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Article ; Online: A Systematic Review of Intervention Trials Utilizing Biomarkers Among Informal Caregivers of People with Alzheimer's Disease & Related Dementias.

O'Riordan, Adam / Chen, Michelle A / Maza, Valentina / Vela, Nyla / Wu-Chung, Lydia / Henderson, Alexandria / Carney, Olivia L / LeRoy, Angie S

Aging and disease

2024

Abstract: Informal caregivers of people with Alzheimer's Disease and Related Dementias (ADRD) experience unique stressors, reduced quality of life, and report poorer health, compared to non-caregivers. Throughout the last thirty years, researchers have developed ... ...

Abstract	Informal caregivers of people with Alzheimer's Disease and Related Dementias (ADRD) experience unique stressors, reduced quality of life, and report poorer health, compared to non-caregivers. Throughout the last thirty years, researchers have developed and tested various psychosocial interventions and their ability to improve caregiver health. Due to an exclusive focus on self-report methods, however, no existing systematic literature reviews specifically examine intervention studies employing biomarkers; this systematic review aims to address this gap in the literature. In each database (PubMed and Web of Science, respectively), a title search was conducted with the following keywords: "alzheimer" OR "dementia" AND "caregiv" AND "intervention", followed by a second search using identical keywords except "intervention" was replaced with "program." Study or intervention protocol articles, exclusively qualitative studies, cultural applicability papers, dissemination studies, descriptive articles or program reports, acceptability/feasibility studies, studies utilizing formal caregiving samples, commentaries, review papers, and meta-analyses, erratums/corrections, measure development articles, factor analyses, and case reports were excluded from the final pool of studies. In this systematic review, the findings of 14 studies are summarized, and are organized based on specific types of biomarkers: neuroendocrine, immune, and autonomic physiological. Overall, the review yielded mixed results, which may, in part, be due to differences in the types of interventions tested, as well as differing biomarker measurement, methodology, and analysis. More biobehavioral intervention trials are needed among ADRD caregivers. Including biological parameters as pre- and post-measures can shed insight into the extent to which interventions may help caregivers heal from the stress of caregiving.
Language	English
Publishing date	2024-01-19
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2625789-0
ISSN	2152-5250 ; 2152-5250
ISSN (online)	2152-5250
ISSN	2152-5250
DOI	10.14336/AD.2024.0115
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: High heart rate variability buffers the effect of attachment insecurity on sleep quality.

Paoletti, Jensine / Argueta, Daniel L / Wu-Chung, E Lydia / Chen, Michelle A / Brown, Ryan L / LeRoy, Angie S / Murdock, Kyle W / Thayer, Julian F / Fagundes, Christopher P

Psychosomatic medicine

2024

Abstract: Objective: Sleep quality is an important health-protective factor. Psychosocial factors, including attachment orientation, may be valuable for understanding who is at risk of poor sleep quality and associated adverse health outcomes. High attachment ... ...

Abstract	Objective: Sleep quality is an important health-protective factor. Psychosocial factors, including attachment orientation, may be valuable for understanding who is at risk of poor sleep quality and associated adverse health outcomes. High attachment anxiety is reliably associated with adverse health outcomes, while high attachment avoidance is associated with adverse health outcomes when co-occurring with poor self-regulatory capacity, indexed by heart rate variability (HRV). We examined the associations between attachment anxiety, attachment avoidance, HRV, and sleep quality. Methods: Using longitudinal data from a sample of 171 older adults measured four times over one year (M = 66.18 years old; 67.83% women), we separated the between-person variance (which we call "trait") and within-person variance (which we call "state") for attachment anxiety, attachment avoidance, and HRV (via the root mean square of successive differences). Sleep quality was measured with the Pittsburgh Sleep Quality Index. Results: Higher trait attachment anxiety was associated with poorer global sleep quality (B = 0.22, p = .005). Higher state attachment avoidance was associated with poorer sleep quality (B = -0.13, p = .01), except for those with higher trait HRV. Higher state attachment anxiety was associated with poorer sleep quality (B = -0.15, p = .002), except for those with higher or mean trait HRV. Higher trait attachment anxiety was associated with poorer sleep quality (B = -0.31, p = .02), except for those with higher trait HRV. Conclusions: High trait HRV mitigated the adverse effects of attachment insecurity on sleep quality. Our results suggest that people with high trait HRV had greater self-regulation capacity, which may be able them to enact emotion regulation strategies effectively.
Language	English
Publishing date	2024-03-04
Publishing country	United States
Document type	Journal Article
ZDB-ID	3469-1
ISSN	1534-7796 ; 0033-3174
ISSN (online)	1534-7796
ISSN	0033-3174
DOI	10.1097/PSY.0000000000001295
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Article ; Online: Grief Symptoms Promote Inflammation During Acute Stress Among Bereaved Spouses.

Brown, Ryan L / LeRoy, Angie S / Chen, Michelle A / Suchting, Robert / Jaremka, Lisa M / Liu, Jia / Heijnen, Cobi / Fagundes, Christopher P

Psychological science

2022 Volume 33, Issue 6, Page(s) 859–873

Abstract: The death of a spouse is associated with maladaptive immune alterations; grief severity may exacerbate this link. We investigated whether high grief symptoms were associated with an amplified inflammatory response to subsequent stress among 111 recently ... ...

Abstract	The death of a spouse is associated with maladaptive immune alterations; grief severity may exacerbate this link. We investigated whether high grief symptoms were associated with an amplified inflammatory response to subsequent stress among 111 recently bereaved older adults. Participants completed a standardized psychological stressor and underwent a blood draw before, 45 min after, and 2 hr after the stressor. Those experiencing high grief symptoms (i.e., scoring > 25 on the Inventory of Complicated Grief) experienced a 45% increase in interleukin-6 (IL-6; a proinflammatory cytokine) per hour, whereas those experiencing low grief symptoms demonstrated a 26% increase. In other words, high grief was related to a 19% increase in IL-6 per hour relative to low grief. The grief levels of recently bereaved people were associated with the rate of change in IL-6 following a subsequent stressor, above and beyond depressive symptoms. This is the first study to demonstrate that high grief symptoms promote inflammation following acute stress.
MeSH term(s)	Aged ; Bereavement ; Grief ; Humans ; Inflammation ; Interleukin-6/blood ; Spouses/psychology
Chemical Substances	IL6 protein, human ; Interleukin-6
Language	English
Publishing date	2022-06-08
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2022256-7
ISSN	1467-9280 ; 0956-7976
ISSN (online)	1467-9280
ISSN	0956-7976
DOI	10.1177/09567976211059502
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Article ; Online: Employment and family income in psychological and immune outcomes during bereavement.

Paoletti, Jensine / Chen, Michelle A / Wu-Chung, E Lydia / Brown, Ryan L / LeRoy, Angie S / Murdock, Kyle W / Heijnen, Cobi J / Fagundes, Christopher P

Psychoneuroendocrinology

2023 Volume 150, Page(s) 106024

Abstract: ... er)s, bereaved about three months prior, we examined the intersection of employment, family income ... such that family income was positively associated with perceived stress and grief symptoms for employed window(er)s ...

Abstract	Spousal bereavement is one of the most stressful experiences in adulthood. In a sample of 183 widow(er)s, bereaved about three months prior, we examined the intersection of employment, family income, and health outcomes (proinflammatory marker production, perceived stress, and grief symptoms). Bereaved employees had higher levels of monocyte-stimulated interleukin-6, tumor necrosis factor-α, chemokine ligands 4, and perceived stress than bereaved retirees. We also found an interaction such that family income was positively associated with perceived stress and grief symptoms for employed window(er)s, but not for retirees. These findings align with the reserve capacity model, which states that people at higher levels of socioeconomic status have more psychosocial resources to address psychosocial stressors. Employment likely served as an added psychological and inflammatory burden for all bereaved workers, except those with the highest incomes.
MeSH term(s)	Humans ; Bereavement ; Grief ; Interleukin-6 ; Tumor Necrosis Factor-alpha ; Employment ; Family/psychology
Chemical Substances	Interleukin-6 ; Tumor Necrosis Factor-alpha
Language	English
Publishing date	2023-01-05
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	197636-9
ISSN	1873-3360 ; 0306-4530
ISSN (online)	1873-3360
ISSN	0306-4530
DOI	10.1016/j.psyneuen.2023.106024
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Article ; Online: Inflammation and future depressive symptoms among recently bereaved spouses.

Wu, E Lydia / LeRoy, Angie S / Heijnen, Cobi J / Fagundes, Christopher P

Psychoneuroendocrinology

2021 Volume 128, Page(s) 105206

Abstract: ... insight into identifying vulnerable widow(er)s at risk for maladaptive grief coping. ...

Abstract	Major depressive disorder (MDD) is an important contributor to the total disease burden because of its high comorbidity with chronic illnesses. Many people with high levels of depressive symptoms exhibit elevated systemic inflammation, but inflammation is not a necessary determinant of depression onset. Among those who recently experienced the death of a spouse, we investigated whether (a) inflammation assessed early in bereavement predicted future depressive symptoms and whether (b) inflammation predicted change in depressive symptoms from baseline to follow-up. Ninety-nine spousally bereaved individuals (M=68.61, SD=10.70) from a larger study were evaluated at baseline (3 months post-death) and follow-up (6 months post-death). Subjects received a venous blood draw and completed the Center for Epidemiologic Studies Depression Scale (CES-D). Stimulated T-cell derived cytokines (IL-6, TNF-α, and IFN-γ) were assessed individually and as a pro-inflammatory composite index. After controlling for confounding factors (i.e., age, sex, body mass index, race, ethnicity, anti-inflammatory medication, days since spousal death, smoking status, comorbidities), individuals with higher levels of IL-6, TNF-α, and IFN-γ at baseline exhibited more depressive symptoms (composite index, p = .05) and an increased probability of experiencing clinical levels of depression (CES-D score ≥16) (composite index, p = .04). Inflammatory levels were not predictive of change in depressive symptoms or in clinical depression status from baseline to follow-up. Among individuals who did not experience clinical levels of depression at baseline, baseline inflammatory levels predicted clinical levels of depression 3 months later (p = .03). This study provides support for an inflammatory mechanism underlying depression following bereavement. It suggests that one's inflammatory profile following a significant social stressor in older adulthood can be prognostic of depression risk months later. These findings add to our understanding of the physiological and mental health risks experienced by the bereaved population and provide insight into identifying vulnerable widow(er)s at risk for maladaptive grief coping.
MeSH term(s)	Aged ; Bereavement ; Depression/diagnosis ; Depressive Disorder, Major ; Female ; Humans ; Inflammation/psychology ; Interferon-gamma ; Interleukin-6 ; Male ; Prognosis ; Spouses/psychology ; Tumor Necrosis Factor-alpha
Chemical Substances	IFNG protein, human ; Interleukin-6 ; Tumor Necrosis Factor-alpha ; Interferon-gamma (82115-62-6)
Language	English
Publishing date	2021-03-27
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	197636-9
ISSN	1873-3360 ; 0306-4530
ISSN (online)	1873-3360
ISSN	0306-4530
DOI	10.1016/j.psyneuen.2021.105206
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Article ; Online: Trajectories of depressive symptoms early in the course of bereavement: Patterns, psychosocial factors and risk of prolonged grief.

Majd, Marzieh / Chen, Michelle A / Chirinos, Diana A / Brown, Ryan L / LeRoy, Angie S / Murdock, Kyle W / Wu-Chung, E Lydia / Thayer, Julian F / Fagundes, Christopher P

Stress and health : journal of the International Society for the Investigation of Stress

2023 , Page(s) e3340

Abstract: ... depression' groups than the 'resilient' and 'moderate depression-improved' groups. Widow(er)s with higher ...

Abstract	In the context of bereavement, little is known about the mechanisms that differentiate normative adjustment patterns from those that may indicate potential psychopathology. This study aimed to replicate and extend previous work by (1) characterizing the trajectories of depressive symptoms from 3 to 12 months after the loss of a spouse, (2) examining whether (a) childhood maltreatment and attachment style predicted distinct depression trajectories, and (b) different depression trajectories were associated with the risk of prolonged grief at 12 months post-loss. Recently bereaved individuals (N = 175) completed self-report assessments at 3, 4, 6, and 12-months post-loss. Trajectories of depressive symptoms were estimated using group-based trajectory modelling. Four distinct trajectories of depressive symptoms were identified: (1) resilience (minimal/no depression across time points; 45%), (2) moderate depression-improved (alleviated to 'mild' by 12 months; 31%), (3) severe depression-improved (alleviated to 'moderate' by 12 months; 15%), and (4) chronic depression ('severe' symptoms across time points; 9%). Higher childhood maltreatment predicted a greater likelihood of belonging to the 'severe depression-improved' and 'chronic depression' groups than the 'resilient' and 'moderate depression-improved' groups. Widow(er)s with higher attachment anxiety were more likely to belong to the 'severe depression-improved' and 'chronic depression' groups than the 'resilient' group. The trajectory groups with persistent levels of depressive symptoms up until 6 months were more likely to exhibit prolonged grief at 12 months post-loss. Changes from pre-loss functioning cannot be estimated. Our findings provide insight into the early identification of post-loss prolonged grief.
Language	English
Publishing date	2023-11-05
Publishing country	England
Document type	Journal Article
ZDB-ID	2042041-9
ISSN	1532-2998 ; 1532-3005
ISSN (online)	1532-2998
ISSN	1532-3005
DOI	10.1002/smi.3340
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Dying in the face of the COVID-19 pandemic: Contextual considerations and clinical recommendations.

LeRoy, Angie S / Robles, Barbara / Kilpela, Lisa S / Garcini, Luz M

Psychological trauma : theory, research, practice and policy

2020 Volume 12, Issue S1, Page(s) S98–S99

Abstract: Dying is a natural part of life; however, death is often a fearful, frightening event. Dying in the midst of the COVID-19 pandemic presents challenges that magnify normative fears and may interfere with a healthy grieving process. To maintain a resilient ...

Abstract	Dying is a natural part of life; however, death is often a fearful, frightening event. Dying in the midst of the COVID-19 pandemic presents challenges that magnify normative fears and may interfere with a healthy grieving process. To maintain a resilient spirit among those who are at risk of losing a loved one or who have lost a family member to COVID-19, it is important that they be provided with the necessary contextually and culturally appropriate skills and resources to facilitate healing in the face of hardship and uncertainty. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
MeSH term(s)	Adult ; Attitude to Death ; Bereavement ; COVID-19 ; Coronavirus Infections/psychology ; Family/psychology ; Humans ; Mental Health Services ; Pandemics ; Pneumonia, Viral/psychology ; Psychological Trauma/psychology
Keywords	covid19
Language	English
Publishing date	2020-06-11
Publishing country	United States
Document type	Journal Article
ZDB-ID	2497028-1
ISSN	1942-969X ; 1942-9681
ISSN (online)	1942-969X
ISSN	1942-9681
DOI	10.1037/tra0000818
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Article ; Online: Inhibition is associated with metabolic syndrome and depression through inflammation.

Murdock, Kyle W / LeRoy, Angie S / Fagundes, Christopher P

Stress and health : journal of the International Society for the Investigation of Stress

2018 Volume 34, Issue 3, Page(s) 457–461

Abstract: Inhibition is the ability to stop one's self from responding, or paying attention, to tempting/distracting stimuli or thoughts. Those with poor inhibition are at greater risk of depression and a variety of diseases of older adulthood than those with ... ...

Abstract	Inhibition is the ability to stop one's self from responding, or paying attention, to tempting/distracting stimuli or thoughts. Those with poor inhibition are at greater risk of depression and a variety of diseases of older adulthood than those with better inhibition. Inflammation may be a mechanism underlying these links. A total of 840 participants from the Midlife in the United States study completed a neuropsychological measure of inhibition, a self-report measure of depressive symptoms, and a blood draw. Results indicated that poor inhibition was associated with high interleukin-6 (IL-6). Inhibition was indirectly associated with metabolic syndrome incidence and depressive symptoms through IL-6. Findings suggest that IL-6 may be a mechanism linking inhibition with metabolic syndrome and depression.
MeSH term(s)	Comorbidity ; Depression/epidemiology ; Depression/physiopathology ; Female ; Humans ; Inflammation/blood ; Inflammation/epidemiology ; Inhibition (Psychology) ; Interleukin-6/blood ; Male ; Metabolic Syndrome/blood ; Metabolic Syndrome/epidemiology ; Middle Aged ; United States
Chemical Substances	IL6 protein, human ; Interleukin-6
Language	English
Publishing date	2018-03-30
Publishing country	England
Document type	Journal Article
ZDB-ID	2042041-9
ISSN	1532-2998 ; 1532-3005
ISSN (online)	1532-2998
ISSN	1532-3005
DOI	10.1002/smi.2808
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Zs.A 2060: Show issues

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Article: Immune and Epigenetic Pathways Linking Childhood Adversity and Health Across the Lifespan.

Chen, Michelle A / LeRoy, Angie S / Majd, Marzieh / Chen, Jonathan Y / Brown, Ryan L / Christian, Lisa M / Fagundes, Christopher P

Frontiers in psychology

2021 Volume 12, Page(s) 788351

Abstract: Childhood adversity is associated with a host of mental and physical health problems across the lifespan. Individuals who have experienced childhood adversity (e.g., child abuse and neglect, family conflict, poor parent/child relationships, low ... ...

Abstract	Childhood adversity is associated with a host of mental and physical health problems across the lifespan. Individuals who have experienced childhood adversity (e.g., child abuse and neglect, family conflict, poor parent/child relationships, low socioeconomic status or extreme poverty) are at a greater risk for morbidity and premature mortality than those not exposed to childhood adversity. Several mechanisms likely contribute to the relationship between childhood adversity and health across the lifespan (e.g., health behaviors, cardiovascular reactivity). In this paper, we review a large body of research within the field of psychoneuroimmunology, demonstrating the relationship between early life stress and alterations of the immune system. We first review the literature demonstrating that childhood adversity is associated with immune dysregulation across different indices, including proinflammatory cytokine production (and its impact on telomere length), illness and infection susceptibility, latent herpesvirus reactivation, and immune response to a tumor. We then summarize the growing literature on how childhood adversity may alter epigenetic processes. Finally, we propose future directions related to this work that have basic and applied implications.
Language	English
Publishing date	2021-11-26
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2563826-9
ISSN	1664-1078
ISSN	1664-1078
DOI	10.3389/fpsyg.2021.788351
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Article ; Online: Dying in the face of the COVID-19 pandemic

LeRoy, Angie S. / Robles, Barbara / Kilpela, Lisa S. / Garcini, Luz M.

Psychological Trauma: Theory, Research, Practice, and Policy

Contextual considerations and clinical recommendations.

2020 Volume 12, Issue S1, Page(s) S98–S99

Keywords	Clinical Psychology ; Social Psychology ; covid19
Language	English
Publisher	American Psychological Association (APA)
Publishing country	us
Document type	Article ; Online
ZDB-ID	2497028-1
ISSN	1942-969X ; 1942-9681
ISSN (online)	1942-969X
ISSN	1942-9681
DOI	10.1037/tra0000818
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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