Browsing by Person "Snider, Leslie"

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Cortisol awakening response over the course of humanitarian aid deployment: A prospective cohort study
(Taylor & Francis, 2020-12-21) Qing, Yulan; van Zuiden, Mirjam; Eriksson, Cynthia; Lopes Cardozo, Barbara; Simon, Winnifred; Ager, Alastair; Snider, Leslie; Lewis Sabin, Miriam; Scholte, Willem; Kaiser, Reinhard; Rijnen, Bas; Olff, Miranda
Background: Internationally deployed humanitarian aid (HA) workers are routinely confronted with potentially traumatic stressors. However, it remains unknown whether HA deployment and related traumatic stress are associated with long-term changes in hypothalamic-pituitary-adrenal (HPA) axis function. Therefore, we investigated whether cortisol awakening response (CAR) decreased upon deployment and whether this was moderated by previous and recent trauma exposure and parallel changes in symptom severity and perceived social support.
Decreased awakening cortisol over the course of humanitarian aid deployment is associated with stress-related symptoms: A prospective cohort study
(Taylor & Francis, 2019-06-10) Qing, Yulan; van Zuiden, Mirjam; Eriksson, Cynthia; Ager, Alastair; Snider, Leslie; Lewis Sabin, Miriam; Scholte, Willem F.; Simon, Winnifred; Kaiser, Reinhard; Lopes Cardoza, Barbara; Olff, Miranda
Background: Internationally deployed humanitarian aid (HA) workers are at risk for traumatic and chronic stress, and consequently stress-related psychopathology. Therefore, HA deployment may lead to long-term changes in neuroendocrine stress reactivity. Objective: We investigated whether awakening cortisol changed upon deployment, and whether this was associated with lifetime childhood and adulthood traumatic stressors, current deployment-related traumatic and chronic stressors and within-person changes in stress-related symptomatology upon deployment. Method: From a prospective study among expatriate HA workers (n = 214) from 19 international NGOs, we included n = 86 participants (68% females, 33 ± 8 years) who completed questionnaires and cortisol assessments at three points: pre-deployment, early post-deployment and 3–6 months post-deployment. At each assessment, cortisol parameters were calculated from two saliva samples: at awakening and 30 minutes post-awakening. Results: Linear mixed models showed significant decreased awakening cortisol over time (bs: −.036 [SE = .011] to −.008 [SE = .003], all ps < .007). Cortisol was significantly predicted by three-way interactions between lifetime stressors, deployment stressors and time, with the smallest decrease over time in those with limited lifetime and current stressors (all ps < .05). The change in cortisol was no longer significant upon inclusion of stress-related symptoms in the model. Moreover, a sharper cortisol decrease was significantly associated with higher anxiety (p = .004) and PTSD symptoms (p = .049) across assessments. Conclusions: This is the first study indicating decreased awakening cortisol after HA deployment. The exact decrease within participants depended on the amount of lifetime and current stressors. Importantly, when taking changes in stress-related symptomatology into account, we found these accounted for the attenuated awakening cortisol.
Implementing sport and physical activity across each layer of the Mental Health and Psychosocial Support (MHPSS) pyramid for populations affected by displacement
(Elsevier, 2025-06-19) Rosenbaum, Simon; Farello, Anna; Latimer, Kathleen; Vancampfort, Davy; Ventevogel, Peter; Richards, Justin; Warria, Ajwang’; Ager, Alastair; Bray, Maria; Snider, Leslie; Hermosilla, Sabrina; Clark, Jadranka Stikovac; Ferris, Jojo; Kurt, Gülsah
Physical activity (PA) and sport are increasingly recognized as integral parts of mental health and psychosocial support (MHPSS) programming within humanitarian response, for people affected by forced displacement. Nonetheless, the programming and implementation of physical activity within MHPSS responses remains inconsistent and largely ad hoc.. In this Short Communication, our team of multidisciplinary authors including academics, and practitioners from disciplines of psychiatry, psychology, physical therapy and sport for development, examine the implementation of sport and PA more broadly, across each layer of the Inter Agency Standing Committee (IASC) MHPSS Pyramid. We demonstrate how PA can be implemented at each layer, to improve MHPSS outcomes in humanitarian settings. We outline examples of how PA is being implemented across the IASC MHPSS pyramid, from ensuring access to inclusive and enabling environments (Layer 1), to strengthening participation in community-based PA and sport initiatives (Layer 2), delivering targeted programs with intentional mental health outcomes (Layer 3), and providing specialized physical activity promotion within clinical mental health services (Layer 4). This Short Communication provides guidance for humanitarian actors on integrating sport and PA across each layer of the IASC MHPSS pyramid.