Can Mindfulness-Based Training Reduce Stress and Burnout in Surgeons?

Posted on May 27, 2019 by Marie Benz MD FAAD

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MedicalResearch.com Interview with:

Carter Lebares, MDAssistant Professor of SurgeryDirector, Center for Mindfulness in SurgeryDepartment of Surgery, UCSF

Dr. Lebares

Carter Lebares, MD
Assistant Professor of Surgery
Director, Center for Mindfulness in Surgery
Department of Surgery, UCSF

MedicalResearch.com: What is the background for this study?

Response: This study was inspired by extensive evidence of the effectiveness of mindfulness-based interventions (MBIs) for mitigating stress and enhancing performance in other high-stress populations like police and the military. We know that overwhelming stress is related to burnout and to cognitive errors – two critical issues within surgery, today. This prompted us to tailor and streamline an MBI specifically for surgeons, and to test it in our trainees.

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Is It Always Your Fault? Taking Too Much Responsibility Can Lead to OCD

Posted on April 26, 2019 by Marie Benz MD FAAD

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MedicalResearch.com Interview with:
Yoshinori SUGIURA Ph.D.
Associate Professor
Hiroshima University
Graduate School of Integrated Arts and Sciences
Behavioural Sciences Section
Higashi-Hiroshima, Japan

MedicalResearch.com: What is the background for this study?

Response: Lengthy worrying or repeated checking if the door is locked are common manifestations of anxiety in the general population. However, if their frequency, intensity, and interference become too much, they are diagnosed as Generalized Anxiety Disorder (GAD) and Obsessive Compulsive Disorder (OCD) respectively.

People with OCD are tortured by repeatedly occurring negative thinking and they take some strategy to prevent i. GAD is a very pervasive type of anxiety. GAD patients worry about everything.

Despite their burden, both are relatively difficult to treat. Furthermore complicated, as they are two different disorders, mental health professionals have to master separate strategies. To overcome such situation, transdiagnostic research, which seeks common causes for different disorders, is now eagerly pursued by psychologists/psychiatrists. As one of such endeavors, we predicted that inflated responsibility is the common predictor of both OCD and GAD symptoms.

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Stress from Traumatic Events Linked to Increased Risk of Heart Disease

Posted on April 11, 2019 by Marie Benz MD FAAD

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MedicalResearch.com Interview with:

Huan Song Associated Department of Medical Epidemiology and Biostatistics Karolinska Institutet

Huan Song

Huan Song, PhD
Center of Public Health Sciences, Faculty of Medicine,
University of Iceland, Reykjavík, Iceland
Department of Medical Epidemiology and Biostatistics
Karolinska Institutet, Stockholm, Sweden

MedicalResearch.com: What is the background for this study?

Response: Cardiovascular disease (CVD) presents a group of diseases that are common and sometimes fatal in general population. The possible role of stress-related disorders in the development of CVD has been reported. However, the main body of the preceding evidence was derived from male samples (veterans or active-duty military personnel) focusing mainly on posttraumatic stress disorder (PTSD) or self-reported PTSD symptoms. Data on the role of stress-related disorders in CVD in women were, until now, limited. Although incomplete control for familial factors and co-occurring psychiatric disorder, as well as the sample size restriction, limit the solid inference on this association, especially for subtypes of CVD.

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Disaster-Related Media Exposure Can Heighten Post-Storm Stress

Posted on January 6, 2019 by Marie Benz MD FAAD

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MedicalResearch.com Interview with:

Rebecca R. Thompson, Ph.D. Postdoctoral Scholar Department of Psychological Science University of California, Irvine

Dr. Thompson

Rebecca R. Thompson, Ph.D.
Postdoctoral Scholar
Department of Psychological Science
University of California, Irvine

MedicalResearch.com: What is the background for this study?

Response: Our research team has been interested in how people respond to the repeated threat of disaster exposure for many years. We recently published a review of the literature on evacuation from natural disasters, and one of our main findings was that there have been no studies that include assessments of individuals’ intentions, perceptions, and psychological states assessed prior to an approaching storm’s landfall – all prior research has been retrospective, and recall is undoubtedly biased and unreliable. Our goal in undertaking this study was to fill this hole in the literature. We sought to assess individuals’ responses to Hurricane Irma in the days leading up to and immediately after its landfall in the State of Florida.

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Heart Attacks Spike During Holiday Season – How Can You Minimize Your Risk?

Posted on December 5, 2018 by Marie Benz MD FAAD

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MedicalResearch.com Interview with:

Dr. Lowell H. Steen, Jr., M.D. Interventional Cardiologist Loyola University Medical Center

Dr. Steen

Dr. Lowell H. Steen, Jr., M.D.
Interventional Cardiologist
Loyola University Medical Center

Dr. Steen discusses how holiday treats & stress can increase the risk of heart attack.

MedicalResearch.com: What are the main factors that are linked to an increase in heart related adverse events during the Christmas holiday season? Who is most at risk?

Response: The increase in holiday season heart-related hospitalizations and deaths are due to a variety of behaviors such as putting off seeking medical help until after the holidays, overeating rich foods, strenuous travel, excessive alcohol consumption and stressful family interactions. These factors can all trigger heart issues.

Factors such as age, diabetes, high cholesterol and smoking all increase heart risk. Additionally, those with high blood pressure, which is a leading risk factor for heart disease and stroke, are exceptionally at risk and should celebrate the hectic holiday season with caution. Continue reading →

Stress at Night May Be More Stressful

Posted on November 28, 2018 by Marie Benz MD FAAD

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MedicalResearch.com Interview with:

Yujiro Yamanaka, Ph.D. Associate Professor Hokkaido University Graduate School of Education Sapporo, Japan

Dr. Yamanaka

Yujiro Yamanaka, Ph.D.
Associate Professor Hokkaido University
Graduate School of Education
Sapporo, Japan

MedicalResearch.com: What is the background for this study?

Response: My laboratory has focused on the human circadian rhythms in particularly investigating the time of day effect of non-photic cues especially physical exercise and psychological stressor on circadian rhythms.

In mammals including humans, the central circadian pacemaker is located in the suprachiasmatic nucleus (SCN) in the brain hypothalamus. The SCN entrains to an external light-dark cycle and generates endogenous 24 h rhythmicity in body function. The hypothalamic-pituitary-adrenal (HPA) axis is our major stress response system. We can assess the response of HPA axis to psychological stress event by measuring the level of glucocorticoid hormone, cortisol in saliva. The cortisol shows clear circadian rhythm with higher levels in the morning and lower levels in the evening. This rhythm is generated by the SCN circadian pacemaker.

Previous study (Kudielka et al. Psychoneuroendocrinology 2004) could demonstrate that the cortisol stress level is significantly elevated by acute psychological stress event in the morning (9 a.m. to 10 a.m.) and afternoon (3 p.m. to 4 p.m.). However, there are no study examining the effect of evening psychological stress event on the HPA axis activity. Thus, our new study focused on examining whether the HPA axis differentially responses to morning and evening stress event in healthy subjects.

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Breastfeeding May Alter Gene That Influences How Children Deal With Stress

Posted on September 28, 2018 by Marie Benz MD FAAD

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MedicalResearch.com Interview with:

Barry M. Lester, PhD Center for the Study of Children at Risk Warren Alpert Medical School, Brown University Women and Infants Hospital of Rhode Island Providence, Rhode Island;

Dr. Lester

Barry M. Lester, PhD
Center for the Study of Children at Risk
Warren Alpert Medical School, Brown University
Women and Infants Hospital of Rhode Island
Providence, Rhode Island;

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: We know from rodent studies that maternal care or nurturing behavior can change the rat pups physiologic response to stress. More nurturing behavior makes it easier for rat pups to relax after stress. Not only that, these changes are permanent, they last into adulthood and there is evidence that these changes can be passed on to the next generation. With animal studies you can unlock the mechanism for this in ways that you can’t do with humans and we know from the rodent studies that the mechanism for these changes has to do with changes in gene activity.

Nurturing behavior controls a specific gene that regulates the infant’s physiological response to stress. In other words, we are looking at maternal behavioral programming of a gene that can make, in our case, a human infant less physiologically reactive to stress.

The physiological reactivity to stress that we studied was the production of the stress hormone cortisol. Cortisol is part of the body’s flight or fight reaction, the body’s major response to stress and too much or too little cortisol can be harmful and is related to a wide range of mental and physical health disorders in children and adults. The concerns about separating immigrant children from their parents that we read about every day in the paper are based on this same physiological system, where brain structures that control cortisol production are damaged by the stress of separation.

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Stress-Induced Cortisol During Pregnancy Linked to Smaller Male Babies

Posted on September 23, 2018 by Marie Benz MD FAAD

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MedicalResearch.com Interview with:

Julie Flom, MD MPH Clinical Fellow Division of Allergy & Immunology Icahn School of Medicine at Mount Sinai

Dr. Flom

Julie Flom, MD MPH
Clinical Fellow
Division of Allergy & Immunology
Icahn School of Medicine at Mount Sinai

MedicalResearch.com: What is the background for this study?

Response: Women who are minorities and of lower socioeconomic have particularly high rates of exposure to chronic ongoing adversity such as poverty as well as traumatic stressors in their lifetime and are also more likely to have low birthweight infants. Not all women exposed to chronic adversity or trauma transfer this risk to the next generation – it is primarily when the trauma results in changes in her bodies’ ability to handle ongoing stress that the developing child can be impacted.

Our group undertook a study to investigate whether women with increased exposure to traumatic stressors over her lifetime were at higher risk of having low birthweight infants and also whether effects of trauma would only be evident among women who produced higher levels of cortisol, the major stress response hormone, while pregnant.

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Stress Disorders Linked to Increase Risk of Autoimmune Disease

Posted on June 21, 2018 by Marie Benz MD FAAD

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MedicalResearch.com Interview with:

Huan Song Associated Department of Medical Epidemiology and Biostatistics Karolinska Institutet

Huan Song

Huan Song
Associated
Department of Medical Epidemiology and Biostatistics
Karolinska Institutet

MedicalResearch.com: What is the background for this study?

Response: Earlier findings from our group (e.g. Fang et al., NEJM 2012; Arnberg et al., Lancet Psychiatry 2015; Lu et al., JAMA Oncol 2016; Shen et al., BMJ 2016; Zhu et al., Ann Oncol 2017) have identified pathways through which stressful events contribute to deterioration in human health. With strong animal models and human data supporting a role of stress in immune dysregulation, the hypothesis linking mental distress with autoimmune is indeed plausible. However, the evidence is as yet limited to clinical observations and a few larger observational studies on US veterans, most of them on men only, and some of which have cross-sectional designs and various other methodological shortcomings.

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Town vs Gown – Why Are City Kids More Stressed?

Posted on May 2, 2018 by Marie Benz MD FAAD

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MedicalResearch.com Interview with:
Prof. Dr. rer. nat. Stefan O. Reber
Laboratory for Molecular Psychosomatics
Clinic for Psychosomatic Medicine and Psychotherapy
University Clinic Ulm
Ulm, Germany

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Our hypothesis was that people who grew up in cities with more than 100.000 inhabitants and without pets will show a more pronounced immune activation towards psychosocial stressors compared with people raised in rural areas in the presence of farm animals. This hypothesis is based on the fact that stress-associated psychiatric disorders, which are linked to or even promoted by an over(re)active immune system and chronic low grade inflammation, are more prevalent in urban compared with rural areas. One possible explanation for a hyper(re)active immune system in people raised in urban relative to rural environments might be a reduced contact to immunoregulatory microorganisms (the so called “old friends”), which is significantly increased in rural people with regular contact with farm animals compared with urban people in the absence of pets.

Our results show that a standardized laboratory psychosocial stressor causes a greater inflammatory response in young healthy participants with an urban upbringing in the absence of pets, relative to young healthy participants with a rural upbringing in the presence of farm animals. Continue reading →

More Heart Attacks In Younger Men Following Canadian Hockey Games

Posted on March 30, 2018 by Marie Benz MD FAAD

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MedicalResearch.com Interview with:

Hung Q. Ly, M.D., S.M., FRCPC
President, Canadian Association of Interventional Cardiology
Program Director, Adult Cardiology Postgraduate Training Program
Associate Professor of Clinical Medicine
Interventional Cardiology Division,
Dept. of Medicine, Montreal Heart Institute, Montréal, Québec, Canada

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Prior scientific reports have discussed the association between major sporting events and cardiovascular events, irrespective of the sport.

Ours is the first to report an increase in hospital admission rates for heart attacks in men younger than 55yo in the day following a hockey game.

MedicalResearch.com: What should readers take away from your report?

Response: Emotional stress and lifestyle habits/behavioural patterns surrounding the spectatorship of hockey (i.e. drinking, unhealthy eating patterns, etc.) might make some Hockey (sports) fans more susceptible to heart attacks. We report a statistically significant increase in the incidence of heart attacks in young men watching the sport. This was an association that we manage to document but not an actual causal relationship.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: (1) Ascertain causality: Document that the “watching/attending a hockey game” was indeed an activity that the patient presenting with a heart attack did indeed do; (2) randomize sports fan to lifestyle changes and/or stress management strategies to explore if there is a decrease in cardiovascular events around the time of a sporting event.

MedicalResearch.com: Is there anything else you would like to add?

Response: (1) I am a hardcore, diehard (no pun intended) Montreal Canadiens fan, which motivated me to perform this analysis; (2) We accounted for the effect of harsh winter conditions as a potential confounder of the increase in hospital rate admission for heart attacks; (3) we were quite surprised that victory, instead of defeat, lead to an increase in events; (4) I have to conflict of interest to declare.

Citations:

Caroline E. Gebhard, Catherine Gebhard, Foued Maafi, Marie-Jeanne Bertrand, Barbara E. Stähli, Karin Wildi, Zurine Galvan, Aurel Toma, Zheng W. Zhang, David Smith, Hung Q. Ly. Hockey Games and the Incidence of ST-Elevation Myocardial Infarction. Canadian Journal of Cardiology, 2018; DOI: 10.1016/j.cjca.2017.12.028

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Chronic Cannabis Users Have Blunted Response To Stress

Posted on July 31, 2017 by Marie Benz MD FAAD

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MedicalResearch.com Interview with:

Carrie Cuttler, Ph.D. Clinical Assistant Professor Washington State University Department of Psychology Pullman, WA, 99164-4820

Dr. Cuttler

Carrie Cuttler, Ph.D.
Clinical Assistant Professor
Washington State University
Department of Psychology
Pullman, WA, 99164-4820

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: One of the most common reasons cannabis users report using cannabis is to cope with stress. In support of this, previous research has shown that acute administration of THC or cannabis dampens affective responses and subjective stress ratings. This has made strains of cannabis popular for use for stress and other ailments with some online outlets, like high thc having reviews such as the og kush strain review to perpective users. However, our study is the first to compare the stress response of sober cannabis users to non-users. More specifically, we randomly assigned 42 non-cannabis users and 40 cannabis users (who abstained from using cannabis for at least 12 hours prior to the study) to either a stress or no stress condition. Participants in the stress condition were required to perform multiple trials of placing their hand in ice water and counting backwards from 2043 by 17s. Each time they made an error they were given negative feedback and told to start again. Further, they were being video recorded and their image was displayed in front of them. Participants who were assigned to the no stress condition were simply required to perform multiple trials of placing their hand in lukewarm water and counting from 1 to 25. They were not given feedback or recorded. Participants were asked to rate their level of stress and to provide a saliva sample, from which the stress hormone cortisol was measured.

The results showed that, as expected, non-users in the stress condition had higher cortisol levels and higher self-reported stress than non-users in the no stress condition. In contrast, cannabis users in the stress condition demonstrated the same levels of cortisol as cannabis users in the no stress condition and their increase in self-reported stress was smaller than that of the non-users.

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Stress of 911 Linked To Decrease In Male Babies Born With Birth Defects

Posted on July 21, 2017 by Marie Benz MD FAAD

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MedicalResearch.com Interview with:
Parvati Singh B. Tech, MBA, MPA
PhD student, Department of Public Health,
University of California, Irvine and
Dr. Tim Bruckner, first author

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: This study builds upon earlier research by our group which showed that male fetal deaths rose and the number of liveborn males fell after the 9/11 attacks. Here we show that, in California, the number of live born males with birth defects fell after 9/11.

This finding appears consistent with the notion that frail male gestations, such as those with defects, may have been lost in utero as a result of the stress induced by the 9/11 attacks.

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Does Stress Raise Risk of Atrial Fibrillation?

Posted on March 15, 2017 by Marie Benz MD FAAD

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MedicalResearch.com Interview with:

Simon Graff MD Department of Public Health Research Unit for General Practice Aarhus University Aarhus C, Denmark

Dr. Simon Graff

Simon Graff MD
Department of Public Health
Research Unit for General Practice
Aarhus University
Aarhus C, Denmark

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The presented study is a continuation of our interest in the role of stress and the possible causes of atrial fibrillation. We published a study that showed that spousal bereavement were followed by a transiently increased risk of new onset of atrial fibrillation. With spousal bereavement being one of the most stressful life-event, we wanted to know whether minor and differentiated stress exposures had an effect as well. Therefore we used register based data on perceived stress as a new measure of exposure.

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PET Scanning Highlights Link Between Stress and Heart Disease

Posted on January 12, 2017 by Marie Benz MD FAAD

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MedicalResearch.com Interview with:

Dr Ahmed Tawakol MD Massachusetts General Hospital and Harvard Medical Schoo

Dr Ahmed Tawakol

Dr Ahmed Tawakol MD
Co-Director, Cardiac MR PET CT Program
Massachusetts General Hospital and
Harvard Medical School

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: While the link between stress and heart disease has long been established, the mechanism mediating that risk hasn’t been clearly understood. Animal studies showed that stress activates bone marrow to produce white blood cells, leading to arterial inflammation. This study suggests an analogous path exists in humans. Moreover, this study identifies, for the first time in animal models or humans, the region of the brain (the amygdala) that links stress to the risk of heart attack and stroke.

The paper reports on two complementary studies.

The first analyzed imaging and medical records data from almost 300 individuals who had PET/CT brain imaging, primarily for cancer screening, using a radiopharmaceutical called FDG that both measures the activity of areas within the brain and reflects inflammation within arteries. All participants in that study had no active cancer or cardiovascular disease at the time of imaging and each had information in their medical records on at least three additional clinical visits after imaging.

The second study enrolled 13 individuals with a history of post-traumatic stress disorder, who were evaluated for their current levels of perceived stress and received FDG-PET scanning to measure both amygdala activity and arterial inflammation.

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Stress May Aggravate GI Symptoms in Autism Spectrum Disorder

Posted on January 5, 2017 by Marie Benz MD FAAD

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MedicalResearch.com Interview with:

David Q. Beversdor MD Center for Translational Neuroscience University Hospital University of Missouri Health System Columbia, MO 65212

Dr. David Beversdor

David Q. Beversdor MD
Center for Translational Neuroscience
University Hospital
University of Missouri Health System
Columbia, MO 65212

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Altered stress reactivity, alterations in cytokines and a high incidence of gastrointestinal disturbances have all been observed in autism spectrum disorder (ASD). We wished to examine the interactions between these factors.

What we found was that patients with greater stress reactivity, as indicated by cortisol response in the testing environment, had greater symptomatology involving the lower gastrointestinal tract, which was predominated by constipation.

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Can Probiotics in Yogurt Protect Against Stress and Anxiety?

Posted on December 2, 2016 by Marie Benz MD FAAD

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MedicalResearch.com Interview with:

Elizabeth Bryda, PhD Professor, Director, Rat Resource and Research Center Veterinary Pathobiology University of Missouri Columbia, Missouri

Dr. Elizabeth Bryda

Elizabeth Bryda, PhD
Professor, Director, Rat Resource and Research Center
Veterinary Pathobiology
University of Missouri
Columbia, Missouri

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: A number of groups have demonstrated the ability of probiotics to benefit digestive health and there is a growing body of evidence to suggest an association between mental health and “gut health”. We were interested to see if probiotic bacteria could decrease anxiety- or stress-related behavior in a controlled setting using zebrafish as our model organism of choice for these studies.

We were able to show that Lactobacillus plantarum decreased overall anxiety-related behavior and protected against stress-induced dysbiosis (microbial imbalance). The fact that administration of probiotic bacteria also protected other resident gut bacteria from the dramatic changes seen in “stressed” fish not receiving the probiotic was unexpected and suggested that these bacteria may be working at the level of the GI tract and the central nervous system.

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Neighborhood Violence Associated With Biological Stress in Children

Posted on November 15, 2016 by Marie Benz MD FAAD

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MedicalResearch.com Interview with:

Katherine P. Theall, PhD Associate Professor Global Community Health and Behavioral Services Tulane University School of Public Health and Tropical Medicine New Orleans, Louisiana

Dr. Katherine P. Theall

Katherine P. Theall, PhD
Associate Professor
Global Community Health and Behavioral Services
Tulane University School of Public Health and Tropical Medicine
New Orleans, Louisiana

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: There are stark health disparities in the U.S. by socioeconomic position as well as between racial and ethnic groups. Many of these health disparities may have a root cause in childhood and be driven by social risk factors. The authors report each neighborhood stressor was associated with biological stress as measured by shortened telomere length and cortisol functioning. Many children are exposed to violence and a greater understanding of the effect on children’s health is critical because social environmental conditions likely contribute to health disparities. Socioeconomically disadvantaged communities have a higher exposure to violence. Limitations of the study include its lack of applicability to other demographic groups. The study also cannot establish causality.

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Childhood Stress Raises Risk of Adult Heart Disease

Posted on October 18, 2015 by Marie Benz MD FAAD

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Ashley Winning, ScD, MPH Postdoctoral Research Fellow Department of Social and Behavioral Sciences Harvard T.H. Chan School of Public Health

Dr. Ashley Winning

MedicalResearch.com Interview with:
Ashley Winning, ScD, MPH
Postdoctoral Research Fellow
Department of Social and Behavioral Sciences
Harvard T.H. Chan
School of Public Health

Medical Research: What is the background for this study?

Dr. Winning: Several studies have found associations between psychological distress and heart disease and diabetes; however, much of the research has measured distress and disease risk in adulthood and we can’t tell how long people have been distressed or how far-reaching the effects of distress are. Some work has shown that childhood distress is associated with adult health, indicating that distress may start to affect health even earlier in life than we thought. However most of the research has measured distress at a single point in time so we have not been able to answer questions regarding effects of persistent distress or if effects on health are less bad if people become less distressed over time.

Medical Research: What are the main findings?

Dr. Winning: Distress at any period in the life course was associated with increased cardiovascular and metabolic disease risk in adulthood (age 45). Not surprisingly, those with high levels of distress in both childhood and adulthood had the greatest cardiometabolic risk. The most striking finding is that high levels of childhood distress (measured in childhood) predicted heightened adult disease risk, even when there was no evidence that these high levels of distress persisted into adulthood.

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Reducing Stress Decreases Health Care Utilization

Posted on October 14, 2015 by Marie Benz MD FAAD

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James E. Stahl, MD Senior Scientist Assistant Professor of Medicine, Harvard Medical School MGH Institute for Technology Assessment

Dr. James E. Stahl

MedicalResearch.com Interview with:
James E. Stahl, MD
Senior Scientist
Assistant Professor of Medicine,
Harvard Medical School
MGH Institute for Technology Assessment

Medical Research: What is the background for this study? What are the main findings?

Dr. Stahl: Poor psychological and physical resilience in response to stress drives a great deal of health care utilization. Mind-body interventions can reduce stress and build resiliency. Over the last few decades we have seen substantial evidence that evoking the relaxation response helps the heart, blood pressure, reduces inflammation and creates changes all the way down to the epigenetic level. We have not until now had a broad look at the effect at the health systems level. The rationale for this study is therefore to estimate the effect of mind-body interventions on healthcare utilization.

The main findings are that looking at a broad population these tools, and specifically the relaxation response and resiliency training offered at the BHI, results in real world reductions in health care utilization.

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Neuroblastoma Risk May Be Increased by Stress During Pregnancy

Posted on April 27, 2015 by Marie Benz MD FAAD

MedicalResearch.com Interview with:
Joanna Kitlinska, PhD
Assistant Professor
Georgetown University Medical Center
Department of Biochemistry and Molecular & Cellular Biology
Washington, DC 20057

MedicalResearch: What is the background for this study? What are the main findings?

Dr. Kitlinska: Neuroblastoma is a pediatric tumor which arises due to defects in normal fetal neuronal development. Although the disease is associated with genetic changes, there are also clinical and experimental data implicating non-genetic factors in its etiology. We hypothesized that maternal stress during pregnancy can be one such factor, as it leads to fetal hypoxia and elevated cortisol levels – the two factors known to alter normal neuronal development and increase aggressiveness of neuroblastoma. Indeed, using an animal model of neuroblastoma, we have found that offspring of mothers which have been subjected to stress during pregnancy develop tumors twice as frequently as those from intact pregnancies. Moreover, tumors developing in prenatally-stressed mice were spreading more often to distant organs.

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Stress Management Reduces Depression In Breast Cancer

Posted on March 23, 2015 by Marie Benz MD FAAD

MedicalResearch.com Interview with:
Michael H. Antoni, Ph.D.
Professor of Psychology and Psychiatry and Behavioral Sciences
Director, Center for Psycho-oncology Research
Program co-Leader, Cancer Prevention Control and Survivorship
Sylvester Cancer Center Sylvester Professor, Director Miami CTSI Pilot and Translational Studies Component University of Miami

Medical Research: What is the background for this study? What are the main findings?

Dr. Antoni: We have been conducting stress management intervention trials with breast cancer patients for the past two decades. We have shown that the form of stress management we developed, a 10-week cognitive behavioral stress management (CBSM) intervention, combining relaxation techniques, cognitive behavioral therapy techniques and coping and interpersonal skills training (assertiveness and anger management) delivered in a supportive group, can improve how women adapt during breast cancer treatment and up to one year later. These improvements in psychological status (less depressive symptoms, less negative mood and more positive mood) are associated with reductions in circulating serum cortisol levels, improved immune function and decreased inflammatory signaling over the first year of treatment. Since depressive symptoms are prevalent during cancer treatment our prior work showing that cognitive behavioral stress management reduces depressive symptoms over the 1st yr of treatment is significant . Since persisting depressive symptoms into survivorship are also common these new findings that women receiving cognitive behavioral stress management during primary treatment show beneficial effects out to 15 yrs suggests a real impact on their quality of life well into survivorship.
Further, since data just released this week at the American Psychosomatic Society meeting in Savannah, GA shows that depressive symptoms during breast cancer treatment predict greater odds of mortality over the next 8-15 yrs it is plausible that these cognitive behavioral stress management effects on reduced long-term depressive symptoms may have implications for survival. Finally since depressive symptoms relate to greater signs of inflammation in breast cancer patients and because inflammation promotes cancer disease progression via effects on angiogenesis, invasion and metastasis, then managing depressive symptoms during and after active treatment for breast cancer could have effects on health outcomes via lower inflammation.

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Majority of Women Experience Stressful Life Events In Year Before Giving Birth

Posted on March 13, 2015 by Marie Benz MD FAAD

MedicalResearch.com Interview with:
Elizabeth Burns, MPH
Rollins School of Public Health
Emory University

MedicalResearch: What is the background for this study? What are the main findings?

Response: Epidemiologic studies suggest that prenatal stress is associated with preterm birth, low birth weight and peripartum anxiety and depressive symptoms. The most recent population-based study on the prevalence of stress among pregnant women, which used data from 1990-1995, reported that 64% of women experience stressful life events (SLEs) in the year before their infant’s birth. More recent estimates of prevalence and trends of prenatal stressful life events are useful for clinicians in order to understand the risk profile of their patients.

The Pregnancy Risk Assessment Monitoring System (PRAMS) collects self-reported information on maternal experiences and behaviors before, during, and after pregnancy among women who delivered a live infant. PRAMS includes 13 questions about maternal SLEs experienced in the year preceding the birth of the child. Based on previous research, SLEs were grouped into four dichotomous constructs:

1) emotional stressors (family member was ill and hospitalized or someone very close died);
2) financial stressors (moved to a new address, lost job, partner lost job, or unable to pay bills);
3) partner-associated stressors (separated/divorced, argued more than usual with partner/husband, or husband/partner said he did not want pregnancy); and
4) traumatic stressors (homeless, involved in a physical fight, partner or self-went to jail, or someone very close had a problem with drinking or drugs).

The prevalence of self-reported stressful life events decreased modestly but significantly during 2000–2010. Despite this, 70.2% of women reported ≥1 SLEs in 2010. Prevalence of stressful life events vary by state and maternal demographic characteristics and are especially prevalent among younger women, women with ≤12 years of education (75.6%), unmarried women (79.6%), and women that were covered by Medicaid for prenatal care or delivery of their child (78.7%).

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Stress Reduces Cardiovascular Benefits of Exercise in Adolescence

Posted on March 5, 2015 by Marie Benz MD FAAD

MedicalResearch.com Interview with:
Prof. Scott Montgomery
Prof. Montgomery is a clinical epidemiologist, conducting research in life-course influences on chronic disease risk
Örebro Univeristy

Medical Research: What is the background for this study? What are the main findings?

Prof. Montgomery: Stress is thought to increase the risk of heart disease. However, an experience that is stressful for one person may not be so for another, as stress resilience varies. As we believe that stress resilience is influenced by childhood experiences, we examined whether teenagers with low stress resilience were more likely to have coronary heart disease in subsequent adulthood (they were followed to a maximum age of 58 years). In this study of 237,980 men, we found that low stress resilience in adolescence was associated with a raised risk of heart disease. A surprising result was that although higher levels of fitness in adolescence were associated with lower heart disease risk, the benefit of such fitness, in terms of heart disease risk, was not present in the men with low stress resilience.

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Women Veterans Undergoing Cardiac Catheterization Highlight Link Between Stress and CAD

Posted on February 24, 2015 by Marie Benz MD FAAD

MedicalResearch.com Interview with:
Claire Duvernoy, MD
Chief, Cardiology Section
VA Ann Arbor Healthcare System
Professor of Medicine
University of Michigan Health System Ann Arbor, MI

MedicalResearch: What is the background for this study? What are the main findings?

Dr. Duvernoy: We wanted to look at the indications and outcomes for women veterans undergoing cardiac catheterization procedures as compared with men veterans, given that we know that there are significant gender differences in the non-veteran population between women and men undergoing cardiac catheterization.
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Mental Stress Linked To Poor Heart Attack Recovery For Women

Posted on February 16, 2015 by Marie Benz MD FAAD

MedicalResearch.com Interview with:
Xiao Xu, PhD Assistant Professor
Department of Obstetrics, Gynecology and Reproductive Sciences
Yale University School of Medicine and

Harlan M Krumholz MD, SM
Harold H. Hines, Jr. Professor of Medicine (Cardiology) and Professor of Faculty of Arts and Sciences, of Investigative Medicine and of Public Health (Health Policy); Co-Director, Clinical Scholars Program; Director, Yale-New Haven Hospital Center for Outcomes Research and Evaluation New Haven, CT 06510

Medical Research: What is the background for this study? What are the main findings?

Response: Prior research of heart attack has mostly examined older patients, while few studies have focused on younger patients. Although we know that younger women differ from men and older patients in heart attack etiology and mortality, there is limited data on non-mortality outcomes of younger women and factors influencing their recovery. Mental stress is a particularly relevant factor for younger women as prior research showed higher stress in women than in men and an inverse association between age and stress. Therefore, in this study, we compared women and men 18-55 years old with heart attack and examined gender difference in mental stress and its potential role in explaining the worse recovery in women.

We addressed these questions using data from the Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients (VIRGO) project, which is the largest prospective observational study of young and middle-aged women and men with heart attack and has comprehensive information on patients’ clinical and psychosocial characteristics. Our findings showed significantly higher stress in women than in men. Moreover, mental stress is associated with worse recovery in multiple health outcomes 1 month after heart attack, such as angina-specific and overall quality of life. The greater stress in women may partially contribute to their worse recovery.

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Link Between Stress and Fertility Examined

Posted on January 21, 2015 by Marie Benz MD FAAD

MedicalResearch.com Interview with:
Anna Geraghty
Department of Integrative Biology
University of California, Berkeley, Berkeley,

Medical Research: What is the background for this study? What are the main findings?

Response: RFRP3 in mammals has been well characterized as a negative regulator of the hormonal reproductive axis. It shuts down release of gonadotropins necessary for successful reproduction, similar to how stress inhibits reproduction. Our lab has previously shown that stress can directly regulate RFRP3 levels in males-both acute and chronic stress lead to an upregulation of RFRP3 levels in the male rat. As a followup to that study, we were interested in looking at whether this response was similar in females, and how that may affect long term fertility. We found that chronic (18 days) of stress led to an increase in RFRP3 levels all all stages of the estrous cycle. This increase was also sustained for at least 4 days, or one whole estrous cycle, after the stress ended- the equivalent to a month menstrual cycle in humans. In rats that were stressed and then allowed to recover for 4 days, animals that were stressed were significantly less successful at reproducing- 76% success rate in controls compared to 21% in the stressed animals. This was a result of a combination of deficits in the mating process- less stressed animals successfully copulated, those that did successfully mate had fewer pregnancies, and gave birth to smaller litters. However, utilizing an inducible virus to knockdown RFRP levels in the hypothalamus specifically during the stress period prevented all of these problems- stressed animals without stress-induced RFRP3 increases looked indistinguishable to controls.

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