Scientific Concept of the National Cohort (status ... - Nationale Kohorte

A.3
A.3 Study design
to the extent of interest or engagement in new experiences. Highly open persons present
as eager for knowledge, imaginative, and willing to try new behaviors.
By means of the recently developed and comprehensively validated BFI-10 494 , which goes
back to the longer version BF-44 495 , human personality in terms of the five-factor model can
be measured in an extremely economic way while maintaining reliability and validity of the
measurements at the same time. In the BFI-10, each of the five factors is covered by only
two items.
The Trier Inventory for the Assessment of Chronic Stress (TICS) 496 captures different
facets of chronic stress experience in selected life domains. It is based on an interactionrelated
stress concept, i.e., stress evolves when there is an insufficient fit between the demands
a person has to master in everyday life and the resources this person has at his/her
disposal. Depending on the type of demand, different sources of stress arise. The different
kinds of chronic stress that have been described include job overload, social overload, pressure
to succeed, work discontent, excessive demands at work, lack of social recognition,
social tensions, social isolation, and chronic worrying. Typically, several of these kinds of
stress occur at the same time and are accompanied by states of negative affectivity. Generally,
chronic stress is characterized by the following features: it has a subtle, unspecified
begin, can be of long or short duration, is characterized by frequently recurring strains, and
can be of either high or low intensity 496 .
These kinds of chronic stress as captured by the TICS scales have been linked to sleep
quality as well as to indicators of physical and mental performance. In particular, the observed
associations with mental performance were fairly high 497, 498 . Several psychobiological
studies support systematic relationships between TICS scales and the cortisol response
to awakening 496, 499 . In addition, different professional groups seem to differ in how they
experience chronic stress 498 .
The original version of TICS 496 comprises 57 items, which are to be assessed on 5-point
Likert scales covering all nine kinds of stress named above. Twelve items of the TICS
constitute the Screening Subscale of Chronic Stress (TICS-SSCS), which provides an unspecific
global measure of chronic stress. TICS screening items refer to aspects such as
being afraid that something unpleasant may happen, not being able to suppress worrying
thoughts, or not being able to cope with all duties. Higher values indicate greater stress 500 .
Traumatic childhood experiences: Research over the past decade has suggested that
traumatic experiences during childhood are a key factor in predicting negative health outcomes,
especially for psychiatric diseases, but also in several somatic disorders and substance
abuse 501 . Every year 4–16% of all children in high income countries are physically
abused, 10% experience psychological abuse or neglect, and 5–10% are exposed to penetrative
sexual abuse. Childhood maltreatment has been implicated as an important risk
factor for major depression and somatization disorders but also obesity, CHD, and various
autoimmune diseases. In addition aversive environmental factors in early life can induce
long-lasting pathophysiological alterations such as an increased load of inflammatory factors
and alterations in the neuroendocrine system which are subject to gene–environment
interactions 502 and DNA methylation 503 . The assessment of childhood maltreatment offers
therefore the opportunity to better define biological models of disease onset within the
framework of the National Cohort and will improve our understanding of the pathophysiology
of common disorders assessed in this study.
78