a trauma-informed mindfulness-based parenting (MBP) intervention on quality of parenting behaviors of mothers primarily with opioid use disorders as well as examine associations between exposure to adverse childhood experiences and self-reported mindful parenting. METHODS: A pretest posttest design was used with repeated measures. A total of 160 women were recruited from a substance use treatment program into the 12-week-long group-based intervention comprised didactic and experiential mindfulness activities. The Keys to Interactive Parenting Scale (KIPS) measured quality of parenting behavior, the Adverse Childhood Experiences Tool captured history of exposure to childhood trauma, and the Interpersonal Mindfulness in Parenting (IM-P) scale measured the degree of mindful parenting. Analyses were conducted using multilevel modeling. RESULTS: The MBP intervention resulted in clinically significant improvements in KIPS total and all subscale scores and an IM-P total score. Data showed higher baseline Adverse Childhood Experiences and higher program attendance significantly predicted improved overall quality of parenting behaviors at a greater rate over time. Higher IM-P scores were associated with greater rate of improvement in KIPS total and all subscale scores. CONCLUSIONS: Study findings suggest a trauma-informed MBP intervention for parenting women with opioid use disorders is associated with significant clinical improvements in quality of parenting behavior. Results of this model show promise in supporting parenting of mothers receiving treatment for opioid use disorders to enhance bonding and parenting.
Assuntos
Adultos Sobreviventes de Eventos Adversos na Infância , Atenção Plena/métodos , Mães , Transtornos Relacionados ao Uso de Opioides/terapia , Avaliação de Resultados em Cuidados de Saúde , Poder Familiar , Adulto , Adultos Sobreviventes de Eventos Adversos na Infância/psicologia , Pré-Escolar , Feminino , Humanos , Lactente , Mães/psicologia , Poder Familiar/psicologia , Adulto JovemRESUMO
The future of medicine is discussed in the context of epigenetic influences during the entire life course and the lived experiences of each person, avoiding as much as possible the "medicalization" of the individual and taking a more humanistic view. The reciprocal communication between brain and body via the neuroendocrine, autonomic, metabolic and immune systems and the plasticity of brain architecture provide the basis for devising better "top down" interventions that engage the whole person in working towards his or her welfare. The life course perspective emphasizes the importance of intervening early in life to prevent adverse early life experiences, including the effects of poverty, that can have lifelong consequences, referred to as "biological embedding". In the spirit of integrative, humanistic medicine, treatments that "open windows of plasticity" allow targeted behavioral interventions to redirect brain and body functions and behavior in healthier directions. Policies of government and the private sector, particularly at the local, community level, can create a supporting environment for such interventions. See "Common Ground for Health: Personalized, Precision and Social Medicine McEwen & Getz - https://www.youtube.com/watch?v=IRy_uUWyrEw.
Assuntos
Epigenômica/métodos , Estilo de Vida Saudável , Medicina Integrativa/história , Comunicação Interdisciplinar , Transtornos Mentais/terapia , Terapias Mente-Corpo , Terapias em Estudo , Adultos Sobreviventes de Eventos Adversos na Infância/psicologia , Animais , Transtorno Depressivo/fisiopatologia , Transtorno Depressivo/prevenção & controle , Transtorno Depressivo/psicologia , Transtorno Depressivo/terapia , Epigênese Genética , Epigenômica/tendências , História do Século XX , História do Século XXI , Humanos , Medicina Integrativa/métodos , Medicina Integrativa/tendências , Acontecimentos que Mudam a Vida , Transtornos Mentais/fisiopatologia , Transtornos Mentais/prevenção & controle , Transtornos Mentais/psicologia , Terapias Mente-Corpo/tendências , Plasticidade Neuronal , Pobreza/psicologia , Medicina de Precisão/métodos , Medicina de Precisão/tendências , Resiliência Psicológica , Terminologia como Assunto , Terapias em Estudo/tendênciasRESUMO
It is rare for studies to approach psychosocial outcomes of childhood cancer in a holistic and explanatory way. Doing so would enable a greater understanding of why and in what way a young person's life may be affected by cancer. This qualitative study aimed to explore the views of childhood cancer survivors (CCS) regarding how they perceive their illness to have influenced them and their subsequent lives. Twelve CCS with a median age of 23 years old took part in either a focus group or a telephone interview. Data were analysed using thematic analysis. The main themes were altered life perspectives, perceptions of self and lasting effects on relationships. Through these themes, the survivors gave insight into how their experience had influenced their views and how this had impacted on different areas of their lives. Although positive aspects were discussed, enduring issues were reported by some. Findings suggest that despite high levels of achievement, some survivors may still benefit from further information and support especially in relation to relationships and fertility. This study will inform the development of a questionnaire aiming to collect important information on the many factors which may influence long-term psychosocial outcomes in CCS.
Assuntos
Adultos Sobreviventes de Eventos Adversos na Infância/psicologia , Neoplasias/psicologia , Adaptação Psicológica , Adolescente , Adulto , Idade de Início , Atitude Frente a Saúde , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Infertilidade/psicologia , Intenção , Relações Interpessoais , Acontecimentos que Mudam a Vida , Masculino , Pesquisa Qualitativa , Autoimagem , Adulto JovemRESUMO
Severe, chronic childhood trauma commonly results in a set of negative core self-beliefs. These include blaming the self for the abuse, feeling unworthy and unlovable, believing the world would be better off if one committed suicide, and believing that one does not deserve peace or happiness. Linked to these cognitive errors are beliefs that one is not worthy of God's love, that God wanted the person to be abused, and that the person can avoid God's judgment if she does not go to church. Strategies for dealing with these cognitive errors about God are presented within the context of a secular psychotherapy.
Assuntos
Adultos Sobreviventes de Eventos Adversos na Infância/psicologia , Terapia Cognitivo-Comportamental/métodos , Religião e Psicologia , Espiritualidade , Suicídio , Humanos , Controle Interno-ExternoRESUMO
Depression and inflammation fuel one another. Inflammation plays a key role in depression's pathogenesis for a subset of depressed individuals; depression also primes larger cytokine responses to stressors and pathogens that do not appear to habituate. Accordingly, treatment decisions may be informed by attention to questions of how (pathways) and for whom (predispositions) these links exist, which are the focus of this article. When combined with predisposing factors (moderators such as childhood adversity and obesity), stressors and pathogens can lead to exaggerated or prolonged inflammatory responses. The resulting sickness behaviors (e.g., pain, disturbed sleep), depressive symptoms, and negative health behaviors (e.g., poor diet, a sedentary lifestyle) may act as mediating pathways that lead to further, unrestrained inflammation and depression. Depression, childhood adversity, stressors, and diet can all influence the gut microbiome and promote intestinal permeability, another pathway to enhanced inflammatory responses. Larger, more frequent, or more prolonged inflammatory responses could have negative mental and physical health consequences. In clinical practice, inflammation provides a guide to potential targets for symptom management by signaling responsiveness to certain therapeutic strategies. For example, a theme across research with cytokine antagonists, omega-3 fatty acids, celecoxib, and exercise is that anti-inflammatory interventions have a substantially greater impact on mood in individuals with heightened inflammation. Thus, when inflammation and depression co-occur, treating them in tandem may enhance recovery and reduce the risk of recurrence. The bidirectional links between depression, inflammation, and disease suggest that effective depression treatments could have a far-reaching impact on mood, inflammation, and health.
Assuntos
Citocinas/imunologia , Depressão/imunologia , Transtorno Depressivo Maior/imunologia , Inflamação/imunologia , Obesidade/imunologia , Estresse Psicológico/imunologia , Adultos Sobreviventes de Eventos Adversos na Infância/psicologia , Depressão/psicologia , Transtorno Depressivo Maior/psicologia , Disbiose/imunologia , Disbiose/psicologia , Microbioma Gastrointestinal/imunologia , Comportamentos Relacionados com a Saúde , Humanos , Inflamação/psicologia , Mucosa Intestinal/metabolismo , Permeabilidade , Estresse Psicológico/psicologiaRESUMO
The study investigated the role of an associative information network as a mechanism underlying the relation of peer victimization and social anxiety disorder (SAD). A sample of N = 80 was divided according to diagnosis (SAD vs. no diagnosis) and amount of peer victimization (low vs. high). Responses to memory of a personally experienced aversive social situation and to imagining a standardized negative social situation were assessed. In terms of skin conductance level, subjects with SAD and peer victimization were more reactive to the memory script than the other three groups while responses to the standardized script did not vary. As to heart rate, there were no differences between the groups. Emotional responses presented with an inconsistent pattern. The results provide a first indication that associative memory structures resulting from aversive social experiences might play a role in the development and maintenance of SAD, but further research is needed.