Resilience And Biomarkers Of Health Risk In Black Smokers And Nonsmokers Pdf

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Publications by authors named "J Alan Payne"

Either your web browser doesn't support Javascript or it is currently turned off. In the latter case, please turn on Javascript support in your web browser and reload this page. Free to read. Blacks are disproportionately affected by tobacco-related illnesses as well as traumatic events that are associated with psychiatric conditions and smoking.

We examined the potential protective nature of resilience within this context, hypothesizing that resilience differentially moderates the associations of traumatic experiences to depressive symptoms as well as to biomarkers of health risk among Black ever versus never smokers.

Measures of resilience, traumatic experiences, depressive symptoms, and biomarkers interleukin-6 [IL-6], C-reactive protein [CRP], allostatic load were obtained among Blacks recruited from Grady Memorial Hospital in Atlanta to participate in a study of trauma. Never smokers with higher resilience had a negative association between childhood trauma and depressive symptoms, whereas those with lower resilience had a positive association between childhood trauma and depressive symptoms.

Interventions targeting resilience may prevent smoking and adverse health outcomes as well as provide a basis for understanding mechanisms of intervention impact. The exposome comprises overlapping domains that include: 1 general external environments e. The public health exposome model conceptualizes these pathways to include environmental exposures, personal characteristics, and moderating factors, that in turn, are associated with health disparities among communities at greatest risk Juarez, One such community is Blacks in the US.

This hypothesis provides a framework for examining the impact of exposure factors with greater prevalence among Blacks that may together influence health outcomes. An important exposure associated with multiple negative health outcomes is the experience of traumatic events e. Cumulatively, the impact of traumatic experiences on health are significant and multidimensional. Compared to Whites, Blacks are more likely to report higher rates of childhood trauma, including parental death and severe alcoholism, as well as extreme economic deprivation Breslau et al.

Blacks experience more traumatic events in adulthood, such as being attacked or raped, threatened with a weapon, or witnessing an injury or murder Breslau et al. Blacks also have higher lifetime and current rates of posttraumatic stress disorder Breslau et al. Blacks are disproportionately affected by tobacco-related illnesses.

Smoking-related illnesses are the number one cause of death in the Black community, surpassing all other causes of death, including AIDS, homicide, diabetes, and accidents ACS, Blacks suffer disproportionate tobacco-related morbidity and mortality despite the fact that they tend to smoke fewer cigarettes per day and begin smoking later in life Alexander et al. This phenomenon remains unexplained but has been attributed to a variety of factors including stress associated with living in conditions of socio-environmental disadvantage.

The disproportionate burden of smoking-related diseases among Blacks is further compounded by the co-occurrence of smoking and depression that can result from trauma. Studies have shown an increased risk of nicotine dependence among individuals who report exposure to trauma or adverse events Al Mamun et al. For example, Breslau and colleagues Breslau et al. Depressive symptoms are strongly associated with nicotine dependence Breslau et al. Resilience is a personal characteristic that may account for differential health outcomes among people with histories of trauma.

Definitions of resilience have included: positive outcomes despite serious threats to adaptation and development Masten, ; the absence of a particular negative outcome in at-risk populations e. However, no previous research has examined the differential role of resilience on depressive symptoms and smoking among Blacks, which is particularly relevant given the range of sociodemographic and psychosocial differences between smokers and nonsmokers e.

Additionally, while resilience has frequently been examined in terms of mental health outcomes, it has been infrequently examined in relation to the internal environmental component of the exposome, such as physiological biomarkers associated with illness or disease e. IL-6 is an interleukin that acts as both a pro-inflammatory and anti-inflammatory cytokine Ferguson-Smith et al.

It is secreted by T cells and macrophages to stimulate immune response e. CRP is a sensitive marker of systemic low-grade inflammation and is currently recommended as the principal inflammatory marker in research and clinical practice Pearson et al. Elevated plasma levels of CRP have been associated with an increased risk of coronary heart disease Koenig et al. Moreover, elevated plasma CRP levels have been associated with obesity, insulin resistance, the metabolic syndrome, endothelial dysfunction, and an increased risk of developing Type 2 diabetes Festa et al.

Allostatic load is commonly conceptualized as an aggregate measure of disease risk markers, such as blood pressure, body mass index BMI , waist circumference, and blood glucose Barboza Solis et al.

Additionally, we hypothesized that these associations may differ for smokers and nonsmokers. Our assumptions in testing the models were that childhood traumatic experiences pre-date tobacco initiation and ongoing use as well as depressive symptoms.

However, the availability of additional measures of adult exposure to traumatic experiences provides a lifetime exposome indicator that has not been available in other studies. Given consistent evidence of positive associations between smoking and trauma exposure as well as depression, we hypothesized that their joint influences on weathering might differ for smokers and nonsmokers. We tested structural equation models to capture the complexity of the potential associations among these factors.

Such approaches are essential for sorting out the complex and interdependent factors that are likely to contribute to health disparities. Characterizing groups for whom the link between depression and resilience is most pronounced could inform future interventions for tobacco users. Conceptual framework examining exposures across the exposome and impact on health risk biomarkers.

This analysis was part of a larger study investigating genetic and trauma-related risk factors for post-traumatic stress disorder and depression in a population of urban, low-income, highly traumatized, predominantly Black men and women Binder et al. Inclusion criteria included ages 18 to 75 years, understanding English, and ability to give informed consent.

Members of the research team approached adult patients waiting for their outpatient appointments at the primary medical care or obstetrical-gynecological clinics of Grady Memorial Hospital in Atlanta, Georgia, to solicit for study participation Binder et al.

If the first participant that the staff approached in the waiting room did not agree to do the study, the staff approached at least two additional possible participants. Participants gave informed consent and completed a battery of self-report measures. Due to variation between participants with respect to literacy, all self-report measures were obtained by interview. Blood pressure, weight kg , height cm , and waist circumference cm were obtained by trained nursing staff at the Grady Hospital Clinical Research Center.

Sociodemographics included age, sex, education, income, employment, and disability. Bernstein et al. Reliability for the CTQ is good with high internal consistency scores. Over a three-month period, the test-retest coefficient was 0. Factor analysis on the five-factor CTQ model showed structural invariance, demonstrating good validity D. Adulthood trauma was assessed using the Traumatic Events Inventory Gillespie et al. This instrument screens for lifetime exposure to different categories of trauma, including natural disaster, serious accident or injury, sudden life-threatening illness, military combat, being attacked with a weapon, witnessing a family member or friend being attacked with a weapon, being attacked without a weapon, witnessing a family member or friend being attacked without a weapon, witnessing the murder of a friend or family member, or being sexually assaulted under duress.

For each category of the instrument, having had the exposure was scored as 1 and no exposure as 0. Score ranges from 0 to 15 for adulthood trauma, with higher scores reflecting exposure to more types of trauma.

The childhood trauma items in this inventory were excluded to avoid overlap with the information collected with the CTQ. Items were rated on a four-point Likert scale of 0 to 3; total score ranges from 0 to 63, with higher scores reflecting higher levels of depression.

This variable was operationalized as a continuous variable. Scores range from 0 to 40, with higher score reflecting greater resilience. Whole blood was collected under fasting conditions between am and am and processed by centrifugation to separate the plasma from the buffy coat.

Plasma samples were used to assess IL-6 and CRP, as well as cortisol used in the measure of allostatic load below. Allostatic load was operationalized as an aggregate measure of biomarkers of disease risk.

Individual biomarker scores were standardized and summed, creating a cumulative allostatic load score. We adapted our measure from Seeman et al. This approach has been studied in population-based survey research and indicated that higher allostatic load scores were associated with higher morbidity and mortality Seeman et al. Moreover, lower allostatic load scores were associated with higher educational levels and better psychosocial factor scores Seeman et al. The five factors comprising the allostatic load measure were: cortisol, systolic blood pressure, diastolic blood pressure, BMI, and waist-to-hip circumference.

A point was assigned for each criterion, yielding scores of 0 to 5, with 5 indicating highest risk. Descriptive univariate analyses were conducted to assess distributions and the extent of missing data. Bivariate analyses were used to examine the differences between ever smokers and never smokers. These were followed by analyses into the patterns of missing data and multivariable regression analyses including residual analyses for each of the endogenous constructs e.

Joint normality was assessed. Structural equation modeling was then conducted to examine the mediating role of depressive symptoms as well as the moderating role of resilience comparing relationships between ever and never smokers.

Estimation for the two-group model used maximum likelihood with missing values. No auxiliary variables were included, as missingness in the data was due to administration of different modules at different times independent of specific participant characteristics and were thus assumed to be missing completely at random. Post SEM, residuals were inspected. Data were cleaned and descriptive, univariate, bivariate, and multivariable analyses were conducted using SAS 9.

Structural equation modeling analyses were conducting using Stata Based on results from the bivariate analyses, age and sex were included as covariates in the structural equation model. Participant characteristics and bivariate analyses examining differences between ever smokers and never smokers. The overall coefficient of determinant CD was 0. Older age was also associated with higher IL-6, and being female was associated with higher allostatic load. Structural equation models examining the impact of trauma, resilience, and depressive symptoms on biological outcomes among ever smokers and never smokers, respectively.

Note: Solid black lines indicate significant associations, whereas gray lines indicate insignificant associations. Equation estimates for structural equation models for ever smokers and never smokers, respectively, and comparisons of coefficients across groups. Never smokers with higher resilience showed a negative association between childhood trauma and depressive symptoms, whereas those with lower resilience showed a positive association between childhood trauma and depressive symptoms see Figure 3.

Older age and being female was also associated with higher CRP. Resilience moderating the relationship between childhood trauma and depression among never smokers. Examining these groups separately is critical, as our results and the prior literature Agaku, King, Dube, et al. As anticipated, resilience served as a buffer between specific upstream risk factors i. In addition, our hypothesis that resilience would differentially moderate the associations between traumatic experiences, depressive symptoms, and health risk biomarkers among ever versus never smokers was also supported.

First, these findings highlight the need for early intervention among Blacks experiencing childhood trauma. Our results show that, among ever smokers, childhood trauma — but not adulthood trauma — was associated with higher depressive symptoms.

This finding points to biological embedding Hertzman, , Biological embedding suggests that long-term and stable differences in experience, under different nurturant conditions, lead to differences in learning and behavior over the life course.

Resilience and biomarkers of health risk in Black smokers and nonsmokers.

The ability of some individuals to reach extreme old age in the presence of clearly high exposure to damaging factors may signal an innate biological advantage. For this study we used data on 4, current and never smokers, ages 50 and above, from NHANES III to examine whether long-lived smokers represent a biologically resilient phenotype that could facilitate our understanding of heterogeneity in the aging process. Using a proportional hazards model, our results showed that while smoking significantly increased mortality in most age groups, it did not increase the mortality risk for those who were age 80 and over at baseline. Given that factors which allow some individuals to withstand smoking may also enable others to cope with everyday biological stressors, the investigation of long-lived smokers may eventually allow us to identify molecular and genetic mechanisms which enable longevity extension. This is an open-access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Previous attempts to locate hydrothermal vent fields and unravel the nature of venting at the ultraslow spreading and magma starved parts of the Arctic Mid Ocean Ridge AMOR have been unsuccessful. A black smoker vent field was eventually discovered at the Mohns-Knipovich bend at Fluid compositions are anomalous to other basalt-hosted fields and indicate interactions with sediments at depths. The vent field is associated with an unusually large hydrothermal deposit, which documents that extensive venting occurs at ultraslow spreading ridges despite the strongly reduced magmatic heat budget. ROV surveys have shown that venting occurs in two areas separated by around m. Micro-bathymetry acquired by a Hugin AUV documents that two tall mounds that coalesce at the base have developed around the vent sites. The micro-bathymetry also shows that the venting is located above two normal faults that define the NW margin of a rift that runs along the crest of the volcano.


Resilience and Biomarkers of Health Risk in Black Smokers and Nonsmokers In never smokers, childhood (p<) and adulthood trauma (p) were associated Diagnostic and Statistical Manual of Mental Disorders. 4.


Memory resilience occurs when genetically at-risk adults perform at high and sustained levels. We investigated whether a memory resilience to AD genetic risk is predicted by biological and other risk markers and b the prediction profiles vary by sex and AD risk variant. Growth mixture models classified resilience. For both sexes, younger age, higher education, stronger grip, and everyday novel cognitive activity predicted memory resilience. For women, 9 factors from functional, health, mobility, and lifestyle domains were also predictive.

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Resilience and Biomarkers of Health Risk in Black Smokers Never smokers with higher resilience had a negative association between childhood trauma and figures//cancer-facts-and-figurespdf. American.


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