Kristin Vickers

Parenting stress mediates between maternal maltreatment history and maternal sensitivity in a community sample.

OBJECTIVE Maternal maltreatment history and current parenting stress are associated with parenting difficulties. However, researchers have not investigated the mechanism by which these variables are interlinked. We hypothesized that parenting stress mediates the relation between history of maltreatment and parenting behavior. METHODS We assessed a community sample of 291 mothers as they interacted with their 16-month old infants in the home. Maternal history of maltreatment and parenting stress were assessed via self-report inventory; maternal sensitivity toward the infant was assessed with 2h of direct behavioral observation. RESULTS Mothers who reported more maltreatment in childhood were less sensitive with their infants; mothers who reported more current parenting stress were also less sensitive. Parenting stress mediated between maternal maltreatment history and current parental behavior. CONCLUSIONS Findings are consistent with an interpretation of parenting stress as a pathway through which maternal history of maltreatment may be linked to decreased maternal sensitivity.

Assessing late-onset stress symptomatology among aging male combat veterans

This studys goal was to develop a measure of late-onset stress symptomatology (LOSS). LOSS is a phenomenon observed in aging combat veterans who (a) were exposed to highly stressful combat events in their early adult years, (b) have functioned successfully throughout midlife with no history of chronic stress-related disorders, but (c) begin to register increased combat-related thoughts, feelings, and reminiscences commensurate with the changes and challenges of aging. Several samples of older male combat veterans from World War II, the Korean Conflict, and the Vietnam War served as participants. We developed a LOSS Scale that demonstrated a high degree of internal consistency reliability (coefficient alpha = 0.97). Scores were stable over brief intervals but were sensitive to developmental change over an extended period. Factor analysis suggested a single LOSS factor. Bivariate associations between LOSS score and other variables (e.g., indicators of contemporary life stressors, resilience, quality of life) were consistent with hypotheses, and there was support for the incremental validity of LOSS vis-à-vis posttraumatic stress symptoms and symptoms of general distress. Discussion of the potential uses of the scale, future directions for psychometric research, and suggestions for generalizing the LOSS construct to other trauma populations are provided.

Gulf war illness: symptomatology among veterans 10 years after deployment.

Objective: To further elucidate the nature of illness in veterans of the 1990 to 1991 Gulf War (GW) by examining the GW Illness (GWI) definition advanced by the Centers for Disease Control and Prevention, which specified caseness as having at least one symptom from two of the three factors: fatigue, mood-cognition, and musculoskeletal. Methods: A total of 311 male and female GW veterans drawn from across the nation were assessed in a survey-based study approximately 10 years after deployment. Results: A total of 33.8% of the probability-weighted sample met GWI criteria. Multiple symptom profiles were found, with more than half of GWI cases endorsing a symptom on all the three factors, and almost all cases endorsing at least one mood-cognition symptom. Conclusion: Although the Centers for Disease Control and Prevention definition has some limitations that should be considered, it remains a useful tool for assessing the presence of illness in GW veterans.

The 35% carbon dioxide test in stress and panic research: Overview of effects and integration of findings

The carbon dioxide test--a vital capacity breath of air containing 35% carbon dioxide (CO(2))--provokes panic attacks in many individuals with panic disorder (PD). It has thus been extensively used as an experimental model of panic and less frequently as a clinical method of provoking symptoms for interoceptive exposure treatment. Recently, stress researchers have suggested another use for the CO(2) test: that of an acute physiological stressor indexing the human stress response. The purpose of this review is to synthesize findings about the effects of the CO(2) test from both the panic and stress literatures in order to advance understanding about this increasingly popular test. Both panic and stress researchers have examined the fleeting effects of the CO(2) test, finding that the test engenders transient breathlessness, dizziness, and minor anxiety in most participants and panic attacks in those with or at risk for PD. Physiological measurements after the test indicate a brief homeostatic disruption in many bodily systems, including increased respiration, systolic blood pressure, and noradrenaline, and decreased heart rate. Most studies indicate increased cortisol. Possible benefits of integrating findings from the panic and stress research lines, given their common use of the CO(2) test, are discussed.

Sex differences in salivary cortisol reactivity to the Trier Social Stress Test (TSST): A meta-analysis

Some, but not all studies using the Trier Social Stress Test (TSST) have demonstrated evidence in support of sex differences in salivary cortisol. The aim of the current meta-analysis is to examine sex differences in salivary cortisol following exposure to the TSST. We further explored the effects of modifications to the TSST protocol and procedural variations as potential moderators. We searched articles published from January, 1993 to February, 2016 in MedLine, PsychINFO, and ProQuest Theses and Dissertations. This meta-analysis is based on 34 studies, with a total sample size of 1350 individuals (640 women and 710 men). Using a random effects model, we found significant heterogeneity in salivary cortisol output across sexes, such that men were observed to have higher cortisol values at peak and recovery following the TSST compared to women. Modifications to the sampling trajectory of cortisol (i.e., duration of acclimation, peak sampling time, and duration of recovery) significantly moderated the heterogeneity across both sexes. Further, there are observed sex differences at various time points of the reactive cortisol following the TSST. Lastly, current results suggest that these sex differences can be, at least in part, attributed to variations in methodological considerations across studies. Future research could advance this line of inquiry by using other methods of analyses (e.g., area under the curve; AUC), in order to better understand the effects of methodological variations and their implications for research design.

Re-conceptualizing stress: Shifting views on the consequences of stress and its effects on stress reactivity

Background The consequences of stress are typically regarded from a deficit-oriented approach, conceptualizing stress to be entirely negative in its outcomes. This approach is unbalanced, and may further hinder individuals from engaging in adaptive coping. In the current study, we explored whether negative views and beliefs regarding stress interacted with a stress framing manipulation (positive, neutral and negative) on measures of stress reactivity for both psychosocial and physiological stressors. Method Ninety participants were randomized into one of three framing conditions that conceptualized the experience of stress in balanced, unbalanced-negative or unbalanced-positive ways. After watching a video on stress, participants underwent a psychosocial (Trier Social Stress Test), or a physiological (CO2 challenge) method of stress-induction. Subjective and objective markers of stress were assessed. Results Most of the sampled population regarded stress as negative prior to framing. Further, subjective and objective reactivity were greater to the TSST compared to the CO2 challenge. Additionally, significant cubic trends were observed in the interactions of stress framing and stress-induction methodologies on heart rate and blood pressure. Balanced framing conditions in the TSST group had a significantly larger decrease in heart rate and diastolic blood pressure following stress compared to the positive and negative framing conditions. Conclusion Findings confirmed a deficit-orientation of stress within the sampled population. In addition, results highlighted the relative efficacy of the TSST compared to CO2 as a method of stress provocation. Finally, individuals in framing conditions that posited stress outcomes in unbalanced manners responded to stressors less efficiently. This suggests that unbalanced framing of stress may have set forth unrealistic expectations regarding stress that later hindered individuals from adaptive responses to stress. Potential benefits of alternative conceptualizations of stress on stress reactivity are discussed, and suggestions for future research are made.

Assessing accident phobia in mild traumatic brain injury: The Accident Fear Questionnaire.

PURPOSE Despite a documented prevalence of accident phobia in almost 40% of motor vehicle accident (MVA) survivors, the onset of accident phobia after traumatic brain injury (TBI) remains poorly understood. There is currently a body of knowledge about posttraumatic stress disorder (PTSD) in patients with TBI, but less is known about accident phobia following TBI, particularly in cases of mild TBI (mTBI). Accident phobia can impede safe return to driving or motor vehicle travel, inhibiting return to daily functioning. In addition, pain complaints have been found to correlate positively with postinjury anxiety disorders. METHOD The present study sought to determine the reliability and validity of the Accident Fear Questionnaire (AFQ), a measure used to assess accident phobia, in 72 patients with mTBI using secondary data analysis and the subsequent development of accident phobia postinjury. Furthermore, we sought to examine the impact of pain, anxiety, and depression complaints on the AFQ. RESULTS Results reveal convergent validity and reliability in mTBI populations. Additionally, pain, anxiety, and depression measures were significantly correlated with scores on the AFQ. CONCLUSIONS Psychometrically, the phobia avoidance subscale of the AFQ is a reliable measure for use with mTBI populations, although some limitations were found. In particular, the accident profile (AP) subscale was not found to be reliable or valid and could be eliminated from the AFQ. Collectively, the present study contributes to the small body of published literature evaluating accident phobia in patients with mTBI and the impact of pain on the development of postinjury anxiety disorders. (PsycINFO Database Record

Reactivity to 35% carbon dioxide in bulimia nervosa and panic disorder

The inhalation of 35% carbon dioxide (CO₂) induces panic and anxiety in people with panic disorder (PD) and in people with various other psychiatric disorders. The anxiogenic effect of CO₂ in people with eating disorders has received sparse attention despite the fact that PD and bulimia nervosa (BN) have several common psychological and neurobiological features. This study compared CO₂-reactivity across three groups of participants: females with BN, females with PD, and female controls without known risk factors for enhanced CO₂-reactivity (e.g., social anxiety disorder, first degree relatives with PD). Reactivity was measured by self-reported ratings of panic symptomatology and subjective anxiety, analyzed as both continuous variables (change from room-air to CO₂) and dichotomous variables (positive versus negative responses to CO₂). Analyses of each outcome measure demonstrated that CO₂-reactivity was similar across the BN and PD groups, and reactivity within each of these two groups was significantly stronger than that in the control group. This is the first study to demonstrate CO₂-hyperreactivity in individuals with BN, supporting the hypothesis that reactivity to this biological paradigm is not specific to PD. Further research would benefit from examining transdiagnostic mechanisms in CO₂-hyperreactivity, such as anxiety sensitivity, which may account for this studys results.

Multitasking in the classroom: Testing an educational intervention as a method of reducing multitasking:

Increasingly, students engage in multitasking during lecture by shifting their attention between class material and irrelevant information from texts and webpages. It is well established that this divided attention impairs memory and learning. Less is known about how to correct the problem. This study used an educational intervention in the form of a PowerPoint presentation that informed students in the experimental condition about the deleterious effects of multitasking. Students were randomly assigned to the experimental condition, the placebo condition (a slideshow about sleep), or no intervention. Participants self-reported the percentage of the time they multitasked in class and paid attention at two time points, baseline (before the intervention), and in a second lab visit 3 weeks later. The experimental intervention did not reduce student multitasking or increase student attention, relative to the other conditions. Supplementary research questions examined students’ beliefs about multitasking, finding that most thought it decreased their grades. The correlations between grade point average, stress, and boredom proneness, on one hand, and baseline attention and multitasking in class, on the other, were also inspected, revealing that students with higher grade point average pay more attention in class and multitask less. Suggestions for future research to reduce multitasking are made, including having students engage in multitasking to observe the effect on their memory retention.

The effect of pet therapy on the physiological and subjective stress response: A meta-analysis

Studies have reported that exposure to pet therapy (PT) can reduce physiological and subjective stress and anxiety levels. The aim of this meta-analysis is to examine the efficacy of PT as a method for reducing physiological stress levels (blood pressure and heart rate) and subjective stress and anxiety scores (self-reported stress/anxiety). Further, we examined the effects of sample characteristics and modifications to the PT (different age groups and health status of participants across samples, whether a stressor was present, and individual versus group PT) as potential moderators of the relationship between PT and stress reactivity. Our searches incorporated articles published from May 2017 and earlier in PsycINFO, MEDLINE, and PubMed. This meta-analysis included 28 articles with 34 independent samples and contained a total of 1,310 participants. Using a random effects model, we determined that significant differences occurred in heart rate, self-reported anxiety, and self-reported stress after PT exposure compared with before PT. However, we did not detect significant differences in blood pressure after PT. Sample characteristics and modifications to the PT significantly moderated the effect of PT on stress responses. Our results suggest that PT can be an effective program for reducing stress reactivity.