Pressurizing or encouraging: Health behaviors among long-distance couples.

Couples in long-distance relationships face unique challenges that affect their health outcomes and relationship dynamics in ways that are different from couples in close proximal relationships (PR). The results of previous literature analyzing health outcomes for long-distance relationship (LDR) couples have been mixed, and factors such as couple satisfaction and gender of the individuals contribute to the variance. This study examined the good health practices of couples in LDRs, the ways in which partners influence each other's health, and the health outcomes of these couples as compared to couples in PRs. Multilevel multivariate analysis showed that couples in LDRs had better health practices than those in PRs, and men overall had poorer health practices than women. There was no main effect seen for LDRs when we examined strategies used for influencing health. There was a main effect for gender, though, and we found that women tend to use more collaborative and pressurizing strategies for influencing their partner's health. On health indices, we found that LDR couples tended to have lower levels of fatigue and sleep disturbance as compared to PR couples. In the adjusted model with covariates, which included age, income, couple satisfaction, and married or unmarried couples, we found that lower couple satisfaction and lower income significantly predicted poorer health on all health indices. These results are discussed in light of unequal gender roles, social control, and positive aspects of LDRs on health in an attempt to understand LDRs better and destigmatize the narrative of these relationships as 'less than' PRs. Implications for health and mental health practitioners are also discussed.

Ending the silo effect: A test of the relational domain spillover model.

Couple interventions are limited in their effectiveness for reducing marital distress and dissolution. One explanation for this may be the narrow focus on conflict management and a limited understanding of how other domains in marriage influence one another over time. We present the first test of the relational domain spillover model (RDSM) to understand the extent to which poor functioning in either positive or negative areas of the relationship spill over into other aspects of relationship functioning across time. Husbands and wives reported annually on the quality of five relationship domains (emotional intimacy, sex, support, power/control, and conflict) over the first seven years of marriage. Longitudinal dyadic multilevel modeling techniques were used to examine how domains change over time and how earlier declines in positive areas of couple functioning predict later problems in negative areas of couple functioning and vice versa. We found support for both directions of the RDSM model. Earlier declines in sexuality and support predicted later declines in conflict, and, for wives, earlier declines in couple sexuality were linked to later control issues. Earlier declines in conflict communication and control predicted later problems with emotional intimacy. For men, longitudinal associations between sexuality and conflict, and control, were bidirectional. These findings point to the need to move toward a multi-dimensional, dynamic conceptualization of relationship functioning across time and the importance of focusing on different relational domains as targets for couple interventions.

Social Factors Predict Treatment Engagement in Veterans with PTSD or SUD.

Veterans with PTSD and SUDs often fail to initiate, or prematurely discontinue, mental health treatment in Veteran Affairs Medical Centers (VAMC). While much is known about clinical characteristics and demographic factors impacting treatment engagement in this population, less is known about the role of social factors. This retrospective study examines primary care-based screening assessment and specialty mental healthcare appointment data in a VAMC, to test whether social factors predict treatment initiation and appointment attendance. Findings reveal veterans were more likely to initiate treatment when (a) those with SUDs (n = 235) reported more frequent negative exchanges with others and (b) those with PTSD (n = 2107) reported more perceived support or being partnered. Those with PTSD who were partnered had higher appointment attendance rates. Findings suggest social factors are relevant to treatment initiation among veterans with PTSD and SUDs and that close others may be helpful in facilitating referrals.

The role of Sirt1: at the crossroad between promotion of longevity and protection against Alzheimer's disease neuropathology.

Sirt1, a mammalian member of the sirtuin gene family, holds great potential for promoting longevity, preventing against disease and increasing cell survival. For example, studies suggest that the beneficial impact of caloric restriction in promoting longevity and cellular function may be mediated, in part, by Sirt1 through mechanisms involving PGC-1alpha, which plays important role in the regulation of cellular metabolism and inflammatory and antioxidant responses. Sirt1 may also interfere with mechanisms implicated in pathological disorders. We will present recent evidence indicating that Sirt1 may protect against Alzheimer's disease by interfering with the generation of beta-amyloid peptides. We will discuss Sirt1 as a potential novel target, in addition to the development of Sirt1 activators for the prevention and treatment of Alzheimer's disease.

Treating depressive symptoms among veterans in primary care: A multi-site RCT of brief behavioral activation.

BACKGROUND: Behavioral activation is ideal for embedded behavioral health providers (BHPs) working in primary care settings treating patients reporting a range of depressive symptoms. The current study tested whether a brief version of Behavioral Activation (two 30-minute appointments, 2 boosters) designed for primary care (BA-PC) was more effective than primary care behavioral health treatment-as-usual (TAU) in reducing depressive symptoms and improving quality of life and functioning. METHODS: Parallel-arm, multi-site randomized controlled trial. 140 Veterans were randomized to BA-PC or TAU and completed assessments at baseline, 6 weeks, 12 weeks, and 24 weeks. RESULTS: Reductions in depressive symptoms were observed in both groups between baseline and 3-weeks prior to any treatment, with continued reductions among those in the BA-PC condition through 12-weeks. However, there was no significant condition X time interaction at 12-weeks. Quality of life and mental health functioning were significantly improved for those in the BA-PC condition, compared to TAU, at 12 weeks. LIMITATIONS: Generalizability to a broader population may be limited as this sample consisted of veterans. Although engagement in TAU matched other prior work, it was lower than engagement in BA-PC, which also may compromise results. CONCLUSIONS: Although this study found that both TAU and BA-PC participants showed a decline in depressive symptoms, improvements in functioning and quality of life within those assigned to BA-PC, strong treatment retention and feasibility of BA-PC, and significant reductions in depressive symptoms among those with more severe baseline depressive symptoms are encouraging and support continued research on BA-PC. This trial was registered in clinicaltrials.gov as Improving Mood in Veterans in Primary Care (NCT02276807).

Social support predicts self-care confidence in patients with heart failure.

BACKGROUND: Self-care for patients with heart failure includes engaging in behaviours that maintain medical stability and manage problematic symptoms, as well as the confidence in one's ability to carry out such behaviours. Given the social context of self-care behaviours in heart failure, there has been increasing interest in social support as a predictor of self-care. AIM: The goal of the present study was to examine the role of social support in self-care across time for persons with heart failure. METHODS: Using data from an observational study of patients with chronic heart failure ( n = 280), we examined the role of three types of support - instrumental support, emotional support and assistance with self-care - in the longitudinal course of self-care maintenance, management and confidence. Self-report questionnaire data were collected at baseline and at three and six months later. RESULTS: We found that instrumental and emotional support predicted better self-care confidence on average and that self-care confidence improved at a faster rate for those with less instrumental support. Emotional support was positively associated with self-care management and self-care confidence, and assistance with self-care was positively associated with self-care maintenance. CONCLUSION: These findings highlight the contribution of social support to self-care in heart failure and provide guidance for future family-based interventions to improve self-care.

Neuropsychological Effects of Placebo Stimulants in College Students.

Many college students underestimate or ignore the side-effects associated with nonmedical use of prescription stimulants (NMUPS) and are motivated by hopes of academic enhancement. The present study measured the effect a placebo stimulant and personal expectancies have on subjective physiological changes and cognitive enhancement. Undergraduate college students participated in a two-phase study. Phase 1 (n = 305) involved completing an online survey to gather distal study variables and individual stimulant expectancy data. Phase 2 (n = 166) required students to attend an in-person session where they completed physiological and neuropsychological measures (e.g., Physical Symptom Checklist, Digit Span, Passage Comprehension). Students were randomized to receive a placebo stimulant medication (experimental) or no medication (control). Following a 30-minute absorption period, participants completed another set of physiological and neuropsychological measures. Experimental participants reported significant increases in positive symptoms resulting from the placebo stimulant. Expectancies moderated the impact of the placebo stimulant on Passage Comprehension performance; no other neuropsychological task performance was impacted. Despite subjective reports of feeling the effects of stimulants, task performance was unaffected. Moreover, expectancies may play a small role in perceptions of the effects of stimulants.

Alzheimer's disease biomarker discovery in symptomatic and asymptomatic patients: experimental approaches and future clinical applications.

Alzheimer's disease (AD) is the most common form of dementia in the elderly. Current treatments for AD are not as effective as needed, nor is there any definitive antemortem diagnostic. Understanding the biological processes that occur during AD onset and/or progression will improve disease diagnosis and treatment. Recent applications of microarray technologies for analysis of messenger (m) RNA expression profiles have elucidated distinct changes in the brain as a function of AD dementia initiation and progression. However, mRNA analysis underestimates post-transcriptional modifications and therefore provides only a partial view of the molecular changes in the AD brain. Combining mRNA studies with protein expression analysis may provide a more global picture of the biological processes associated with AD dementia. Information gathered could lead to the development of select biological indices (biomarkers) for guiding AD diagnosis and therapy. We will provide a brief background on AD, followed by a review on the applications of microarray, proteomics, as well as microRNA expression profile analysis to develop novel diagnostic strategies that may be useful for the diagnosis AD and for monitoring disease progression. The availability of biomarkers that promote early disease diagnosis, particularly among asymptomatic patients, will lead to the application of personalized medicine in AD.

Personalized medicine in traumatic brain injury.

Patients who have sustained a mild traumatic brain injury (TBI) from both civilian and military populations exhibit clinical symptoms of varying severity with minimal to profound impact on their daily functioning. Although most patients make a full recovery, a subgroup of mild TBI patients develop cognitive, somatic, and neurobehavioral sequelae that generally resolve over 3 to 6 months; a smaller subgroup develop persisting symptoms. The reason why a mild TBI results in varying clinical symptoms is currently unknown. Based on evidence that microRNA species in peripheral blood mononuclear cells (PBMCs) may reflect molecular alterations in neurodegenerative disorders, it can be hypothesized that at early, preclinical phases of the disease, PBMC may provide an ideal and clinically assessable "window" into the brain. Thus, it is conceivable that changes in the expression profile of clinically accessible biological indices (biomarkers), such as microRNA in PBMC, may reflect molecular alterations following TBI that contribute to the onset and progression of TBI phenotypes including chronic traumatic encephalopathy. It is possible that the availability of TBI biomarkers may provide potential elements with clinical relevance to prevention, prognosis, and treatment of postconcussive disorders.

Grape-seed polyphenolic extract improves the eye phenotype in a Drosophila model of tauopathy.

Drosophila models of tauopathies have been developed by transgenically overexpressing the disease-associated forms of tau. In this paper we report for the first time that a recently developed Grape-Seed Polyphenolic Extract (GSPE) improves the eye phenotype of a Drosophila eye model of R406W tau. GSPE-mediated improvements in this distinct in vivo neurodegeneration model for protein misfolding/aggregation suggest that GSPE may have therapeutic value in disorders involving aberrant protein aggregation.