Resilience in Newly Diagnosed Breast Cancer Women: The Predictive Role of Diurnal Cortisol and Social Support.

BACKGROUND: Breast cancer is currently the most prevalent malignancy among women. Psychological resilience is an important factor that diminishes the stress-related emotional and psychosocial disturbances triggered when receiving the diagnosis. Furthermore, resilience appears to be associated with cortisol, the hormonal end-product of the hypothalamic-pituitary-adrenal axis; however, further studies are needed due to the mixed results reported. Thus, we aim to examine the predictive role of social support and cortisol in resilience among breast cancer patients. METHODS: A total of 132 women with primary breast cancer completed the Medical Outcomes Study-Social Support Survey (MOS-SSS) and the Resilience Scale (RS-14) and provided four salivary samples for the estimation of participants' total daily cortisol production, for which the formula of the area under the curve with respect to the ground (AUCg) was applied. Moderation analyses were performed to study the influence of social support and AUCg on psychological resilience levels. RESULTS: The regression analyses showed a direct significant effect for the emotional support subscale of MOS-SSS on resilience and the interaction between emotional support and AUCg was also found to be statistically significant. Specifically, the conditional effect of emotional support on resilience was found to be significant at middle (M = 3.08; p < .05) and low levels (M = .59; p < .001) of AUCg. CONCLUSIONS: Our results suggest that newly diagnosed breast cancer women with middle and low diurnal cortisol profiles may benefit more from emotional support based-interventions while women with high diurnal cortisol may need more individualized therapies.

Gender differences in unplanned hospital admission: A population-based approach.

Gender inequities are present not only in the health status of individuals but also in access to health services. Unplanned hospitalizations can indicate dysfunction in health systems by detecting unmet health problems prior to the health care needs of a person, while planned hospitalizations indicate effective management by the system. Thus, we aim to analyze the association between sex and the probability of unplanned or planned hospitalization for different diseases. A cross-sectional retrospective study was performed with data regarding the 700 447 hospitalizations at all registered centers in the Basque Country from 2016 to 2018. Adjusted odds ratios were carried out to determine the association between sex and admission circumstances for each diagnostic category. Results showed that women had higher odds ratio for unplanned hospitalization for various diseases of the circulatory system and inguinal hernia among others, while men had a higher odds ratio for diseases such as neoplasms, metabolic diseases, and multiple sclerosis. The differences by sex indicate that the odds applied to the circumstance of hospitalization is a sensitive indicator and potentially applicable for detecting diseases likely to generate gender-based inequalities.

A Nurse-Led Education Program to Improve COVID-19 Prevention Knowledge Among Adolescent Students.

BACKGROUND: Adolescents are more susceptible than originally thought to COVID-19, and they could play a significant role in community transmission. We aim to evaluate a health education program on students' declarative knowledge and risk awareness concerning COVID-19-related public health recommendations. METHODS: A quasi-experimental pre-post pilot study was conducted. A number of 487 students aged between 12 and 17 years old participated in an educational program. Following Socratic Method, preventive actions were simulated in order to encourage students to seek answers about the correct application of measures. The program covered 3 prevention areas: (1) practice hygienic handwashing; (2) instruction on the appropriate use of masks; and (3) promotion of physical distancing, and was implemented in class by 3 registered nurses. RESULTS: Following the educational program, declarative knowledge regarding handwashing and mask use improved along with the students' total score. In the pre-test, students 16 years and older as well as female students obtained higher scores in declarative knowledge. Age-dependent differences between groups vanished in the post-test, but girls still achieved better scores. CONCLUSION: This nurse-led health education program proved to be effective to enhance declarative knowledge about COVID-19-related public health recommendations.

Evaluating gender awareness, gender-related health knowledge and patient pain legitimation among nursing students: A quasi-experimental study.

The aim of the study was to measure the associations between and the evolution of gender awareness, gender-related health knowledge and patient pain legitimation among nursing students. BACKGROUND: Evidence indicates that gender equity skills are still lacking among nurses. Indeed, several studies report gender-biased patient assessment and care, arguing that greater attention should be paid to the gender perspective at university, in order to train nurses who are sensitive to this issue. Recently, certain gender perspective measurement scales have been adapted to the nursing population, offering new opportunities for the educational field. DESIGN: A quasi-experimental study was used for this study. METHODS: This study was conducted in the second semester of the first year of the Nursing Degree run by the University of the Basque Country. A sample of 103 students enrolled in the Anthropology, Ethics and Legislation module completed the Nijmegen Gender Awareness in Medicine Scale, the Pain Legitimation Scale and the Gender Perspective Health Knowledge Scale before and after the second semester, during which part of the syllabus focused on developing gender equity skills. Data were collected between January - April 2022. RESULTS: We found positive correlations between gender-related health knowledge and pain legitimation at post-test, and between said knowledge and gender sensitivity at both pre- and post-test (p < 0.05). The repeated measures indicated that traditional expositive teaching did not increase overall scores for gender awareness, gender-related health knowledge or pain legitimation. CONCLUSIONS: The results suggest that gender-related health knowledge may be a key modifiable factor that leads to enhanced gender awareness in dealings with patients. However, traditional expositive lectures were not enough to produce a robust increase in gender awareness, pain legitimation or gender-related health knowledge levels. The effectiveness of active teaching methodologies should be tested, in order to help nursing students strengthen their resistance to clinical gender stereotypes and become active assets in the move from inequality to equity.

Psychological resilience and cortisol levels in adults: A systematic review.

Resilience or the capacity to "bend but not break" refers to the ability to maintain or regain psychobiological equilibrium during or after exposure to stressful life events. Specifically, resilience has been proposed as a potential resource for staving off pathological states that often emerge after exposure to repeated stress and that are related to alterations in circulating cortisol. The aim of this systematic review of the literature was to gather evidence related to the relationship between psychological resilience and cortisol levels in adult humans. An extensive systematic search was carried out following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method in the PubMed and Web of Science databases. In total, 1256 articles were identified and, of these, 35 peer-reviewed articles were included in the systematic review. We categorized findings according to (1) the short and long-term secretion period covered by the cortisol matrices selected by studies and also according to (2) the differentiated diurnal, phasic (acute), and tonic (basal) components of the HPA output to which they refer and their relationships with resilience. Reported relationships between psychological resilience and distinct cortisol output parameters varied widely across studies, finding positive, negative, and null associations between the two variables. Notably, several of the studies that found no relationship between resilience and cortisol used a single morning saliva or plasma sample as their assessment of HPA axis activity. Despite limitations such as the great variability of the instruments and methods used by the studies to measure both resilience and cortisol, together with their high heterogeneity and small sample sizes, the evidence found in this systematic review points to the potential of resilience as a modifiable key factor to modulate the physiological response to stress. Therefore, further exploration of the interaction between the two variables is necessary for the eventual development of future interventions aimed at promoting resilience as an essential component of health prevention.

Chronic social instability stress down-regulates IL-10 and up-regulates CX3CR1 in tumor-bearing and non-tumor-bearing female mice.

Extensive literature has reported a link between stress and tumor progression, and between both of these factors and mental health. Despite the higher incidence of affective disorders in females and the neurochemical differences according to sex, female populations have been understudied. The aim of this study was therefore to analyze the effect of stress on tumor development in female OF1 mice. For this purpose, subjects were inoculated with B16F10 melanoma cells and exposed to the Chronic Social Instability Stress (CSIS) model. Behavioral, neurochemical and neuroendocrine parameters were analyzed. Female mice exposed to CSIS exhibited reduced body weight and increased arousal, but there was no evidence of depressive behavior or anxiety. Exposure to CSIS did not affect either corticosterone levels or tumor development, although it did provoke an imbalance in cerebral inflammatory cytokines, decreasing IL-10 expression (IL-6/IL-10 and TNF-α/IL-10); chemokines, increasing CX3CR1 expression (CX3CL1/CX3CR1); and glucocorticoid receptors, decreasing GR expression (MR/GR). In contrast, tumor development did not alter body weight and, although it did alter behavior, it did so to a much lesser extent. Tumor inoculation did not affect corticosterone levels, but increased the MR/GR ratio in the hippocampus and provoked an imbalance in cerebral inflammatory cytokines and chemokines, although differently from stress. These results underscore the need for experimental approaches that allow us to take sex differences into account when exploring this issue, since these results appear to indicate that the female response to stress is mediated by mechanisms different from those often proposed in relation to male mice.

The Impact of Sexism and Gender Stereotypes on the Legitimization of Women's Low Back Pain.

BACKGROUND: Low back pain is the worldwide leading cause of disability and, even though women's pain experience is more severe, frequent, and enduring, female patients are often underdiagnosed and undertreated. Health professionals' gender stereotypes and social norms may underlie the downgrading of pain. AIM: This pilot study aimed to examine the legitimation of low back pain by health professionals in relation to the sex of the patient as well as their gender awareness and the relationship between them. METHOD: This study had a cross-sectional design. Eighty health professionals and students selected by convenience answered a 4-part online questionnaire. The eligibility criteria for participants were: aged >18 years, students in the last course of nursing/medicine or a physician/nurse, and Spanish-speaking. The questionnaire comprises: (1) a between-subjects virtual clinical low back pain case with four random versions (female/male patient and evidence/non-evidence of pathology); (2) the Spanish version of Nijmegen Gender Awareness Scale (S-NGAMS); (3) Ambivalent Sexism Inventory (ASI); and (4) Ambivalence toward Men Inventory (AMI). RESULTS: The total score of legitimation of low back pain correlated negatively with gender role ideology and sexism scales (when the virtual patient was female), as well as the subscales of willingness to offer support and credibility. CONCLUSIONS: Both sexism and gender role ideology could undermine the legitimation of low back pain, the willingness to offer support, and credibility only in female patients. The results showed a possible gender bias in low back pain assessment in health professionals. Low gender sensitivity and high sexism must be treated as modifiable risk factors for health inequities in pain care.

Efecto del método del caso en el conocimiento sobre vacunación en estudiantes de Enfermería / Impact of Case Method on vaccination knowledge among Nursing students

Objetivo: analizar las diferencias en la adquisición de conocimiento declarativo y argumentativo sobre la vacunación mediante dos metodologías educativas (método del caso (MdC) y clase expositiva (CE)) en estudiantes de segundo curso del Grado en Enfermería de la Universidad del País Vasco/Euskal Herriko Unibertsitatea.Métodos: estudio post-intervención con grupo control no equivalente realizado en el curso 2019/20. Se incluyó a todos los estudiantes (n= 29) matriculados en la asignatura “Enfermería del Ciclo Vital I” de segundo curso. El grupo experimental (GE: MdC) lo formaron quienes eligieron evaluación continuada y el grupo control (GC: CE) quienes eligieron evaluación final. Ambos recibieron 12 horas de formación semipresencial impartidas por la misma docente. Se analizaron: sexo, edad, tipo de formación y resultados en conocimiento declarativo y argumentativo obtenidos en el examen final de la asignatura. Se realizaron índices de estadística descriptiva y análisis bivariantes.Resultados: participaron 29 estudiantes (GE n= 23; GC n= 6). De forma global se obtuvo una mediana (Me) de 8 sobre 17 puntos. En conocimiento declarativo (sobre 10 puntos) los resultados fueron: GE [Me= 6; RIQ (4-8)]; GC [Me= 1; RIQ (0-2,75)]; p= 0,003. En conocimiento argumentativo (sobre 7 puntos) los resultados fueron: GE [Me= 2; RIQ(1-4)]; GC [Me= 1; RIQ (0,75-1,25)]; p= 0,012.Conclusiones: el método del caso es una herramienta más efectiva frente al modelo expositivo para que los futuros enfermeros memoricen información y argumenten las dudas que plantean los usuarios sobre la vacunación. Los resultados indican que hay margen de mejora en ambos grupos.(AU)

Objective: to analyze the differences in acquiring declarative and argumentative knowledge about vaccination through two educational methodologies: Case Method (CM) and Lecture Class (LC) in 2nd year students of the Nursing Degree at the Universidad del País Vasco/Euskal Herriko Unibertsitatea.Method: a post-intervention study with a non-equivalent control arm, conducted in the 2019/20 year. The study included all students (n= 29) enrolled in the Nursing Care in the Life Cycle I subject in their second year. The experimental arm (EA: CM) was formed by those who chose continuous evaluation, and the control arm (CA: LC) by those who chose final evaluation. Both arms received a 12-hour blended training course by the same teacher. There was analysis of: gender, age, type of training, and results in declarative and argumentative knowledge obtained at the final exam of the subjects. Descriptive statistics indexes and bivariate analyses were conducted.Results: the study included 29 students (EA n= 23; CA n= 6). Overall, the median (Me) score achieved was 8 out of 17. In declarative knowledge (from 1 to 10), the results were: EA [Me= 6; IQR (4-8)]; CA [Me= 1; IQR (0-2.75)]; p= 0.003. In argumentative knowledge (from 1 to 7), the results were: EA [Me= 2; IQR (1-4)]; CA [Me= 1; IQR (0.75-1.25)]; p= 0.012.Conclusions: case Method is a more effective tool vs. the lecture model, for future nurses to memorize information and argue about any doubts asked by users about vaccination. Results have shown that there is room for improvement in both arms.(AU)

Anxiety and depression after breast cancer: The predictive role of monoamine levels.

PURPOSE: Despite the fact that the prevalence of anxiety and depression in breast cancer survivors is higher than in the general female population, the psychobiological substrate of this phenomenon has yet to be elucidated. We aimed to examine the predictive role of peripheral dopamine (DA), noradrenaline (NA), serotonin (5-HT) and kynurenine (KYN) in anxiety and depression among breast cancer survivors. METHOD: We evaluated 107 women using the Hospital Anxiety and Depression Scale, and monoamine levels were analyzed via high-performance liquid chromatography. RESULTS: High KYN levels predicted both disorders, while low NA and DA predicted anxiety and depressive symptoms, respectively. A negative conditional effect of 5-HT was found for anxiety and depression among younger women only, while being both middle-aged and younger influenced the negative conditional effect of DA on depression. CONCLUSION: Monoamine variations may render breast cancer survivors more vulnerable to anxiety and depression, with young women being especially vulnerable to the detrimental effect of low DA and 5-HT. Assessing subclinical psychobiological markers allows mental health nurses to identify vulnerable survivors prior to the onset of anxiety and depression, and to adjust nursing interventions accordingly.

Venlafaxine reduces the striatal il6/il10 ratio and increases hippocampal GR expression in female mice subjected to chronic social instability stress.

Women are twice as likely as men to develop depression and antidepressant treatment is more frequent in females. Moreover, neuroinflammatory changes related to affective disorders differ in accordance with sex. Despite this evidence, female populations have been largely omitted from preclinical experiments studying antidepressants. The aim of this work is to analyze the potential restorative effect of venlafaxine on an animal model of depression. Female CD1 mice were subjected to chronic social instability (CSI) stress for 7 weeks, and were administered venlafaxine during the last 3 weeks of the stress period. Behavioral and physiological parameters were then analyzed. Stressed mice showed a decreased sucrose preference and increased whisking behavior, and had a lower body weight, higher plasma corticosterone levels and increased hypothalamic GR expression. They also had lower levels of 5-HT, 5-HIAA and NA and a higher KYN/TRYP ratio in the hippocampus. Moreover, CSI increased striatal IL-6 mRNA expression levels. Venlafaxine treatment reduced the striatal IL-6/IL-10 ratio and increased hippocampal GR expression, although it did not reverse stress-induced behavioral changes. In conclusion, seven weeks of exposure to CSI produced depressive-like alterations in female mice. The venlafaxine treatment regimen was found to have a modest anti-inflammatory effect in the striatum and increased hippocampal GR mRNA, although it failed to redress stress-induced behavioral disturbances.

The use of structured debate as a teaching strategy among undergraduate nursing students: A systematic review.

BACKGROUND: Nurse educators are required to prepare graduates for the increasing complexities of the practice environment. Debate is an active teaching strategy long recognised in many disciplines to promote student-centred learning by enhancing the development of communication skills, collaboration, and critical thinking, all of which are essential skill for future nurses. OBJECTIVES: The aim of this study was to compare in-class university structured debate implementation methods among undergraduate nursing students, and to identify the effect of such debate methods in the students' learning. DESIGN: A systematic review of the literature. DATA SOURCES: Publications in English identified in multiple databases (PubMed, CINAHL, Web of Science, Medline and ERIC) from the launch of the database until 26th November 2019. REVIEW METHOD: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guided the review. Studies that investigated the use of in-class debate among undergraduate nursing students as a pedagogical tool were eligible. Information related to the study design, debate process characteristics, evaluation method of the teaching strategy and results were collected. RESULTS: We identified 14 relevant studies describing structured implementation of debate, 11 of which were instructional design and 3 quasi-experimental studies. Heterogeneity was found across the papers regarding topics, timing schedules, group formation and positioning. Most of the studies evaluated implementation using satisfaction questionnaires or subjective observations. Three quasi-experimental studies reported that implementation of debating improved declarative capacity, argumentative capacity, idealistic moral judgment, and realistic moral judgment. CONCLUSIONS: Current studies do not provide enough evidence to understand the scope of structured debating as an instrument to develop personal competences needed in nursing. However, based on the evidence reviewed, we have identified elements to establish a debate-based learning format that might enhance student's learning and future studies.

Distress, proinflammatory cytokines and self-esteem as predictors of quality of life in breast cancer survivors.

OBJECTIVE: To examine the extent to which anxiety and depressive symptoms, self-esteem and proinflammatory cytokines interact to significantly predict quality of life in breast cancer survivors. METHODS: Cross-sectional data were collected from 134 breast cancer survivors. Hospital Anxiety and Depression Scale, Rosenberg Self-Esteem Scale and Quality of Life in Adult Cancer Survivors questionnaire, which includes the generic quality of life (QOL) and the quality of life related to cancer (QOLRC) subscales, were administered. Plasma IL-6 and TNF-α levels were measured using ELISA kits. Moderation analyses were performed to study the influence of psychobiological variables on quality of life. RESULTS: Anxiety and depressive symptoms, TNF-α predicted QOL scores, and both medium and high levels of TNF-α influenced the negative conditional effect of depressive symptoms on QOL. Anxiety symptoms and TNF-α was associated with QOLRC scores, and lower self-esteem predicted poorer QOLRC when women had high levels of TNF-α. CONCLUSIONS: These results highlight the booster effect of TNF-α for poorer quality of life in breast cancer survivors, both alone and in combination with depressive symptoms or low self-esteem. The study provides a framework for assessing subclinical markers, identifying vulnerable survivors and implementing psychological strategies to improve quality of life.

Behavioral coping strategies predict tumor development and behavioral impairment after chronic social stress in mice.

The aims of this study were to identify behavioral strategies to cope with social defeat, evaluate their impact on tumor development and analyze the contributions of both to changes in physiology and behavior produced by chronic defeat stress. For this purpose, OF1 mice were inoculated with B16F10 melanoma cells and subjected to 18 days of repeated defeat stress in the presence of a resident selected for consistent levels of aggression. Combined cluster and discriminant analyses of behavior that manifested during the first social interaction identified three types of behavioral profiles: active/aggressive (AA), passive/reactive (PR) and an intermediate active/non-aggressive (ANA) profile. Animals that showed a PR coping strategy developed more pulmonary metastases at the end of the social stress period than animals in other groups. The ANA but not AA group also showed higher tumor metastases than non-stressed subjects. In addition, the ANA group differed from the other groups because it displayed the highest corticosterone levels after the first interaction. Chronic stress reduced sucrose consumption, which indicates anhedonia, in all the stressed groups. However, the PR subjects exhibited a longer immobility time and swam for less time than other subjects in the forced swim test (FST), and they travelled a shorter distance in the open field test (OFT). In this test, the ANA group also travelled smaller distances than the non-stressed group, but the difference was more moderate. In contrast, tumor development but not stress increased behaviors associated with anxiety in the OFT (e.g., time in the center) in all tumor-bearing subjects. In summary, although the effects of social stress and tumor development on behavior were rather moderate, the results indicate the importance of behavioral coping strategies in modulating the effects of chronic stress on health.

Active and Passive Coping Strategies: Comparing Psychological Distress, Cortisol, and Proinflammatory Cytokine Levels in Breast Cancer Survivors.

BACKGROUND: Breast cancer survivors can experience psychological distress, such as anxiety and depression, long after treatment has ended, and the development of such negative affective states has been related to the coping strategy used. OBJECTIVES: This pilot study aims to determine whether different coping strategies are associated with differences in psychological distress, cortisol, and tumor necrosis factor alpha (TNF-a) levels in breast cancer survivors. METHODS: 54 breast cancer survivors completed the Stress Coping Questionnaire and the Hospital Anxiety and Depression Scale and provided a blood sample for cortisol and proinflammatory cytokine measures. FINDINGS: Passive coping strategies were associated with higher psychological distress, cortisol, and TNF-a levels. The passive group had more avoidance and negative self-targeting and less positive reappraisal and focusing on a problem's solution.

Predictors of psychological distress in breast cancer survivors: A biopsychosocial approach.

OBJECTIVE: A cross-sectional study was conducted to examine the extent to which perceived social support, cortisol-awaking response (CAR) and tumour necrosis factor alpha (TNF-α) interact to statistically predict psychological distress in breast cancer survivors. METHOD: Moderation analyses were performed to study the influence of some psychobiological variables on psychological distress. The sample was comprised by 80 survivor women. RESULTS: TNF-α moderate the relation between social support and psychological distress, with both high and moderate levels being significant. In relation to age, a negative association between social support and psychological distress was found only in younger- and middle-age women, while lower levels of CAR were associated with psychological distress in older breast cancer survivors. CONCLUSION: This study provides a biopsychosocial approach about the predictors of psychological distress among breast cancer survivors. Social support interventions during and after treatment may help to improve women's longer-term health and quality of live during survivorship.

Social instability in female rodents as a model of stress related disorders: A systematic review.

The risk of developing stress related disorders such as depression is two times higher in women than in men, and social stress is considered the principal etiology for this disorder. Social defeat animal model is the most common procedure to induce social stress in male rodents, but the stressful stimulus and the stress response can be different for each sex. In this regard, social defeat stress model does not fit the social nature of females, and according to the emerging evidence, the social instability stress (SIS) model could be a suitable procedure to investigate this stress related disorder in females. This study aims to systematically review the effects of SIS on physiological and behavioral parameters involved in the pathophysiology of depression, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method on PubMed, Medline and Web of Science. Seventeen studies met the inclusion criteria. The reported physiological measures comprised the hypothalamic-pituitary-adrenal axis activity, neurotrophic factors, immune and monoaminergic systems, vasopressin and oxytocin receptors, sex hormone levels and estrus cycle, while main behavioral measures involved sucrose preference test, forced swimming test, elevated plus maze, open field test and social interaction. This systematic review revealed a wide variability on the social instability regimen and on the measured variables. However, all studies agree that SIS model can elicit behavioral and physiological alteration involved in stress related disorders, with HPA axis hyperactivity, increased anxiety-like behavior and disrupted reward system being the most repeated outcomes. A unified SIS application criterion is required in order to obtain consistent data and elucidate the underlying mechanisms of anxiety and depression in females.

Biological Sex Differences in Depression: A Systematic Review.

Depression is the leading cause of disability worldwide, and its prevalence is 2 times higher in women than in men. There is, however, a lack of data on sex-specific pathophysiology of this disorder. The purpose of this systematic review is to identify the biological sex differences found in major depressive disorder (MDD) in studies published in the last 10 years. We conducted a literature search using the Medline, PsycInfo, PubMed, and Web of Science databases, selecting English-language studies that included physiological measures compared by sex in addition to MDD. We identified 20 relevant studies, which consisted primarily of mixed methodology and samples. The reported physiological measures comprised a variety of serum biomarkers, gene mRNA expression, and brain activity. Findings suggest different biological patterns in those with MDD depending on sex. Specifically, women presented higher levels of inflammatory, neurotrophic, and serotonergic markers and a stronger correlation between levels of some inflammatory and neurotrophic factors and the severity of symptoms. This review provides information about possible different biological patterns for women and men with depressive disorder and may have important implications for treatment. Future research should include homogeneous samples; make comparisons based on sex, control sex hormone fluctuations and pharmacological treatment; and use consistent criteria for evaluating psychobiological changes in MDD.

Reduced hippocampal IL-10 expression, altered monoaminergic activity and anxiety and depressive-like behavior in female mice subjected to chronic social instability stress.

Evidence indicates that release of pro-inflammatory cytokines induced by social stress contributes to affective disorders. Additionally, there are known sex differences in both the stress response and the stressors that can elicit this response. In this regard, the chronic social instability (CSI) rodent model of stress appears to be the best fit for the social nature of females. This study analyzed the effects of CSI on female mouse behavior, hippocampal cytokine expression, tryptophan metabolism and monoaminergic activity. The activity of hypothalamic-pituitary-adrenal (HPA) and hypothalamic-pituitary-gonadal (HPG) axes were also measured. Results showed a decrease in sucrose consumption in stressed subjects, indicative of anhedonic behavior and an increase in climbing activity in the forced swimming test (FST) and in whisking behavior, which have been associated with anxiety. Decreased interleukin-10 (IL-10) expression was found in the hippocampus of the stressed mice, while no differences in pro-inflammatory cytokine expression and tryptophan (TRYP), kynurenine (KYN) or 3-hydroxy kynurenine (3-HK) levels were found. Increased hippocampal serotoninergic and noradrenergic activity was observed in stressed mice. The higher plasma corticosterone and lower hypothalamic glucocorticoid receptor (GR) expression levels showed an increase in HPA activity after CSI. No differences were found in the plasma estradiol levels or the central estrogen receptors (ERα and ERß) expression levels. These data indicate that the CSI stress-induced behavioral and physiological changes associated with anxiety and depressive disorders. Although additional studies are warranted, the results suggest an involvement of anti-inflammatory cytokines in the biobehavioral effects of social stress in female mice.