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Article Summaries for February–March 2016 Psychosomatic Medicine, Volume 78, Issue 2

doi: 10.1097/PSY.0000000000000319

A meta-analysis by Cohen et al. indicates that a higher sense of purpose in life is associated with a reduced risk for both cardiovascular disease events and all-cause mortality. Pathophysiologic and behavioral mechanisms are discussed, as well as potential clinical implications for those individuals identified as having a reduced sense of purpose in life.

Pages 122–133; Web:

Financial problems are known to be associated with various psychological problems and adverse health outcomes, but the biobehavioral mechanisms of these relationships are insufficiently understood. Sturgeon et al. investigated the association of financial stressors with psychosocial functioning and inflammation (indexed by interleukin-6 and C-reactive protein). The experience of significant financial stress within the previous year was associated with greater psychosocial distress, lower ratings of well-being, and greater interpersonal stress. The association between financial stress and inflammation was complex and was partly attributable to lower psychological well-being.

Pages 134–143; Web:

Konttinen et al. investigated whether socioeconomic position modifies the effect of depression on coronary heart disease (CHD) mortality. Use of antidepressants served as a proxy measure of depression status in this study of data from a large sample of the Finnish population. During an 8-year follow-up, individuals in lower socioeconomic categories had overall higher rates of CHD mortality. Depression as indexed by antidepressant use was also related to a higher risk of CHD mortality, but no support was found that low socioeconomic position exacerbated the adverse effects of depression on CHD-related mortality. The authors note that the study took place in a country with universal health care services, which may have influenced the results.

Pages 144–152; Web:

Blumenthal et al. examined the prognostic value of select biobehavioral factors in patients with chronic obstructive pulmonary disease (COPD). Outpatients with COPD underwent assessments of pulmonary function, physical activity, body mass index, inflammation, pulmonary symptoms, depression, and pulmonary disease-related quality of life and were followed up for up to 5.4 years. Results showed that classification according to Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria and functional capacity were the strongest predictors of all-cause mortality and COPD hospitalizations. Developing interventions to improve functional status and reduce somatic symptoms may be especially worthwhile in improving clinical outcomes in COPD.

Pages 153–162; Web:

Evidence suggests that the experience of parental divorce during childhood is associated with elevated risk of behavioral and physical health problems, potentially driven by dysregulated adrenocortical activity. In a 15-year longitudinal study, Luecken et al. evaluated the impact of post-divorce maternal warmth on offspring cortisol activity. Higher child-reported maternal warmth in adolescence predicted lower cortisol stress response in young adulthood.

Pages 163–170; Web:

Adverse experiences in childhood may influence later cardiovascular health. Using a population sample of participants who were assessed at several points from 1980 to 2007, Hakulinen et al. examined whether different types of adverse experiences in childhood were associated with carotid intima-media thickness (IMT), a marker of subclinical cardiovascular disease, in adulthood. A cumulative psychosocial risk score was derived from aspects of the childhood environment. Results indicated that the experience of multiple adverse environmental factors in childhood was associated with higher IMT and a steeper IMT progression over time, indicating an increased cardiovascular health risk in adulthood.

Pages 171–181; Web:

Elevations in levels of the stress-related hormone cortisol have been associated with hippocampal degeneration and memory problems. In a 5-year longitudinal investigation of older adults by Segerstrom et al., long-term but not short-term elevations in cortisol were correlated with worse memory (verbal learning and recall) but not with other cognitive functions. Higher secretion of cortisol may, over time, contribute to memory dysfunction in older adults.

Pages 182–191; Web:

Naiberg et al. provide a systematic review of the association between flow-mediated dilation (FMD) and cognitive function in individuals without cerebrovascular disease. The majority of the studies concluded that FMD is associated with poorer cognitive functioning, particularly in executive functioning and working memory tasks. These findings suggest that interventions to improve vascular function may also improve cognition.

Pages 192–207; Web:

Angiotensin II plays a significant role in the regulation of cardiovascular, neuroendocrine, and behavioral factors by stimulation of angiotensin-1 receptors (AT1R). Milik et al. evaluated the messenger RNA (mRNA) expression of AT1aR (angiotensin Type 1a receptor) in groups of control rats and rats that had been exposed to chronic mild stress. Results indicated that chronic mild stress significantly increases AT1aR’s mRNA expression in the brain and kidney.

Pages 208–220; Web:

Tully et al. examined key biological measures that may link depressive symptoms with the development of Type 2 diabetes in men 35 years or older. Biological measures included endogenous total testosterone, interleukin-6, high-sensitivity C-reactive protein, sE-selectin, fasting glucose, and glycated hemoglobin (HbA1c). Assessments were made at baseline and 5 years later. The study showed that persistent depressive symptoms and lower total testosterone levels were associated with incident diabetes risk. Cognitive depressive symptoms and testosterone were also associated with increases in HbA1c over time.

Pages 221–232; Web:

Depression and anxiety are more prevalent in people with diabetes, but there has been some debate regarding whether a person’s awareness of having diabetes may be a contributing factor. Meurs et al. examined cross-sectional data from more than 90,000 people and found that depression was more prevalent in participants with diagnosed as well as undiagnosed diabetes, compared with participants without diabetes. Anxiety, on the other hand, was more prevalent only in participants who were aware of their diabetes.

Pages 233–241; Web:

Caregiving is often a stressful experience, yet it is unclear how this stress translates into physiologic disruption. In 140 caregivers of hematopoietic stem cell transplant patients, Sannes et al. found that higher stress was associated with a more erratic cortisol output (greater intra-individual cortisol variability). Other commonly used cortisol indices (slope, total output, awakening response) were unrelated to stress, suggesting that intra-individual cortisol variability may be a more sensitive marker of stress-system disruption.

Pages 242–247; Web:

Interoceptive fear learning and generalization of fear have been hypothesized to play a key role in unexplained abdominal and esophageal pain in patients with functional gastrointestinal disorders, but experimental evidence has been lacking. Zaman et al. tested a fear learning–generalization paradigm in healthy volunteers by using conditioned (an innocuous esophageal balloon distension) and unconditioned (a painful but harmless electrical shock) stimuli. The results show that fear can be learned in response to mild visceral sensations in a healthy population and that such fear generalizes toward more intense painful visceral stimuli.

Pages 248–258; Web:

Copyright © 2016 by American Psychosomatic Society