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1. Cognitive Symptoms of Post–COVID-19 Condition and Daily Functioning

   https://doi.org/10.1001/jamanetworkopen.2023.56098  

   Jaywant, Abhishek ; Gunning, Faith M. ; Oberlin, Lauren E. ; Santillana, Mauricio ; Ognyanova, Katherine ; Druckman, James N. ; Baum, Matthew A. ; Lazer, David ; Perlis, Roy H. ( February 2024 , JAMA Network Open)

   The frequent occurrence of cognitive symptoms in post–COVID-19 condition has been described, but the nature of these symptoms and their demographic and functional factors are not well characterized in generalizable populations.

   To investigate the prevalence of self-reported cognitive symptoms in post–COVID-19 condition, in comparison with individuals with prior acute SARS-CoV-2 infection who did not develop post–COVID-19 condition, and their association with other individual features, including depressive symptoms and functional status.

   Two waves of a 50-state nonprobability population-based internet survey conducted between December 22, 2022, and May 5, 2023. Participants included survey respondents aged 18 years and older.

   Post–COVID-19 condition, defined as self-report of symptoms attributed to COVID-19 beyond 2 months after the initial month of illness.

   Seven items from the Neuro-QoL cognition battery assessing the frequency of cognitive symptoms in the past week and patient Health Questionnaire-9.

   The 14 767 individuals reporting test-confirmed COVID-19 illness at least 2 months before the survey had a mean (SD) age of 44.6 (16.3) years; 568 (3.8%) were Asian, 1484 (10.0%) were Black, 1408 (9.5%) were Hispanic, and 10 811 (73.2%) were White. A total of 10 037 respondents (68.0%) were women and 4730 (32.0%) were men. Of the 1683 individuals reporting post–COVID-19 condition, 955 (56.7%) reported at least 1 cognitive symptom experienced daily, compared with 3552 of 13 084 (27.1%) of those who did not report post–COVID-19 condition. More daily cognitive symptoms were associated with a greater likelihood of reporting at least moderate interference with functioning (unadjusted odds ratio [OR], 1.31 [95% CI, 1.25-1.36]; adjusted [AOR], 1.30 [95% CI, 1.25-1.36]), lesser likelihood of full-time employment (unadjusted OR, 0.95 [95% CI, 0.91-0.99]; AOR, 0.92 [95% CI, 0.88-0.96]) and greater severity of depressive symptoms (unadjusted coefficient, 1.40 [95% CI, 1.29-1.51]; adjusted coefficient 1.27 [95% CI, 1.17-1.38). After including depressive symptoms in regression models, associations were also found between cognitive symptoms and at least moderate interference with everyday functioning (AOR, 1.27 [95% CI, 1.21-1.33]) and between cognitive symptoms and lower odds of full-time employment (AOR, 0.92 [95% CI, 0.88-0.97]).

   The findings of this survey study of US adults suggest that cognitive symptoms are common among individuals with post–COVID-19 condition and associated with greater self-reported functional impairment, lesser likelihood of full-time employment, and greater depressive symptom severity. Screening for and addressing cognitive symptoms is an important component of the public health response to post–COVID-19 condition.

    

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2. Ethnic–Racial Discrimination Exposure and Anxiety in Latina Girls: Amygdala Volume as an Indirect Neurobiological Pathway

   https://doi.org/10.1007/s11577-024-00946-2  

   Mullins, Jordan L. ; Díaz, Dana E. ; Firat, Rengin B. ; Michalska, Kalina J. ( April 2024 , KZfSS Kölner Zeitschrift für Soziologie und Sozialpsychologie)

   Ethnic–racial discrimination, the differential treatment of individuals based on ethnic or racial group membership, predicts poor mental health outcomes such as anxiety. This is supported by long-standing theories on the social determinants of health and minority stress. However, these theories are rarely expanded to neurobiological sciences, limiting our understanding of mechanisms underlying observed associations. One potential neurobiological pathway between ethnic–racial discrimination exposure and anxiety is that ongoing exposure to racially charged encounters presents imminent threats that may modify stress-sensitive neurocircuitry, like the amygdala.

   The current study evaluated whether amygdala volume mediated associations between ethnic–racial discrimination exposure and anxiety symptoms in Latina girls, a group exhibiting heightened levels of untreated anxiety and disproportionately subjected to ethnic–racial discrimination.

   Thirty predominantly Mexican-identifying Latina girls residing in Southern California (M_Age = 9.76,SD = 1.11 years) completed a T1-weighted structural MRI scan. Using thePerceptions of Racism in Children and Youth, participants self-reported the prevalence and severity of various discriminatory experiences. Participants also self-reported their anxiety symptoms via theScreen for Child Anxiety and Related Emotional Disorders.Controlling for total intracranial volume and annual household income, an indirect effect of ethnic–racial discrimination on anxiety symptoms via left amygdala volume was observed,β = −0.28,SE = 0.17, BC 95% CI [−0.690, −0.017]. The current findings suggest that the left amygdala is sensitive to racialized threats in childhood and that stress-related alterations may, in part, contribute to elevated anxiety in Latina girls. Our data elucidate a potential mechanism by which this form of sociocultural stress can adversely impact mental health, particularly in the transition from middle childhood to early adolescence, a period marked by a host of interlinked neurophysiological and social changes.

    

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3. Multimorbidity and Quality of Life: The Mediating Role of ADL, IADL, Loneliness, and Depressive Symptoms

   https://doi.org/10.1093/geroni/igad047  

   Sieber, Stefan ; Roquet, Angélique ; Lampraki, Charikleia ; Jopp, Daniela S. ; Thorpe, Jr, ed., Roland J. ( June 2023 , Innovation in Aging)

   The ubiquity of multimorbidity makes it crucial to examine the intermediary factors linking it with quality of life (QoL). The objective was to examine to what extent the association between multimorbidity and QoL was mediated by functional and emotional/mental health and how these mediation pathways differed by sociodemographic factors (age, gender, education, and financial strain).

   Data from Waves 4 to 8 of 36,908 individuals from the Survey of Health, Aging, and Retirement in Europe (SHARE) were included. Multimorbidity (exposure) was defined as having 2 or more chronic conditions. Mediators included limitations with (instrumental) activities of daily living (ADL and IADL), loneliness, and depressive symptoms. QoL (outcome) was assessed with the CASP-12 scale. Longitudinal model-based causal mediation analyses were performed to decompose the total association between multimorbidity and QoL into direct and indirect effects. Moderated mediation analyses tested for differences in mediation pathways by sociodemographic factors.

   Multimorbidity was significantly associated with lower QoL (direct effect: b = −0.66). This association was mediated by ADL limitations (percentage mediated 0.97%), IADL limitations (3.24%), and depressive symptoms (16.70%), but not by loneliness. The mediation pathways were moderated by age, education, financial strain, and gender.

   ADL, IADL, and depressive symptoms are crucial intermediary factors between multimorbidity and QoL in older European adults, with changing importance according to age, education, financial strain, and gender. The findings may help to increase the QoL of individuals with multimorbidity and redirect care efforts to these factors.

    

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4. A cotwin control study of associations between financial hardship and binge eating phenotypes during COVID ‐19

   https://doi.org/10.1002/eat.23841  

   Mikhail, Megan E. ; Ackerman, Lindsay S. ; Culbert, Kristen M. ; Burt, S. Alexandra ; Neale, Michael C. ; Keel, Pamela K. ; Katzman, Debra K. ; Klump, Kelly L. ( October 2022 , International Journal of Eating Disorders)

   COVID‐19 was associated with significant financial hardship and increased binge eating (BE). However, it is largely unknown whether financial stressors contributed to BE during the pandemic. We used a longitudinal, cotwin control design that controls for genetic/environmental confounds by comparing twins in the same family to examine whether financial hardship during COVID‐19 was associated with BE.

   Female twins (N = 158;M_age = 22.13) from the Michigan State University Twin Registry rated financial stressors (e.g., inability to afford necessities) daily for 49 consecutive days during COVID‐19. We first examined whether financial hardship was associated with BE phenotypes across the full sample. We then examined whether cotwins who differed on financial hardship also differed in BE.

   Participants who experienced greater mean financial hardship across the study had significantly greater dimensional BE symptoms, and participants who experienced greater financial hardship on a given day reported significantly more emotional eating that day. These results were replicated in cotwin control analyses. Twins who experienced more financial hardship than their cotwin across the study reported greater dimensional BE symptoms than their cotwin, and participants who experienced more financial hardship than their cotwin on a given day reported greater emotional eating that day. Results were identical when restricting analyses to monozygotic twins, suggesting associations were not due to genetic confounds.

   Results suggest that BE‐related symptoms may be elevated in women who experienced financial hardship during COVID‐19 independent of potential genetic/environmental confounds. However, additional research in larger samples is needed.

   Little is known regarding how financial difficulties during the COVID‐19 pandemic may have contributed to increased binge eating (BE). We found preliminary evidence that financial hardship during COVID‐19 may be associated with greater rates of BE‐related symptoms even when comparing twins from the same family. While additional research is needed, results suggest that people who experienced financial hardship during COVID‐19 may be at increased risk for BE.

    

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5. Stressful social environment and financial strain drive depressive symptoms, and reveal the effects of a FKBP5 variant and male sex, in African Americans living in Tallahassee

   https://doi.org/10.1002/ajpa.24362  

   Fuller, Kia ; Gravlee, Clarence C. ; McCarty, Christopher ; Mitchell, Miaisha M. ; Mulligan, Connie J. ( July 2021 , American Journal of Physical Anthropology)

   The World Health Organization estimates that almost 300 million people suffer from depression worldwide. African Americans are understudied for depression‐related phenotypes despite widespread racial disparities. In our study of African Americans, we integrated information on psychosocial stressors with genetic variation in order to better understand how these factors associated with depressive symptoms.

   Our research strategy combined information on financial strain and social networks with genetic data to investigate variation in symptoms of depression (CES‐D scores). We collected self‐report data on depressive symptoms, financial strain (difficulty paying bills) and personal social networks (a model of an individual's social environment), and we genotyped genetic variants in five genes previously implicated in depressive disorders (HTR1a, BDNF, GNB3, SLC6A4, andFKBP5) in 128 African Americans residing in Tallahassee, Florida. We tested for direct and gene–environment interactive effects of the psychosocial stressors and genetic variants on depressive symptoms.

   Significant associations were identified between high CES‐D scores and a stressful social environment (i.e., a high percentage of people in participants' social network who were a source of stress) and high financial strain. Only one genetic variant (rs1360780 inFKBP5) was significantly associated with CES‐D scores and only when psychosocial stressors were included in the model; the T allele had an additive effect on depressive symptoms. Sex was also significantly associated with CES‐D score in the model with psychosocial stressors and genetic variants; males had higher CES‐D scores. No significant interactive effects were detected.

   A stressful social environment and material disadvantage increase depressive symptoms in the study population. Additional associations withFKBP5and male sex were revealed in models that included both psychosocial and genetic data. Our results suggest that incorporating psychosocial stressors may empower future genetic association studies and help clarify the biological consequences of social and financial stress.

    

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