Anda Gershon

Stanford Medicine, Stanford, CA, United States

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Publications (9)29.34 Total impact

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    ABSTRACT: Early adversity is a strong and enduring predictor of psychiatric disorders including mood disorders, anxiety disorders, substance abuse or dependence, and posttraumatic stress disorder. However, the mechanisms of this effect are not well understood. The purpose of this review is to summarize and integrate the current research knowledge pertaining to the long-term effects of early adversity on psychiatric disorders, particularly in late life. We explore definitional considerations including key dimensions of the experience such as type, severity, and timing of adversity relative to development. We then review the potential biological and environmental mediators and moderators of the relationships between early adversity and psychiatric disorders. We conclude with clinical implications, methodological challenges and suggestions for future research.
    Current Psychiatry Reports 04/2013; 15(4):352. · 3.23 Impact Factor
  • A Gershon, S L Johnson, I Miller
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    ABSTRACT: BACKGROUND: Exposure to life stress is known to adversely impact the course of bipolar disorder. Few studies have disentangled the effects of multiple types of stressors on the longitudinal course of bipolar I disorder. This study examines whether severity of chronic stressors and exposure to trauma are prospectively associated with course of illness among bipolar patients. Method One hundred and thirty-one participants diagnosed with bipolar I disorder were recruited through treatment centers, support groups and community advertisements. Severity of chronic stressors and exposure to trauma were assessed at study entry with in-person interviews using the Bedford College Life Event and Difficulty Schedule (LEDS). Course of illness was assessed by monthly interviews conducted over the course of 24 months (over 3000 assessments). RESULTS: Trauma exposure was related to more severe interpersonal chronic stressors. Multiple regression models provided evidence that severity of overall chronic stressors predicted depressive but not manic symptoms, accounting for 7.5% of explained variance. CONCLUSIONS: Overall chronic stressors seem to be an important determinant of depressive symptoms within bipolar disorder, highlighting the importance of studying multiple forms of life stress.
    Psychological Medicine 02/2013; · 5.59 Impact Factor
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    ABSTRACT: Many studies have provided strong evidence of a fundamental and complex role for sleep disturbances in adult posttraumatic stress disorder (PTSD). Investigations of adult PTSD using subjective and objective measures document sleep architecture abnormalities and high prevalence of sleep disordered breathing, periodic limb movement disorder, nightmares, and insomnia. PTSD treatment methods do appear to significantly improve sleep disturbance, and also studies suggest that treatments for sleep disorders often result in improvements in PTSD symptoms. Further, the most recent evidence suggests sleep abnormalities may precede the development of PTSD. Given the importance of sleep disorders to the onset, course, and treatment of adult PTSD, examination of sleep disturbances far earlier in the life course is imperative. Here we review the literature on what we know about sleep disturbances and disorders in pediatric PTSD. Our review indicates that the extant, empirical data examining sleep disturbance and disorders in pediatric PTSD is limited. Yet, this literature suggests there are significantly higher reports of sleep disturbances and nightmares in children and adolescents exposed to trauma and/or diagnosed with PTSD than in non-trauma-exposed samples. Sleep questionnaires are predominantly employed to assess sleep disorders in pediatric PTSD, with few studies utilizing objective measures. Given the important, complex relationship being uncovered between adult PTSD and sleep, this review calls for further research of sleep in children with PTSD using more specific subjective measures and also objective measures, such as polysomnography and eventually treatment trial studies. Kovachy B; O'Hara R; Hawkins N; Gershon A; Primeau MM; Madej J; Carrion V. Sleep disturbance in pediatric PTSD: current findings and future directions. J Clin Sleep Med 2013;9(5):501-510.
    Journal of clinical sleep medicine: JCSM: official publication of the American Academy of Sleep Medicine 01/2013; 9(5):501-510. · 2.93 Impact Factor
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    ABSTRACT: This study focused on social support and social strain and their cross-sectional associations with instabilities in sleep and social rhythms in inter-episode bipolar disorder (BD). Thirty-five adults diagnosed with inter-episode BD type I and 38 healthy controls completed measures of perceived social support and social strain. Group differences in support and strain were examined. Within the BD group, instabilities in sleep and social rhythms were assessed with 28 days of daily diary and actigraphy. Correlation and regression analyses were used to examine cross-sectional and prospective associations between social support, social strain, instabilities in sleep and social rhythms, and mood symptoms. The BD group reported lower social support and higher social strain than the control group. Additionally, social strain was positively correlated with manic and depressive symptoms in the BD group. Furthermore, there was a cross-sectional association between social support and more stable sleep on actigraphy in the BD group, although social support did not predict future sleep instability. These results indicate that inter-episode BD is associated with deficient social support and elevated social strain compared to controls, and that this may be due to persistent inter-episode mood symptoms. Social strain may be particularly important given its association with manic and depressive symptoms. The results also raise the possibility that sleep instability is related to poor social support in BD.
    Bipolar Disorders 08/2012; 14(6):628-40. · 4.62 Impact Factor
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    ABSTRACT: Disturbances in sleep and affect are prominent features of bipolar disorder, even during interepisode periods. Few longitudinal studies have prospectively examined the relationship between naturally occurring sleep and affect, and no studies to date have done so during interepisode periods of bipolar disorder and using the entire set of "gold standard" sleep parameters. Participants diagnosed with bipolar I disorder who were interepisode (n = 32) and healthy controls (n = 36) completed diagnostic and symptom severity interviews, and a daily sleep and affect diary, as well as an actigraphy sleep assessment, for eight weeks (M = 54 days, ± 8 days). Mutual information analysis was used to assess the degree of statistical dependence, or coupling, between time series data of sleep and affect. As measured by actigraphy, longer sleep onset latency was coupled with higher negative affect more strongly in the bipolar group than in the control group. As measured by sleep diary, longer wakefulness after sleep onset and lower sleep efficiency were coupled with higher negative affect significantly more strongly in the bipolar group than in the control group. By contrast, there were no significant differences between groups in the degree of coupling between any measures of sleep and positive affect. Findings support the coupling of sleep disturbance and negative affect during interepisode bipolar disorder. Ongoing monitoring of sleep-affect coupling may provide an important target for intervention in bipolar disorder. (PsycINFO Database Record (c) 2012 APA, all rights reserved).
    Journal of Abnormal Psychology 07/2012; · 4.86 Impact Factor
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    ABSTRACT: This study used a comprehensive, interview-based measure of life stress to assess the role of different types of stress in predicting first onset of psychiatric disorders among daughters of depressed (n = 22) mothers and healthy (n = 22) mothers. Several types of stress were assessed: Chronic interpersonal stress, chronic non-interpersonal stress, episodic dependent (i.e., self-generated) interpersonal stress, episodic dependent non-interpersonal stress, episodic independent interpersonal stress, and episodic independent non-interpersonal stress. Daughters (ages 9-14) were recruited to have no clinically significant symptoms upon entry (T1). By a 30-month follow-up assessment (T2), 45% of the daughters of depressed mothers, but none of the daughters of healthy mothers, had developed a psychiatric disorder. Overall, daughters of depressed mothers were exposed to more severe chronic interpersonal and non-interpersonal stress than were daughters of healthy mothers. Further, daughters of depressed mothers who developed a psychiatric disorder by T2 were exposed to more severe chronic non-interpersonal stress and episodic dependent stress than were daughters of depressed mothers who remained healthy. We discuss the implications of these findings in the context of a stress-generation model for the intergenerational transmission of psychiatric risk among children of depressed mothers.
    Journal of psychiatric research 07/2011; 45(7):855-62. · 3.72 Impact Factor
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    ABSTRACT: The aim of this article is to highlight the importance of the sleep-wake cycle in children, adolescents, and adults with bipolar disorder. After reviewing the evidence that has accrued to date on the nature and severity of the sleep disturbance experienced, we document the importance of sleep for quality of life, risk for relapse, affective functioning, cognitive functioning, health (sleep disturbance is implicated in obesity, poor diet, and inadequate exercise), impulsivity, and risk taking. We argue that sleep may be critically important in the complex multifactorial cause of interepisode dysfunction, adverse health outcomes, and relapse. An agenda for future research is presented that includes improving the quality of sleep measures and controlling for the impact of bipolar medications.
    Clinical Psychology Science and Practice 06/2009; 16(2):256-277. · 2.92 Impact Factor
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    ABSTRACT: Insomnia, nightmares, or nocturnal panic attacks are prominent features of sleep disturbance that spans across many anxiery disorders. In a meta-analysis of 177 studies, Benca and colleagues (1992) reported that individuals with an anxiery disorder take longer ro get to sleep at the beginning of the night, ex-perience more awakenings during rhe night, obtain less sleep overall, and exhibit poorer sleep efficienry, relative to nonpatients. More recently, a review of dre literature by Papadimitriou and Linkowski 2005) suggesrs rhat the major findings reported bv Benca et al. have held over the ensuing decade. \,foreover, Papadimitriou and Linkowski (2005) tbund an especially strong association beween sleep disturbance and several anxiety disorders, including panic disorder, generalized anxiery disorder (GAD), obsessive-compulsive disorder, and posttraumatic stress disorder (PTSD). Afthough -ort of the evi-dence to date is based on samples of aduhs in their rriddle years, there is also evidence ofan association)erween sleep disturbance and anxiety disorders in ;hildren and adolescence (Forbes et al., 2006), as well as among older adults (Spira, Friedman, Flint, & Sheikh,2005). The first aim of this chapter is to highlight the potential importance of sleep problems in individu-als with anxiery disorders. W'e argue that disturbed sleep not only impairs the qualiry of a patientt life but may also contribute to rhe maintenance of the anxiety disorder. Our second aim is to review the evidence base for rrearing parienrs who sufFer from comorbid sleep disturbance and anxiery disorder. As will become evident throughout the chapter, there is a dearth of evidence that specifically delineates the relationship berween sleep disturbance and anxiery disorder and thus several ofour proposals are based on evidence from healthy nonpatients or patienrs with other clinical disorders. 'We raise this caveat at
    01/2008;
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    ABSTRACT: In the current study we used both quantitative and qualitative methods in a sample of sixth-grade girls in order to investigate the relationship between girls' concerns with weight and their adherence to gender-stereotyped roles as assessed by their scripts for an imagined date. Girls who had previous dating experience did not differ from those who did not in their adherence to gender stereotypes of dating. As hypothesized, girls who endorsed a gender-stereotyped perspective of dating in their scripts expressed significantly greater concern with their weight than did girls who endorsed a non-gender-stereotyped perspective of dating. The findings highlight the influence of holding a stereotyped view of gender roles on dissatisfaction with body weight during adolescence.
    Sex Roles 03/2004; 50(7):515-523. · 1.47 Impact Factor

Publication Stats

16 Citations
29.34 Total Impact Points

Institutions

  • 2013
    • Stanford Medicine
      • Department of Psychiatry and Behavioral Sciences
      Stanford, CA, United States
  • 2004–2013
    • Stanford University
      • Department of Psychiatry and Behavioral Sciences
      Palo Alto, CA, United States
  • 2009
    • University of California, Berkeley
      • Department of Psychology
      Berkeley, MO, United States