Browsing by Author "Chen, Michelle Ai-Lien"

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    Adverse Childhood Experiences and Individual Differences among Dementia Spousal Caregivers: A Biobehavioral Approach to Stress Across the Lifespan
    (2022-08-09) Chen, Michelle Ai-Lien; Fagundes, Christopher
    Caregiving for a spouse with Alzheimer’s disease and related dementia (ADRD) is a chronic stressor that puts individuals at an increased risk for poor mental and physical health outcomes. Chronic stress can dysregulate the immune system and promote sustained elevated proinflammatory cytokine production, an important indicator of morbidity and mortality. However, not all ADRD spousal caregivers experiences the same amount of risk. Of note, individuals with a history of adverse childhood experiences are more psychologically and physiologically reactive to subsequent stressors across the lifespan (i.e., caregiving for a spouse with ADRD) than others without a history of adverse childhood experiences. Inhibitory control, defined as the ability to regulate undesired thoughts, actions, and emotional responses to stress, may further impact the relationship between adverse childhood experiences and health outcomes among individuals facing chronic stress later in life. In this study, I aimed to examine individual differences underlying how adverse childhood experiences may cause some ADRD spousal caregivers to be at a greater risk for stress-induced alterations in pro-inflammatory cytokines and poorer spousal caregiver well-being. Participants (n = 91) completed self-report assessments of adverse childhood experiences, inhibitory control, health, caregiver burden, grief symptoms, and quality of life. Across multiple measurements, adverse childhood experiences were associated with some, but not all domains of self-reported health and caregiver well-being. Furthermore, inhibitory control moderated the relationship between adverse childhood experiences and caregiver well-being across multiple measurements. Finally, inhibitory control moderated the relationship between childhood abuse and emotional well-being, energy, and depressive symptoms. Future studies should further explore mechanisms underlying these relationships and identify potential interventions that may mitigate the risk of adverse health outcomes for caregivers with a history of adverse childhood experiences.
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    The Role of Childhood Maltreatment and Self-Regulatory Processes on Inflammation, Depressive Symptoms, and Grief Symptoms During Spousal Bereavement
    (2020-08-13) Chen, Michelle Ai-Lien; Fagundes, Christopher P
    Early life adversity, such as childhood maltreatment, promotes physiological and physical dysregulation throughout the lifespan, increasing vulnerability to negative health outcomes. The stress associated with childhood maltreatment, which includes physical abuse, physical neglect, emotional abuse, emotional neglect, and sexual abuse inflicted by an older person or an adult towards a child, promotes an exaggerated physiological and psychological response to threats. Specifically, early life stress causes increases in chronic inflammation, which is associated with chronic diseases such as cardiovascular disease and cancer. In addition to increased physiological dysregulation (i.e., elevated inflammation), childhood maltreatment is associated with psychological dysregulation (i.e., depression), which may further contribute to disease later in life. Given the impact that early life adversity has on adverse health outcomes, it is important to identify how childhood maltreatment affects physiological and psychological dysregulation, especially for populations facing stress. Spousal bereavement ranks as the most stressful life event and is associated with elevated inflammation, depressive symptoms, and grief symptoms. Understanding how childhood maltreatment interacts with psychological and physiological mechanisms to predict inflammation, depressive symptoms, and grief symptoms will provide a useful direction in forecasting physical and mental health outcomes among a highly stressed, bereaved population. Individual differences in vagally-mediated heart rate variability, an index of an individual’s self-regulatory ability, may partially explain the relationship between childhood maltreatment and poor physiological (i.e., elevated inflammation) and psychological dysregulation (i.e., depression and grief) among a highly stressed population. Examining changes in inflammation, depressive symptoms, and grief symptoms throughout the bereavement experience may be prognostic of individuals who are more vulnerable to adverse health outcomes following the death of a spouse. Given the role that self-regulation may have in moderating the relationships between childhood maltreatment and inflammation, depressive symptoms, and grief severity, different emotion regulation strategies could also moderate these relationships. Thus, identifying the risk and resilience factors that underlie how childhood maltreatment impacts physiological and psychological dysregulation can be an influential factor in forecasting physical and mental outcomes among a highly stressed, bereaved population.