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Sleep Medicine Mar 2019Depression increases during menopause, and subclinical depressive symptoms increase risk for major depression. Insomnia is common among postmenopausal women and... (Comparative Study)
Comparative Study Randomized Controlled Trial
Treating insomnia improves depression, maladaptive thinking, and hyperarousal in postmenopausal women: comparing cognitive-behavioral therapy for insomnia (CBTI), sleep restriction therapy, and sleep hygiene education.
INTRODUCTION
Depression increases during menopause, and subclinical depressive symptoms increase risk for major depression. Insomnia is common among postmenopausal women and increases depression-risk in this already-vulnerable population. Recent evidence supports the efficacy of cognitive-behavioral therapy for insomnia (CBTI) to treat menopausal insomnia, but it remains unclear whether treating insomnia also alleviates co-occurring depressive symptoms and depressogenic features. This trial tested whether CBTI improves depressive symptoms, maladaptive thinking, and somatic hyperarousal in postmenopausal women with insomnia; as well as whether sleep restriction therapy (SRT)-a single component of CBTI-is equally efficacious.
MATERIALS AND METHODS
Single-site, randomized controlled trial. 117 postmenopausal women (56.34 ± 5.41 years) with peri-or-postmenopausal onset of chronic insomnia were randomized to three treatment conditions: sleep hygiene education control (SHE), SRT, and CBTI. Blinded assessments were performed at baseline, posttreatment, and six-month follow-up.
RESULTS
CBTI produced moderate-to-large reductions in depressive symptoms, whereas SRT produced moderate reductions but not until six months posttreatment. Treatment effects on maladaptive thinking were mixed. CBTI and SRT both produced large improvements in dysfunctional beliefs about sleep, but weaker influences on presleep cognitive arousal, rumination, and worry. Presleep somatic arousal greatly improved in the CBTI group and moderately improved in the SRT group. Improvements in depression, maladaptive thinking, and hyperarousal were linked to improved sleep. SHE produced no durable treatment effects.
CONCLUSIONS
CBTI and SRT reduce depressive symptoms, dysfunctional beliefs about sleep, and presleep somatic hyperarousal in postmenopausal women, with CBTI producing superior results. Despite its cognitive emphasis, cognitive arousal did not respond strongly or durably to CBTI. NAME: Behavioral Treatment of Menopausal Insomnia: Sleep and Daytime Outcomes. URL: clinicaltrials.gov.
REGISTRATION
NCT01933295.
Topics: Cognitive Behavioral Therapy; Depression; Female; Follow-Up Studies; Humans; Middle Aged; Patient Education as Topic; Pessimism; Postmenopause; Sleep Arousal Disorders; Sleep Deprivation; Sleep Hygiene; Sleep Initiation and Maintenance Disorders; Treatment Outcome
PubMed: 30785053
DOI: 10.1016/j.sleep.2018.11.019 -
Progress in Cardiovascular Diseases 2023Poor psychological health is associated with Takotsubo cardiomyopathy, cardiac syndrome X, coronary microcirculatory dysfunction, peripheral artery disease, or... (Meta-Analysis)
Meta-Analysis Review
Poor psychological health is associated with Takotsubo cardiomyopathy, cardiac syndrome X, coronary microcirculatory dysfunction, peripheral artery disease, or spontaneous coronary artery dissection. Data regarding pessimism, cardiovascular disease (CVD) events and mortality and all-cause mortality remained inconclusive. This systematic review and meta-analysis aim to provide an overview of the association between pessimism, CVD outcomes and mortality. A systematic search of electronic databases was conducted from inception through July 2022 for studies evaluating pessimism and adverse outcomes. A total of 17 studies published between 1966 and July 2022 met our inclusion criteria, for a total of 232,533 individuals. Pooled hazard ratios were calculated in random-effects meta-analyses. Based on pooled analysis of adjusted HRs, pessimism was associated with adjusted HR of 1.13 (95% CI 1.07-1.19) for all-cause mortality with minimal heterogeneity (I = 28.5%). Based on pooled analysis of adjusted HRs, pessimism was associated with adjusted HR of 1.30 (95% CI 0.43-3.95) for CHD mortality, adjusted HR of 1.41 (95% CI 1.05-1.91) for CVD mortality, and adjusted HR of 1.43 (95% CI 0.64-3.16) for stroke. In conclusion, pessimism seems to be significantly associated with a higher risk for and poorer outcomes from CVD events than optimistic styles. There are genetic and other bases for these life approaches, but behavioral, cognitive and meditative interventions can modify patients' level of pessimism, hopefully leading to better medical outcomes. Testing this theory would yield highly useful and practical data for clinical care.
Topics: Humans; Pessimism; Microcirculation; Cardiovascular Diseases
PubMed: 36462555
DOI: 10.1016/j.pcad.2022.11.018 -
PLoS Computational Biology Jan 2022The replay of task-relevant trajectories is known to contribute to memory consolidation and improved task performance. A wide variety of experimental data show that the...
The replay of task-relevant trajectories is known to contribute to memory consolidation and improved task performance. A wide variety of experimental data show that the content of replayed sequences is highly specific and can be modulated by reward as well as other prominent task variables. However, the rules governing the choice of sequences to be replayed still remain poorly understood. One recent theoretical suggestion is that the prioritization of replay experiences in decision-making problems is based on their effect on the choice of action. We show that this implies that subjects should replay sub-optimal actions that they dysfunctionally choose rather than optimal ones, when, by being forgetful, they experience large amounts of uncertainty in their internal models of the world. We use this to account for recent experimental data demonstrating exactly pessimal replay, fitting model parameters to the individual subjects' choices.
Topics: Computational Biology; Decision Making; Humans; Memory Consolidation; Models, Neurological; Optimism; Pessimism; Uncertainty
PubMed: 35020718
DOI: 10.1371/journal.pcbi.1009634 -
Psychiatria Danubina Sep 2017There is evidence in the literature that adverse early attachment experiences and subsequent attachment insecurities during adulthood would lead to pessimism, low... (Review)
Review
BACKGROUND
There is evidence in the literature that adverse early attachment experiences and subsequent attachment insecurities during adulthood would lead to pessimism, low self-esteem, hopelessness and, ultimately, to suicide risk.
SUBJECTS AND METHODS
This paper aims to review finding on the link between attachment style and suicidality. We searched the literature using the database of the U.S. National Center for Biotechnology Information (NCBI)-MedLine/Pubmed system from January 1992 until December 2016. We started with 1992 because, as far as we know, there are no published studies exploring the relationship between suicide and insecure attachment before that year. We considered reports published on the relationship between attachment style and suicidality. We applied several combinations of the following search terms: attachment, adult attachment style and suicidality, suicide, suicidal ideation, suicidal behavior or suicidal thoughts, and suicide attempts. We selected only English language studies.
RESULTS
Research suggests that insecure attachment style, mostly anxious, and unresolved traumas are associated with an increased suicide risk. Few studies prospectively examined clinical course, comorbid psychiatric disorders, familial suicidality or other psychosocial factors.
CONCLUSIONS
Further research is needed to highlight the nature of the link between attachment and suicidality. The presence of suicidal ideation and attempts might be a consequence of an underlying interaction between the emergence of psychiatrics symptoms, and the long-lasting presence of inadequate patterns of attachment. Within this context, Separation Anxiety Disorder, categorized in the DSM-5 as a condition not confined to childhood but as an anxiety disorder that may occur through the entire lifespan, might be the a key for the comprehension of this link. From a neurobiological point of view, the role of oxytocin remains unclear.
Topics: Adult; Anxiety Disorders; Female; Hope; Humans; Male; Mental Disorders; Object Attachment; Pessimism; Risk Factors; Self Concept; Suicidal Ideation; Suicide; Suicide, Attempted; Suicide Prevention
PubMed: 28949306
DOI: 10.24869/psyd.2017.250 -
Journal of Personality Aug 2022Optimism is linked to varied advantageous outcomes, ranging from improved health to better relationships, while pessimism is linked to reduced well-being. Relatively...
OBJECTIVES
Optimism is linked to varied advantageous outcomes, ranging from improved health to better relationships, while pessimism is linked to reduced well-being. Relatively little is known about how optimism and pessimism may work together to shape the perception of support within marital relationships, and whether perceived support can affect couple-members' optimism and pessimism.
METHOD
We used three waves of a nationally representative sample of older couples (N = 1681 couples), spanning a period of eight years. Partners reported perceived support, optimism, and pessimism in each wave. We used a random-intercept cross-lagged panel model (RI-CLPM) to test within- and between-person effects.
RESULTS
At the within-person level, husbands', but not wife's, future expectations were associated with partners' perceived marital support; increases in husbands' pessimism on a given wave were related to decreases in husbands' perceived marital support at the next wave, and vice versa (i.e., actor effect). Within the same wave, increases in husbands' pessimism were associated with wives' decreased perceived marital support. At the between-person level, both partners' optimism and pessimism were associated with marital support.
DISCUSSION
Findings suggest that changes in husbands' levels of pessimism propel marital support experiences of both partners. At the methodological level, results highlight the importance of examining interpersonal processes at both the within- and between-levels of analyses, as they may yield divergent patterns.
Topics: Aged; Humans; Longitudinal Studies; Marriage; Optimism; Pessimism; Spouses
PubMed: 34773263
DOI: 10.1111/jopy.12688 -
Journal of Population Therapeutics and... 2022The aim of this research is to prepare a healthy psychological course and study its impact on the levels of serum uric acid (SUA) and pessimism and depression. The...
The aim of this research is to prepare a healthy psychological course and study its impact on the levels of serum uric acid (SUA) and pessimism and depression. The research sample was limited to teaching staff of the Iraqi State Universities in Baghdad, who were retired at 63-65 years of age. Data were collected by independent group experimental approach via pre- and posttest measurements. The study sample consisted of 21 people with cases of pessimism and depression. The sample was randomly chosen based on their consent to do pre- and posttests and to be subjected to healthy psychological approach. After collecting the data obtained from the samples and processing them statistically, the results showed that the healthy psychological course had a positive effect on the levels of SUA, pessimism, and depression of the research sample.
Topics: Health Status; Humans; Uric Acid
PubMed: 35044115
DOI: 10.47750/jptcp.2022.855 -
Journal of Pediatric Psychology Jun 2024High levels of optimism (and low levels of pessimism) are associated with improved physical health in adults. However, relatively less is known about these relations in...
OBJECTIVE
High levels of optimism (and low levels of pessimism) are associated with improved physical health in adults. However, relatively less is known about these relations in youth. The present study aimed to review the literature investigating optimism, pessimism, and physical health in children and adolescents from populations with and without health conditions.
METHODS
We conducted a scoping review up until February 2024. Studies were included if they sampled youth (average age ≤18 years) and treated optimism or pessimism as predictors of health behaviors or outcomes. Data on study and sample characteristics, health outcome, optimism construct, and findings were extracted from eligible papers and results were synthesized.
RESULTS
Sixty studies were retained. Most studies were conducted in North America, with adolescents, and used cross-sectional designs and self-reported measures of health. Measures of optimism and pessimism differed across studies. Roughly one-third of studies sampled medical populations. Health categories included substance use, diet and physical activity, sexual health practices, medical adherence, other health behaviors, cardiometabolic health, subjective health/health-related quality of life, pain, sleep, and oral health. Generally, we observed adaptive associations between optimism and health. Higher optimism and lower pessimism were most consistently associated with lower rates of substance use and lower cardiometabolic risk.
CONCLUSIONS
The presence of optimism or the absence of pessimism appears to be associated with various adaptive health outcomes among youth with and without health conditions. Developmental, methodological, and clinical considerations for future research are discussed, such as conducting longitudinal studies with objective measures of health and psychometrically validated instruments.
PubMed: 38879445
DOI: 10.1093/jpepsy/jsae045 -
Academic Psychiatry : the Journal of... Dec 2018
Topics: Humans; Mental Disorders; Pessimism; Poetry as Topic; Professional-Patient Relations
PubMed: 30291618
DOI: 10.1007/s40596-018-0991-6 -
Neuroscience and Biobehavioral Reviews Nov 2021Humans express stable differences in pessimism that render some individuals more vulnerable to stressors and mood disorders. We explored whether non-human animals... (Review)
Review
Humans express stable differences in pessimism that render some individuals more vulnerable to stressors and mood disorders. We explored whether non-human animals express stable individual differences in expectations (assessed via judgment bias tests) and whether these differences relate to susceptibility to stressors. Judgment bias tests do not distinguish pessimism from sensitivity to reinforcers; negative expectations are likely driven by a combination of these two elements. The available evidence suggests that animals express stable individual differences in expectations such that some persistently perceive ambiguous situations in a more negative way. A lack of research prevents drawing firm conclusions on how negative expectations affect responses to stressors, but current evidence suggests a link between negative expectations and the adoption of avoidance coping strategies, stronger responses to uncontrollable stressors and risk of mood-related disorders. We explore implications for animals living in captivity and for research using animals as models for human disorders.
Topics: Animals; Behavior, Animal; Bias; Judgment; Motivation; Pessimism
PubMed: 34454913
DOI: 10.1016/j.neubiorev.2021.08.025 -
Hormones and Behavior Mar 2024The cumulative negative effects of prolonged Hypothalamic-Pituitary-Adrenal axis (HPA axis) activation are associated with several age-related diseases. Some...
The cumulative negative effects of prolonged Hypothalamic-Pituitary-Adrenal axis (HPA axis) activation are associated with several age-related diseases. Some psychological traits such as optimism and pessimism have been shown to be related to both health and the stress response, although their relationship with the HPA axis is inconclusive. More stable HPA axis biomarkers, such as hair samples of cortisol (HC) and dehydroepiandrosterone (HDHEA), would help to clarify the association between these psychological traits and HPA axis functioning. The main aim of this study was to test the relationships between optimism and pessimism and chronic stress biomarkers measured in hair (HC and HDHEA). Additionally, a secondary objective was to explore sex differences in HC and HDHEA levels and their relationship with these psychological traits. We measured optimism, pessimism, and their combination (dispositional optimism) using the Life Orientation Test Revised (LOT-R) and chronic stress biomarkers (HC and HDHEA) in 119 healthy participants (46 men and 73 women) between 56 and 81 years old who belonged to a university program. Regression analyses controlling for perceived stress and BMI indicated that higher dispositional optimism was related to lower HC and HC:HDHEA (β = -0.256, p = .008 and β = -0.300, p = .002, respectively). More specifically, higher pessimism was related to higher HC (β = 0.235; p = .012) and HC:HDHEA (β = 0.240; p = .011), whereas higher optimism was associated with a lower HC:HDHEA(β = -0.205; p = .031). Moderation analyses showed no sex differences. To date, this is the first study to investigate the link between these traits and HC and HDHEA in older people. Our results confirm that positive and negative expectations about the future (i.e. optimism and pessimism) may play an important role in health due to their relationship with the HPA axis. They also strengthen the idea that the negative effects of pessimism have a greater weight than the protective effects of optimism in their relationship with HPA axis regulation.
Topics: Humans; Male; Female; Aged; Middle Aged; Aged, 80 and over; Hydrocortisone; Pessimism; Hypothalamo-Hypophyseal System; Pituitary-Adrenal System; Biomarkers; Hair; Dehydroepiandrosterone
PubMed: 38194858
DOI: 10.1016/j.yhbeh.2023.105474