Neural contributors to trauma resilience: a review of longitudinal neuroimaging studies

Resilience in the face of major life stressors is changeable over time and with experience. Accordingly, differing sets of neurobiological factors may contribute to an adaptive stress response before, during, and after the stressor. Longitudinal studies are therefore particularly effective in answering questions about the determinants of resilience. Here we provide an overview of the rapidly-growing body of longitudinal neuroimaging research on stress resilience. Despite lingering gaps and limitations, these studies are beginning to reveal individual differences in neural circuit structure and function that appear protective against the emergence of future psychopathology following a major life stressor. Here we outline a neural circuit model of resilience to trauma. Specifically, pre-trauma biomarkers of resilience show that an ability to modulate activity within threat and salience networks predicts fewer stress-related symptoms. In contrast, early post-trauma biomarkers of subsequent resilience or recovery show a more complex pattern, spanning a number of major circuits including attention and cognitive control networks as well as primary sensory cortices. This novel synthesis suggests stress resilience may be scaffolded by stable individual differences in the processing of threat cues, and further buttressed by post-trauma adaptations to the stressor that encompass multiple mechanisms and circuits. More attention and resources supporting this work will inform the targets and timing of mechanistic resilience-boosting interventions.

Investigating Posttraumatic Growth in Midlife Using an Intensive Longitudinal Research Design: Posttraumatic Growth Is Not as Prevalent as Previously Considered

The notion that adversity leads to enduring improvements in psychological functioning carries promise given the diverse adversities individuals confront over their life course. However, research on posttraumatic growth (PTG) has relied on cross-sectional research designs, which severely limit the ability to discern whether growth transpires following adversity. Our goal was to examine whether PTG is possible across a diverse array of outcomes and identify factors that promote PTG. We analyzed data from a longitudinal, prospective study that assessed midlife participants monthly for a period of 2 years. Over the study period, 276 participants experienced a major life stressor, and multiphase multilevel models were used to examine whether PTG transpired in life satisfaction, gratitude, compassion, generativity, meaning-making, and religiosity/spirituality. On average, life satisfaction, generativity, and meaning-making declined following adversity; substantial between-person differences were observed across all outcomes. Our multidimensional approach revealed that, on average, individuals experienced PTG in less than one outcome. More anticipated support and less interpersonal strain were consistently associated with positive functioning in each outcome. Our discussion focuses on how multidimensional approaches to studying PTG promise to disentangle which outcomes potentially grow following adversity and illuminate best research practices for examining PTG, laying the groundwork for future research.

The Stressor in Adolescence of Menstruation: Coping Strategies, Emotional Stress & Impacts on School Absences among Young Women in Nepal

Throughout the developing world, girls face hardships surrounding menstruation, often resulting in poor emotional wellbeing and missing school. Providing ways to keep girls in school will increase their educational and earning potentials, which will ultimately trickle down to improving the economic standing of nations in the next generation. Informed by the Transactional Model of Stress and Coping, this work evaluates the roles that cultural and school environments play in appraisals of menstruation as a major life stressor for adolescent females and the impacts of emotional stress on missing school. Using primary survey data from schools in Nepal, robust results are found to support the theoretical framework based on conditional mixed-process (CMP) estimation with fixed effects, utilizing multiple index building techniques. Strong cultural norms during menstruation appear to increase the probability of girls self-reporting emotional stress, while the presence of hygiene supporting infrastructure at schools reduces this outcome. Furthermore, there is strong support for the finding that the presence of emotional stress during menstruation increases the likelihood of not only missing school but also for an extended period of time. Our findings motivate increasing government policies to provide stronger hygiene infrastructure in schools to improve successful coping skills and attendance rates.

Testing Invariance of Measures of Internalizing Symptoms Before and After a Major Life Stressor: The Impact of COVID-19 in an Adolescent and Young Adult Sample

There are reports of increases in levels of internalizing psychopathology during the COVID-19 pandemic. However, these studies presume that measurement properties of these constructs remained unchanged from before the pandemic. In this study, we examined longitudinal measurement invariance of assessments of depression, anxiety, and intolerance of uncertainty (IU) in adolescents and young adults from ongoing longitudinal studies. We found consistent support for configural and metric invariance across all constructs, but scalar invariance was unsupported for depression and IU. Thus, it is necessary to interpret pandemic-associated mean-level changes in depression and IU cautiously. In contrast, mean-level comparisons of panic, generalized, and social anxiety symptoms were not compromised. These findings are limited to the specific measures examined and the developmental period of the sample. We acknowledge that there is tremendous distress accompanying disruptions due to the COVID-19 outbreak. However, for some instruments, comparisons of symptom levels before and during the pandemic may be limited.

Cancer-related fatigue: an overview

A diagnosis of cancer is a major life stressor that can affect the physiological, psychological and physical state of the person concerned. Fatigue is a particularly common and troubling symptom that has a negative impact on quality of life throughout all phases of treatment and stages of the illness. The aim of this review is to provide background information on cancer-related fatigue. This review discusses cancer-related fatigue (CRF) in terms of the definition, prevalence, risk factors, aetiology, and the measurement scales used. The differences between definitions of symptoms and relevant theories will be explored and discussed to help explain the variety of instruments used in its measurement. The prevalence of fatigue will be assessed by looking critically at the evidence of fatigue and the factors that affect it. Potential treatment and management strategies for CRF will also be discussed. Finally, there will be an overview of the instruments used to measure fatigue. This review also provides important evidence for measuring and managing CRF that can help nurses to understand fatigue among patients with cancer. Assessing CRF should be routinely undertaken in clinical settings to help identify the proper interventions, treatments and management to reduce fatigue among cancer patients.

The relationship between social support, stressful events, and menopause symptoms

Many women going through the menopausal transition experience vasomotor symptoms (VMS), and research has shown that there is a large amount of variation in their frequency and severity. Many lifestyle factors have been found to co-vary with VMS, including the level of social support received by the woman, and how stressed she is. Stress is well documented to worsen menopause symptoms, and there is some evidence that support eases them; however, there is little research into whether support is an effective buffer against the negative effects of stress on VMS. Using nine years of data from the Study of Women’s Health Across the Nation (n = 2718), we use multilevel Poisson regression with random effects to test: 1) if more social support is associated with decreased VMS frequency, 2) if increased life stress worsens VMS, and 3) if support acts as a buffer against stress. After adjusting for age, marital status, smoking, self-perceived overall health, ethnicity, and menopausal status, we find that stress increases the frequency of VMS. Contrary to our hypothesis, we did not find strong evidence that emotional support led to lower VMS frequency, or that support buffers against the effects of stress. Experience of a stressful event, but not amount of social support, was included in the best fitting model; with the degree to which the woman was upset by the life stressor having the largest effect on menopause symptoms. Here, women who said they were currently upset by a stressful event experienced 21% more VMS than women who had experienced no life stressor. This research highlights that social factors may impact the menopausal transition.

Music and Mood Regulation 1 during the early-stages of the COVID-19 Pandemic

Music-listening can be an effective strategy for regulating affect, leading to positive wellbeing. 16 However, it is unclear how differences in culture and disposition can impact music’s affective 17 benefits. The COVID-19 pandemic provides a unique opportunity to study how music is used to 18 cope with stress, loss, and unease across the world. We used an online survey to test if people 19 from four different countries used music to manage their emotions during quarantine and if the 20 functions of music depended on empathy, anxiety, depression, or country of residence. We 21 found a positive relationship between the use of music-listening for affect regulation and current 22 wellbeing, particularly for participants from India. While people with stronger symptoms of 23 depression and anxiety used music differently, the end result was still a positive change in 24 affect. Our findings highlight the universality of music’s affective potency and its ability to help 25 people manage an unprecedented life stressor.

Coronavirus Lockdown as a Major Life Stressor: Does It Affect TMD Symptoms?

Temporomandibular disorders are multi-factorial conditions that are caused by both physical and psychological factors. It has been well established that stress triggers or worsens TMDs. This paper looks to present early research, still unfolding, on the relationship between COVID-19 as a major life stressor and TMDs. The main aims of this study were to: investigate the presence of symptoms related to TMDs and the time of onset and the worsening of painful symptoms in relation to the changes in social life imposed by the coronavirus pandemic; and to evaluate the perception of COVID-19 as a major stressful event in subjects who report worsening of painful TMD symptoms. One hundred and eighty-two subjects answered questionnaires—Axis II of the RDC/TMD, the PSS, and specific items about coronavirus as a stressful event—during the lockdown period for COVID-19 in Italy to evaluate the presence of reported symptoms of TMD and the level of depression, somatization, and stress perceived. The results showed that 40.7% of subjects complained about TMD symptoms in the past month. Regarding the time of onset, 60.8% of them reported that facial pain started in the last three months, while 51.4% of these subjects reported that their symptoms worsened in the last month and were related to the aggravation of pain due to the coronavirus lockdown as a major life event and to the stress experienced. The results of this study seem to support the hypothesis that stress during the pandemic lockdown influenced the onset of temporomandibular joint disorders and facial pain, albeit with individual responses.

Understanding in transition: The influence of becoming parents on empathic accuracy

Empathic accuracy (EA), the ability to understand a close other’s thoughts and feelings, is linked to relationship satisfaction. Yet, it is unclear whether stress interferes with relationship partners’ ability to be empathically accurate. The present study investigates whether a major life stressor, the transition to parenthood (TTP), interferes with EA between partners. In a daily diary study of 78 couples expecting their first child, couples reported on their own and their partners’ daily mood for 3 weeks during three separate time periods across the TTP: pregnancy, infancy, and toddlerhood. Both mothers and their partners demonstrated EA across the TTP. However, there was evidence that the transition interfered with EA: Partners’ ability to track mothers’ negative mood dropped significantly during infancy and remained low in toddlerhood, whereas mothers’ ability to track their partners’ positive mood dropped significantly in infancy and recovered in toddlerhood. This suggests that one way in which a major life stressor, in this case, the TTP, may interfere with relationship functioning is by decreasing couples’ understanding of each other’s mood states.