Lifetime trauma and mortality risk: A systematic review.

OBJECTIVE: Various literature are suggestive of a relation between lifetime trauma and mortality risk in adulthood, however, findings seem unclear and inconsistent. In our preregistered review, we conducted a systematic review to examine the association between lifetime trauma and mortality risk in adulthood. METHOD: Six databases (Scopus, Web of Science, CINAHL [EBSCO], PsycInfo [EBSCO], Embase, and Medline [PubMed]); were searched up to April 2023 for studies reporting adult mortality outcomes associated with traumatic events accumulated across the lifespan. Five studies were found, and a narrative review of the literature was conducted. RESULTS: Five studies met the inclusion criteria, including 5,506 individuals. Two studies with men/male-only samples reported no relation between lifetime trauma and mortality risk; however, three studies with a mixed-sex sample found a positive relation between lifetime trauma and mortality risk, indicating that the more traumatic events a person has across their lifespan, the greater their mortality risk. CONCLUSION: Lifetime trauma appears to be associated with mortality risk during adulthood. The strongest evidence stems from larger samples. However, research is sparse and inconclusive. A plethora of additional research is needed to address several limitations within the current literature, which includes utilizing standardized measures of lifetime trauma, replication of effects, and the examination of vulnerable and underrepresented populations. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Personality traits and mediating pathways to mortality risk: A systematic review.

OBJECTIVE: Personality traits have been regularly linked with all-cause mortality risk. However, what mechanisms may provide an indirect pathway from personality traits to mortality is unclear. We sought to systematically review the literature and provide an overview of the potential mechanisms that have been identified in the literature. METHOD: Five electronic databases (PubMed, Web of Science, CINAHL, PsycInfo, and PsycArticles) were searched from inception to January 27, 2023. From 611 studies initially identified, seven studies met the final inclusion criteria. These seven papers have a combined sample of 60,104 individuals (M = 8,585, SD = 14,600; range 957-44,094). RESULTS: These papers found that several variables, such as smoking, inflammation biomarkers, blood pressure, and sleep, mediated the relationship between various personality traits and mortality. There was considerable variation in the impact of results across cohorts, even when looking at similar variables, and notable differences in methodological approaches and reporting were discussed. CONCLUSIONS: This review identified a small pool of research looking at a range of indirect pathways (mediating variables). The review identified traits with well-established associations with mortality risk, such as neuroticism, do not have consistent findings in the mediation literature and a high level of variance in the degree to which mediators account for the personality-mortality relation between different cohorts. Despite these limitations, it is clear that examining indirect effects (mediation) has a crucial role to play in developing our understanding of the complex pathways that connect personality-mortality risk. We identify several avenues and considerations for future research. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Self-Acceptance and Purpose in Life Are Mechanisms Linking Adverse Childhood Experiences to Mortality Risk.

OBJECTIVE: Adverse childhood experiences (ACEs) are associated with an increased risk of premature mortality, but it is not clear why. Individuals with ACEs tend to have lower self-acceptance and purpose in life, which may be pathways between ACEs and risk of premature mortality. As such, we tested whether purpose and self-acceptance are mechanisms that link ACEs to mortality risk. METHODS: We used the Midlife in the United States Survey ( N = 6218; mean [standard deviation] = 46.89 [12.94] years) to test whether these factors were indirect pathways between ACEs and mortality hazards over 24 years of follow-up. We used a comprehensive ACE measure that included 20 possible childhood adversities including emotional and physical abuse, household instability, socioeconomic climate, and ill health. RESULTS: ACEs significantly increased mortality risk (hazard ratio = 1.028, 95% confidence interval = 1.008-1.047, p = .006). Self-acceptance and purpose accounted for an estimated 15% and 4% of the ACEs-mortality relation, respectively. These effects withstood a range of adjustments and sensitivity analyses. CONCLUSIONS: ACEs may affect mortality risk partially through lower self-acceptance and purpose during adulthood. Given that self-acceptance and purpose may change through intervention, these factors may be useful targets for individuals with ACEs that could lead to a longer life.

Neuroticism facets and mortality risk in adulthood: A systematic review and narrative synthesis.

OBJECTIVE: This systematic review sought to summarize comprehensively the research investigating the association between facets of neuroticism and mortality risk. METHODS: A systematic review of prospective cohort studies utilizing rigorous reporting methods was conducted. Six electronic bibliographic databases, MEDLINE [Ovid], Embase, PsycINFO, CINAHL, Web of Science, and SCOPUS, were searched for eligible studies using keywords encompassing personality traits and mortality. Articles from inception to January 2023 were reviewed. The risk of bias was also assessed. RESULTS: Six of the 2358 identified studies met the inclusion criteria for extraction. Included studies had 335,715 participants, of whom 3.23% died. Participants ages at baseline ranged from 20 to 102, and 54% were female. Five of the six studies reported statistically significant associations between facets of neuroticism and mortality risk. Several underlying facets were reported to be associated with an increased mortality risk, namely vulnerability, cynicism, pessimistic, anxious, and depressive facets. Inadequacy, and worried-vulnerable were reported as protective. One study reported protective effects for impulsiveness, but this was not observed in a further follow-up study. CONCLUSIONS: Various facets related to neuroticism are associated with an increased or decreased mortality risk. Encompassing all facets in a broad trait likely masks very important personality-health relations, which later impact longevity. Based on these findings, recommendations and future considerations are discussed.

Adverse childhood experiences and all-cause mortality risk in adulthood.

BACKGROUND: Adverse Childhood Experiences (ACEs) have been associated with mortality risk in adulthood. It is unclear, however, whether ACEs perpetrated beyond parents may be associated with mortality risk, if the risk is accumulative or plateaus at a certain frequency, whether associations differ dependent on ACE types, whether types interact with one another, or if observed effects differ by sex. OBJECTIVE: To examine associations between ACEs and mortality risk. PARTICIPANTS AND SETTING: 6319 participants (age range 25-74 years, mean [SD] 46.91 [12.95] years; 51.6 % female) followed from 1995/96 to 2018 as part of the survey of Midlife Development in the United States. METHODS: ACE variables were self-reported exposure to 20 ACE types from five categories: physical abuse, emotional abuse, socioeconomic disadvantage, adverse family structure, and poor health at age 16 years. Cox proportional hazards models were used to estimate mortality risk. RESULTS: ACEs were accumulatively associated with increased mortality risk in adjusted models (HR = 1.033; p ≤ .001, 95 % CI, 1.014-1.053). The association was linear. Only physical abuse (HR = 1.05; p = .024, 95 % CI, 1.01-1.10) remained significantly predictive of increased mortality risk adjusting for other types. No interaction by sex or amongst ACE types was observed. CONCLUSIONS: ACEs may be cumulatively associated with increased mortality risk, such that each individual ACE increases risk. Physical abuse may be an important ACE type within a mortality risk context. Individual ACE types warrant further study as each type may have their own differential impact on mortality risk.

Personality trait associations with quality-of-life outcomes following bariatric surgery: a systematic review.

BACKGROUND: Obesity can be a significant challenge to health and quality of life (QoL). Bariatric surgery assists with weight loss and may help improve QoL. However, not all patients benefit from surgery. Personality traits may be related to QoL outcomes after bariatric surgery, but these associations are unclear. PURPOSE: This research reviews the published literature on the associations between personality and QoL among post-operative bariatric patients. METHOD: Four databases (CINAHL Complete, Medline with Full Text, APA PsycINFO, and Scopus) were searched from inception until March 2022. Forward searching was conducted using Google Scholar, and backward reference citation searches were also performed. RESULTS: Five studies met inclusion criteria yielding data from N = 441 post-bariatric patients including both pre/post and cross-sectional designs. Higher agreeableness was related to lower overall health-related QoL (HRQol) and gastric HRQol and positively associated with psychological HRQol. Higher emotional stability was positively related to overall HRQol. Higher impulsivity was negatively associated with mental HRQol and was unrelated to physical HRQol. Effects for the remaining traits were either mainly mixed or null. CONCLUSION: Personality traits may be associated with HRQol outcomes. However, it is difficult to reliably discern the role of personality traits for HRQol and QoL outcomes given the methodological issues and few published studies. More rigorous research is needed to address these issues and clarify possible associations.

Clinicians' Experience of Collaboration in the Treatment of Suicidal Clients Within the Collaborative Assessment and Management of Suicidality Framework.

INTRODUCTION: There is little known about the clinicians' experience of collaboration using the Collaborative Assessment and Management of Suicide (CAMS) framework. This study aimed to give voice to the clinician experience. METHOD: A qualitative design utilised semi-structured interviews with ten psychologists who worked in a Suicide Assessment and Treatment Service (SATS) in Ireland which utilises the CAMS framework. RESULTS: An Interpretative Phenomenological Analysis (IPA) approach revealed several important findings. The superordinate themes included 'Finding Safety', 'Regulation of the Self', 'Connecting', and 'Systemic Challenges'. DISCUSSION: The CAMS framework plays an important role in providing a safe base for the clinician (in terms of understanding suicidality, in addition to the structures of the framework). It provides a mechanism in which to process difficult emotions, and a way of communicating a formulation of suicide to the treating team. Importantly, the CAMS emerged as facilitating a collaborative, therapeutic way of working.

Loneliness, Social Isolation, and Living Alone Associations With Mortality Risk in Individuals Living With Cardiovascular Disease: A Systematic Review, Meta-Analysis, and Meta-Regression.

OBJECTIVE: This study aimed to conduct a systematic review and meta-analysis of associations between loneliness, social isolation, and living alone and risk of mortality among individuals with established cardiovascular disease. METHODS: Five electronic databases were searched (MEDLINE [Ovid], PsycINFO, EMBASE, PubMed, and SCOPUS) from inception to November 25, 2021. In all, 35 studies were included in a narrative synthesis and, where appropriate, a meta-analytic evaluation using a random-effects model. RESULTS: Living alone was associated with increased risk of all-cause mortality ( k = 15, n = 80,243, hazard ratio [HR] = 1.48, 95% confidence interval [CI] = 1.20-1.83, I2 = 83%), and meta-regressions found that the effects were stronger in studies from Europe and with longer follow-up. However, there was evidence of publication bias. Social isolation was associated with increased risk of all-cause mortality, measured both as a dichotomous variable ( k = 3, n = 2648, HR = 1.46, 95% CI = 1.08-2.04, I2 = 31%) and as a continuous variable ( k = 5, n = 2388, HR = 1.11, 95% CI = 1.02-1.24, I2 = 51%). Meta-analysis was not feasible for loneliness as exposure, but narrative synthesis of four studies suggested a tentative association between loneliness and increased risk of all-cause mortality. CONCLUSIONS: Supporting public health concerns, our review finds that loneliness, social isolation, and living alone are associated with premature mortality among individuals with established cardiovascular disease. However, evidence of publication bias and large methodological differences across studies point to the need for more rigorous research.

Childhood abuse and neglect, and mortality risk in adulthood: A systematic review and meta-analysis.

BACKGROUND: Research findings on the relationship between childhood abuse and neglect (CAN) and mortality risk in adulthood are inconsistent. OBJECTIVE: To examine the association between CAN and mortality risk in adulthood. PARTICIPANTS AND SETTING: Systematic review and meta-analysis. METHODS: Six databases were searched up to November 2021 for studies reporting adult mortality outcomes associated with childhood physical abuse, emotional abuse, sexual abuse, physical neglect and/or emotional neglect. When feasible, results were pooled using a random-effects meta-analysis. RESULTS: Nine studies met the inclusion criteria, involving 265,858 individuals. Abuse included physical (4/9), sexual (2/9), emotional (2/9), combined physical or sexual (2/9) and combined abuse and neglect (4/9). Only one study reported neglect separately. Three studies that examined the association between combined childhood abuse and neglect and mortality showed a pooled HR of 1.86 (95 % CI = 1.26-2.73, I2 = 81 %). Specific types of abuse (physical, emotional, sexual) were unrelated to mortality risk, but subgroup analyses suggested that physical and emotional abuse were associated with greater mortality risk among women. There was high heterogeneity (I2 of >75 %) between estimates for almost all predictors. CONCLUSIONS: Research suggests an association between CAN and adult mortality risk. However, more research is needed to address several limitations within the literature. These include standardising measures of CAN, representative sampling from vulnerable populations and differing geographical regions, and more detailed examination of the multi-faceted experience of abuse and neglect in childhood.

Anxiety following myocardial infarction: A systematic review of psychological interventions.

OBJECTIVE: Anxiety is highly prevalent following myocardial infarction (MI) and is linked with adverse effects on a person's recovery, quality of life, physical health, and life expectancy. The primary objective of this systematic review was to assess the effectiveness of psychological interventions for anxiety following MI. METHOD: CINAHL, Medline, PsycINFO, PsycARTICLES, Cochrane Library, EMBASE, and Web of Science were systematically searched for studies that provided information on anxiety pre and post psychological intervention following MI. RESULTS: Eighteen studies were included (15 randomized controlled trials [RCTs] and three non-RCTs). Within these studies, psychological interventions comprised cognitive behavioral therapy, eye movement desensitization reprocessing, counseling, psychotherapy, psychological/psychosocial cardiac rehabilitation, illness perception interventions, relaxation training, mindfulness, stress management, and other psychological-based programmes. Ten studies reported a significant decrease in anxiety following a psychological intervention, when compared with usual care. Three studies noted mixed results, and five studies reported no significant difference in anxiety following a psychological intervention. The interventions varied in length, setting, facilitation, and format. Poor reporting of information increased the risk of bias within studies. CONCLUSION: Psychological interventions may be beneficial to individuals who experience anxiety following a MI. No particular type of psychological intervention appears to be superior to others within the existing literature. Further rigorous research is needed to identify the needs of this population and the specific form of psychological intervention that is most effective in alleviating anxiety following MI. Clinical implications and recommendations for future research are provided. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Actor and Partner Effect of Loneliness on Episodic Memory and Verbal Fluency: A Dyadic Multilevel Analysis of Romantic Couples Across 28 Countries.

OBJECTIVES: There is evidence that loneliness is detrimental to cognitive health. Most studies, however, do not consider the association between loneliness and cognition in the context of close relationships, such as a spouse or romantic partner. This study examines loneliness, experienced by both the individual and their romantic partner, and cognitive performance. METHODS: Data were from 24,689 opposite-sex couples (49,378 participants) from 28 countries in the Survey of Health, Aging and Retirement in Europe. Each couple participant reported loneliness and completed memory and verbal fluency tasks. A multilevel sex-stratified analysis was used to account for the nested data structure and evaluate actor and partner effects of loneliness on cognitive performance for male and female partners. RESULTS: Consistent with the literature, there were small actor effects of loneliness on memory and verbal fluency for both males and females: A person's own loneliness was associated negatively with their cognitive performance on both tasks. There were also small partner effects: A person with a partner who was lonely tended to have worse cognitive performance above and beyond their own loneliness. Actor and partners effects were similar for male and female partners, replicated in most countries, and generally held controlling for age, education, household size, and disease burden. For memory, loneliness effects were slightly stronger among older participants. DISCUSSION: Both the experience of loneliness and loneliness of a partner have a negative association with cognitive health.

The bite is worse than the bark: Associations of personality and depressive symptoms with memory discrepancy.

The discrepancy between subjective memory rating and objective memory performance is the tendency to misestimate one's memory. For example, better self-rated memory compared to performance on memory tasks reflects an overestimation of one's memory. This discrepancy may shape how individuals cognitively age: Overestimating one's memory could mask incident cognitive decline and underestimation could act as a negative self-fulfilling prophecy. This study sought to examine the association between personality traits and depressive symptoms and memory discrepancy in five large samples of middle-aged and older adults (N > 23,000). We preregistered three hypotheses: neuroticism would be related to underestimation, extraversion to overestimation, and conscientiousness to higher accuracy. Controlling for sociodemographic covariates (age, gender, race, ethnicity, and education), results from regression models were pooled using random-effect meta-analyses. Openness was associated with underestimation of memory performance. Contrary to our hypothesis, neuroticism was related to overestimation. Surprisingly, depressive symptoms were also associated with overestimation. Cognitive status (impaired vs. unimpaired) did not moderate the association between personality and memory discrepancy, but it did with depressive symptoms, with a null or opposite effect among individuals with impaired cognition. In conclusion, although previous studies demonstrate consistent associations between personality traits and subjective memory ratings and memory performance, the current findings suggest null or unexpected links between personality and memory discrepancy. The findings suggest that clinicians should not dismiss cognitive complaints in the presence of depressive symptoms or high neuroticism because objective memory performance could be even worse than self-rated memory. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Familial sleep and autism spectrum disorder: a pilot actigraphy study of sleep quality, quality of life and psychological distress.

OBJECTIVES: Sleep problems are common among children with autism spectrum disorder (ASD) and can have a negative impact on the child's behaviour and daytime functioning. The current pilot study examined objective measurements of child and parent sleep as factors associated with the stress, anxiety, depressive symptoms, social support and quality of life of parents of children with ASD. METHODS: Participants were nine children with ASD and their parents (nine mothers and three fathers). Participants wore an actigraph for 7 consecutive days and nights. Measures of sleep habits and quality were used to ascertain child and parent sleep. Measures of parenting stress, anxiety, depressive symptoms, quality of life and social support were collated. RESULTS: Results indicated the emergence of high parental stress, anxiety and depressive symptoms. Significant correlations were observed between parent depressive symptoms, and both subjective sleep quality and child sleep disruptions. CONCLUSIONS: The present study found that parental well-being is affected by child sleep problems.

Pathways From Early-Life SES to Dementia Risk in Old Age: The Role of Personality.

OBJECTIVES: This study investigates the association between childhood socioeconomic status (cSES) and risk of cognitive impairment in older adulthood, and whether the Five-Factor Model personality traits mediated this association. METHODS: A sample of 9,995 participants (mean age = 67.01 years) from the Health and Retirement Study were followed up every 2 years from 2006 to 2018. cSES was tested as a predictor of risk of dementia and risk of cognitive impairment not dementia (CIND). Personality was tested as a mediator of these associations. Models were adjusted for age, gender, ethnicity, race, education, and baseline year. RESULTS: Although effect sizes were modest, results indicated that lower cSES was associated with a higher risk of dementia (hazard ratio = 0.88 [0.775-0.985]). Higher cSES was also associated with higher conscientiousness and lower neuroticism. Conscientiousness and neuroticism each accounted for 7.9% of the total effect of cSES on dementia. Results were similar for CIND. DISCUSSION: Early childhood socioeconomic factors may contribute to cognitive impairment in older adulthood, an association mediated, in part, through adult personality traits.

An integrative network analysis framework for identifying molecular functions in complex disorders examining major depressive disorder as a test case.

In addition to the psychological depressive phenotype, major depressive disorder (MDD) patients are also associated with underlying immune dysregulation that correlates with metabolic syndrome prevalent in depressive patients. A robust integrative analysis of biological pathways underlying the dysregulated neural connectivity and systemic inflammatory response will provide implications in the development of effective strategies for the diagnosis, management and the alleviation of associated comorbidities. In the current study, focusing on MDD, we explored an integrative network analysis methodology to analyze transcriptomic data combined with the meta-analysis of biomarker data available throughout public databases and published scientific peer-reviewed articles. Detailed gene set enrichment analysis and complex protein-protein, gene regulatory and biochemical pathway analysis has been undertaken to identify the functional significance and potential biomarker utility of differentially regulated genes, proteins and metabolite markers. This integrative analysis method provides insights into the molecular mechanisms along with key glycosylation dysregulation underlying altered neutrophil-platelet activation and dysregulated neuronal survival maintenance and synaptic functioning. Highlighting the significant gap that exists in the current literature, the network analysis framework proposed reduces the impact of data gaps and permits the identification of key molecular signatures underlying complex disorders with multiple etiologies such as within MDD and presents multiple treatment options to address their molecular dysfunction.

Is neuroticism differentially associated with risk of Alzheimer's disease, vascular dementia, and frontotemporal dementia?

This study examines whether neuroticism is differentially associated with risk of incident Alzheimer's disease (AD), vascular dementia (VD), and frontotemporal dementia (FTD) using a prospective study design. Participants from the UK Biobank (N = 401,422) completed a self-report neuroticism scale in 2006-2010 and incident all-cause dementia, AD, VD, and FTD were ascertained using electronic health records or death records up to 2018. During an average follow-up of 8.8 years (3,566,123 person-years), there were 1798 incident of all-cause dementia, 675 AD, 376 VD, and 81 FTD. Accounting for age and sex, compared to individuals in the low quartile, individuals in the top quartile of neuroticism had higher risk of all-cause dementia (HR = 1.70; 95% CI: 1.49-1.93), AD (HR = 1.42; 1.15-1.75), VD (HR = 1.73; 1.30-2.29), but not FTD (HR = 0.89; 0.49-1.63). The associations with AD and VD were attenuated but remained significant after further accounting for education, household income, deprivation index, diabetes, hypertension, stroke, heart attack, ever smoker, physical activity, obesity, hemoglobin A1c, C-reactive protein, and low-density lipoprotein. The associations were not moderated by socioeconomic status. The findings were consistent in analyses that excluded cases that occurred within the first 5 years of follow-up. In conclusion, neuroticism is a robust predictor of incident AD and VD, but not FTD. This pattern suggests that the affective symptoms that distinguish dementia types may partly reflect premorbid differences in trait neuroticism.

Self-reported and mother-rated personality traits at age 16 are associated with cognitive function measured concurrently and 30 years later.

BACKGROUND: Models of personality and health suggest that personality contributes to health outcomes across adulthood. Personality traits, such as neuroticism and conscientiousness, have long-term predictive power for cognitive impairment in older adulthood, a critical health outcome. Less is known about whether personality measured earlier in life is also associated with cognition across adulthood prior to dementia. METHODS: Using data from the British Cohort Study 1970 (N = 4218; 58% female), the current research examined the relation between self-reported and mother-rated personality at age 16 and cognitive function concurrently at age 16 and cognitive function measured 30 years later at age 46, and whether these traits mediate the relation between childhood social class and midlife cognition. RESULTS: Self-reported and mother-rated conscientiousness at age 16 were each associated with every cognitive measure at age 16 and most measures at age 46. Self-reported openness was likewise associated with better cognitive performance on all tasks at age 16 and prospectively predicted age 46 performance (mothers did not rate openness). Mother-rated agreeableness, but not self-reported, was associated with better cognitive performance at both time points. Adolescent personality mediated the relation between childhood social class and midlife cognitive function. CONCLUSIONS: The current study advances personality and cognition by showing that (1) adolescent personality predicts midlife cognition 30 years later, (2) both self-reports and mother-ratings are important sources of information on personality associated with midlife cognition, and (3) adolescent personality may be one pathway through which the early life socioeconomic environment is associated with midlife cognition.

The cardiovascular response to acute psychological stress is related to subjectively giving and receiving social support.

The pathways linking giving and receiving emotional and instrumental social support, and cardiovascular reactivity (CVR) are not yet fully understood. Eight-two healthy young adults completed psychometric measures of giving and receiving emotional and instrumental social support and participated in a standardised laboratory stress task. Cardiovascular and hemodynamic parameters were monitored throughout. Both giving and receiving emotional support were positively associated with systolic blood pressure (SBP) and diastolic blood pressure (DBP), such that those reporting giving and receiving more emotional support had higher reactivity. Only receiving instrumental was associated with DBP, with those receiving more instrumental support having higher reactivity. Moreover, while the significant association between giving social support and CVR withstood adjustment for several confounding factors (e.g., BMI, sex) it was abolished when receiving support was controlled for. These findings are novel and extend the literature on social support and CVR. Taken together, these findings suggest that receipt of support, rather than giving, may be more influential in this context.

Personality pathways to mortality: Interleukin-6 links conscientiousness to mortality risk.

Personality is associated consistently with mortality hazards, but the physiological pathways are not yet clear. Immune system dysregulation may be one such pathway due to its role in age-related morbidity and mortality. In this preregistered study, we tested whether interleukin-6 (IL-6) and C-reactive protein (CRP) mediated the associations between personality traits and mortality hazards. The sample included 957 participants (M ± SD = 58.65 ± 11.51 years; range = 35-86 years) from the Midlife in the United States Survey that had 14 years of follow-up. Higher conscientiousness was associated with lower mortality hazards, with each one standard deviation higher conscientiousness associated with a 35% lower mortality risk. IL-6, but not CRP, partially mediated this association, with IL-6 accounting for 18% of this association in the fully adjusted model. While there was initial evidence that the biomarkers mediated both neuroticism and agreeableness and mortality risk, the indirect effects were not significant when controlling for the sociodemographic variables. Taken together, higher conscientiousness may lead to a longer life partially as a result of lower IL-6. This work highlights the importance of biological pathways that link personality to future mortality risk.

Relationship between parent-reported gastrointestinal symptoms, sleep problems, autism spectrum disorder symptoms, and behavior problems in children and adolescents with 22q11.2 deletion syndrome.

BACKGROUND: 22q11.2 deletion syndrome (22q) is a chromosome disorder, where a segment of chromosome 22, located at q11.2, is missing. This study aims to investigate the relationship between a number of parent-reported comorbid conditions including gastrointestinal symptoms, sleep problems, autism spectrum disorder (ASD) symptoms and behavior problems in children and adolescents with 22q deletion syndrome. METHOD: The Gastrointestinal Symptom Inventory, Children's Sleep Habits Questionnaire, Behavior Problem Inventory-Short Form and the Social Communication Questionnaire were completed by parents of 149 children and adolescents aged 3-18 years with a diagnosis of 22q. RESULTS: A series of correlations and hierarchical multiple regressions were conducted to examine the relationships between GI symptoms, sleep problems and behavior problems in children and adolescents with 22q deletion syndrome. A significant moderate relationship was found between GI symptoms and sleep problems. Gender and ASD symptoms predicted GI symptoms. Significant small relationships were found between GI symptoms and self-injurious behavior. Significant small to moderate relationships were found between sleep problems and self-injurious behavior, aggressive/destructive behavior, and sterotyped behavior. Sleep problems predicted challenging behavior. CONCLUSIONS: This research demonstrated the importance of studying the relationship between comorbidities, including gastrointestinal symptoms, sleep problems, and behavior problems and how they shape the phenotype of 22q deletion syndrome.