Living With HIV During the COVID-19 Pandemic: Impacts for Older Adults in Palm Springs, California

We conducted surveys in March 2020 with 100 older adults living in Palm Springs, CA, to (1) report the impact of the COVID-19 pandemic on their day-to-day well-being and (2) describe the factors related to missing HIV medication during the pandemic. Respondent's mean age was 64.2 and the majority identified as White, men, and gay. The majority stated that the pandemic had impacted their lives “much,” “very much,” or “extremely.” One-third experienced financial challenges and 46.0% experienced disruptions to health care. Almost a quarter (24.0%) reported missing a dose of their HIV medication during the pandemic. Compared to those ages 64+, younger respondents were more likely to report some negative impacts like changes in sleep patterns, financial challenges, and missed HIV medication doses, and had higher PTSD severity scores. In adjusted logistic regression, higher PTSD severity scores and disruption to health care were associated with missed doses of medications (ps < .05).

The ADCYAP1R1 Gene Is Correlated With Posttraumatic Stress Disorder Symptoms Through Diverse Epistases in a Traumatized Chinese Population

The adenylate cyclase activating polypeptide 1 (pituitary) receptor (ADCYAP1R1) gene is associated with the hypothalamic-pituitary-adrenal (HPA) axis, which controls stress responses. The single-nucleotide polymorphism of ADCYAP1R1, rs2267735, has been investigated in many studies to test its association with posttraumatic stress disorder (PTSD), but the results have not been consistent. It is worth systematically exploring the role of rs2267735 in PTSD development. In this study, we analyzed rs2267735 in 1,132 trauma-exposed Chinese individuals (772 females and 360 males). We utilized the PTSD checklist for DSM-5 (PCL-5) to measure the PTSD symptoms. Then, we analyzed the main, G × E (rs2267735 × trauma exposure), and G × G (with other HPA axis gene polymorphisms) effects of rs2267735 on PTSD severity (total symptoms). There were no significant main or G × E effects (P &gt; 0.05). The G × G ADCYAP1R1-FKBP5 interaction (rs2267735 × rs1360780) was associated with PTSD severity (beta = −1.31 and P = 0.049) based on all subjects, and the G × G ADCYAP1R1-CRHR1 interaction (rs2267735 × rs242924) was correlated with PTSD severity in men (beta = −4.72 and P = 0.023). Our study indicated that the ADCYAP1R1 polymorphism rs2267735 may affect PTSD development through diverse gene-gene interactions.

The DRD2 Taq1A polymorphism moderates the effect of PTSD symptom severity on the left hippocampal CA3 volume: a pilot study

Rationale and objectives The hippocampus, especially the CA1, CA3, and dentate gyrus (DG) subfields, is reported to be associated with post-traumatic stress disorder (PTSD) after trauma. However, neuroimaging studies of the associations between PTSD and hippocampal subfield volumes have failed to yield consistent findings. The aim of this study is to examine whether the dopamine D2 receptor (DRD2) Taq1A polymorphism, which is associated with both hippocampal function and PTSD, moderated the association between PTSD severity and hippocampal CA1, CA3 and DG volumes. Methods T1-weighted images were acquired from 142 trauma survivors from the 2008 Wenchuan earthquake using a 3.0-T magnetic resonance imaging system. Hippocampal subfield segmentations were performed with FreeSurfer v6.0. We used the simple moderation model from the PROCESS v3.4 tool for SPSS 23.0 to examine the association between the rs1800497 polymorphism, PTSD severity, and hippocampal CA3 and DG volumes. Results A significant genotype × PTSD symptom severity interaction was found for the left CA3 volume (ΔF = 5.01, p = 0.008, ΔR2 = 0.05). Post hoc, exploratory analyses deconstructing the interaction revealed that severe PTSD symptomatology were associated with reduced left CA3 volume among TC heterozygotes (t = − 2.86, p = 0.005). Conclusions This study suggests that DRD2 Taq1A polymorphism moderates the association between PTSD symptomatology and left CA3 volume, which promotes an etiological understanding of the hippocampal atrophy at the subfield level. This highlights the complex effect of environmental stress, and provides possible mechanism for the relationship between the dopaminergic system and hippocampal function in PTSD.

A closer examination of facets of social interactions in predicting posttraumatic stress disorder and factors that moderate these associations

Posttraumatic social interactions are among the most robust predictors of posttraumatic stress disorder (PTSD) following trauma, but social interactions have been widely defined and quantified in the literature. This study explored whether negative social interactions were more strongly associated with PTSD symptoms than positive interactions among adults recently exposed to a traumatic event, as well as factors that moderate these associations. Participants (N = 149) were assessed by the clinician-administered PTSD scale and completed self-reported measures of social interactions and disclosure style. Only negative social interactions, specifically general societal disapproval and disapproval from family and friends, emerged as significant predictors of PTSD severity in a multiple regression analysis. Sex, trauma type, and dysfunctional disclosure style did not moderate relationships between negative social interactions and PTSD severity. Findings imply that negative social interactions may be more integral to trauma recovery than positive ones. Clinical implications are discussed.

A closer examination of facets of social interactions in predicting posttraumatic stress disorder and factors that moderate these associations

Posttraumatic social interactions are among the most robust predictors of posttraumatic stress disorder (PTSD) following trauma, but social interactions have been widely defined and quantified in the literature. This study explored whether negative social interactions were more strongly associated with PTSD symptoms than positive interactions among adults recently exposed to a traumatic event, as well as factors that moderate these associations. Participants (N = 149) were assessed by the clinician-administered PTSD scale and completed self-reported measures of social interactions and disclosure style. Only negative social interactions, specifically general societal disapproval and disapproval from family and friends, emerged as significant predictors of PTSD severity in a multiple regression analysis. Sex, trauma type, and dysfunctional disclosure style did not moderate relationships between negative social interactions and PTSD severity. Findings imply that negative social interactions may be more integral to trauma recovery than positive ones. Clinical implications are discussed.

735 Neighborhood Stress Predicts Fear of Sleep Independently of Posttraumatic Stress Disorder

Introduction Chronic insufficient sleep is linked to a variety of adverse health outcomes, with African Americans reporting and objectively receiving poorer sleep outcomes in comparison to their non-Hispanic white counterparts. African Americans live disproportionately in low-income and disordered neighborhoods that increase one’s risk of experiencing a traumatic event and interfere with sleep. It has been demonstrated that posttraumatic stress disorder disrupts sleep in part due to its association with sleep-related fears. However, less research has evaluated the additional contribution of perceived neighborhood stress on the sleep-related fears African Americans experience in their sleep environments. Methods The present study features a nonclinical sample of 163 African American participants (ages 18–35) who reside in DC to investigate whether PTSD severity (Clinician Administered PTSD Scale for DSM-5 Severity Score, CAPS-5) and perceived neighborhood stress (City Stress Index, CSI) are predictive of sleep-related fears (Fear of Sleep Inventory, FoSI). Results After controlling for gender, hierarchical linear regression analyses revealed that PTSD severity and perceptions of the neighborhood environment accounted for approximately 33% of the variance in sleep-related fears (∆R2 = .329, p = .000). Regression coefficients suggest that subjective perceptions of the neighborhood (β = .388) may be a stronger predictor of sleep-related fears than PTSD severity (β = .300) Conclusion Results from this study have implications for future interventions that involve improving coping skills among African Americans in the context of their sleep environments. Support (if any) 5R01HL136626 from the National Heart Lung and Blood Institute

The societal influences and quality of life among healthcare team members under COVID-19 pandemic

Background: The corona virus infection disease 2019 (COVID-19) pandemic is likely to put healthcare professionals across the world in an unprecedented situation. Methods: 683 healthcare workers were recruited in this study. Short form-12 items (SF-12), Societal Influences Survey Questionnaire (SISQ), and Disaster-Related Psychological Screening Test (DRPST) were used to survey participants. Multiple linear regression and structural equation model (SEM) were used to explore the possible factors to the societal influences and quality of life. Results: Female, older, more education years, married, regular intake and posttraumatic stress disorder (PTSD) frequency had positive effects to SISQ. To physical component summary (PCS) of SF-12, chronic illness, sleep score, PTSD frequency and social distance had negative effects and exercise habits had positive effect. To mental component summary (MCS) value of SF-12, age, participate in clubs, volunteer or charity activities and social information had positive effects and PTSD frequency, sleep score, social anxiety and depression had negative effects. Under SEM analysis, PTSD had positive effect to SISQ. Sleep score and MCS value had negative effects to SISQ. PTSD severity, older age, Sleep score, smoking and Nursing staff had negative effects to PCS value. Young age, PTSD frequency, sleep score and depression had negative effects to MCS value. Conclusion: Healthcare team members with severer PTSD symptoms suffered more societal influences. Relative to PTSD severity, PTSD frequency was more important to the quality of life. Members of older age, who frequently participate in clubs, volunteers or charity activities had better mental life quality.

Differential Roles of Positive and Negative Valence Systems in the Development of Post-Traumatic Stress Psychopathology

Negative and positive valence systems (NVS and PVS) pertain to processing of aversive and rewarding stimuli, respectively. Post-Traumatic Stress Disorder (PTSD) has been typically associated with hyper-responsivity of the NVS, and more recently, with deficient PVS functionality. The respective roles of these systems in early PTSD development have yet to be resolved. Here, we assessed neurobehavioral indicators of PVS and NVS longitudinally among 171 adult civilians at 1-, 6-, and 14-months following trauma exposure (TP1, TP2, and TP3). Using the "Safe or Risky Domino Choice" (SRDC) game during fMRI, NVS and PVS functionality (i.e., activity and connectivity) were indicated by the amygdala and ventral striatum (VS) responses to punishments and rewards, respectively. The complementary functionality of these systems was behaviorally assessed as the percentage of risky choices taken during the game. Results revealed that increased amygdala functionality at TP1 was associated with greater PTSD severity at TP1 and TP3, specifically with hyperarousal and intrusion. Decreased VS functionality at TP1 was associated with greater PTSD severity at TP3, specifically with avoidance. Explainable machine learning revealed the primacy of PVS over NVS functionality at TP1 in predicting PTSD severity at TP3. Behaviorally, fewer risky choices were associated with more severe symptoms at TP1, especially with intrusion and avoidance. Overall, these results suggest a differential and potentially complementary involvement of NVS and PVS in PTSD development following trauma. Early therapeutics for PTSD in the immediate aftermath of trauma may thus target both negative and positive valence processing.