Neuroendocrinological Models of Stress and Psychopathology

Author(s):  
Nestor L. Lopez-Duran ◽  
Valerie J. Micol ◽  
Andrea Roberts

Neuroendocrine systems play a critical role in modulating biological, cognitive, and affective responses to stress. Not surprisingly, variability in neuroendocrine functioning, and particularly the hypothalamic-pituitary-adrenal axis, has been extensively linked to stress-related mental health disorders. This chapter examines the potential mechanisms that underlie this link and the conceptual challenges that must be addressed in order to advance a more cohesive neuroendocrine model of stress-related psychopathology. To this end, the chapter first explores the various sources of variability in neuroendocrine responses to stress, including individual differences in neural networks and neuroendocrine systems, as well as contextual factors, such as characteristics of the stressors and personality traits. The chapter then examines potential proximal and distal mechanisms that link variability in neuroendocrine functioning to the risk for onset, phenomenology, and course of stress-related disorders, including depression and posttraumatic stress disorder.

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
C Acarturk ◽  
Z İlkkurşun ◽  
T Yurtbakan ◽  
J Troian ◽  
E Uygun

Abstract Background The crisis in Syria has caused millions of Syrians to seek refuge in neighboring countries and Europe. Refugees often experience war related traumatic events and other various adversities during war and flight. These traumatic events increase the risk for common mental health disorders such as depression, anxiety, posttraumatic stress disorder and related somatic symptoms compared to that of host populations. However, despite the high prevalence rates of mental health disorders, refugees' access to mental health services are low. As a public health priority, it is essential to address the mental health needs of refugees. The World Health Organization has developed evidence-based short psychosocial interventions to bridge this gap and Problem Management Plus (PM+) is one of them. PM+ is under investigation within the STRENGTHS project and in Turkey, which is a partner country to the project, the group version of the intervention has been implemented with Syrian refugees. This presentation will provide an overview of the pilot study in Turkey. Methods A randomized controlled trial with 46 Syrian refugees in a community sample was conducted. Participants with elevated levels of distress measured by Kessler 10 (K10 > 15) and self-reported functional impairment (WHODAS 2.0 > 16) were randomly allocated in a 1:1 ratio either to Group PM + (N= 24) or enhanced care as usual (E-CAU, N = 22). Results No adverse events were reported during the trial and assessments. There was no significant difference between control and experiment group with respect to anxiety (d = .14, p=.63), depression (d = .27, p=.36) and symptoms of posttraumatic stress disorder (d = .18, p=.55) at 3 months follow-up. The main trial will be conducted with a larger sample (N = 380) to detect any significant effect and provide more generalizable results. Conclusions The challenges of implementation of group PM+ in a community sample of Syrian refugees in Turkey will be discussed.


2020 ◽  
Vol 7 (1A) ◽  
pp. 261-270
Author(s):  
Bela Novita Amaris Susanto

Latar Belakang: Pandemi Coronavirus Disease 2019 (COVID-19) merupakan masalah kesehatan yang menyerang masyarakat secara global. Virus 19-nCoV telah menyebabkan kematian lebih dari 500.000 dan lebih dari 120.000.000 kasus positif. Wabah COVID-19 dikaitkan dengan dampak gangguan kesehatan mental terutama pada petugas kesehatan yang bertugas sebagai garda depan. Review ini bertujuan untuk membahas sosio-demografi, gangguan kesehatan mental, hubungan kesehatan mental dengan COVID-19, serta mekanisme koping dan kebutuhan perawatan kesehatan mental pada petugas kesehatan selama pandemi COVID-19. Rancangan: Pencarian artikel dilakukan database berikut PubMed, Science Direct, Medline, Google Scholar dan Crossref selama bulai April-Juni 2020. Sebanyak 65 artikel dipilih pada penyaringan awal dan 15 artikel dibahas sebagai ulasan akhir. Hasil: Variabel sosio-demografi antara lain usia, jenis kelamin, jenis profesi, jenjang karier dan tempat bekerja. Gangguan kesehatan mental seperti kecemasan, depresi, stres, post-traumatic stress disorder (PTSD), insomnia, somatisasi, gejala obesif-kompulsif, efikasi diri, sensitivitas interpersonal, photic anxiety dan lekas marah disebakan karena kurang dukungan sosial, kurang informasi tentang COVID-19, pelatihan penggunaan dan kurangnya alat pelindung diri (APD), langkah mengendalikan infeksi, bekerja di ruang isolasi, khawatir akan terinfeksi dan menularkan ke keluarga, perasaan frusasi ketidak puasan pada pekerjaan, perasaan kesepian terisolasi, kontak langsung dengan pasien positif COVID-19, pasien menyembunyikan riwayat medis dan peningkatan rasio kerja. Kesimpulan:  Penting untuk memperhatikan kesehatan mental petugas kesehatan selama pandemi COVID-19, diperlukan sumber daya, perencanaan dan tindakan yang serius untuk mengatasi masalah ini. Kata Kunci: COVID-19, pandemi, petugas kesehatan, gangguan kesehatan mental   Literature Review: Adverse effect of Mental Health Disorders on Healthcare Workers During the Coronavirus Disease 2019 Pandemic Background: The coronavirus disease (COVID-19) pandemic is a health problem that attacks people globally. The disease caused by 19-nCOV has caused more than 500,000 deaths and more than 120,000,000 positive cases. The COVID-19 outbreak was related to the adverse effect of mental health disorders, especially on healthcare workers who serve as the frontline. This review aims to discuss socio-demographics, mental health disorders, the relationship of mental health with COVID-19, as well as coping mechanisms and the need for mental health care for healthcare workers during the COVID-19 pandemic. Design: The article search was conducted with the following PubMed, Science Direct, Medline, Google Scholar, and Crossref from April to June 2020. A total of 65 articles were selected at initial screening and 15 articles were discussed as a final review. Results: Socio-demographic variables include age, sex, type of profession, career path, and place of work. Mental health disorders such as anxiety, depression, stress, post-traumatic stress disorder (PTSD), insomnia, somatization, obesity-compulsive symptoms, self-efficacy, interpersonal sensitivity, photic anxiety, and irritability are caused by lack of social support, lack of information about COVID- 19, training on the use and lack of PPE, measures to control infection, work in isolation, worry about being infected and spread to the family, feelings of frustration at work dissatisfaction, feelings of loneliness isolated, direct contact with positive patients with COVID-19, patients conceal medical history and increase work ratio. Conclusion: It is important to pay attention to the mental health of healthcare workers during the COVID-19 pandemic, resources, planning, and serious actions that are needed to overcome this problem. Keywords: COVID-19, pandemic, healthcare workers, mental health disorders


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