Browsing by Author "Fagundes, Christopher"

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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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    An Evaluation of Perceived Health Risk and Depressive Symptoms Before a Disaster in Predicting Postdisaster Inflammation
    (Wolters Kluwer, 2018) Murdock, Kyle; Stowe, Raymond; Peek, M.; Lawrence, Savannah; Fagundes, Christopher
    OBJECTIVE: Exposure to major life stressors is associated with subsequent enhanced inflammation-related disease processes. Depressive symptoms exacerbate stress-induced inflammatory responses. Moreover, those who report a high degree of perceived health risk before being exposed to a major life stressor such as a disaster are at risk for poor health outcomes. The present study examined whether perceived health risk and depressive symptoms before a disaster were associated with postdisaster inflammation markers. METHODS: The sample included 124 participants (mean [standard deviation] age = 55 [16] years; 69% women). At a baseline visit, participants completed self-report measures of perceived health risk and depressive symptoms (Center for Epidemiologic Studies Depression Scale) in addition to a blood draw for the assessment of inflammation markers (C-reactive protein, tumor necrosis factor receptor 1, and interleukin 6). All participants lived near a large petrochemical complex where an unexpected explosion occurred. A second blood sample was obtained 2 to 6 months after the explosion. RESULTS: No significant differences in inflammation markers were found between predisaster and postdisaster assessment (p > .21). An interaction between predisaster perceived health risk and depressive symptoms in predicting postdisaster circulating inflammation markers was identified (Cohen f = 0.051). Specifically, predisaster perceived health risk was associated with postdisaster circulating inflammation markers if predisaster depressive symptoms were greater than 8.10 on the Center for Epidemiologic Studies Depression Scale. CONCLUSIONS: These findings add to our understanding of the complex interactions between stress, depression, and immune responses. Indeed, findings provide a potential mechanism (i.e., inflammation) explaining the association between exposure to major life stressors and negative mental and physical health outcomes.
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    Associations of meaning of illness with psychosocial, clinical, and immunological characteristics in patients with Leptomeningeal metastasis
    (Elsevier, 2021) Walker, Julie G.; Armstrong, Terri S.; O'Brien, Barbara J.; Gilbert, Mark R.; Casarez, Rebecca L.; Fagundes, Christopher; Heijnen, Cobi J.; Andersen, Clark R.; Yuan, Ying; Wu, Jimin; LoBiondo-Wood, Geri
    Background Leptomeningeal metastasis (LM) creates symptoms related to both the disease within the nervous system and treatment toxicities. Biologic processes, such as inflammation and behavioral processes, such as the meaning ascribed to illness (Meaning of Illness: MoI), can impact physical and psychosocial symptoms. The aim of this study was to understand the relationships among MoI, physical and psychosocial symptoms, and inflammation in patients with LM. Methods Thirty enrolled participants completed the MD Anderson Symptom Inventory-Brain Tumor with spine experimental symptoms added. Meaning of illness, quality of life (QoL), and depression were captured by validated instruments. Interleukin (IL)-6 and tumor necrosis factor (TNF)-α in serum and cerebrospinal fluid (CSF) were measured by ELISA. Correlations were performed to assess relationships among the variables. Results Participants were primarily white (73%), female (63%). Median age was 54 years (34–83). Breast (50%) and lung (20%) were most common diagnosis. Higher MoI scores were associated with better QoL (p < .01) and fewer depressive symptoms (p < .01). All CSF samples contained IL-6 and all but one sample had elevated IL-6. Higher levels of IL-6 in the CSF were associated with greater symptom burden (p < .01) and interference of symptoms in daily life (p = .02) but not MoI. Conclusions MoI was associated with QoL and depression. High levels of IL-6 in the CSF were associated with more severe symptoms. This study provides the groundwork for future research, including interventional studies to improve QoL in patients with LM.
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    Behavioral Symptoms after Breast Cancer Treatment: A Biobehavioral Approach
    (MDPI, 2015) Fagundes, Christopher; LeRoy, Angie; Karuga, Maryanne
    Being diagnosed and treated for breast cancer is emotionally and physically challenging. Breast cancer is the most commonly diagnosed cancer and the second leading cause of death for women in the United States. Accordingly, women with a breast cancer history are the largest group of female cancer survivors. Psychological stress substantially augments adverse autonomic, endocrine, and immune discharge, including enhanced production of proinflammatory cytokines. Importantly, inflammation is a key biological mechanism underlying the symptom cluster of pain, depression, fatigue, and sleep disturbances; there is also good evidence that inflammation contributes to breast cancer recurrence. Stress may exert direct effects on psychological and physiological risk processes. In this review, we take a biobehavioral approach to understanding predictors and mechanisms underlying somatic symptoms in breast cancer survivors.
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    Examining Links Between Distinct Affective States and Tobacco Lapse During a Cessation Attempt Among African Americans: A Cohort Study
    (Oxford University Press, 2024) Jones, Dusti R; Potter, Lindsey N; Lam, Cho Y; Schlechter, Chelsey R; Nahum-Shani, Inbal; Fagundes, Christopher; Wetter, David W
    Affect states are posited to play a pivotal role in addiction-related processes, including tobacco lapse (i.e., smoking during a quit attempt), and distinct affective states (e.g., joy vs. happiness) may differentially influence lapse likelihood. However, few studies have examined the influence of distinct affective states on tobacco lapse.This study examines the influence of 23 distinct affect states on tobacco lapse among a sample of tobacco users attempting to quit.Participants were 220 adults who identified as African American (50% female, ages 18–74). Ecological momentary assessment was used to assess affect and lapse in real-time. Between and within-person associations testing links between distinct affect states and lapse were examined with multilevel modeling for binary outcomes.After adjusting for previous time’s lapse and for all other positive or negative affect items, results suggested that at the between-person level, joy was associated with lower odds of lapse, and at the within-person level, attentiveness was associated with lower odds of lapse. Results also suggested that at the between-person level, guilt and nervous were associated with higher odds of lapse, and at the within-person level, shame was associated with higher odds of lapse.The present study uses real-time, real-world data to demonstrate the role of distinct positive and negative affects on momentary tobacco lapse. This work helps elucidate specific affective experiences that facilitate or hinder the ability to abstain from tobacco use during a quit attempt.
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    Pathways linking racial/ethnic discrimination and sleep among U.S.-born and foreign-born Latinxs
    (Springer, 2018) Garcini, Luz M.; Chirinos, Diana A.; Murdock, Kyle W.; Seiler, Annina; LeRoy, Angie S.; Peek, Kristen; Cutchin, Malcom P.; Fagundes, Christopher
    This study examined the association between racial/ethnic discrimination and sleep through psychological distress and body mass index (BMI), and determined whether the aforementioned associations vary between U.S. and foreign-born Latinxs. Participants were 1332 Latinx adults enrolled in the Texas City Stress and Health Study. Multistage sampling methods were used to select participants. A model linking racial/ethnic discrimination with sleep disturbances through direct and indirect (i.e., psychological distress and BMI) paths demonstrated good fit. Greater racial/ethnic discrimination was associated with greater psychological distress and higher BMI. Psychological distress and BMI were also significant predictors of sleep disturbances. The indirect path from racial/ethnic discrimination to sleep disturbances via psychological distress was significant. A model with parameters constrained to be equal between U.S.-born and foreign-born Latinxs suggested associations were comparable between these groups. Our study demonstrated the relevance of racial/ethnic discrimination to sleep disturbances, particularly its association via psychological distress among Latinxs.