Emily Brenny Kroska Thomas

Pregnancy is characterized by pronounced neuroplasticity and heightened risk for psychopathology. While previous research has primarily examined postpartum depression, less work has investigated changes in internalizing symptoms measured dimensionally across the peripartum period. Furthermore, limited research has identified functional changes in the prefrontal cortex (PFC) across pregnancy, a brain area implicated in psychopathology. Understanding the dynamic changes in internalizing symptoms and PFC neuroconnectivity throughout pregnancy and their interrelations is crucial for early identification of perinatal psychopathology. This pre‐registered longitudinal study examined changes in and associations between internalizing symptoms and PFC functional connectivity throughout the first and third trimesters of pregnancy. Pregnant individuals recruited from a community sample of females engaged in prenatal care ( N = 60, M _age = 32.31, SD = 5.34, 90% White, 91.7% non‐Hispanic/Latine) completed structured clinical interviews assessing mood and anxiety symptoms and resting‐state functional near‐infrared spectroscopy measuring PFC connectivity during the first and third trimesters of pregnancy. From the first to third trimester, longitudinal results revealed a significant decrease in symptoms of distress and fear and significant increases in neuroconnectivity anchored in left medial frontal areas of the PFC. Cross‐sectionally, higher first trimester fear was associated with lower within‐region right medial PFC and higher within‐region left medial PFC connectivity. Longitudinal decreases in distress from first to third trimester were associated with increased connectivity between left medial and right lateral PFC, alongside weakened connectivity between bilateral medial frontal regions. These findings demonstrate that internalizing symptoms relate to prefrontal connectivity from first to third trimester in a community sample of pregnant women. Examining internalizing symptoms dimensionally across pregnancy allows for characterization of the full range of symptoms that impact pregnant individuals. Future research should explore prevention and intervention implications of the relations between neural profiles and internalizing symptoms during pregnancy to improve long‐term outcomes for the mother and child.

Adults with major depressive disorder (MDD) have greater sleep impairments and engage in higher sedentary time (SED), and lower levels of physical activity (PA) than adults without MDD (Baglioni et...

Objective: During the COVID-19 pandemic, educators were impacted across domains of psychological, physical, social, and occupational health. Occupational environments, including classrooms, changed significantly due to COVID-19. This study aimed to characterize the nuanced experience of educators during the COVID-19 pandemic. Methods: Participants included 918 United States educators (e.g., teachers, paraeducators, support professionals, and administrators). Educators completed the survey via Qualtrics during November and December of 2020. The survey included eight qualitative questions, and responses were randomized to inductive or deductive datasets for analyses. Results: Our deductive results showed that individuals reported changes in several facets of health, with educators reporting increases in stress (38.0%) and feelings of isolation (45.9%). Our results also showed impacted occupational health, citing increased responsibility at work (34.0%) and feeling as though their voice was not heard after voicing concerns to either building- or district-level administration (28.2%). Conclusions: One of the key findings that emerged at the systemic level was educators reporting a lack of decision-making agency within the workplace. Through including educators in the conversations regarding decisions at all levels, agency may be increased. Educators not only shape the students they teach, but the communities within which they work, making a focus on their health paramount.

Long COVID is associated with significant physical and mental health burden, resulting in substantial quality of life limitations. The lived experience of individuals with long COVID is a vital consideration in evaluating the impact of the condition. Thirty-four adults with self-reported long COVID participated in a semi-structured in-depth interview study. An interview guide assessed physical and mental health symptoms, changes to plans, goals, and beliefs, and social impacts of long COVID. Participants were an average age of 51.6 years (SD = 17.0), and most identified as female (61.8%), white (97.1%), and not Hispanic or Latino/a/e (97.1%). Two coders read each interview while creating a codebook. The coders individually coded each interview transcript with themes emerging from the coded interviews. Each code reached an agreement level of at least 80%, with a Kappa (RK) score range of 0.90 to 0.98 in each interview, indicating adequate interrater reliability. Five themes emerged from the thematic analysis: decreased autonomy, decreased trust, changes in worldview, social impacts, and uncertainty. Individuals with long COVID reported heterogenous experiences, with often significant changes to daily functional abilities and outlook on life. Considering the unique lived experiences of individuals with long COVID will be important in developing a complete understanding of the condition and its implications.

BACKGROUND Perinatal depression is a major public health concern, and internet-based interventions may increase access to empirically based interventions. Investigating the contributing components of internet-based interventions is critical to implementation research and sustainability efforts within healthcare systems. OBJECTIVE This randomized components trial investigated the impact of an internet-based cognitive behavioral therapy intervention for perinatal depression, comparing the online intervention alone to the online intervention plus phone coaching, assessed with quantitative and qualitative outcomes. METHODS Pregnant and postpartum Veterans (N = 51) were randomized to 1) MomMoodBooster (MMB) or 2) MomMoodBooster + phone coaching (MMBPC) and completed three study assessments (baseline, 3-month follow-up, 6-month follow-up). The intervention consisted of six weekly modules and two optional booster modules. Linear mixed-effects modeling was used to determine the impact of intervention condition over time on depressive symptoms, behavioral activation, and negative automatic thoughts. The impact of intervention condition throughout the intervention was assessed using the Patient Health Questionnaire-9 at weeks 1, 3, and 5 of the intervention. Qualitative analyses identified themes related to helpful aspects of the program and areas for improvement. RESULTS Veterans who completed the welcome call, required for login to the intervention, were included in the analyses (n = 46). Between-assessment analyses were limited by attrition observed across both conditions. Results indicated that significant improvements in depressive symptom severity (F(2, 54.28) = 6.16, P = .004), behavioral activation (F(2, 41.68) = 4.21, P = 0.02), and negative automatic thoughts (F(2, 39.77) = 4.10, P = 0.02) were observed over time but not by condition (ps > .05). Within-intervention change also indicated a significant main effect of time (F(2, 63.88) = 21.62, p < .001), but not condition (p > .05). Qualitative analyses indicated positivity about the intervention and desire for more interaction. CONCLUSIONS Perinatal Veterans experienced therapeutic benefit during and after the online CBT intervention. Despite value of, or desire for, interaction depending on condition, both conditions experienced improvements in the depression, the primary outcome, and the targeted therapeutic processes. Future work should continue to explore contributing components of empirically based interventions for implementation, dissemination, and scalability efforts. CLINICALTRIAL The study was pre-registered on ClinicalTrials.gov (NCT05196152).

Background: Disordered eating behaviors and depressive symptoms can be problematic during pregnancy for both the individual and their offspring. Our study aimed to determine the extent to which body image dissatisfaction early in pregnancy predicts eating disorder behaviors and/or depressive symptoms across pregnancy. Methods: Participants (N = 253) completed self-report assessments of depressive and eating disorder symptoms alongside the modified Body Image in Pregnancy Scale in their first, second, and third trimesters. Latent trajectory modeling was used to examine eating disorder behaviors and depressive symptoms across time. Results: Latent trajectory modeling demonstrated that body image-namely, Preoccupation with Body Size, Preoccupation with Attractiveness, and Dissatisfaction with Strength, Tone, and Flexibility-significantly predicted both disordered eating and depressive symptoms in the third trimester, even when controlling for body mass index, eating pathology symptoms, and depressive symptoms in the first trimester. Change in Dissatisfaction with Strength, Tone, and Flexibility across pregnancy also significantly predicted third-trimester disordered eating (b = 0.41, standard error [SE] = 0.12, p < 0.001) and depressive symptoms (b = 0.40, SE = 0.12, p = 0.001). Conclusions: Although depressive symptoms are often assessed during prenatal care, disordered eating behaviors during pregnancy are often missed. While it is unknown how many participants met criteria for an eating disorder or major depressive disorder given only self-report measures were utilized rather than clinical interviews, this study suggests that assessing body image concerns early during the first trimester could help to identify individuals who may benefit from psychological treatment during pregnancy.

Although myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) symptoms (dysautonomia, dizziness, balance impairments) may theoretically contribute to an association with concussion, the nature of this association has not been determined. This study explored the association between ME/CFS and concussion, as well as risk factors for concussion, history of recent falls, and feelings of being dizzy or off balance. 2023 National Health Interview Survey data were utilized. United States adults (unweighted N = 29,373) responded to items regarding sociodemographic factors, ME/CFS status, and history of concussion, falls, and feeling off balance or dizzy. Logistic regression analyses assessed the association between ME/CFS and concussion, falls, and feeling dizziness or balance problems within the past year, adjusting for sociodemographic factors. Individuals with ME/CFS had 4.89 times greater odds of reporting concussion in the past year compared to individuals without ME/CFS. Individuals with ME/CFS also had 2.86 times greater odds of having fallen within the past year and 5.88 times greater odds of reporting feeling dizzy or off balance in the past year. ME/CFS status may be associated with concussion status. Healthcare practitioners should improve concussion screening and referrals for reducing concussion risk among individuals with ME/CFS.

Veterans are at increased risk of experiencing postpartum depression yet are understudied. Environmental factors like rurality and resource richness are associated with various health outcomes, although environmental relations to mental health outcomes, such as postpartum depression (PPD), have not been explored thoroughly. The current study aimed to examine the relation between living environment utilizing two indices (Area Deprivation Index and Rural Urban Commuting Area) and postpartum depressive symptom severity in postpartum Veterans. The study sample included postpartum Veterans that were recruited for an online CBT intervention. We utilized screening data from this recruitment effort. Depressive symptom severity was measured via the Patient Health Questionnaire-9. Individual Veteran-level administrative data included age, race, ethnicity, and residential address. Linear regression was used to determine whether resource richness and rurality were associated with depressive symptom severity when adjusting for race. Black Veterans had greater depressive symptom severity than White Veterans (β = 0.12, t = 3.39, p < .001). Rural-dwelling Veterans had lower depressive symptom severity than non-rural dwelling Veterans. Resource richness was not significantly associated with depressive symptom severity. There was not a significant interaction between race and rurality. The results of this study indicate that Black postpartum Veterans enrolled in VA care experienced greater depressive symptom severity. Additionally, rural-dwelling postpartum Veterans reported lower depressive symptom severity. Many postpartum Veterans in this sample were experiencing high symptom burden. Screenings for depressive symptom severity in the postpartum period should be provided to all childbearing individuals, but among Veterans, this may be particularly important.