Adapting to Crisis: A Binational Study on the Impact of Flexibility on Latent Profiles of Coping with COVID-19

Introduction. The high level of uncertainty brought by the COVID-19 pandemic has affected the general population’s well-being and ability to cope with daily challenges. Studies indicate that flexibility, defined as the ability to employ and adapt a variety of emotional, cognitive, and behavioral strategies in accordance with changing contextual demands, may significantly contribute to coping with long-term stressors such as COVID-19. Objectives. We aimed to investigate which facets of flexibility predict different latent coping profiles in Israel and Germany. Methods. 2330 Israelis and 743 Germans completed online questionnaires measuring cognitive, emotional and trauma-related regulatory flexibility, and cognitive, emotional, and behavioral coping with COVID-19. Results. Analyses revealed three distinct coping profiles in each country (high, medium and low). These profiles differed in both anxiety and depression symptoms with the low coping group experiencing clinically relevant symptoms both in Israel and in Germany. Additionally, cognitive flexibility and trauma-related regulatory flexibility, but not emotion regulatory flexibility, emerged as significant predictors of coping in both countries. Conclusions. Training cognitive and trauma-related regulatory flexibility may help individuals to better cope with psychosocial stressors such as COVID-19. Such trainings could be selectively administered to less flexible subpopulations, as well as adapted to the specific population characteristics.

Stress-impaired reward pathway promotes distinct feeding behavior patterns

Psychosocial stress can impact feeding behavior outcomes. Although many studies have examined alterations to food intake, little is known about how stress affects feeding behavior patterns. To determine the impact of psychological stress on feeding behavior patterns, mice were subjected to various psychosocial stressors (social isolation, intermittent high-fat-diet, or physical restraint) prior to timed observations in a feeding arena that incorporated multiple bait loci. In addition, in vivo microdialysis was used to assess the effects of stressors on the reward system by measuring dopamine levels in the nucleus accumbens (NAcc) shell. Impaired feeding behavior patterns characterized by significant deviations in bait selection (i.e. fixated feeding) and prolonged periods of eating (i.e. protracted feeding) were observed in stressed mice relative to non-stressed controls. In addition to clear behavioral effects, the stressors also negatively impacted dopamine levels at the nucleus accumbens shell. Normalization of dopamine reversed the fixated feeding behavior, whereas specifically inhibiting neuronal activity in the dopaminergic neurons of the ventral tegmental area that project to the nucleus accumbens shell caused similar impairments in feeding. Given that the deviations were not consistently accompanied by changes in the amount of bait consumed, body weight, or metabolic factors, the qualitative effects of psychosocial stressors on feeding behavior likely reflect perturbations to a critical pathway in the mesolimbic dopamine system. These findings provide compelling evidence that aberrations in feeding behavior patterns can be developed as sensitive biomarkers of psychosocial stress and possibly a prodromal state of neuropsychiatric diseases.

School Sanitation-Related Psychosocial Stressors among Nigerian Students

Psychosocial stressors are indicative of challenges associated with the social and environmental conditions an individual is subjected to. In a bid to clearly understand the present gaps in school sanitation, this cross-sectional study aimed to identify the sanitation-related psychosocial stressors experienced by students in a Nigerian peri-urban community and their associated impacts. A three-stage sampling technique was used to select 400 students from 10 schools. The students to toilet ratio were 1,521:0 and 1,510:0 for the public-school boys and girls, respectively, and 74:1 and 70:1 for the private-school boys and girls, respectively. Furthermore, public-school students had a significantly higher average stress level (P < 0.001, η2p = 0.071) and a significantly higher proportion of students experiencing school absenteeism (P < 0.001; odds ratio [OR] = 4.8; 95% confidence interval [C.I] = 2.7–8.2), missed classes (P < 0.001; OR = 5.8; CI = 2.8–12.0), long urine/fecal retention time (P < 0.001; OR = 2.9; CI = 1.8–4.7), open defecation practice (P < 0.001; OR = 4.2; CI = 2.5–7.1), and open defecation-related anxiety (P < 0.001; OR = 3.6; CI = 2.0–6.5). Moreover, the inability to practice menstrual hygiene management was significantly associated with student-reported monthly school absence among girls (P < 0.001; OR = 4.5; CI = 2.2–9.4). Overall, over 50% of the respondents had reportedly been subjected to at least 14 of the 17 stressors outlined. The most prevalent stressors identified were concerns about disease contraction, toilet cleanliness, toilet phobia, privacy, and assault/injury during open defecation/urination. In conclusion, results show that the absence of functional sanitation facilities purportedly has a grievous effect on the mental, physical, social, and academic well-being of the students. This was clearly seen among public-school students. Subsequent sanitation interventions need to be targeted at ameliorating identified stressors.

Loneliness Predicts Development of Pain, Fatigue, and Depression in Older Adults

Pain, fatigue, and depression form a well-recognized symptom cluster that is posited to have a shared mechanism. It is possible that chronic psychosocial stressors such as loneliness may impact the central nervous system and immune system, potentially leading to symptom cluster development. Loneliness is an increasingly recognized type of psychosocial stress, especially among older American adults. Thus, we investigated whether loneliness increased risk of developing the symptom cluster of pain, fatigue, and depression over time. Using Health and Retirement Study data from 2006 – 2016, we examined self-respondents ≥50 years-old for the presence of co-occurring pain, fatigue, and depressive symptoms surpassing threshold levels (ie., the symptom cluster). Loneliness (measured by the 3-item UCLA Loneliness Scale) at baseline was used as the predictor of interest. Of the total sample (n=11,766), n=5,956 (50.6%) had up to two complete sets of follow-up symptom cluster measurements. Logistic regression models for longitudinal data were fitted using a generalized estimating equation (GEE). After adjusting for demographic and clinical variables, loneliness strongly predicted the development of the symptom cluster (adjusted OR=3.16 (95% CI 2.77, 3.61)) as well as each component symptom (pain adjusted OR=1.54 (95% CI 1.42, 1.67); fatigue adjusted OR=1.88 (95% CI 1.74, 2.03); depression adjusted OR = 3.87 (95% CI 3.55, 4.21). Further research should investigate whether interventions targeting loneliness or other psychosocial stressors may have a role in prevention of this symptom cluster.

Number of Attributed Reasons for Everyday Discrimination and Mortality Among Older Blacks

To date, little is known about the significance of the number of attributions for everyday discrimination on all-cause mortality risk among older Blacks. Data are from a subsample of older Black respondents in the Health and Retirement Study (HRS), a nationally representative panel study of adults above the age of 50 in the 2006/2008 HRS waves, respondents completed a battery of questions on experience with psychosocial stressors, which included the number of attributed reasons for everyday discrimination. Vital status was obtained from the National Death Index and reports from key household informants (spanning 2006–2016). Cox proportional hazard models were used to estimate the risk of mortality. During the 10-year observation period, 450 deaths occurred. A higher number of attributed reasons for everyday discrimination was associated with a higher likelihood of death after adjusting for demographic characteristics and remained significant after further adjustments for other psychosocial, health, behavioral, and economic covariates.

Mental Health Problems Among School-Aged Children After School Reopening: A Cross-Sectional Study During the COVID-19 Post-pandemic in East China

Background: Most studies on mental health problems caused by COVID-19 crisis in children were limited to the period of home quarantine. It remained unclear what adverse impact of the psychosocial stressors caused by school reopening, as well as the transitions in daily activities and social interactions had on mental health in children.Methods: A total of 6400 students in primary schools were enrolled in a cross-sectional study conducted in East China, between June 26 and July 6, 2020, when schools reopened. Children’s mental health status was assessed by the parent version of Strengths and Difficulties Questionnaire (SDQ). Ultimately, data on a total of 6017 children with completed information on mental health, psychosocial stressors, daily activities, and social interactions were eligible for analysis. The associations of mental health with psychosocial stressors, daily activities, and social interactions were determined by ordinal logistic regression models. Stratified analyses were conducted according to grade, gender, school level, area, and caregiver–child relationship to further observe the effects of stressors on mental status.Results: The prevalence of borderline, moderately abnormal, and prominently abnormal scores were 7.16, 3.34, and 1.96% for total difficulties, and 13.83, 13.45, and 17.85% for prosocial behavior, respectively. Children with psychological stressors had a significantly higher risk of being in a worse category of mental health status, with the maximum adjusted OR of 7.90 (95% CI 3.33–18.75) in those definitely afraid of inadaptation to study and life styles. Time used in home work and computer games was positively related to mental health problems, while physical exercises and frequency of communication with others was negatively related. The effects of psychological stressors on total difficulties were more evident in middle-high grade students (OR = 7.52, 95% CI 4.16–8.61), boys (OR = 6.95, 95% CI 4.83–8.55), those who lived in Taizhou (OR = 7.62, 95% CI 4.72–8.61) and with poor caregiver–child relationship (OR = 7.79, 95% CI 2.26–8.65).Conclusion: Emotional and behavioral difficulties, especially less prosocial behavior, were prevalent in primary school children after schools reopened. The Chinese government, communities, schools, and families need to provide more effective support for students’ transition back into the school building and address emotional and behavioral problems for children with difficulties.

Stress and spirituality in relation to HPA axis gene methylation among US Black women: results from the Black Women's Health Study and the Study on Stress, Spirituality and Health

Background: Few epigenetics studies have been conducted within the Black community to examine the impact of diverse psychosocial stressors and resources for resiliency on the stress pathway (hypothalamus-pituitary-adrenal axis). Methods: Among 1000 participants from the Black Women's Health Study, associations between ten psychosocial stressors and DNA methylation (DNAm) of four stress-related genes ( NR3C1, HSDB1, HSD11B2 and FKBP5) were tested. Whether religiosity or spirituality (R/S) significantly modified these stress-DNAm associations was also assessed. Results: Associations were found for several stressors with DNAm of individual CpG loci and average DNAm levels across each gene, but no associations remained significant after false discovery rate (FDR) correction. Several R/S variables appeared to modify the relationship between two stressors and DNAm, but no identified interaction remained significant after FDR correction. Conclusion: There is limited evidence for a strong signal between stress and DNAm of hypothalamus-pituitary-adrenal axis genes in this general population cohort of US Black women.