Vanesa Hidalgo

Long COVID is associated with persistent physical and emotional symptoms that may substantially impair health-related quality of life, with growing evidence suggesting that these outcomes differ between women and men. This cross-sectional study examined sex differences in health-related quality of life, lifestyle habits, and symptom severity in long COVID, and explored factors associated with health-related quality of life in women and men. A total of 342 adults with long COVID (mean age = 51.20 years, SD = 10.49; 265 women and 77 men) completed a battery of questionnaires during a single, face-to-face individual assessment session. The questionnaires assessed health-related quality of life, smoking behaviour, physical activity, dyspnoea, fatigue, and anxiety and depressive symptoms. Controlling for age and months since diagnosis, women reported lower quality of life and greater dyspnoea severity than men, whereas no sex differences were observed in smoking behaviour, fatigue severity, or anxiety and depressive symptoms. In sex-stratified exploratory analyses, poorer quality of life was associated with greater dyspnoea, fatigue, and emotional symptom severity in women, whereas in men it was associated with greater fatigue. However, interactions between sex and these factors were not statistically significant. These findings indicate sex differences in health-related quality of life and dyspnoea severity among individuals with long COVID. Larger, adequately powered studies are needed to determine whether the factors associated with health-related quality of life differ by sex.

Subjective cognitive decline (SCD) refers to a persistent self-perception of deteriorating cognitive function, particularly in memory, despite normal performance on standardized neuropsychological assessments. Increasing evidence supports its role as a potential preclinical marker of the Alzheimer's disease (AD) continuum. In recent years, the field has witnessed substantial growth, prompting the development of novel research frameworks and methodological approaches. This theoretical study synthesizes recent advances and key findings from longitudinal studies, which offer critical insights into the temporal relationship between SCD and progression to clinically defined stages of cognitive impairment. The literature consistently reports associations between SCD and subtle declines in objective cognitive performance, as well as the influence of sociodemographic and psychosocial factors, including differences related to sex and ethnicity. Additionally, emerging data link SCD with alterations in neurobiological biomarkers assessed through neuroimaging and fluid-based analyses, reinforcing its relevance as an early indicator of pathological aging. Based on this body of evidence, a preliminary comprehensive evaluation framework for clinical practice is proposed to improve early detection. Together, these findings underscore the need for standardized diagnostic criteria and integrative models that encompass the clinical, biological, cognitive, and psychosocial domains to enhance the predictive and diagnostic value of SCD in the context of neurodegenerative disease.

The relationship between hormonal reactivity to acute stress and memory is well established, but the role of anticipatory cortisol and dehydroepiandrosterone (DHEA) levels remains underexplored. This study aimed to assess the psychobiological responses (anxiety, affect, cortisol and DHEA) to an academic examination, subsequent memory performance and associations between anticipatory hormonal response and memory retrieval. Seventy-nine undergraduates (10 males) completed an acquisition session involving picture encoding and immediate free recall. Forty-eight hours later, during the recall session, they sat a written examination followed by delayed free recall and recognition tasks. Results showed higher anticipatory anxiety, negative affect and cortisol levels in the recall session than in the acquisition session. Participants showed poorer delayed recall performance and reduced recognition of neutral pictures. In addition, after correction for multiple comparisons, exploratory hierarchical regression analyses indicated that anticipatory cortisol levels and the cortisol/DHEA ratio assessed prior to the recall session were negatively associated with total delayed free recall performance, with the cortisol/DHEA ratio also being negatively associated with delayed free recall of negative pictures. In the absence of a control group, these findings cannot be used to make causal inferences. However, they are consistent with theoretical accounts of DHEA’s anti-glucocorticoid role and highlight associations between cortisol/DHEA balance and delayed free recall performance, particularly for negative emotional material.

Young individuals often experience executive functioning challenges, such as attentional lapses, impulsivity, and poor self-regulation, which may indicate underlying prefrontal dysfunction and contribute to stress and emotional dysregulation. Research suggests that specific personality traits, particularly harm avoidance and self-directedness, are closely related to these executive difficulties. Harm avoidance refers to a temperament trait characterized by excessive worry, fear, and avoidance of uncertainty, whereas self-directedness reflects a character trait involving goal orientation, self-control, and responsibility. However, the mechanisms linking these traits to executive functioning remain insufficiently understood. Psychological inflexibility, defined as a rigid and avoidance-based response to internal distress, has been proposed as a transdiagnostic process that may explain this link. This study investigates the mediating role of psychological inflexibility in the link between harm avoidance and self-directedness with prefrontal dysfunction in 501 young adults (56.69% male, M = 21.00 years, SD = 2.62). Participants completed self-report measures on personality traits, psychological inflexibility and prefrontal symptomatology. Mediation analyses using PROCESS Macro (model 4) showed that harm avoidance positively predicted psychological inflexibility (path a ₁ : β = 0.50, p < .001), which in turn predicted greater prefrontal symptomatology (path b ₁ : β = 0.45, p < .001). Conversely, self-directedness negatively predicted psychological inflexibility (path a ₂ : β = −0.54, p < .001), which was associated with lower prefrontal symptomatology (path b ₂ : β = 0.40, p < .001). Indirect effects were significant for both harm avoidance ( β = 0.23, 95% CI [0.17, 0.29]) and self-directedness ( β = −0.21, 95% CI [−0.27, −0.16]), indicating partial mediation. Overall, these findings highlight that psychological inflexibility serves as a key mechanism linking personality dispositions to executive and emotional self-regulation in young adults. Interventions aimed at increasing psychological flexibility may enhance adaptive functioning and resilience during this developmental period.

Introduction: Late childhood or preadolescence is an important period of development in which high levels of anxiety and stress can occur due to physical and psychological changes; the efficacy of interventions such as mindfulness in reducing stress and anxiety at these ages has been under-examined. This study aimed to evaluate the effectiveness of a mindfulness intervention program on different indicators of stress and anxiety in primary school students aged 9 to 12 years belonging to a public primary school. Method: 125 children were evaluated in anxiety (STAIC), Stress (IIEC), emotional valence, arousal, perceived self-control (SAM), and salivary cortisol, before, during, and after the intervention (14 sessions in 5 weeks, three sessions a week, 40 minutes/session). Sixty-three children participated in an intervention group, and sixty-two children were enrolled in the control group (waist list). Results: After the intervention, a noteworthy decrease in the levels of perceived stress at school, arousal, and cortisol in saliva was observed. Conclusions: Mindfulness appears to be an appropriate tool for reducing perceived stress, particularly in the school setting, as it reduces perceived arousal and lowers cortisol levels after one month of intervention. Introducción: La infancia tardía o preadolescencia es un periodo importante del desarrollo de las personas en el que se pueden presentar altos niveles de ansiedad y estrés debido a los cambios físicos y psicológicos experimentados. Sin embargo, la eficacia de intervenciones como el mindfulness en la reducción el estrés y la ansiedad en estas edades ha sido poco examinado. El objetivo de este estudio fue evaluar la eficacia de un programa de intervención con mindfulness sobre diferentes indicadores de estrés y ansiedad en estudiantes de primaria de 9 a 12 años, pertenecientes a una escuela de primaria pública. Método: 125 niños fueron evaluados en estrés (IIEC), arousal (calma-activación-SAM) y en cortisol en saliva cortisol, antes, durante y después de la intervención con mindfulness (14 sesiones in 5 semanas, tres sesiones por semana, 40 minutos por sesión). Sesenta y tres niños participaron en el grupo intervención y sesenta y dos niños en el grupo control (lista de espera). Resultados: Después de la intervención se observó una disminución significativa de los niveles de estrés percibido en la escuela, arousal y cortisol en saliva. Conclusiones: el mindfulness parece una herramienta adecuada para disminuir el estrés percibido, específicamente en el área escolar, ya que además de disminuir la percepción en arousal, reduce los niveles de cortisol después de un mes de la intervención.

Age-associated cognitive decline is a growing social problem and a major concern for older adults, highlighting the need to identify modifiable factors to mitigate it. The basal functioning of the hypothalamic-pituitary-adrenal (HPA) axis, and, especially, the post-awakening cortisol levels, seems to play a key role in cognitive performance related to functions dependent on the prefrontal cortex and hippocampus. Regulating these cortisol levels is crucial in this context, and resilience has been recognized as vital for successful aging and cognitive functioning. This study was designed to examine how post-awakening cortisol levels (both the cortisol awakening response, CAR (AUCi) and total post-awakening cortisol secretion, AUCg) could predict cognitive decline across different domains, and explore the role of resilience in this relationship. To investigate this, a follow-up study conducted between 2018 (Wave 1, W1) and 2022 (Wave 2, W2) included 53 healthy adults who completed tasks assessing verbal fluency, executive function, declarative memory, and resilience in both waves to study the cognitive decline. Moreover, in W1, participants provided four morning saliva samples on two consecutive working days to assess post-awakening cortisol levels on days that were different from the cognitive testing sessions. Results showed a negative association between AUCg and both phonemic and semantic fluency decline, but not in other cognitive domains, indicating a beneficial effect of post-awakening cortisol secretion on cognitive maintenance that appears be domain specific. In addition, resilience positively mediated the association between the CAR and the maintenance of semantic fluency. These findings underscore the role of post-awakening cortisol levels in supporting resilience and protecting prefrontal cortex-dependent functions, such as semantic fluency, over functions reliant on the hippocampus.