Biomedical subjects

Andrew Baum

Publications and source records attributed to Andrew Baum.

18 recordsLinked to original sources

PubMed2006

Increased cortisol in women with intimate partner violence-related posttraumatic stress disorder.

BACKGROUND: Alterations of hypothalamic-pituitary-adrenal (HPA) axis function and sympathetic-adrenal activity have been proposed as key factors in biological models of posttraumatic stress disorder (PTSD). METHODS: We examined neuroendocrine function in female survivors of intimate partner violence (IPV) with lifetime (current or remitted) PTSD (n=29) and in women who were exposed to IPV but never developed PTSD (n=20). Salivary cortisol was collected as a marker of HPA axis function at 1, 4, 9, and 11 h after awakening. Platelet epinephrine and norepinephrine were assayed as markers of sympathetic-adrenal activation. RESULTS: Women with lifetime PTSD had significantly higher cortisol levels across the day compared to abuse-exposed participants without PTSD, after controlling for age, depression, severity, and latency of abuse. There were no significant group differences in levels of platelet catecholamines. CONCLUSIONS: Elevated cortisol levels may be a biomarker of IPV-related lifetime PTSD, reflecting long-lasting changes associated with trauma-exposure or possibly a reflection of risk for PTSD in women.

Adult↗

PubMed2006

The Life Engagement Test: assessing purpose in life.

This article describes a 6-item scale, the Life Engagement Test, designed to measure purpose in life, defined in terms of the extent to which a person engages in activities that are personally valued. Psychometric data are presented including information about the scale's factor structure, internal consistency, test-retest reliability, convergent validity, discriminant predictive validity, and norms. The data suggest that the Life Engagement Test is psychometrically sound across different gender, age, and ethnic groups and is appropriate for wider use. Discussion centers on the use of the Life Engagement Test in behavioral medicine and health psychology research and recent associations that have begun to emerge between the scale and health-relevant outcomes.

Adult↗

PubMed2006

Increased cortisol in women with intimate partner violence-related posttraumatic stress disorder.

Intimate partner violence (IPV) is a chronic and recurrent traumatic stressor associated with PTSD; however, its biological correlates are not well understood. This study examined diurnal salivary cortisol and platelet catecholamines in women with lifetime IPV-related PTSD and in women exposed to IPV who did not develop PTSD. Cortisol was elevated in women with lifetime PTSD compared to controls. No differences were found for platelet catecholamines.

Biomarkers↗

PubMed2006

Stress and quality of life in African American cancer survivors.

The quality of life (QOL) of cancer survivors must be investigated as we learn about the risks and protective factors associated with cancer survival. Little research has included African American cancer survivors, and this group could be more or less vulnerable to the added stress of cancer. By virtue of the greater stress burden imposed by minority status, lower socioeconomic status, and other social/ cultural factors, African Americans may be at increased risk for poor QOL and poor health outcomes. Alternatively, they may be protected from some of these negative outcomes. We propose a model to better understand the unique sociocultural features that influence QOL for certain cancer sites where racial disparities are well established. A comprehensive knowledge of QOL among these survivors will guide future research and facilitate the development of interventions to improve QOL, possibly reducing observed health disparities.

Adaptation, Psychological↗

PubMed2005

Traditional Chinese medicines Wu Wei Zi (Schisandra chinensis Baill) and Gan Cao (Glycyrrhiza uralensis Fisch) activate pregnane X receptor and increase warfarin clearance in rats.

The traditional Chinese medicines (TCMs) are essential components of alternative medicines. Many TCMs are known to alter the expression of hepatic drug-metabolizing enzymes and transporters. The molecular mechanism by which TCMs and/or their constituents regulate enzyme and transporter expression, however, has remained largely unknown. In this report, we show that two TCMs, Wu Wei Zi (Schisandra chinensis Baill) and Gan Cao (Glycyrrhiza uralensis Fisch), and their selected constituents activate the xenobiotic orphan nuclear receptor pregnane X receptor (PXR). Treatment with TCM extracts and the Schisandrol and Schisandrin constituents of Wu Wei Zi induced the expression of drug-metabolizing enzymes and transporters in reporter gene assays and in primary hepatocyte cultures. The affected enzymes and transporters include CYP3A and 2C isozymes and the multidrug resistance-associated protein 2. In transient transfection and reporter gene assays, the Schisandrin constituents of Wu Wei Zi had an estimated EC50 of 2 and 1.25 microM on hPXR and mPXR, respectively. Interestingly, mutations that were intended to alter the pore of the ligand-binding cavity of PXR had species-specific effects on the activities of the individual Schisandrols and Schisandrins. In rats, the administration of Wu Wei Zi and Gan Cao increased the metabolism of the coadministered warfarin, reinforcing concerns involving the safe use of herbal medicines and other nutraceuticals to avoid PXR-mediated drug-drug interactions. Meanwhile, the activation of PXR and induction of detoxifying enzymes provide a molecular mechanism for the hepatoprotective effects of certain TCMs.

Animals↗

PubMed2005

Genomic profiling of restraint stress-induced alterations in mouse T lymphocytes.

DNA damage-, DNA repair-, and apoptosis-related gene expression in CD3(+) T lymphocytes of BALB/c mice subjected to 2-h restraint stress were compared to that in CD3(+)T lymphocytes from control mice. Using targeted cDNA arrays, significant increases in expression of genes serving as sensors of DNA damage, including MSH genes and RAD53, were observed. GADD45g, a gene responsible for regulating cell cycle arrest and apoptosis, was significantly induced; as was Pura, a gene involved in cell proliferation. These data suggest that, at the molecular level, stress activates genes responsible for priming the T cell to either undergo apoptosis or proliferation.

Animals↗

PubMed2005

Media exposure to bioterrorism: stress and the anthrax attacks.

This study examined media exposure and adjustment to anthrax bioterrorism attacks and the terrorist attacks on 9/11 in a sample of 300 people who lived distant from the attacks. Measures of direct and indirect exposure to terrorism, perceived risk of anthrax exposure, psychological distress, and outlook were assessed at 2 to 3 months and at 8 months after the first reported anthrax attack. Initial anthrax media exposure was a powerful predictor of distress, whereas subsequent anthrax media exposure only predicted negative changes in outlook over time. Perceived risk of anthrax exposure predicted distress and outlook but did not appear to mediate the effects of media exposure. Determining the nature and consequences of media exposure to threatening and frightening events like terrorism will help predict and manage response to future bioterrorism.

Adaptation, Psychological↗

PubMed2004

Quality of life in patients diagnosed with primary hepatocellular carcinoma: hepatic arterial infusion of Cisplatin versus 90-Yttrium microspheres (Therasphere).

BACKGROUND: The aims of the study were to test the difference in health-related quality (HRQL) of life and survival in patients diagnosed with primary hepatocellular carcionma (HCC) and treated with either hepatic arterial infusion (HAI) of Cisplatin or 90-Yttrium microspheres (Therasphere). METHOD: The design of the study was a non-randomized parallel cohort study. Twenty-eight patients participated in the present study. HRQL was assessed by administration of the Functional Assessment of Cancer Therapy-Hepatobiliary. Survival was measured using Kaplan Meier methods. RESULTS: The results of present study suggest treatment with Therasphere) had an advantage in regard to HRQL and survival when compared to Cisplatin. At 3-month follow-up, patients who were treated with Therasphere had a higher level of functional well-being as well as overall quality of life when compared to patients treated with Cisplatin. At 6-month follow-up patients (treated with Therasphere) continued to have better functional well-being when compared to patients being treated with HAI of Cisplatin. At 6-month follow-up, survival was found to be similar for patients treated with Therasphere when compared to patients being treated with Cisplatin. CONCLUSIONS: Preliminary data suggest that treatment with Therasphere has a modest advantage in regard to HRQL when compared patients treated with HAI of Cisplatin. Future research with Therasphere, that includes a larger sample size and longer follow-up, is necessary to make definitive conclusions regarding the efficacy and effect on HRQL.

Adolescent↗

PubMed2003

2002 Robert Ader New Investigator award. Relationship of cardiovascular reactivity, stressful life events, and multiple sclerosis disease activity.

Previous studies of stress in multiple sclerosis patients have suggested that life events may alter the onset and development of MS. However, results have been inconsistent because of infrequent monitoring and reporting bias. We followed fifty female MS patients for 1 year to determine characteristics of life events associated with MS exacerbations, and examine the influence of cardiovascular activity. Subjects completed weekly life-event checklists. The short- and long-term threat of each event was determined using the Life Events and Difficulties Schedule. Neurologic symptoms were also monitored weekly. MS exacerbations were confirmed by a neurologist blinded to psychosocial events. Cardiovascular reactivity to an acute psychological stressor was determined at study onset, and resting heart rate and blood pressure were monitored monthly. Forty-two percent of life events were associated with exacerbations in the subsequent 6 weeks. Logistic regression confirmed that exacerbations were more likely during at-risk periods following life events and were relatively independent of the threat level and type of stressor. Participants with higher cardiovascular reactivity to acute stress and higher baseline heart rate demonstrated a greater number of exacerbations and proportion of weeks ill. Using multiple regression, we found that disability level, medication usage, cardiovascular reactivity, baseline heart rate, and life event density explained approximately 30% of the variance in the proportion of weeks ill. These results are consistent with the hypothesis that stress is a potential trigger of MS disease activity and suggest that autonomic tone and stress reactivity may play a role in the development of stress-related exacerbations.

Adaptation, Psychological↗

PubMed2003

End-of-life caregiving: what helps family caregivers cope?

Patient care needs and patient quality-of-life (QOL) deficits can be significant stressors for family caregivers. Often, greater caregiving demands and poorer patient QOL are associated with greater caregiver strain. However, caregiver coping behavior can attenuate the effect of caregiving stressors on caregiver strain. This study examined the relationships among caregiving stressors, coping, and caregiver strain in a sample of 31 family caregivers and their terminally ill loved ones enrolled in home hospice programs. Caregiving stressors included patient activity of daily living (ADL) needs and dimensions of patient QOL. Coping was measured with the Family Crisis Personal Evaluation Scale (F-COPES), which has five coping scales: acquiring social support, reframing, seeking spiritual support, passive appraisal, and mobilizing the family to acquire and accept help. Caregiver strain was significantly correlated with patient ADL needs (r = 0.51), patient psychological distress (r = 0.42), and patient existential QOL (r = -0.65). Regression equations indicated that reframing coping lessened caregiver strain. Caregivers who accepted their loved one's illness, redefined illness-related problems in a more manageable way, and felt capable of solving illness-related problems had less caregiver strain than caregivers who used less of a reframing coping style.

Activities of Daily Living↗

PubMed2003

Cognitive behavioral stress management effects on injury and illness among competitive athletes: a randomized clinical trial.

Cognitive behavioral stress management (CBSM) has previously been found to reduce fatigue, depression, and cortisol response to heavy exercise training among competitive collegiate athletes and to speed physical and psychological recovery from surgery. Our study assessed the efficacy of a CBSM program to reduce the frequency of injury and illness among collegiate athletes in a randomized, single-blind, controlled clinical trial. Following assessment of baseline medical history, mood state, stress, cortisol, sleep, alcohol use, and exercise training, collegiate rowers were stratified by gender and competitive level and randomly assigned to either a control group or a CBSM group. Exercise training information and psychosocial assessments were repeated immediately following the intervention period, and health care providers who were blinded to participant assignment recorded the frequency of medical visits and the number of days injured or ill until the end of the season. Athletes randomly assigned to a CBSM group experienced significant reductions in the number of illness and injury days as compared to control group athletes. CBSM participants also had half the number of health service visits as did controls. The data suggest that a time-limited CBSM intervention designed specifically for an athlete population may be an effective prophylactic treatment to reduce the incidence of injury and illness among competitive collegiate athletes.

Adolescent↗

PubMed2002

Factors associated with the accuracy of family caregiver estimates of patient pain.

This study identified factors associated with inaccurate family caregiver assessments of patient pain. Participants were 31 caregiver-patient dyads receiving hospice home care. All patients had a primary diagnosis of end-stage cancer. As expected, caregivers overestimated patient pain. The degree of disparity for each dyad was calculated by subtracting the patient's pain rating from the caregiver's rating of patient pain. Caregiver knowledge of cancer pain management was not related to the degree of disparity in pain ratings, but caregivers' experience of patient pain was significantly related to accuracy of caregivers' pain ratings. Those caregivers who 1) perceived their loved one to be in a great deal of distress secondary to pain, 2) associated greater efforts at pain relief (i.e., more medication) with greater levels of pain, and 3) were themselves distressed by the patient's pain had the most inaccurate estimates of patient pain. There was a trend for greater disparity in pain estimates to be related to poorer existential quality of life for patients. Overall, the findings suggest that health care providers need to take into consideration family members' interpretation of patient pain when providing pain management education services.

Adult↗

PubMed2002

Depressive symptomatology and coronary heart disease in Type I diabetes mellitus: a study of possible mechanisms.

Recent evidence has suggested that depressive symptomatology is a risk factor for the development of coronary heart disease (CHD) in patients with diabetes mellitus, although little is understood about mechanisms that may explain this association. The Pittsburgh Epidemiology of Diabetes Complications (EDC) Study is a natural history study of 658 men and women with childhood-onset Type I diabetes. Participants from the EDC Study who reported the fewest depressive symptoms on the Beck Depression Inventory at baseline examination were least likely to develop CHD over 10 years. Differences in insulin resistance, autonomic dysregulation, inflammation, smoking, and complications associated with Type I diabetes appear to help explain this relationship. Future research should clarify causal pathways between depressive symptomatology, behavioral and physiological processes, and CHD.

Adult↗

PubMed2002

Stability of individual differences in cellular immune responses to two different laboratory tasks.

To explore the stability of immune reactivity across laboratory tasks, we correlated enumerative and functional lymphocyte responses to a speech task and a mental arithmetic task, delivered on the same occasion of testing in 31 healthy undergraduates. Both tasks were associated with an increase in peripheral CD8+ and CD56+ cell populations, and a decrease in proliferative response to phytohemagglutinin (PHA) and ratio of CD4:CD8 cells. Intertask correlations were significant for the magnitude of change in proliferative responses at two different concentrations of PHA, r = 0.76, p < .0001 and r = 0.46, p < .05, and in numbers of circulating CD56+ cells, r = 0.46, p < .005. Concomitant heart rate and systolic blood pressure responses also correlated significantly over the two experimental tasks (heart rate: r = 0.52 and systolic blood pressure: r = 0.58. ps < .0005). These data provide initial evidence that interindividual variability of some cellular immune responses is moderately reproducible across different stimulus conditions, providing further evidence that it may denote a stable individual difference.

Adolescent↗

PubMedDate not supplied

Physiologic markers of chronic stress in premenopausal, middle-aged women.

OBJECTIVE: The purpose of this study was to identify physiological markers of chronic stress in middle-aged women that can be assessed simply and are thus feasible for introduction into large-scale, epidemiologic studies of aging. METHODS: Subjects were 40 nonsmoking, premenopausal women between the ages of 42 and 52 years, 20 of whom were chronically stressed because of undergoing a divorce or separation and 20 of whom were nonstressed because of being in stable marriages. Stressed and nonstressed women were matched for age, ethnicity, and education. Hypotheses focused on morning and evening salivary cortisol, overnight urinary catecholamines, cortisol, and testosterone, and platelet catecholamines. RESULTS: Relative to the nonstressed control subjects, the stressed women had elevated evening (9 PM) salivary cortisols, a finding that was observed on both days (mixed effects model: effect = 0.44; se = 0.14, p =.003). Support for the importance of the HPA axis was provided by the observation that the stressed women had less suppression of salivary cortisol in response to low-dose dexamethasone. Contrary to our hypothesis that stressed women would have lower overnight urinary testosterone, they had higher testosterone on day 2 (stressed = 0.76 ng/mg, nonstressed = 0.55 ng/mg; p =.04). Post hoc repeated measures analysis revealed a significant group effect over all time periods of observation (F = 5.48, p =.03, df = 1,18). Stressed women had a nonsignificant trend toward elevated platelet catecholamines. No association was found for overnight urinary catecholamines or cortisol. CONCLUSIONS: Promising markers of marital upheaval in middle-aged women are evening salivary cortisol and urinary testosterone from a first morning void. Replication of these findings with the same and different chronic stressors and with women of older ages is needed. The low cost and minimal burden of these potential markers makes it feasible to introduce them into large-scale epidemiologic studies of health in aging women.

Adult↗

PubMedDate not supplied

Stressful life events precede exacerbations of multiple sclerosis.

OBJECTIVE: We longitudinally monitored life events and health changes in patients with multiple sclerosis (MS) to determine whether stressful events may trigger exacerbation of MS. METHODS: Twenty-three women with MS were followed for 1 year. Each subject completed the Psychiatric Epidemiologic Research Interview on a weekly basis. Further information on potentially stressful events was acquired using the Life Events and Difficulties Schedule. Neurologic symptoms were also monitored on a weekly basis throughout the year. Potential MS exacerbations were confirmed by a neurologist who was blind to the presence and timing of stressors. RESULTS: Eighty-five percent of MS exacerbations were associated with stressful life events in the preceding 6 weeks. Stressful life events occurred an average of 14 days before MS exacerbations, compared with 33 days before a randomly selected control date (p < .0001). Survival analysis confirmed that an increase in frequency of life events was associated with greater likelihood of MS exacerbations (hazard ratio = 13.18, p < .05). CONCLUSIONS: These results are consistent with the hypothesis that stress is a potential trigger of disease activity in patients with relapsing-remitting MS.

Adult↗

PubMedDate not supplied

Posttraumatic stress associated with cancer history and BRCA1/2 genetic testing.

OBJECTIVE: A subset of women who are at elevated cancer risk due to family history exhibit evidence of cancer-specific distress. These stress responses may represent symptoms of posttraumatic stress disorder (PTSD). The present study assessed rates of PTSD related to personal or family cancer history and BRCA1/2 testing. METHODS: Participants were 84 women enrolled in a larger project focused on genetic testing decisions. Semistructured diagnostic interviews were used to identify instances of threshold and subthreshold PTSD. RESULTS: Results indicated that 16.7% of the women reported current threshold or subthreshold PTSD related to personal or family cancer history. An additional 26.2% reported past-only cancer-related threshold or subthreshold PTSD. Of the 65 women who received BRCA1/2 results and completed the test-related PTSD module, only 7.7% reported threshold or subthreshold PTSD related to the genetic testing process. However, when rates were examined based on carrier status, 25.0% of BRCA1/2 carriers reported test-related threshold or subthreshold PTSD compared with only 10.0% of variants and 2.3% of noncarriers. CONCLUSIONS: Results from this study suggest that both personal and family cancer diagnoses can be significant stressors for a subset of high-risk women. Rates of threshold and subthreshold PTSD related to genetic testing appear to be less common, although carriers may be at higher risk for significant posttraumatic symptoms.

Adult↗

PubMedDate not supplied

Socioeconomic status is associated with stress hormones.

OBJECTIVE: We assess whether socioeconomic status (SES) is associated with basal levels of cortisol and catecholamines and determine if any association between SES and these hormones can be explained (is mediated) by behavioral, social, and emotional differences across the SES gradient. METHODS: One hundred ninety-three adult subjects, including men and women and whites and African-Americans, provided 24-hour urine catecholamine samples on each of 2 days and seven saliva cortisol samples on each of 3 days beginning 1 hour after wake-up and ending 14 to 16 hours later. Values for both hormones were averaged across days to obtain basal levels. RESULTS: Lower SES (income and education) was associated with higher levels of cortisol and epinephrine and marginally higher levels of norepinephrine. These associations were independent of race, age, gender, and body mass. Low SES was also associated with a greater likelihood of smoking, of not eating breakfast, and with less diverse social networks. Further analyses provided evidence consistent with the hypothesis that these behavioral and social variables mediate the link between SES and the three stress hormones. CONCLUSIONS: Lower SES was associated in a graded fashion with higher basal levels of cortisol and catecholamines. These associations occurred independent of race, and the data were consistent with mediation by health practices and social factors.

Adult↗