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72 Somatization and Headaches in people with insomnia during the COVID-19 Pandemic: the benefit of exercise.
- Kymberly Henderson-Arredondo, Samantha Jankowski, Emmett Suckow, Shivani Desai, Melissa Reich-Fuehrer, Lindsey Hildebrand, William D.S. Killgore
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 581-582
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Objective:
Stress is well known to increase the severity of somatization and insomnia. A recent major stressor that could have influenced the severity of these presentations was world-wide COVID-19 Pandemic. Somatization is the physical expression of stress and emotional distress that can manifest itself throughout various corporal domains and can be a comorbidity to insomnia. Headaches represent some of the most common complaints associated with brain injuries and neurological disorders but are common in somaticized disorders as well. In large survey study we examined whether exercise was associated with severity of somatization and headaches. We hypothesized that both healthy individuals and those with insomnia who exercised during the pandemic would report less severe somatic symptoms and headaches than those who did not.
Participants and Methods:A large survey was sent out to 4,073 individuals to measure their experience in numerous domains during the COVID-19 pandemic. This survey included a short symptom questionnaire used to measure somatization and the Insomnia Scale Index to measure insomnia. These questionnaires were administered along with a “yes or no” question on whether the participants exercised regularly in that period. A univariate ANOVA was performed to analyze the data to determine if exercise during the pandemic was beneficial in the reduction of somatic symptoms and headache severity. Furthermore, these tests were run to determine if the effect was greater on those with insomnia.
Results:The effect of insomnia and exercise on total somatic symptoms were significant at F(1, 3445)=650.5, p<0.001 and F(1, 3445)=26.1, p<0.001, respectively. For reported headache severity, there was a significant effect of exercise F(1, 4073)=14.5, p<0.001 and insomnia F(1, 4073)=160.5, p<0.001; therefore, those who exercised reported less severe headaches and those who suffered from insomnia reported more severe somatic symptoms. This meant that those who exercised reported less severe somatization and headaches than those who didn’t and those with insomnia reported more severe somatization and headaches than healthy individuals. However, the interaction between exercise and insomnia on overall somatization severity was not significant at F(1, 3445)=3.4, p=0.066 nor for reported headache severity F(1, 4073)=0.81, p=0.370. Despite there not being a significant interaction, the benefit of exercise was slightly greater on healthy individuals than those with insomnia.
Conclusions:Those with insomnia reported more severe headaches and overall somatic symptoms than non-insomniacs regardless of whether they exercised or not. Exercise did make a difference on the reported severity of headaches and somatization in both groups; however, the benefit of exercise on headaches and somatization was greater in individuals who do not suffer from insomnia. Thus, exercise was noted to be beneficial to those in the general population and those suffering from insomnia as it can potentially reduce the severity of somatization and headaches. Of course, this research was cross sectional and correlational, so the directionality of the effects cannot be inferred. For future research, it would be instrumental to use experimental methods to help determine the duration and type of exercise that may optimize its potential benefits on headaches and somatic symptoms.
58 Sex Differences in the Relationship Between Sleep Disruption and Depressive Symptoms During Acute and Chronic Stages of Mild Traumatic Brain Injury (mTBI)
- Melissa J Reich-Fuehrer, Lindsey Hildebrand, Shivani Desai, Kymberly Henderson-Arredondo, William D.S. Killgore
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 163-164
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Objective:
mTBI is trauma to the brain due to a blow or other mechanical force affecting the head. Prior research has established that common symptoms of mTBI include decreased sleep quality and onset/worsening of emotional dysregulation. However, there is little published research investigating how sleep disruption and depressive symptoms are experienced at varying stages of mTBI. We hypothesized that sleep disruption would change with differing time since injury, and that depressive symptoms should accordingly. Additionally, since females tend to have higher rates of depression, we predicted that there would be a significant difference between the sexes at different stages post-mTBI.
Participants and Methods:This study included 145 healthy adults, split into six groups, comparing healthy controls consisting of 15 males (Mage=23.67, SD=5.066) and 17 females (Mage=25.35, SD=7.035) to individuals who had mTBI, 41 males (Mage=26.88, SD=8.509) and 72 females (Mage=23.79, SD=6.898) at five points post-mTBI: 2 weeks and 1, 3, 6, and 12 months. The Pittsburgh Sleep Quality Index (PSQI) global score was used to assess individual sleep quality and disturbances; higher scores indicated poorer sleep quality. The Beck Depression Index (BDI-II) was used to assess characteristics and symptoms of depression. We adjusted the score to exclude item 16, which measures changes in sleep. Higher scores indicate more severe depressive symptoms. We conducted a multivariate analysis of variance and Pearson correlation to examine whether there were significant differences in sleep and depression at different stages of mTBI for each sex.
Results:We discovered that sleep quality was worse at chronic stages of mTBI (i.e, 12M, p=<.001), than at acute stages (2W, p=.049), and compared to healthy controls. There were also significant differences in depression scores compared to healthy controls at 2W, p=.008, 3M, p=<.001, and 6M, p=.012, but not 12M, p=.313, suggesting that depressive symptoms resolved by 12M in those with mTBI. To explain this, we investigated sex differences, as males tend to experience fewer depressive disorders than females. However, females reported fewer depressive symptoms than males at chronic stages of mTBI. This finding was not statistically significant as females had a Mbdi_total=6.84, SD=7.98 and males had a Mbdi_total=5.38, SD=6.078; still, this could be due to the low statistical power of the study, and with a larger sample size, could produce statistically significant differences between the sexes. Despite this, there is a statistically significant difference in the depression score for females between 2W and 12M post-mTBI (p=.046; effect size of d=.99). Comparatively, males showed no significant divergence between depression and sleep scores.
Conclusions:Sleep disruption and depressive symptoms were correlated in individuals with mTBI in both acute and chronic stages; however, at 12M, there was a decrease in this correlation due to females exhibiting fewer depressive symptoms in combination with greater sleep disruption in the chronic phase of mTBI. Further research investigating the relationship between depression and sleep quality by looking at females with a much larger sample size would be helpful in clarifying these associations.
58 Examining the Link Between Self-Reported Anxiety and Aggressive Behaviors
- Shivani Desai, Lindsey Hildebrand, Melissa Reich-Feuhrer, Kymberly Henderson-Arredondo, William D.S. Killgore
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 843-844
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Objective:
It is well known that there are differences between men and women in anxiety and aggression. Moreover, prior research has shown an association between anxiety and aggression but the strength of these associations in males and females has not been well characterized, and it remains unclear whether such associations are driven by comorbid disorders such as posttraumatic stress disorder (PTSD) or substance abuse. Therefore, we examined these associations in a large sample of males and females, and statistically controlled for the aforementioned potential confounding variables.
Participants and Methods:A total of 13,313 adults completed the survey on Amazon Mechanical Turk between April 2020 and April 2021, including 5,598 females (Mage=36.4, SD=11.9) and 7,654 males (Mage=37.81, SD=12.7). Aggression was measured using the Buss Perry Aggression Questionnaire (BPAQ), while the Generalized Anxiety Disorders (GAD-7) scale was used to gauge anxiety levels. PTSD was assessed with the PC-PTSD scale, and alcohol misuse was assessed with the Alcohol Use Disorders Inventory (AUDIT). Data were analyzed with zero-order correlations and linear regression to control for the effects of PTSD and alcohol misuse. Lastly, we used a Fisher r-to-z transformation to compare the correlations between males and females for both physical and verbal aggression with anxiety.
Results:Higher aggression (i.e., BPAQ) was correlated with greater anxiety (i.e., GAD; r(13213)=0.482, p<0.0001)). This association between anxiety and aggression held even when other potential confounders were controlled, such as PTSD (p<0.0001), and alcohol misuse, p<0.0001. Additionally, the correlation between anxiety and physical aggression was significantly stronger in males than females (z=5.02, p<0.0001), a pattern that was also true for the association between anxiety and verbal aggression (z=4.13, p<0.0001).
Conclusions:Our findings suggest that there is a linear relationship between the severity of anxiety and the severity of both verbal and physical aggression, that these associations tend to be stronger among males, and are not accounted for by associated conditions such as PTSD or alcohol misuse. This data augments existing research on the factors that contribute to aggression and further suggest that anxious feelings are more directly associated with aggression in males. These findings raise the possibility that interventions that target anxiety may prove helpful in reducing aggressive behavior among males. It may be fruitful for future work to identify neural systems that are associated with both anxiety and aggression and which are also modulated by sex. While measures of neurochemistry were not collected here, prior research has suggested that there are sex differences in brain systems that rely on serotonergic neurotransmission and arginine vasopressin, which could provide a target for future work.
76 Investigating the Severity of Insomnia Comorbidities Between the Sexes
- Shivani Desai, Lindsey Hildebrand, Melissa Reich-Feuhrer, Kymberly Henderon-Arredondo, William D.S. Killgore
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 584-585
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Objective:
Previous research indicates that women tend to struggle with insomnia at higher rates both prior to and during the global COVID-19 pandemic; however, not much research has investigated the extent to which insomnia correlates with comorbid problems, including aggression, depression, anxiety, PTSD severity, and alcohol use between the sexes. On a neurobiological level, insomnia could be associated with those mood disorders due to the effects of sleep disturbance on serotonergic and GABA neurotransmission, and males might experience such associations at a lower frequency due to their increased rates of serotonin synthesis. Consequently, we hypothesized that women would demonstrate higher prevalence of the aforementioned comorbidities during COVID than males due to higher rates of insomnia reported in women during COVID.
Participants and Methods:We surveyed a total of 13,313 adults, with 5,598 females (Mage=36.4, SD=11.9) and 7,654 males (Mage=37.81, SD=12.7) using Amazon Mechanical Turk between April 2020 and April 2021. Insomnia was measured using the Insomnia Severity Index (ISI), while levels of depression, anxiety, PTSD severity, and alcohol use, and aggression were assessed through Patient Stress Questionnaires (PSQs) and the Buss Perry Aggression Questionnaire (BPAQ).
Results:As expected, there were significant positive correlations between ISI and BPAQ (r(13306)=0.364, p<0.0001), PSQ Depression (r(13300)=0.694, p<0.0001), PSQ Anxiety (r(13211)=0.627, p<0.0001), PSQ PTSD (r(13305)=0.444, p<0.0001), and PSQ Alcohol (r(12915)=0.218, p<0.001). The strength of these associations was significantly higher in males than females in almost all categories: aggression (z=4.27, p<0.0001), depression (z=2.41, p=0.016), anxiety (z=3.16, p=0.0016), and alcohol use (z=5.89, p<0.0001) - not significant for PTSD severity (z=1.48, p=0.14).
Conclusions:We found that insomnia was more strongly correlated with comorbid emotional and behavioral problems among males than females. This stands in contrast to our initial hypothesis, as the findings suggest that men who suffer from greater insomnia are more likely to experience those four comorbidities than females. This suggests that sex may play a role in the association between sleep disturbances and other clinical presentations relevant to neuropsychology. Further work will be necessary to identify the neurobiological mechanisms that drive the sex differences in these associations. While the present findings cannot determine the causal direction of the association, it will be crucial to determine the directionality of these associations and the mechanisms that lead to differences in expression between the sexes.
Shared and Divergent Auditory and Tactile Processing in Children with Autism and Children with Sensory Processing Dysfunction Relative to Typically Developing Peers
- Carly Demopoulos, Annie N. Brandes-Aitken, Shivani S. Desai, Susanna S. Hill, Ashley D. Antovich, Julia Harris, Elysa J. Marco
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- Journal:
- Journal of the International Neuropsychological Society / Volume 21 / Issue 6 / July 2015
- Published online by Cambridge University Press:
- 06 July 2015, pp. 444-454
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The aim of this study was to compare sensory processing in typically developing children (TDC), children with Autism Spectrum Disorder (ASD), and those with sensory processing dysfunction (SPD) in the absence of an ASD. Performance-based measures of auditory and tactile processing were compared between male children ages 8–12 years assigned to an ASD (N=20), SPD (N=15), or TDC group (N=19). Both the SPD and ASD groups were impaired relative to the TDC group on a performance-based measure of tactile processing (right-handed graphesthesia). In contrast, only the ASD group showed significant impairment on an auditory processing index assessing dichotic listening, temporal patterning, and auditory discrimination. Furthermore, this impaired auditory processing was associated with parent-rated communication skills for both the ASD group and the combined study sample. No significant group differences were detected on measures of left-handed graphesthesia, tactile sensitivity, or form discrimination; however, more participants in the SPD group demonstrated a higher tactile detection threshold (60%) compared to the TDC (26.7%) and ASD groups (35%). This study provides support for use of performance-based measures in the assessment of children with ASD and SPD and highlights the need to better understand how sensory processing affects the higher order cognitive abilities associated with ASD, such as verbal and non-verbal communication, regardless of diagnostic classification. (JINS, 2015, 21, 444–454)