International study of the Complex Stress Reaction Syndrome:Implications for transdiagnostic clinical practice

BACKGROUND The debate regarding diagnostic classification systems in psychiatry(categorial vs dimensional systems)has essential implications for the diagnosis,prevention and treatment of stress reactions.We previously found a unique pattern of stress reaction in a study executed during the coronavirus disease 2019 pandemic using large representative samples in two countries,and termed it the Complex Stress Reaction Syndrome(CSRS).AIM To investigate CSRS,Type A(psychiatric symptoms,spanning anxiety,depression,stress symptoms,and posttraumatic stress disorder(PTSD)),with or without long-coronavirus disease(COVID)residuals(CSRS,Type B,neuropsychiatric symptoms spanning cognitive deficits and fatigue,excluding systemic symptoms).Our two-tailed hypothesis was that CSRS is a condition related to an unrecognized type of stress reaction in daily life in the general population(Type A)or that it is related to the severe acute respiratory syndrome coronavirus 2 infection and its long-COVID residuals(Type B).METHODS 977 individuals in four continents(North America,Europe,Australia and the Middle East)completed the online study questionnaire in six languages using the Qualtrics platform.The study was managed by six teams in six countries that promoted the study on social media.The questionnaire assessed anxiety,depression,stress symptoms and PTSD(CSRS,Type A),cognitive deficits and fatigue(CSRS,Type B).The data were analyzed using Proportion Analyses,Multivariate Analysis of Co-Variance(MANCOVA),linear regression analyses and validated clinical cutoff points.RESULTS The results of the Proportion Analyses showed that the prevalence of 4 symptoms spanning anxiety,depression,stress symptoms,and PTSD was significantly higher than the most prevalent combinations of fewer symptoms across 4 continents,age groups,and gender.This supports the transdiagnostic argument embedded in the CSRS(Type A).The same pattern of results was found in infected/recovered individuals.The prevalence of the 4 psychiatric symptoms combination was significantly greater than that of 5 and 6 symptoms,when adding cognitive deficits and fatigue,respectively.MANCOVA showed a significant three-way interaction(age×gender×continent).Further analyses showed that the sources of this three-way interaction were threefold relating to two sub-populations at-risk:(1)Individuals that self-identified as non-binary gender scored significantly higher on all 4 psychiatric symptoms of the CSRS,Type A at young age groups(<50 years old)in North America compared to(self-identified)women and men located in the 4 continents studied,and to other ages across the adult life span;and(2)This pattern of results(CSRS,Type A)was found also in women at young ages(<40 years old)in North America who scored higher compared to men and women in other continents and other ages.Linear regression analyses confirmed the MANCOVA results.CONCLUSION These results show a combined mental health risk factor related to stress reactivity,suggesting that the CSRS is sensitive to populations at risk and may be applied to future identification of other vulnerable sub-populations.It also supports the transdiagnostic approach for more accurate prevention and treatment.Time will tell if such transdiagnostic syndromes will be part of the discussions on the next revisions of the traditional classification systems or whether the crisis in psychiatry further evolves.

How Emotion Nurtures Mentality:The Influencing Mechanism of Social-Emotional Competency on the Mental Health of University Students

Social-Emotional Competency(SEC),regarded as a critical psychological resource for individuals to adapt to social environments,is an effective protective factor for students’mental health,impacting their future success and well-being.Analyzing the impact of SEC on university students’mental health can offer valuable insights for nurturing talents with healthy psychological and physical development.Based on data from two large-scale surveys of Chinese university students,this study designed two comprehensive Multiple Mediation Models involving SEC,stress,coping strategies,and stress reaction to explore the pathway of emotion nurturing mentality.Study 1 utilized a parallel mediation model to examine the relationships between SEC,academic stress,interpersonal stress,and stress reactions.The results indicated that SEC negatively predicted academic stress,interpersonal stress,and stress reactions.Additionally,academic and interpersonal stress mediated the relationships between SEC and stress reactions in parallel.Extending these findings,Study 2 further investigated the role of coping strategies.By constructing a multiple-chain mediation model,it examined the predictive relationships among SEC,academic stress,interpersonal stress,three types of coping strategies,and stress reactions.The findings indicated that SEC negatively predicted stress,problemavoiding strategy,and stress reactions,while positively predicting problem-solving and assistant-seeking strategies.Furthermore,the two stress types and three coping strategies significantly mediated the relationship between SEC and stress reactions.This indicated that higher SEC was associated with reduced stress and more adaptive coping strategies and subsequently contributed to more favorable stress reactions.This research explored the impact of university students’SEC on mental health and its relational mechanisms,aiming to provide theoretical reference and practical insights for future efforts in cultivating SEC among university students to adjust academic and interpersonal stress,to enhance problem-solving and stress resistance capabilities,and to maintain their mental health.

Ameliorated stress related proteins are associated with improved cardiac function by sarcoplasmic reticulum calcium ATPase gene transfer in heart failure

Background Previous studies showed that overexpression of sarco-endoplasmic retieulum calcium ATPase （SERCA2a） in a variety of heart failure （HF） models was associated with greatly enhanced cardiac performance. However, it still undefined the effect of SERCA2a overexpression on the systemic inflammatory response and neuro-hormonal factors. Methods A rapid right ventricular pacing model of experimental HF was used in beagles. Then the animals underwent recombinant adeno-associated vires 1 （rAAV1） mediated gene trans- fection by direct intra-myocardium injection. HF animals were randomized to receive the SERCA2a gene, enhanced green fluorescent protein （control） gene, or equivalent phosphate buffered saline. Thirty days after gene delivery, the cardiac function was evaluated by echocardiographic testing. The protein level of SERCA2a was measured by western blotting. The proteomic analysis of left ventricular （LV） sample was determined using two-dimensional （2-D） gel el^ctrophoresis and MALDI-TOF-MS. The serum levels of the systemic inflammatory and neuro-hormonal factors were assayed using radioimmunoassay kits. Results The cardiac function improved after SERCA- 2a gene transfer due to the significantly increased SERCA2a protein level. Beagles treated with SERCA2a had significantly decreased serum levels of the inflammatory markers （interleukin-6 and tumor necrosis factor-a） and neuro-hormonal factors （brain natriuretic peptide, endothelin-1 and angiotensin II） compared with HF animals. The myocardial proteomic analysis showed that haptoglobin heavy chain, heat shock protein （alpha-crystallin-related, B6） were down-regulated, and galectin-1 was up-regulated in SERCA2a group compared with HF group, companied by up-regulated contractile proteins and NADH dehydrogenase. Conclusions These findings demonstrate that regional intramyocardial injections of rAAV 1-SERCA2a vectors may improve global LV function, correlating with reverse activation of the systemic inflammatory, excessive neuroendocrine factors and the stress-associated myocardial proteins, suggesting that the beneficial effects of SERCA2a gene transfer may involve the attenuation of stress-associated reaction.

Effect of Beak Trimming Stress on the Apoptosis and Its Related Protein Expression of Chicken Spleen

Beak trimming was a part of routine husbandry for poultry industry,which was the most efficient and economic way to reduce the incidence of cannibalism.However,the controversy about young chicken trimming still exits and it was drawing more concern recently along with the popular of animal behavior and welfare theory.To evaluate the influence of beak trimming on young chicken spleen development and find the key regulators of the spleen development,in this study,the electron microscope technique,flow cytometry and immunohistochemical techniques were used to investigate the effects of beak trimming stress on the spleen development.The result of electronic microscope showed that significant stress response could be found in chicken spleen cells after beak trimming.Cell volume became larger,chromatin of cell nuclear agglutinated conglobation,cytoplasm formed more vacuole,and mitochondria emerged vacuolization phenomenon in splenic lymphocyte after beak trimming.From the flow cytometry,the lymphocyte of spleen in the control group and experimental group were mainly in G1 phase,and the remaining small amount was in S and M phases.Of interest,the number of the lymphocyte which are in G1 phase within immune organ in the experimental group were more than that in the control group,but the number of cells in S and M phases were less than that in the control group.And beak trimming decreased the lymphocytes proliferation index of spleen.Inmmuohistochemical result showed that the beak trimming stress did not affect the expression sites of two apoptosis-related genes,Bcl-2 and Bax,in the spleen.But the expression level of Bcl-2 decreased while Bax increased in chicken immune organs after beak trimming.Furthermore,the beak trimming increased spleen cell apoptosis with a time-dependant style.Our findings may make a contribution to the active precaution of stress response.

CLINICAL APPLICATION OF ACUPUNCTURE ON ALLEVIATION OF STRESS REACTION INDUCED BY TRACHEAL INTUBATION IN GENERAL ANESTHESIA

By summarizing the formation of stress reaction induced by tracheal intubation and method of medicinal control, the recognition of Chinese medicine in treatment of cardiac arrhythmia and hypertension with acupuncture and the clinical application of acupuncture on stress reaction induced by tracheal intubation, it is concluded that the side effects of tracheal intubation are inevitable, even though there are many methods presented for the prevention and treatment for it. In recent years, the functions of acupuncture in anesthesia, especially in regulation of circulatory properties have been developed gradually and have been applied by many physicians in controlling the stress reaction induced by tracheal intubation in general anesthesia. Being a kind of dual-directional and positive regulation and stimulation, acupuncture provides definite and safe effects on controlling the stress reaction induced by tracheal intubation.

The Roots of Psychological Trauma and Post-TraumaticStress Reaction/Disorders and the Intervention

Psychological trauma refers to the catastrophic or traumatic events harmful to individuals＇ inner world. Strong emotional and psychological reaction caused by traumatic factors will form psychological shadows, and the improper coping of these events will lead to a post-traumatic stress disorder. In this paper, the author makes an exploration on the roots of psychological trauma and of post-traumatic stress reaction or disorders, which were caused by natural traumatic event, such as floods, snowstorms, earthquakes and other man-made factors such as wars, accidents from a psychological point of view. Finally, some suggestions of intervention are provided for the relevant departments to make relevant rebuilding policies.

Investigation on Cracking in Surfacing Layer of Ni_3Al Base Alloy

Investigation has been made on the causes of hot cracking in the surfacing layer of Ni_3Al basealloy by analysing the solidification process of fusion pool and the distribution of thermal stresses. The re-sults show that the cracking is directly related to both the occurrence of eutectic phase β' (NiAI) within theinterdendritic region and high thernial stresses in the surfacing layer ,and which are caused by selecting highwelding rate. When the process of electric arc weld is changed from straight line rnovement to that along’Z’pattern,the cracking in the surfacing layer of Ni_3Al base alloy is prevented owing to being reduced of boththe cooling rate of liquid in the fusion liool and the speed of the moving heat source. Lowering the outputpower of the electric arc welding could lead to the reducing of rnelting volume of the base material ,and lowerthe arnount of iron atoms dissolving in the fusion pool ,so that the trend of the eutectic reaction within the in-terdendritic region is reduced,and which is helpful to suppress the cracking in the surfacing layer of Ni_3Albase alloy.

Advances in Treatment of Post-Traumatic Stress Disorder with Chinese Medicine

“Timely,near,and expectation”is the main principle of battlefield rescue for military combat stress reaction(CSR).Post-traumatic stress disorder(PTSD)is the most common form of CSR and a long-term persistent mental disorder that is caused by unusual threatening or catastrophic psychological trauma.Chinese medicine(CM)has abundant resources,is simple,easy to master,with few side effects.This article summarizes the cellular and animal experimental mechanisms of CM treatment on PTSD,suggesting that traditional Chinese herbs and acupuncture can protect brain functional areas,and adjust hypothalamus-pituitary-adrenal axis.Traditional Chinese herbs and acupuncture have shown good anti-stress efficacy and fewer side effects in clinical application,which may improve the CSR in the battlefield.

On intergranular mechanical interactions and the theory of deformation crystallography of metals

The equilibrium of intergranular stress and strain can be realized simultaneously,whereas five independent slip systems of the Taylor principle and the criterion of minimal internal work are unnecessary.In fact,the Taylor principle applied in current theories is incorrect both in practice and theory,in which the activation mechanism of plastic deformation systems must violate the Schmid’s law and deviate from the elastic-plastic characteristics of deformed matrix.The intergranular reaction stress(RS)during deformation can be calculated according to Hooke’s law and elastic limit without additional subjective presupposition,therefore the RS theory is established intuitively.Under the combination of the RS(the intergranular elastic effect)and the external loading the slips penetrating grains are activated and produce deformation texture,but certain non-penetrating slips near grain boundaries will become active(the intergranular plastic effect)and produce some random texture when a RS reaches the yield strength of grains.The RS theory is simple,intuitive and reasonable,based on which the texture simulation can well reproduce the texture formation of various metals under different external loadings and under different crystallographic mechanisms.