Anxiety Sensitivity and Distress Intolerance as Predictors of Cannabis Dependence Symptoms, Problems, and Craving: The Mediating Role of Coping Motives

PubMed Central

Farris, Samantha G.; Metrik, Jane; Bonn-Miller, Marcel O.; Kahler, Christopher W.; Zvolensky, Michael J.

2016-01-01

Objective: The tendency to react with fear to anxiety-related sensations (anxiety sensitivity) and the inability to tolerate distressing psychological or physiological states (distress intolerance) are implicated in the comorbidity between affective psychopathology and cannabis use disorders. Emotionally vulnerable cannabis users may be particularly apt to use cannabis to cope with distress, which may both lead to and maintain its problematic use (e.g., dependence, craving). The current study tested a comprehensive model of anxiety sensitivity and distress intolerance as predictors of the number of cannabis dependence symptoms and problems, and severity of cannabis craving following deprivation from cannabis, and the mediating role of cannabis coping motives. Method: Participants (n = 103; mean age = 21.2 years, SD = 4.3; 35.9% female) were non–treatment-seeking frequent cannabis users. Data were cross-sectional in nature. Anxiety sensitivity was assessed via self-report, and distress intolerance was assessed via both self-report and breath-holding duration. Results: Greater perceived distress intolerance, but not breath-holding duration or anxiety sensitivity, was associated with a greater number of cannabis dependence symptoms and problems and elevated cannabis craving. These relations were mediated by cannabis coping motives. Conclusions: Findings provide specificity for the etiologic mechanisms related to emotional vulnerability and maintenance of cannabis problems. Perceived distress intolerance appears to be uniquely related to maladaptive coping motives for cannabis use, which could be meaningfully targeted in interventions for emotionally vulnerable cannabis users. PMID:27797690

Anxiety Sensitivity and Distress Intolerance as Predictors of Cannabis Dependence Symptoms, Problems, and Craving: The Mediating Role of Coping Motives.

PubMed

Farris, Samantha G; Metrik, Jane; Bonn-Miller, Marcel O; Kahler, Christopher W; Zvolensky, Michael J

2016-11-01

The tendency to react with fear to anxiety-related sensations (anxiety sensitivity) and the inability to tolerate distressing psychological or physiological states (distress intolerance) are implicated in the comorbidity between affective psychopathology and cannabis use disorders. Emotionally vulnerable cannabis users may be particularly apt to use cannabis to cope with distress, which may both lead to and maintain its problematic use (e.g., dependence, craving). The current study tested a comprehensive model of anxiety sensitivity and distress intolerance as predictors of the number of cannabis dependence symptoms and problems, and severity of cannabis craving following deprivation from cannabis, and the mediating role of cannabis coping motives. Participants (n = 103; mean age = 21.2 years, SD = 4.3; 35.9% female) were non-treatment-seeking frequent cannabis users. Data were cross-sectional in nature. Anxiety sensitivity was assessed via self-report, and distress intolerance was assessed via both self-report and breath-holding duration. Greater perceived distress intolerance, but not breath-holding duration or anxiety sensitivity, was associated with a greater number of cannabis dependence symptoms and problems and elevated cannabis craving. These relations were mediated by cannabis coping motives. Findings provide specificity for the etiologic mechanisms related to emotional vulnerability and maintenance of cannabis problems. Perceived distress intolerance appears to be uniquely related to maladaptive coping motives for cannabis use, which could be meaningfully targeted in interventions for emotionally vulnerable cannabis users.

Early Childhood Adversity and Its Associations with Anxiety, Depression, and Distress in Women with Breast Cancer

PubMed Central

McFarland, Daniel C; Andreotti, Charissa; Harris, Kirk; Mandeli, John; Tiersten, Amy; Holland, Jimmie

2016-01-01

Introduction Certain vulnerability factors have been found to place patients at risk for depression and anxiety, especially within the context of medical illness. Early childhood adversity (ECA) primes adults to become more vulnerable to depression by enhancing their reactivity to stress; this relationship is not adequately described in patients with breast cancer. Methods Breast cancer patients (Stage 0-IV) were assessed for ECA (i.e., the Risky Families Questionnaire [RFQ]-subscales include Abuse/Neglect/Chaotic Home Environment), distress (i.e., Distress Thermometer and Problem List [DT&PL]), anxiety (Hospital Anxiety and Depression Scale-Anxiety [HADS-A]), depression (Hospital Anxiety and Depression Scale-Depression [HADS-D]), meeting standardized cut-off thresholds for distress (DT&PL ≥4 or ≥7)/anxiety (HADS-A ≥8)/depression (HADS-D ≥8), and demographic factors. Results One hundred twenty-five participants completed the study (78% response rate). ECA was associated with depression (p<.001), anxiety (p=.001), and distress (p=.006) and with meeting cut-off threshold criteria for distress (p=.024), anxiety (p=.048), and depression (p=.001). On Multivariate analysis, only depression (p=.04) and emotional issues (i.e, component of DT&PL)(p=.001) were associated with ECA. Neglect, but not Abuse and Chaotic Home Environment, was associated with depression (β=.442, p<.001), anxiety (β=.342, p=.002), and self-identified problems with family (β−.288, p=.022), emotion (β=.345, p=.004), and physical issues (β=.408, p<.001). Conclusion ECA and neglect are associated with multiple psychological symptoms but most specifically depression in the setting of breast cancer. ECA contributes to psychological burden as a vulnerability factor. ECA may help to explain individual patient trajectories and influence the provision of patient centered care for psychological symptoms in patients with breast cancer. PMID:26876888

Perceived distress tolerance accounts for the covariance between discrimination experiences and anxiety symptoms among sexual minority adults.

PubMed

Reitzel, Lorraine R; Smith, Nathan Grant; Obasi, Ezemenari M; Forney, Margot; Leventhal, Adam M

2017-05-01

Sexual orientation-related discrimination experiences have been implicated in elevated rates of anxiety symptoms within sexual minority groups. Theory suggests that chronic discrimination experiences may dampen the ability to tolerate distress, increasing vulnerability for anxiety. This study examined the role of distress tolerance, or the capacity to withstand negative emotions, as a construct underlying associations between discriminatory experiences and anxiety among sexual minority adults. Participants (N=119;M age =36.4±14.8; 50% cisgender male, 31% cisgender female, 19% transgender; 37% non-Latino white) were recruited from Houston, Texas. Measures administered included the Heterosexist Harassment, Rejection, and Discrimination Scale (discrimination experiences), Distress Tolerance Scale (distress tolerance), and the State-Trait Inventory for Cognitive and Somatic Anxiety (anxiety). The association of discrimination experiences and anxiety through distress tolerance was assessed using covariate-adjusted mediation modeling. Results indicated that sexual orientation-related discrimination experiences were significantly and positively associated with anxiety and that this association was mediated through lower distress tolerance. Significant indirect effects were specific to cognitive (versus somatic) anxiety symptoms. Results suggest that distress tolerance may be an explanatory mechanism in the association between discriminatory experiences and cognitive symptoms of anxiety and a potentially relevant target within clinical interventions to address anxiety-related health disparities among sexual minority adults. However, more sophisticated designs are needed to delineate causal associations. Copyright © 2016 Elsevier Ltd. All rights reserved.

The association of metacognitive beliefs with emotional distress after diagnosis of cancer.

PubMed

Cook, Sharon A; Salmon, Peter; Dunn, Graham; Holcombe, Chris; Cornford, Philip; Fisher, Peter

2015-03-01

Emotional distress after a diagnosis of cancer is normal and, for most people, will diminish over time. However, a significant minority of patients with cancer experience persistent or recurrent symptoms of emotional distress for which they need help. A model developed in mental health, the self-regulatory executive function model (S-REF), specifies that maladaptive metacognitive beliefs and processes, including persistent worry, are key to understanding why such emotional problems persist. This cross-sectional study explored, for the first, time whether metacognitive beliefs were associated with emotional distress in a cancer population, and whether this relationship was mediated by worry, as predicted by the S-REF model. Two hundred twenty-nine participants within 3 months of diagnosis of, and before treatment for, primary breast or prostate cancer completed self-report questionnaires measuring anxiety, depression, posttraumatic stress disorder (PTSD) symptoms, metacognitive beliefs, worry, and illness perceptions. Regression analysis showed that metacognitive beliefs were associated with symptoms of anxiety, depression, and PTSD, and explained additional variance in these outcomes after controlling for age, gender, and illness perceptions. Structural equation modeling was consistent with cross-sectional hypotheses derived from the theory that metacognitive beliefs cause and maintain distress both directly and indirectly by driving worry. The findings provide promising first evidence that the S-REF model may be usefully applied in cancer. Further study is required to establish the predictive and clinical utility of these findings. PsycINFO Database Record (c) 2015 APA, all rights reserved.

Alleviating Emotional Distress in Adolescent and Young Adult Cancer Survivors: An Open Trial of Metacognitive Therapy.

PubMed

Fisher, Peter L; McNicol, Kirsten; Young, Bridget; Smith, Ed; Salmon, Peter

2015-06-01

Metacognitive therapy (MCT) is an effective psychological treatment for a range of emotional disorders. However, the applicability of MCT to treating emotional distress in physical health populations has yet to be tested. The present study examined the potential of MCT for alleviating emotional distress in adolescent and young adult cancer (AYAC) survivors. Twelve AYAC survivors, aged 18-23, who had completed acute medical treatment participated in this pilot open trial with 6 months follow-up. Each participant completed a baseline period followed by 8-14 sessions of MCT that targeted perseverative thinking (worry and rumination), attentional control, and metacognitive beliefs. The primary outcome variable was severity of depression and anxiety symptoms as measured by the Hospital Anxiety and Depression Scale (HADS). MCT was associated with large and statistically significant reductions in anxiety, depression, trauma symptoms, and metacognitive beliefs and processes. In the intention-to-treat sample, 50% of participants met standardized criteria for recovery on the HADS at posttreatment and these gains were maintained through to 6-month follow-up. MCT is a promising transdiagnostic approach to treating different forms of emotional distress in AYAC survivors. Further investigation in controlled trials is now warranted.

Anxiety moderates the effects of stressor controllability and cognitive reappraisal on distress following aversive exposure: An experimental investigation.

PubMed

Le, Lillian; Moulds, Michelle; Nickerson, Angela

2018-05-08

Emerging evidence suggests that the effectiveness of cognitive reappraisal (CR) depends on different factors, including the individual's psychological wellbeing (e.g., level of anxiety) and the context in which the strategy is used (e.g., stressor controllability). The present study aimed to investigate the emotional (negative affect) and physiological (skin conductance levels) effects of emotion regulation following exposure to controllable versus uncontrollable stress. Ninety-five undergraduate students completed measures assessing anxiety, and were randomly assigned to a condition in which they had (a) control or (b) no control over the viewing duration of distressing film clips, and were then instructed to either (a) cognitively reappraise or (b) ruminate about the clips. There were no significant interactions between controllability, emotion regulation, and pre-post changes in responses. However, individual differences in anxiety moderated the effects of controllability and emotion regulation on distress responses. For participants low in anxiety, CR was related to smaller increases in distress following uncontrollable than controllable stress. This pattern was not observed for those high in anxiety following stress exposure. This study used a non-clinical sample, limiting the generalizability of the findings. These findings indicate that the utility of CR may depend upon contextual factors such as stressor controllability, and individual differences in psychological symptoms. Copyright © 2018 Elsevier Ltd. All rights reserved.

Maternal trait anxiety, emotional distress, and salivary cortisol in pregnancy.

PubMed

Pluess, Michael; Bolten, Margarete; Pirke, Karl-Martin; Hellhammer, Dirk

2010-03-01

Animal models suggest that stress-induced hormonal changes in the mother during pregnancy lead to enduring changes in the fetus and empirical links between prenatal maternal stress and negative child development have been discerned repeatedly in human studies. But the role of heritable personality traits has received little attention in the latter work. The goal of the current study was to investigate the relationship between maternal personality, psychological measures of maternal distress and maternal salivary cortisol during pregnancy. Maternal reports of personality (16 PF) and stress-related psychological measures (depression, pregnancy-related anxiety, perceived stress, negative life events) as well as salivary cortisol samples of 66 healthy pregnant women were collected in early and late pregnancy. Maternal trait anxiety proved related to all stress-related psychological measures and high anxiety predicted low baseline cortisol awakening levels in early pregnancy. Maternal trait anxiety is related to both psychological and biological stress measures during pregnancy. Copyright 2009 Elsevier B.V. All rights reserved.

Neural correlates of emotion acceptance vs worry or suppression in generalized anxiety disorder

PubMed Central

Barlow, David H.; Whitfield-Gabrieli, Susan; Gabrieli, John D.E.; Deckersbach, Thilo

2017-01-01

Abstract Recent emotion dysregulation models of generalized anxiety disorder (GAD) propose chronic worry in GAD functions as a maladaptive attempt to regulate anxiety related to uncertain or unpredictable outcomes. Emotion acceptance is an adaptive emotion regulation strategy increasingly incorporated into newer cognitive behavioral therapy (CBT) approaches to GAD to counter chronic worry. The current study explores the mechanisms of emotion acceptance as an alternate emotion regulation strategy to worry or emotion suppression using functional magnetic resonance imaging. Twenty-one female participants diagnosed with GAD followed counterbalanced instructions to regulate responses to personally relevant worry statements by engaging in either emotion acceptance, worry or emotion suppression. Emotion acceptance resulted in lower ratings of distress than worry and was associated with increased dorsal anterior cingulate cortex (dACC) activation and increased ventrolateral prefrontal cortex (VLPFC)-amygdala functional connectivity. In contrast, worry showed significantly greater distress ratings than acceptance or suppression and was associated with increased precuneus, VLPFC, amygdala and hippocampal activation. Suppression did not significantly differ from acceptance in distress ratings or amygdala recruitment, but resulted in significantly greater insula and VLPFC activation and decreased VLPFC-amygdala functional connectivity. Emotion acceptance closely aligned with activation and connectivity patterns reported in studies of contextual extinction learning and mindful awareness. PMID:28402571

Emotional distress as a predictor of statin non-adherence among Swedish first-time myocardial infarction patients, 2006-2013.

PubMed

Lissåker, C T; Wallert, J; Held, C; Olsson, E

2017-06-01

Emotional distress (depression and anxiety) has been known to affect mortality after a myocardial infarction (MI). One possible mechanism is through medication non-adherence. Few studies have investigated the link between statin adherence and emotional distress, and results are not consistent. We aimed to explore whether emotional distress affects adherence among first-time MI patients younger than 75years old receiving a prescription for the first time. We identified first-MI individuals younger than 75years from the SWEDEHEART national quality registers discharged with a statin prescription. The main exposure was the anxiety/depression portion of the EQ-5D from Interview 1 (6-10weeks post-MI) and Interview 2 (12-14months post-MI). We calculated adherence from the Swedish Prescribed Drugs Register during three observation periods (OP): [1] Interview 1 to Interview 2, [2] one year post Interview 2, and [3] two years post Interview 1. Emotional distress at Interview 1 was not associated with statin adherence for OP1 (RR: 0.99, 95% CI: 0.98, 1.01). Emotional distress at Interview 2 was associated with lower adherence one year later (RR: 0.95, 95% CI: 0.93, 0.98). Emotional distress at Interview 1 was associated with a small decrease in adherence in the complete OP for adherence (RR: 0.98, 95% CI: 0.96, 0.99). Emotional distress was marginally, but independently, associated with lower adherence to statin two years after the MI. Our study suggests that emotional distress may be an important factor for long-term statin adherence, and, thus, may play a clinically important role in long-term outcome. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Anxiety, Depression, and Cigarette Smoking: A Transdiagnostic Vulnerability Framework to Understanding Emotion-Smoking Comorbidity

PubMed Central

Leventhal, Adam M.; Zvolensky, Michael J.

2014-01-01

Research into the comorbidity between emotional psychopathology and cigarette smoking has often focused upon anxiety and depression’s manifest symptoms and syndromes, with limited theoretical and clinical advancement. This paper presents a novel framework to understanding emotion-smoking comorbidity. We propose that transdiagnostic emotional vulnerabilities—core biobehavioral traits reflecting maladaptive responses to emotional states that underpin multiple types of emotional psychopathology—link various anxiety and depressive psychopathologies to smoking. This framework is applied in a review and synthesis of the empirical literature on three trandiagnostic emotional vulnerabilities implicated in smoking: (1) anhedonia (Anh; diminished pleasure/interest in response to rewards); (2) anxiety sensitivity (AS; fear of anxiety-related sensations); and (3) distress tolerance (DT; ability to withstand distressing states). We conclude that Anh, AS, and DT collectively: (a) underpin multiple emotional psychopathologies; (b) amplify smoking’s anticipated and actual affect enhancing properties and other mechanisms underlying smoking; (c) promote progression across the smoking trajectory (i.e., initiation, escalation/progression, maintenance, cessation/relapse); and (d) are promising targets for smoking intervention. After existing gaps are identified, an integrative model of transdiagnostic processes linking emotional psychopathology to smoking is proposed. The model’s key premise is that Anh amplifies smoking’s anticipated and actual pleasure-enhancing effects, AS amplifies smoking’s anxiolytic effects, and poor DT amplifies smoking’s distress terminating effects. Collectively, these processes augment the reinforcing properties of smoking for individuals with emotional psychopathology to heighten risk of smoking initiation, progression, maintenance, cessation avoidance, and relapse. We conclude by drawing clinical and scientific implications from this

Anxiety symptomatology and perceived health in African American adults: Moderating role of emotion regulation

PubMed Central

Carter, Sierra E.; Walker, Rheeda L.

2014-01-01

Though emotional health has been theoretically and empirically linked to physical health, the anxiety-physical health association in particular is not well understood for African American adults. This study examined anxiety as a specific correlate of perceived health in addition to testing the potential moderating role of emotion regulation, an index of how and when individuals modulate emotions, in the association for anxiety to perceived health. Study participants were 151 community-based African American adults who completed measures of anxiety symptomatology and emotion regulation in addition to responding to a self-report question of perceived health. Results showed that higher levels of anxiety symptomatology were associated with poorer health ratings for those who reported more limited access to emotion regulation strategies but not those who reported having more emotion regulation strategies. The findings suggest that anxiety-related distress and health problems may be interrelated when emotion regulation strategies are limited. PMID:25045943

Sequences of emotional distress expressed by clients and acknowledged by therapists: are they associated more with some therapists than others?

PubMed

Viney, L L

1994-11-01

When clients come to psychotherapy they are distressed, this distress usually being expressed in the form of anxiety, hostility, depression and helplessness. This study explored the sequences of emotional distress expressed by clients and acknowledged by therapists, and examined their associations with other factors. The transcripts of five therapists (two single sessions each) were content-analysed: they used personal construct, client centered, rational-emotive, Gestalt and transactional analysis therapy. Log-linear analyses of appropriate contingency table cell frequencies were conducted to test associations between identified sequences and the two variables of therapist and timing of completion of the sequence. Therapist-client sequences of Anxiety-Anxiety, Anxiety-Hostility and Helplessness-Hostility were found to be associated more with the personal construct and client centred therapists than with the rational-emotive therapist. Client-therapist sequences of Anxiety-Anxiety, Helplessness-Anxiety and Helplessness-Helplessness were more often found with the client centred therapist than the other therapists. For most of these sequences timing had an effect, yet timing rarely interacted with the therapist variable. The findings are discussed in terms of their relevance to the theoretical positions represented, the shortcomings of the research and the value of this methodology in studies linking therapy process with outcome.

Relationships between Adolescents' Preferred Sources of Help and Emotional Distress, Ambivalence over Emotional Expression, and Causal Attribution of Symptoms: A Singapore Study

ERIC Educational Resources Information Center

Lee, Boon-Ooi

2009-01-01

Past research has shown that many adolescents with depression and anxiety disorders do not consult mental health professionals. This study examines how emotional distress, ambivalence over emotional expression, and causal attribution of depressive and anxious symptoms are related to adolescents' preferred sources of help for these symptoms. 300…

The mediating effects of social support and self-efficacy on the relationship between social distress and emotional distress in head and neck cancer outpatients with facial disfigurement.

PubMed

Deno, Minako; Tashiro, Mie; Miyashita, Mitsunori; Asakage, Takahiro; Takahashi, Koji; Saito, Kenich; Busujima, Yasunobu; Mori, Yoshiyuki; Saito, Hiroto; Ichikawa, Yuji

2012-02-01

Although social support has been recognized as an important factor in the quality of life of head and neck cancer patients, there has been little investigation of the buffering effect of social support on these patients' social distress or of the coping skill of self-efficacy. The aim of this study was to examine how social support and self-efficacy mediate the relationship between social distress and emotional distress in head and neck cancer patients. Two hundred twenty-five head and neck cancer patients completed our questionnaire (effective response rate, 92.2%). Of these, 129 (57.3%) had facial disfigurement. These participants responded to questions about perception of social distress, social support, self-efficacy, and emotional distress (depression and anxiety). We used structural equation modeling for statistical analysis. The fit indices of this model were excellent (χ2 (7) = 9.147, p = 0.242, goodness of fit index (GFI) = 0.981, adjusted goodness of fit index (AGFI) = 0.922, comparative fit index (CFI) = 0.993, root mean square error of approximation (RMSEA) = 0.049). Self-efficacy strongly buffered the negative influence of social distress on emotional distress. Social support from family members did not have a direct or indirect influence on emotional distress. Social support from friends was related to lower social distress and higher emotional distress. Our findings suggest that self-efficacy might confound the relationship between social support and emotional distress, and that different sources of social support might play different roles in the mediation of social distress on emotional distress. Copyright © 2010 John Wiley & Sons, Ltd.

Attachment linked predictors of women's emotional and cognitive responses to infant distress.

PubMed

Leerkes, Esther M; Siepak, Kathryn J

2006-03-01

The purpose of this study was to examine associations among women's emotional and cognitive responses to infant fear and anger and to identify attachment linked predictors of these responses. Four hundred and forty Caucasian and African American undergraduate college women viewed video clips of two crying infants, one displaying anger and the other displaying fear. They identified what the infants were feeling, made causal attributions about the cause of crying, rated their own emotional reactions to the crying infants, and reported on the extent to which their parents met their emotional needs in childhood and their current adult attachment patterns. Emotional and cognitive responses to infant fear and anger were interrelated. Consistent with prediction, a history of parental emotional rejection and adult attachment anxiety and avoidance correlated negatively with accurate identification of emotions and positively with negative attributions, amusement, and neutral responses to infant distress. Adult attachment security moderated the effects of early parental rejection on emotional and cognitive responses to infant distress, and these results varied based on race and parent gender. Results are discussed from an attachment theory perspective.

Emotional distress in family caregivers of adolescents with bronchial asthma: analysis of its predictors.

PubMed

Valero-Moreno, Selene; Pérez-Marín, Marián; Montoya-Castilla, Inmaculada; Castillo-Corullón, Silvia; Ramírez-Aguilar, Alvar; Escribano-Montaner, Amparo

2018-04-01

Adolescents with asthma face problems inherent to this stage in their development, to which the challenges of taking over control of their disease, complying with a daily treatment and regular medical followup are added. Any rejection generated by this may lead to treatment non-adherence and poor asthma control, which brings about problems in family dynamics, made worse by the stress or the emotional distress that this situation causes in caregivers. Identify adjustment profiles and predictors of risk for the well-being of caregivers of pediatric patients with bronchial asthma. Seventy-nine family caregivers of pediatric patients with bronchial asthma. Instruments were used to assess the emotional status (Hospital Anxiety and DepressionScale, HADS) and the perceived level of stress associated with medical care of a pediatric patient (Pediatric Inventory for Parents, PIP). We analyzed the patient's medical outcome measures and the family caregiver's psychological outcome measures regarding their emotional distress and stress. Of all caregivers studied, 34.8% exhibit anxiety symptomatology and moderate perceived stress. Emotional symptomatology correlates positively and significantly with the stress level. The models that best predict emotional distress of caregivers (40-50% of explained variance) include time since diagnosis and patient's treatment burden as stress indicators. The presence of stress resulting from care, time of exposure and burden of treatments associated with the disease are identified as the main predictors of risk for the well-being of caregivers. Sociedad Argentina de Pediatría.

Main and Interactive Effects of Emotion Dysregulation and Breath-Holding Duration in Relation to Panic-Relevant Fear and Expectancies about Anxiety-Related Sensations among Adult Daily Smokers

PubMed Central

Brandt, Charles P.; Johnson, Kirsten A.; Schmidt, Norman B.; Zvolensky, Michael J.

2011-01-01

The current study investigated the main and interactive effects of emotion dysregulation and distress tolerance in relation to panic-relevant variables among daily smokers. The sample consisted of 172 adults (61.2% male; Mage = 31.58, SD = 11.51), who reported smoking an average of 15.99 cigarettes per day (SD = 10.00). Results indicated that both emotion dysregulation and distress tolerance were significantly related to interoceptive fear and agoraphobia. Additionally, emotion dysregulation, but not distress tolerance, was significantly related to anxiety sensitivity. All effects were evident above and beyond the variance accounted for by average cigarettes per day, tobacco-related physical illness, and panic attack history. The interaction between emotion dysregulation and distress tolerance significantly predicted interoceptive and agoraphobic fears as well as the cognitive component of anxiety sensitivity. Such findings underscore the importance of emotion dysregulation and distress tolerance in regard to panic-specific fear and expectancies about anxiety-related sensations among daily smokers. PMID:22119451

Main and interactive effects of emotion dysregulation and breath-holding duration in relation to panic-relevant fear and expectancies about anxiety-related sensations among adult daily smokers.

PubMed

Brandt, Charles P; Johnson, Kirsten A; Schmidt, Norman B; Zvolensky, Michael J

2012-01-01

The current study investigated the main and interactive effects of emotion dysregulation and distress tolerance in relation to panic-relevant variables among daily smokers. The sample consisted of 172 adults (61.2% male; M(age)=31.58, SD=11.51), who reported smoking an average of 15.99 cigarettes per day (SD=10.00). Results indicated that both emotion dysregulation and distress tolerance were significantly related to interoceptive fear and agoraphobia. Additionally, emotion dysregulation, but not distress tolerance, was significantly related to anxiety sensitivity. All effects were evident above and beyond the variance accounted for by average cigarettes per day, tobacco-related physical illness, and panic attack history. The interaction between emotion dysregulation and distress tolerance significantly predicted interoceptive and agoraphobic fears as well as the cognitive component of anxiety sensitivity. Such findings underscore the importance of emotion dysregulation and distress tolerance in regard to panic-specific fear and expectancies about anxiety-related sensations among daily smokers. Copyright © 2011 Elsevier Ltd. All rights reserved.

The Effect of Child Distress on Accommodation of Anxiety: Relations With Maternal Beliefs, Empathy, and Anxiety.

PubMed

Settipani, Cara A; Kendall, Philip C

2017-01-01

Little is known about the influence of child behaviors on accommodation of anxiety and how accommodation relates to other parent factors. The present study examined the comparative effect of high and low levels of child distress on mother-reported accommodation, mother factors in relation to accommodation, and moderators of the relation between accommodation and child distress. Maternal perceptions of accommodation were measured by vignettes depicting youth exhibiting high or low levels of distress in anxiety-provoking situations that elicited social anxiety, generalized anxiety, or separation anxiety in a sample of 7- to 17-year-old youth with anxiety disorders (N = 70, M = 11.66, 47.1% male). Findings indicated an effect of child distress on mother-reported accommodation of youth anxiety, such that mothers reported more overall accommodation under conditions of high child distress; situation-level analyses revealed this effect for social and generalized anxiety situations. Furthermore, an association was found between greater mother-reported accommodation and more negative beliefs about their child's experience of anxiety, which held across situations. Maternal empathy moderated the relation between overall accommodation and child distress. Maternal anxiety also moderated the relation between accommodation and child distress, with results varying based on situation type. Findings, consistent with theory, indicate a relation between child distress and mother-reported accommodation and suggest that maternal beliefs about anxiety are an important treatment target. High maternal empathy may be related to a greater degree of adaptability in response to child behaviors, whereas maternal anxiety may be linked with less adaptive responses to child behaviors.

Agoraphobic avoidance predicts emotional distress and increased physical concerns in chronic obstructive pulmonary disease.

PubMed

Holas, Pawel; Michałowski, Jaroslaw; Gawęda, Łukasz; Domagała-Kulawik, Joanna

2017-07-01

Anxiety and panic attacks are more common in chronic obstructive pulmonary disease (COPD) than in the overall population. Individuals with panic attacks often attempt to avoid situations perceived as at risk of eliciting bodily sensations such as dyspnea, which paradoxically may lead to anxiety-related responsivity. Although there is some evidence that COPD individuals restrict their participation in various life activities because they fear that these may trigger breathlessness, little is known about agoraphobic avoidance and its impact on cognitions and emotional distress in this population. It was thus our aim to investigate the degree of agoraphobic avoidance in COPD individuals, its clinical concomitants and consequences. A total of 48 patients with COPD and 48 matched controlled subjects completed measures of anxiety sensitivity, agoraphobic avoidance, anxiety and depression. Objective COPD severity was measured using forced expiratory volume in the first second. Patients showed significant impairment in respiratory functioning and psychological distress. Relative to the control, the COPD group exhibited greater depression, anxiety, physical symptom concerns and avoidance (alone and accompanied), irrespective of whether they were panickers or not. Patients with high avoidance showed more intense physical concerns when compared to those with low avoidance. Importantly, the level of avoidance predicted emotional distress and increased physical concerns in COPD. Physical concerns scores in COPD patients are partially explained by avoidance in this group. The results of the study provide evidence for the importance of evaluating avoidance in COPD patients and implicate targeting this behavior in therapeutic interventions. Copyright © 2017 Elsevier Ltd. All rights reserved.

Assessing Irrational Beliefs and Emotional Distress: Evidence and Implications of Limited Discriminant Validity.

ERIC Educational Resources Information Center

Zurawski, Raymond M.; Smith, Timothy W.

1987-01-01

Examined the disciminant validity of measures of irrational beliefs. The Irrational Beliefs Test and the Rational Behavior Inventory were highly correlated but were equally highly correlated with self-report measures of depression and anxiety. Thus, rather than assessing beliefs correlated with emotional distress, the measures may actually assess…

A phenomenological understanding of residents' emotional distress of living in an environmental justice community.

PubMed

Dory, Gabriela; Qiu, Zeyuan; Qiu, Christina M; Fu, Mei R; Ryan, Caitlin E

2017-12-01

Deteriorative environmental conditions in environmental justice (EJ) communities not only post direct health risks such as chronic illnesses, but also cause emotional distress such as anxiety, fear, and anger among residents, which may further exacerbate health risks. This study applies a descriptive phenomenological method to explore and describe the emotional experience of residents living in Ironbound, a known EJ community located in Newark, New Jersey. Twenty-three residents participated in the study. Four essential themes regarding the residents' emotional experiences were elicited from 43 interviews: (1) being worried about the harmful effects of the surrounding pollution; (2) being distressed by the known historical pollution sources; (3) being frustrated by the unheard voices and/or lack of responses; and (4) being angered by the ongoing pollution sources. Participants not only expressed their emotions of worry, distress, frustration, and anger in detail but also described reasons or situations that provoked such negative emotions. Such detailed depictions provide insights into potential meaningful strategies to improve residents' psychological wellbeing by alleviating negative emotions and meaningfully engaging residents in developing, implementing, and enforcing environmental laws, regulations, and policies to achieve EJ goals.

A phenomenological understanding of residents’ emotional distress of living in an environmental justice community

PubMed Central

Dory, Gabriela; Qiu, Zeyuan; Qiu, Christina M.; Fu, Mei R.; Ryan, Caitlin E.

2017-01-01

ABSTRACT Deteriorative environmental conditions in environmental justice (EJ) communities not only post direct health risks such as chronic illnesses, but also cause emotional distress such as anxiety, fear, and anger among residents, which may further exacerbate health risks. This study applies a descriptive phenomenological method to explore and describe the emotional experience of residents living in Ironbound, a known EJ community located in Newark, New Jersey. Twenty-three residents participated in the study. Four essential themes regarding the residents’ emotional experiences were elicited from 43 interviews: (1) being worried about the harmful effects of the surrounding pollution; (2) being distressed by the known historical pollution sources; (3) being frustrated by the unheard voices and/or lack of responses; and (4) being angered by the ongoing pollution sources. Participants not only expressed their emotions of worry, distress, frustration, and anger in detail but also described reasons or situations that provoked such negative emotions. Such detailed depictions provide insights into potential meaningful strategies to improve residents’ psychological wellbeing by alleviating negative emotions and meaningfully engaging residents in developing, implementing, and enforcing environmental laws, regulations, and policies to achieve EJ goals. PMID:28452606

Prospective assessment of emotional distress, cognitive function, and quality of life in patients with cancer treated with chemotherapy.

PubMed

Iconomou, Gregoris; Mega, Vasiliki; Koutras, Angelos; Iconomou, Alexander V; Kalofonos, Haralabos P

2004-07-15

The current study sought to delineate prospectively the rates and clinical course of emotional distress, cognitive impairment, and quality of life (QOL) in chemotherapy-naive patients with cancer and to consider the determinants of global QOL. Patients who consented to participate were administered the European Organization for Research and Treatment of Cancer QLQ-C30 questionnaire, the Mini-Mental State Examination (MMSE), and the Hospital Anxiety and Depression Scale before and at the end of treatment (EOT). Of the 102 patients initially assessed, 80 (78.4%) completed the study. Most aspects of QOL did not change considerably over time. At EOT, patients reported only significant increases in fatigue and significant decreases in sleep disturbance. Although no significant changes emerged in the rates of anxiety or depression throughout chemotherapy, nearly one-third of the patients experienced severe emotional distress at both points in time. In addition, the authors observed neither significant alteration in the cognitive performance over time nor reliable associations between scores on the MMSE and subjective cognitive function, emotional distress, or QOL. Finally, depression proved to be the leading predictor of global QOL at baseline and at EOT. The results indicated that a significant proportion of Greek patients with cancer experienced intense anxiety and depression throughout chemotherapy and confirmed the importance of depression as a strong predictor of global QOL. Routine screening of emotional distress across all phases of cancer is mandatory because it will contribute to the identification of patients who are in need of pharmaceutical and/or psychologic intervention. Copyright 2004 American Cancer Society.

Physical Distress, Emotional Status, and Quality of Life in Patients With Nasopharyngeal Cancer Complicated by Post-Radiotherapy Endocrinopathy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lue, B.-H.; Department of Social Medicine, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan

2008-01-01

Purpose: To explore factors affecting quality of life (QOL) among patients with nasopharyngeal cancer (NPC) complicated by post-radiotherapy endocrinopathy. Methods and Materials: This cross-sectional study was conducted in a tertiary medical center and involved a total of 43 post-radiotherapy, recurrence-free NPC patients with endocrinopathy. They performed self-assessment of their emotional status using the Beck Anxiety Inventory and Beck Depression Inventory-II, and their QoL with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) questionnaire and the H and N35 cancer module. Results: Emotional and cognitive functioning of EORTC QLQ-C30 were the most affected. Fatigue,more » insomnia, and pain were the main concerns. Of the patients, 22 (51.2%) had anxiety and 19 (44.2%) had depression. Both depression and anxiety were negatively correlated with functional scales and global QoL but positively correlated with symptom scales. Multiple linear regression analysis revealed that physical distress symptoms of QLQ-C30 and physical functioning were the significant predictors of global QoL. Emotional and social functioning could predict depression, whereas emotional and physical functioning were significant predictors of anxiety. Conclusions: NPC patients with post-radiotherapy endocrinopathy exhibit impaired cognitive function and negative emotions. Symptoms of physical distress play an important role in QoL perception. Measurement of EORTC QLQ-C30 can be a useful instrument for the early detection of patients' impaired cognitive function and psychological morbidity. The high psychological distress related to the endocrine disturbances or the impact of NPC itself needs further study.« less

Systematic review of depression, anxiety, and other indicators of psychological distress among U.S. and Canadian medical students.

PubMed

Dyrbye, Liselotte N; Thomas, Matthew R; Shanafelt, Tait D

2006-04-01

To systematically review articles reporting on depression, anxiety, and burnout among U.S. and Canadian medical students. Medline and PubMed were searched to identify peer-reviewed English-language studies published between January 1980 and May 2005 reporting on depression, anxiety, and burnout among U.S. and Canadian medical students. Searches used combinations of the Medical Subject Heading terms medical student and depression, depressive disorder major, depressive disorder, professional burnout, mental health, depersonalization, distress, anxiety, or emotional exhaustion. Reference lists of retrieved articles were inspected to identify relevant additional articles. Demographic information, instruments used, prevalence data on student distress, and statistically significant associations were abstracted. The search identified 40 articles on medical student psychological distress (i.e., depression, anxiety, burnout, and related mental health problems) that met the authors' criteria. No studies of burnout among medical students were identified. The studies suggest a high prevalence of depression and anxiety among medical students, with levels of overall psychological distress consistently higher than in the general population and age-matched peers by the later years of training. Overall, the studies suggest psychological distress may be higher among female students. Limited data were available regarding the causes of student distress and its impact on academic performance, dropout rates, and professional development. Medical school is a time of significant psychological distress for physicians-in-training. Currently available information is insufficient to draw firm conclusions on the causes and consequences of student distress. Large, prospective, multicenter studies are needed to identify personal and training-related features that influence depression, anxiety, and burnout among students and explore relationships between distress and competency.

[Correlation between depressive and anxiety symptoms, distress and functioning].

PubMed

Małyszczak, Krzysztof; Pawłowski, Tomasz; Pyszel, Angelika; Kiejna, Andrzej

2006-01-01

The aim of the study was to define the correlation between anxiety/depressive symptoms, distress and functioning. The research is based on the analysis of 104 persons (65 women, 39 men), who were patients of psychiatrists (42 persons), or general physician attenders (62 persons) complaining of anxiety or depressive symptoms. Distress was estimated with the General Health Questionnaire (GHQ-30), psychopathological symptoms and diagnoses were evaluated with the Present State Examination (PSE) and the level of functioning with Global Assessment of Functioning (GAF). The intensity of ICD-10 symptoms was calculated for: generalized anxiety disorder, agoraphobia, social phobia, panic disorder, depressive disorder and dysthymia. The lowest score of distress was found in the group with sub-clinical, sole anxiety or depressive symptoms. An intermediate level was present in the group with anxiety and mixed anxiety-depressive disorders, and the highest in the group with depression. The functioning scores were in an inverse order. The differences in scores of distress and functioning between groups of patients with anxiety disorders, mixed anxiety-depressive disorders and depression are dependent on the intensity of depressive symptoms and are independent of the intensity of anxiety symptoms.

Beliefs about Emotions, Depression, Anxiety and Fatigue: A Mediational Analysis.

PubMed

Sydenham, Mia; Beardwood, Jennifer; Rimes, Katharine A

2017-01-01

Beliefs that it is unacceptable to experience or express negative emotions have been found to be associated with various clinical problems. It is unclear how such beliefs, which could be viewed as a form of unhelpful perfectionism about emotions, may contribute to symptomatology. This study investigated two hypotheses: a) greater endorsement of beliefs about the unacceptability of negative emotions will be associated with greater emotional avoidance and lower levels of support-seeking and self-compassion; b) these beliefs about emotions will be associated with higher levels of symptoms of depression, anxiety and fatigue and that this relationship will be mediated by social support-seeking, emotional avoidance and self-compassion. Online questionnaires were completed by 451 community participants. Mediational analyses were undertaken to investigate emotional avoidance, social support-seeking and self-compassion as mediators of the relationship between beliefs about emotions and symptoms of depression, anxiety and fatigue. Beliefs about the unacceptability of negative emotions were significantly associated with more emotional avoidance and less self-compassion and support-seeking. The relationships between beliefs about emotions and depression, anxiety and fatigue were significantly mediated by self-compassion and emotional avoidance but not social support-seeking. Future research should investigate whether interventions that pay particular attention to emotional avoidance and self-compassion, such as mindfulness-based therapy or modified forms of CBT, may be beneficial in reducing distress and fatigue associated with beliefs about the unacceptability of negative emotions.

Distress, anxiety, and depression in cancer patients undergoing chemotherapy

PubMed Central

Pandey, Manoj; Sarita, Gangadharan P; Devi, Nandkumar; Thomas, Bejoy C; Hussain, Badridien M; Krishnan, Rita

2006-01-01

Background Chemotherapy for cancer is an intense and cyclic treatment associated with number of side-effects. The present study evaluated the effect of chemotherapy on distress, anxiety and depression. Patients and methods A total of 117 patients were evaluated by using distress inventory for cancer (DIC2) and hospital anxiety and depression scale (HADS). Majority of the patients were taking chemotherapy for solid tumors (52; 44.4%). Results The mean distress score was 24, 18 (15.38%) were found to have anxiety while 19 (16.23%) had depression. High social status was the only factor found to influence distress while female gender was the only factor found to influence depression in the present study. Conclusion The study highlights high psychological morbidity of cancer patients and influence of gender on depression. Construct of distress as evaluated by DIC 2 may have a possible overlap with anxiety. PMID:17002797

Psychosocial resiliency is associated with lower emotional distress among dyads of patients and their informal caregivers in the neuroscience intensive care unit.

PubMed

Shaffer, Kelly M; Riklin, Eric; Jacobs, Jamie M; Rosand, Jonathan; Vranceanu, Ana-Maria

2016-12-01

The purpose of the study is to examine the associations of patients' and their informal caregivers' psychosocial resiliency factors with their own and their partners' emotion domains (distress, anxiety, depression, and anger) after admission to the neuroscience intensive care unit (Neuro-ICU). Eighty-three dyads of patients (total n = 87) and their informal caregivers (total n = 99) participated in this observational, cross-sectional study by self-reporting demographics and measures of resiliency factors (mindfulness [Cognitive and Affective Mindfulness Scale Revised], coping [Measure of Coping Status-A], intimate bond [Intimate Bond Measure], self-efficacy [patients: General Self-Efficacy Scale; caregivers: Revised Caregiver Self-Efficacy Scale]) and emotion domains (Emotion Thermometers) within 2 weeks of Neuro-ICU admission. There were no differences between patients' and caregivers' levels of psychosocial resiliency, distress, or anxiety. Patients reported greater depression and anger relative to their caregivers. Overall, roughly half of patients (50.6%) and caregivers (42.4%) reported clinically significant emotional distress. Patients' and caregivers' own psychosocial resiliency factors were associated with their own, but not their partner's, emotion domains. Findings of high distress among both patients and caregivers at admission emphasize the importance of attending to the mental health of both patients and caregivers in the Neuro-ICU. As modifiable psychosocial resiliency factors were associated with emotion domains for both patients and caregivers, interventions to enhance these factors may ameliorate emotional distress among these vulnerable populations. Copyright © 2016 Elsevier Inc. All rights reserved.

Perceived stress in first year medical students - associations with personal resources and emotional distress.

PubMed

Heinen, Ines; Bullinger, Monika; Kocalevent, Rüya-Daniela

2017-01-06

Medical students have been found to report high levels of perceived stress, yet there is a lack of theoretical frameworks examining possible reasons. This cross-sectional study examines correlates of perceived stress in medical students on the basis of a conceptual stress model originally developed for and applied to the general population. The aim was to identify via structural equation modeling the associations between perceived stress and emotional distress (anxiety and depression), taking into account the activation of personal resources (optimism, self-efficacy and resilient coping). Within this cross-sectional study, 321 first year medical students (age 22 ± 4 years, 39.3% men) completed the Perceived Stress Questionnaire (PSQ-20), the Self-Efficacy Optimism Scale (SWOP) and the Brief Resilient Coping Scale (BRCS) as well as the Patient Health Questionnaire (PHQ-4). The statistical analyses used t-tests, ANOVA, Spearman Rho correlation and multiple regression analysis as well as structural equation modeling. Medical students reported higher levels of perceived stress and higher levels of anxiety and depression than reference samples. No statistically significant differences in stress levels were found within the sample according to gender, migration background or employment status. Students reported more self-efficacy, optimism, and resilient coping and higher emotional distress compared to validation samples and results in other studies. Structural equation analysis revealed a satisfactory fit between empirical data and the proposed stress model indicating that personal resources modulated perceived stress, which in turn had an impact on emotional distress. Medical students' perceived stress and emotional distress levels are generally high, with personal resources acting as a buffer, thus supporting the population-based general stress model. Results suggest providing individual interventions for those students, who need support in dealing with the

An examination of distress intolerance in undergraduate students high in symptoms of generalized anxiety disorder.

PubMed

MacDonald, Emma M; Pawluk, Elizabeth J; Koerner, Naomi; Goodwill, Alasdair M

2015-01-01

People with generalized anxiety disorder (GAD) engage in maladaptive coping strategies to reduce or avoid distress. Evidence suggests that uncertainty and negative emotions are triggers for distress in people with GAD; however, there may also be other triggers. Recent conceptualizations have highlighted six types of experiences that people report having difficulty withstanding: uncertainty, negative emotions, ambiguity, frustration, physical discomfort, and the perceived consequences of anxious arousal. The present study examined the extent to which individuals high in symptoms of GAD are intolerant of these distress triggers, compared to individuals high in depressive symptoms, and individuals who are low in GAD and depressive symptoms. Undergraduate students (N = 217) completed self-report measures of GAD symptoms, depressive symptoms, and distress intolerance. Individuals high in GAD symptoms reported greater intolerance of all of the distress triggers compared to people low in symptoms of GAD and depression. Individuals high in GAD symptoms reported greater intolerance of physical discomfort compared to those high in depressive symptoms. Furthermore, intolerance of physical discomfort was the best unique correlate of GAD status, suggesting that it may be specific to GAD (versus depression). These findings support continued investigation of the transdiagnosticity and specificity of distress intolerance.

The Effects of a Mindfulness-Based Intervention on Emotional Distress, Quality of Life, and HbA1c in Outpatients With Diabetes (DiaMind)

PubMed Central

van Son, Jenny; Nyklíček, Ivan; Pop, Victor J.; Blonk, Marion C.; Erdtsieck, Ronald J.; Spooren, Pieter F.; Toorians, Arno W.; Pouwer, François

2013-01-01

OBJECTIVE Emotional distress is common in outpatients with diabetes, affecting ∼20–40% of the patients. The aim of this study was to determine the effectiveness of group therapy with Mindfulness-Based Cognitive Therapy (MBCT), relative to usual care, for patients with diabetes with regard to reducing emotional distress and improving health-related quality of life and glycemic control. RESEARCH DESIGN AND METHODS In the present randomized controlled trial, 139 outpatients with diabetes (type 1 or type 2) and low levels of emotional well-being were randomized to MBCT (n = 70) or a waiting list group (n = 69). Primary outcomes were perceived stress (Perceived Stress Scale), anxiety and depressive symptoms (Hospital Anxiety and Depression Scale), mood (Profiles of Mood States), and diabetes-specific distress (Problem Areas In Diabetes). Secondary outcomes were health-related quality of life (12-Item Short-Form Health Survey), and glycemic control (HbA1c). Assessments were conducted at baseline and at 4 and 8 weeks of follow-up. RESULTS Compared with control, MBCT was more effective in reducing stress (P < 0.001, Cohen d = 0.70), depressive symptoms (P = 0.006, d = 0.59), and anxiety (P = 0.019, d = 0.44). In addition, MBCT was more effective in improving quality of life (mental: P = 0.003, d = 0.55; physical: P = 0.032, d = 0.40). We found no significant effect on HbA1c or diabetes-specific distress, although patients with elevated diabetes distress in the MBCT group tended to show a decrease in diabetes distress (P = 0.07, d = 0.70) compared with the control group. CONCLUSIONS Compared with usual care, MBCT resulted in a reduction of emotional distress and an increase in health-related quality of life in diabetic patients who had lower levels of emotional well-being. PMID:23193218

Separating Common from Unique Variance Within Emotional Distress: An Examination of Reliability and Relations to Worry.

PubMed

Marshall, Andrew J; Evanovich, Emma K; David, Sarah Jo; Mumma, Gregory H

2018-01-17

High comorbidity rates among emotional disorders have led researchers to examine transdiagnostic factors that may contribute to shared psychopathology. Bifactor models provide a unique method for examining transdiagnostic variables by modelling the common and unique factors within measures. Previous findings suggest that the bifactor model of the Depression Anxiety and Stress Scale (DASS) may provide a method for examining transdiagnostic factors within emotional disorders. This study aimed to replicate the bifactor model of the DASS, a multidimensional measure of psychological distress, within a US adult sample and provide initial estimates of the reliability of the general and domain-specific factors. Furthermore, this study hypothesized that Worry, a theorized transdiagnostic variable, would show stronger relations to general emotional distress than domain-specific subscales. Confirmatory factor analysis was used to evaluate the bifactor model structure of the DASS in 456 US adult participants (279 females and 177 males, mean age 35.9 years) recruited online. The DASS bifactor model fitted well (CFI = 0.98; RMSEA = 0.05). The General Emotional Distress factor accounted for most of the reliable variance in item scores. Domain-specific subscales accounted for modest portions of reliable variance in items after accounting for the general scale. Finally, structural equation modelling indicated that Worry was strongly predicted by the General Emotional Distress factor. The DASS bifactor model is generalizable to a US community sample and General Emotional Distress, but not domain-specific factors, strongly predict the transdiagnostic variable Worry.

Unfamiliar Instructional Practice and Its Relationship to Student Emotional Distress in the ESL Classroom.

ERIC Educational Resources Information Center

Bassano, Sharron Kay

It is generally recognized that students' feelings about learning affect their ability to learn. One of the three strongest influencing factors on second-language learning is classroom anxiety. This paper focuses on student emotional distress in the English as a second language (ESL) classroom, and suggests that one of the primary causes of this…

Emotion regulation and emotional distress: The mediating role of hope on reappraisal and anxiety/depression in newly diagnosed cancer patients.

PubMed

Peh, Chao Xu; Liu, Jianlin; Bishop, George D; Chan, Hui Yu; Chua, Shi Min; Kua, Ee Heok; Mahendran, Rathi

2017-08-01

A proportion of newly diagnosed cancer patients may experience anxiety and depression. Emotion suppression has been associated with poorer psychoemotional outcomes, whereas reappraisal may be an adaptive emotion regulation strategy. Few studies have examined potential mechanisms linking reappraisal to psychoemotional outcomes in cancer patients. This study aims to replicate findings on reappraisal and suppression and further examines if hope mediates the association between reappraisal and anxiety/depression in patients newly diagnosed with cancer. Participants were 144 adult cancer patients (65.3% female, mean age = 48.96 years, SD = 9.23). Patients completed a set of study questionnaires, including the Emotion Regulation Questionnaire, Adult Hope Scale, and the Hospital Anxiety and Depression Scale. Path analysis was used to examine if hope mediated the association between reappraisal and anxiety/depression. Prevalence of anxiety was 39.6% and depression was 25.0%. Reappraisal and hope were correlated with lower anxiety and depression, whereas suppression was correlated with higher anxiety and depression. The hypothesized mediation model provided fit to the data, comparative fit index = 0.95, Tucker-Lewis index = 0.94, root-mean-square-error of approximation = 0.05. There was a significant indirect effect of reappraisal on anxiety and depression via hope, b = -0.95, SE = 0.42, 95% confidence interval = -1.77 to -0.12, whereas the direct effect of reappraisal was nonsignificant. The study findings suggest that hope mediated the association between reappraisal and anxiety/depression outcomes. Moreover, the high prevalence of anxiety and depression implies a need for healthcare providers to attend to the psychoemotional needs of newly diagnosed cancer patients. Copyright © 2016 John Wiley & Sons, Ltd.

Decision making, cognitive distortions and emotional distress: A comparison between pathological gamblers and healthy controls.

PubMed

Ciccarelli, Maria; Griffiths, Mark D; Nigro, Giovanna; Cosenza, Marina

2017-03-01

The etiology of problem gambling is multifaceted and complex. Among others factors, poor decision making, cognitive distortions (i.e., irrational beliefs about gambling), and emotional factors (e.g., negative mood states) appear to be among the most important factors in the development and maintenance of problem gambling. Although empirical evidence has suggested that cognitive distortions facilitate gambling and negative emotions are associated with gambling, the interplay between cognitive distortions, emotional states, and decision making in gambling remains unexplored. Pathological gamblers (N = 54) and healthy controls (N = 54) completed the South Oaks Gambling Screen (SOGS), the Iowa Gambling Task (IGT), the Gambling Related Cognitions Scale (GRCS), and the Depression Anxiety Stress Scale (DASS-21). Compared to healthy controls, pathological gamblers showed poorer decision making and reported higher scores on measures assessing cognitive distortions and emotional distress. All measures were positively associated with gambling severity. A significant negative correlation between decision making and cognitive distortions was also observed. No associations were found between poor decision making and emotional distress. Logistic regression analysis indicated that cognitive distortions, emotional distress, and poor decision making were significant predictors of problem gambling. The use of self-report measures and the absence of female participants limit the generalizability of the reported findings. The present study is the first to demonstrate the mutual influence between irrational beliefs and poor decision making, as well as the role of cognitive bias, emotional distress, and poor decision making in gambling disorder. Copyright © 2016 Elsevier Ltd. All rights reserved.

Relatives' expressed emotion, distress and attributions in clinical high-risk and recent onset of psychosis.

PubMed

Domínguez-Martínez, Tecelli; Medina-Pradas, Cristina; Kwapil, Thomas R; Barrantes-Vidal, Neus

2017-01-01

It has been well-demonstrated that Expressed Emotion (EE) in caregivers of schizophrenia patients is related to their illness attributions, but little is known about relatives' cognitive and emotional appraisals at early stages of psychosis. This study examined differences on the relationships of EE with distress and illness attributions in 78 relatives of At-Risk Mental States (ARMS) and First-Episode of Psychosis (FEP) patients, and which of those variables better predicted EE. Criticism and Emotional Over-Involvement (EOI) were associated with distress and with several illness attributions in both groups. Anxiety was more strongly associated with criticism in ARMS than in FEP-relatives, and it was associated with EOI in the ARMS but not in the FEP-group. No differences on the relationships of EE with depression or attributions were found. Furthermore, distress and attributions of blame toward the patients predicted criticism. Attributions of control by the patient and emotional negative representation about the disorder predicted EOI. Findings highlight the need to focus on early family interventions that provide proper information and psychological support in accordance with the illness stage, to help relatives improve their understanding of the disorder, handle difficult thoughts and emotions, reduce negative appraisals, and prevent high-EE over the psychotic process. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Emotional Distress and Cognitive Functioning of Older Couples: A Dyadic Analysis

PubMed Central

Lee, Jinkook; Paddock, Susan M.; Feeney, Kevin

2017-01-01

This paper examines the relationship between cognitive functioning and emotional distress in a sample of 2,684 married couples from the 2006 and 2008 Korean Longitudinal Study of Aging surveys. Using the Center for Epidemiologic Studies Depression (CESD) scale and the Mini-Mental State Exam (MMSE), we examine longitudinal interrelation between emotional and cognitive health for individuals and spouses. We test how emotional distress and cognitive impairment affect each other for individuals and how these for one spouse may affect the other. We find emotional distress contributes to cognitive impairment for wives, but not for husbands. We also find emotional distress and cognitive impairment in one spouse affects that in the other, although the emotional distress of wives affects husbands’ more than that of husbands affects wives’. We find no evidence indicating that emotional distress of one’s spouse affects one’s own cognitive impairment or that the cognitive ability of one’s spouse leads to one’s own emotional distress. PMID:21990580

Interactive Effects of Generalized and Situational Expectancies on the Arousal of Cognitive and Emotional Components of Social Anxiety.

ERIC Educational Resources Information Center

Morris, Larry W.; And Others

1981-01-01

Examined the arousal of social anxiety in an interview setting as a function of anticipated self-disclosure. During the interview, both components of anxeity (worry and emotionality) were affected by expectancy conditions, and emotionality was higher for high- than for low-social-avoidance-and-distress subjects. (Author)

A longitudinal study on anxiety, depressive and adjustment disorder, suicide ideation and symptoms of emotional distress in patients with cancer undergoing radiotherapy.

PubMed

Hernández Blázquez, Manuel; Cruzado, Juan Antonio

2016-08-01

The aim of this study is to evaluate the presence of anxiety, depressive and adjustment disorders, suicide ideation, and symptoms of anxiety and depression in patients with cancer before (T1), and after radiotherapy (T2) and at the 1-month follow-up (T3). A longitudinal study on 103 patients with cancer treated as outpatients undergoing radiotherapy was carried out, evaluating them three times (T1-T2-T3) according to DSM-IV criteria with the Mini-International Neuropsychiatric Interview and the Hospital Anxiety and Depression Scale. Prevalence of the depressive disorders was: T1=6.8%, T2=3.9% and T3=3.9%; for anxiety disorders: T1=16.5%, T2=18.4% and T3=16.5%; for adjustment disorder: 10.7%, 5.8% and 7.8%; and for suicide ideation: T1=11.7%, T2=7.8% and T3=7.8%. In all, the presence of disorders was: T1=35%, T2=26.2%0.4% and T3=29.1%. At least one mental disorder was diagnosed in 46.6% of patients in one of the three times of the study. In relation to the symptoms, the prevalence of the possible cases of clinical anxiety was: T1=35.9%, T2=18.4% and T3=22.3%; the prevalence of possible cases of clinical depression was 19.4%, 16.5% and 10.7%, respectively; and the prevalence of emotional distress was 27.2%, 17.5% and 18.4%, respectively. All symptoms decreased significantly from T1 to T2 and from T1 to T3, with moderate effect sizes. No changes were observed between the end of the radiotherapy and the follow-up period. High prevalence of mental disorders and symptoms of anxiety, depression and distress were observed in the patients with cancer before finishing radiotherapy treatment and during the follow-up. Basurto University Hospital and Basque Foundation for Innovation and Research in Health-BIOEF. Copyright © 2016 Elsevier Inc. All rights reserved.

Perceived distress and its association with depression and anxiety in breast cancer patients.

PubMed

Ng, Chong Guan; Mohamed, Salina; Kaur, Kiran; Sulaiman, Ahmad Hatim; Zainal, Nor Zuraida; Taib, Nur Aishah

2017-01-01

Breast cancer patients often experience a high level of distress. Psychological distress is a broad construct encompass both depression and anxiety. Previous studies in examining which of these psychological symptoms (either anxiety or depression) were more significantly associated with the distress level in breast cancer patients is lacking. This study aims to compare the level of depression and anxiety between patients with different level of distress. The correlation between the changes in distress level with depression or anxiety over 12 months was also examined. This study is from the MyBCC cohort study. Two hundred and twenty one female breast cancer patients were included into the study. They were assessed at the time of diagnosis, 6 months and 12 month using Hospital Anxiety and Depression Scale (HADS) and distress thermometer. The information on age, ethnicity, treatment types and staging of cancer were collected. 50.2%, 51.6% and 40.3% of patients had perceived high level of distress at baseline, 6 months and 1 year after diagnosis. Those with high perceived level of distress had significant higher anxiety scores even after adjusted for the underlying depressive scores (Adjusted OR at baseline = 1.28, 95% CI = 1.13-1.44; adjusted OR at 6 months = 1.27, 95% CI = 1.11-1.45; adjusted OR at 12 months = 1.51, 95% CI = 1.29-1.76). There were no significant differences in the depressive scores between the subjects with either low or high distress level. There was reduction in perceived level of distress, anxiety and depression scores at 12 months after the diagnosis. The decrease of distress was positively correlated with the reduction of anxiety scores but not the changes of depressive scores (r' = 0.25). Anxiety is a more significant psychological state that contributed to the feeling of distress in breast cancer as compared with depression. Levels of anxiety at diagnosis in this study would justify screening for anxiety, early identification and therapy for

Perceived distress and its association with depression and anxiety in breast cancer patients

PubMed Central

Ng, Chong Guan; Mohamed, Salina; Kaur, Kiran; Sulaiman, Ahmad Hatim; Zainal, Nor Zuraida; Taib, Nur Aishah

2017-01-01

Background Breast cancer patients often experience a high level of distress. Psychological distress is a broad construct encompass both depression and anxiety. Previous studies in examining which of these psychological symptoms (either anxiety or depression) were more significantly associated with the distress level in breast cancer patients is lacking. This study aims to compare the level of depression and anxiety between patients with different level of distress. The correlation between the changes in distress level with depression or anxiety over 12 months was also examined. Methods This study is from the MyBCC cohort study. Two hundred and twenty one female breast cancer patients were included into the study. They were assessed at the time of diagnosis, 6 months and 12 month using Hospital Anxiety and Depression Scale (HADS) and distress thermometer. The information on age, ethnicity, treatment types and staging of cancer were collected. Results 50.2%, 51.6% and 40.3% of patients had perceived high level of distress at baseline, 6 months and 1 year after diagnosis. Those with high perceived level of distress had significant higher anxiety scores even after adjusted for the underlying depressive scores (Adjusted OR at baseline = 1.28, 95% CI = 1.13–1.44; adjusted OR at 6 months = 1.27, 95% CI = 1.11–1.45; adjusted OR at 12 months = 1.51, 95% CI = 1.29–1.76). There were no significant differences in the depressive scores between the subjects with either low or high distress level. There was reduction in perceived level of distress, anxiety and depression scores at 12 months after the diagnosis. The decrease of distress was positively correlated with the reduction of anxiety scores but not the changes of depressive scores (r’ = 0.25). Conclusion Anxiety is a more significant psychological state that contributed to the feeling of distress in breast cancer as compared with depression. Levels of anxiety at diagnosis in this study would justify screening for

Using the Nominal Response Model to Evaluate Response Category Discrimination in the PROMIS Emotional Distress Item Pools

ERIC Educational Resources Information Center

Preston, Kathleen; Reise, Steven; Cai, Li; Hays, Ron D.

2011-01-01

The authors used a nominal response item response theory model to estimate category boundary discrimination (CBD) parameters for items drawn from the Emotional Distress item pools (Depression, Anxiety, and Anger) developed in the Patient-Reported Outcomes Measurement Information Systems (PROMIS) project. For polytomous items with ordered response…

Emotional distress following genetic testing for hereditary breast and ovarian cancer: a meta-analytic review.

PubMed

Hamilton, Jada G; Lobel, Marci; Moyer, Anne

2009-07-01

Meta-analysis was used to synthesize results of studies on emotional consequences of predictive genetic testing for BRCA1/2 mutations conferring increased risk of breast and ovarian cancer. Studies assessing anxiety or cancer-specific distress before and after provision of test results (k = 20) were analyzed using a random-effects model. Moderator variables included country of data collection and personal cancer history of study participants. Standardized mean gain effect sizes were calculated for mutation carriers, noncarriers, and those with inconclusive results over short (0-4 weeks), moderate (5-24 weeks), or long (25-52 weeks) periods of time after testing. Distress among carriers increased shortly after receiving results and returned to pretesting levels over time. Distress among noncarriers and those with inconclusive results decreased over time. Some distress patterns differed in studies conducted outside the United States and for individuals with varying cancer histories. Results underscore the importance of time; changes in distress observed shortly after test-result disclosure frequently differed from the pattern of distress seen subsequently. Although emotional consequences of this testing appear minimal, it remains possible that testing may affect cognitive and behavioral outcomes, which have rarely been examined through meta-analysis. Testing may also affect understudied subgroups differently.

Resilience to emotional distress in response to failure, error or mistakes: A systematic review.

PubMed

Johnson, Judith; Panagioti, Maria; Bass, Jennifer; Ramsey, Lauren; Harrison, Reema

2017-03-01

Perceptions of failure have been implicated in a range of psychological disorders, and even a single experience of failure can heighten anxiety and depression. However, not all individuals experience significant emotional distress following failure, indicating the presence of resilience. The current systematic review synthesised studies investigating resilience factors to emotional distress resulting from the experience of failure. For the definition of resilience we used the Bi-Dimensional Framework for resilience research (BDF) which suggests that resilience factors are those which buffer the impact of risk factors, and outlines criteria a variable should meet in order to be considered as conferring resilience. Studies were identified through electronic searches of PsycINFO, MEDLINE, EMBASE and Web of Knowledge. Forty-six relevant studies reported in 38 papers met the inclusion criteria. These provided evidence of the presence of factors which confer resilience to emotional distress in response to failure. The strongest support was found for the factors of higher self-esteem, more positive attributional style, and lower socially-prescribed perfectionism. Weaker evidence was found for the factors of lower trait reappraisal, lower self-oriented perfectionism and higher emotional intelligence. The majority of studies used experimental or longitudinal designs. These results identify specific factors which should be targeted by resilience-building interventions. Resilience; failure; stress; self-esteem; attributional style; perfectionism. Copyright © 2016 Elsevier Ltd. All rights reserved.

[Emotion Regulation and Emotional Vulnerability in Adolescents with Anxiety Disorders].

PubMed

Zimmermann, Peter; Iwanski, Alexandra; Çelik, Fatma

2015-01-01

From an attachment perspective, insecure attachment patterns in both infancy and adolescence are risk factors for the development of anxiety disorders in adolescence. Dysfunctional emotion regulation and biased social information processing are possible mediating processes. This study examines differences in emotion regulation, emotional vulnerability, and behaviour inhibition in adolescents with clinical diagnosis of anxiety disorder and healthy controls. Adolescents with anxiety disorder reported more maladaptive emotion regulation depending on the specific emotion and a higher incidence of reporting hurt feelings in social interactions. In contrast, behaviour inhibition did not explain additional variance. The results suggest that adolescents with anxiety disorders show a bias in the interpretation of social interactions as frequently emotionally hurting, and the use of dysfunctional emotion regulation strategies that minimize the possibility for effective social emotion regulation by close others or therapists. The results are interpreted within attachment framework.

The relationship between emotional suppression and psychological distress in breast cancer patients after surgery.

PubMed

Nakatani, Yuki; Iwamitsu, Yumi; Kuranami, Masaru; Okazaki, Shigemi; Shikanai, Hiroe; Yamamoto, Kenji; Watanabe, Masahiko; Miyaoka, Hitoshi

2014-09-01

The purpose of this study was to examine the relationship between emotional suppression and psychological distress in breast cancer patients after surgery. We examined this relationship using questionnaires at the first visit to the breast cancer outpatient clinic at our hospital and after surgery, as well as interviews after surgery. A total of 31 breast cancer patients were asked to complete the Courtauld Emotional Control Scale and the Profile of Mood States at their first visit to the outpatient clinic. Patients were also asked to complete the Profile of Mood States between 1 and 6 months after surgery. Trained clinical psychologists conducted the interviews, asking patients to speak freely about their current anxieties, worries and thoughts. Based on the median Courtauld Emotional Control Scale score of 42 points, participants were divided into emotional suppression and emotional expression groups. The Total Mood Disturbance score, as well as each of the subscale (except vigor) scores of the Profile of Mood States, were significantly higher in the emotional suppression group than the emotional expression group. The emotional suppression group expressed significantly more negative emotions and fewer positive emotions than the emotional expression group. Patients with emotional suppression felt and expressed more psychological distress after surgery. This finding highlights the need for medical staff to comprehend the psychological traits of breast cancer patients, including emotional suppression, in the early stages of breast cancer in order to provide adequate psychological support. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Suicidal Ideation in Anxiety-Disordered Youth: Identifying Predictors of Risk

PubMed Central

O'Neil Rodriguez, Kelly A.; Kendall, Philip C.

2014-01-01

Objective Evidence is mixed regarding an independent association between anxiety and suicidality. Beyond associations with demographic factors and depression, do anxiety disorders increase risk for suicidality in youth? Given that not all anxiety-disordered youth experience suicidal ideation, potential predictors of risk also require investigation. Method The present study examined (a) the independent relationship between anxiety and suicidal ideation and (b) emotion dysregulation and distress intolerance as predictors of risk for suicidal ideation in a sample of anxiety-disordered youth aged 7-17 (N = 86, M = 11.5). Youth and their parents reported on suicidality, emotion dysregulation, and distress intolerance. Distress tolerance was also measured by a computerized behavioral task. Results Results support an independent relationship between anxiety symptomatology and youth-reported suicidal ideation, controlling for depressive symptoms. Youth self-report of emotion dysregulation and distress intolerance predicted higher levels of suicidal ideation in univariate analyses. In a multivariate analysis including all significant predictors, only anxiety symptomatology uniquely predicted suicidal ideation. Conclusions Results provide recommendations for the assessment and treatment of suicidality in anxiety-disordered youth. Suggestions for future research investigating the relationship between anxiety and suicidal ideation are offered. PMID:24156368

Hunger, inhibitory control and distress-induced emotional eating.

PubMed

van Strien, Tatjana; Ouwens, Machteld A; Engel, Carmen; de Weerth, Carolina

2014-08-01

Self-reported emotional eating has been found to significantly moderate distress-induced food intake, with low emotional eaters eating less after a stress task than after a control task and high emotional eaters eating more. The aim of the present study was to explore possible underlying mechanisms by assessing possible associations with (1) ability to experience the typical post-stress reduction of hunger and (2) inhibitory control. We studied these effects in 54 female students who were preselected on the basis of extremely high or low scores on an emotional eating questionnaire. Using a within subject design we measured the difference of actual food or snack intake after a control or a stress task (Trier Social Stress Test). As expected, the moderator effect of emotional eating on distress-induced food intake was found to be only present in females with a failure to report the typical reduction of hunger immediately after a stress task (an a-typical hunger stress response). Contrary to our expectations, this moderator effect of emotional eating was also found to be only present in females with high ability to stop motor impulses (high inhibitory control). These findings suggest that an a-typical hunger stress response but not poor inhibitory control may underlie the moderator effect of emotional eating on distress-induced food intake. However, inhibitory control may play a role whether or not there is a moderator effect of self-reported emotional eating on distress-induced food intake. Copyright © 2014 Elsevier Ltd. All rights reserved.

Adolescent emotional distress: the role of family obligations and school connectedness.

PubMed

Wilkinson-Lee, Ada M; Zhang, Qionghui; Nuno, Velia Leybas; Wilhelm, Mari S

2011-02-01

The current study draws upon ecodevelopmental theory to identify protective and risk factors that may influence emotional distress during adolescence. Hierarchical regression analyses were used to examine the relationship among family obligations, school connectedness and emotional distress of 4,198 (51% female) middle and high school students who were primarily (59%) European American. The overall model explained 21.1% of the variance in student emotional distress. A significant interaction effect was found indicating that school connectedness moderated the relationship between family obligations and emotional distress. Specifically, for students with low to moderate levels of family obligations, a stronger sense of school connectedness was associated with lower emotional distress. The buffering effect of school connectedness was weakened as the level of family obligations increased and completely disappeared for students who experienced high levels of family obligations. The creation of a program that takes a holistic approach, in order to curtail the levels of highly emotionally distressed adolescents, must continue to address the ever changing demands that adolescents encounter and prepare youth to deal with functioning within multiple contexts and do so while maintaining emotional well-being.

Partner relationship satisfaction and maternal emotional distress in early pregnancy

PubMed Central

2011-01-01

Background Recognition of maternal emotional distress during pregnancy and the identification of risk factors for this distress are of considerable clinical- and public health importance. The mental health of the mother is important both for herself, and for the physical and psychological health of her children and the welfare of the family. The first aim of the present study was to identify risk factors for maternal emotional distress during pregnancy with special focus on partner relationship satisfaction. The second aim was to assess interaction effects between relationship satisfaction and the main predictors. Methods Pregnant women enrolled in the Norwegian Mother and Child Cohort Study (n = 51,558) completed a questionnaire with questions about maternal emotional distress, relationship satisfaction, and other risk factors. Associations between 37 predictor variables and emotional distress were estimated by multiple linear regression analysis. Results Relationship dissatisfaction was the strongest predictor of maternal emotional distress (β = 0.25). Other predictors were dissatisfaction at work (β = 0.11), somatic disease (β = 0.11), work related stress (β = 0.10) and maternal alcohol problems in the preceding year (β = 0.09). Relationship satisfaction appeared to buffer the effects of frequent moving, somatic disease, maternal smoking, family income, irregular working hours, dissatisfaction at work, work stress, and mother's sick leave (P < 0.05). Conclusions Dissatisfaction with the partner relationship is a significant predictor of maternal emotional distress in pregnancy. A good partner relationship can have a protective effect against some stressors. PMID:21401914

Effects of Rational-Emotive Hospice Care Therapy on Problematic Assumptions, Death Anxiety, and Psychological Distress in a Sample of Cancer Patients and Their Family Caregivers in Nigeria

PubMed Central

Onyechi, Kay Chinonyelum Nwamaka; Onuigbo, Liziana N.; Eseadi, Chiedu; Ikechukwu-Ilomuanya, Amaka B.; Nwaubani, Okechukwu Onyinye; Umoke, Prince C.I.; Agu, Fedinand U.; Otu, Mkpoikanke Sunday; Utoh-Ofong, Anthonia N.

2016-01-01

This study was a preliminary investigation that aimed to examine the effects of rational emotive hospice care therapy (REHCT) on problematic assumptions, death anxiety, and psychological distress in a sample of cancer patients and their family caregivers in Nigeria. The study adopted a pre-posttest randomized control group design. Participants were community-dwelling cancer patients (n = 32) and their family caregivers (n = 52). The treatment process consisted of 10 weeks of full intervention and 4 weeks of follow-up meetings that marked the end of intervention. The study used repeated-measures analysis of variance for data analysis. The findings revealed significant effects of a REHCT intervention program on problematic assumptions, death anxiety, and psychological distress reduction among the cancer patients and their family caregivers at the end of the intervention. The improvements were also maintained at follow-up meetings in the treatment group compared with the control group who received the usual care and conventional counseling. The researchers have been able to show that REHCT intervention is more effective than a control therapy for cancer patients’ care, education, and counseling in the Nigerian context. PMID:27657099

Effects of Self-Image on Anxiety, Judgement Bias and Emotion Regulation in Social Anxiety Disorder.

PubMed

Lee, Hannah; Ahn, Jung-Kwang; Kwon, Jung-Hye

2018-04-25

Research to date has focused on the detrimental effects of negative self-images for individuals with social anxiety disorder (SAD), but the benefits of positive self-images have been neglected. The present study examined the effect of holding a positive versus negative self-image in mind on anxiety, judgement bias and emotion regulation (ER) in individuals with SAD. Forty-two individuals who met the diagnostic criteria for SAD were randomly assigned to either a positive or a negative self-image group. Participants were assessed twice with a week's interval in between using the Reactivity and Regulation Situation Task, which measures social anxiety, discomfort, judgement bias and ER, prior to and after the inducement of a positive or negative self-image. Individuals in the positive self-image group reported less social anxiety, discomfort and distress from social cost when compared with their pre-induction state. They also used more adaptive ER strategies and experienced less anxiety and discomfort after using ER. In contrast, individuals in the negative self-image group showed no significant differences in anxiety, judgement bias or ER strategies before and after the induction. This study highlights the beneficial effects of positive self-images on social anxiety and ER.

The relationship between negative urgency and generalized anxiety disorder symptoms: the role of intolerance of negative emotions and intolerance of uncertainty.

PubMed

Pawluk, Elizabeth J; Koerner, Naomi

2016-11-01

GAD symptoms are associated with greater negative urgency, a dimension of impulsivity defined as the tendency to act rashly when distressed. This study examined the degree to which intolerance of negative emotional states and intolerance of uncertainty account for the association between negative urgency and GAD symptoms. An analysis of indirect effects evaluated whether intolerance of negative emotions and intolerance of uncertainty uniquely account for the association between negative urgency and GAD symptom severity. Undergraduate students (N = 308) completed measures of GAD symptoms, trait anxiety, negative urgency, distress tolerance, and intolerance of uncertainty. Greater symptoms of GAD, intolerance of negative emotional states, and intolerance of uncertainty were associated with greater negative urgency. There was an indirect relationship between negative urgency and GAD symptoms through intolerance of negative emotional states and intolerance of uncertainty even when controlling for trait anxiety. Intolerance of negative emotional states and intolerance of uncertainty each had an indirect relationship with GAD severity through negative urgency, suggesting possible bi-directional relations. Future studies should examine the role of intolerance of negative emotional states and intolerance of uncertainty in the impulsive behavior of individuals with GAD, and whether impulsive behavior reinforces these processes.

Parents of Children with ASD Experience More Psychological Distress, Parenting Stress, and Attachment-Related Anxiety.

PubMed

Keenan, Belinda M; Newman, Louise K; Gray, Kylie M; Rinehart, Nicole J

2016-09-01

There has been limited study of the relationship between child attachment and caregiver wellbeing amongst children with autism spectrum disorder (ASD). This study examined self-reported child attachment quality alongside caregivers' report of their own psychological distress, parenting stress and attachment style, amongst 24 children with high-functioning autism or Asperger's disorder (ASD; aged 7-14 years) and 24 typically developing children (aged 7-12 years), and their primary caregiver. Children with ASD were no less secure, but their caregivers were more stressed and reported more attachment-related anxiety, compared to typically developing dyads. Child attachment security was related to caregiver psychological distress and attachment style, but only amongst typically developing children. Impacts of emotion processing impairments on caregiver-child relationships in ASD are discussed.

Hormone-treated transsexuals report less social distress, anxiety and depression.

PubMed

Gómez-Gil, Esther; Zubiaurre-Elorza, Leire; Esteva, Isabel; Guillamon, Antonio; Godás, Teresa; Cruz Almaraz, M; Halperin, Irene; Salamero, Manel

2012-05-01

The aim of the present study was to evaluate the presence of symptoms of current social distress, anxiety and depression in transsexuals. We investigated a group of 187 transsexual patients attending a gender identity unit; 120 had undergone hormonal sex-reassignment (SR) treatment and 67 had not. We used the Social Anxiety and Distress Scale (SADS) for assessing social anxiety and the Hospital Anxiety and Depression Scale (HADS) for evaluating current depression and anxiety. The mean SADS and HADS scores were in the normal range except for the HAD-Anxiety subscale (HAD-A) on the non-treated transsexual group. SADS, HAD-A, and HAD-Depression (HAD-D) mean scores were significantly higher among patients who had not begun cross-sex hormonal treatment compared with patients in hormonal treatment (F=4.362, p=.038; F=14.589, p=.001; F=9.523, p=.002 respectively). Similarly, current symptoms of anxiety and depression were present in a significantly higher percentage of untreated patients than in treated patients (61% vs. 33% and 31% vs. 8% respectively). The results suggest that most transsexual patients attending a gender identity unit reported subclinical levels of social distress, anxiety, and depression. Moreover, patients under cross-sex hormonal treatment displayed a lower prevalence of these symptoms than patients who had not initiated hormonal therapy. Although the findings do not conclusively demonstrate a direct positive effect of hormone treatment in transsexuals, initiating this treatment may be associated with better mental health of these patients. Copyright © 2011 Elsevier Ltd. All rights reserved.

Impact of chronic disease on emotional distress in adult survivors of childhood cancer: A report from the Childhood Cancer Survivor Study.

PubMed

Vuotto, Stefanie C; Krull, Kevin R; Li, Chenghong; Oeffinger, Kevin C; Green, Daniel M; Patel, Sunita K; Srivastava, Deokumar; Stovall, Marilyn; Ness, Kirsten K; Armstrong, Gregory T; Robison, Leslie L; Brinkman, Tara M

2017-02-01

The current study was performed to examine associations between childhood cancer therapies, chronic health conditions, and symptoms of emotional distress in adult survivors of childhood cancer. Participants included 5021 adult survivors of childhood cancer (mean age, 32.0 years [standard deviation, 7.6 years] with a time since diagnosis of 23.2 years [standard deviation, 4.5 years]) who completed measures assessing symptoms of anxiety, depression, and posttraumatic stress. Cardiac, pulmonary, and endocrine conditions were graded using the National Cancer Institute Common Terminology Criteria for Adverse Events (version 4.03; grades 1-4). Structural equation modeling was used to examine hypothesized pathways between cancer treatment exposures, chronic health conditions, and symptoms of emotional distress. Multivariable models were used to estimate relative risks (RRs) for associations between chronic health conditions and distress. Survivors with cardiovascular, endocrine, or pulmonary conditions were found to have a significantly higher prevalence of emotional distress symptoms. In path analyses and multivariable models, significant effects were observed between endocrine (β = .12 [P = .002] and RR, 1.3 [95% confidence interval (95% CI), 1.1-1.6]) and pulmonary (β = .13 [P<.001] and RR, 1.4 [95% CI, 1.1-1.7]) conditions and depression, and between cardiac (β = .13 [P = .001] and RR, 1.5 [95% CI, 1.2-1.8]) and pulmonary (β = .15 [P<.001] and RR, 1.6 [95% CI, 1.3-2.0]) conditions and anxiety. All treatment-related chronic health conditions were found to be associated with posttraumatic stress symptoms (cardiac: β = .09 [P = .004] and RR, 1.3 [95% CI, 1.2-1.5]; endocrine: β = .12 [P<.001] and RR, 1.3 [95% CI, 1.2-1.5]; and pulmonary: β = .13 [P<.001] and RR, 1.4 [95% CI, 1.2-1.6]). Chronic health conditions resulting from childhood cancer therapies contribute to emotional distress in adult survivors. Targeted mental

Using lexical analysis to identify emotional distress in psychometric schizotypy.

PubMed

Abplanalp, Samuel J; Buck, Benjamin; Gonzenbach, Virgilio; Janela, Carlos; Lysaker, Paul H; Minor, Kyle S

2017-09-01

Through the use of lexical analysis software, researchers have demonstrated a greater frequency of negative affect word use in those with schizophrenia and schizotypy compared to the general population. In addition, those with schizotypy endorse greater emotional distress than healthy controls. In this study, our aim was to expand on previous findings in schizotypy to determine whether negative affect word use could be linked to emotional distress. Schizotypy (n=33) and non-schizotypy groups (n=33) completed an open-ended, semi-structured interview and negative affect word use was analyzed using a validated lexical analysis instrument. Emotional distress was assessed using subjective questionnaires of depression and psychological quality of life (QOL). When groups were compared, those with schizotypy used significantly more negative affect words; endorsed greater depression; and reported lower QOL. Within schizotypy, a trend level association between depression and negative affect word use was observed; QOL and negative affect word use showed a significant inverse association. Our findings offer preliminary evidence of the potential effectiveness of lexical analysis as an objective, behavior-based method for identifying emotional distress throughout the schizophrenia-spectrum. Utilizing lexical analysis in schizotypy offers promise for providing researchers with an assessment capable of objectively detecting emotional distress. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

Post-traumatic stress disorder, social anxiety disorder, and depression in survivors of the Kosovo War: experiential avoidance as a contributor to distress and quality of life.

PubMed

Kashdan, Todd B; Morina, Nexhmedin; Priebe, Stefan

2009-03-01

Few studies have been conducted on psychological disorders other than post-traumatic stress disorder (PTSD) in war survivors. The aim of this study was to examine PTSD, social anxiety disorder (SAD), and major depressive disorder (MDD) and their associations with distress and quality of life in 174 Albanian civilian survivors of the Kosovo War. This included testing of conceptual models suggesting that experiential avoidance might influence associations between anxiety and mood disorders with psychological functioning. Each of the three psychiatric disorders was associated with greater experiential avoidance and psychological distress, and lower quality of life. Being a refugee was associated with a higher likelihood of having SAD and MDD. We found evidence for experiential avoidance as a partial mediator of the respective effects of SAD and PTSD on quality of life; experiential avoidance did not mediate the effects of disorders on global distress. We also found support for a moderation model showing that only war survivors without SAD and low experiential avoidance reported elevated quality of life; people with either SAD or excessive reliance on experiential avoidance reported compromised, low quality of life. This is the third independent study, each using a different methodology, to find empirical support for this moderation model [Kashdan, T. B., & Breen, W. E. (2008). Social anxiety and positive emotions: a prospective examination of a self-regulatory model with tendencies to suppress or express emotions as a moderating variable. Behavior Therapy, 39, 1-12; Kashdan, T. B., & Steger, M. F. (2006). Expanding the topography of social anxiety: an experience sampling assessment of positive emotions and events, and emotion suppression. Psychological Science, 17, 120-128]. Overall, we provided initial evidence for the importance of addressing PTSD, SAD, MDD, and experiential avoidance in primarily civilian war survivors.

Relationship between infertility-related stress and emotional distress and marital satisfaction.

PubMed

Gana, Kamel; Jakubowska, Sylwia

2016-06-01

The aim of this study was to evaluate the predictive effects of infertility-related stress on psychological distress and marital satisfaction. Structural equation modeling was used to estimate a nonrecursive model hypothesizing the impact of infertility-related stress on both emotional distress and marital dissatisfaction, which were supposed to have a reciprocal influence on each other. The model was estimated using data from a sample of 150 infertile patients (78 males and 72 females). Findings confirmed the predictive effects of infertility-related stress on both emotional and marital distress. However, infertility-related stress was found to have more impact on emotional distress than on marital satisfaction. © The Author(s) 2014.

Lateralisation for processing facial emotion and anxiety: contrasting state, trait and social anxiety.

PubMed

Bourne, Victoria J; Vladeanu, Matei

2011-04-01

Recent neuropsychological studies have attempted to distinguish between different types of anxiety by contrasting patterns of brain organisation or activation; however, lateralisation for processing emotional stimuli has received relatively little attention. This study examines the relationship between strength of lateralisation for the processing of facial expressions of emotion and three measures of anxiety: state anxiety, trait anxiety and social anxiety. Across all six of the basic emotions (anger, disgust, fear, happiness, sadness, surprise) the same patterns of association were found. Participants with high levels of trait anxiety were more strongly lateralised to the right hemisphere for processing facial emotion. In contrast, participants with high levels of self-reported physiological arousal in response to social anxiety were more weakly lateralised to the right hemisphere, or even lateralised to the left hemisphere, for the processing of facial emotion. There were also sex differences in these associations: the relationships were evident for males only. The finding of distinct patterns of lateralisation for trait anxiety and self-reported physiological arousal suggests different neural circuitry for trait and social anxiety. Copyright © 2011. Published by Elsevier Ltd.

Emotional distress in junior house officers.

PubMed Central

Firth-Cozens, J

1987-01-01

In a study of 170 junior house officers who were followed up from their fourth year in medical school mean levels of stress were higher than in other reported occupational groups, and the estimated prevalence of emotional disturbance was 50%, with 28% of the subjects showing evidence of depression. Nearly a fifth of the subjects reported occasional or frequent bouts of heavy drinking, a quarter took drugs for physical illness, and a few took drugs for recreation. Those who were emotionally distressed at the initial study and the follow up were more empathetic and more self critical than those who had low levels of stress on both occasions. Overwork was the most stressful aspect of their jobs, though the number of hours worked was not related to stress levels, unlike diet and sleep. The more stressed they were the more unfavourably they viewed aspects of their jobs. The incidence of distress is unacceptably high in junior house officers, and both they and the hospitals need to deal with the causes of the distress. PMID:3117213

The association of age, sense of control, optimism, and self-esteem with emotional distress.

PubMed

Jiménez, M Guadalupe; Montorio, Ignacio; Izal, María

2017-07-01

The aim of this study was to test a model of emotional distress, which incorporates the potential mediator role of positive resources (sense of control, self-esteem, and optimism) in the association of age with emotional distress. The study used a cross-sectional design with intentional sampling and the voluntary participation of 325 adults between 18 and 87 years (M = 46.8 ± 19.10). The results show that emotional distress was negatively associated with age. Psychological resources also varied according to age, with older subjects presenting higher optimism and external control as well as lower internal control. The association between internal control and emotional distress was mediated by optimism and self-esteem. Moreover, the combined association of these 3 personal resources significantly increased the relationship between age and lower emotional distress. The results suggest that optimism and self-esteem are powerful resources in relieving emotional distress. The data provide potentially useful information for the design of psychological interventions aimed at reducing emotional distress. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Emotional distress and burden among caregivers of children with oncological/hematological disorders.

PubMed

Edmond, Sara N; Graves, Patricia E; Whiting, Sara E; Karlson, Cynthia W

2016-06-01

Caring for children with oncological and hematological disorders may lead to caregiver emotional distress and caregiver burden; however, little work has examined the relationship between children's symptoms and caregiver's distress and burden. This study used self-report survey data from caregivers (N = 96) and a cross-sectional design to examine correlates of caregiver emotional distress and burden. Data collected included caregiver and child demographic data, child symptoms (i.e., sleep problems, pain, and emotional/behavioral problems), caregiver emotional distress, and caregiver burden. Multiple linear regression found that parent reported financial difficulty (β = 0.29, t = 3.13, p = .003), greater child sleep problems (β = 0.29 t = 2.81, p = .007), greater child pain (β = 0.33 t = 3.48, p = .001), and greater child emotional/behavioral problems (β = 0.27, t = 2.71, p = .009) were all related to higher levels of caregiver emotional distress. Only financial difficulties (β = -0.35, t = -2.03, p = .04) and child pain (β = -0.30, t = -2.33, p = .02) were related to caregiver burden. Child symptoms may play an important role in the development of caregiver distress and caregiver burden; future research should utilize longitudinal designs to examine temporal and casual relationships. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Trajectories of distress, anxiety, and depression among women with breast cancer: Looking beyond the mean.

PubMed

Bidstrup, Pernille Envold; Christensen, Jane; Mertz, Birgitte Goldschmidt; Rottmann, Nina; Dalton, Susanne Oksbjerg; Johansen, Christoffer

2015-05-01

Little is known about the development of psychological wellbeing over time among women who have been treated for breast cancer. The aim of this study was to identify distinct patterns of distress, anxiety, and depression in such women. We invited 426 consecutive women with newly diagnosed primary breast cancer to participate in this study, and 323 (76%) provided information on distress ('distress thermometer') and on symptoms of anxiety and depression ('hospital anxiety and depression scale'). Semiparametric group-based mixture modeling was used to identify distinct trajectories of distress, anxiety, and depressive symptoms assessed the week before surgery and four and eight months later. Logistic regression analysis was used to evaluate the characteristics of women in the distinct groups. Although no sub-group of women with chronic severe anxiety or depressive symptoms was found, we did identify a sub-group of 8% of the women who experienced continuously severe distress. Young age, having a partner, shorter education, and receiving chemotherapy but not radiotherapy might characterize women whose psychological symptoms remain strong eight months after diagnosis. By looking beyond the mean, we found that 8% of the women experienced chronic severe distress; no sub-groups with chronic severe anxiety or depression were identified. Several socio-demographic and treatment factors characterized the women whose distress level remained severe eight months after diagnosis. The results suggest that support could be focused on relatively small groups of patients most in need.

Measuring death-related anxiety in advanced cancer: preliminary psychometrics of the Death and Dying Distress Scale.

PubMed

Lo, Christopher; Hales, Sarah; Zimmermann, Camilla; Gagliese, Lucia; Rydall, Anne; Rodin, Gary

2011-10-01

The alleviation of distress associated with death and dying is a central goal of palliative care, despite the lack of routine measurement of this outcome. In this study, we introduce the Death and Dying Distress Scale (DADDS), a new, brief measure we have developed to assess death-related anxiety in advanced cancer and other palliative populations. We describe its preliminary psychometrics based on a sample of 33 patients with advanced or metastatic cancer. The DADDS broadly captures distress about the loss of time and opportunity, the process of death and dying, and its impact on others. The initial version of the scale has a one-factor structure and good internal reliability. Dying and death-related distress was positively associated with depression and negatively associated with spiritual, emotional, physical, and functional well-being, providing early evidence of construct validity. This distress was relatively common, with 45% of the sample scoring in the upper reaches of the scale, suggesting that the DADDS may be a relevant outcome for palliative intervention. We conclude by presenting a revised 15-item version of the scale for further study in advanced cancer and other palliative populations.

Social exclusion intensifies anxiety-like behavior in adolescent rats.

PubMed

Lee, Hyunchan; Noh, Jihyun

2015-05-01

Social connection reduces the physiological reactivity to stressors, while social exclusion causes emotional distress. Stressful experiences in rats result in the facilitation of aversive memory and induction of anxiety. To determine the effect of social interaction, such as social connection, social exclusion and equality or inequality, on emotional change in adolescent distressed rats, the emotional alteration induced by restraint stress in individual rats following exposure to various social interaction circumstances was examined. Rats were assigned to one of the following groups: all freely moving rats, all rats restrained, rats restrained in the presence of freely moving rats and freely moving rats with a restrained rat. No significant difference in fear-memory and sucrose consumption between all groups was found. Change in body weight significantly increased in freely moving rats with a restrained rat, suggesting that those rats seems to share the stressful experience of the restrained rat. Interestingly, examination of the anxiety-like behavior revealed only rats restrained in the presence of freely moving rats to have a significant increase, suggesting that emotional distress intensifies in positions of social exclusion. These results demonstrate that unequally excluded social interaction circumstances could cause the amplification of distressed status and anxiety-related emotional alteration. Copyright © 2015 Elsevier B.V. All rights reserved.

Culture, distress, and oxytocin receptor polymorphism (OXTR) interact to influence emotional support seeking.

PubMed

Kim, Heejung S; Sherman, David K; Sasaki, Joni Y; Xu, Jun; Chu, Thai Q; Ryu, Chorong; Suh, Eunkook M; Graham, Kelsey; Taylor, Shelley E

2010-09-07

Research has demonstrated that certain genotypes are expressed in different forms, depending on input from the social environment. To examine sensitivity to cultural norms regarding emotional support seeking as a type of social environment, we explored the behavioral expression of oxytocin receptor polymorphism (OXTR) rs53576, a gene previously related to socio-emotional sensitivity. Seeking emotional support in times of distress is normative in American culture but not in Korean culture. Consequently, we predicted a three-way interaction of culture, distress, and OXTR genotype on emotional support seeking. Korean and American participants (n = 274) completed assessments of psychological distress and emotional support seeking and were genotyped for OXTR. We found the predicted three-way interaction: among distressed American participants, those with the GG/AG genotypes reported seeking more emotional social support, compared with those with the AA genotype, whereas Korean participants did not differ significantly by genotype; under conditions of low distress, OXTR groups did not differ significantly in either cultural group. These findings suggest that OXTR rs53576 is sensitive to input from the social environment, specifically cultural norms regarding emotional social support seeking. These findings also indicate that psychological distress and culture are important moderators that shape behavioral outcomes associated with OXTR genotypes.

Change in self-reported emotional distress and parenting among parents referred to inpatient child psychiatric family treatment

PubMed Central

Rimehaug, Tormod; Berg-Nielsen, Turid Suzanne; Wallander, Jan

2012-01-01

Rimehaug T, Berg-Nielsen TS, Wallander J. Change in self-reported emotional distress and parenting among parents referred to inpatient child psychiatric family treatment. Nord J Psychiatry 2011;64:1–8. Aims: Our aim was to examine changes in distress symptoms and parenting dimensions among parents in child psychiatry services (clinic parents) (n= 102). Parents were followed from referral and admission to 3-month and 12-month follow-ups of “treatment-as-usual” at inpatient family clinics. These measurements were compared with a sample of community parent (n = 439) standards. Methods: Standardized questionnaires measuring the child's problems, parental anxiety and depression symptoms (distress), and warmth protectiveness and authoritarianism (parenting dimensions), were distributed to parents four times (T0–T1–T2–T3). The family clinics received families whose children had long-term problems and unsatisfactory previous treatment outcomes. Results: Clinic mothers, but not fathers, showed an improvement in distress symptoms at the 3-month (T2) and 12-month (T3) follow-ups relative to at admission (T1). Nevertheless, clinic mothers displayed distress symptoms at all measurement points compared with community parents. Parents of children with learning/developmental problems and attention disorders showed significantly higher warmth scores at the 3-month and 12-month follow-up compared with at admission, although the levels remained lower than those of community parents. In contrast, parents of children with emotional problems showed the same level of warmth as community parents and lower levels of protectiveness, but no change in these parenting dimensions T1–T2. Implications: Parental emotional distress symptoms and parenting characteristics should be addressed systematically in child psychiatry to inform evaluations of the context of the child's problems and the family's treatment needs. Systematic and effective treatment components related to parenting

Key constructs in "classical" and "new wave" cognitive behavioral psychotherapies: relationships among each other and with emotional distress.

PubMed

Cristea, Ioana A; Montgomery, Guy H; Szamoskozi, Stefan; David, Daniel

2013-06-01

We aimed to relate key constructs from three forms of cognitive behavioral therapy that are often placed in competition: rational emotive behavior therapy, cognitive therapy, and acceptance and commitment therapy. The key constructs of the underlying theories (i.e., irrational beliefs/unconditional self-acceptance, dysfunctional cognitions, experiential avoidance/psychological inflexibility) of these therapies have not been explicitly studied in their relationships to each other and with emotional distress. We used a cross-sectional design. The variables were selected to indicate key constructs of the three major forms of therapy considered. Study 1 used a sample of 152 students, who were assessed during a stressful period of their semester (mean age = 21.71; 118 females), while Study 2 used a clinical sample of 28 patients with generalized anxiety disorder (mean age = 26.67; 26 females). Results showed that these constructs, central in the therapies considered, had medium to high associations to each other and to distress. Experiential avoidance was found to mediate the relationship between the other, schema-type cognitive constructs and emotional distress. Moreover, multiple mediation analysis in Study 2 seemed to indicate that the influence of the more general constructs on distress was mediated by experiential avoidance, whose effect seemed to be carried on further by automatic thoughts that were the most proximal to distress. Although each of the cognitive constructs considered comes with its underlying theory, the relationships between them can no longer be ignored and cognitive behavioral therapy theoretical models reliably accounting for these relationships should be proposed and tested. © 2013 Wiley Periodicals, Inc.

Financial Distress and Its Associations With Physical and Emotional Symptoms and Quality of Life Among Advanced Cancer Patients.

PubMed

Delgado-Guay, Marvin; Ferrer, Jeanette; Rieber, Alyssa G; Rhondali, Wadih; Tayjasanant, Supakarn; Ochoa, Jewel; Cantu, Hilda; Chisholm, Gary; Williams, Janet; Frisbee-Hume, Susan; Bruera, Eduardo

2015-09-01

There are limited data on the effects of financial distress (FD) on overall suffering and quality of life (QOL) of patients with advanced cancer (AdCa). In this cross-sectional study, we examined the frequency of FD and its correlates in AdCa. We interviewed 149 patients, 77 at a comprehensive cancer center (CCC) and 72 at a general public hospital (GPH). AdCa completed a self-rated FD (subjective experience of distress attributed to financial problems) numeric rating scale (0 = best, 10 = worst) and validated questionnaires assessing symptoms (Edmonton Symptom Assessment System [ESAS]), psychosocial distress (Hospital Anxiety and Depression Scale [HADS]), and QOL (Functional Assessment of Cancer Therapy-General [FACT-G]). The patients' median age was 60 years (95% confidence interval [CI]: 58.6-61.5 years); 74 (50%) were female; 48 of 77 at CCC (62%) versus 13 of 72 at GPH (18%) were white; 21 of 77 (27%) versus 32 of 72 (38%) at CCC and GPH, respectively, were black; and 7 of 77 (9%) versus 27 of 72 (38%) at CCC and GPH, respectively, were Hispanic (p < .0001). FD was present in 65 of 75 at CCC (86%; 95% CI: 76%-93%) versus 65 of 72 at GPH (90%; 95% CI: 81%-96%; p = .45). The median intensity of FD at CCC and GPH was 4 (interquartile range [IQR]: 1-7) versus 8 (IQR: 3-10), respectively (p = .0003). FD was reported as more severe than physical distress, distress about physical functioning, social/family distress, and emotional distress by 45 (30%), 46 (31%), 64 (43%), and 55 (37%) AdCa, respectively (all significantly worse for patients at GPH) (p < .05). AdCa reported that FD was affecting their general well-being (0 = not at all, 10 = very much) with a median score of 5 (IQR: 1-8). FD correlated (Spearman correlation) with FACT-G (r = -0.23, p = .0057); HADS-anxiety (r = .27, p = .0014), ESAS-anxiety (r = .2, p = .0151), and ESAS-depression (r = .18, p = .0336). FD was very frequent in both groups, but median intensity was double among GPH patients. More than 30

The Role of Emotion Reactivity in Health Anxiety.

PubMed

O'Bryan, Emily M; McLeish, Alison C; Johnson, Adrienne L

2017-11-01

Emotion reactivity, defined as heightened sensitivity, intensity, and persistence of emotional states, has been shown to contribute to the exacerbation of anxiety. However, the association between emotion reactivity and health anxiety has yet to be examined. The aim of the present investigation was to examine the unique predictive ability of emotion reactivity in terms of health anxiety in a sample of medically healthy undergraduates ( n = 194; 59.3% female, M age = 19.42, SD = 1.51, range = 18-26 years; 84.0% Caucasian). Findings indicated that, after controlling for the effects of gender, age, and anxiety sensitivity, greater emotion reactivity significantly predicted greater overall health anxiety (3.1% variance), as well as higher levels of affective (4.1% unique variance) and behavioral (4.8% unique variance) components. Findings suggest that experiencing emotions more frequently, intensely, and for longer durations of time prior to returning to baseline are associated with greater health preoccupations.

Empathy and distress: two distinct but related emotions in response to infant crying.

PubMed

Lin, Hung-Chu; McFatter, Robert

2012-12-01

This study examined a largely overlooked, yet potentially important, association between empathy and distress in cry responding. The cry stimulus included a 1-min-long video clip of a 4-week-old, crying, male infant. Participants reported their dispositional empathy and distress, perceived aversiveness of the cry stimulus, response emotions, and intention to intervene with the crying infant. Empathy and distress covaried positively both in disposition and in cry responding. Response empathy and distress were related to their corresponding dispositional emotions, but response empathy was also related to dispositional distress. Perceived aversiveness interacted with response distress in predicting response empathy. Both response empathy and distress appeared to be important determinants of intention to intervene. Overall, empathy and distress in response to infant crying appeared more closely related than previously thought. Implications concerning the regulation of emotions in cry responding are discussed. Copyright © 2012 Elsevier Inc. All rights reserved.

Predicting short-term positive affect in individuals with social anxiety disorder: The role of selected personality traits and emotion regulation strategies.

PubMed

Weisman, Jaclyn S; Rodebaugh, Thomas L; Lim, Michelle H; Fernandez, Katya C

2015-08-01

Recently, research has provided support for a moderate, inverse relationship between social anxiety and dispositional positive affect. However, the dynamics of this relationship remain poorly understood. The present study evaluates whether certain personality traits and emotion regulation variables predict short-term positive affect for individuals with social anxiety disorder and healthy controls. Positive affect as measured by two self-report instruments was assessed before and after two tasks in which the participant conversed with either a friend or a romantic partner. Tests of models examining the hypothesized prospective predictors revealed that the paths did not differ significantly across diagnostic group and both groups showed the hypothesized patterns of endorsement for the emotion regulation variables. Further, a variable reflecting difficulty redirecting oneself when distressed prospectively predicted one measure of positive affect. Additional research is needed to explore further the role of emotion regulation strategies on positive emotions for individuals higher in social anxiety. Copyright © 2015 Elsevier Ltd. All rights reserved.

Predicting changes in quality of life and emotional distress in Chinese patients with lung, gastric, and colon-rectal cancer diagnoses: the role of psychological resilience.

PubMed

Ye, Zeng Jie; Qiu, Hong Zhong; Li, Peng Fei; Liang, Mu Zi; Zhu, Yun Fei; Zeng, Zhen; Hu, Guang Yun; Wang, Shu Ni; Quan, Xiao Ming

2017-06-01

Patients with cancer often experience considerable emotional distress, which decreases their quality of life (QOL). Resilience is defined as the psychological characteristics that promote positive adaptation in the face of stress and adversity; however, the relationships among QOL, resilience, and emotional distress in patients with cancer, especially Chinese patients with cancer, are under-researched in the literature. Quality of Life Questionnaire Core 30 items, Zung Self-Rating Anxiety Scale, and the Zung Self-Rating Depression Scale were applied in this study. Univariate correlated analysis and multivariate logistic regression analysis were used to test the associations among resilience, emotional distress, and QOL with a sample of 276 participants. A Sobel test was conducted to determine whether the indirect effect of resilience was significant. The mean ratings of QOL (59.2), resilience (20.8), anxiety (43.1), and depression (47.7) were reported. The correlations between resilience and QOL in patients with lung cancer were significantly increased compared with patients with gastric or colorectal cancer (Spearman coefficient squares of 0.284, 0.189, and 0.227, respectively). The highest quartile of the resilience level was associated with a 64% (odds ratio = 0.36, 95% confidence interval = 0.17-0.75, P = .006), 70% (odds ratio = 0.30, 95% confidence interval = 0.14-0.63), and 90% (odds ratio = 0.10, 95% confidence interval = 0.04-0.26, P < .001) reduction in the risk of emotional distress compared with the lowest quartile. The Sobel test indicated a buffering effect of resilience that was significant for depression (Sobel value = 2.002, P = .045) but not anxiety (Sobel value = 1.336, P = .182). The present study suggests that psychological resilience is positively associated with QOL and may comprise a robust buffer between depression and QOL in Chinese patients with cancer. Copyright © 2016 John Wiley & Sons, Ltd.

The relation between social support, anxiety and distress symptoms and maternal fetal attachment.

PubMed

Hopkins, Joyce; Miller, Jennifer L; Butler, Kristina; Gibson, Lynda; Hedrick, Laura; Boyle, Deborah Anne

2018-05-04

The aims of this study were to: (1) examine the relation between social support, trait anxiety, symptoms of maternal distress (including stress, depression and anxiety) and maternal-fetal attachment; and (2) to determine if social support buffers the relation between trait anxiety, symptoms of distress and maternal-fetal attachment. Ninety-four pregnant women completed five self-report questions. Two hierarchical regression analyses were conducted to examine the influence of trait anxiety, symptoms of distress, and social support on two factors of maternal-fetal attachment, quality and intensity/frequency. In the first model with the dependent measure as the maternal-fetal attachment quality score, trait anxiety (β = -.24, p < .05) and social support (β = .30, p < .01) were significant predictors, accounting for 18% of the variance. In the second model with the dependent measure as the maternal-fetal attachment intensity/frequency score, trait anxiety (β = -.23, p < .05) and social support (β = .32, p < .01) were significant predictors, accounting for 23% of the variance. In addition, the interaction term contributed a significant 4% of the variance, indicating that when social support is high, the relation between anxiety and maternal-fetal attachment intensity/frequency is attenuated. This study demonstrates that prenatal attachment is related to trait anxiety and social support. These findings suggest that interventions to decrease anxiety and increase social support could enhance maternal-fetal attachment.

Diabetes-related emotional distress instruments: a systematic review of measurement properties.

PubMed

Lee, Jiyeon; Lee, Eun-Hyun; Kim, Chun-Ja; Moon, Seung Hei

2015-12-01

The objectives of this study were to identify all available diabetes-related emotional distress instruments and evaluate the evidence regarding their measurement properties to help in the selection of the most appropriate instrument for use in practice and research. A systematic literature search was performed. PubMed, Embase, CINAHL, and PsycINFO were searched systematically for articles on diabetes-related emotional distress instruments. The Consensus-based Standards for the Selection of Health Measurement Instruments checklist was used to evaluate the methodological quality of the identified studies. The quality of results with respect to the measurement properties of each study was evaluated using Terwee's quality criteria. An ancillary meta-analysis was performed. Of the 2345 articles yielded by the search, 19 full-text articles evaluating 6 diabetes-related emotional distress instruments were included in this study. No instrument demonstrated evidence for all measurement properties. The Problem Areas in Diabetes scale (PAID) was the most frequently studied and the best validated of the instruments. Pooled summary estimates of the correlation coefficient between the PAID and serum glycated hemoglobin revealed a positive but weak correlation. No diabetes-related emotional distress instrument demonstrated evidence for all measurement properties. No instrument was better than another, although the PAID was the best validated and is thus recommended for use. Further psychometric studies of the diabetes-related emotional distress instruments with rigorous methodologies are required. Copyright © 2015 Elsevier Ltd. All rights reserved.

Anxious Writers: Distinguishing Anxiety from Pathology.

ERIC Educational Resources Information Center

Bloom, Martin

An exploration of writing anxiety suggests that it is a normal form of behavior rather than a pathology, but that it varies in degrees of its dysfunctionality. Excerpts from the log books of college students in a writing anxiety workshop illustrate four broad categories of writing anxiety: procrastination, feeling emotionally distressed, thinking…

Feeling of burden, psychological distress, and anxiety among primary caregivers of children with home enteral nutrition.

PubMed

Calderón, Caterina; Gómez-López, Lilianne; Martínez-Costa, Cecilia; Borraz, Soraya; Moreno-Villares, José Manuel; Pedrón-Giner, Consuelo

2011-03-01

To examine the relationship between several psychological factors and the feeling of burden experienced by caregivers of children with home enteral nutrition. Fifty-six mothers of pediatric patients with chronic diseases requiring long-term home enteral nutrition were recruited. They were asked to respond to specific questionnaires about their anxiety symptoms (State-Trait Anxiety Inventory), psychological distress (SCL-90-R) and feeling of burden (Zarit-scale). Caregivers' feeling of burden was found to be statistically associated to psychological distress (r = .516, p < .001) and trait anxiety (r = .376, p = .005). No significant differences were found between the type of diagnosis and caregiver burden. Regression analysis indicated psychological distress has a partial mediational effect in the relationship between trait anxiety and caregivers' burden. Psychological distress and anxiety show a positive correlation with caregivers' feeling of burden, and may disrupt family well-being. Early identification of high-risk situations is essential in order to plan specific psychosocial aid efficiently.

Anxiety sensitivity and affect regulatory strategies: individual and interactive risk factors for anxiety-related symptoms.

PubMed

Kashdan, Todd B; Zvolensky, Michael J; McLeish, Alison C

2008-01-01

Studies have shown that anxiety sensitivity (AS) is a risk factor in the development of pathological anxiety. Recent theoretical models emphasize the additional importance of how people handle their anxious experiences. The present study examined whether high AS and being fixated on the control and regulation of unwanted anxious feelings or being unable to properly modulate affect as needed lead to particularly problematic outcomes. We examined the interactive influence of AS and affect regulatory strategies on the frequency and intensity of anxiety symptoms. Questionnaires were completed by 248 young adults in the community. Results showed a general pattern with anxiety symptoms being the most severe when high AS was paired with affect regulatory difficulties. Of participants high in AS, anxious arousal and worry were heightened in the presence of less acceptance of emotional distress; anxious arousal, worry, and agoraphobic cognitions were heightened when fewer resources were available to properly modulate affect; and agoraphobic cognitions were heightened in the presence of high emotion expressiveness. As evidence of construct specificity, an alternative model with anhedonic depressive symptoms as a main effect and interaction effect (with regulatory strategies) failed to predict anxiety symptoms. However, anxiety sensitivity and less acceptance of emotional distress were associated with greater anhedonia. Results are discussed in the context of how and when affect regulatory behavior shifts individuals from normative anxiety to pathology.

A Bowen Family Systems Model of Generalized Anxiety Disorder and Romantic Relationship Distress.

PubMed

Priest, Jacob B

2015-07-01

Many individuals with generalized anxiety disorder (GAD) do not respond well to currently available treatments. Moreover, treatments are less effective when GAD is accompanied by romantic relationship distress. In order to develop effective treatments for GAD and relationship distress, it is necessary to conduct theory-based research to identify links common to both GAD and romantic relationship distress. Drawing on Bowen's family systems theory, the roles of family abuse/violence and differentiation in GAD and romantic relationship distress were examined using existing data from the National Comorbidity Survey Replication (n = 2,312; 2005). As predicted, family abuse/violence was directly linked to both GAD and romantic relationship distress. Differentiation mediated the relationship between family abuse/violence and GAD, and partially mediated the relationship between family abuse/violence and romantic relationship distress. Findings suggest that current and past relationship processes may help maintain chronic anxiety and that Bowen's theory may be a useful framework for developing couple therapy treatment of GAD and romantic relationship distress. © 2013 American Association for Marriage and Family Therapy.

Social anxiety and interpersonal stress generation: the moderating role of interpersonal distress.

PubMed

Siegel, David M; Burke, Taylor A; Hamilton, Jessica L; Piccirillo, Marilyn L; Scharff, Adela; Alloy, Lauren B

2018-06-01

Existing models of social anxiety scarcely account for interpersonal stress generation. These models also seldom include interpersonal factors that compound the effects of social anxiety. Given recent findings that two forms of interpersonal distress, perceived burdensomeness and thwarted belongingness, intensify social anxiety and cause interpersonal stress generation, these two constructs may be especially relevant to examining social anxiety and interpersonal stress generation together. The current study extended prior research by examining the role of social anxiety in the occurrence of negative and positive interpersonal events and evaluated whether interpersonal distress moderated these associations. Undergraduate students (N = 243; M = 20.46 years; 83% female) completed self-report measures of social anxiety, perceived burdensomeness, and thwarted belongingness, as well as a self-report measure and clinician-rated interview assessing negative and positive interpersonal events that occurred over the past six weeks. Higher levels of social anxiety were associated only with a higher occurrence of negative interpersonal dependent events, after controlling for depressive symptoms. This relationship was stronger among individuals who also reported higher levels of perceived burdensomeness, but not thwarted belongingness. It may be important to more strongly consider interpersonal stress generation in models of social anxiety.

Associations Between Internet-Based Professional Social Networking and Emotional Distress.

PubMed

Jones, Jacquelynn R; Colditz, Jason B; Shensa, Ariel; Sidani, Jaime E; Lin, Liu Yi; Terry, Martha Ann; Primack, Brian A

2016-10-01

Professional social networking websites are commonly used among young professionals. In light of emerging concerns regarding social networking use and emotional distress, the purpose of this study was to investigate the association between frequency of use of LinkedIn, the most commonly used professional social networking website, and depression and anxiety among young adults. In October 2014, we assessed a nationally representative sample of 1,780 U.S. young adults between the ages of 19-32 regarding frequency of LinkedIn use, depression and anxiety, and sociodemographic covariates. We measured depression and anxiety using validated Patient-Reported Outcomes Measurement Information System measures. We used bivariable and multivariable logistic regression to assess the association between LinkedIn use and depression and anxiety, while controlling for age, sex, race, relationship status, living situation, household income, education level, and overall social media use. In weighted analyses, 72% of participants did not report use of LinkedIn, 16% reported at least some use, but less than once each week, and 12% reported use at least once per week. In multivariable analyses controlling for all covariates, compared with those who did not use LinkedIn, participants using LinkedIn at least once per week had significantly greater odds of increased depression (adjusted odds ratio [AOR] = 2.10, 95% confidence interval [CI] = 1.31-3.38) and increased anxiety (AOR = 2.79, 95% CI = 1.72-4.53). LinkedIn use was significantly related to both outcomes in a dose-response manner. Future research should investigate directionality of this association and possible reasons for it.

Associations Between Internet-Based Professional Social Networking and Emotional Distress

PubMed Central

Jones, Jacquelynn R.; Colditz, Jason B.; Shensa, Ariel; Sidani, Jaime E.; Lin, Liu Yi; Terry, Martha Ann

2016-01-01

Abstract Professional social networking websites are commonly used among young professionals. In light of emerging concerns regarding social networking use and emotional distress, the purpose of this study was to investigate the association between frequency of use of LinkedIn, the most commonly used professional social networking website, and depression and anxiety among young adults. In October 2014, we assessed a nationally representative sample of 1,780 U.S. young adults between the ages of 19–32 regarding frequency of LinkedIn use, depression and anxiety, and sociodemographic covariates. We measured depression and anxiety using validated Patient-Reported Outcomes Measurement Information System measures. We used bivariable and multivariable logistic regression to assess the association between LinkedIn use and depression and anxiety, while controlling for age, sex, race, relationship status, living situation, household income, education level, and overall social media use. In weighted analyses, 72% of participants did not report use of LinkedIn, 16% reported at least some use, but less than once each week, and 12% reported use at least once per week. In multivariable analyses controlling for all covariates, compared with those who did not use LinkedIn, participants using LinkedIn at least once per week had significantly greater odds of increased depression (adjusted odds ratio [AOR] = 2.10, 95% confidence interval [CI] = 1.31–3.38) and increased anxiety (AOR = 2.79, 95% CI = 1.72–4.53). LinkedIn use was significantly related to both outcomes in a dose–response manner. Future research should investigate directionality of this association and possible reasons for it. PMID:27732077

Specificity of emotion regulation deficits in social anxiety: an internet study.

PubMed

Rusch, Silke; Westermann, Stefan; Lincoln, Tania M

2012-09-01

There is evidence for an association between social anxiety and emotion regulation difficulties. This study investigates that emotion regulation difficulties are specific to two domains of social anxiety. An explorative study was conducted to examine the associations between emotion regulation facets and social anxiety in the normal population. N= 149 healthy volunteers participated in an internet-based survey. Emotion regulation deficits were measured by the Difficulties in Emotion Regulation Scale which consists of six subscales. Social anxiety was measured by the Social Phobia Scale and the Social Interaction Anxiety Scale. Hierarchical regression analyses showed that anxiety of interactive social situations is associated with non-acceptance of negative emotions, impulse control difficulties, and lack of functional emotion regulation strategies over and above the impact of age and general psychopathology. In contrast, anxiety of being observed by others was not specifically associated with emotion regulation strategies. The results support the hypothesis that specific emotion regulation deficits are relevant to specific aspects of social anxiety. Implications for further research and therapy are discussed. © 2011 The British Psychological Society.

A randomized control study of psychological intervention to reduce anxiety, amotivation and psychological distress among medical students.

PubMed

Saravanan, Coumaravelou; Kingston, Rajiah

2014-05-01

Test anxiety aggravates psychological distress and reduces the motivation among graduate students. This study aimed to identify psychological intervention for test anxiety, which reduces the level of psychological distress, amotivation and increases the intrinsic and extrinsic motivation among medical students. Westside test anxiety scale, Kessler Perceived Stress Scale and Academic Motivation Scale were used to measure test anxiety, psychological distress and motivation on 436 1(st) year medical students. Out of 436 students, 74 students who exhibited moderate to high test anxiety were randomly divided into either experimental or waiting list group. In this true randomized experimental study, 32 participants from the intervention group received five sessions of psychological intervention consist of psychoeducation, relaxation therapy and systematic desensitization. Thirty-three students from waiting list received one session of advice and suggestions. After received psychological intervention participants from the intervention group experienced less anxiety, psychological distress, and amotivation (P < 0.01) and high intrinsic and extrinsic motivation (P < 0.01) in the postassessment compared with their preassessment scores. Overall psychological intervention is effective to reduce anxiety scores and its related variables.

Testing the effectiveness of a mindfulness-based intervention to reduce emotional distress in outpatients with diabetes (DiaMind): design of a randomized controlled trial.

PubMed

van Son, Jenny; Nyklíček, Ivan; Pop, Victor J M; Pouwer, François

2011-02-24

Approximately 20-40% of outpatients with diabetes experience elevated levels of emotional distress, varying from disease-specific distress to general symptoms of anxiety and depression. The patient's emotional well-being is related to other unfavorable outcomes, like reduced quality of life, sub-optimal self-care, impaired glycemic control, higher risk of complications, and increased mortality rates. The purpose of this study is to test the effectiveness of a new diabetes-specific, mindfulness-based psychological intervention. First, with regard to reducing emotional distress; second, with respect to improving quality of life, dispositional mindfulness, and self-esteem of patients with diabetes; third, with regard to self-care and clinical outcomes; finally, a potential effect modification by clinical and personality characteristics will be explored. The Diabetes and Mindfulness study (DiaMind) is a randomized controlled trial. Patients with diabetes with low levels of emotional well-being will be recruited from outpatient diabetes clinics. Eligible patients will be randomized to an intervention group or a wait-list control group. The intervention group will receive the mindfulness program immediately, while the control group will receive the program eight months later. The primary outcome is emotional distress (anxiety, stress, depressive symptoms), for which data will be collected at baseline, four weeks, post intervention, and after six months follow-up. In addition, self-report data will be collected on quality of life, dispositional mindfulness, self-esteem, self-care, and personality, while complications and glycemic control will be assessed from medical files and blood pressure will be measured. Group differences will be analyzed with repeated measures analysis of covariance.The study is supported by grants from the Dutch Diabetes Research Foundation and Tilburg University and has been approved by a medical ethics committee. It is hypothesized that emotional

Alexithymia and psychological distress in fibromyalgia: prevalence and relation with quality of life.

PubMed

Castelli, Lorys; Tesio, Valentina; Colonna, Fabrizio; Molinaro, Stefania; Leombruni, Paolo; Bruzzone, Maria; Fusaro, Enrico; Sarzi-Puttini, Piercarlo; Torta, Riccardo

2012-01-01

Fibromyalgia (FM) is a chronic syndrome characterised by widespread musculoskeletal pain associated with other symptoms like fatigue, stiffness, non-restorative sleep and psychological distress that strongly affects the quality of life in FM patients. While the psychological distress has been widely explored in FM, only a few studies investigated alexithymia, an emotional dysregulation trait. Evaluate the prevalence of alexithymia and psychological distress and their impact on patients quality of life. A battery of tests assessing alexithymia, depression, anxiety, emotional distress symptoms and the health related quality of life (HRQoL) was filled out by 55 female FM patients. After having analysed their prevalence, two regression analyses were performed in order to evaluate the role that alexithymia, depression, anxiety, emotional distress and pain characteristics have on quality of life of FM patients. Results showed that a clinically relevant level of psychological distress was present in more than half of our sample, whereas alexithymic traits were present in 20% of the patients. Regression analyses showed that pain intensity, depression and current pain were the variables that best contribute to explain the physical component of the HRQoL while anxiety, depression and pain intensity were the variables that mainly contributed to explain the mental component of quality of life. These results underline the high prevalence of alexithymia in FM patients and the great impact of psychological symptoms on FM patients HRQoL. Wholistic care of FM patients which addresses both physical and psychological symptoms is needed.

A 3-stage model of patient-centered communication for addressing cancer patients' emotional distress.

PubMed

Dean, Marleah; Street, Richard L

2014-02-01

To describe pathways through which clinicians can more effectively respond to patients' emotions in ways that contribute to betterment of the patient's health and well-being. A representative review of literature on managing emotions in clinical consultations was conducted. A three-stage, conceptual model for assisting clinicians to more effectively address the challenges of recognizing, exploring, and managing cancer patients' emotional distress in the clinical encounter was developed. To enhance and enact recognition of patients' emotions, clinicians can engage in mindfulness, self-situational awareness, active listening, and facilitative communication. To enact exploration, clinicians can acknowledge and validate emotions and provide empathy. Finally, clinicians can provide information empathetically, identify therapeutic resources, and give referrals and interventions as needed to help lessen patients' emotional distress. This model serves as a framework for future research examining pathways that link clinicians' emotional cue recognition to patient-centered responses exploring a patient's emotional distress to therapeutic actions that contribute to improved psychological and emotional health. Specific communicative and cognitive strategies are presented that can help clinicians better recognize a patient's emotional distress and respond in ways that have therapeutic value. Published by Elsevier Ireland Ltd.

Anxiety, emotional processing and depression in people with multiple sclerosis.

PubMed

Gay, Marie-Claire; Bungener, Catherine; Thomas, Sarah; Vrignaud, Pierre; Thomas, Peter W; Baker, Roger; Montel, Sébastien; Heinzlef, Olivier; Papeix, Caroline; Assouad, Rana; Montreuil, Michèle

2017-02-23

Despite the high comorbidity of anxiety and depression in people with multiple sclerosis (MS), little is known about their inter-relationships. Both involve emotional perturbations and the way in which emotions are processed is likely central to both. The aim of the current study was to explore relationships between the domains of mood, emotional processing and coping and to analyse how anxiety affects coping, emotional processing, emotional balance and depression in people with MS. A cross-sectional questionnaire study involving 189 people with MS with a confirmed diagnosis of MS recruited from three French hospitals. Study participants completed a battery of questionnaires encompassing the following domains: i. anxiety and depression (Hospital Anxiety and Depression Scale (HADS)); ii. emotional processing (Emotional Processing Scale (EPS-25)); iii. positive and negative emotions (Positive and Negative Emotionality Scale (EPN-31)); iv. alexithymia (Bermond-Vorst Alexithymia Questionnaire) and v. coping (Coping with Health Injuries and Problems-Neuro (CHIP-Neuro) questionnaire. Relationships between these domains were explored using path analysis. Anxiety was a strong predictor of depression, in both a direct and indirect way, and our model explained 48% of the variance of depression. Gender and functional status (measured by the Expanded Disability Status Scale) played a modest role. Non-depressed people with MS reported high levels of negative emotions and low levels of positive emotions. Anxiety also had an indirect impact on depression via one of the subscales of the Emotional Processing Scale ("Unregulated Emotion") and via negative emotions (EPN-31). This research confirms that anxiety is a vulnerability factor for depression via both direct and indirect pathways. Anxiety symptoms should therefore be assessed systematically and treated in order to lessen the likelihood of depression symptoms.

Does emotional reasoning change during cognitive behavioural therapy for anxiety?

PubMed

Berle, David; Moulds, Michelle L; Starcevic, Vladan; Milicevic, Denise; Hannan, Anthony; Dale, Erin; Viswasam, Kirupamani; Brakoulias, Vlasios

2016-01-01

Emotional reasoning refers to the use of subjective emotions, rather than objective evidence, to form conclusions about oneself and the world. It is a key interpretative bias in cognitive models of anxiety disorders and appears to be especially evident in individuals with anxiety disorders. However, the amenability of emotional reasoning to change during treatment has not yet been investigated. We sought to determine whether emotional reasoning tendencies change during a course of routine cognitive-behavioural therapy (CBT). Emotional reasoning tendencies were assessed in 36 individuals with a primary anxiety disorder who were seeking treatment at an outpatient clinic. Changes in anxiety and depressive symptoms as well as emotional reasoning tendencies after 12 sessions of CBT were examined in 25 individuals for whom there was complete data. Emotional reasoning tendencies were evident at pretreatment assessment. Although anxiety and depressive symptoms decreased during CBT, only one of six emotional reasoning interpretative styles (pertaining to conclusions that one is incompetent) changed significantly during the course of therapy. Attrition rates were high and there was not enough information regarding the extent to which therapy specifically focused on addressing emotional reasoning tendencies. Individuals seeking treatment for anxiety disorders appear to engage in emotional reasoning, however routine individual CBT does not appear to result in changes in emotional reasoning tendencies.

The buffering effect of relationship satisfaction on emotional distress in couples

PubMed Central

2012-01-01

Background Marital distress and depression frequently co-occur, and partnership quality is associated with depressive symptoms and mental disorders in both men and women. One aim of this study was to investigate the contribution of a set of risk factors for emotional distress among men and women in couples, with a special focus on satisfaction with partner relationship. The most important aim was to investigate the extent to which high relationship satisfaction in couples acts as a buffer against stressful events. Methods Pregnant women and their husbands (n = 62,956 couples) enrolled in the Norwegian Mother and Child Cohort Study completed a questionnaire with questions about emotional distress, relationship satisfaction, and other risk factors. Twelve potential risk factors were included in the analyses, including relationship satisfaction, demographic characteristics, and somatic diseases in men and women. Associations between the predictor variables and emotional distress were estimated by multiple linear regression analysis. Cross-spousal effects, in which data reported by one of the spouses predicted emotional distress in the other, were also investigated. Possible interaction effects between certain risk factors and self-reported and partner's relationship satisfaction were tested and further explored with regression analyses in subsamples stratified by relationship satisfaction scores. Results The unique effects of relationship satisfaction were of similar sizes for both men and women: substantial for self-reported (β = -0.23 and β = -0.28, respectively) and weak for partner-reported satisfaction (β = -0.04 and β = -0.02, respectively). Other relatively strong risk factors were somatic disease, first-time motherhood, and unemployment. Self-reported as well as partner-reported relationship satisfaction appeared to strongly buffer the effects of a number of stressors. Conclusions Partner relationship dissatisfaction is strongly associated with emotional

The Impact of Multiple Concussions on Emotional Distress, Post-Concussive Symptoms, and Neurocognitive Functioning in Active Duty United States Marines Independent of Combat Exposure or Emotional Distress

PubMed Central

Lathan, Corinna E.; Bleiberg, Joseph; Tsao, Jack W.

2014-01-01

Abstract Controversy exists as to whether the lingering effects of concussion on emotional, physical, and cognitive symptoms is because of the effects of brain trauma or purely to emotional factors such as post-traumatic stress disorder or depression. This study examines the independent effects of concussion on persistent symptoms. The Defense Automated Neurobehavioral Assessment, a clinical decision support tool, was used to assess neurobehavioral functioning in 646 United States Marines, all of whom were fit for duty. Marines were assessed for concussion history, post-concussive symptoms, emotional distress, neurocognitive functioning, and deployment history. Results showed that a recent concussion or ever having experienced a concussion was associated with an increase in emotional distress, but not with persistent post-concussive symptoms (PPCS) or neurocognitive functioning. Having had multiple lifetime concussions, however, was associated with greater emotional distress, PPCS, and reduced neurocognitive functioning that needs attention and rapid discrimination, but not for memory-based tasks. These results are independent of deployment history, combat exposure, and symptoms of post-traumatic stress disorder and depression. Results supported earlier findings that a previous concussion is not generally associated with post-concussive symptoms independent of covariates. In contrast with other studies that failed to find a unique contribution for concussion to PPCS, however, evidence of recent and multiple concussion was seen across a range of emotional distress, post-concussive symptoms, and neurocognitive functioning in this study population. Results are discussed in terms of implications for assessing concussion on return from combat. PMID:25003552

Emotional reasoning and anxiety sensitivity: associations with social anxiety disorder in childhood.

PubMed

Alkozei, Anna; Cooper, Peter J; Creswell, Cathy

2014-01-01

Two specific cognitive constructs that have been implicated in the development and maintenance of anxiety symptoms are anxiety sensitivity and emotional reasoning, both of which relate to the experience and meaning of physical symptoms of arousal or anxiety. The interpretation of physical symptoms has been particularly implicated in theories of social anxiety disorder, where internal physical symptoms are hypothesized to influence the individual's appraisals of the self as a social object. The current study compared 75 children on measures of anxiety sensitivity and emotional reasoning: 25 with social anxiety disorder, 25 with other anxiety disorders, and 25 nonanxious children (aged 7-12 years). Children with social anxiety disorder reported higher levels of anxiety sensitivity and were more likely than both other groups to view ambiguous situations as anxiety provoking, whether physical information was present or not. There were no group differences in the extent to which physical information altered children's interpretation of hypothetical scenarios. This study is the first to investigate emotional reasoning in clinically anxious children and therefore replication is needed. In addition, those in both anxious groups commonly had comorbid conditions and, consequently, specific conclusions about social anxiety disorder need to be treated with caution. The findings highlight cognitive characteristics that may be particularly pertinent in the context of social anxiety disorder in childhood and which may be potential targets for treatment. Furthermore, the findings suggest that strategies to modify these particular cognitive constructs may not be necessary in treatments of some other childhood anxiety disorders. © 2013 The Authors. Published by Elsevier B.V. All rights reserved.

Emotional reasoning and anxiety sensitivity: Associations with social anxiety disorder in childhood☆

PubMed Central

Alkozei, Anna; Cooper, Peter J.; Creswell, Cathy

2014-01-01

Background Two specific cognitive constructs that have been implicated in the development and maintenance of anxiety symptoms are anxiety sensitivity and emotional reasoning, both of which relate to the experience and meaning of physical symptoms of arousal or anxiety. The interpretation of physical symptoms has been particularly implicated in theories of social anxiety disorder, where internal physical symptoms are hypothesized to influence the individual's appraisals of the self as a social object. Method The current study compared 75 children on measures of anxiety sensitivity and emotional reasoning: 25 with social anxiety disorder, 25 with other anxiety disorders, and 25 nonanxious children (aged 7–12 years). Results Children with social anxiety disorder reported higher levels of anxiety sensitivity and were more likely than both other groups to view ambiguous situations as anxiety provoking, whether physical information was present or not. There were no group differences in the extent to which physical information altered children's interpretation of hypothetical scenarios. Limitations This study is the first to investigate emotional reasoning in clinically anxious children and therefore replication is needed. In addition, those in both anxious groups commonly had comorbid conditions and, consequently, specific conclusions about social anxiety disorder need to be treated with caution. Conclusion The findings highlight cognitive characteristics that may be particularly pertinent in the context of social anxiety disorder in childhood and which may be potential targets for treatment. Furthermore, the findings suggest that strategies to modify these particular cognitive constructs may not be necessary in treatments of some other childhood anxiety disorders. PMID:24120086

Alexithymia, emotion processing and social anxiety in adults with ADHD.

PubMed

Edel, M-A; Rudel, A; Hubert, C; Scheele, D; Brüne, M; Juckel, G; Assion, Hans-Jörg

2010-09-24

given sparse research on the issue, this study sought to shed light upon the interactions of alexithymia, emotion processing, and social anxiety in adults with attention-deficit hyperactivity disorder (ADHD). 73 German adults with ADHD according to DSM-IV diagnostic criteria participated. We used the Toronto Alexithymia Scale (TAS-20) to assess alexithymia, the Social Phobia Scale (SPS) and the Social Interaction Anxiety Scale (SIAS) to assess different features of social anxiety, and we applied the German "Experience of Emotions Scalerdquor; (SEE) to measure emotion processing. 40% of the sample were found to meet the DSM-IV criteria of social anxiety disorder, and about 22% were highly alexithymic according to a TAS-20 total score ≥ 61; however, the mean TAS-20 total score of 50.94 ± 9.3 was not much higher than in community samples. Alexithymic traits emerged to be closely linked to emotion processing problems, particularly 'difficulty accepting own emotions', and to social anxiety features. our findings suggest interactions of alexithymia, emotion processing dysfunction, and social anxiety in adults with ADHD, which may entail the therapeutic implication to thoroughly instruct these patients to identify, accept, communicate, and regulate their emotions to aid reducing interaction anxiety.

fMRI Study of Social Anxiety during Social Ostracism with and without Emotional Support.

PubMed

Nishiyama, Yoshiko; Okamoto, Yasumasa; Kunisato, Yoshihiko; Okada, Go; Yoshimura, Shinpei; Kanai, Yoshihiro; Yamamura, Takanao; Yoshino, Atsuo; Jinnin, Ran; Takagaki, Koki; Onoda, Keiichi; Yamawaki, Shigeto

2015-01-01

Social anxiety is characterized by an excessive fear of being embarrassed in social interactions or social performance situations. Emotional support can help to decrease or diminish social distress. Such support may play an important role at different points of social interaction. However, it is unclear how the beneficial effects of social support are represented in the brains of socially anxious individuals. To explore this, we used the same paradigm previously used to examine the effects of emotional support on social pain caused by exclusion. Undergraduates (n = 46) showing a wide range of social anxiety scores underwent functional magnetic resonance imaging (fMRI) while participating in a Cyberball game. Participants were initially included and later excluded from the game. In the latter half of the session in which participants were excluded, they were provided with supportive messages. In line with our previous work, we found that social exclusion led to increased anterior cingulate cortex (ACC) activity, whereas emotional support led to increased left dorsolateral prefrontal cortex (DLPFC) activity. Despite validation of the paradigm, social anxiety was not associated with increased ACC activity during social exclusion, or during perceived emotional support. Instead, fear of negative evaluation as assessed by the Brief Fear of Negative Evaluation (BFNE) scale showed positive associations with left DLPFC activation while receiving emotional support, compared to while being socially excluded. The more socially anxious an individual was, the greater was the left DLPFC activity increased during receipt of messages. This suggests that highly socially anxious people still have the ability to perceive social support, but that they are nevertheless susceptible to negative evaluation by others.

fMRI Study of Social Anxiety during Social Ostracism with and without Emotional Support

PubMed Central

Nishiyama, Yoshiko; Okamoto, Yasumasa; Kunisato, Yoshihiko; Okada, Go; Yoshimura, Shinpei; Kanai, Yoshihiro; Yamamura, Takanao; Yoshino, Atsuo; Jinnin, Ran; Takagaki, Koki; Onoda, Keiichi; Yamawaki, Shigeto

2015-01-01

Social anxiety is characterized by an excessive fear of being embarrassed in social interactions or social performance situations. Emotional support can help to decrease or diminish social distress. Such support may play an important role at different points of social interaction. However, it is unclear how the beneficial effects of social support are represented in the brains of socially anxious individuals. To explore this, we used the same paradigm previously used to examine the effects of emotional support on social pain caused by exclusion. Undergraduates (n = 46) showing a wide range of social anxiety scores underwent functional magnetic resonance imaging (fMRI) while participating in a Cyberball game. Participants were initially included and later excluded from the game. In the latter half of the session in which participants were excluded, they were provided with supportive messages. In line with our previous work, we found that social exclusion led to increased anterior cingulate cortex (ACC) activity, whereas emotional support led to increased left dorsolateral prefrontal cortex (DLPFC) activity. Despite validation of the paradigm, social anxiety was not associated with increased ACC activity during social exclusion, or during perceived emotional support. Instead, fear of negative evaluation as assessed by the Brief Fear of Negative Evaluation (BFNE) scale showed positive associations with left DLPFC activation while receiving emotional support, compared to while being socially excluded. The more socially anxious an individual was, the greater was the left DLPFC activity increased during receipt of messages. This suggests that highly socially anxious people still have the ability to perceive social support, but that they are nevertheless susceptible to negative evaluation by others. PMID:26000902

Medical student depression, anxiety and distress outside North America: a systematic review.

PubMed

Hope, Valerie; Henderson, Max

2014-10-01

North American medical students are more depressed and anxious than their peers. In the UK, the regulator now has responsibility for medical students, which may potentially increase scrutiny of their health. This may either help or hinder medical students in accessing appropriate care. The prevalences of anxiety, depression and psychological distress in medical students outside North America are not clear. A better understanding of the prevalence of, risk factors for and results of psychological distress will guide the configuration of support services, increasingly available for doctors, for medical students too. The aim of this study was to examine the prevalences of depression, anxiety and psychological distress in students in medical schools in the UK, Europe and elsewhere in the English-speaking world outside North America. A systematic review was conducted using search terms encompassing psychological distress amongst medical students. OvidSP was used to search the following databases: Ovid MEDLINE (R) from 1948 to October 2013; PsycINFO from 1806 to October 2013, and EMBASE from 1980 to October 2013. Results were restricted to medical schools in Europe and the English-speaking world outside North America, and were evaluated against a set of inclusion criteria including the use of validated assessment tools. The searches identified 29 eligible studies. Prevalences of 7.7-65.5% for anxiety, 6.0-66.5% for depression and 12.2-96.7% for psychological distress were recorded. The wide range of results reflects the variable quality of the studies. Almost all were cross-sectional and many did not mention ethical approval. Better-quality studies found lower prevalences. There was little information on the causes or consequences of depression or anxiety. Prevalences of psychological distress amongst medical students outside North America are substantial. Future research should move on from simple cross-sectional studies to better-quality longitudinal work which can

Emotional Distress Increases the Likelihood of Undergoing Surgery among Men with Localized Prostate Cancer.

PubMed

Orom, Heather; Underwood, Willie; Biddle, Caitlin

2017-02-01

We determined whether among men with clinically localized prostate cancer, particularly men with low risk disease, greater emotional distress increases the likelihood of undergoing surgery vs radiation or active surveillance. Participants were 1,531 patients recruited from 2 academic and 3 community facilities (nonHispanic white 83%, nonHispanic black 11% and Hispanic 6%; low risk 36%, intermediate risk 49% and high risk 15%; choice of active surveillance 24%, radiation 27% and surgery 48%). Emotional distress was assessed shortly after diagnosis and after men made a treatment decision with the Distress Thermometer. We used multinomial logistic regression with robust standard errors to test if emotional distress at either point predicted treatment choice in the sample as a whole and after stratifying by D'Amico risk score. In the sample as a whole the participants who were more emotionally distressed at diagnosis were more likely to choose surgery over active surveillance (RRR 1.07; 95% CI 1.01, 1.14; p=0.02). Men who were more distressed close to the time they made a treatment choice were more likely to have chosen surgery over active surveillance (RRR 1.16; 95% CI 1.09, 1.24; p <0.001) or surgery over radiation (RRR 1.12; 95% CI 1.05, 1.19; p=0.001). This pattern was also found in men with low risk disease. Emotional distress may motivate men with low risk prostate cancer to choose more aggressive treatment. Addressing emotional distress before and during treatment decision making may reduce a barrier to the uptake of active surveillance. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

A randomized control study of psychological intervention to reduce anxiety, amotivation and psychological distress among medical students

PubMed Central

Saravanan, Coumaravelou; Kingston, Rajiah

2014-01-01

Background: Test anxiety aggravates psychological distress and reduces the motivation among graduate students. This study aimed to identify psychological intervention for test anxiety, which reduces the level of psychological distress, amotivation and increases the intrinsic and extrinsic motivation among medical students. Materials and Methods: Westside test anxiety scale, Kessler Perceived Stress Scale and Academic Motivation Scale were used to measure test anxiety, psychological distress and motivation on 436 1st year medical students. Out of 436 students, 74 students who exhibited moderate to high test anxiety were randomly divided into either experimental or waiting list group. In this true randomized experimental study, 32 participants from the intervention group received five sessions of psychological intervention consist of psychoeducation, relaxation therapy and systematic desensitization. Thirty-three students from waiting list received one session of advice and suggestions. Results: After received psychological intervention participants from the intervention group experienced less anxiety, psychological distress, and amotivation (P < 0.01) and high intrinsic and extrinsic motivation (P < 0.01) in the postassessment compared with their preassessment scores. Conclusion: Overall psychological intervention is effective to reduce anxiety scores and its related variables. PMID:25097619

The Effect of Reappraising Social Exclusion on Emotional Distress

ERIC Educational Resources Information Center

Kitchens, Michael B.; Gohm, Carol L.

2010-01-01

The purpose of this investigation was to examine whether reappraisal, which is a strategy where the personal meaning of an event is reevaluated, would influence participants' emotional reactions to social exclusion feedback. It was expected that reappraising this event would reduce the emotional distress that accompanies social exclusion, but…

Prevention case management improves socioeconomic standing and reduces symptoms of psychological and emotional distress among transgender women.

PubMed

Reback, Cathy J; Shoptaw, Steven; Downing, Martin J

2012-01-01

Urban transgender women often experience several sociocultural co-factors which contribute to their risk of HIV infection. A transgender-specific HIV Prevention Case Management (PCM) intervention was implemented in a community HIV prevention setting and targeted reducing sex work and homelessness, increasing legal employment and income, and reducing psychological and emotional distress symptoms. Sixty high-risk transgender women were enrolled in the ten-session PCM intervention. Participants completed approximately nine out of the ten sessions (M = 8.7; SD = 2.6) and six-month follow-up evaluations were completed with 97% of the participants. Findings from baseline to follow-up evaluations demonstrated a decrease in homelessness (31.0% vs. 10.3%, p<0.01), less reliance on exchange sex as a primary source of income (41.4% vs. 22.4%, p < 0.05), and significant decreases in symptom complaints across multiple Brief Symptom Inventory sub-scales, including depression, hostility, phobic anxiety, and psychoticism (all significant at p<0.05). Further, socioeconomic improvements following the intervention were significantly associated with psychological and emotional gains. The study suggests that adding a culturally appropriate PCM intervention in a community setting is beneficial in addressing co-factors for HIV infection as well as psychological and emotional distress symptoms among this extremely high-risk population.

Are alexithymia and emotional characteristics of disclosure associated with blood pressure reactivity and psychological distress following written emotional disclosure?

PubMed

O'Connor, Daryl B; Ashley, Laura

2008-09-01

This study had three aims: 1) to investigate whether cardiovascular responses to laboratory stress and levels of emotional distress were attenuated following written emotional disclosure; 2) to test, in addition to the potential main effects, whether levels of alexithymia moderated the impact of writing; and 3) to examine whether alexithymics who successfully disclosed emotion in their essays would experience positive effects following writing. Eighty-seven participants wrote about their most stressful life experience or about a non-stressful experience, for 15 minutes, over 3 consecutive days. Two weeks later, blood pressure (BP) responses to laboratory stress and levels of emotional distress were assessed. Emotional characteristics of the disclosure essays were analysed with the Linguistic Inquiry and Word Count programme and alexithymia was assessed at baseline using the Toronto Alexithymia Scale-20. Analyses found no evidence in support of the main effects of disclosure on cardiovascular responses to stress or on emotional distress. However, alexithymia was found to moderate the impact of writing such that non-alexithymic participants in the experimental condition reported significantly lower emotional distress 2 weeks later. In addition, alexithymic participants who disclosed a greater number of negative when compared with positive emotion words exhibited reduced systolic and diastolic responses to stress. Conversely, non-alexithymic participants who disclosed more positive and less negative emotion words displayed attenuated BP reactivity to stress. The results of this exploratory study are important as they highlighted, in the absence of main effects, the importance of examining potential moderators of the emotional writing process. These findings may have implications for the development of cardiovascular health interventions.

The physical and psychological health benefits of positive emotional writing: Investigating the moderating role of Type D (distressed) personality.

PubMed

Smith, Michael A; Thompson, Alexandra; Hall, Lynsey J; Allen, Sarah F; Wetherell, Mark A

2018-06-03

Type D personality is associated with psychological and physical ill-health. However, there has been limited investigation of the role of Type D personality in interventions designed to enhance well-being. This study investigated associations between Type D personality and the efficacy of positive emotional writing for reducing stress, anxiety, and physical symptoms. A between-subjects longitudinal design was employed. Participants (N = 71, M age  = 28.2, SD age  = 12.4) completed self-report measures of Type D personality, physical symptoms, perceived stress, and trait anxiety, before completing either (1) positive emotional writing or (2) a non-emotive control writing task, for 20 min per day over three consecutive days. State anxiety was measured immediately before and after each writing session, and self-report questionnaires were again administered 4 weeks post-writing. Participants in the positive emotional writing condition showed significantly greater reductions in (1) state anxiety and (2) both trait anxiety and perceived stress over the 4-week follow-up period, compared to the control group. While these effects were not moderated by Type D personality, a decrease in trait anxiety was particularly evident in participants who reported both high levels of social inhibition and low negative affectivity. Linguistic analysis of the writing diaries showed that Type D personality was positively associated with swear word use, but not any other linguistic categories. These findings support the efficacy of positive emotional writing for alleviating stress and anxiety, but not perceived physical symptoms. Swearing may be a coping strategy employed by high Type D individuals. Statement of contribution What is already known on this subject? Type D (distressed) personality is characterized by high levels of both negative affectivity and social inhibition, and has been associated with adverse physical and psychological health. Positive emotional writing is known

Brief report: Emotional distress and recent stressful life events in long QT syndrome mutation carriers.

PubMed

Määttänen, Ilmari; Jokela, Markus; Pulkki-Råback, Laura; Keltikangas-Järvinen, Liisa; Swan, Heikki; Toivonen, Lauri; Merjonen, Päivi; Hintsa, Taina

2015-11-01

To study emotional distress in symptomatic and asymptomatic long QT syndrome mutation carriers who had experienced a recent stressful life event. The participants were 209 symptomatic and 279 asymptomatic long QT syndrome mutation carriers. Emotional distress was assessed with the Cope questionnaire and stressful life events with the Social Readjustment Rating Scale. Symptomatic long QT syndrome mutation carriers with burdening recent stressful life events reported a higher emotional distress (β = 0.35, p < 0.001), while the asymptomatic did not show such difference (β = 0.13, p = 0.393). Symptomatic long QT syndrome mutation carriers who have experienced stressful life events recently report an increased emotional distress. © The Author(s) 2013.

Alexithymia, emotion processing and social anxiety in adults with ADHD

PubMed Central

2010-01-01

Objective Given sparse research on the issue, this study sought to shed light upon the interactions of alexithymia, emotion processing, and social anxiety in adults with attention-deficit hyperactivity disorder (ADHD). Subjects and methods 73 German adults with ADHD according to DSM-IV diagnostic criteria participated. We used the Toronto Alexithymia Scale (TAS-20) to assess alexithymia, the Social Phobia Scale (SPS) and the Social Interaction Anxiety Scale (SIAS) to assess different features of social anxiety, and we applied the German 'Experience of Emotions Scale' (SEE) to measure emotion processing. Results 40% of the sample were found to meet the DSM-IV criteria of social anxiety disorder, and about 22% were highly alexithymic according to a TAS-20 total score ≥ 61; however, the mean TAS-20 total score of 50.94 ± 9.3 was not much higher than in community samples. Alexithymic traits emerged to be closely linked to emotion processing problems, particularly 'difficulty accepting own emotions', and to social anxiety features. Discussion/conclusion Our findings suggest interactions of alexithymia, emotion processing dysfunction, and social anxiety in adults with ADHD, which may entail the therapeutic implication to thoroughly instruct these patients to identify, accept, communicate, and regulate their emotions to aid reducing interaction anxiety. PMID:20952350

Relations Between Anxiety Sensitivity, Distress Tolerance, and Fear Reactivity to Bodily Sensations to Coping and Conformity Marijuana Use Motives Among Young Adult Marijuana Users

PubMed Central

Zvolensky, Michael J.; Marshall, Erin C.; Johnson, Kirsten; Hogan, Julianna; Bernstein, Amit; Bonn-Miller, Marcel O.

2011-01-01

The present investigation examines anxiety sensitivity, distress tolerance, and fear reactivity to bodily sensations in relation to Coping and Conformity marijuana use motives among a sample of young adult marijuana users (n = 135; 46.7% women; Mage = 20.45, SD = 5.0). After controlling for current marijuana use frequency (past 30 days), daily cigarette smoking rate, average volume of alcohol used over the past year, negative affectivity, and other marijuana use motives, anxiety sensitivity was significantly and uniquely associated with Coping and Conformity motives for marijuana use. Distress tolerance evidenced significant and unique incremental relations to Coping motives, whereas fear reactivity to bodily sensations was unrelated to any marijuana use motive. These results provide novel information related to the role of emotional sensitivity and tolerance factors as they pertain to specific types of motives for marijuana use among young adults. PMID:19186932

Maternal and paternal emotional contributions to children's distress tolerance: Relations to child depressive symptoms.

PubMed

Doan, Stacey N; Son, Heimi; Kim, Lawrence N

2018-06-08

In recent years, empirical studies have shown that the inability to tolerate distress is associated with a wide range of negative outcomes including eating addiction, drug abuse, alcohol use, and antisocial behavior in adults. However, few studies have examined family correlates of this ability in children. Also, past literature on child emotional competencies has mainly focused on documenting the linkages between mother and child and has neglected the role of fathers. Children (N = 54, M age = 10.15 years, SD = 1.02; 55.6% males) and their parents participated. Parents reported on their emotion regulation strategies and children reported on their depressive symptoms. Distress tolerance (DT) was assessed using the computerized distress tolerance task, the Behavioral Indicator of Resiliency to Distress. Children who were able to complete the BIRD had lower levels of depression. Analyses examining relations among father and mother emotion regulation and children's DT showed children's DT is more closely related to their mothers' than fathers' emotion regulation styles. These findings suggest that DT is an important construct in understanding children's psychopathology, but also that maternal emotion regulation is associated with children's distress tolerance. Copyright © 2018 Elsevier B.V. All rights reserved.

Anxiety Sensitivity Mediates Relations between Emotional Disorders and Smoking

PubMed Central

Zvolensky, Michael J.; Farris, Samantha G.; Leventhal, Adam; Schmidt, Norman B.

2014-01-01

Objectives Research has documented consistent and robust relations between emotional disorders (i.e., depressive and anxiety disorders) and smoking. Yet, it is presently unclear whether anxiety sensitivity, the fear of aversive internal anxiety states, may account for the relations between emotional disorders and various smoking processes, including nicotine dependence, perceived barriers to smoking cessation, and severity of problematic symptoms while quitting during past cessation attempts. Method Participants (n = 465) were treatment-seeking daily tobacco smokers recruited as part of a larger tobacco cessation study. Baseline (pre-treatment) data were utilized. Emotional disorders were assessed via clinical diagnostic interview; self-report measures were used to assess anxiety sensitivity and three criterion variables: nicotine dependence, barriers to smoking cessation, and severity of problematic symptoms while quitting in past attempts. Results Emotional disorders were predictive of higher levels of nicotine dependence, greater perceived barriers to cessation, and greater severity of problematic symptoms while quitting in past attempts; each of these relations were accounted for by the indirect effect of anxiety sensitivity. Discussion The present findings suggest that anxiety sensitivity may be an important transdiagnostic construct in explicating the nature of the relations between emotional disorders and various smoking processes. PMID:25222178

Parent-child interactions and children with cerebral palsy: An exploratory study investigating emotional availability, functional ability, and parent distress.

PubMed

Barfoot, J; Meredith, P; Ziviani, J; Whittingham, K

2017-11-01

Emotionally available parent-child relationships are supportive of child health and development. When a child has cerebral palsy, a range of child and parent factors can potentially impact the parent-child relationship; however, little research has specifically addressed this question. The aim of this study is to investigate links between parent-child emotional availability and both child functional abilities and parent distress in a sample of parents and children with cerebral palsy. Twenty-three mothers (mean age 37.3+/-5.7 years) and their children (mean age 4.9+/-3.3 years) with cerebral palsy completed a 20 min videoed parent-child interaction, scored using the Emotional Availability Scales. Parents also completed the Depression Anxiety Stress Scale, the Paediatric Evaluation of Disability Inventory, and the Strengths and Difficulties Questionnaire. Correlational analyses were conducted, and qualitative observations were made. Parent-child dyads in which the parent reported depressive symptoms scored poorer on all aspects of parent-child emotional availability. Where parents reported experiencing anxiety or stress, increased parent hostility and decreased child responsiveness was found. There was no relationship between child functional abilities and either parent distress or parent-child emotional availability. Parent sensitivity, structuring, and nonintrusiveness were negatively associated with child peer problems. Both child responsiveness and child involvement were negatively associated with hyperactivity/inattention. Observations of video footage suggested that parent implementation of therapy strategies impacted negatively on parent-child emotional availability for some dyads. Findings from this study are consistent with the wider literature showing a link between parental depression and the parent-child relationship and extend this link to the cerebral palsy population. The importance of routine screening for parental mental health problems in early

Adjustment to Cancer: Anxiety and Distress (PDQ®)—Patient Version

Cancer.gov

Expert-reviewed information summary about the difficult emotional responses many cancer patients experience. This summary focuses on normal adjustment issues, psychosocial distress, and adjustment disorders.

Emotional Freedom Techniques for Anxiety: A Systematic Review With Meta-analysis.

PubMed

Clond, Morgan

2016-05-01

Emotional Freedom Technique (EFT) combines elements of exposure and cognitive therapies with acupressure for the treatment of psychological distress. Randomized controlled trials retrieved by literature search were assessed for quality using the criteria developed by the American Psychological Association's Division 12 Task Force on Empirically Validated Treatments. As of December 2015, 14 studies (n = 658) met inclusion criteria. Results were analyzed using an inverse variance weighted meta-analysis. The pre-post effect size for the EFT treatment group was 1.23 (95% confidence interval, 0.82-1.64; p < 0.001), whereas the effect size for combined controls was 0.41 (95% confidence interval, 0.17-0.67; p = 0.001). Emotional freedom technique treatment demonstrated a significant decrease in anxiety scores, even when accounting for the effect size of control treatment. However, there were too few data available comparing EFT to standard-of-care treatments such as cognitive behavioral therapy, and further research is needed to establish the relative efficacy of EFT to established protocols.

Emotional stability, anxiety, and natural killer activity under examination stress.

PubMed

Borella, P; Bargellini, A; Rovesti, S; Pinelli, M; Vivoli, R; Solfrini, V; Vivoli, G

1999-08-01

This study was performed to evaluate the relation between a stable personality trait, a mood state and immune response to an examination stress. A self-reported measure of emotional stability (BFQ-ES scale) was obtained in a sample (n = 39) randomly selected from 277 cadets; this personality trait was also investigated by completing a neuroticism scale (Eysenck personality inventory) and a trait-anxiety scale (STAI). Natural killer (NK) cell activity was measured at baseline, long before the examination time and the examination day. The state-anxiety scale evaluated the response to the stressful stimulus. Taking subjects all together, the academic task did not result in significant modification over baseline in NK cell activity. Subjects were then divided into three groups based on emotional stability and state-anxiety scores: high emotional stability/low anxiety, medium, and low emotional stability/high anxiety. Examination stress induced significant increases in NK cell activity in the high emotional stability/low anxiety group, no effect in the medium group, and significant decreases in the low emotional stability/high anxiety group. The repeated-measure ANOVA revealed a significant interaction of group x period (baseline vs. examination) for both lytic units and percent cytolysis. The results did not change after introducing coffee and smoking habits as covariates. Our findings suggest that the state-anxiety acts in concert with a stable personality trait to modulate NK response in healthy subjects exposed to a psychological naturalistic stress. The relation between anxiety and poor immune control has been already described, whereas the ability of emotional stability to associate with an immunoenhancement has not yet reported. The peculiarity of our population, a very homogeneous and healthy group for life style and habits, can have highlighted the role of emotional stability, and may account for the difference with other studies.

Self-care strategies for emotional distress among young adults in Catalonia: a qualitative study.

PubMed

Martorell-Poveda, Maria-Antonia; Martinez-Hernáez, Angel; Carceller-Maicas, Natalia; Correa-Urquiza, Martin

2015-01-01

Emotional distress is common in adolescence, and self-care strategies are frequently preferred to address it. The aim of this article is to analyze the self-care strategies among adolescents and young people diagnosed with depression or with self-perceived depressive distress in Catalonia using a qualitative design. We analyzed the self-care strategies of 105 young people (17-21 years of age) in Catalonia who had participated in a national survey on adolescents. The sample was divided into thirds, with 37 who had a previous diagnosis of depression, 33 who had self-perceived emotional distress, and 35 controls. The participants' narratives on self-care strategies for emotional distress were elicited through in-depth semi-structured interviews. The data were managed using ATLAS-Ti 6.5 software18. We applied hermeneutic theory and the ethnographic method to analyze the interviews. The ten self-care strategies identified in the analysis were grouped into four areas covering the various pathways the young people followed according to whether they had a diagnosis of depression or their depressive distress was self-perceived. The young people feel responsible for their emotional distress and consider that they are capable of resolving it through their own resources. Their strategies ranged from their individuality to sociability expressed through their relationships with others, membership of groups or other self-care strategies (relaxation, meditation, naturopathy, etc.). The study results highlight the importance of sensitivity in considering young people's self-care strategies as another option in the care of emotional distress.

Emotional complexity and its effect on psychological distress as a function of chronological age and subjective distance-to-death.

PubMed

Shrira, Amit; Bodner, Ehud; Palgi, Yuval

2015-01-01

In light of mixed evidence regarding the associations between age, emotional complexity, and psychological distress, this study examined emotional complexity and its effect on psychological distress as a function of age and subjective distance-to-death. A sample of 188 participants (age range = 29-100) rated their subjective distance-to-death and psychological distress, and reported their emotions across 14 days. Emotional complexity was unrelated to age, but negatively related to feeling closer to death. Moreover, emotional complexity was negatively related to psychological distress among those feeling closer to death. Results suggest that when death is perceived to be nearer, emotional complexity is hampered, yet becomes relevant in buffering psychological distress.

Genetic testing for hereditary cancer: effects of alexithymia and coping strategies on variations in anxiety before and after result disclosure.

PubMed

Fantini-Hauwel, Carole; Dauvier, Bruno; Arciszewski, Thomas; Antoine, Pascal; Manouvrier, Sylvie

2011-07-01

This study assessed the impact of the results of genetic testing for hereditary cancer from a multifactorial health psychology perspective, considering that emotional expression plays a key role in psychological adjustment. Measures of dispositional and transactional coping strategies, anxiety and alexithymia were filled out by 77 participants in a longitudinal study design. Statistical analyses were performed using general linear models and partial least squares path modelling, low-constraint methods that are particularly useful in the behavioural sciences. While anxiety levels prior to the result announcement were predictive of the distress experienced by noncarriers, considerable variability was observed for mutation carriers. Some subjects who had lower anxiety levels before the test displayed greater anxiety afterwards, but others seemed to anticipate the distress they would experience with the result that they showed a decrease in anxiety. The mutation carriers behaved as though their adaptive functioning were reshaped by the test result, independent of their disposition and previous emotional state, except in the case of alexithymia. Difficulty expressing emotions prior to genetic testing contributed to a similar difficulty after receiving the result, adding to the latter's emotional impact by promoting emotion-focused coping strategies and increasing distress. © 2011 Taylor & Francis

Emotional Variability and Clarity in Depression and Social Anxiety

PubMed Central

Thompson, Renee J.; Boden, Matthew Tyler; Gotlib, Ian H.

2016-01-01

Recent research has underscored the importance of elucidating specific patterns of emotion that characterize mental disorders. We examined two emotion traits, emotional variability and emotional clarity, in relation to both categorical (diagnostic interview) and dimensional (self-report) measures of Major Depressive Disorder (MDD) and Social Anxiety Disorder (SAD) in women diagnosed with MDD only (n=35), SAD only (n=31), MDD and SAD (n=26), or no psychiatric disorder (n=38). Results of the categorical analyses suggest that elevated emotional variability and diminished emotional clarity are transdiagnostic of MDD and SAD. More specifically, emotional variability was elevated for MDD and SAD diagnoses compared to no diagnosis, showing an additive effect for co-occurring MDD and SAD. Similarly diminished levels of emotional clarity characterized all three clinical groups compared to the healthy control group. Dimensional findings suggest that whereas emotional variability is associated more consistently with depression than with social anxiety, emotional clarity is associated more consistently with social anxiety than with depression. Results are interpreted using a threshold- and dose-response framework. PMID:26371579

Emotional intelligence, anxiety, and emotional eating: A deeper insight into a recently reported association?

PubMed

Zysberg, Leehu

2018-04-01

Recent studies reported a negative association between emotional intelligence (EI: defined here as individual predispositions associated with effective identification and regulation of emotions) and emotional eating. Although theory provides some insights into how the concept represents mechanisms that may serve as protective factors, empirical evidence of the mechanism behind the association has yet to be presented. This study tested a proposed model in which anxiety levels mediate the association between emotional intelligence and emotional-eating patterns in a normative sample of women in Israel. A cross-sectional/correlational design was used to gather data from 208 generally healthy female participants who completed measures of trait emotional intelligence, anxiety, and tendency toward emotional eating, as well as demographics. Anxiety levels mediated the negative association between emotional intelligence and emotional eating. Background variables had only marginal involvement in this model. The results shed light on the mechanisms underlying the association between emotional intelligence and emotional eating. Should future studies corroborate the findings, they may serve as a basis for future screening protocols, prevention and interventions with individuals and groups at risk of EE and eating disorders. Copyright © 2018 Elsevier Ltd. All rights reserved.

Acceptance and commitment group therapy for health anxiety--results from a pilot study.

PubMed

Eilenberg, T; Kronstrand, L; Fink, P; Frostholm, L

2013-06-01

Health anxiety (or hypochondriasis) is prevalent, may be persistent and disabling for the sufferers and associated with high societal costs. Acceptance and Commitment Therapy (ACT) is a new third-wave behavioral cognitive therapy that has not yet been tested in health anxiety. 34 consecutive Danish patients with severe health anxiety were referred from general practitioners or hospital departments and received a ten-session ACT group therapy. Patients were followed up by questionnaires for 6 months. There were significant reductions in health anxiety, somatic symptoms and emotional distress at 6 months compared to baseline: a 49% reduction in health anxiety (Whiteley-7 Index), a 47% decrease in emotional distress (SCL-8), and a 40% decrease in somatic symptoms (SCL-90R Somatization Subscale). The patients' emotional representations and perception of the consequences of their illness (IPQ) improved significantly, and 87% of the patients were very or extremely satisfied with the treatment. Copyright © 2013 Elsevier Ltd. All rights reserved.

Linking emotional distress to unhealthy sleep duration: analysis of the 2009 National Health Interview Survey.

PubMed

Seixas, Azizi A; Nunes, Joao V; Airhihenbuwa, Collins O; Williams, Natasha J; Pandi-Perumal, Seithikurippu Ratnas; James, Caryl C; Jean-Louis, Girardin

2015-01-01

The objective of the study was to examine the independent association of emotional distress with unhealthy sleep duration (defined as <7 or >8 hours). Data from the 2009 National Health Interview Survey (NHIS), a cross-sectional household survey, were analyzed to investigate the associations of emotional distress with unhealthy sleep durations, adjusting for sociodemographic factors, health risks, and chronic diseases through hierarchical multiple logistic regression analysis. A total of 27,731 participants (age range 18-85 years) from the NHIS 2009 dataset were interviewed. Unhealthy sleep duration is defined as sleep duration <7 or >8 hours, whereas healthy sleep is defined as sleep duration lasting for 7-8 hours. Emotional distress is based on the Kessler 6 Non-Specific Distress Battery, which assesses the frequency of feeling sad, nervous, restless, hopeless, worthless, and burdened, over a 30-day period. Of the sample, 51.7% were female; 83.1% were white and 16.9% were black. Eleven percent experienced emotional distress and 37.6% reported unhealthy sleep. Adjusted logistic regression analysis revealed that individuals with emotional distress had 55% greater odds of reporting unhealthy sleep (odds ratio [OR] =1.55, 95% confidence interval [CI] =1.42, 1.68, P<0.001). Emotional distress, an important proxy for poor psychological health, was a significant predictor of unhealthy sleep, independent of the influences of several factors including demographic (age, education, sex, race/ethnicity, and family income), health risks (alcohol consumption and smoking status), and chronic diseases/conditions (diabetes, obesity, hypertension, heart disease, cancer, and arthritis).

Linking emotional distress to unhealthy sleep duration: analysis of the 2009 National Health Interview Survey

PubMed Central

Seixas, Azizi A; Nunes, Joao V; Airhihenbuwa, Collins O; Williams, Natasha J; Pandi-Perumal, Seithikurippu Ratnas; James, Caryl C; Jean-Louis, Girardin

2015-01-01

Objective The objective of the study was to examine the independent association of emotional distress with unhealthy sleep duration (defined as <7 or >8 hours). Methods Data from the 2009 National Health Interview Survey (NHIS), a cross-sectional household survey, were analyzed to investigate the associations of emotional distress with unhealthy sleep durations, adjusting for sociodemographic factors, health risks, and chronic diseases through hierarchical multiple logistic regression analysis. Participants A total of 27,731 participants (age range 18–85 years) from the NHIS 2009 dataset were interviewed. Measures Unhealthy sleep duration is defined as sleep duration <7 or >8 hours, whereas healthy sleep is defined as sleep duration lasting for 7–8 hours. Emotional distress is based on the Kessler 6 Non-Specific Distress Battery, which assesses the frequency of feeling sad, nervous, restless, hopeless, worthless, and burdened, over a 30-day period. Results Of the sample, 51.7% were female; 83.1% were white and 16.9% were black. Eleven percent experienced emotional distress and 37.6% reported unhealthy sleep. Adjusted logistic regression analysis revealed that individuals with emotional distress had 55% greater odds of reporting unhealthy sleep (odds ratio [OR] =1.55, 95% confidence interval [CI] =1.42, 1.68, P<0.001). Conclusion Emotional distress, an important proxy for poor psychological health, was a significant predictor of unhealthy sleep, independent of the influences of several factors including demographic (age, education, sex, race/ethnicity, and family income), health risks (alcohol consumption and smoking status), and chronic diseases/conditions (diabetes, obesity, hypertension, heart disease, cancer, and arthritis). PMID:26442563

What's in a Name? The Case of Emotional Disclosure of Pain-Related Distress.

PubMed

Cano, Annmarie; Goubert, Liesbet

2017-08-01

Pain behavior plays a key role in many theoretical models of pain, with many of these models conceptualizing pain behaviors as potentially detrimental to patient functioning. We propose that a certain class of behaviors-talking to others about one's pain-related distress (ie, emotional disclosures of pain-related distress)-can be distinguished from other behaviors traditionally conceptualized as pain behaviors. Emotional disclosures of pain-related distress include verbally disclosing one's anger, sadness, or worry about the pain and its effects to another person. In this article, conceptual and empirical evidence is offered to indicate that these verbal behaviors are distinct from other pain behaviors such as bodily expressions and motions, facial expressions, pain ratings, and paraverbal expressions. Emotion and relationships models are also applied to assert that disclosures of pain-related distress may have functions that are not shared with other pain behaviors. In addition to an expanded conceptualization of these verbal expressions of distress about pain, further directions are provided to spur new research as well as clinical recommendations concerning appropriate responses to these behaviors. This article offers an expanded conceptualization of one type of pain behavior-emotional disclosure of pain-related distress-by showing the theoretical and empirical distinctions between this behavior and other pain behaviors. This perspective may enhance clinical work and research aimed at identifying adaptive responses to these behaviors to improve pain adjustment. Copyright © 2017 American Pain Society. Published by Elsevier Inc. All rights reserved.

Relations between life satisfaction, adjustment to illness, and emotional distress in a sample of men with ischemic cardiopathy.

PubMed

Ruiz, María Angeles; Sanjuan, Pilar; Pérez-García, Ana M; Rueda, Beatriz

2011-05-01

Fifty-two men who had suffered a first episode ischemic heart disease reported their degree of life satisfaction, the strategies they used to adjust to the illness, and the symptoms of anxiety and depression they felt. The multiple regression analyses carried out indicated that emotional distress was associated with a lower level of life satisfaction. In the analyses of anxiety symptoms, the use of negative adjustment strategies was also a significant predictor. Lastly, a significant Life Satisfaction x Type of Adjustment interaction was obtained. According to this, the patients who felt more satisfaction with their lives used more positive strategies to adjust to the illness and fewer negative ones, than the group of patients who were less satisfied. In conclusion, life satisfaction predicts emotional wellbeing of patients with ischemic heart disease and it enhances the implementation of appropriate strategies to cope with the disease. Moreover, although life satisfaction has been considered a stable measure, we suggest it may change as the experience of illness limits individuals' important goals.

Anxiety, Depression and Emotion Regulation Among Regular Online Poker Players.

PubMed

Barrault, Servane; Bonnaire, Céline; Herrmann, Florian

2017-12-01

Poker is a type of gambling that has specific features, including the need to regulate one's emotion to be successful. The aim of the present study is to assess emotion regulation, anxiety and depression in a sample of regular poker players, and to compare the results of problem and non-problem gamblers. 416 regular online poker players completed online questionnaires including sociodemographic data, measures of problem gambling (CPGI), anxiety and depression (HAD scale), and emotion regulation (ERQ). The CPGI was used to divide participants into four groups according to the intensity of their gambling practice (non-problem, low risk, moderate risk and problem gamblers). Anxiety and depression were significantly higher among severe-problem gamblers than among the other groups. Both significantly predicted problem gambling. On the other hand, there was no difference between groups in emotion regulation (cognitive reappraisal and expressive suppression), which was linked neither to problem gambling nor to anxiety and depression (except for cognitive reappraisal, which was significantly correlated to anxiety). Our results underline the links between anxiety, depression and problem gambling among poker players. If emotion regulation is involved in problem gambling among poker players, as strongly suggested by data from the literature, the emotion regulation strategies we assessed (cognitive reappraisal and expressive suppression) may not be those involved. Further studies are thus needed to investigate the involvement of other emotion regulation strategies.

Effect of trait anxiety on prefrontal control mechanisms during emotional conflict.

PubMed

Comte, Magali; Cancel, Aïda; Coull, Jennifer T; Schön, Daniele; Reynaud, Emmanuelle; Boukezzi, Sarah; Rousseau, Pierre-François; Robert, Gabriel; Khalfa, Stéphanie; Guedj, Eric; Blin, Olivier; Weinberger, Daniel R; Fakra, Eric

2015-06-01

Converging evidence points to a link between anxiety proneness and altered emotional functioning, including threat-related biases in selective attention and higher susceptibility to emotionally ambiguous stimuli. However, during these complex emotional situations, it remains unclear how trait anxiety affects the engagement of the prefrontal emotional control system and particularly the anterior cingulate cortex (ACC), a core region at the intersection of the limbic and prefrontal systems. Using an emotional conflict task and functional magnetic resonance imaging (fMRI), we investigated in healthy subjects the relations between trait anxiety and both regional activity and functional connectivity (psychophysiological interaction) of the ACC. Higher levels of anxiety were associated with stronger task-related activation in ACC but with reduced functional connectivity between ACC and lateral prefrontal cortex (LPFC). These results support the hypothesis that when one is faced with emotionally incompatible information, anxiety leads to inefficient high-order control, characterized by insufficient ACC-LPFC functional coupling and increases, possibly compensatory, in activation of ACC. Our findings provide a deeper understanding of the pathophysiology of the neural circuitry underlying anxiety and may offer potential treatment markers for anxiety disorders. © 2015 Wiley Periodicals, Inc.

Could we use parent report as a valid proxy of child report on anxiety, depression, and distress? A systematic investigation of father-mother-child triads in children successfully treated for leukemia.

PubMed

Abate, Cybelle; Lippé, Sarah; Bertout, Laurence; Drouin, Simon; Krajinovic, Maja; Rondeau, Émélie; Sinnett, Daniel; Laverdière, Caroline; Sultan, Serge

2018-02-01

Systematic assessment of emotional distress is recommended in after care. Yet, it is unclear if parent report may be used as a proxy of child report. The aim of this study was to assess agreements and differences and explore possible moderators of disagreement between child and parent ratings. Sixty-two young survivors treated for acute lymphoblastic leukemia (9-18 years) and both parents responded to the Beck Youth Inventory (anxiety and depression) and the distress rating scale on the child's status. Parents completed the Brief Symptom Inventory-18 on their own psychological status. Systematic analyses of agreement and differences were performed. Mother-child and father-child agreements were fair on anxiety, depression, and distress (median intraclass correlation coefficient = 0.37). Differences between parents and children were medium sized (median d = 0.55) with parents giving higher scores than their children on anxiety, depression, and distress. Mothers reported distress more frequently than fathers (39 vs. 17%) when children reported none. The child being female and lower parental income were associated with lower agreement in fathers when rating child distress. Higher levels of parental psychological symptoms were consistently associated with lower agreement. Parent-child differences when rating adolescent survivors' difficulties may be more important than previously thought. Parent report probably cannot be considered as a valid proxy of older child report on such internalized domains as anxiety, depression, or distress in the after-care clinic. Parents' report is also likely to be influenced by their own mood, a factor that should be corrected for when using their report. © 2017 Wiley Periodicals, Inc.

Anxiety and depression in chronic hemodialysis: some somatopsychic determinants.

PubMed

Jadoulle, V; Hoyois, P; Jadoul, M

2005-02-01

Depression and anxiety are so common in hemodialysis (HD) patients that we found it useful to study the respective contributions of the subjective somatic sensations and of the objective medical comorbidity to psychological distress. We also hypothesized that denial has a protective effect against anxiety and depression, and that alexithymia is, on the contrary, a risk factor. In a cross-sectional design, we investigated relationships between psychological distress and somatic complaints, Charlson comorbidity index, denial and alexithymia, in a group of 54 patients on incenter HD. They filled psychometric self-rated questionnaires in (State Anxiety Inventory, Hospital Anxiety and Depression Scale, 13-item Short Beck Depression Inventory, Kidney Disease Quality of Life Short Form, 20-item Toronto Alexithymia Scale). A principal component analysis allowed us to focus on HADS-total score, which was confirmed to be representative of anxio-depression. Then, correlational analyses and a stepwise regression analysis were performed. HADS-total score is inversely associated with the use of denial as a psychological defence mechanism (p < 0.001), and positively correlated with difficulties in identifying emotions (p < 0.001), with difficulties in expressing feelings (p < 0.05), and with the intensity of subjective somatic complaints (p < 0.001). On the contrary, it is not related to the somatic comorbidity. In the stepwise regression, the somatic complaints, the denial and the difficulties in recognizing emotions emerge as the three main variables related to the HADS-total score (p < 0.001). Subjective physical complaints are here associated with psychological distress in chronic HD patients, while objective organic comorbidity does not seem to influence their mood and anxiety status. Denial is an efficient coping style against negative emotions, but it can diminish compliance. So, the subjective perception of the disease seems to have an important impact on the anxiety and

A new model of the role of psychological and emotional distress in promoting obesity: conceptual review with implications for treatment and prevention.

PubMed

Hemmingsson, E

2014-09-01

The lack of significant treatment and prevention progress highlights the need for a more expanded strategy. Given the robust association between socioeconomic factors and obesity, combined with new insights into how socioeconomic disadvantage affects both behaviour and biology, a new causal model is proposed. The model posits that psychological and emotional distress is a fundamental link between socioeconomic disadvantage and weight gain. At particular risk are children growing up in a disharmonious family environment, mainly caused by parental socioeconomic disadvantage, where they are exposed to parental frustrations, relationship discord, a lack of support and cohesion, negative belief systems, unmet emotional needs and general insecurity. Without adequate resilience, such experiences increase the risk of psychological and emotional distress, including low self-esteem and self-worth, negative emotions, negative self-belief, powerlessness, depression, anxiety, insecurity and a heightened sensitivity to stress. These inner disturbances eventually cause a psycho-emotional overload, triggering a cascade of weight gain-inducing effects including maladaptive coping strategies such as eating to suppress negative emotions, chronic stress, appetite up-regulation, low-grade inflammation and possibly reduced basal metabolism. Over time, this causes obesity, circular causality and further weight gain. Tackling these proposed root causes of weight gain could potentially improve both treatment and prevention outcomes. © 2014 The Author. obesity reviews © 2014 World Obesity.

Emotional Distress among LGBT Youth: The Influence of Perceived Discrimination Based on Sexual Orientation

ERIC Educational Resources Information Center

Almeida, Joanna; Johnson, Renee M.; Corliss, Heather L.; Molnar, Beth E.; Azrael, Deborah

2009-01-01

The authors evaluated emotional distress among 9th-12th grade students, and examined whether the association between being lesbian, gay, bisexual, and/or transgendered (i.e., "LGBT") and emotional distress was mediated by perceptions of having been treated badly or discriminated against because others thought they were gay or lesbian.…

Emotional security in the family system and psychological distress in female survivors of child sexual abuse.

PubMed

Cantón-Cortés, David; Cantón, José; Cortés, María Rosario

2016-01-01

The Emotional Security Theory (EST) was originally developed to investigate the association between high levels of interparental conflict and child maladaptative outcome. The objective of the present study was to analyze the effects of emotional security in the family system on psychological distress among a sample of young female adult survivors of child sexual abuse (CSA). The role of emotional security was investigated through the interactive effects of a number of factors including the type of abuse, the continuity of abuse, the relationship with the perpetrator and the existence of disclosure for the abuse. Participants were 167 female survivors of CSA. Information about the abuse was obtained from a self-reported questionnaire. Emotional security was assessed with the Security in the Family System (SIFS) Scale, and the Symptom Checklist-90-Revised (SCL-90-R) was used to assess psychological distress. In the total sample, insecurity (preoccupation and disengagement) was correlated with high psychological distress scores, whereas no relationship was found between security and psychological distress. The relationship between emotional insecurity and psychological distress was stronger in cases of continued abuse and non-disclosure, while the relationship between emotional security and distress was stronger in cases of extrafamilial abuse and especially isolated or several incidents and when a disclosure had been made. No interactive effect was found between any of the three emotional variables and the type of abuse committed. The results of the current study suggest that characteristics of CSA such as relationship with the perpetrator and, especially, continuity of abuse and whether or not disclosure had been made, can affect the impact of emotional security on psychological distress of CSA survivors. Copyright © 2015 Elsevier Ltd. All rights reserved.

Daily family conflict and emotional distress among adolescents from Latin American, Asian, and European backgrounds.

PubMed

Chung, Grace H; Flook, Lisa; Fuligni, Andrew J

2009-09-01

The authors employed a daily diary method to assess daily frequencies of interparental and parent-adolescent conflict over a 2-week period and their implications for emotional distress across the high school years in a longitudinal sample of 415 adolescents from Latin American, Asian, and European backgrounds. Although family conflict remained fairly infrequent among all ethnic backgrounds across the high school years, its impact on emotional distress was significant across ethnicity and gender. In addition, parent-adolescent conflict significantly mediated the association between interparental conflict and emotional distress. These associations were observed at both the individual and the daily levels, providing evidence for both the chronic and episodic implications of family conflict for adolescents' emotional adjustment.

Adjustment to Cancer: Anxiety and Distress (PDQ®)—Health Professional Version

Cancer.gov

Expert-reviewed information summary about the difficult emotional responses many cancer patients experience. This summary focuses on normal adjustment issues, psychosocial distress, and adjustment disorders.

The Association of Age, Sense of Control, Optimism, and Self-Esteem with Emotional Distress

ERIC Educational Resources Information Center

Jiménez, M. Guadalupe; Montorio, Ignacio; Izal, María

2017-01-01

The aim of this study was to test a model of emotional distress, which incorporates the potential mediator role of positive resources (sense of control, self-esteem, and optimism) in the association of age with emotional distress. The study used a cross-sectional design with intentional sampling and the voluntary participation of 325 adults…

Emotional regulation, attachment to possessions and hoarding symptoms.

PubMed

Phung, Philip J; Moulding, Richard; Taylor, Jasmine K; Nedeljkovic, Maja

2015-10-01

This study aimed to test which particular facets of emotion regulation (ER) are most linked to symptoms of hoarding disorder, and whether beliefs about emotional attachment to possessions (EA) mediate this relationship. A non-clinical sample of 150 participants (108 females) completed questionnaires of emotional tolerance (distress tolerance, anxiety sensitivity, negative urgency - impulsivity when experiencing negative emotions), depressed mood, hoarding, and beliefs about emotional attachment to possessions. While all emotional tolerance measures related to hoarding, when considered together and controlling for depression and age, anxiety sensitivity and urgency were the significant predictors. Anxiety sensitivity was fully mediated, and urgency partially mediated, via beliefs regarding emotional attachment to possessions. These findings provide further support for (1) the importance of anxiety sensitivity and negative urgency for hoarding symptoms, and (2) the view that individuals with HD symptoms may rely on items for emotion regulation, leading to stronger beliefs that items are integral to emotional wellbeing. © 2015 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

Socio-economic status and emotional distress of female Turkish immigrants and native German women living in Berlin.

PubMed

Aichberger, M C; Bromand, Z; Heredia Montesinos, A; Temur-Erman, S; Mundt, A; Heinz, A; Rapp, M A; Schouler-Ocak, M

2012-06-01

Many immigrants face more economic strains and hardship than non-immigrants. Income inequality and an increasing social gap between immigrants and non-immigrants in Europe warrant further studies on the impact of socioeconomic factors on health in immigrant groups. The purpose of this study was to examine the association of socioeconomic status (SES) and emotional distress in women of Turkish descent and in women of German descent. A total of 405 women of German or Turkish descent residing in Berlin were interviewed. Emotional distress was assessed by the General Health Questionnaire-28 (GHQ-28), and SES was examined by level of education, employment status, and income. The associations of emotional distress and SES were estimated in multivariate linear regression analyses. Unemployment was associated with increased levels of emotional distress in all women, with the highest level of distress in the group of unemployed Turkish women. The overall SES level was related to a greater level of emotional distress in Turkish women, but not in German women (-3.2, 95%CI -5.9 - -.5; p=.020 vs. -.8, 95%CI -2.7 - 1.2; p=.431). Further stratified analyses by relationship status revealed that the association of SES and emotional distress only remained significant among single women. The impact of socioeconomic hardship appears to be complicated by social roles and expectations related to these. Further in-depth study of the complex nature of the interaction of social roles and socioeconomic position in female Turkish immigrants in Germany is needed to better understand differing risk patterns for emotional distress. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

Emotional Awareness: A Transdiagnostic Predictor of Depression and Anxiety for Children and Adolescents.

PubMed

Kranzler, Amy; Young, Jami F; Hankin, Benjamin L; Abela, John R Z; Elias, Maurice J; Selby, Edward A

2016-01-01

Research increasingly suggests that low emotional awareness may be associated with symptoms of depression and anxiety among children and adolescents. However, because most studies have been cross-sectional, it has remained unclear whether low emotional awareness predicts subsequent internalizing symptoms. The current study used longitudinal data to examine the role of emotional awareness as a transdiagnostic predictor of subsequent symptoms of depression and anxiety. Participants were 204 youth (86 boys and 118 girls) ages 7-16 who completed self-report measures of emotional awareness, depressive symptoms, and anxiety symptoms at baseline, as well as measures of depression and anxiety symptoms every 3 months for a year. Results from hierarchical mixed effects modeling indicated that low baseline emotional awareness predicted both depressive and anxiety symptoms across a 1-year period. These findings suggest that emotional awareness may constitute a transdiagnostic factor, predicting symptoms of both depression and anxiety, and that emotional awareness training may be a beneficial component of treatment and prevention programs for youth depression and anxiety.

Contentment Duration Mediates the Associations between Anxious Attachment Style and Psychological Distress

PubMed Central

Ng, Sin Man; Hou, Wai Kai

2017-01-01

Relatively little is known about the emotional processes underlying the association between adult attachment styles and psychological distress. This study aims to examine the role of contentment in terms of intensity and duration in the positive associations between anxious and avoidant attachment styles and psychological distress. A sample of 284 Chinese university students completed a self-reported questionnaire on attachment styles, intensity and duration of contentment, and anxiety and depressive symptoms. Structural equation modeling revealed that duration of contentment mediated the positive associations of anxious attachment style with anxiety symptoms [β = 0.05, p = 0.004; BC 95% CI (0.02,0.11)] and depressive symptoms [β = 0.04, p = 0.03; BC 95% CI (0.003,0.09)], model fit: χ2(259) = 455.06, p < 0.001, CFI = 0.95, TLI = 0.94, RMSEA = 0.05, SRMR = 0.07. Participants with higher anxious attachment style were more likely to report shorter duration of contentment, which was, in turn, associated with higher anxiety and depressive symptoms. The results suggest a positive emotional pathway underlying the association between anxious attachment style and psychological distress. Implications based on the findings are discussed. PMID:28275363

Relations of Inhibition and Emotion-Related Parenting to Young Children's Prosocial and Vicariously Induced Distress Behavior.

PubMed

Eisenberg, Nancy; Spinrad, Tracy L; Taylor, Zoe E; Liew, Jeffrey

2017-08-31

Children's prosocial behavior and personal distress are likely affected by children's temperament as well as parenting quality. In this study, we examined bidirectional relations from age 30 to 42 months between children's (N = 218) prosocial or self-focused (presumably distressed) reactions to a relative stranger's distress and both supportive emotion-related maternal reactions to children's emotions and children's shyness/inhibition. When controlling for 30-month prosocial behavior and personal distress behavior, maternal supportive (emotion-focused and problem-focused) reactions were positively related to prosocial behavior and marginally negatively related to children's personal distress behaviors and shyness/inhibition at 42 months. Thirty-month personal distress behavior predicted greater shyness/inhibition at 42 months, and 30-month shyness/inhibition was negatively related to prosocial behavior at 30 months. © 2017 The Authors. Child Development © 2017 Society for Research in Child Development, Inc.

Are flatter diurnal cortisol rhythms associated with major depression and anxiety disorders in late adolescence? The role of life stress and daily negative emotion.

PubMed

Doane, Leah D; Mineka, Susan; Zinbarg, Richard E; Craske, Michelle; Griffith, James W; Adam, Emma K

2013-08-01

Alterations in hypothalamic-pituitary-adrenal (HPA) axis functioning have been associated with major depression disorder (MDD) and some anxiety disorders. Few researchers have tested the possibility that high levels of recent life stress or elevations in negative emotion may partially account for the HPA axis alterations observed in these disorders. In a sample of 300 adolescents from the Youth Emotion Project, we examined associations between MDD and anxiety disorders, dimensional measures of internalizing symptomatology, life stress, mood on the days of cortisol testing, and HPA axis functioning. Adolescents with a past MDD episode and those with a recent MDD episode comorbid with an anxiety disorder had flatter diurnal cortisol slopes than adolescents without a history of internalizing disorders. Higher reports of general distress, a dimension of internalizing symptomatology, were also associated with flatter slopes. Negative emotion, specifically sadness and loneliness, was associated with flatter slopes and partially accounted for the associations between comorbid MDD and anxiety disorders and cortisol. The associations between past MDD and cortisol slopes were not accounted for by negative emotion, dimensional variation in internalizing symptomatology, or levels of life stress, indicating that flatter cortisol slopes may also be a "scar" marker of past experiences of MDD.

Emotional reactivity and blood pressure elevations: anxiety as a mediator.

PubMed

Ifeagwazi, Chuka Mike; Egberi, Helen Eleh; Chukwuorji, JohnBosco Chika

2018-06-01

There is a strong link between emotional reactivity and hypertension, yet little research to date has examined mediators of this relationship. Ourstudy  investigated the mediating roleof anxiety on the relationship between emotional reactivity and blood pressure elevations. Participants were226 hypertensive patients (93 men and 133 women, Mean age = 53.09, SD = 13.88 years), purposivelydrawn from the General Outpatient Department in University of Calabar Teaching Hospital, Calabar, , Nigeria. .  Measures for data collection were Emotional Reactivity Scale, State Trait Anxiety Inventory, and the Mercury Sphygmomanometer. Hayes PROCESS macro for SPSS which uses a regression-based, path-analytical framework, was employed in analysing the data. Results showed that emotional reactivity was positively associated with blood pressure elevations. Anxiety was positively associated with blood pressure elevations. Anxiety also fully mediated the relationship between emotional reactivity and blood pressure elevations, even after adjusting for the control variables (e.g., age, family history of hypertension, and educational status). The finding suggests that being less emotionally reactive is associated with a decrease in disabling influences of anxiety, thereby contributing to lower levels of mean arterial blood pressure. The findings may be helpful  in improving prevention, control and management of hypertension in healthcare.

Iowa Gambling Task performance and emotional distress interact to predict risky sexual behavior in individuals with dual substance and HIV diagnoses

PubMed Central

Wardle, Margaret C.; Gonzalez, Raul; Bechara, Antoine; Martin-Thormeyer, Eileen M.

2013-01-01

HIV+ substance-dependent individuals (SDIs) show emotional distress and executive impairment, but in isolation these poorly predict sexual risk. We hypothesized that an executive measure sensitive to emotional aspects of judgment (Iowa Gambling Task; IGT) would identify HIV+ SDIs whose sexual risks were influenced by emotional distress. We assessed emotional distress and performance on several executive tasks in 190 HIV+ SDIs. IGT performance interacted significantly with emotional distress, such that only in better performers were distress and risk related. Our results are interpreted using the somatic marker hypothesis and indicate that the IGT identifies HIV+ SDIs for whom psychological distress influences HIV risk. PMID:20480423

Association of different forms of bullying victimisation with adolescents' psychological distress and reduced emotional wellbeing.

PubMed

Thomas, Hannah J; Chan, Gary C K; Scott, James G; Connor, Jason P; Kelly, Adrian B; Williams, Joanne

2016-04-01

The frequency and emotional response to bullying victimisation are known to be associated with adolescent mental ill health. A potentially important under-investigated factor is the form of bullying. Four common forms of bullying behaviours are name-calling, physical threats or harm, rumour spreading and social exclusion. To more comprehensively understand bullying victimisation in adolescence, we examined the association of all three factors (frequency, emotional response, form) to psychological distress and emotional wellbeing. A stratified, random sample of adolescents (n = 10, 273; mean age = 14.33 years, standard deviation = 1.68 years) completed validated measures of bullying victimisation (Gatehouse Bullying Questionnaire), psychological distress (K10) and emotional wellbeing (Mental Health Inventory) in classroom time. Associations between the form of bullying victimisation and mental health outcomes were examined. Adolescents reported a high prevalence of all four forms of bullying: teased or called names (30.6%), rumour spreading (17.9%), social exclusion (14.3%) and physical threats or harm (10.7%). Victimisation was independently associated with significantly higher levels of psychological distress and reduced levels of emotional wellbeing for all forms of bullying. In particular, social exclusion had a strong association with mental ill health. Adolescents who experienced frequent bullying that was upsetting reported higher psychological distress and reduced emotional wellbeing. Different forms of bullying victimisation were independently associated with psychological distress and reduced emotional wellbeing. In particular, frequent and upsetting social exclusion requires a targeted and measured response by school communities and health practitioners. © The Royal Australian and New Zealand College of Psychiatrists 2015.

Associations between Intimate Partner Violence and Emotional Distress among Pregnant Women in Durban, South Africa

ERIC Educational Resources Information Center

Groves, Allison K.; Kagee, Ashraf; Maman, Suzanne; Moodley, Dhayendre; Rouse, Petrica

2012-01-01

Intimate partner violence (IPV) during pregnancy has been associated with multiple negative health outcomes including emotional distress during pregnancy. However, little is known about IPV during pregnancy and its association with emotional distress among South African women. The objectives of this study were to determine the prevalence of both…

Emotion-Induced Retrograde Amnesia and Trait Anxiety

ERIC Educational Resources Information Center

Miu, Andrei C.; Heilman, Renata M.; Opre, Adrian; Miclea, Mircea

2005-01-01

Emotional arousal can both enhance and impair memory. Considering that both emotional memory and trait anxiety (TA) have been associated with adrenergic activity, the authors investigated whether there is an association between 2 opposite emotional memory biases and the TA. The authors used a procedure recently put forward by B. A. Strange, R.…

Insomnia in patients with chronic tinnitus: Cognitive and emotional distress as moderator variables.

PubMed

Crönlein, Tatjana; Langguth, Berthold; Pregler, Maximilian; Kreuzer, Peter M; Wetter, Thomas C; Schecklmann, Martin

2016-04-01

Tinnitus is often associated with disturbed sleep, but there are also patients without sleep problems. The mechanisms for developing insomnia or not in tinnitus patients are still unknown. The aim of the present study was to extract possible tinnitus specific factors that increase the risk of developing insomnia based on the analysis of a large patient cohort suffering from chronic tinnitus. 173 patients presenting at the multidisciplinary tinnitus center of a University Hospital completed a questionnaire measuring specific psychological symptoms of insomnia (RIS) and a tinnitus questionnaire (TQ). The scores of all ten RIS items were compared between tinnitus patients and 94 healthy individuals by separate ANOVAs in order to specify the extent of insomnia specific symptoms in the tinnitus group. In a second step a multiple linear regression analysis was performed in the tinnitus sample with subscales of the TQ (excluding the TQ sleep scale), age and duration of tinnitus as independent variables and the RIS score as the dependent variables. Tinnitus patients differed from healthy controls not only in impaired sleep quality but also in insomnia specific concerns and anxiety. Tinnitus related emotional and cognitive distress and somatic complaints correlated with severity of insomnia, whereas no association of age or duration of tinnitus with severity of insomnia was found. Our results suggest that chronic tinnitus patients have more sleeping difficulties and associated worries about sleep or negative emotions in contrast to healthy controls. Tinnitus-related distress is related to insomnia. Copyright © 2016. Published by Elsevier Inc.

Using food to soothe: Maternal attachment anxiety is associated with child emotional eating.

PubMed

Hardman, Charlotte A; Christiansen, Paul; Wilkinson, Laura L

2016-04-01

Attachment anxiety (fear of abandonment) is associated with disinhibited eating in adults. Both maternal disinhibited eating and use of emotional feedings strategies are associated with emotional eating in children. On this basis, the current study sought to determine whether attachment anxiety is an underlying maternal characteristic that predicts parental reports of child emotional over-eating via its effects on maternal disinhibited eating and emotional feeding. Mothers of a preadolescent child (N = 116) completed an internet-delivered questionnaire. Maternal attachment anxiety and dietary disinhibition were assessed by the Experiences in Close Relationships questionnaire and the Three Factor Eating Questionnaire, respectively. The Parental Feeding Strategies Questionnaire and the Child Eating Behaviour Questionnaire were used to quantify emotional feeding and child emotional over-eating, respectively. Bias-corrected bootstrapping indicated a significant direct effect of maternal attachment anxiety on child emotional over-eating (i.e., controlling for maternal disinhibited eating and emotional feeding). There was also a significant indirect effect of maternal attachment anxiety on child emotional over-eating via emotional feeding strategies. In a subsequent model to investigate bi-directional relationships, the direct effect of maternal attachment anxiety on emotional feeding strategies was not statistically significant after controlling for child emotional over-eating. There was, however, a significant indirect effect of maternal attachment anxiety on emotional feeding strategies via child emotional over-eating. These findings highlight the influence of maternal attachment anxiety on parental reports of aberrant eating behaviour in children. While this may be partly due to use of emotional feeding strategies, there is stronger evidence for a "child-responsive" model whereby anxiously-attached mothers use these feeding practices in response to perceived

Facial and prosodic emotion recognition in social anxiety disorder.

PubMed

Tseng, Huai-Hsuan; Huang, Yu-Lien; Chen, Jian-Ting; Liang, Kuei-Yu; Lin, Chao-Cheng; Chen, Sue-Huei

2017-07-01

Patients with social anxiety disorder (SAD) have a cognitive preference to negatively evaluate emotional information. In particular, the preferential biases in prosodic emotion recognition in SAD have been much less explored. The present study aims to investigate whether SAD patients retain negative evaluation biases across visual and auditory modalities when given sufficient response time to recognise emotions. Thirty-one SAD patients and 31 age- and gender-matched healthy participants completed a culturally suitable non-verbal emotion recognition task and received clinical assessments for social anxiety and depressive symptoms. A repeated measures analysis of variance was conducted to examine group differences in emotion recognition. Compared to healthy participants, SAD patients were significantly less accurate at recognising facial and prosodic emotions, and spent more time on emotion recognition. The differences were mainly driven by the lower accuracy and longer reaction times for recognising fearful emotions in SAD patients. Within the SAD patients, lower accuracy of sad face recognition was associated with higher severity of depressive and social anxiety symptoms, particularly with avoidance symptoms. These findings may represent a cross-modality pattern of avoidance in the later stage of identifying negative emotions in SAD. This pattern may be linked to clinical symptom severity.

[Gender violence and other factors associated with emotional distress in female users of public health services in Mexico].

PubMed

Valdez-Santiago, Rosario; Juárez-Ramírez, Clara; Salgado-de Snyder, V Nelly; Agoff, Carolina; Avila-Burgos, Leticia; Híjar, Martha C

2006-01-01

To identify and describe the factors associated with emotional distress in a national sample of women users of public health services in Mexico, such a Secretaria de Salud (SSA), Instituto Mexicano del Seguro Social (IMSS), Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE). This research study was conducted using the database of the National Survey of Violence against Women that consisted of the responses of a total of 26 042 female users of health care services provided by the Mexican government health agencies. The Personal Health Scale (ESP per its initials in Spanish) was used to assess emotional distress. To measure violence a 19-item scale which explores different types of violence as well as severity was used. The relationship between emotional distress and gender violence was determined through a binary logistic regression model, as were economic status and demographic variables. One of the most important findings of this study is the high prevalence of emotional distress (15.3%) among women seeking health care services from the public sector and the relationship of such emotional distress with the experience of marital physical, psychological, and sexual violence. Factors associated with emotional distress among female users of health care services were age (26 and older); activity (laborer); working hours (71 hours a week or more); alcohol intake (greater intake); abuse during childhood (frequency and types of abuse); severity of marital violence (severe violence); socioeconomic status (very low SES); and type of dwelling (urban). The principal predictor of emotional distress was intimate partner abuse, especially in severe expression. The next predictor was violence in childhood. Taking into consideration these predictors it is recommended to use screening instruments to identify emotional distress and gender violence in health setting. It is important to design and implement attention and reference programs in public

Will you thrive under pressure or burn out? Linking anxiety motivation and emotional exhaustion.

PubMed

Strack, Juliane; Lopes, Paulo N; Esteves, Francisco

2015-01-01

Can individual differences in the tendency to use anxiety as a source of motivation explain emotional exhaustion? We examined the effects of using anxiety as a source of energy or as a source of information (viewed here as two forms of anxiety motivation) on emotional exhaustion. In Study 1, the use of anxiety as a source of energy predicted decreased emotional exhaustion one year later. Moreover, both forms of anxiety motivation buffered people from the detrimental effects of trait anxiety on later emotional exhaustion. In Study 2, an experiment, participants who were instructed to use anxiety as a source of energy reported lower emotional exhaustion following a stressful task, compared to those instructed to focus on the task or to simply do their best. These findings suggest that using anxiety as a source of motivation may protect people against emotional exhaustion.

Exploring Sources of Emotional Distress among People Living with Scleroderma: A Focus Group Study

PubMed Central

Gumuchian, Stephanie T.; Peláez, Sandra; Delisle, Vanessa C.; Carrier, Marie-Eve; Jewett, Lisa R.; El-Baalbaki, Ghassan; Fortune, Catherine; Hudson, Marie; Impens, Ann; Körner, Annett; Persmann, Jennifer; Kwakkenbos, Linda; Bartlett, Susan J.; Thombs, Brett D.

2016-01-01

Background Systemic sclerosis, or scleroderma, is a chronic and rare connective tissue disease with negative physical and psychological implications. Sources of emotional distress and the impact they have on the lives of people with scleroderma are not well understood. Objectives To gain an in-depth understanding of the emotional experiences and sources of emotional distress for women and men living with scleroderma through focus group discussions. Methods Three semi-structured focus group discussions were conducted (two in English, one in French) with a total of 22 people with scleroderma recruited through the Scleroderma Society of Ontario in Hamilton, Ontario and a scleroderma clinic in Montreal, Canada. Interviews were recorded, transcribed, and then coded for emerging themes using thematic inductive analysis. Results Core themes representing sources of emotional distress were identified, including: (a) facing a new reality; (b) the daily struggle of living with scleroderma; (c) handling work, employment and general financial burden; (d) changing family roles; (e) social interactions; and (f) navigating the health care system. Collectively, these themes refer to the stressful journey of living with scleroderma including the obstacles faced and the emotional experiences beginning prior to receiving a diagnosis and continuing throughout the participants’ lives. Conclusion Scleroderma was portrayed as being an unpredictable and overwhelming disease, resulting in many individuals experiencing multiple sources of emotional distress. Interventions and supportive resources need to be developed to help individuals with scleroderma and people close to them manage and cope with the emotional aspects of the disease. PMID:27008209

Effect of anxiety on memory for emotional information in older adults.

PubMed

Herrera, Sara; Montorio, Ignacio; Cabrera, Isabel

2017-04-01

Several studies have shown that anxiety is associated with a better memory of negative events. However, this anxiety-related memory bias has not been studied in the elderly, in which there is a preferential processing of positive information. To study the effect of anxiety in a recognition task and an autobiographical memory task in 102 older adults with high and low levels of trait anxiety. Negative, positive and neutral pictures were used in the recognition task. In the autobiographical memory task, memories of the participants' lives were recorded, how they felt when thinking about them, and the personal relevance of these memories. In the recognition task, no anxiety-related bias was found toward negative information. Individuals with high trait anxiety were found to remember less positive pictures than those with low trait anxiety. In the autobiographical memory task, both groups remembered negative and positive events equally. However, people with high trait anxiety remembered life experiences with more negative emotions, especially when remembering negative events. Individuals with low trait anxiety tended to feel more positive emotions when remembering their life experiences and most of these referred to feeling positive emotions when remembering negative events. Older adults with anxiety tend to recognize less positive information and to present more negative emotions when remembering life events; while individuals without anxiety have a more positive experience of negative memories.

Associations between recent gay-related stressful events, emotional distress, social support and unprotected anal intercourse behavior among Chinese men who have sex with men.

PubMed

Yunyong, Liu; Zhe, Wang; Junting, Xu; Yan, Zhou; Xiaoxia, An; Li, Zhao; Yuan, Gu; Chao, Jiang

2016-07-01

This study was designed to assess the levels of and associations between gay-related stressful events, social support, emotional distress and the number of unprotected anal intercourse partners among Chinese men who have sex with men. Using a respondent-driven sampling method, 807 men who have sex with men were recruited in urban areas of northeast China and data were collected via face-to-face interviews. Gay-related stressful events were measured using the Gay-Related Stressful Life Events Scale; levels of depression, anxiety symptoms and social support were measured using the Self-Rating Depression Scale, the Self-Rating Anxiety Scale and the Social Support Rating Scale, respectively. Over a quarter of study participants experienced gay-related stressful events during the preceding 3 months. Their average Self-Rating Depression Scale, Self-Rating Anxiety Scale and Social Support scores differed significantly from the national norm. Gay-related stressful events significantly correlated with anxiety (r = 0.167, p < 0.001), depression (r = 0.165, p < 0.001), social support (r = -0.107, p = 0.002) and number of unprotected anal intercourse partners (r = 0.13, p < 0.001), showing a clear dose-response relationship. Gay-related stressful events are common and are significantly associated with emotional distress, lack of social support and high-risk sexual behaviors among Chinese men who have sex with men. Multifaceted approaches are warranted to increase social support and reduce intolerance toward homosexual behaviors and to reduce risky sexual behaviors related to the rapid HIV epidemic among men who have sex with men population in China. © The Royal Australian and New Zealand College of Psychiatrists 2015.

Interpersonal Emotion Regulation Model of Mood and Anxiety Disorders.

PubMed

Hofmann, Stefan G

2014-10-01

Although social factors are of critical importance in the development and maintenance of emotional disorders, the contemporary view of emotion regulation has been primarily limited to intrapersonal processes. Based on diverse perspectives pointing to the communicative function of emotions, the social processes in self-regulation, and the role of social support, this article presents an interpersonal model of emotion regulation of mood and anxiety disorders. This model provides a theoretical framework to understand and explain how mood and anxiety disorders are regulated and maintained through others. The literature, which provides support for the model, is reviewed and the clinical implications are discussed.

Psychological characteristics and subjective symptoms as determinants of psychological distress in patients prior to breast cancer diagnosis.

PubMed

Ando, Noriko; Iwamitsu, Yumi; Kuranami, Masaru; Okazaki, Shigemi; Wada, Mei; Yamamoto, Kenji; Todoroki, Keiko; Watanabe, Masahiko; Miyaoka, Hitoshi

2009-11-01

The objective of this study was to determine how psychological characteristics, subjective symptoms, a family history of breast cancer, and age impact psychological distress in outpatients at the first hospital visit prior to breast cancer diagnosis. Participants were prediagnosed women with complaints of breast symptoms who either came to our hospital directly, or with a referral from another clinic. Patients were asked to complete questionnaires to determine the following: trait anxiety (State-Trait Anxiety Inventory), negative emotional suppression (Courtauld Emotional Control Scale), life stress events (Life Experiences Survey), and psychological distress (Profile of Mood States). We examined subjective symptoms (lumps, pain, abnormal nipple discharge, or deformed nipple) and family history of breast cancer based on answers to the interview sheet filled out by patients on their first visit. We analyzed a total of 154 patients who completed the questionnaires out of 237 eligible patients. A significant model was obtained by multiple regression analysis (adjusted R (2) = 0.574, p < 0.01) in which the standard partial regression coefficients for trait anxiety, suppression of anxiety, negative life change events, positive life change events, and subjective symptoms were statistically significant (beta = 0.623, 0.133, 0.155, 0.108, and 0.124, respectively; p < 0.05). Psychological distress prior to diagnosis was higher in patients who had high trait anxiety, suppression of anxiety, many life stress events, and subjective symptoms. In particular, trait anxiety had a large impact on psychological distress, underscoring the need for and importance of adequate psychological care.

Prevalence and Predictors of Mental/Emotional Distress Among HIV+ Jail Detainees at Enrollment in an Observational Study

PubMed Central

Lincoln, Thomas; Simon-Levine, Dominique; Smith, JuliAnna; Donenberg, Geri R.; Springer, Sandra A.; Zaller, Nickolas; Altice, Frederick L.; Moore, Kevin; Jordan, Alison O.; Draine, Jeffrey; Desabrais, Maureen

2015-01-01

This study evaluates the prevalence of mental/emotional distress and its specific correlates among people living with HIV/AIDS (PLWHA) in 20 jail systems across the United States. Of the 878 PLWHA jail detainees, 52% had high levels of mental/emotional distress, defined by the composite Addiction Severity Index score. High mental/emotional distress was found to be associated with the inmate living in a city with lower income inequality, lower health ranking, and higher degree of danger. Proximate variables included being female, bisexual orientation, poorer physical health, and increased severity of substance abuse. Inmates in jails with accredited health services and those satisfied with family support had lower mental/emotional distress scores. These findings indicate the need for expanded mental health assessment of PLWHAs entering jail. PMID:25788608

Pathways to social anxiety: the role of reinforcement sensitivities and emotion regulation.

PubMed

O'Connor, Elodie J; Staiger, Petra K; Kambouropoulos, Nicolas; Smillie, Luke D

2014-12-30

Past research has demonstrated a strong relationship between threat sensitivity and social anxiety; however, the relationship between reward sensitivity and social anxiety is less clear. Further, the role that emotion regulation (ER) may play in the expression of social anxiety disorder (SAD) is rarely considered. The current study tested whether two emotion regulation strategies (emotional suppression and cognitive reappraisal) mediated associations between threat sensitivity and reward sensitivity and social anxiety in a community sample (402 adults, 78% female; Mage=32.49, S.D.age=11.53). Path analyses indicated that low reappraisal mediated the relationship between high threat sensitivity and high social anxiety; and both low reappraisal and high suppression mediated the relationship between low reward sensitivity and high social anxiety. These results highlight the potential role that emotion regulation plays in the relationship between trait motivation and social anxiety. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Social anxiety and emotion regulation flexibility: considering emotion intensity and type as contextual factors.

PubMed

O'Toole, Mia S; Zachariae, Robert; Mennin, Douglas S

2017-11-01

Individuals with social anxiety disorder have often been considered inflexible in their emotion regulation. The aim of this study was to investigate emotion regulation flexibility in socially anxious individuals in response to two contextual factors, namely different levels of emotion intensity and emotion type. A daily diary approach was employed, investigating emotion regulation (i.e., experiential avoidance, expressive suppression and cognitive reappraisal) in college students scoring high (N = 62; HSA) and low (N = 52; LSA) on social anxiety. Results revealed that HSAs were found to use more experiential avoidance than LSAs, especially at higher levels of negative intensity. The use of this emotion regulation strategy appeared to be driven by guilt, nervousness, and sadness. There were no between-group differences concerning the other strategies in response to varying levels of emotional intensity. Together, the results provide evidence for inflexible emotion regulation in HSAs, reflected in an unwillingness to experience negative emotions.

Positive and Negative Emotion Prospectively Predict Trajectories of Resilience and Distress Among High-Exposure Police Officers

PubMed Central

Galatzer-Levy, Isaac R.; Brown, Adam D.; Henn-Haase, Clare; Metzler, Thomas J.; Neylan, Thomas C.; Marmar, Charles R.

2013-01-01

Responses to both potentially traumatic events and other significant life stressors have been shown to conform to discrete patterns of response such as resilience, anticipatory stress, initial distress with gradual recovery, and chronic distress. The etiology of these trajectories is still unclear. Individual differences in levels of negative and positive emotion are believed to play a role in determining risk and resilience following traumatic exposure. In the current investigation, we followed police officers prospectively from academy training through 48 months of active duty, assessing levels of distress every 12 months. Using latent class growth analysis, we identified 4 trajectories closely conforming to prototypical patterns. Furthermore, we found that lower levels of self-reported negative emotion during academy training prospectively predicted membership in the resilient trajectory compared with the more symptomatic trajectories following the initiation of active duty, whereas higher levels of positive emotion during academy training differentiated resilience from a trajectory that was equivalently low on distress during academy training but consistently grew in distress through 4 years of active duty. These findings emerging from a prospective longitudinal design provide evidence that resilience is predicted by both lower levels of negative emotion and higher levels of positive emotion prior to active duty stressor exposure. PMID:23339621

Time course of processing emotional stimuli as a function of perceived emotional intelligence, anxiety, and depression

PubMed Central

Fisher, Joscelyn E.; Sass, Sarah M.; Heller, Wendy; Silton, Rebecca Levin; Edgar, J. Christopher; Stewart, Jennifer L.; Miller, Gregory A.

2014-01-01

An individual’s self-reported abilities to attend to, understand, and reinterpret emotional situations or events have been associated with anxiety and depression, but it is unclear how these abilities affect the processing of emotional stimuli, especially in individuals with these symptoms. The present study recorded event-related brain potentials while individuals reporting features of anxiety and depression completed an emotion-word Stroop task. Results indicated that anxious apprehension, anxious arousal, and depression were associated with self-reported emotion abilities, consistent with prior literature. Additionally, lower anxious apprehension and greater reported emotional clarity were related to slower processing of negative stimuli indexed by event-related potentials (ERPs). Higher anxious arousal and reported attention to emotion were associated with ERP evidence of early attention to all stimuli regardless of emotional content. Reduced later engagement with stimuli was also associated with anxious arousal and with clarity of emotions. Depression was not differentially associated with any emotion processing stage indexed by ERPs. Research in this area may lead to the development of therapies that focus on minimization of anxiety in order to foster successful emotion regulation. PMID:20677866

God, Can I Tell You Something? The Effect of Religious Coping on the Relationship between Anxiety Over Emotional Expression, Anxiety, and Depressive Symptoms.

PubMed

Bryan, Jennifer L; Lucas, Sydnee; Quist, Michelle C; Steers, Mai-Ly N; Foster, Dawn W; Young, Chelsie M; Lu, Qian

2016-02-01

The current study investigated whether religious coping would moderate the association between ambivalence over emotional expression (AEE) and depressive symptoms and anxiety symptoms such that the positive relationship between AEE and depressive symptoms and anxiety symptoms would be weaker among those higher in religious coping. Three-hundred and fifty-two undergraduates ( M age=23.51 years, SD =6.80; 84.4% female) completed study materials. Contrary to expectations, results revealed a significant interaction between religious coping and AEE such that religious coping exacerbated the relationship between higher AEE and distress symptoms. The implications of this study suggest that religious coping may not be an ideal coping mechanism for individuals with high levels of AEE. These results indicate the need to further examine the role of AEE in religious coping, and have potential implications for clinicians, healthcare professionals, and religious mentors who may promote the use of religious coping in treatment.

The mediating role of emotional intelligence between negative life events and psychological distress among nursing students: A cross-sectional study.

PubMed

Zhang, Pan; Li, Chang-Zai; Zhao, Ya-Ning; Xing, Feng-Mei; Chen, Chang-Xiang; Tian, Xi-Feng; Tang, Qi-Qun

2016-09-01

Previous studies have highlighted that negative life events and emotional intelligence are significant predictors of mental health. However, whether emotional intelligence mediates the relationship between negative life events and psychological distress among nursing students have not been given adequate attention. To explore the relationship among negative life events, emotional intelligence and psychological distress and to examine the mediating role of emotional intelligence in psychological distress among Chinese nursing students. A cross-sectional survey using convenience sampling. A total of 467 nursing students who were enrolled in a university in mainland of China. A structured questionnaire was administered from September-November in 2013 to participants who consented to participate in the study. Independent variables were personal variables, emotional intelligence and negative life events. Outcome variable was psychological health. The means and standard deviations were computed. Student's t-test and one-way analysis of variance (ANOVA) were performed, to test the differences among the demographic characteristics on the psychological distress scores. Pearson correlation analyses and hierarchical regression analyses were performed. Negative life events were positively associated with psychological distress. Emotional intelligence was negatively associated with psychological distress and negative life events. Emotional intelligence mediated the relationship between negative life events and psychological distress. The findings support the theory of Salovey and his colleagues, and provide evidence for emotional intelligence as a factor that buffers effects of negative life events on psychological distress. Copyright © 2016 Elsevier Ltd. All rights reserved.

The Affective Tie That Binds: Examining the Contribution of Positive Emotions and Anxiety to Relationship Formation in Social Anxiety Disorder

PubMed Central

Taylor, Charles T.; Pearlstein, Sarah; Stein, Murray B.

2017-01-01

Individuals with social anxiety disorder (SAD) have difficulty forming social relationships. The prevailing clinical perspective is that negative emotions such as anxiety inhibit one’s capacity to develop satisfying social connections. However, empirical findings from social psychology and affective neuroscience suggest that positive emotional experiences are fundamental to establishing new social bonds. To reconcile these perspectives, we collected repeated measurements of anxiety, positive emotions (pleasantness), and connectedness over the course of a controlled relationship formation encounter in 56 participants diagnosed with SAD (64% female; Mage = 23.3, SD = 4.7). Participants experienced both increases in positive emotions and decreases in anxiety throughout the interaction. Change in positive emotions was the most robust predictor of subsequent increases in connectedness, as well as a greater desire to engage one’s partner in future social activities, above and beyond reductions in anxiety (medium to large sized effects). Those findings suggest that anxiety-based models alone may not fully explain difficulties in relationship formation in SAD, and underscore the potential value of considering positive emotional experiences in conceptual and treatment models of SAD. PMID:28384621

Psychological distress, perceived stigma, and coping among caregivers of patients with schizophrenia

PubMed Central

Ong, Hui Chien; Ibrahim, Norhayati; Wahab, Suzaily

2016-01-01

Nowadays, family members are gradually taking on the role of full-time caregivers for patients suffering from schizophrenia. The increasing burden and tasks of caretaking can cause them psychological distress such as depression or anxiety. The aim of this study was to measure the correlation between perceived stigma and coping, and psychological distress as well as determine the predictors of psychological distress among the caregivers. Results showed that 31.5% of the caregivers experienced psychological distress. “Community rejection” was found to be positively associated with psychological distress. In case of coping subscales, psychological distress had a positive correlation with substance use, use of emotional support, behavioral disengagement, venting, and self-blame, while it was negatively correlated with “positive reframing”. Behavioral disengagement was the best predictor of psychological distress among caregivers of patients with schizophrenia, followed by positive reframing, use of emotional support, self-blame, and venting. Health practitioners can use adaptive coping strategies instead of maladaptive for caregivers to help ease their distress and prevent further deterioration of psychological disorders. PMID:27574475

Item Banks for Measuring Emotional Distress From the Patient-Reported Outcomes Measurement Information System (PROMIS®): Depression, Anxiety, and Anger

PubMed Central

Pilkonis, Paul A.; Choi, Seung W.; Reise, Steven P.; Stover, Angela M.; Riley, William T.; Cella, David

2011-01-01

The authors report on the development and calibration of item banks for depression, anxiety, and anger as part of the Patient-Reported Outcomes Measurement Information System (PROMIS®). Comprehensive literature searches yielded an initial bank of 1,404 items from 305 instruments. After qualitative item analysis (including focus groups and cognitive interviewing), 168 items (56 for each construct) were written in a first person, past tense format with a 7-day time frame and five response options reflecting frequency. The calibration sample included nearly 15,000 respondents. Final banks of 28, 29, and 29 items were calibrated for depression, anxiety, and anger, respectively, using item response theory. Test information curves showed that the PROMIS item banks provided more information than conventional measures in a range of severity from approximately −1 to +3 standard deviations (with higher scores indicating greater distress). Short forms consisting of seven to eight items provided information comparable to legacy measures containing more items. PMID:21697139

Item banks for measuring emotional distress from the Patient-Reported Outcomes Measurement Information System (PROMIS®): depression, anxiety, and anger.

PubMed

Pilkonis, Paul A; Choi, Seung W; Reise, Steven P; Stover, Angela M; Riley, William T; Cella, David

2011-09-01

The authors report on the development and calibration of item banks for depression, anxiety, and anger as part of the Patient-Reported Outcomes Measurement Information System (PROMIS®). Comprehensive literature searches yielded an initial bank of 1,404 items from 305 instruments. After qualitative item analysis (including focus groups and cognitive interviewing), 168 items (56 for each construct) were written in a first person, past tense format with a 7-day time frame and five response options reflecting frequency. The calibration sample included nearly 15,000 respondents. Final banks of 28, 29, and 29 items were calibrated for depression, anxiety, and anger, respectively, using item response theory. Test information curves showed that the PROMIS item banks provided more information than conventional measures in a range of severity from approximately -1 to +3 standard deviations (with higher scores indicating greater distress). Short forms consisting of seven to eight items provided information comparable to legacy measures containing more items.

Emotional Self-Disclosure and Emotional Avoidance: Relations with Symptoms of Depression and Anxiety

ERIC Educational Resources Information Center

Kahn, Jeffrey H.; Garrison, Angela M.

2009-01-01

Research suggests that individuals with heightened symptoms of mood and anxiety disorders engage in diminished emotional disclosure. On the basis of emotion regulation theories, the authors hypothesized that this symptom-disclosure relationship would be mediated by the avoidance of emotional experience and expression. In Study 1, college students…

Interpersonal Emotion Regulation Model of Mood and Anxiety Disorders

PubMed Central

Hofmann, Stefan G.

2014-01-01

Although social factors are of critical importance in the development and maintenance of emotional disorders, the contemporary view of emotion regulation has been primarily limited to intrapersonal processes. Based on diverse perspectives pointing to the communicative function of emotions, the social processes in self-regulation, and the role of social support, this article presents an interpersonal model of emotion regulation of mood and anxiety disorders. This model provides a theoretical framework to understand and explain how mood and anxiety disorders are regulated and maintained through others. The literature, which provides support for the model, is reviewed and the clinical implications are discussed. PMID:25267867

Gender Role Conflict, Emotional Approach Coping, Self-Compassion and Distress in Prostate Cancer Patients: A Model of Direct and Moderating Effects.

PubMed

Lennon, Jennifer; Hevey, David; Kinsella, Louise

2018-05-14

Gender role conflict or the negative consequences of male socialization may compromise men's adjustment to prostate cancer by shaping how patients perceive and cope with their illness. Given mixed findings regarding how gender role conflict interacts with emotional approach coping to regulate distress in prostate cancer patients, the present study examined the effects of emotional approach coping, when considered alongside self-compassion, the ability to be kind and understanding of oneself. 92 prostate cancer patients completed questionnaires measuring gender role conflict, emotional approach coping, self-compassion and distress. A moderated mediation model was tested, where emotional approach coping mediated the path between gender role conflict and distress and self compassion moderated paths between (a) gender role conflict and emotional approach coping, and (b) gender role conflict and distress. Results partially supported this model with all study variables predicting distress in the expected directions. Emotional approach coping did not mediate associations between gender role conflict and distress; however, self-compassion did moderate the pathway between these variables. Results indicated that higher levels of self-compassion might protect men from distress related to emasculating aspects of the cancer experience. Further investigation is required to understand how self-compassion interacts with emotionality and subsequently influences distress in prostate cancer patients. To better understand the effectiveness of emotional approach coping in reducing distress in prostate cancer patients, it is recommended that future research accounts for the receptiveness of social environments to men's emotional displays. This article is protected by copyright. All rights reserved.

Physical, emotional, and behavioral reactions to breaking up: the roles of gender, age, emotional involvement, and attachment style.

PubMed

Davis, Deborah; Shaver, Phillip R; Vernon, Michael L

2003-07-01

Associations between gender, age, emotional involvement, and attachment style and reactions to romantic relationship dissolution were studied in a survey of more than 5,000 Internet respondents. It was hypothesized that individual reactions to breakups would be congruent with characteristic attachment behaviors and affect-regulation strategies generally associated with attachment style. Attachment-related anxiety was associated with greater preoccupation with the lost partner, greater perseveration over the loss, more extreme physical and emotional distress, exaggerated attempts to reestablish the relationship, partner-related sexual motivation, angry and vengeful behavior, interference with exploratory activities, dysfunctional coping strategies, and disordered resolution. Attachment-related avoidance was weakly and negatively associated with most distress/proximity-seeking reactions to breakups and strongly and positively associated with avoidant and self-reliant coping strategies. Security (low scores on the anxiety and avoidance dimensions) was associated with social coping strategies (e.g., using friends and family as "safe havens"). Attachment insecurity, particularly anxiety, was associated with using drugs and alcohol to cope with loss.

Routine cognitive errors: a trait-like predictor of individual differences in anxiety and distress.

PubMed

Fetterman, Adam K; Robinson, Michael D

2011-02-01

Five studies (N=361) sought to model a class of errors--namely, those in routine tasks--that several literatures have suggested may predispose individuals to higher levels of emotional distress. Individual differences in error frequency were assessed in choice reaction-time tasks of a routine cognitive type. In Study 1, it was found that tendencies toward error in such tasks exhibit trait-like stability over time. In Study 3, it was found that tendencies toward error exhibit trait-like consistency across different tasks. Higher error frequency, in turn, predicted higher levels of negative affect, general distress symptoms, displayed levels of negative emotion during an interview, and momentary experiences of negative emotion in daily life (Studies 2-5). In all cases, such predictive relations remained significant with individual differences in neuroticism controlled. The results thus converge on the idea that error frequency in simple cognitive tasks is a significant and consequential predictor of emotional distress in everyday life. The results are novel, but discussed within the context of the wider literatures that informed them. © 2010 Psychology Press, an imprint of the Taylor & Francis Group, an Informa business

Paradoxical cardiovascular effects of implementing adaptive emotion regulation strategies in generalized anxiety disorder.

PubMed

Aldao, Amelia; Mennin, Douglas S

2012-02-01

Recent models of generalized anxiety disorder (GAD) have expanded on Borkovec's avoidance theory by delineating emotion regulation deficits associated with the excessive worry characteristic of this disorder (see Behar, DiMarco, Hekler, Mohlman, & Staples, 2009). However, it has been difficult to determine whether emotion regulation is simply a useful heuristic for the avoidant properties of worry or an important extension to conceptualizations of GAD. Some of this difficulty may arise from a focus on purported maladaptive regulation strategies, which may be confounded with symptomatic distress components of the disorder (such as worry). We examined the implementation of adaptive regulation strategies by participants with and without a diagnosis of GAD while watching emotion-eliciting film clips. In a between-subjects design, participants were randomly assigned to accept, reappraise, or were not given specific regulation instructions. Implementation of adaptive regulation strategies produced differential effects in the physiological (but not subjective) domain across diagnostic groups. Whereas participants with GAD demonstrated lower cardiac flexibility when implementing adaptive regulation strategies than when not given specific instructions on how to regulate, healthy controls showed the opposite pattern, suggesting they benefited from the use of adaptive regulation strategies. We discuss the implications of these findings for the delineation of emotion regulation deficits in psychopathology. Copyright © 2011 Elsevier Ltd. All rights reserved.

Ironic effects of emotion suppression when recounting distressing memories.

PubMed

Dalgleish, Tim; Yiend, Jenny; Schweizer, Susanne; Dunn, Barnaby D

2009-10-01

Theories of ironic mental control posit that under conditions in which effortful control is compromised, for example, in laboratory manipulations of mental load or in those suffering from clinical levels of negative affect, attempts to suppress negative emotions can lead to a paradoxical increase in such feelings, relative to conditions in which no suppression is attempted. In line with this, we showed that high negative affect participants, when asked to suppress (downregulate) their negative feelings while writing about a distressing personal memory, exhibited an ironically greater increase in negative emotions compared with a no-instruction condition, in contrast to low negative affect controls who were able to suppress their emotions. Comparable ironic effects were not associated with instructions to experience emotions. This first demonstration of ironic effects of emotion suppression in response to personal material in those with emotional problems sheds light into how certain emotion regulation strategies may maintain and exacerbate such conditions.

Emotional Responses to Service Learning: An Exploratory Study

ERIC Educational Resources Information Center

Priesmeyer, H. Richard; Mudge, Suzanne D.; Ward, Stephanie G.

2016-01-01

This study measured the emotional responses of students to common service learning activities. Two hypotheses focused on (1) expected changes in the mean emotion scores and (2) expected differences in individual responses. Results showed significant increases in Surprise, Anxiety and Distress and individual differences in Contempt, Disgust and…

Relationship between emotional distress and quality of life on type 2 diabetes mellitus patients in Meranti island regency hospital

NASA Astrophysics Data System (ADS)

Faridah, I. N.; Perwitasari, D. A.; Pusfita, M.; Jasman, H.

2017-11-01

Type 2 Diabetes mellitus (T2DM) always got treatment for a long time so that it can affect the emotional distress and the quality of life. This study aimed to find the relationship between emotional distress with quality of life. This study used cross sectional design. DDS was used to measure patients emotional distress. EQ-5D was used to measure patients quality of life. Subjects of this study were T2DM patients ICD X.E11 with aged over 18 years old. A total of 80 patients participated in the study. The result showed that the mean of score on emotional burden was 2.985±0.678, physician distress was 2.650±0.801, regiment distress was 3.222±0.75 and interpersonal distress was 2.529±0.859. The result of the analysis showed that there was relationship between employment and interpersonal distress with index and correlation showed weak negative (r-0.212, -0.306) and significant relationship (p<0.05). The relationship between education and VAS showed weak positive correlation (r0.334) and significant relationship (p<0.01). The relationship between employment and emotional burden with VAS showed weak negative correlation (r-0.215, -0.251) and significant relationship (p<0.01). Employment and education was factors that affected the quality of life. High emotional distress can degraded the quality of life.

Emotional arousal state influences the ability of amygdalar endocannabinoid signaling to modulate anxiety.

PubMed

Morena, Maria; Leitl, Kira D; Vecchiarelli, Haley A; Gray, J Megan; Campolongo, Patrizia; Hill, Matthew N

2016-12-01

Systemic activation of cannabinoid receptors often induces biphasic effects on emotional memory and anxiety depending on the levels of emotional arousal associated to the experimental context. The basolateral nucleus of the amygdala (BLA) represents a crucial structure for the ability of endocannabinoid (eCB) signaling to modulate emotional behaviour, and receives dense projections from brainstem arousal system nuclei. We examined whether changes in emotional arousal state would influence the ability of acute eCB manipulations within the BLA to modulate anxiety. Rats were tested in an elevated plus maze (EPM) under low or high arousal conditions. The low emotional arousal group was extensively handled and habituated to the experimental room and tested under red light condition, the high emotional arousal group was not handled or habituated and tested under high light condition. We examined amygdalar eCB anandamide (AEA) and 2-arachidonoylglycerol (2-AG) levels immediately after the EPM and the effects of intra-BLA administration of the AEA hydrolysis inhibitor URB597 or the 2-AG hydrolysis inhibitor KML29 on anxiety behaviour. The modulation of anxiety-like behaviour by eCBs in the BLA was strictly dependent on the environmental-associated emotional arousal. Pharmacologically-induced elevations of AEA or 2-AG in the BLA decreased anxiety under conditions of low emotional arousal. Conversely, when the level of emotional arousal increased, local eCB manipulation was ineffective in the modulation of the emotional arousal-induced anxiety response. These findings suggest that, depending on the emotional arousal state, eCB system is differentially activated to regulate the anxiety response in the amygdala and help to understand the state-dependency of many interventions on anxiety. Copyright © 2016. Published by Elsevier Ltd.

What Good are Positive Emotions for Treatment? Trait Positive Emotionality Predicts Response to Cognitive Behavioral Therapy for Anxiety

PubMed Central

Taylor, Charles T.; Knapp, Sarah E.; Bomyea, Jessica A.; Ramsawh, Holly J.; Paulus, Martin P.; Stein, Murray B.

2017-01-01

Objective Cognitive behavioral therapy (CBT) is empirically supported for the treatment of anxiety disorders; however, not all individuals achieve recovery following CBT. Positive emotions serve a number of functions that theoretically should facilitate response to CBT – they promote flexible patterns of information processing and assimilation of new information, encourage approach-oriented behavior, and speed physiological recovery from negative emotions. We conducted a secondary analysis of an existing clinical trial dataset to test the a priori hypothesis that individual differences in trait positive emotions would predict CBT response for anxiety. Method Participants meeting diagnostic criteria for panic disorder (n=28) or generalized anxiety disorder (n=31) completed 10 weekly individual CBT sessions. Trait positive emotionality was assessed at pre-treatment, and severity of anxiety symptoms and associated impairment was assessed throughout treatment. Results Participants who reported a greater propensity to experience positive emotions at pre-treatment displayed the largest reduction in anxiety symptoms as well as fewer symptoms following treatment. Positive emotions remained a robust predictor of change in symptoms when controlling for baseline depression severity. Conclusions Initial evidence supports the predictive value of trait positive emotions as a prognostic indicator for CBT outcome in a GAD and PD sample. PMID:28342947

What good are positive emotions for treatment? Trait positive emotionality predicts response to Cognitive Behavioral Therapy for anxiety.

PubMed

Taylor, Charles T; Knapp, Sarah E; Bomyea, Jessica A; Ramsawh, Holly J; Paulus, Martin P; Stein, Murray B

2017-06-01

Cognitive behavioral therapy (CBT) is empirically supported for the treatment of anxiety disorders; however, not all individuals achieve recovery following CBT. Positive emotions serve a number of functions that theoretically should facilitate response to CBT - they promote flexible patterns of information processing and assimilation of new information, encourage approach-oriented behavior, and speed physiological recovery from negative emotions. We conducted a secondary analysis of an existing clinical trial dataset to test the a priori hypothesis that individual differences in trait positive emotions would predict CBT response for anxiety. Participants meeting diagnostic criteria for panic disorder (n = 28) or generalized anxiety disorder (n = 31) completed 10 weekly individual CBT sessions. Trait positive emotionality was assessed at pre-treatment, and severity of anxiety symptoms and associated impairment was assessed throughout treatment. Participants who reported a greater propensity to experience positive emotions at pre-treatment displayed the largest reduction in anxiety symptoms as well as fewer symptoms following treatment. Positive emotions remained a robust predictor of change in symptoms when controlling for baseline depression severity. Initial evidence supports the predictive value of trait positive emotions as a prognostic indicator for CBT outcome in a GAD and PD sample. Copyright © 2017 Elsevier Ltd. All rights reserved.

Effect of an oral contraceptive on emotional distress, anxiety and depression of women with polycystic ovary syndrome: a prospective study.

PubMed

Cinar, Nese; Harmanci, Ayla; Demir, Basaran; Yildiz, Bulent O

2012-06-01

We aimed to determine the impact of an oral contraceptive (OC) treatment on health-related quality of life (HRQOL), depressive and anxiety symptoms in polycystic ovary syndrome (PCOS). OC therapy in PCOS improves hirsutism and menstrual disturbances, along with HRQOL. This improvement is not associated with any change in the prevalence of depressive and anxiety symptoms. WHAT IS KNOWN AND WHAT THIS ARTICLE ADDS: Limited data are available regarding the effects of an OC on HRQOL, and depressive and anxiety symptoms in PCOS. This study reports the effects of the ethinyl estradiol/drospirenone (EE/DRSP) OC on an HRQOL questionnaire for women with PCOS (PCOSQ), depressive and anxiety symptoms after 6 months of treatment. Prospective observational study. All participants completed PCOSQ, Beck Depression Inventory, Hospital Anxiety and Depression Scale and General Health Questionnaire. Serum androgens, fasting insulin, fasting and postload glucose values during an oral glucose tolerance test were measured. Changes in these variables and the scores of questionnaires were evaluated after 6 months of treatment with EE/DRSP (3 mg/30 μg). Thirty-six patients with PCOS without a previous psychiatric diagnosis were included in the study. The main complaints of the patients were hirsutism and irregular menses. Accordingly, menstrual and hirsutism problems were the most serious concerns followed by emotional problems on the PCOSQ. Eight patients (22.2%) had clinical depression scores. After treatment, regular menstrual cycles were attained and hirsutism was significantly improved in all patients. Hirsutism and emotion domains of the PCOSQ improved at 6 months (P< 0.05 for both). Depression was improved in five of eight depressive patients and four new patients showed increased depression scores. Overall, depression, anxiety mean scores and depression rates did not show a significant change. The study is subject to the strengths and limitations of observational study design. A

Emotional Competence and Anxiety in Childhood and Adolescence: A Meta-Analytic Review.

PubMed

Mathews, Brittany L; Koehn, Amanda J; Abtahi, Mahsa Movahed; Kerns, Kathryn A

2016-06-01

Anxiety is conceptualized as a state of negative emotional arousal that is accompanied by concern about future threat. The purpose of this meta-analytic review was to evaluate the evidence of associations between emotional competence and anxiety by examining how specific emotional competence domains (emotion recognition, emotion expression, emotion awareness, emotion understanding, acceptance of emotion, emotional self-efficacy, sympathetic/empathic responses to others' emotions, recognition of how emotion communication and self-presentation affect relationships, and emotion regulatory processes) relate to anxiety in childhood and adolescence. A total of 185 studies were included in a series of meta-analyses (N's ranged from 573 to 25,711). Results showed that anxious youth are less effective at expressing (r = -0.15) and understanding emotions (r = -0.20), less aware of (r = -0.28) and less accepting of their own emotions (r = -0.49), and report less emotional self-efficacy (r = -0.36). More anxious children use more support-seeking coping strategies (r = 0.07) and are more likely to use less adaptive coping strategies including avoidant coping (r = 0.18), externalizing (r = 0.18), and maladaptive cognitive coping (r = 0.34). Emotion acceptance and awareness, emotional self-efficacy, and maladaptive cognitive coping yielded the largest effect sizes. Some effects varied with children's age. The findings inform intervention and treatment programs of anxiety in youth and identify several areas for future research.

Effects of social anxiety on metaphorical associations between emotional valence and clothing brightness.

PubMed

Ishikawa, Kenta; Suzuki, Hikaru; Okubo, Matia

2018-06-05

Individuals with social anxiety have various types of deficiencies in emotional processing. Diversity of deficiencies may imply that socially anxious individuals have malfunctions in fundamental parts of emotional processing. Therefore, we hypothesized that social anxiety contributes to deficiencies in building on the metaphorical relationship between emotional experience and brightness. We conducted a judgment task of valences of faces with manipulated clothing brightness (bright or dark). A congruency effect between the emotional valence and clothing brightness was observed in participants with low social anxiety. However, this pattern was not found in participants with high social anxiety. The results suggested that a deficiency in metaphorical associations leads to maladaptive emotional processing in individuals with social anxiety. Our findings cannot be directly generalized to clinical populations. Such populations should be tested in the future studies. We may expand Lakoff and Johnson's (1999) conceptual metaphor theory by showing the relationships between social anxiety and malfunction in metaphorical processing. Malfunctions in metaphorical processing could lead to various types of psychological disorders which have deficiencies in emotional processing. Copyright © 2018 Elsevier Ltd. All rights reserved.

The affective tie that binds: Examining the contribution of positive emotions and anxiety to relationship formation in social anxiety disorder.

PubMed

Taylor, Charles T; Pearlstein, Sarah L; Stein, Murray B

2017-06-01

Individuals with social anxiety disorder (SAD) have difficulty forming social relationships. The prevailing clinical perspective is that negative emotions such as anxiety inhibit one's capacity to develop satisfying social connections. However, empirical findings from social psychology and affective neuroscience suggest that positive emotional experiences are fundamental to establishing new social bonds. To reconcile these perspectives, we collected repeated measurements of anxiety, positive emotions (pleasantness), and connectedness over the course of a controlled relationship formation encounter in 56 participants diagnosed with SAD (64% female; M age =23.3, SD=4.7). Participants experienced both increases in positive emotions and decreases in anxiety throughout the interaction. Change in positive emotions was the most robust predictor of subsequent increases in connectedness, as well as a greater desire to engage one's partner in future social activities, above and beyond reductions in anxiety (medium to large sized effects). Those findings suggest that anxiety-based models alone may not fully explain difficulties in relationship formation in SAD, and underscore the potential value of considering positive emotional experiences in conceptual and treatment models of SAD. Copyright © 2017 Elsevier Ltd. All rights reserved.

Trajectories of Change in Emotion Regulation and Social Anxiety During Cognitive-Behavioral Therapy for Social Anxiety Disorder

PubMed Central

Goldin, Philippe R.; Lee, Ihno; Ziv, Michal; Jazaieri, Hooria; Heimberg, Richard G.; Gross, James J.

2014-01-01

Cognitive-behavioral therapy (CBT) for social anxiety disorder (SAD) may decrease social anxiety by training emotion regulation skills. This randomized controlled trial of CBT for SAD examined changes in weekly frequency and success of cognitive reappraisal and expressive suppression, as well as weekly intensity of social anxiety among patients receiving 16 weekly sessions of individual CBT. We expected these variables to (1) differ from pre-to-post-CBT vs. Waitlist, (2) have differential trajectories during CBT, and (3) covary during CBT. We also expected that weekly changes in emotion regulation would predict (4) subsequent weekly changes in social anxiety, and (5) changes in social anxiety both during and post-CBT. Compared to Waitlist, CBT increased cognitive reappraisal frequency and success, decreased social anxiety, but had no impact on expressive suppression. During CBT, weekly cognitive reappraisal frequency and success increased, whereas weekly expressive suppression frequency and social anxiety decreased. Weekly decreases in social anxiety were associated with concurrent increases in reappraisal success and decreases in suppression frequency. Granger causality analysis showed that only reappraisal success increases predicted decreases in subsequent social anxiety during CBT. Reappraisal success increases pre-to-post-CBT predicted reductions in social anxiety symptom severity post-CBT. The trajectory of weekly changes in emotion regulation strategies may help clinicians understand whether CBT is effective and predict decreases in social anxiety. PMID:24632110

Unemployment, Parental Distress and Youth Emotional Well-Being: The Moderation Roles of Parent-Youth Relationship and Financial Deprivation.

PubMed

Frasquilho, Diana; de Matos, Margarida Gaspar; Marques, Adilson; Neville, Fergus G; Gaspar, Tânia; Caldas-de-Almeida, J M

2016-10-01

We investigated, in a sample of 112 unemployed parents of adolescents aged 10-19 years, the links between parental distress and change in youth emotional problems related to parental unemployment, and the moderation roles of parent-youth relationship and financial deprivation. Data were analyzed using descriptive statistics and correlations. Further, simple moderation, additive moderation, and moderated moderation models of regression were performed to analyze the effects of parental distress, parent-youth relationship and financial deprivation in predicting change in youth emotional problems related to parental unemployment. Results show that parental distress moderated by parent-youth relationship predicted levels of change in youth emotional problems related to parental unemployment. This study provides evidence that during job loss, parental distress is linked to youth emotional well-being and that parent-youth relationships play an important moderation role. This raises the importance of further researching parental distress impacts on youth well-being, especially during periods of high unemployment rates.

Perceived emotional social support in bereaved spouses mediates the relationship between anxiety and depression.

PubMed

Jacobson, Nicholas C; Lord, Kayla A; Newman, Michelle G

2017-03-15

Prior research has shown that anxiety symptoms predict later depression symptoms following bereavement. Nevertheless, no research has investigated mechanisms of the temporal relationship between anxiety and later depressive symptoms or examined the impact of depressive symptoms on later anxiety symptoms following bereavement. The current study examined perceived emotional social support as a possible mediator between anxiety and depressive symptoms in a bereaved sample of older adults (N =250). Anxiety and depressive symptoms were measured at Wave 1 (immediately after bereavement), social support was measured at Wave 2 (18 months after bereavement), and anxiety and depressive symptoms were also measured at Wave 3 (48 months after bereavement). Using Bayesian structural equation models, when controlling for baseline depression, anxiety symptoms significantly positively predicted depressive symptoms 48 months later, Further, perceived emotional social support significantly mediated the relationship between anxiety symptoms and later depressive symptoms, such that anxiety symptoms significantly negatively predicted later emotional social support, and emotional social support significantly negatively predicted later depressive symptoms. Also, when controlling for baseline anxiety, depressive symptoms positively predicted anxiety symptoms 48 months later. However, low emotional social support failed to mediate this relationship. Low perceived emotional social support may be a mechanism by which anxiety symptoms predict depressive symptoms 48 months later for bereaved individuals. Copyright © 2017 Elsevier B.V. All rights reserved.

Perceived Emotional Social Support in Bereaved Spouses Mediates the Relationship between Anxiety and Depression

PubMed Central

Jacobson, Nicholas C.; Lord, Kayla A.; Newman, Michelle G.

2017-01-01

Background Prior research has shown that anxiety symptoms predict later depression symptoms following bereavement. Nevertheless, no research has investigated mechanisms of the temporal relationship between anxiety and later depressive symptoms or examined the impact of depressive symptoms on later anxiety symptoms following bereavement. Methods The current study examined perceived emotional social support as a possible mediator between anxiety and depressive symptoms in a bereaved sample of older adults (N = 250). Anxiety and depressive symptoms were measured at Wave 1 (immediately after bereavement), social support was measured at Wave 2 (18 months after bereavement), and anxiety and depressive symptoms were also measured at Wave 3 (48 months after bereavement). Results Using Bayesian structural equation models, when controlling for baseline depression, anxiety symptoms significantly positively predicted depressive symptoms 48 months later, Further, perceived emotional social support significantly mediated the relationship between anxiety symptoms and later depressive symptoms, such that anxiety symptoms significantly negatively predicted later emotional social support, and emotional social support significantly negatively predicted later depressive symptoms. Also, when controlling for baseline anxiety, depressive symptoms positively predicted anxiety symptoms 48 months later. However, low emotional social support failed to mediate this relationship. Conclusions Low perceived emotional social support may be a mechanism by which anxiety symptoms predict depressive symptoms 48 months later for bereaved individuals. PMID:28103522

Longitudinal relationship between diabetes-specific emotional distress and follow-up HbA1c in adults with Type 1 diabetes mellitus

PubMed Central

Strandberg, R B; Graue, M; Wentzel-Larsen, T; Peyrot, M; Thordarson, H B; Rokne, B

2015-01-01

Aim To examine whether diabetes-specific emotional distress was related to follow-up glycaemic control in adults with Type 1 diabetes mellitus. Methods Adults with Type 1 diabetes mellitus completed the Diabetes Distress Scale and reported sociodemographic information when attending a clinical consultation at a university endocrinology unit. Blood samples to determine baseline HbA1c were taken during consultations. All respondents’ HbA1c measurements registered from January 2009 to December 2011 were collected from medical records. The relationship between baseline diabetes-specific emotional distress and HbA1c was examined with linear mixed-effects models in 175 patients with complete data. Results After controlling for confounders, baseline diabetes-specific emotional distress and glycaemic control were significantly associated (fixed-effect coefficient 0.40, P < 0.001) and the regimen-related distress subscale had the strongest association with glycaemic control (fixed-effect coefficient 0.47, P < 0.001). The two-item measure of diabetes-specific distress had a weaker but still significant association with glycaemic control (fixed-effect coefficient 0.31, P < 0.001). None of these relationships was significant after adjusting for the baseline HbA1c. Conclusions People with elevated baseline diabetes-specific emotional distress are at risk of prolonged suboptimum glycaemic control; therefore, elevated diabetes-specific emotional distress, especially regimen-related distress, might be an important marker for prolonged suboptimum glycaemic control, and might indicate a need for special attention regarding patient self-management. What’s new? In adults with Type 1 diabetes, elevated baseline diabetes-specific emotional distress is associated with worse glycaemic control over a 1–3-year period and regimen-related distress had the strongest association with subsequent glycaemic control. Baseline diabetes-specific emotional distress is associated with the

Coping and emotional distress during acute hospitalization in older persons with earlier trauma: the case of Holocaust survivors.

PubMed

Kimron, Lee; Cohen, Miri

2012-06-01

Older persons with earlier trauma are often more vulnerable to stresses of old age. To examine the levels of emotional distress in relation to cognitive appraisal of acute hospitalization and coping strategies in Holocaust survivors compared with an age- and education-matched group of elderly persons without Holocaust experience. This is a cross-sectional study of 63 Holocaust survivors, 65 years and older, hospitalized for an acute illness, and 57 age-, education- and hospital unit-matched people without Holocaust experience. Participants completed appraisal and coping strategies (COPE) questionnaires, and the brief symptoms inventory (BSI-18). Holocaust survivors reported higher levels of emotional distress, appraised the hospitalization higher as a threat and lower as a challenge, and used more emotion-focused and less problem-focused or support-seeking coping strategies than the comparison group. Study variables explained 65% of the variance of emotional distress; significant predictors of emotional distress in the final regression model were not having a partner and more use of emotion-focused coping. The latter mediated the relation of group variable and challenge appraisal to emotional distress. Health professionals must be aware of the potential impact of the hospital environment on the survivors of Holocaust as well as survivors of other trauma. Being sensitive to their specific needs may reduce the negative impact of hospitalization.

Emotional reactivity to daily events in youth with anxiety disorders.

PubMed

Herres, Joanna; Caporino, Nicole E; Cummings, Colleen M; Kendall, Philip C

2018-05-07

Although research supports associations between anxiety and emotional reactivity in adults (Cisler, J. M., Olatunji, B. O., Feldner, M. T., & Forsyth, J. P. (2010). Emotion regulation and the anxiety disorders: an integrative review. Journal of Psychopathology and Behavioral Assessment, 32(1), 68-82.), few studies have examined emotional reactivity in anxious youth (e.g., Carthy et al., 2010; Tan, P. Z., Forbes, E. E., Dahl, R. E., Ryan, N. D., Siegle, G. J., Ladouceur, C. D., & Silk, J. S. (2012). Emotional reactivity and regulation in anxious and nonanxious youth: a cell-phone ecological momentary assessment study. Journal of Child Psychology and Psychiatry, 53(2), 197-206.). Using daily diary methodology, this study examined both negative affect (NA) and positive affect (PA) reactivity to daily events in youth diagnosed with anxiety (N = 68; 60% female; 78% non-Hispanic White; M age = 11.18 years, SD = 3.17). We also examined whether parent-reported emotion regulation would predict emotional reactivity. Participants reported more NA on days they experienced more negative parent and teacher events and less PA on days that they experienced more negative peer events. Additionally, better emotion regulation was associated with less NA reactivity to negative teacher events and to both negative and positive academic events. Interpersonal events have a salient effect on daily affect for anxious youth. Youth anxiety therapists should target emotion regulation associated with negative events involving adults and address barriers to developing and maintaining positive peer relationships.

Emotional clarity and attention to emotions in cognitive behavioral group therapy and mindfulness-based stress reduction for social anxiety disorder.

PubMed

Butler, Rachel M; Boden, Matthew T; Olino, Thomas M; Morrison, Amanda S; Goldin, Philippe R; Gross, James J; Heimberg, Richard G

2018-04-01

We examined (1) differences between controls and patients with social anxiety disorder (SAD) in emotional clarity and attention to emotions; (2) changes in emotional clarity and attention to emotions associated with cognitive-behavioral group therapy (CBGT), mindfulness-based stress reduction (MBSR), or a waitlist (WL) condition; and (3) whether emotional clarity and attention to emotions moderated changes in social anxiety across treatment. Participants were healthy controls (n = 37) and patients with SAD (n = 108) who were assigned to CBGT, MBSR, or WL in a randomized controlled trial. At pretreatment, posttreatment, and 12-month follow-up, patients with SAD completed measures of social anxiety, emotional clarity, and attention to emotions. Controls completed measures at baseline only. At pretreatment, patients with SAD had lower levels of emotional clarity than controls. Emotional clarity increased significantly among patients receiving CBGT, and changes were maintained at 12-month follow-up. Emotional clarity at posttreatment did not differ between CBGT and MBSR or between MBSR and WL. Changes in emotional clarity predicted changes in social anxiety, but emotional clarity did not moderate treatment outcome. Analyses of attention to emotions were not significant. Implications for the role of emotional clarity in the treatment of SAD are discussed. Copyright © 2018 Elsevier Ltd. All rights reserved.

Identification of Distress in Oncology Patients: A Comparison of the Hospital Anxiety and Depression Scale and a Thorough Clinical Assessment.

PubMed

Thalén-Lindström, Annika M; Glimelius, Bengt G; Johansson, Birgitta B

2016-01-01

Screening is recommended to identify cancer patients with distress, anxiety, and depression. The ability of current methods to identify distress in oncology patients is of high importance. We compared the Hospital Anxiety and Depression Scale (HADS) with a thorough clinical assessment. Furthermore, we explored the agreement of HADS with clinical assessment outcomes as a function of age, sex, and treatment intention. One hundred forty-six oncology patients, representing both sexes, different ages (<65/≥ 65 years), and treatment intention (curative/palliative), completed the HADS before the clinical assessment. Two study team members (blind to the HADS results) completed clinical assessments of anxiety, depression, and distress analogous to categories used in the HADS. The HADS identified 49 participants and the clinical assessment 71 participants as having anxiety, depression, or distress. The overall agreement between the HADS and the clinical assessment was moderate. The greatest differences were found to be a function of participant sex and age. Agreement between the methods was better for females than for males in relation to distress and anxiety and better for the older (≥ 65 years) than younger participants in relation to depression. By treatment intention, agreement was equal for all domains. Especially male and young participants appear to have potential problems that the HADS fails to identify. When the HADS is used for screening, nurses must be aware of psychosocial problems perceived by patients that are not covered by the HADS. Many patients identified as having distress have resources to manage problems without additional support.

Psychological Factors Associated with Emotional Distress among Palestinian Arabs from East Jerusalem Accessing Psychiatric Care in Israel.

PubMed

Nakash, Ora; Nagar, Maayan; Levav, Itzhak; Danilovich, Eli; Abu-Tair, Mamoun; Podolsky, Grigory

2016-01-01

The Palestinian population residing in East Jerusalem is characterized by high rates of poverty and unemployment and is subject to discrimination in various forms, including infrastructure of mental health services. Little is known about the help seeking needs and practices of East Jerusalem residents. We examined socio-demographic and clinical characteristics of a consecutive sample Palestinian residents from East Jerusalem (N=50) who accessed a specially assigned psychiatric clinic in Israel. In addition, we examined the psychological factors associated with emotional distress among these service-users upon entry to care. Participants completed a survey in Arabic that included a socio-demographic questionnaire and measures assessing emotional distress, perceived exposure to discrimination and social support, and mental health stigma. Participants reported high levels of emotional distress. Female gender, low socioeconomic status, higher perceived exposure to discrimination and higher perceived social support were associated with increased emotional distress. Findings add to the scarce body of knowledge on specific mental health characteristics of East Jerusalem Palestinian residents.

Distress and functioning in mixed anxiety and depressive disorder.

PubMed

Małyszczak, Krzysztof; Pawłowski, Tomasz

2006-04-01

The aim of the present study was to evaluate the validity of mixed anxiety and depressive disorder (MADD) with reference to functional characteristics and symptomatic characteristics in comparison with anxiety disorders, depressive disorders, and groups showing subthreshold symptoms (exclusively depressive or anxiety related). The present study was carried out in the following three medical settings: two psychiatric and one primary care. Patients seeking care in psychiatric institutions due to anxiety and depressive symptoms and attending primary medical settings for any reason were taken into account. A total of 104 patients (65 women and 39 men, mean age 41.1 years) were given a General Health Questionnaire (GHQ-30), Global Assessment of Functioning (GAF) and Present State Examination questionnaire, a part of Schedules for Clinical Assessment in Neuropsychiatry, Version 2.0. There were no statistically relevant differences between MADD and anxiety disorders in median GHQ score (19 vs 16) and median GAF score (median 68.5 vs 65). When considering depressive disorders the median GHQ score (28) was higher, and median GAF score (59) was lower than that in MADD. In groups with separated subthreshold anxiety or depressive symptoms, median GHQ scores (12) were lower and median GAF scores (75) were higher than that in MADD. The most frequent symptoms of MADD are symptoms of generalized anxiety disorder (GAD) and depression. Mixed anxiety and depressive disorder differs significantly from GAD only in higher rates of depressed mood and lower rates of somatic anxiety symptoms. Distinction from depression was clearer; six of 10 depressive symptoms are more minor in severity in MADD than in the case of depression. Distress and interference with personal functions in MADD are similar to that of other anxiety disorders. A pattern of MADD symptoms locates this disorder between depression and GAD.

Emotional distress in the Hebrew Bible. Somatic or psychological?

PubMed

Mumford, D B

1992-01-01

A systematic search was made in the Hebrew Bible for expressions of emotional distress. A wide range of somatic and psychological vocabulary was found, especially in the Psalms and other poetic literature. Somatic expressions most frequently involved the heart, bowels, belly, bones, and eyes. Head symptoms were rare. Metaphors referring to the heart were common; other somatic expressions appeared to be descriptions of actual physical sensations. Usually somatic and psychological expressions were paired together, utilising the 'parallelism' of Hebrew verse form. Biblical Hebrew thus incorporated a powerful and sophisticated language of emotional expression.

Does exercise habit strength moderate the relationship between emotional distress and short-term memory in Malaysian primary school children?

PubMed

Zainol, Nurul Ain; Hashim, Hairul Anuar

2015-01-01

We examined the moderating effects of exercise habit strength on the relationship between emotional distress and short-term memory in primary school children. The sample consisted of 165 primary school students (10-12 years old). Participants completed measures of emotional distress, exercise habit strength, and the Digit Span Test. Mid-year exam results were used as an indicator of academic performance. Structural equation modelling (SEM) was used to analyse the data. The results of SEM revealed an acceptable fit for the hypothesised model. Exercise habit was positively associated with short-term memory, and better short-term memory was associated with better academic performance. However, although an inverse relationship was found between emotional distress and short-term memory, a positive association was found between exercise habit strength and emotional distress. The findings indicate that exercise habit is positively associated with cognitive ability and mediates the negative effect of distress.

Emotion malleability beliefs, emotion regulation, and psychopathology: Integrating affective and clinical science.

PubMed

Kneeland, Elizabeth T; Dovidio, John F; Joormann, Jutta; Clark, Margaret S

2016-04-01

Beliefs that individuals hold about whether emotions are malleable or fixed, also referred to as emotion malleability beliefs, may play a crucial role in individuals' emotional experiences and their engagement in changing their emotions. The current review integrates affective science and clinical science perspectives to provide a comprehensive review of how emotion malleability beliefs relate to emotionality, emotion regulation, and specific clinical disorders and treatment. Specifically, we discuss how holding more malleable views of emotion could be associated with more active emotion regulation efforts, greater motivation to engage in active regulatory efforts, more effort expended regulating emotions, and lower levels of pathological distress. In addition, we explain how extending emotion malleability beliefs into the clinical domain can complement and extend current conceptualizations of major depressive disorder, social anxiety disorder, and generalized anxiety disorder. This may prove important given the increasingly central role emotion dysregulation has been given in conceptualization and intervention for these psychiatric conditions. Additionally, discussion focuses on how emotion beliefs could be more explicitly addressed in existing cognitive therapies. Promising future directions for research are identified throughout the review. Copyright © 2016 Elsevier Ltd. All rights reserved.

Mindfulness facets, trait emotional intelligence, emotional distress, and multiple health behaviors: A serial two-mediator model.

PubMed

Jacobs, Ingo; Wollny, Anna; Sim, Chu-Won; Horsch, Antje

2016-06-01

In the present study, we tested a serial mindfulness facets-trait emotional intelligence (TEI)-emotional distress-multiple health behaviors mediation model in a sample of N = 427 German-speaking occupational therapists. The mindfulness facets-TEI-emotional distress section of the mediation model revealed partial mediation for the mindfulness facets Act with awareness (Act/Aware) and Accept without judgment (Accept); inconsistent mediation was found for the Describe facet. The serial two-mediator model included three mediational pathways that may link each of the four mindfulness facets with multiple health behaviors. Eight out of 12 indirect effects reached significance and fully mediated the links between Act/Aware and Describe to multiple health behaviors; partial mediation was found for Accept. The mindfulness facet Observe was most relevant for multiple health behaviors, but its relation was not amenable to mediation. Implications of the findings will be discussed. © 2016 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

Effect of rational and irrational statements on intensity and 'inappropriateness' of emotional distress and irrational beliefs in psychotherapy patients.

PubMed

Cramer, D; Kupshik, G

1993-09-01

Ellis's rational-emotive theory postulates that since irrational statements augment emotional distress, replacing irrational with rational statements should lessen distress. This hypothesis was tested in the initial stages of psychotherapy by having 13 and 14 clinical out-patients respectively repeat for one minute either rational or irrational statements about their major presenting psychological problem. The distinction by Ellis & Harper (1975) that 'inappropriate' emotions differ qualitatively from 'appropriate' emotions was also examined. Although the experimental intervention had no effect on a post-test measure of irrational beliefs, patients repeating rational statements had significantly lower appropriate and inappropriate negative emotions at post-test, suggesting that inappropriate emotions do not differ qualitatively from appropriate emotions and that making rational statements may lower emotional distress in patients. Patients reiterating irrational statements showed no change in emotions, implying that these kinds of irrational cognitions may have already been present.

Conditioned Emotional Distress in Women Receiving Chemotherapy for Breast Cancer.

ERIC Educational Resources Information Center

Jacobsen, Paul B.; And Others

1995-01-01

Investigated whether women undergoing outpatient chemotherapy for breast cancer can develop classically conditioned emotional distress. Patients' responses to a distinctive stimulus were assessed in a location not associated with chemotherapy administration. Results supported hypothesis that pairing a distinctive stimulus with chemotherapy would…

Predictors of psychological distress after diagnosis in breast cancer patients and patients with benign breast problems.

PubMed

Ando, Noriko; Iwamitsu, Yumi; Kuranami, Masaru; Okazaki, Shigemi; Nakatani, Yuki; Yamamoto, Kenji; Watanabe, Masahiko; Miyaoka, Hitoshi

2011-01-01

The objective of this study was to determine how age and psychological characteristics assessed prior to diagnosis could predict psychological distress in outpatients immediately after disclosure of their diagnosis. This is a longitudinal and prospective study, and participants were breast cancer patients and patients with benign breast problems (BBP). Patients were asked to complete questionnaires to determine levels of the following: trait anxiety (State-Trait Anxiety Inventory), negative emotional suppression (Courtauld Emotional Control Scale), life stress events (Life Experiences Survey), and psychological distress (Profile of Mood Status) prior to diagnosis. They were asked to complete a questionnaire measuring psychological distress after being told their diagnosis. We analyzed a total of 38 women diagnosed with breast cancer and 95 women diagnosed with a BBP. A two-way analysis of variance (prior to, after diagnosis × cancer, benign) showed that psychological distress after diagnosis among breast cancer patients was significantly higher than in patients with a BBP. The multiple regression model accounted for a significant amount of variance in the breast cancer group (model adjusted R(2) = 0.545, p < 0.001), and only trait anxiety was statistically significant (β = 0.778, p < 0.001). In the BBP group, the multiple regression analysis yielded a significant result (model adjusted R(2) = 0.462, p < 0.001), with trait anxiety and negative life changes as statistically significant factors (β = 0.449 and 0.324 respectively; p < 0.01). In both groups, trait anxiety assessed prior to diagnosis was the significant predictor of psychological distress after diagnosis, and might have prospects as a screening method for psychologically vulnerable women. Copyright © 2011 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

Examination of Anxiety Sensitivity and Distress Tolerance as Transdiagnostic Mechanisms Linking Multiple Anxiety Pathologies to Alcohol Use Problems in Adolescents

PubMed Central

Wolitzky-Taylor, Kate; Guillot, Casey R.; Pang, Raina D.; Kirkpatrick, Matthew G.; Zvolensky, Michael J.; Buckner, Julia D.; Leventhal, Adam M.

2015-01-01

Background Multiple forms of anxiety psychopathology are associated with alcohol use problems in adolescents. Yet, the mechanisms underlying this association are unclear. Anxiety sensitivity (AS) and distress tolerance (DT) represent 2 distinct, conceptually relevant transdiagnostic constructs implicated in multiple manifestations of anxiety that may also underlie alcohol use problems and thereby explain why people with anxiety are more likely to have alcohol problems. Methods The current cross-sectional study examined whether AS and DT accounted for (i.e., statistically mediated) the relationship between manifest indicators of the 3 common anxiety phenotypes (generalized anxiety, social anxiety, and panic disorders) and alcohol problems in a sample of 534 high school students (14 to 15 years old). Results Multiple manifestations of anxiety were associated with greater alcohol use problems. AS statistically mediated multiple anxiety–alcohol associations, but DT did not. Conclusions These findings provide preliminary evidence suggesting AS may be an important transdiagnostic target for alcohol prevention programs for those in early adolescence that experience elevated anxiety symptoms. PMID:25706521

Neighborhood income inequality, social capital and emotional distress among adolescents: A population-based study.

PubMed

Vilhjalmsdottir, Arndis; Gardarsdottir, Ragna B; Bernburg, Jon Gunnar; Sigfusdottir, Inga Dora

2016-08-01

Theory holds that income inequality may harm adolescent mental health by reducing social capital within neighborhood communities. However, research on this topic has been very limited. We use multilevel data on 102 public schools and 5958 adolescents in Iceland (15 and 16 years old) to examine whether income inequality within neighborhoods is associated with emotional distress in adolescents. Moreover, we test whether indicators of social capital, including social trust and embeddedness in neighborhood social networks, mediate this contextual effect. The findings show that neighborhood income inequality positively influences emotional distress of individual adolescents, net of their personal household situations and social relations. However, although the indicators of social capital negatively influence emotional distress, they do not mediate the contextual effect of neighborhood income inequality. The study illustrates the role of economic disparities in adolescent mental health, but calls for more research on the underlying social and social-psychological mechanisms. Copyright © 2016 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Emotional Distress Among LGBT Youth: The Influence of Perceived Discrimination Based on Sexual Orientation

PubMed Central

Almeida, Joanna; Johnson, Renee M.; Corliss, Heather L.; Molnar, Beth E.; Azrael, Deborah

2013-01-01

The authors evaluated emotional distress among 9th-12th grade students, and examined whether the association between LGBT status and emotional distress was mediated by perceptions of having been treated badly or discriminated against because others thought they were gay or lesbian. Data come from a school-based survey in Boston, MA (n=1,032); 10% were LGBT, 58% were female, and age ranged from 13-19 years. About 45% were Black, 31% were Hispanic, and 14% were White. LGBT youth scored significantly higher on the scale of depressive symptomatology. They were also more likely than heterosexual, non-transgendered youth to report suicidal ideation (30% vs. 6%, p<0.0001) and self-harm (5% vs. 3%, p<0.0001). Mediation analyses showed that perceived discrimination accounted for increased depressive symptomatology among LGBT males and females, and accounted for an elevated risk of self-harm and suicidal ideation among LGBT males. Perceived discrimination is a likely contributor to emotional distress among LGBT youth. PMID:19636742

The role of emotion and emotion regulation in social anxiety disorder.

PubMed

Jazaieri, Hooria; Morrison, Amanda S; Goldin, Philippe R; Gross, James J

2015-01-01

Many psychiatric disorders involve problematic patterns of emotional reactivity and regulation. In this review, we consider recent findings regarding emotion and emotion regulation in the context of social anxiety disorder (SAD). We first describe key features of SAD which suggest altered emotional and self-related processing difficulties. Next, we lay the conceptual foundation for a discussion of emotion and emotion regulation and present a common framework for understanding emotion regulation, the process model of emotion regulation. Using the process model, we evaluate the recent empirical literature spanning self-report, observational, behavioral, and physiological methods across five specific families of emotion regulation processes-situation selection, situation modification, attentional deployment, cognitive change, and response modulation. Next, we examine the empirical evidence behind two psychosocial interventions for SAD: cognitive behavioral therapy (CBT) and mindfulness-based stress reduction (MBSR). Throughout, we present suggestions for future directions in the continued examination of emotion and emotion regulation in SAD.

Neural basis of emotional decision making in trait anxiety.

PubMed

Xu, Pengfei; Gu, Ruolei; Broster, Lucas S; Wu, Runguo; Van Dam, Nicholas T; Jiang, Yang; Fan, Jin; Luo, Yue-jia

2013-11-20

Although trait anxiety has been associated with risk decision making, whether it is related to risk per se or to the feeling of the risk, as well as the underlying neurocognitive mechanisms, remains unclear. Using a decision-making task with a manipulation of frame (i.e., written description of options as a potential gain or loss) and functional magnetic resonance imaging, we investigated the neurocognitive relationship between trait anxiety and decision making. The classic framing effect was observed: participants chose the safe option when it was described as a potential gain, but they avoided the same option when it was described as a potential loss. Most importantly, trait anxiety was positively correlated with this behavioral bias. Trait anxiety was also positively correlated with amygdala-based "emotional" system activation and its coupling with the ventromedial prefrontal cortex (vmPFC) when decisions were consistent with the framing effect, but negatively correlated with the dorsal anterior cingulate cortex (dACC)-based "analytic" system activation and its connectivity to the vmPFC when decisions ran counter to the framing effect. Our findings suggest that trait anxiety is not associated with subjective risk preference but an evaluative bias of emotional information in decision making, underpinned by a hyperactive emotional system and a hypoactive analytic system in the brain.

Experiential avoidance as a generalized psychological vulnerability: comparisons with coping and emotion regulation strategies.

PubMed

Kashdan, Todd B; Barrios, Velma; Forsyth, John P; Steger, Michael F

2006-09-01

Extending previous work, we conducted two studies concerning the toxic influences of experiential avoidance (EA) as a core mechanism in the development and maintenance of psychological distress, and disruption of pleasant, engaging, and spontaneous activity. Of particular interest was whether EA accounted for relationships between coping and emotion regulation strategies on anxiety-related pathology (Study 1) and psychological distress and hedonic functioning over the course of a 21-day monitoring period (Study 2). In Study 1, EA mediated the effects of maladaptive coping, emotional responses styles, and uncontrollability on anxiety-related distress (e.g., anxiety sensitivity, trait anxiety, suffocation fears, and body sensation fears). In Study 2, EA completely mediated the effects of two emotion regulation strategies (i.e., suppression and reappraisal) on daily negative and positive experiences and was associated with diminished daily positive affective experiences and healthy life appraisals, diminished frequency of positive events and more frequent negative life events, and greater negative affective experiences. The present data show that cognitive reappraisal, a primary process of traditional cognitive-behavior therapy, was much less predictive of the quality of psychological experiences and events in everyday life compared with EA. Further consideration of experiential avoidance as a generalized diathesis and toxic process will be useful in improving our understanding of the etiology, phenomenology, and treatment of anxiety conditions, general human suffering, and disruptions in hedonic capacity.

Task relevance of emotional information affects anxiety-linked attention bias in visual search.

PubMed

Dodd, Helen F; Vogt, Julia; Turkileri, Nilgun; Notebaert, Lies

2017-01-01

Task relevance affects emotional attention in healthy individuals. Here, we investigate whether the association between anxiety and attention bias is affected by the task relevance of emotion during an attention task. Participants completed two visual search tasks. In the emotion-irrelevant task, participants were asked to indicate whether a discrepant face in a crowd of neutral, middle-aged faces was old or young. Irrelevant to the task, target faces displayed angry, happy, or neutral expressions. In the emotion-relevant task, participants were asked to indicate whether a discrepant face in a crowd of middle-aged neutral faces was happy or angry (target faces also varied in age). Trait anxiety was not associated with attention in the emotion-relevant task. However, in the emotion-irrelevant task, trait anxiety was associated with a bias for angry over happy faces. These findings demonstrate that the task relevance of emotional information affects conclusions about the presence of an anxiety-linked attention bias. Copyright © 2016 Elsevier B.V. All rights reserved.

Maternal cognitions about distress and anxiety in young Latino children with disruptive behaviors.

PubMed

Arcia, Emily; Castillo, Hector; Fernández, María C

2004-03-01

This study was undertaken to describe how Caribbean Latina mothers understand distress in children, the behaviors that they attribute to it, and the labels that they use to express their cognitions. Findings from 62 mothers of young children with disruptive behaviors indicated that mothers made attributions about anxiety in 40% of the children with a high likelihood of clinical anxiety. Hyperactive and restless behavior, but not children's fears, was understood by mothers to reflect anxiety. References to 'nervios' could be categorized into: an illness condition, a crisis condition, and a temperament type. Only temperament usage was applied to children.

A rational-emotive stress management intervention for reducing job burnout and dysfunctional distress among special education teachers

PubMed Central

Ugwoke, Samuel C.; Eseadi, Chiedu; Onuigbo, Liziana N.; Aye, Eucharia N.; Akaneme, Immaculata N.; Oboegbulem, Angie I.; Ezenwaji, Ifeyinwa O.; Nwobi, Anthonia U.; Nwaubani, Okechukwu O.; Ezegbe, Bernedeth N.; Ede, Moses O.; Orji, Chibueze T.; Onuoha, Joseph C.; Onu, Eucharia U.; Okeke, Francisca; Agu, Patricia; Omeje, Joachim C.; Omeke, Faith; Ugwu, Romanus; Arumede, Florence; Eneh, Annastasia

2018-01-01

Abstract Background: Job-related burnout and distress are adverse stress responses which affect individuals in their occupational environment. This study aimed at investigating the effect of a rational-emotive stress management program on job burnout and dysfunctional distress among special education teachers in Nigeria. Methods: A pretest–posttest randomized control group design was used. The participants in the study were 54 special education teachers. Data were collected using self-report questionnaires. Participants were allocated to either the treatment group (n = 28 [59.1%]) or the waitlist control group (n = 26 [48.1%]), respectively. A rational-emotive stress management manual was used to deliver the intervention. We statistically analyzed the data collected at three-time points with repeated-measures analysis of variance. Results: At baseline, the job-related burnout symptoms and distress scores of participants were high. However, an intention-to-treat analysis showed that the rational-emotive stress management intervention program was efficacious in reducing the levels of job-related burnout symptoms and dysfunctional distress among participants assigned to the treatment group, compared to a waitlisted group at post-treatment and follow-up meetings. Conclusion: Our study demonstrates the effectiveness of a rational-emotive stress management intervention in reducing the level of job-related burnout and distress in a sample of special education teachers in Nigeria. Occupational health counsellors and other clinicians with sufficient knowledge of rational-emotive behavior therapy framework are urged to employ this approach in assisting other employees in managing job burnout symptoms, and distress. PMID:29703004

Operating characteristics of depression and anxiety disorder phenotype dimensions and trait neuroticism: a theoretical examination of the fear and distress disorders from the Netherlands study of depression and anxiety.

PubMed

Tully, Phillip J; Wardenaar, Klaas J; Penninx, Brenda W J H

2015-03-15

The receiver operating characteristics (ROC) of anhedonic depression and anxious arousal to detect the distress- (major depression, dysthymia, generalized anxiety disorder) and fear-disorder clusters (i.e. panic disorder, agoraphobia, social phobia) have not been reported in a large sample. A sample of 2981 persons underwent structured psychiatric interview; n=652 were without lifetime depression and anxiety disorder history. Participants also completed a neuroticism scale (Revised NEO Five Factor Inventory [NEO-FFI]), and the 30-item short adaptation of the Mood and Anxiety Symptoms Questionnaire (MASQ-D30) measuring anhedonic depression, anxious arousal and general distress. Maximal sensitivity and specificity was determined by the Youden Index and the area-under-the-curve (AUC) in ROC analysis. A total of 2624 completed all measures (age M=42.4 years±13.1, 1760 females [67.1%]), including 1060 (40.4%) persons who met criteria for a distress-disorder, and 973 (37.1%) who met criteria for a fear-disorder. The general distress dimension provided the highest ROC values in the detection of the distress-disorders (AUC=.814, sensitivity=71.95%, specificity=76.34%, positive predictive value=67.33, negative predictive value=80.07). None of the measures provided suitable operating characteristics in the detection of the fear-disorders with specificity values <75%. Over sampling of depression and anxiety disorders may lead to inflated positive- and negative predictive values. The MASQ-D30 general distress dimension showed clinically suitable operating characteristics in the detection of distress-disorders. Neither neuroticism nor the MASQ-D30 dimensions provided suitable operating characteristics in the detection of the fear-disorders. Copyright © 2014 Elsevier B.V. All rights reserved.

Anxiety and depression states of adolescents with polycystic ovary syndrome

PubMed

Emeksiz, Hamdi Cihan; Bideci, Aysun; Nalbantoğlu, Burçin; Nalbantoğlu, Ayşin; Çelik, Cem; Yulaf, Yasemin; Çamurdan, Mahmut Orhun; Cinaz, Peyami

2018-06-14

Background/aim: Various studies have shown that adult patients with polycystic ovary syndrome (PCOS) have higher levels of anxiety and depression compared to their normal counterparts. However, it is still unclear whether these mood disorders already exist in adolescents affected by PCOS. The aim of the present study is to assess differences in anxiety and depression levels between adolescents with PCOS and age- and body mass index (BMI)-matched controls and to determine the possible factor(s) impacting these psychological parameters in adolescents with PCOS. Materials and methods: The study included 80 adolescents with PCOS and 50 age- and BMI-matched controls. All participants completed standardized questionnaires assessing anxiety and depression. A multiple linear regression model was used to analyze the impact of potential variables on anxiety and depression scores of the adolescents with PCOS. Results: Significantly higher levels of anxiety, specifically generalized and social anxieties, as well as depression were found in adolescents with PCOS compared to controls. Higher BMI was found to be associated with higher levels of depression and generalized anxiety, and higher modified Ferriman-Gallwey score with higher level of panic disorder in adolescents affected by PCOS. Conclusion: Adolescents with PCOS experience significantly more emotional distress compared to adolescents without PCOS. This emotional distress may be related, at least in part, to certain clinical features of PCOS including obesity and hirsutism. PCOS in adolescents should be assessed not only for the gynecological and metabolic aspects but also for the emotional aspects of the disease.

Cognitive risk factors explain the relations between neuroticism and social anxiety for males and females.

PubMed

Allan, Nicholas P; Oglesby, Mary E; Uhl, Aubree; Schmidt, Norman B

2017-04-01

The hierarchical model of vulnerabilities to emotional distress contextualizes the relation between neuroticism and social anxiety as occurring indirectly through cognitive risk factors. In particular, inhibitory intolerance of uncertainty (IU; difficulty in uncertain circumstances), fear of negative evaluation (FNE; fear of being judged negatively), and anxiety sensitivity (AS) social concerns (fear of outwardly observable anxiety) are related to social anxiety. It is unclear whether these risk factors uniquely relate to social anxiety, and whether they account for the relations between neuroticism and social anxiety. The indirect relations between neuroticism and social anxiety through these and other risk factors were examined using structural equation modeling in a sample of 462 individuals (M age = 36.56, SD = 12.93; 64.3% female). Results indicated that the relations between neuroticism and social anxiety could be explained through inhibitory IU, FNE, and AS social concerns. No gender differences were found. These findings provide support for the hierarchical model of vulnerabilities to emotional distress disorders, although the cognitive risk factors accounted for variance beyond their contribution to the relation between neuroticism and social anxiety, suggesting a more complex model than that expressed in the hierarchical model of vulnerabilities.

Social anxiety and romantic relationships: the costs and benefits of negative emotion expression are context-dependent.

PubMed

Kashdan, Todd B; Volkmann, Jeffrey R; Breen, William E; Han, Susan

2007-01-01

In general, expressing emotions is beneficial and withholding emotions has personal and social costs. Yet, to serve social functions there are situations when emotions are withheld strategically. We examined whether social anxiety influenced when and how emotion expressiveness influences interpersonal closeness in existing romantic relationships. For people with greater social anxiety, withholding the expression of negative emotions was proposed to preserve romantic relationships and their benefits. We examined whether social anxiety and emotion expressiveness interacted to predict prospective changes in romantic relationship closeness over a 12-week period. For people with less social anxiety, relationship closeness was enhanced over time when negative emotions were openly expressed whereas relationship deterioration was found for those more likely to withhold emotions. The reverse pattern was found for people with greater social anxiety such that relationship closeness was enhanced over time for those more likely to withhold negative emotions. Related social anxiety findings were found for discrepancies between desired and actual feelings of closeness over time. Findings were not attributable to depressive symptoms. These results suggest that the costs and benefits of emotion expression are influenced by a person's degree of social anxiety.

Emotional Schemas and Resistance to Change in Anxiety Disorders

ERIC Educational Resources Information Center

Leahy, Robert L.

2007-01-01

Cognitive-behavioral treatment for all anxiety disorders involves exposure to feared situations and feared emotions. Dropout from therapy is a continued problem for final treatment effectiveness. A meta-emotional model of fear of negative emotions (and anxious sensations and thoughts) is advanced that can be used as a transdiagnostic treatment…

Cognitive, affective, and behavioral characteristics of mothers with anxiety disorders in the context of child anxiety disorder.

PubMed

Creswell, Cathy; Apetroaia, Adela; Murray, Lynne; Cooper, Peter

2013-02-01

Parental emotional distress, particularly high maternal anxiety, is one of the most consistent predictors of child anxiety treatment outcome. In order to identify the cognitive, affective, and behavioral parenting characteristics of mothers of children with anxiety disorders who themselves have an anxiety disorder, we assessed the expectations, appraisals, and behaviors of 88 mothers of anxious children (44 mothers who were not anxious [NONANX] and 44 mothers with a current anxiety disorder [ANX]) when interacting with their 7-12-year-old children. There were no observed differences in anxiety and avoidance among children of ANX and NONANX mothers, but, compared with NONANX mothers, ANX mothers held more negative expectations, and they differed on observations of intrusiveness, expressed anxiety, warmth, and the quality of the relationship. Associations were moderated by the degree to which children expressed anxiety during the tasks. Maternal-reported negative emotions during the task significantly mediated the association between maternal anxiety status and the observed quality of the relationship. These findings suggest that maternal anxiety disorder is associated with reduced tolerance of children's negative emotions. This may interfere with the maintenance of a positive, supportive mother-child interaction under conditions of stress and, as such, this may impede optimum treatment outcomes. The findings identify potential cognitive, affective, and behavioral targets to improve treatment outcomes for children with anxiety disorders in the context of a current maternal anxiety disorder. 2013 APA, all rights reserved

Adverse Life Experience and Psychological Distress in Adolescence: Moderating and Mediating Effects of Emotion Regulation and Rumination.

PubMed

Boyes, Mark E; Hasking, Penelope A; Martin, Graham

2016-10-01

The current study tested whether emotion regulation and rumination moderated and/or mediated the relationship between accumulated adverse life experience and psychological distress in adolescence. In class, Australian high school students (n = 2637, 12-18 years, 68% female) from 41 schools completed well-validated measures of adverse life experience, emotion regulation, rumination and psychological distress, and were followed up 1 year later (n = 1973, 75% retention rate). Adjusting for age, gender and baseline psychological distress, adverse life experience predicted psychological distress 1 year later. Expressive suppression and rumination were positively associated with psychological distress. Cognitive reappraisal was negatively associated with psychological distress and moderated the relationship between adverse life experience and psychological distress. This relationship was also partially mediated by cognitive reappraisal, expressive suppression and rumination. Promoting cognitive reappraisal and minimizing expressive suppression and rumination may be useful strategies to improve mental health for adolescents who have experienced adverse life events. Future research should examine whether adolescents who have experienced adverse life events can be trained in effective emotion regulation strategies and whether this training can prevent development of psychological maladjustment. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Emotion Dysregulation and Anxiety in Adults with ASD: Does Social Motivation Play a Role?

PubMed

Swain, Deanna; Scarpa, Angela; White, Susan; Laugeson, Elizabeth

2015-12-01

Young adults with ASD and no intellectual impairment are more likely to exhibit clinical levels of anxiety than typically developing peers (DSM-5, American Psychiatric Association, 2013). This study tests a mechanistic model in which anxiety culminates via emotion dysregulation and social motivation. Adults with ASD (49 males, 20 females) completed self-report measures on emotion regulation, caregivers completed measures on ASD severity and both on social anxiety. Results indicated that emotion dysregulation (p < .001; p < .05) and social motivation (p < .05, p < .001) significantly predicted social anxiety as reported by caregivers and young adults respectively. However, social motivation did not appear to play a moderating role in the relationship between emotion regulation and anxiety, even when controlling for social awareness. Significant predictor variables of social anxiety varied based on reporter (i.e. caregiver versus young adult), with difficulty engaging in goal-directed behaviors during negative emotions serving as the only shared predictor.

Emotional Intelligence Moderates Perfectionism and Test Anxiety among Iranian Students

ERIC Educational Resources Information Center

Abdollahi, Abbas; Abu Talib, Mansor

2015-01-01

Test anxiety is one of the common forms of anxiety for students. Thus, it is necessary to improve our knowledge regarding the etiology of test anxiety. The purpose of this study was to explore the relationships between perfectionism, emotional intelligence, and test anxiety among Iranian students. This study also was conducted to test emotional…

The meaning of self-reported death anxiety in advanced cancer.

PubMed

Tong, Eryn; Deckert, Amy; Gani, Nina; Nissim, Rinat; Rydall, Anne; Hales, Sarah; Rodin, Gary; Lo, Chris

2016-09-01

Death anxiety is important but understudied in palliative care. New self-report measurements have been developed, but their interpretation and clinical utility may not be evident. To inform our understanding of death anxiety in patients with advanced cancer by exploring the relationship between this self-reported symptom and its clinical presentation. Participants were part of a psychotherapy trial in advanced cancer. First therapy session transcripts were analyzed using interpretive description in patients reporting low, moderate, and high death anxiety on the Death and Dying Distress Scale (DADDS). A total of 16 participants (10 women and 6 men) with advanced or metastatic cancer were sampled from the Princess Margaret Cancer Centre, Toronto, Canada. Six participants reported low death anxiety scores (Death and Dying Distress Scale: 0-19), five moderate (Death and Dying Distress Scale: 20-50), and five high (Death and Dying Distress Scale: 51-75). The low death anxiety group exhibited psychological readiness for death, or contrastingly, non-reflectiveness about death. The moderate group recognized the imminence of mortality, which impacted treatment decisions and future plans. Prior experience with death was discussed as raising the salience of mortality. The high group felt dominated by powerful emotions and could not make sense of their situation. Their distress was exacerbated by substantial relational concerns. Self-reported death anxiety is affected by the awareness and ability to reflect on mortality. Death and Dying Distress Scale scores may facilitate exploration of this symptom as part of a clinical assessment and may serve to guide treatment approaches. Greater attention to death anxiety is consistent with and recommended by contemporary approaches to palliative care. © The Author(s) 2016.

Explaining the Links between Workload, Distress, and Work-Family Conflict among School Employees: Physical, Cognitive, and Emotional Fatigue

ERIC Educational Resources Information Center

Ilies, Remus; Huth, Megan; Ryan, Ann Marie; Dimotakis, Nikolaos

2015-01-01

This study examined the intraindividual relationships among workload and affective distress; cognitive, physical, and emotional fatigue; and work-family conflict among school employees. Using a repeated-measure, within-person research design, the authors found that work demands and affective distress, as well as cognitive, emotional, and physical…

Maternal Attachment Style and Responses to Adolescents’ Negative Emotions: The Mediating Role of Maternal Emotion Regulation

PubMed Central

Jones, Jason D.; Brett, Bonnie E.; Ehrlich, Katherine B.; Lejuez, Carl W.; Cassidy, Jude

2014-01-01

SYNOPSIS Objective Previous research has examined the developmental consequences, particularly in early childhood, of parents’ supportive and unsupportive responses to children’s negative emotions. Much less is known about factors that explain why parents respond in ways that may support or undermine their children’s emotions, and even less is known about how these parenting processes unfold with adolescents. We examined the associations between mothers’ attachment styles and their distress, harsh, and supportive responses to their adolescents’ negative emotions two years later and whether these links were mediated by maternal emotion regulation difficulties. Design Mothers in a longitudinal study (n = 230) reported on their attachment style, difficulties regulating their emotions, and their hypothetical responses to their adolescents’ negative emotions, respectively, at consecutive laboratory visits one year apart. Results Mothers who reported greater attachment-related avoidance and anxiety reported having greater difficulties with emotion regulation one year later. Emotion dysregulation, in turn, predicted more distressed, harsher, and less supportive maternal responses to adolescents’ negative emotions the following year. In addition, greater avoidance directly predicted harsher maternal responses two years later. Conclusions These findings extend previous research by identifying maternal attachment style as a predictor of responses to adolescent distress and by documenting the underlying role of emotion dysregulation in the link between adult attachment style and parenting. PMID:25568638

Perceived family burden and emotional distress: similarities and differences between mothers and fathers of children with type 1 diabetes in a population-based study.

PubMed

Haugstvedt, Anne; Wentzel-Larsen, Tore; Rokne, Berit; Graue, Marit

2011-03-01

Parenting children with diabetes entail an extra burden for the families. More information is needed about associations between perceived family burden and emotional distress in both mothers and fathers. To analyze (i) perceived burden and emotional distress in mothers and fathers of children with type 1 diabetes and (ii) associations between parental burden and distress and factors related to the child. Mothers (n = 103) and fathers (n = 97) of 115 children (1-15 yr) with type 1 diabetes participated in this population-based survey. The parents completed the Hopkins Symptom Checklist-25 items (HSCL-25), measuring emotional distress, and the Family Burden Scale, which includes five questions measuring perceived family burden related to the child's diabetes. Both mothers and fathers reported that the greatest burden was related to long-term health concerns. The mothers reported a significantly greater burden related to medical treatment and significantly more emotional distress than the fathers. The mothers' perceived burden was significantly correlated with emotional distress. Nighttime blood glucose measurements were significantly associated with perceived parental burden, and experienced nocturnal hypoglycemia was significantly associated with parental emotional distress. The higher perceived burden related to medical treatment, the more emotional distress, and the correlations between burdens and emotional distress in mothers vs. fathers emphasize the importance of discussing both parents' roles and responsibilities in relation to the child's diabetes in follow-up. In the consultations, emphasizing nighttime caregiving and nocturnal hypoglycemia might also be important to prevent emotional distress. © 2010 John Wiley & Sons A/S.

Emotional distress and disordered eating practices among southern Italian women.

PubMed

Cheney, Ann M

2012-09-01

This study is one of the first to examine the narrative links connecting social change, contested gender norms, body image, and eating disordered practices among southern Italian women. The research is based on 16 months of fieldwork, and I compare and contrast the stories of 23 educated women in southern Italy to highlight the contentious realities of entering adolescence in conservative social contexts where gender relations and value systems are undergoing rapid transformations. I examine how these young women dealt with conflicting cultural expectations of womanhood and whether it affected their emotional, psychological, and physical well-being. Their stories shed light on how parental control, community surveillance, and conflicts in developing gender identities and maturing womanly bodies contributed to their emotional distress. Distressed young women used rebellion and manipulation and control of food and the body to negotiate unjust social relations, specifically gender relations, that delegitimized their selves and, in some cases, their bodies.

Emotional rigidity negatively impacts remission from anxiety and recovery of well-being.

PubMed

Wiltgen, Anika; Shepard, Christopher; Smith, Ryan; Fowler, J Christopher

2018-08-15

Emotional rigidity is described in clinical literature as a significant barrier to recovery; however, few there are few empirical measures of the construct. The current study had two aims: Study 1 aimed to identify latent factors that may bear on the construct of emotional rigidity while Study 2 assessed the potential impact of the latent factor(s) on anxiety remission rates and well-being. This study utilized data from 2472 adult inpatients (1176 females and 1296 males) with severe psychopathology. Study 1 utilized exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) to identify latent factors of emotional rigidity. Study 2 utilized hierarchical logistic regression analyses to assess the relationships among emotional rigidity factors and anxiety remission and well-being recovery at discharge. Study 1 yielded a two-factor solution identified in EFA was confirmed with CFA. Factor 1 consisted of neuroticism, experiential avoidance, non-acceptance of emotions, impaired goal-directed behavior, impulse control difficulties and limited access to emotion regulation strategies when experiencing negative emotions. Factor 2 consisted of lack of emotional awareness and lack of emotional clarity when experiencing negative emotions. Results of Study 2 indicated higher scores on Factor 1 was associated with lower remission rates from anxiety and poorer well-being upon discharge. Factor 2 was not predictive of outcome. Emotional rigidity appears to be a latent construct that negatively impacts remission rates from anxiety. Limitations of the present study include its retrospective design, and inefficient methods of assessing emotional rigidity. Copyright © 2018. Published by Elsevier B.V.

Distress in response to emotional and sexual infidelity: evidence of evolved gender differences in Spanish students.

PubMed

Fernandez, Ana Maria; Vera-Villarroel, Pablo; Sierra, Juan Carlos; Zubeidat, Ihab

2007-01-01

The authors studied gender differences in response to hypothetical infidelity in Spanish students. Using a forced-choice methodology, the authors asked a sample of 266 participants to indicate which kind of infidelity would be more distressing: emotional or sexual. Men were significantly more distressed by sexual infidelity than were women, and women were significantly more distressed by emotional infidelity than were men. Results supported the hypothesis that particular infidelity types, which resemble adaptive problems that human beings faced in the past, contribute to the psychology of jealousy. The results are consistent with previous cross-cultural research.

Mindfulness Based Stress Reduction: effect on emotional distress in diabetes

PubMed Central

Young, Laura A; Cappola, Anne R; Baime, Michael J

2017-01-01

Psychological distress is common in patients with diabetes. Little is known about the impact of Mindfulness Based Stress Reduction (MBSR), a non-traditional, cognitive behavioural intervention designed to improve stress management skills, in patients with diabetes. The purpose of this retrospective analysis was to evaluate the impact of MBSR training on mood states in 25 individuals with diabetes. All participants completed the Profile of Mood States Short Form (POMS-SF) at baseline and following eight weeks of MBSR. Overall psychological distress measured by the total mood score (TMS) and six subscales – including tension/anxiety, depression/dejection, anger/hostility, fatigue/inertia, confusion/bewilderment and vigour/activity – were assessed. Overall mood, measured by the TMS, as well as all subscale mood measurements improved significantly from baseline following MBSR training. Compared to population means, those with diabetes had higher distress at baseline and similar levels of distress following MBSR training. The primary reason participants reported for enrolling in the MBSR course was to improve stress management skills. It was concluded that MBSR training is a promising, group-based intervention that can be used to decrease psychological distress in individuals with diabetes who perceive a need for training in stress management. PMID:28781569

Relations between PTSD and distress dimensions in an Indian child/adolescent sample following the 2008 Mumbai terrorist attacks.

PubMed

Contractor, Ateka A; Mehta, Panna; Tiamiyu, Mojisola F; Hovey, Joseph D; Geers, Andrew L; Charak, Ruby; Tamburrino, Marijo B; Elhai, Jon D

2014-08-01

Posttraumatic stress disorder's (PTSD) four-factor dysphoria model has substantial empirical support (reviewed in Elhai & Palmieri, Journal of Anxiety Disorders, 25, 849-854, 2011; Yufik & Simms, Journal of Abnormal Psychology, 119, 764-776, 2010). However, debatable is whether the model's dysphoria factor adequately captures all of PTSD's emotional distress (e.g., Marshall et al., Journal of Abnormal Psychology, 119(1), 126-135, 2010), which is relevant to understanding the assessment and psychopathology of PTSD. Thus, the present study assessed the factor-level relationship between PTSD and emotional distress in 818 children/adolescents attending school in the vicinity of the 2008 Mumbai terrorist attacks. The effective sample had a mean age of 12.85 years (SD = 1.33), with the majority being male (n = 435, 53.8 %). PTSD and emotional distress were measured by the UCLA PTSD Reaction Index (PTSD-RI) and Brief Symptom Inventory-18 (BSI-18) respectively. Confirmatory factor analyses (CFA) assessed the PTSD and BSI-18 model fit; Wald tests assessed hypothesized PTSD-distress latent-level relations; and invariance testing examined PTSD-distress parameter differences using age, gender and direct exposure as moderators. There were no moderating effects for the PTSD-distress structural parameters. BSI-18's depression and somatization factors related more to PTSD's dysphoria than PTSD's avoidance factor. The results emphasize assessing for specificity and distress variance of PTSD factors on a continuum, rather than assuming dysphoria factor's complete accountability for PTSD's inherent distress. Additionally, PTSD's dysphoria factor related more to BSI-18's depression than BSI-18's anxiety/somatization factors; this may explain PTSD's comorbidity mechanism with depressive disorders.

Disgust- and anxiety-based emotional reasoning in non-clinical fear of vomiting.

PubMed

Verwoerd, Johan; van Hout, Wiljo J P J; de Jong, Peter J

2016-03-01

Emotional reasoning has been described as a dysfunctional tendency to use subjective responses to make erroneous inferences about threatening outcomes in objectively safe situations (e.g., "If I feel anxious/disgusted, there must be danger/risk of becoming ill"). Prior studies found evidence for anxiety-based emotional reasoning (ER) in several anxiety disorders as well as disgust-based ER in healthy individuals scoring above the clinical cut-off on a measure of contamination fear. The current study tested whether disgust- and anxiety-based ER might be involved in fear of vomiting, a phobic disorder in which both fear/anxiety and disgust are assumed to play an important role. Non-clinical participants scoring high (>75%; n = 35) and low (<25%; n = 38) on a measure of fear of vomiting were presented with a series of scripts describing objectively safe everyday situations that systematically varied in the absence/presence of the actor's disgust/anxiety response. Following each script, participants rated their perceived danger and threat of contamination/illness. In line with hypotheses, specifically high vomit-fearful individuals used experienced disgust and anxiety to overestimate risk of becoming ill. Follow up analyses taking into account shared variance between both emotions revealed that more pronounced ER in the high vomit fearful group was mainly driven by the emotion of disgust. Current study asked participants to imagine experienced emotions in scenarios instead of experimentally inducing real-life emotions. These findings are consistent with the view that disgust-based ER is involved in fear of vomiting. Copyright © 2015 Elsevier Ltd. All rights reserved.

Emotional distress among LGBT youth: the influence of perceived discrimination based on sexual orientation.

PubMed

Almeida, Joanna; Johnson, Renee M; Corliss, Heather L; Molnar, Beth E; Azrael, Deborah

2009-08-01

The authors evaluated emotional distress among 9th-12th grade students, and examined whether the association between being lesbian, gay, bisexual, and/or transgendered (i.e., "LGBT") and emotional distress was mediated by perceptions of having been treated badly or discriminated against because others thought they were gay or lesbian. Data come from a school-based survey in Boston, Massachusetts (n = 1,032); 10% were LGBT, 58% were female, and ages ranged from 13 to 19 years. About 45% were Black, 31% were Hispanic, and 14% were White. LGBT youth scored significantly higher on the scale of depressive symptomatology. They were also more likely than heterosexual, non-transgendered youth to report suicidal ideation (30% vs. 6%, p < 0.0001) and self-harm (21% vs. 6%, p < 0.0001). Mediation analyses showed that perceived discrimination accounted for increased depressive symptomatology among LGBT males and females, and accounted for an elevated risk of self-harm and suicidal ideation among LGBT males. Perceived discrimination is a likely contributor to emotional distress among LGBT youth.

An investigation of experiential avoidance, emotion dysregulation, and distress tolerance in young adult outpatients with borderline personality disorder symptoms.

PubMed

Iverson, Katherine M; Follette, Victoria M; Pistorello, Jacqueline; Fruzzetti, Alan E

2012-10-01

In this study we investigated 3 domains of emotional functioning--emotion dysregulation, distress tolerance, and experiential avoidance--in young adult outpatients with borderline personality disorder (BPD) symptoms. Participants were 40 young adult outpatients at a university counseling center who reported current suicidal ideation and met diagnostic criteria for BPD or experienced subthreshold BPD symptoms (i.e., met diagnostic criteria for 3 or 4 symptoms). Participants completed 3 self-report measures of emotional functioning-experiential avoidance (Acceptance and Action Questionnaire-2; Bond et al., 2011; Hayes et al., 2004), emotion dysregulation (Difficulties in Emotion Regulation Scale; Gratz & Roemer, 2004), and distress tolerance (Distress Tolerance Scale; Simons & Gaher, 2005)-and a behavioral measure of distress tolerance (Paced Auditory Serial Addition Task-Computerized; Lejuez, Kahler, & Brown, 2003), in addition to self-report measures of depression and BPD symptom severity. Partial correlations demonstrated that both emotion dysregulation and experiential avoidance were significantly associated with BPD symptom severity after accounting for depression. However, neither the self-report nor behavioral measure of distress tolerance were related to BPD symptom severity. A regression analysis with emotion dysregulation and experiential avoidance as independent variables revealed that only experiential avoidance was significantly associated with BPD symptom severity after controlling for depression symptoms. The current findings suggest that experiential avoidance may be a central process in BPD symptom severity. Future research directions are discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

Bullying victimization and emotional distress: is there strength in numbers for vulnerable youth?

PubMed

Eisenberg, Marla E; McMorris, Barbara J; Gower, Amy L; Chatterjee, Debanjana

2016-07-01

The present study examines whether the prevalence of vulnerable peers in school protects the emotional health of youth who are lesbian, gay, bisexual or questioning (LGBQ), overweight, or have a disability, and if the adverse emotional effects of bullying victimization are mitigated by the presence of these peers. Survey data come from a large school-based sample of adolescents attending 505 schools. The primary independent variable was the percent of students in school with each vulnerability characteristic. Multilevel logistic regression models estimated the odds of internalizing problems, self-harm, suicidal ideation and suicide attempts among students who were LGBQ, overweight or had a disability. Cross-level interaction terms were added to determine if the association between being victimized and emotional distress was moderated by the presence of vulnerable peers. Greater presence of similar students was, on average, protective against emotional distress for LGBQ girls and overweight boys. In contrast, greater presence of students with a disability was, on average, a risk factor among girls with a disability. Several tests of effect modification indicated that odds of emotional distress for those who had been victimized were lower in schools with a higher proportion of vulnerable youth. The presence of a similar peer group may increase the likelihood that a bystander or witness to bullying will react in a helpful way. School personnel, health care providers and other youth service professionals should inquire about social relationships at school, including experiences of harassment and perceptions of peer support, to buffer negative experiences. Copyright © 2016 Elsevier Inc. All rights reserved.

Beta-blocker therapy is not associated with symptoms of depression and anxiety in patients receiving an implantable cardioverter-defibrillator.

PubMed

Hoogwegt, Madelein T; Kupper, Nina; Theuns, Dominic A M J; Jordaens, Luc; Pedersen, Susanne S

2012-01-01

Beta-blockers are frequently prescribed to implantable cardioverter-defibrillator (ICD) patients. Beta-blocker therapy has been proposed to induce emotional distress such as depression and anxiety, but a paucity of studies has examined the relationship between beta-blockers and distress. We investigated the association between beta-blocker therapy, including type and dosage, and symptoms of anxiety and depression in a consecutive cohort of patients receiving an ICD. Between 2003 and 2010, 448 consecutively implanted ICD patients were enrolled in the prospective Mood and personality as precipitants of arrhythmia in patients with an Implantable cardioverter Defibrillator: A prospective Study (MIDAS), of which 429 completed the Hospital Anxiety and Depression Scale (HADS) and the ICD Patient Concerns questionnaire (ICDC) at baseline. Eighty per cent of all patients received beta-blocker therapy. In univariate analysis, beta-blocker therapy was not significantly associated with symptoms of anxiety, depression, and ICD concerns (β = -0.030, β = 0.007, and β = -0.045, respectively; all P's >0.36). Type of beta-blocker showed a trend towards significance for mean levels of ICD concerns (P = 0.09). No association was found between dosage and emotional distress (all P's >0.21). After adjustment for relevant clinical and demographic variables, the association of beta-blocker therapy and symptoms of anxiety, depression, and ICD concerns remained non-significant (β = 0.009, β = 0.037, and β = 0.019, respectively; all P's >0.47). In patients receiving an ICD, beta-blocker therapy was not associated with symptoms of anxiety, depression, and ICD concerns. Research is warranted that further elucidates the link between beta-blocker therapy and emotional distress in this vulnerable patient group.

Measuring anxiety in depressed patients: A comparison of the Hamilton anxiety rating scale and the DSM-5 Anxious Distress Specifier Interview.

PubMed

Zimmerman, Mark; Martin, Jacob; Clark, Heather; McGonigal, Patrick; Harris, Lauren; Holst, Carolina Guzman

2017-10-01

DSM-5 included criteria for an anxious distress specifier for major depressive disorder (MDD). In the present report from the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project we examined whether a measure of the specifier, the DSM-5 Anxious Distress Specifier Interview (DADSI), was as valid as the Hamilton Anxiety Scale (HAMA) as a measure of the severity of anxiety in depressed patients. Two hundred three psychiatric patients with MDD were interviewed by trained diagnostic raters who administered the Structured Clinical Interview for DSM-IV (SCID) supplemented with questions to rate the DADSI, HAMA, and Hamilton Depression Rating Scale (HAMD). The patients completed self-report measures of depression, anxiety, and irritability. Sensitivity to change was examined in 30 patients. The DADSI and HAMA were significantly correlated (r = 0.60, p < 0.001). Both the DADSI and HAMA were more highly correlated with measures of anxiety than with measures of the other symptom domains. The HAMD was significantly more highly correlated with the HAMA than with the DADSI. For each anxiety disorder, patients with the disorder scored significantly higher on both the DADSI and HAMA than did patients with no current anxiety disorder. A large effect size of treatment was found for both measures (DADSI: d = 1.48; HAMA: d = 1.37). Both the DADSI and HAMA were valid measures of anxiety severity in depressed patients, though the HAMA was more highly confounded with measures of depression than the DADSI. The DADSI is briefer than the HAMA, and may be more feasible to use in clinical practice. Copyright © 2017 Elsevier Ltd. All rights reserved.

The depression distress amplification model in adolescents: A longitudinal examination of anxiety sensitivity cognitive concerns, depression and suicidal ideation

PubMed Central

Capron, Daniel W.; Allan, Nicholas P.; Ialongo, Nicholas S.; Leen-Feldner, Ellen; Schmidt, Norman B.

2015-01-01

Adolescents with comorbid anxiety and depression are at significantly increased risk of suicide. The recently proposed depression distress amplification model appears to have promise for explaining the relations between anxiety, depression, and suicidality, but it has not been tested in adolescents. Participants were 524 adolescents followed over two years. Baseline data for the current report were collected by trained interviewers while the adolescents were in eighth grade. Data were obtained in the same manner when the adolescents were in tenth grade. Baseline anxiety sensitivity cognitive concerns significantly predicted suicidal ideation two years later, above and beyond baseline suicidal ideation and depression. Further, consistent with the depression distress amplification model, anxiety sensitivity cognitive concerns interacted with depressive symptoms to predict suicidal ideation. This report extends the empirical and theoretical support for a relationship between anxiety sensitivity cognitive concerns and suicidality. PMID:25754194

Trait emotional intelligence and mental distress: the mediating role of positive and negative affect.

PubMed

Kong, Feng; Zhao, Jingjing; You, Xuqun

2012-01-01

Over the past decade, emotional intelligence (EI) has received much attention in the literature. Previous studies indicated that higher trait or ability EI was associated with greater mental distress. The present study focused on mediating effects of positive and negative affect on the association between trait EI and mental distress in a sample of Chinese adults. The participants were 726 Chinese adults (384 females) with an age range of 18-60 years. Data were collected by using the Wong Law Emotional Intelligence Scale, the Positive Affect and Negative Affect Scale, and the General Health Questionnaire. Hierarchical regression analysis showed that EI was a significant predictor of positive affect, negative affect and mental distress. Further mediation analysis showed that positive and negative affect acted as partial mediators of the relationship between EI and mental distress. Furthermore, effect contrasts showed that there was no significant difference between the specific indirect effects through positive affect and through negative affect. This result indicated that positive affect and negative affect played an equally important function in the association between EI and distress. The significance and limitations of the results are discussed.

Depression, Anxiety, and Severity of Obesity in Adolescents: Is Emotional Eating the Link?

PubMed

Fox, Claudia K; Gross, Amy C; Rudser, Kyle D; Foy, Allison M H; Kelly, Aaron S

2016-10-01

The purposes of this study were to characterize the impact of depression and anxiety on the severity of obesity among youth seeking weight management treatment and to determine the extent to which emotional eating mediates the relationship between depression and/or anxiety and degree of obesity. This cross-sectional, retrospective chart review of 102 adolescent patients from a weight management clinic analyzed demographics, body mass index, depression (Patient Health Questionnaire-9), and anxiety (Generalized Anxiety Disorder Scale-7) screens and the Child Eating Behavior Questionnaire, Emotional Over-Eating subscale. After adjusting for demographics and emotional eating, the odds of having severe obesity versus obesity were 3.5 times higher for patients with depression compared with those without (odds ratio [OR] = 3.5; 95% CI = 1.1, 11.3; P = .038) and nearly 5 times higher for those with anxiety (OR = 4.9; CI = 1.2, 20.9; P = .030). Emotional eating, however, was not a mediator between depression/anxiety and degree of adiposity. © The Author(s) 2015.

Psychological Distress and Drawing Tests among Women with Breast Cancer.

PubMed

Kim, Jiyeon; Youn, Soyoung; Choi, Byeongil; Jung, Kyung Hae; Ahn, Seung Do; Hwang, Sook Yeon; Chung, Seockhoon; Lee, Jaedam

2018-04-23

The aim of this study was to evaluate the use of the Diagnostic Drawing Series (DDS) as a screening tool for the breast cancer patients with psychological distress. All of 64 patients with breast cancer participated in this study. Patients' depressive and anxiety symptoms were assessed using Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) when the DDS was applied to the partipicants. Depressed patients used more enclosure in the Feeling drawings ( P = 0.002) and tilt in Free drawings ( P = 0.048). Patients with anxiety drew a picture over 67% of the paper ( P = 0.015) in Tree drawing and more medium pressure ( P = 0.049) in Feeling drawings. Thirty four subjects (77.3%) of unstable emotion group used over 67% of the space ( P = 0.002). More Landscapes were observed in the Feeling drawings of unstable patients ( P = 0.042). These results suggested that DDS could be used as a supplemental screening tool for psychological distress in breast cancer patients.

The Effects of Water Insecurity and Emotional Distress on Civic Action for Improved Water Infrastructure in Rural South Africa.

PubMed

Bulled, Nicola

2017-03-01

The South African constitution ratifies water as a human right. Yet millions of citizens remain disconnected from the national water infrastructure. Drawing on data collected in 2013-2014 from women in northern South Africa, this study explores "water citizenship"-individual civic engagement related to improving water service provision. Literature indicates that water insecurity is associated with emotional distress and that water-related emotional distress influences citizen engagement. I extend these lines of research by assessing the connection that water insecurity and emotional distress may collectively have with civic engagement to improve access to water infrastructure. © 2015 by the American Anthropological Association.

The Effects of Water Insecurity and Emotional Distress on Civic Action for Improved Water Infrastructure in Rural South Africa

PubMed Central

Bulled, Nicola

2015-01-01

The South African constitution ratifies water as a human right. Yet millions of citizens remain disconnected from the national water infrastructure. Drawing on data collected in 2013–2014 from women in northern South Africa, this study explores “water citizenship”—individual civic engagement related to improving water service provision. Literature indicates that water insecurity is associated with emotional distress and that water-related emotional distress influences citizen engagement. I extend these lines of research by assessing the connection that water insecurity and emotional distress may collectively have with civic engagement to improve access to water infrastructure. PMID:26698378

Determinants of pre-procedural state anxiety and negative affect in first-time colposcopy patients: implications for intervention.

PubMed

Kola, S; Walsh, J C

2012-07-01

Women experience significant emotional distress in relation to further diagnostic evaluation of pre-cancerous cell changes of the cervix. However, less is known about the specific variables that contribute to elevated state anxiety and negative affect prior to colposcopy. The study aims to identify psychosocial factors that predict distress in this patient group, which can help in the development of more sophisticated interventions to reduce psychological distress. Socio-demographic variables, scores for state anxiety, negative affect, trait anxiety, fear of pain, coping style, pain-related expectancy and knowledge were assessed in 164 first-time colposcopy patients immediately before the colposcopy examination. Twenty-six per cent of variance in pre-colposcopy state anxiety was significantly explained by marital status, parity, trait anxiety, fear of minor pain and expectations of discomfort. Twenty-nine per cent of variance in pre-colposcopy negative affect was significantly explained by trait anxiety and expectations of pain. Women who are single, have children, are high trait anxious, and anticipate pain and discomfort appear to be at risk for pre-colposcopy distress. Interventions aimed at reducing pre-colposcopy psychological distress should include situation-specific variables that are amenable to change, and trait anxious women are likely to benefit from interventions to reduce distress. © 2011 Blackwell Publishing Ltd.

Anxiety, depression, and HIV symptoms among persons living with HIV/AIDS: the role of hazardous drinking.

PubMed

Garey, Lorra; Bakhshaie, Jafar; Sharp, Carla; Neighbors, Clayton; Zvolensky, Michael J; Gonzalez, Adam

2015-01-01

Hazardous drinking is common among persons living with HIV/AIDS (PLWHA) and associated with numerous negative health consequences. Despite the well-established negative effects of hazardous drinking among PLWHA, scholarly work has neglected to explore the role of such drinking in regard to anxiety/depressive symptoms and HIV symptom expression. The current study investigated associations between hazardous drinking and anxiety/depressive symptoms and HIV symptoms among PLWHA. Participants (n = 94; 88.3% male; Mage = 48.55; SD = 9.15) included PLWHA recruited from AIDS service organizations in the northeast. Hazardous drinking was significantly associated with anxiety/depressive symptoms and HIV symptom expression above and beyond the variance accounted for by sex, race, recruitment site, and CD4 T-Cell count, as well as other cognitive-affective variables (emotion dysregulation, distress intolerance, and anxiety sensitivity). The present results provide empirical support that hazardous drinking is indeed related to depressive and anxiety symptoms as well as HIV symptom distress and that this effect is not attributable to other factors commonly related to both alcohol use problems and emotional distress among PLWHA. Results highlight the importance of alcohol interventions for excessive drinking specifically tailored for PLWHA to facilitate better mental and physical health adjustment.

Effects of emotional exposure on state anxiety after acute exercise.

PubMed

Smith, J Carson

2013-02-01

Despite the well-known anxiolytic effect of acute exercise, it is unknown if anxiety reductions after acute exercise conditions survive in the face of a subsequently experienced arousing emotional exposure. The purpose of this study was to compare the effects of moderate-intensity cycle ergometer exercise to a seated rest control condition on state anxiety symptoms after exposure to a variety of highly arousing pleasant and unpleasant stimuli. Thirty-seven healthy and normally physically active young adults completed two conditions on separate days: 1) 30 min of seated rest and 2) 30 min of moderate-intensity cycle ergometer exercise (RPE = 13; "somewhat hard"). After each condition, participants viewed 90 arousing pleasant, unpleasant, and neutral pictures from the International Affective Picture System for 30 min. State anxiety was measured before and 15 min after each condition, and again after exposure to the affective pictures. State anxiety significantly decreased from baseline to after the exercise and seated rest conditions (P = 0.003). After the emotional picture-viewing period, state anxiety significantly increased to baseline values after the seated rest condition (P = 0.001) but remained reduced after the exercise condition. These findings suggest that the anxiolytic effects of acute exercise may be resistant to the potentially detrimental effects on mood after exposure to arousing emotional stimuli.

The confusing tale of depression and distress in patients with diabetes: a call for greater clarity and precision

PubMed Central

Fisher, L.; Gonzalez, J. S.; Polonsky, W. H.

2014-01-01

Studies have identified significant linkages between depression and diabetes, with depression associated with poor self-management behaviour, poor clinical outcomes and high rates of mortality. However, findings are not consistent across studies, yielding confusing and contradictory results about these relationships. We suggest that there has been a failure to define and measure ‘depression’ in a consistent manner. Because the diagnosis of depression is symptom-based only, without reference to source or content, the context that diabetes is not considered when addressing the emotional distress experienced by individuals struggling with diabetes. To reduce this confusion, we suggest that an underlying construct of ‘emotional distress’ be considered as a core construct to link diabetes-related distress, subclinical depression, elevated depression symptoms and major depressive disorder. We view emotional distress as a single, continuous dimension that has two primary characteristics: content and severity; that the primary content of emotional distress among these individuals include diabetes and its management, other life stresses and other contributors; and that both the content and severity of distress be addressed directly in clinical care. We suggest further that all patients, even those whose emotional distress rises to the level of major depressive disorder or anxiety disorders, can benefit from consideration of the content of distress to direct care effectively, and we suggest strategies for integrating the emotional side of diabetes into regular diabetes care. This approach can reduce confusion between depression and distress so that appropriate and targeted patient-centred interventions can occur. PMID:24606397

Common and disorder-specific neural responses to emotional faces in generalised anxiety, social anxiety and panic disorders

PubMed Central

Fonzo, Gregory A.; Ramsawh, Holly J.; Flagan, Taru M.; Sullivan, Sarah G.; Letamendi, Andrea; Simmons, Alan N.; Paulus, Martin P.; Stein, Murray B.

2015-01-01

Background Although evidence exists for abnormal brain function across various anxiety disorders, direct comparison of neural function across diagnoses is needed to elicit abnormalities common across disorders and those distinct to a particular diagnosis. Aims To delineate common and distinct abnormalities within generalised anxiety (GAD), panic and social anxiety disorder (SAD) during affective processing. Method Fifty-nine adults (15 with GAD, 15 with panic disorder, 14 with SAD, and 15 healthy controls) underwent functional magnetic resonance imaging while completing a facial emotion matching task with fearful, angry and happy faces. Results Greater differential right amygdala activation to matching fearful v. happy facial expressions related to greater negative affectivity (i.e. trait anxiety) and was heightened across all anxiety disorder groups compared with controls. Collapsing across emotional face types, participants with panic disorder uniquely displayed greater posterior insula activation. Conclusions These preliminary results highlight a common neural basis for clinical anxiety in these diagnoses and also suggest the presence of disorder-specific dysfunction. PMID:25573399

Differential Effects of Maternal Sensitivity to Infant Distress and Nondistress on Social-Emotional Functioning

ERIC Educational Resources Information Center

Leerkes, Esther M.; Blankson, A. Nayena; O'Brien, Marion

2009-01-01

Associations between maternal sensitivity to infant distress and nondistress and infant social-emotional adjustment were examined in a subset of dyads from the NICHD Study of Early Child Care (N = 376). Mothers reported on infant temperament at 1 and 6 months postpartum, and maternal sensitivity to distress and nondistress were observed at 6…

Cognitive representations of breast cancer, emotional distress and preventive health behaviour: a theoretical perspective.

PubMed

Decruyenaere, M; Evers-Kiebooms, G; Welkenhuysen, M; Denayer, L; Claes, E

2000-01-01

Individuals at high risk for developing breast and/or ovarian cancer are faced with difficult decisions regarding genetic testing, cancer prevention and/or intensive surveillance. Large interindividual differences exist in the uptake of these health-related services. This paper is aimed at understanding and predicting how people emotionally and behaviourally react to information concerning genetic predisposition to breast/ovarian cancer. For this purpose, the self-regulation model of illness representations is elaborated. This model suggests that health-related behaviour is influenced by a person's cognitive and emotional representation of the health threat. These representations generate coping behaviour aimed at resolving the objective health problems (problem-focussed coping) and at reducing the emotional distress induced by the health threat (emotion-focussed coping). Based on theoretical considerations and empirical studies, four interrelated attributes of the cognitive illness representation of hereditary breast/ovarian cancer are described: causal beliefs concerning the disease, perceived severity, perceived susceptibility to the disease and perceived controllability. The paper also addresses the complex interactions between these cognitive attributes, emotional distress and preventive health behaviour.

Just Breathe: The Effects of Emotional Dysregulation and Test Anxiety on GPA

ERIC Educational Resources Information Center

Hartman, Samantha D.; Wasieleski, David T.; Whatley, Mark A.

2017-01-01

College is considered to be one of the most evaluative and stressful times during a student's academic career. A student's inability to regulate emotions may be correlated with an increased level of test anxiety. Previous research has indicated significant relationships between emotional dysregulation and generalized anxiety disorders (e.g.,…

Emotional Maltreatment, Peer Victimization, and Depressive versus Anxiety Symptoms During Adolescence: Hopelessness as a Mediator

PubMed Central

Hamilton, Jessica L.; Shapero, Benjamin G.; Stange, Jonathan P.; Hamlat, Elissa J.; Abramson, Lyn Y.; Alloy, Lauren B.

2013-01-01

Objective Extensive comorbidity between depression and anxiety has driven research to identify unique and shared risk factors. This study prospectively examined the specificity of three interpersonal stressors (emotional abuse, emotional neglect, and relationally-oriented peer victimization) as predictors of depressive versus anxiety symptoms in a racially-diverse community sample of adolescents. We expanded on past research by examining hopelessness as a mediator of the relationships between these interpersonal stressors and symptoms. Method Participants included 225 adolescents (55% African-American; 59% female; Mean age = 12.84 years) who completed measures at baseline (Time 1) and two follow-up assessments (Times 2 and 3). Symptoms of depression and anxiety (social, physical, total) were assessed at Time 1 and Time 3, while intervening emotional maltreatment, peer victimization, and hopelessness were assessed at Time 2. Results Hierarchical linear regressions indicated that emotional abuse was a nonspecific predictor of increases in both depressive symptoms and symptoms of social, physical, and total anxiety, whereas relationally-oriented peer victimization predicted depressive symptoms specifically. Emotional neglect did not predict increases in depressive or anxiety symptoms. In addition, hopelessness mediated the relationships between emotional abuse and increases in symptoms of depression and social anxiety. Conclusions These findings suggest that emotional abuse and relationally-oriented peer victimization are interpersonal stressors that are relevant to the development of internalizing symptoms in adolescence, and that hopelessness may be one mechanism through which emotional abuse contributes to an increased risk of depression and social anxiety. PMID:23534812

Sensory, Emotional and Cognitive Contributions to Anxiety in Autism Spectrum Disorders

PubMed Central

South, Mikle; Rodgers, Jacqui

2017-01-01

Severe symptoms of anxiety add substantial additional burden to many individuals diagnosed with Autism Spectrum Disorder (ASD). Improved understanding of specific factors that contribute to anxiety in ASD can aid research regarding the causes of autism and also provide targets for more effective intervention. This mini-review article focuses on emerging evidence for three concepts that appear to be related to each other and which also strongly predict anxiety in ASD samples. Atypical sensory function is included in the diagnostic criteria for ASD and is likely an important contributor to anxiety. Difficulties in understanding and labeling emotions (alexithymia), although a co-morbidity, may arise in part from atypical sensory function and can lead to confusion and uncertainty about how to respond to social and emotional situations. Intolerance of uncertainty (IU) describes people who have a particularly hard time with ambiguity and is known to be a key mechanism underlying some anxiety disorders. While evidence for linking these ideas is to date incomplete, we put forward a model including each concept as a framework for future studies. Specifically, we propose that IU is a critical mediator for anxiety in ASD, and explore the relationships between sensory function, alexithymia and IU. We further explore the role of the medial prefrontal cortex (mPFC) in regulating emotional response, in connection with limbic and insula-based networks, and suggest that disrupted integration in these networks underlies difficulties with habituation to strong emotional stimuli, which results in an enhanced perception of threat in many people with ASD. Behavioral and biologically-based treatments for anxiety in ASD will benefit from attending to these specific mechanisms as adjunct to traditional interventions. PMID:28174531

Emotional Reactivity and Regulation Following Citalopram Therapy in Children and Adolescents with Anxiety Disorders.

PubMed

Carthy, Tal; Benaroya-Milshtein, Noa; Valevski, Avi; Apter, Alan

2017-02-01

Emotional dysregulation is an important element in the pathophysiology of childhood anxiety disorders and can distinguish anxious subjects from controls. Treatment with selective serotonin inhibitors (SSRIs) has been found to lessen anxiety, but its effects on emotional reactivity and regulation are less documented. The aim of the study was to prospectively assess changes in emotional reactivity and regulation in response to citalopram in children and adolescents with anxiety disorders, with special focus on the mechanism of reappraisal. The sample included 70 children and adolescents (38 boys, 32 girls) 10-17 years of age, divided into three groups: Those with anxiety disorder treated with citalopram for 8 weeks (n = 35); untreated subjects with anxiety disorder on the waiting list for cognitive behavioral therapy (CBT) (n = 15); and subjects without anxiety disorder (controls) (n = 20). Emotional reactivity and regulation (i.e., reappraisal), were assessed at baseline and after 8 weeks (follow-up) with validated computer-based instruments, Reactivity and Regulation-Situations (REAR-S) and Reactivity and Regulation-Images (REAR-I). Citalopram-treated subjects showed significantly greater improvement in reappraisal ability than CBT-waitlisted subjects. Improvement in the ability to reappraise threatening images correlated significantly with the decrease in anxiety. There was a decrease in negative emotional reactivity between assessments, which was positively correlated with clinical improvement. Higher intensity of baseline reactivity (on the REAR-S) predicted more severe symptoms at follow-up. Citalopram therapy improves reappraisal ability in children and adolescents with anxiety. However, the improvement in other examined emotional reactivity indices occurred in both medicated and waitlisted groups. It is possible that these findings may have implications for understanding the pathophysiology of anxiety in children and adolescents.

A Single Bout of Aerobic Exercise Reduces Anxiety Sensitivity But Not Intolerance of Uncertainty or Distress Tolerance: A Randomized Controlled Trial.

PubMed

LeBouthillier, Daniel M; Asmundson, Gordon J G

2015-01-01

Several mechanisms have been posited for the anxiolytic effects of exercise, including reductions in anxiety sensitivity through interoceptive exposure. Studies on aerobic exercise lend support to this hypothesis; however, research investigating aerobic exercise in comparison to placebo, the dose-response relationship between aerobic exercise anxiety sensitivity, the efficacy of aerobic exercise on the spectrum of anxiety sensitivity and the effect of aerobic exercise on other related constructs (e.g. intolerance of uncertainty, distress tolerance) is lacking. We explored reductions in anxiety sensitivity and related constructs following a single session of exercise in a community sample using a randomized controlled trial design. Forty-one participants completed 30 min of aerobic exercise or a placebo stretching control. Anxiety sensitivity, intolerance of uncertainty and distress tolerance were measured at baseline, post-intervention and 3-day and 7-day follow-ups. Individuals in the aerobic exercise group, but not the control group, experienced significant reductions with moderate effect sizes in all dimensions of anxiety sensitivity. Intolerance of uncertainty and distress tolerance remained unchanged in both groups. Our trial supports the efficacy of aerobic exercise in uniquely reducing anxiety sensitivity in individuals with varying levels of the trait and highlights the importance of empirically validating the use of aerobic exercise to address specific mental health vulnerabilities. Aerobic exercise may have potential as a temporary substitute for psychotherapy aimed at reducing anxiety-related psychopathology.

Perfectionism and negative/positive affect associations: the role of cognitive emotion regulation and perceived distress/coping.

PubMed

Castro, Juliana; Soares, Maria João; Pereira, Ana T; Macedo, António

2017-01-01

To explore 1) if perfectionism, perceived distress/coping, and cognitive emotion regulation (CER) are associated with and predictive of negative/positive affect (NA/PA); and 2) if CER and perceived distress/coping are associated with perfectionism and if they mediate the perfectionism-NA/PA associations. There is a distinction between maladaptive and adaptive perfectionism in its association with NA/PA. CER and perceived distress/coping may mediate the maladaptive/adaptive perfectionism and NA/PA associations. 344 students (68.4% girls) completed the Hewitt & Flett and the Frost Multidimensional Perfectionism Scales, the Composite Multidimensional Perfectionism Scale, the Profile of Mood States, the Perceived Stress Scale, and the Cognitive Emotion Regulation Questionnaire. NA predictors were maladaptive/adaptive perfectionism, maladaptive CER and perceived distress (positively), positive reappraisal and planning, and perceived coping (negatively). PA predictors were maladaptive/adaptive perfectionism and perceived distress (negatively), positive reappraisal and planning, positive refocusing and perceived coping (positively). The association between maladaptive perfectionism and NA was mediated by maladaptive CER/low adaptive CER, perceived distress/low coping. Maladaptive perfectionism and low PA association was mediated by perceived distress. High PA was determined by low maladaptive perfectionism and this association was mediated by adaptive REC and coping. Adaptive perfectionism and NA association was mediated by maladaptive CER and perceived distress. CER and perceived distress/coping are associated and mediate the perfectionism-NA/PA associations.

Negative Attachment Cognitions and Emotional Distress in mainland Chinese Adolescents: A Prospective Multi-Wave Test of Vulnerability-Stress and Stress Generation Models

PubMed Central

Cohen, Joseph R.; Hankin, Benjamin L.; Gibb, Brandon E.; Hammen, Constance; Hazel, Nicholas A.; Ma, Denise; Yao, Shuqiao; Zhu, Xiong Zhao; Abela, John R.Z.

2014-01-01

Objective The present study examined the relation between attachment cognitions, stressors, and emotional distress in a sample of Chinese adolescents. Specifically, it was examined whether negative attachment cognitions predicted depression and anxiety symptoms, and if a vulnerability-stress or stress generation model best explained the relation between negative attachment cognitions and internalizing symptoms. Method Participants included 558 adolescents (310 females and 248 males) from an urban school in Changsha, and 592 adolescents (287 females and 305 males) from a rural school in Liuyang, both in Hunan province located in mainland China. Participants completed self-report measures of negative attachment cognitions at baseline, and self-report measures of negative events, depression symptoms, and anxiety symptoms at baseline and at regular one month intervals for an overall 6-month follow-up (i.e., six follow-up assessments). Results Higher levels of negative attachment cognitions predicted prospective depression and anxiety symptoms. Furthermore, support was found for a stress generation model that partially mediated this longitudinal association. No support was found for a vulnerability-stress model. Conclusion Overall, these findings highlight new developmental pathways for development of depression and anxiety symptoms in mainland Chinese adolescents. PMID:23237030

Comparison of EEG propagation speeds under emotional stimuli on smartphone between the different anxiety states

PubMed Central

Asakawa, Tetsuya; Muramatsu, Ayumi; Hayashi, Takuto; Urata, Tatsuya; Taya, Masato; Mizuno-Matsumoto, Yuko

2014-01-01

The current study evaluated the effect of different anxiety states on information processing as measured by an electroencephalography (EEG) using emotional stimuli on a smartphone. Twenty-three healthy subjects were assessed for their anxiety states using The State Trait Anxiety Inventory (STAI) and divided into two groups: low anxiety (I, II) or high anxiety (III and IV, V). An EEG was performed while the participant was presented with emotionally laden audiovisual stimuli (resting, pleasant, and unpleasant sessions) and emotionally laden sentence stimuli (pleasant sentence, unpleasant sentence sessions) and EEG data was analyzed using propagation speed analysis. The propagation speed of the low anxiety group at the medial coronal for resting stimuli for all time segments was higher than those of high anxiety group. The low anxiety group propagation speeds at the medial sagittal for unpleasant stimuli in the 0–30 and 60–150 s time frames were higher than those of high anxiety group. The propagation speeds at 150 s for all stimuli in the low anxiety group were significantly higher than the correspondent propagation speeds of the high anxiety group. These events suggest that neural information processes concerning emotional stimuli differ based on current anxiety state. PMID:25540618

Water insecurity and emotional distress: coping with supply, access, and seasonal variability of water in a Bolivian squatter settlement.

PubMed

Wutich, Amber; Ragsdale, Kathleen

2008-12-01

Recent research suggests that insecure access to key resources is associated with negative mental health outcomes. Many of these studies focus on drought and famine in agricultural, pastoral, and foraging communities, and indicate that food insecurity mediates the link between water insecurity and emotional distress. The present study is the first to systematically examine intra-community patterns of water insecurity in an urban setting. In 2004-2005, we collected interview data from a random sample of 72 household heads in Villa Israel, a squatter settlement of Cochabamba, Bolivia. We examined the extent to which water-related emotional distress is linked with three dimensions of water insecurity: inadequate water supply; insufficient access to water distribution systems; and dependence on seasonal water sources, and with gender. We found that access to water distribution systems and female gender were significantly associated with emotional distress, while water supply and dependence on seasonal water sources were not. Economic assets, social assets, entitlements to water markets, and entitlements to reciprocal exchanges of water were significantly associated with emotional distress, while entitlements to a common-pool water resource institution were not. These results suggest that water-related emotional distress develops as a byproduct of the social and economic negotiations people employ to gain access to water distribution systems in the absence of clear procedures or established water rights rather than as a result of water scarcity per se.

Prolonged Distress of Parents After Early Preterm Birth.

PubMed

Kantrowitz-Gordon, Ira; Altman, Molly R; Vandermause, Roxanne

2016-01-01

To examine how parents describe the distress of early preterm birth in the months and years after the infant's hospital discharge. Discourse analysis of in-depth interviews and photo elicitation. Homes or cafés in the Pacific Northwest United States. Parents of premature infants born between 24 and 30 weeks gestation (N = 10) who experienced significant distress in and out of the hospital. Parents participated in the study when their children were between 15 months and 8 years old. Participants described dealing with prematurity, emotional distress, and parenting in individual interviews and returned for second interviews in which they further described their distress using photographs. Data were analyzed using discourse analysis. Parents described preterm birth, hospitalization, and the aftermath as ongoing traumatic events. Discourses of distress included the Perfect Child, the Good Mother, and the Good Father. Parents used these discourses to reconcile the loss of an idealized birth and parenting after the birth of a premature child. Isolation and Medicalized Parenting were used to explain how parents struggled to interact within their social networks and to parent under challenging circumstances. Participants described their trauma and distress in ways not captured by psychiatric diagnoses such as depression and anxiety. Findings may help nurses be aware of the negative effects of preterm birth and respond to parents' emotional needs. Copyright © 2016 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.

Emotional Intelligence and Its Relationship with Levels of Social Anxiety and Stress in Adolescents.

PubMed

Cejudo, Javier; Rodrigo-Ruiz, Débora; López-Delgado, Maria Luz; Losada, Lidia

2018-05-25

The aim of this work is to extend the research on the relationships between emotional intelligence and various indicators of subjective well-being in adolescents, such as stress and social anxiety. The existence of differences in stress and social anxiety as a function of an emotional intelligence score is also analyzed. A total of 505 Spanish adolescents between the ages of 12 and 18 participated in the study. The results obtained support the existence of a positive relationship between trait emotional intelligence and subjective well-being. Likewise, the existence of a negative association between emotional intelligence and stress, and emotional intelligence and social anxiety, is confirmed. These results are consistent with other similar works based on adolescent samples.

Psychological Distress, Anxiety, and Depression of Cancer-Affected BRCA1/2 Mutation Carriers: a Systematic Review.

PubMed

Ringwald, Johanna; Wochnowski, Christina; Bosse, Kristin; Giel, Katrin Elisabeth; Schäffeler, Norbert; Zipfel, Stephan; Teufel, Martin

2016-10-01

Understanding the intermediate- and long-term psychological consequences of genetic testing for cancer patients has led to encouraging research, but a clear consensus of the psychosocial impact and clinical routine for cancer-affected BRCA1 and BRCA2 mutation carriers is still missing. We performed a systematic review of intermediate- and long-term studies investigating the psychological impact like psychological distress, anxiety, and depression in cancer-affected BRCA mutation carriers compared to unaffected mutation carriers. This review included the screening of 1243 studies. Eight intermediate- and long-term studies focusing on distress, anxiety, and depression symptoms among cancer-affected mutation carriers at least six months after the disclosure of genetic testing results were included. Studies reported a great variety of designs, methods, and patient outcomes. We found evidence indicating that cancer-affected mutation carriers experienced a negative effect in relation to psychological well-being in terms of an increase in symptoms of distress, anxiety, and depression in the first months after test disclosure. In the intermediate- and long-term, no significant clinical relevant symptoms occurred. However, none of the included studies used specific measurements, which can clearly identify psychological burdens of cancer-affected mutation carriers. We concluded that current well-implemented distress screening instruments are not sufficient for precisely identifying the psychological burden of genetic testing. Therefore, future studies should implement coping strategies, specific personality structures, the impact of genetic testing, supportive care needs and disease management behaviour to clearly screen for the possible intermediate- and long-term psychological impact of a positive test disclosure.

Perceived Emotion Control Moderates the Relationship between Neuroticism and Generalized Anxiety Disorder

PubMed Central

Bourgeois, Michelle L.; Brown, Timothy A.

2015-01-01

The relationships between neuroticism, perceived emotion control, and generalized anxiety disorder (GAD) severity were examined in 293 individuals diagnosed with GAD at a specialty anxiety disorders clinic. Hierarchical regression analyses performed within a structural equation modeling framework revealed that (1) neuroticism and perceived emotion control both predicted a latent variable of GAD in the expected direction, and (2) perceived emotion control moderated the relationship between neuroticism and GAD severity, such that lower levels of perceived emotion control were associated with a stronger relationship between neuroticism and GAD severity. The other dimensions of perceived control (i.e., stress and threat control) did not moderate the effect of neuroticism on GAD severity. The findings are discussed with regard to their implications to conceptual models of the psychopathology of GAD, and theory-based differential relationships between dimensions of vulnerability, perceived control, and anxiety disorders. PMID:26236059

Emotion and anxiety potentiate the way attention alters visual appearance.

PubMed

Barbot, Antoine; Carrasco, Marisa

2018-04-12

The ability to swiftly detect and prioritize the processing of relevant information around us is critical for the way we interact with our environment. Selective attention is a key mechanism that serves this purpose, improving performance in numerous visual tasks. Reflexively attending to sudden information helps detect impeding threat or danger, a possible reason why emotion modulates the way selective attention affects perception. For instance, the sudden appearance of a fearful face potentiates the effects of exogenous (involuntary, stimulus-driven) attention on performance. Internal states such as trait anxiety can also modulate the impact of attention on early visual processing. However, attention does not only improve performance; it also alters the way visual information appears to us, e.g. by enhancing perceived contrast. Here we show that emotion potentiates the effects of exogenous attention on both performance and perceived contrast. Moreover, we found that trait anxiety mediates these effects, with stronger influences of attention and emotion in anxious observers. Finally, changes in performance and appearance correlated with each other, likely reflecting common attentional modulations. Altogether, our findings show that emotion and anxiety interact with selective attention to truly alter how we see.

Potential predictors of psychological distress and well-being in medical students: a cross-sectional pilot study.

PubMed

Bore, Miles; Kelly, Brian; Nair, Balakrishnan

2016-01-01

Research has consistently found that the proportion of medical students who experience high levels of psychological distress is significantly greater than that found in the general population. The aim of our research was to assess the levels of psychological distress more extensively than has been done before, and to determine likely predictors of distress and well-being. In 2013, students from an Australian undergraduate medical school (n=127) completed a questionnaire that recorded general demographics, hours per week spent studying, in paid work, volunteer work, and physical exercise; past and current physical and mental health, social support, substance use, measures of psychological distress (Kessler Psychological Distress Scale, depression, anxiety, stress, burnout); and personality traits. Females were found to have higher levels of psychological distress than males. However, in regression analysis, the effect of sex was reduced to nonsignificance when other variables were included as predictors of psychological distress. The most consistent significant predictors of our 20 indicators of psychological distress were social support and the personality traits of emotional resilience and self-control. The findings suggest that emotional resilience skills training embedded into the medical school curriculum could reduce psychological distress among medical students.

Having "been there" doesn't mean I care: when prior experience reduces compassion for emotional distress.

PubMed

Ruttan, Rachel L; McDonnell, Mary-Hunter; Nordgren, Loran F

2015-04-01

The current research found that participants who had previously endured an emotionally distressing event (e.g., bullying) more harshly evaluated another person's failure to endure a similar distressing event compared with participants with no experience enduring the event or those currently enduring the event. These effects emerged for naturally occurring (Studies 1, 3, and 4) and experimentally induced (Study 2) distressing events. This effect was driven by the tendency for those who previously endured the distressing event to view the event as less difficult to overcome (Study 3). Moreover, we demonstrate that the effect is specific to evaluations of perceived failure: Compared with those with no experience, people who previously endured a distressing event made less favorable evaluations of an individual failing to endure the event, but made more favorable evaluations of an individual managing to endure the event (Study 4). Finally, we found that people failed to anticipate this effect of enduring distress, instead believing that individuals who have previously endured emotionally distressing events would most favorably evaluate others' failures to endure (Study 5). Taken together, these findings present a paradox such that, in the face of struggle or defeat, the people we seek for advice or comfort may be the least likely to provide it. (c) 2015 APA, all rights reserved).

The role of negative emotionality and impulsivity in depressive/anxiety disorders and alcohol dependence.

PubMed

Boschloo, L; Vogelzangs, N; van den Brink, W; Smit, J H; Beekman, A T F; Penninx, B W J H

2013-06-01

Much is still unclear about the role of personality in the structure of common psychiatric disorders such as depressive/anxiety disorders and alcohol dependence. This study will therefore examine whether various traits of negative emotionality and impulsivity showed shared or specific associations with these disorders. Method Cross-sectional data were used from the Netherlands Study of Depression and Anxiety (NESDA), including individuals with no DSM-IV psychiatric disorder (n = 460), depressive/anxiety disorder only (i.e. depressive and/or anxiety disorder; n = 1398), alcohol dependence only (n = 32) and co-morbid depressive/anxiety disorder plus alcohol dependence (n = 358). Aspects of negative emotionality were neuroticism, hopelessness, rumination, worry and anxiety sensitivity, whereas aspects of impulsivity included disinhibition, thrill/adventure seeking, experience seeking and boredom susceptibility. Aspects of negative emotionality formed a homogeneous dimension, which was unrelated to the more heterogeneous construct of impulsivity. Although all aspects of negative emotionality were associated with alcohol dependence only, associations were much stronger for depressive/anxiety disorder only and co-morbid depressive/anxiety disorder with alcohol dependence. The results for impulsivity traits were less profound and more variable, with disinhibition and boredom susceptibility showing modest associations with both depressive/anxiety disorder and alcohol dependence, whereas low thrill/adventure seeking and high disinhibition were more strongly related with the first and the latter, respectively. Our results suggest that depressive/anxiety disorder and alcohol dependence result from shared as well as specific aetiological pathways as they showed the same associations with all aspects of negative emotionality, disinhibition and boredom susceptibility as well as specific associations with thrill/adventure seeking and disinhibition.

Predicting general and cancer-related distress in women with newly diagnosed breast cancer.

PubMed

Gibbons, Andrea; Groarke, AnnMarie; Sweeney, Karl

2016-12-03

Psychological distress can impact medical outcomes such as recovery from surgery and experience of side effects during treatment. Identifying the factors that explain variability in distress would guide future interventions aimed at decreasing distress. Two factors that have been implicated in distress are illness perceptions and coping, and are part of the Self-Regulatory Model of Illness Behaviour (SRM). The model suggests that coping mediates the relationship between illness perceptions and distress. Despite this; very little research has assessed this relationship with cancer-related distress, and none have examined women with screen-detected breast cancer. This study is the first to examine the relative contribution of illness perceptions and coping on general and cancer-related distress in women with screen-detected breast cancer. Women recently diagnosed with breast cancer (N = 94) who had yet to receive treatment completed measures of illness perceptions (Revised Illness Perception Questionnaire), cancer-specific coping (Mental Adjustment to Cancer Scale), general anxiety and depression (Hospital Anxiety and Depression scale), and cancer-related distress. Hierarchical regression analyses revealed that medical variables, illness perceptions and coping predicted 50% of the variance in depression, 42% in general anxiety, and 40% in cancer-related distress. Believing in more emotional causes to breast cancer (β = .22, p = .021), more illness identity (β = .25, p = .004), greater anxious preoccupation (β = .23, p = .030), and less fighting spirit (β = -.31, p = .001) predicted greater depression. Greater illness coherence predicted less cancer-related distress (β = -.20, p = .043). Greater anxious preoccupation also led to greater general anxiety (β = .44, p < .001) and cancer-related distress (β = .37, p = .001). Mediation analyses revealed that holding greater beliefs in a chronic timeline

The Role of Maternal Distress in the Report of Behavioral and Emotional Problems among Children with Chronic Disabilities.

PubMed

Silberg, Tamar; Brezner, Amichai; Gal, Gilad; Ahonniska-Assa, Jaana; Levav, Miriam

2016-01-01

Assessments of psychological symptoms in children often rely on caregivers' (usually mothers') reports. However, the reliability may be affected by the caregivers' own emotional distress (ED). The main objectives of this study were to assess the variability in ED of mothers of children with chronic physical disabilities, and its association with the ratings of their children's emotional and behavioral problems. Medical data of children diagnosed with chronic disabilities were analyzed (N = 72). Mothers completed the 12-item General Health Questionnaire (12-GHQ) to measure ED and the Child Behavior Checklist (CBCL) to assess children's emotional and behavioral problems Mothers' ED scores were compared with communitybased counterparts with similar socio-demographic characteristics (N = 657) from the Israel National Health Survey (INHS). Mothers of children with chronic physical disabilities had higher levels of ED compared to mothers in the general population. About 20% of the sample mothers had 12-GHQ scores compatible with DSM- IV depression or anxiety disorders. No differences in ED were found according to the type of child's disability or IQ score. Marked differences in CBCL scores were reported by mothers with high versus low ED, controlling for baseline maternal and child characteristics. High levels of maternal ED were associated with mothers' reports on child's behavioral and emotional problems.This may contaminate the reliability of parental reports on their child's psychological state.

Anxiety, Depression, and General Psychological Distress in Patients with Coronary Slow Flow

PubMed Central

Karataş, Mehmet Baran; Şahan, Ebru; Özcan, Kazım Serhan; Çanga, Yiğit; Güngör, Barış; Onuk, Tolga; İpek, Göktürk; Çakıllı, Yasin; Arugaslan, Emre; Bolca, Osman

2015-01-01

Background The relationship between psychiatric illness and heart disease has been frequently discussed in the literature. The aim of the present study was to investigate the relationship between anxiety, depression and overall psychological distress, and coronary slow flow (CSF). Methods In total, 44 patients with CSF and a control group of 50 patients with normal coronary arteries (NCA) were prospectively recruited. Clinical data, admission laboratory parameters, and echocardiographic and angiographic characteristics were recorded. Symptom Checklist 90 Revised (SCL-90-R), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) scales were administered to each patient. Results The groups were comparable with respect to age, sex, and atherosclerotic risk factors. In the CSF group, BAI score, BDI score, and general symptom index were significantly higher than controls (13 [18.7] vs. 7.5 [7], p = 0.01; 11 [14.7] vs. 6.5 [7], p = 0.01; 1.76 [0.81] vs. 1.1[0.24], p = 0.01; respectively). Patients with CSF in more than one vessel had the highest test scores. In univariate correlation analysis, mean thrombolysis in myocardial infarction (TIMI) frame counts were positively correlated with BAI (r = 0.56, p = 0.01), BDI (r = 0.47, p = 0.01), and general symptom index (r = 0.65, p = 0.01). The psychiatric tests were not correlated with risk factors for atherosclerosis. Conclusion Our study revealed higher rates of depression, anxiety, and overall psychological distress in patients with CSF. This conclusion warrants further studies. PMID:26559983

Clinical events in coronary patients who report low distress: adverse effect of repressive coping.

PubMed

Denollet, Johan; Martens, Elisabeth J; Nyklícek, Ivan; Conraads, Viviane M; de Gelder, Beatrice

2008-05-01

Coronary artery disease (CAD) patients who report low distress are considered to be at low psychological risk for clinical events. However, patients with a repressive coping style may fail to detect and report signals of emotional distress. The authors hypothesized that repressive CAD patients are at risk for clinical events, despite low self-rated distress. This was a prospective 5- to 10-year follow-up study, with a mean follow-up of 6.6 years. At baseline, 731 CAD patients filled out Trait-Anxiety (distress), Marlowe-Crowne (defensiveness), and Type D scales; 159 patients were classified as "repressive," 360 as "nonrepressive," and 212 as "Type D." The primary endpoint was a composite of total mortality or myocardial infarction (MI); the secondary endpoint was cardiac mortality/MI. No patients were lost to follow-up; 91 patients had a clinical event (including 35 cardiac death and 32 MI). Repressive patients reported low levels of anxiety, anger and depression at baseline, but were at increased risk for death/MI (21/159 = 13%) compared with nonrepressive patients (22/360 = 6%), p = .009. Poor systolic function, poor exercise tolerance, 3-vessel disease, index MI and Type-D personality--but not depression, anxiety or anger--also independently predicted clinical events. After controlling for these variables, repressive patients still had a twofold increased risk of death/MI, OR = 2.17, 95% CI = 1.10-4.08, p = .025). These findings were replicated for cardiac mortality/MI. CAD patients who use a repressive coping style are at increased risk for clinical events, despite their claims of low emotional distress. This phenomenon may cause an underestimation of the effect of stress on the heart. (PsycINFO Database Record (c) 2008 APA, all rights reserved).

A rational-emotive stress management intervention for reducing job burnout and dysfunctional distress among special education teachers: An effect study.

PubMed

Ugwoke, Samuel C; Eseadi, Chiedu; Onuigbo, Liziana N; Aye, Eucharia N; Akaneme, Immaculata N; Oboegbulem, Angie I; Ezenwaji, Ifeyinwa O; Nwobi, Anthonia U; Nwaubani, Okechukwu O; Ezegbe, Bernedeth N; Ede, Moses O; Orji, Chibueze T; Onuoha, Joseph C; Onu, Eucharia A; Okeke, Francisca; Agu, Patricia; Omeje, Joachim C; Omeke, Faith; Ugwu, Romanus; Arumede, Florence; Eneh, Annastasia

2018-04-01

Job-related burnout and distress are adverse stress responses which affect individuals in their occupational environment. This study aimed at investigating the effect of a rational-emotive stress management program on job burnout and dysfunctional distress among special education teachers in Nigeria. A pretest-posttest randomized control group design was used. The participants in the study were 54 special education teachers. Data were collected using self-report questionnaires. Participants were allocated to either the treatment group (n = 28 [59.1%]) or the waitlist control group (n = 26 [48.1%]), respectively. A rational-emotive stress management manual was used to deliver the intervention. We statistically analyzed the data collected at three-time points with repeated-measures analysis of variance. At baseline, the job-related burnout symptoms and distress scores of participants were high. However, an intention-to-treat analysis showed that the rational-emotive stress management intervention program was efficacious in reducing the levels of job-related burnout symptoms and dysfunctional distress among participants assigned to the treatment group, compared to a waitlisted group at post-treatment and follow-up meetings. Our study demonstrates the effectiveness of a rational-emotive stress management intervention in reducing the level of job-related burnout and distress in a sample of special education teachers in Nigeria. Occupational health counsellors and other clinicians with sufficient knowledge of rational-emotive behavior therapy framework are urged to employ this approach in assisting other employees in managing job burnout symptoms, and distress.

Death-Related Anxiety in Patients With Advanced Cancer: Validation of the German Version of the Death and Dying Distress Scale.

PubMed

Engelmann, Dorit; Scheffold, Katharina; Friedrich, Michael; Hartung, Tim J; Schulz-Kindermann, Frank; Lordick, Florian; Schilling, Georgia; Lo, Chris; Rodin, Gary; Mehnert, Anja

2016-10-01

Distress and anxiety about issues related to death and dying is commonly experienced in patients with advanced disease and a limited life expectancy. To evaluate the psychometric properties of the German version of the Death and Dying Distress Scale (DADDS-G) in advanced cancer patients. We recruited advanced patients with mixed tumor entities (Union for International Cancer Control [UICC] Stage III/IV) treated in two German University Medical Centers during their outpatient treatment. After testing a preliminary version of the state-of-the-art translated original Death and Dying Distress Scale, we analyzed the psychometric properties of the shortened nine-item adapted DADDS-G using validated instruments measuring distress, anxiety, depression, fear of progression, and quality of life. We obtained complete questionnaires from 77 of 93 patients with advanced cancer (response rate: 83%). Participants were mostly married or cohabiting (75%), well-educated, and both sexes were almost equally represented (52% men; mean age 58 years, SD = 12). The total mean DADDS-G score was 13.3 (SD = 8.5). Patients reported to be most distressed by the feeling of being a burden to others. The exploratory factor analysis led to one factor that accounted for more than 59% of the variance. The DADDS-G's internal consistency was excellent with Cronbach alpha = 0.91. The confirmatory factor analysis demonstrated a very good model fit. Death-related anxiety was significantly associated with distress, depression, anxiety, fear of progression, and lower quality of life (P < 0.001). Results provide further evidence that the DADDS-G is a valid and reliable instrument of high clinical relevance for use in patients with advanced cancer. Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

The association of metacognitive beliefs with emotional distress and trauma symptoms in adolescent and young adult survivors of cancer.

PubMed

Fisher, Peter L; McNicol, Kirsten; Cherry, Mary Gemma; Young, Bridget; Smith, Ed; Abbey, Gareth; Salmon, Peter

2018-04-03

Adolescent and young adults who have survived cancer are at an increased risk of psychological distress. This study investigated whether metacognitive beliefs are associated with emotional distress and trauma symptoms in adolescent and young adult (AYA) survivors of cancer independent of known covariates, including current physical health difficulties. Cross-sectional survey using multiple self-report measures. Eighty-seven AYA survivors of cancer were recruited from follow-up appointments at an oncology unit and completed self-report questionnaires measuring emotional distress, posttraumatic stress symptoms, metacognitive beliefs, demographic information, and current physical health difficulties. Data were analysed using correlational and hierarchical multiple regression analyses. Metacognitive beliefs explained an additional 50% and 41% of the variance in emotional distress and posttraumatic stress symptoms, respectively, after controlling for known covariate effects, including current physical health difficulties. Conclusions/Implications for Psychosocial Providers or Policy: The metacognitive model of psychopathology is potentially applicable to AYA survivors of cancer who present with elevated general distress and/or posttraumatic stress symptoms. Prospective studies are required to determine whether metacognitive beliefs and processes have a causal role in distress in AYA survivors of cancer.

How do cognition, emotion, and epileptogenesis meet? A study of emotional cognitive bias in temporal lobe epilepsy.

PubMed

Lanteaume, Laura; Bartolomei, Fabrice; Bastien-Toniazzo, Mireille

2009-06-01

Emotional distress is one of the most frequently reported seizure precipitants in epilepsy, but little is known about its causes and processes. Interestingly, it is now accepted that emotional distress, such as anxiety, may be accompanied by evolutionary adaptation, or abnormal attentional vigilance toward threatening stimuli. The goal of this research was to study the link between emotional seizure precipitants and pathological attention-related biases toward threat in temporal lobe epilepsy (TLE). To this aim, patients were asked to report the extent to which seizures were elicited or not by emotional precipitants, allowing distinction of two groups: "Emo-TLE" group and "Other-TLE" group. Attentional biases were investigated by comparing patients' emotional Stroop and dot detection paradigms with those of healthy individuals (control group). We found that the Emo-TLE group was characterized by attentional bias toward threatening stimuli compared with neutral stimuli and compared with the other two groups. We thus hypothesize that attentional biases related to threat in patients with TLE may sustain emotional vulnerability and seizure occurrence.

Relationship between athletes' emotional intelligence and precompetitive anxiety.

PubMed

Lu, Frank J-H; Li, Gladys Shuk-fong; Hsu, Eva Ya-wen; Williams, Lavon

2010-02-01

This study examined the relationship between athletes' Emotional Intelligence (EI) and precompetitive anxiety. Taiwanese intercollegiate track and field athletes (N = 111; 64 men, 47 women) completed the Bar-On EQ-i 1 mo. before a1 national intercollegiate athletic meet, and the Competition State Anxiety Inventory-2R 1 hr. before the competition. Analyses indicated that participants with the lowest EI scores reported greater intensity of precompetitive cognitive anxiety than those with the highest EI scores. No other statistically significant differences were found among the groups. Further, correlational analyses and multiple stepwise regression analyses revealed that EI components such as stress management, intrapersonal EI, and interpersonal EI were associated with precompetitive anxiety. Current EI measures provide limited understanding of precompetitive anxiety. A sport-specific EI measure is needed for future research.

Prevalence and patterns of depression and anxiety in hemodialysis patients: a 12-month prospective study on incident and prevalent populations.

PubMed

Ng, Hui Juan; Tan, Wei Jie; Mooppil, Nandakumar; Newman, Stanton; Griva, Konstadina

2015-05-01

Depression is common in dialysis patients and has been shown to be associated with higher morbidity and mortality, but little is known about the course of symptoms over time. The current study set up to explore group and individual patterns of change in symptoms of anxiety and depression within the hemodialysis population and to identify socio-demographic, clinical, and psychological factors that may be associated with different trajectories of emotional distress. A total of 159 hemodialysis patients (n = 42 incident and n = 117 prevalent) completed the Hospital Anxiety and Depression Scale and social support and symptoms subscales from the Kidney Disease Quality of Life (Short Form) on two occasions 12 months apart. Clinical cut-offs were used to identify individual patterns of change in anxiety and depression symptoms across time, and analysis of variance (ANOVA) procedures were employed to establish potential correlates of these trajectories. Mean levels of anxiety and depression symptoms remained unchanged over 1 year with 44.7-54.1% of patients above cut-off at both baseline and follow-up. Individual-level analyses showed that the course of symptoms does not follow a single trajectory. While most patients had either persistent symptoms of distress (39.6% and 31.8% for depression and anxiety, respectively) or no/low symptoms of distress (32.1% and 36.9% for depression and anxiety, respectively), a total of 12.7-18.5% patients either had new-onset symptoms of depression/anxiety or symptoms diminishing over time. Patients with persisting or new-onset symptoms of depression or anxiety reported reduced perceived social support and quality of social interaction compared to the subgroups with low depressive/anxious symptoms. Different patterns of symptoms reflect heterogeneity in patients' emotional reactions and adjustment. More research is needed to identify patients at risk for emotional distress and to explore social support in the context of dialysis. Statement

Changes in caseness of anxiety and depression in breast cancer patients during the first year following surgery: patterns of transiency and severity of the distress response.

PubMed

Saboonchi, Fredrik; Petersson, Lena-Marie; Wennman-Larsen, Agneta; Alexanderson, Kristina; Brännström, Richard; Vaez, Marjan

2014-12-01

Psychological distress is prevalent in patients with breast cancer and is viewed as a non-pathological occurrence. Severe distress and mental disorder display a substantial overlap in both conceptual contexts and studies in oncological settings. A domain that may contribute to distinguishing non-pathological distress from signs of potential disorder is the transiency of distress. To examine the transiency of distress response in breast cancer patients by investigating the changes in clinical caseness of depression and anxiety during one year following surgery. Data on the Hospital Anxiety and Depression Scale from a cohort of 715 women with breast cancer on three assessments within one year following breast surgery were subjected to Generalized Estimation Equation Analysis, McNemar's test, and logistic regression. There was a significant decrease in the proportions of anxiety cases from baseline (37.7%) to 4 months (26.7%) but no significant change from 4 to 12 months. Caseness in depression significantly increased from baseline (18.5%) to 4 months (21.5%) but decreased to 15.3% at 12 months. Only experience of major adverse life events contributed to 12 months caseness of anxiety and depression beyond baseline caseness. The average decrease in caseness of anxiety and depression a year following surgery lends support to the view of distress as a transient non-pathological response. A subgroup of patients, however, displayed enduring or recurrent severe distress indicating the presence of potential disorder. The findings emphasize the importance of screening and follow up monitoring of distress. Copyright © 2014 Elsevier Ltd. All rights reserved.

Effects of Nursing Care Based on Watson's Theory of Human Caring on Anxiety, Distress, And Coping, When Infertility Treatment Fails: A Randomized Controlled Trial.

PubMed

Durgun Ozan, Yeter; Okumuş, Hülya

2017-06-01

Introduction: The failure of infertility treatment leads to individual, familial, and social problems. The objective of this study was to evaluate the effectiveness of the nursing care program based on Watson's "Theory of Human Caring" on anxiety and distress caused by coping when the treatment fails. Methods: This study randomized controlled trial study was conducted from April to November 2012, with 86 Turkish women with infertility (intervention group: 45, control group: 41). Follow-up of 32 infertile women, who failed infertility treatment from intervention group, and 35 infertile women, who failed infertility treatment from control group, continued for another four weeks. Data were collected through Spiel Berger's State/Trait Anxiety Inventory, Distress Scale, and Ways of Coping Questionnaire. The analyses of data were conducted using SPSS ver 13. Results: The intervention and control groups significantly differed in terms of anxiety, distress, and coping levels. The intervention group's mean anxiety score decreased by thirteen points and distress by fourteen points (in a positive direction). The intervention group's mean positive coping style score increased. Whereas a negative increase was observed in the control group's values depending on the failure of the treatment. Conclusion: Watson's theory of human caring is recommended as a guide to nursing patients with infertility treatment to decrease levels of anxiety and distress, and to increase the positive coping style among infertile women.

Reappraisal deficits promote craving and emotional distress among chronic pain patients at risk for prescription opioid misuse.

PubMed

Garland, Eric L; Hanley, Adam W; Bedford, Carter E; Zubieta, Jon-Kar; Howard, Matthew O; Nakamura, Yoshio; Donaldson, Gary W; Froeliger, Brett

2018-06-04

A subset of chronic pain patients misuse prescription opioids as a means of regulating negative emotions. However, opioid misuse may result in deficits in emotion regulation strategies like reappraisal by virtue of the deleterious effects of chronic opioid exposure. The aim of this study was to characterize differences in reappraisal use among chronic pain patients at risk for opioid misuse and those who report taking opioids as prescribed. A sample of 127 pain patients receiving chronic opioid analgesic pharmacotherapy were classified as at risk for opioid misuse (n = 62) or taking opioids as prescribed (n = 65) using the Current Opioid Misuse Measure (COMM). The Emotion Regulation Questionnaire (ERQ) characterized use of emotion regulation strategies including reappraisal and expressive suppression. Participants also reported levels of opioid craving, emotional distress, and pain severity. Patients at risk for opioid misuse reported significantly less reappraisal use (M = 25.31, SD = 7.33) than those who reportedly took opioids as prescribed (M = 30.28, SD = 7.50), p<.001, but did differ with regard to suppression strategies. Reduced reappraisal use was associated with higher opioid craving and emotional distress that mediated the association between reappraisal deficits and opioid misuse risk. Further, there was a significant indirect effect of opioid misuse on emotional distress via reappraisal use. Opioid misuse risk was associated with reduced use of reappraisal, which in turn was associated with dysregulated negative emotions and increased appetitive drive towards consuming opioids. Studying individual differences in emotion regulation may yield efficacious intervention and prevention approaches to stem the rising tide of the prescription opioid crisis.

What's so special about eating? Examining unhealthy diet of adolescents in the context of other health-related behaviours and emotional distress.

PubMed

van Kooten, Maartje; de Ridder, Denise; Vollebergh, Wilma; van Dorsselaer, Saskia

2007-05-01

This study examines to what extent unhealthy diet in adolescents is related to other types of health-risk behaviours (e.g., smoking and alcohol intake). Whereas previous studies have emphasised that adolescents engage in health-risk behaviour because of a tendency to break the rules, the present study hypothesises that unhealthy diet may differ from this general pattern because emotional distress is involved. Data from the cross-sectional Dutch Health Behaviour in School aged Children study (N=5730) were employed to examine this issue. Participants completed questionnaires on eating habits, health-related behaviours, and emotional distress. Factor analysis confirmed the hypothesis that unhealthy diet is only weakly related to other health-risk behaviours. Contrary to our hypothesis, however, emotional distress was not a significant predictor of unhealthy diet. Further research is required to examine which factors other than emotional distress are responsible for engaging in unhealthy diets in adolescence.

Sex differences in anxiety and emotional behavior

PubMed Central

Donner, Nina C.; Lowry, Christopher A.

2013-01-01

Research has elucidated causal links between stress exposure and the development of anxiety disorders, but due to the limited use of female or sex-comparative animal models, little is known about the mechanisms underlying sex differences in those disorders. This is despite an overwhelming wealth of evidence from the clinical literature that the prevalence of anxiety disorders is about twice as high in women compared to men, in addition to gender differences in severity and treatment efficacy. We here review human gender differences in generalized anxiety disorder, panic disorder, posttraumatic stress disorder and anxiety-relevant biological functions, discuss the limitations of classic conflict anxiety tests to measure naturally occurring sex differences in anxiety-like behaviors, describe sex-dependent manifestation of anxiety states after gestational, neonatal, or adolescent stressors, and present animal models of chronic anxiety states induced by acute or chronic stressors during adulthood. Potential mechanisms underlying sex differences in stress-related anxiety states include emerging evidence supporting the existence of two anatomically and functionally distinct serotonergic circuits that are related to the modulation of conflict anxiety and panic-like anxiety, respectively. We discuss how these serotonergic circuits may be controlled by reproductive steroid hormone-dependent modulation of crfr1 and crfr2 expression in the midbrain dorsal raphe nucleus and by estrous stage-dependent alterations of γ-aminobutyric acid (GABAergic) neurotransmission in the periaqueductal gray, ultimately leading to sex differences in emotional behavior. PMID:23588380

Association between level of emotional intelligence and severity of anxiety in generalized social phobia.

PubMed

Jacobs, Madeline; Snow, Joseph; Geraci, Marilla; Vythilingam, Meena; Blair, R J R; Charney, Dennis S; Pine, Daniel S; Blair, Karina S

2008-12-01

Generalized social phobia (GSP) is characterized by a marked fear of most social situations. It is associated with an anomalous neural response to emotional stimuli, and individuals with the disorder frequently show interpretation bias in social situations. From this it might be suggested that GSP involves difficulty in accurately perceiving, using, understanding and managing emotions. Here we applied the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT) to medication-free GSP (n=28) and no pathology (n=21) individuals. Patients with GSP performed within the normal range on the measure however severity of social anxiety significantly correlated with emotional intelligence (EI). Specifically, there was a negative correlation between social anxiety severity and Experiential (basic-level emotional processing) EI. In contrast, there was no significant correlation between social anxiety severity and Strategic (higher-level conscious emotional processing) EI. These results suggest that EI may index emotional processing systems that mitigate the impact of systems causally implicated in GSP.

Association between Level of Emotional Intelligence and Severity of Anxiety in Generalized Social Phobia

PubMed Central

Jacobs, Madeline; Snow, Joseph; Geraci, Marilla; Vythilingam, Meena; Blair, R.J.R.; Charney, Dennis S.; Pine, Daniel S.; Blair, Karina S.

2008-01-01

Generalized Social Phobia (GSP) is characterized by a marked fear of most social situations. It is associated with an anomalous neural response to emotional stimuli, and individuals with the disorder frequently show interpretation bias in social situations. From this it might be suggested that GSP involves difficulty in accurately perceiving, using, understanding and managing emotions. Here we applied the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT) to medication-free GSP (n=28) and no pathology (n=21) individuals. Patients with GSP performed within the normal range on the measure however severity of social anxiety significantly correlated with emotional intelligence (EI). Specifically, there was a negative correlation between social anxiety severity and Experiential (basic-level emotional processing) EI. In contrast, there was no significant correlation between social anxiety severity and Strategic (higher-level conscious emotional processing) EI. These results suggest that EI may index emotional processing systems that mitigate the impact of systems causally implicated in GSP. PMID:18439799

Explaining elevated social anxiety among Asian Americans: emotional attunement and a cultural double bind.

PubMed

Lau, Anna S; Fung, Joey; Wang, Shu-Wen; Kang, Sun-Mee

2009-01-01

Previous research has documented elevated levels of social anxiety in Asian American college students when compared with their European American peers. The authors hypothesized that higher symptoms among Asians could be explained by cultural differences in attunement to the emotional states of others. Socialization within interdependent cultures may cultivate concerns about accurately perceiving other's emotional responses, yet at the same time, norms governing emotional control may limit competencies in emotion recognition. A sample of 264 Asian American and European American college students completed measures of social anxiety, attunement concerns (shame socialization and loss of face), and attunement competencies (self-reported sensitivity and performance on emotion recognition tasks). Results confirmed that ethnic differences in social anxiety symptoms were mediated by differences in attunement concerns and competencies in emotion recognition. Asian American college students may find themselves in a double bind that leads to social unease because of a cultural emphasis on sensitivity to others' emotions in the midst of barriers to developing this attunement skill set.

Psychological Distress and Drawing Tests among Women with Breast Cancer

PubMed Central

2018-01-01

Background The aim of this study was to evaluate the use of the Diagnostic Drawing Series (DDS) as a screening tool for the breast cancer patients with psychological distress. Methods All of 64 patients with breast cancer participated in this study. Patients' depressive and anxiety symptoms were assessed using Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) when the DDS was applied to the partipicants. Results Depressed patients used more enclosure in the Feeling drawings (P = 0.002) and tilt in Free drawings (P = 0.048). Patients with anxiety drew a picture over 67% of the paper (P = 0.015) in Tree drawing and more medium pressure (P = 0.049) in Feeling drawings. Thirty four subjects (77.3%) of unstable emotion group used over 67% of the space (P = 0.002). More Landscapes were observed in the Feeling drawings of unstable patients (P = 0.042). Conclusion These results suggested that DDS could be used as a supplemental screening tool for psychological distress in breast cancer patients. PMID:29686600

Emotion recognition specialization and context-dependent risk of anxiety and depression in adolescents.

PubMed

Oldehinkel, Albertine J; Hartman, Catharina A; Van Oort, Floor V A; Nederhof, Esther

2015-02-01

Some adolescents function poorly in apparently benign environments, while others thrive despite hassles and difficulties. The aim of this study was to examine if adolescents with specialized skills in the recognition of either positive or negative emotions have a context-dependent risk of developing an anxiety or depressive disorder during adolescence, depending on exposure to positive or harsh parenting. Data came from a large prospective Dutch population study (N = 1539). At age 11, perceived parental rejection and emotional warmth were measured by questionnaire, and emotion recognition skills by means of a reaction-time task. Lifetime diagnoses of anxiety and depressive disorders were assessed at about age 19, using a standardized diagnostic interview. Adolescents who were specialized in the recognition of positive emotions had a relatively high probability to develop an anxiety disorder when exposed to parental rejection (Bspecialization*rejection = 0.23, P < 0.01) and a relatively low probability in response to parental emotional warmth (Bspecialization*warmth = -0.24, P = 0.01), while the opposite pattern was found for specialists in negative emotions. The effect of parental emotional warmth on depression onset was likewise modified by emotion recognition specialization (B = -0.13, P = 0.03), but the effect of parental rejection was not (B = 0.02, P = 0.72). In general, the relative advantage of specialists in negative emotions was restricted to fairly uncommon negative conditions. Our results suggest that there is no unequivocal relation between parenting behaviors and the probability to develop an anxiety or depressive disorder in adolescence, and that emotion recognition specialization may be a promising way to distinguish between various types of context-dependent reaction patterns.

Emotion regulation and coping motives serially affect cannabis cessation problems among dually diagnosed outpatients.

PubMed

Buckner, Julia D; Walukevich, Katherine A; Zvolensky, Michael J; Gallagher, Matthew W

2017-11-01

Little empirical work has evaluated why anxious cannabis users are especially vulnerable to poorer cannabis cessation outcomes. Presumably, these individuals rely on cannabis because they have difficulties with emotion regulation and they therefore use cannabis to manage their negative emotions. The current study examined the direct and indirect effects of anxiety severity on a range of cannabis cessation variables among 79 (63.3% non-Hispanic White; 43.0% female) adults with anxiety disorders seeking outpatient treatment for cannabis use disorder. The independent and serial indirect effects of difficulties with emotion regulation and coping motives were examined in relation to the anxiety-cannabis variables. Anxiety severity was directly and robustly related to greater cannabis withdrawal symptom severity, less self-efficacy to refrain from using cannabis in emotionally distressing situations, and more reasons for quitting. Anxiety was indirectly related to cannabis outcomes via the serial effects of emotion regulation and coping motives. These findings document the important role of emotion regulation and coping motives in the relations of anxiety with cannabis cessation variables among dually diagnosed outpatients. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

An evaluation of rational-emotive imagery as a component of rational-emotive therapy in the treatment of test anxiety.

PubMed

Hymen, S P; Warren, R

1978-06-01

This study evaluated the efficacy of rational-emotive imagery as a component of rational-emotive therapy in reduction of college students' test anxiety. 11 volunteers met for 6 1-hr. group treatment sessions over a 3-wk. period. After 2 initial treatment sessions subjects were randomly assigned to groups given either rational-emotive therapy with rational-emotive imagery or rational-emotive therapy without imagery. Contrary to predictions, improvement between groups on self-report and performance measures was nonsignificant. Failure to obtain differences was attributed to similarities in content of treatment sessions and short treatment time. Combined groups reported significant improvement on all dependent measures. Although the study did not yield the predicted benefits of the imagery, results lend further support to the efficacy of rational-emotive therapy procedures in the reduction of test anxiety.

Pain and emotional distress among substance-use patients beginning treatment relative to a representative comparison group

PubMed Central

Wiest, Katharina L.; Colditz, Jason B.; Carr, Kathryn; Asphaug, Victoria J.; McCarty, Dennis; Pilkonis, Paul A.

2014-01-01

Objectives: A secondary analysis assessed health-related quality of life characteristics (i.e. anxiety, depression, fatigue, and types of pain) among patients entering substance-use treatment, and identified characteristics specific to treatment modalities relative to a representative comparison group. Methods: As part of a larger alcohol bank assessment, substance-use patients (n=406) beginning methadone treatment (n=170) or other outpatient treatment (n=236) and a comparison group representative of the general population (n=1000) completed a survey measuring anxiety, depression, fatigue, pain interference, and pain in the last 7 days. Previous studies lacked comparable and concurrent assessments across these three groups. Results: Patients entering substance-use treatment had relatively high levels of emotional distress and poorer health-related quality of life relative to the general population. Among treatment modalities, patients beginning methadone treatment reported the highest levels of pain interference and pain behavior and the poorest physical functioning. Prior to the potentially modifying effects of methadone maintenance, patients beginning agonist therapy reported the greatest levels of compromised quality of life. Conclusion: These data present the magnitude of differences in health-related quality of life characteristics between treatment and comparison groups using the same assessment rubric and may help inform the design and timing of treatment modalities, thereby enhancing treatment efficacy for patients. PMID:25275876

Childhood maltreatment, maladaptive personality types and level and course of psychological distress: A six-year longitudinal study.

PubMed

Spinhoven, Philip; Elzinga, Bernet M; Van Hemert, Albert M; de Rooij, Mark; Penninx, Brenda W

2016-02-01

Childhood maltreatment and maladaptive personality are both cross-sectionally associated with psychological distress. It is unknown whether childhood maltreatment affects the level and longitudinal course of psychological distress in adults and to what extent this effect is mediated by maladaptive personality. A sample of 2947 adults aged 18-65, consisting of healthy controls, persons with a prior history or current episode of depressive and/or anxiety disorders according to the Composite Interview Diagnostic Instrument were assessed in six waves at baseline (T0) and 1 (T1), 2 (T2), 4 (T4) and 6 years (T6) later. At each wave psychological distress was measured with the Inventory of Depressive Symptomatology, Beck Anxiety Inventory, and Fear Questionnaire. At T0 childhood maltreatment types were measured with a semi-structured interview (Childhood Trauma Interview) and personality traits with the NEO-Five Factor Inventory. Using latent variable analyses, we found that severity of childhood maltreatment (emotional neglect and abuse in particular) predicted higher initial levels of psychological distress and that this effect was mediated by maladaptive personality types. Differences in trajectories of distress between persons with varying levels of childhood maltreatment remained significant and stable over time. Childhood maltreatment was assessed retrospectively and maladaptive personality types and level of psychological distress at study entry were assessed concurrently. Routine assessment of maladaptive personality types and possible childhood emotional maltreatment in persons with severe and prolonged psychological distress seems warranted to identify persons who may need a different or more intensive treatment. Copyright © 2015 Elsevier B.V. All rights reserved.

Serotonin transporter polymorphism moderates effects of prenatal maternal anxiety on infant negative emotionality.

PubMed

Pluess, Michael; Velders, Fleur P; Belsky, Jay; van IJzendoorn, Marinus H; Bakermans-Kranenburg, Marian J; Jaddoe, Vincent W V; Hofman, Albert; Arp, Pascal P; Verhulst, Frank C; Tiemeier, Henning

2011-03-15

Consistent with the fetal programming hypothesis, effects of maternal prenatal anxiety have been found to predict various measures of infant temperament in the early postnatal period. In recent years, a polymorphism in the serotonin transporter gene (5-HTTLPR) emerged as a moderator of diverse environmental influences on different outcomes, with individuals carrying the short allele being generally more vulnerable to adversity. We tested whether the association between self-reported maternal anxiety at 20 weeks gestation (Brief Symptom Inventory) and mother-rated infant negative emotionality at 6 months after birth (Infant Behavior Questionnaire-Revised) would be moderated by the 5-HTTLPR in a large Dutch cohort sample (n = 1513). We hypothesized that infants carrying the 5-HTTLPR short allele would be more susceptible and therefore more affected by both low and high prenatal maternal anxiety vis-à-vis negative emotionality than other genotypes. Findings of a significant gene × environment interaction (B = .65, p = .01) were supportive of a vulnerability model, with infants carrying the short allele being more negatively emotional when mothers reported anxiety during pregnancy, whereas there was no difference between genotypes on negative emotionality when maternal anxiety was low. The association between maternal anxiety during pregnancy and negative emotionality in early infancy was significant in infants carrying one or more copies of the short allele but not in those homozygous for the long allele. The 5-HTTLPR short allele might increase vulnerability to adverse environmental influences as early as the fetal period. Copyright © 2011 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

Time for a Change: College Students' Preference for Technology-Mediated Versus Face-to-Face Help for Emotional Distress.

PubMed

Lungu, Anita; Sun, Michael

2016-12-01

Even with recent advances in psychological treatments and mobile technology, online computerized therapy is not yet popular. College students, with ubiquitous access to technology, experiencing high distress, and often nontreatment seekers, could be an important area for online treatment dissemination. Finding ways to reach out to college students by offering psychological interventions through technology, devices, and applications they often use, might increase their engagement in treatment. This study evaluates college students' reported willingness to seek help for emotional distress through novel delivery mediums, to play computer games for learning emotional coping skills, and to disclose personal information online. We also evaluated the role of ethnicity and level of emotional distress in help-seeking patterns. A survey exploring our domains of interest and the Mental Health Inventory ([MHI] as mental health index) were completed by 572 students (mean age 18.7 years, predominantly Asian American, female, and freshmen in college). More participants expressed preference for online versus face-to-face professional help. We found no relationship between MHI and help-seeking preference. A third of participants were likely to disclose at least as much information online as face-to-face. Ownership of mobile technology was pervasive. Asian Americans were more likely to be nontreatment seekers than Caucasians. Most participants were interested in serious games for emotional distress. Our results suggest that college students are very open to creative ways of receiving emotional help such as playing games and seeking emotional help online, suggesting a need for online evidence-based treatments.

Psychological distress and coping in military cadre candidates

PubMed Central

Nakkas, Can; Annen, Hubert; Brand, Serge

2016-01-01

Background Soldiers must cope with stressors during both military operations and training if they are to accomplish their missions successfully and stay mentally stable. This holds true particularly for military superiors, as they bear greater responsibilities and must meet greater demands during both deployment and training. Accordingly, in the present study, we investigated whether recruits chosen for further promotion at the end of basic training differed with regard to psychological distress and coping strategies from those not chosen for promotion, and whether recruits’ coping styles and distress levels were associated. Methods A total of 675 Swiss recruits took part in the study. At the beginning of basic training, recruits filled out self-rating questionnaires covering demographic data, psychological distress (depression, somatization, anxiety, interpersonal sensitivity, and hostility), and coping styles. Results were compared between those recruits who received a recommendation for further promotion at the end of basic training and those who did not. Results Recruits selected for promotion had lower scores for depressive symptoms and hostility, engaged more in active coping, and considered their coping to be more effective. Dysfunctional and functional coping were associated with higher and lower distress levels, respectively. Conclusion Recruits recommended for promotion exhibited less psychological distress during basic training and exhibited a socially more conducive profile of distress. They also endorsed more efficient and more prosocial coping strategies than those recruits not recommended for promotion. These cognitive–emotional features not only contribute to resilience but are also consistent with leadership research, indicating the importance of emotional stability and prosocial behavior in successful leaders. PMID:27621634

Anxiety and stress in the postpartum: is there more to postnatal distress than depression?

PubMed

Miller, Renée L; Pallant, Julie F; Negri, Lisa M

2006-03-24

Postnatal depression has received considerable research and clinical attention, however anxiety and stress in the postpartum has been relatively ignored. Along with the widespread use of the Edinburgh Postnatal Depression Scale (EPDS), depression has become the marker for postnatal maladjustment. Symptoms of anxiety tend to be subsumed within diagnoses of depression, which can result in anxiety being minimized or overlooked in the absence of depression. Some researchers have identified the need to distinguish between postnatal depression and anxiety, and to discern cases where depression and anxiety co-exist. The aim of this study was to assess the prevalence of postnatal distress using the EPDS and the Depression Anxiety Stress Scales (DASS-21). As part of a larger cross-sectional study, the EPDS and DASS-21 were administered to a convenience sample of 325 primiparous mothers, who ranged in age from 18 to 44 years (M = 32 years). Recruited through mother's groups and health centres in Melbourne Australia, inclusion was limited to mothers whose babies were aged between 6 weeks and 6 months. Analyses included comparisons between the classifications of women according to the EPDS and the DASS-21, and an exploration of the extent to which the EPDS identified anxious-depressed women. The EPDS identified 80 women (25%) as possibly depressed (using a cut-off of over 9), of which the DASS-21 corroborated 58%. In the total sample, 61 women (19%) were classified by the DASS-21 to be depressed. Using broader criteria for distress, it was revealed by the DASS-21 that a further 33 women (10%) showed symptoms of anxiety and stress without depression. A total of 41 women (13%) had symptoms of anxiety either in isolation or in combination with depression. The DASS-21 identified 7% of the sample as being both anxious and depressed. This at-risk sub-group had higher mean EPDS and DASS-depression scores than their depressed-only counterparts. The prevalence of anxiety and stress in

Emotion Regulation and the Transdiagnostic Role of Repetitive Negative Thinking in Adolescents with Social Anxiety and Depression.

PubMed

Klemanski, David H; Curtiss, Joshua; McLaughlin, Katie A; Nolen-Hoeksema, Susan

2017-04-01

Social anxiety and depression are common mental health problems among adolescents and are frequently comorbid. Primary aims of this study were to (1) elucidate the nature of individual differences in specific emotion regulation deficits among adolescents with symptoms of social anxiety and depression, and (2) determine whether repetitive negative thinking (RNT) functions as a transdiagnostic factor. A diverse sample of adolescents (N = 1065) completed measures assessing emotion regulation and symptoms of social anxiety and depression. Results indicated that adolescents with high levels of social anxiety and depression symptoms reported decreased emotional awareness, dysregulated emotion expression, and reduced use of emotion management strategies. The hypothesized structural model in which RNT functions as a transdiagnostic factor exhibited a better fit than an alternative model in which worry and rumination function as separate predictors of symptomatology. Findings implicate emotion regulation deficits and RNT in the developmental psychopathology of youth anxiety and mood disorders.

Emotional Distress, Bullying Victimization, and Protective Factors Among Transgender and Gender Diverse Adolescents in City, Suburban, Town, and Rural Locations.

PubMed

Eisenberg, Marla E; Gower, Amy L; McMorris, Barbara J; Rider, G Nicole; Coleman, Eli

2018-06-25

Understanding the root causes of the substantial disparities in risk and protective factors among transgender and gender diverse (TGD) adolescents is essential to the development and expansion of resources and supports for this vulnerable population. This study examines differences in emotional distress, bullying victimization, and protective factors among TGD high school students in city, suburban, town, and rural locations. Data come from a statewide school-based survey conducted in Minnesota in 2016 (n = 2,168 TGD youth). Analysis of covariance models were used to predict the prevalence of multiple indicators of emotional distress, bullying victimization, and protective factors across the 4 location categories, with multiple adjustments. Significant linear trends were observed for 2 emotional distress outcomes and 2 bullying victimization outcomes, with urban TGD students having the lowest rates and rural having the highest prevalences. Additional significant differences in emotional distress were noted, with unexpectedly high rates of depressive symptoms and suicidal ideation among suburban students. Helping TGD adolescents in all types of locations identify resources and supportive professionals is critical to supporting this population. © 2018 National Rural Health Association.

Coping strategies and psychological distress in caregivers of patients with Amyotrophic Lateral Sclerosis (ALS).

PubMed

Siciliano, Mattia; Santangelo, Gabriella; Trojsi, Francesca; Di Somma, Carmela; Patrone, Manila; Femiano, Cinzia; Monsurrò, Maria Rosaria; Trojano, Luigi; Tedeschi, Gioacchino

2017-08-01

Amyotrophic lateral sclerosis (ALS) causes distress in caregivers. The present study aims to examine the association between coping strategies and psychological distress in caregivers of ALS patients. Coping strategies were assessed in 96 ALS informal caregivers by means of the Coping Inventory for Stressful Situations. Data about caregivers' demographic characteristics, levels of burden, depression and anxiety (psychological distress) were also gathered by standardised questionnaires. Patients' clinical, cognitive and behavioural disturbances were evaluated by ALS specific assessment tools. Sequential logistic regression analysis showed that emotion-oriented coping strategy was significantly associated with high levels of depressive (p < 0.01) and anxiety (p < 0.05) symptoms and high levels of burden (p < 0.05), after controlling for all other variables. Moreover, a significant relationship of patients' functional dependence levels with burden experienced by caregivers was observed. No relationships were detected between task-oriented and avoidance-oriented coping strategies and caregivers' levels of psychological distress. The present study supported the mediating effects of coping strategies on intensity of burden, depression and anxiety experienced by ALS caregivers. These findings suggest that interventions aimed at reducing utilisation of maladaptive coping strategies may improve well-being in ALS caregivers, and, possibly, management of symptoms in ALS patients.

Improving help-seeking for postnatal depression and anxiety: a cluster randomised controlled trial of motivational interviewing.

PubMed

Holt, Charlene; Milgrom, Jeannette; Gemmill, Alan W

2017-12-01

Low uptake of treatment by women with symptoms of postnatal depression and anxiety is consistently reported. This study examined whether a brief motivational interviewing (MI) intervention delivered by Maternal and Child Health Nurses (MCHNs) during routine emotional health assessments improves help-seeking following childbirth. In this parallel two-group cluster randomised controlled trial, MCHNs delivered a MI intervention ('PRIMER', n = 20) or Routine Care (n = 20) at women's (n = 541) postnatal consultations. The primary outcome was help-seeking over the 12 months post-birth. Other outcomes were emotional distress measured by the Edinburgh Postnatal Depression Scale, Beck Depression Inventory-Revised and Depression Anxiety Stress Scales, and barriers to help-seeking obtained by self-report via a checklist of potential barriers that was presented to women to select from if applicable. 27.4% of the sample experienced emotional distress over the 12 months post-birth. When comparing women who experienced emotional distress with those who did not, odds of seeking help were 4.0 times higher for the MI condition than Routine Care (p = .004). Of the women who sought help from a psychologist, 47.6% in the MI condition attended 6 + sessions versus 20.0% in Routine Care (numbers too small for reliable significance test). There was a non-significant trend of lower depression, anxiety and stress in the MI condition. Three risk factors for postnatal depression predicted help-seeking: antenatal anxiety (OR = 2.8, p = .002), depression history (OR = 2.5, p = .002) and self-esteem (OR = 0.7, p = .04). Common barriers to seeking help were thinking that one would or should be able to manage without help (endorsed by 11.1%). Treatment uptake for postnatal distress can be increased with MI. Training MCHNs in MI was feasible and valued. Given the devastating effects of depression, further research is needed to ascertain whether MI can improve mental health

[Hyperhidrosis and social anxiety disorder--the same old thing under a different cloak?].

PubMed

Nahaloni, Elad; Iancu, Iulian

2014-10-01

Hyperhidrosis is a reason for treatment by many specialists in medicine, such as dermatologists, family medicine doctors, surgeons and also psychiatrists. Hyperhidrosis causes considerable distress and disability. Despite the fact that the condition has been known for thousands of years, it is yet unclear whether excessive sweating derives from emotional" activation of the central nervous system, whether the emotional symptoms evolve due to local dysfunction of the sweat glands, or a combination of the two problems. In this article, we will present two conditions: hyperhidrosis and Social Anxiety Disorder, a mental condition with anxiety and avoidanrce in social settings that is frequently accompanied by sweating. We will discuss the similarities and differences between these disorders and the various treatments available for these conditions. Research shows that social anxiety does not explain hyperhidrosis, but that excessive sweating reduces the threshold for social anxiety. Among people with hyperhidrosis, the functional disability and the emotional problems are mediated by the social anxiety. We propose treating the symptoms of hyperhidrosis and social anxiety disorder in combination in order to achieve maximal improvement in these patients.

Response expectancy versus response hope in predicting birth-related emotional distress and pain.

PubMed

Anton, Raluca; David, Daniel

2013-01-01

Response expectancies and response hopes have been shown to be two distinct constructs with important implications for nonvolitional outcomes. More specifically, studies show that response expectancies: (1) are sufficient to cause nonvolitional outcomes, (2) are not mediated by other psychological variables, and (3) are self-confirming while seemingly automatic. A new programmatic research line has differentiated between people's response expectancies and their response hopes regarding nonvolitional outcomes and showed that even if response hope and response expectancy are separate constructs, they are not unrelated. These concepts have not yet been studied in pregnant women. Moreover, determining the causal factors that best explain the variance of emotional distress and pain in pregnancy is of great importance. Thus, the aim of this study was to investigate the interrelations between response expectancy and response hope in pregnant women with respect to (1) emotional distress prior to giving birth and (2) pain during giving birth. Additionally, self-reported labor hours were analyzed as a secondary outcome. Results show that response expectancy for pain directly predicts pain, and that the discrepancy between response hopes and response expectancies is a strong predictor of investigated outcomes. Thus, our results support the idea that preventive psychological interventions for pregnant women should emphasize adjusting response expectancies and response hopes regarding the pain and emotional distress associated with giving birth. We believe that the results have both theoretical and practical implications and the topic deserves further investigation.

Prefrontal mediation of emotion regulation in social anxiety disorder during laughter perception.

PubMed

Kreifelts, Benjamin; Brück, Carolin; Ethofer, Thomas; Ritter, Jan; Weigel, Lena; Erb, Michael; Wildgruber, Dirk

2017-02-01

Social anxiety disorder (SAD) is characterized by negatively biased perception of social cues and deficits in emotion regulation. While negatively biased perception is thought to maintain social anxiety, emotion regulation represents an ability necessary to overcome both biased perception and social anxiety. Here, we used laughter as a social threat in a functional magnetic resonance imaging (fMRI) study to identify cerebral mediators linking SAD with attention and interpretation biases and their modification through cognitive emotion regulation in the form of reappraisal. We found that reappraisal abolished the negative laughter interpretation bias in SAD and that this process was directly mediated through activation patterns of the left dorsolateral prefrontal cortex (DLPFC) serving as a cerebral pivot between biased social perception and its normalization through reappraisal. Connectivity analyses revealed reduced prefrontal control over threat-processing sensory cortices (here: the temporal voice area) during cognitive emotion regulation in SAD. Our results indicate a central role for the left DLPFC in SAD which might represent a valuable target for future research on interventions either aiming to directly modulate cognitive emotion regulation in SAD or to evaluate its potential as physiological marker for psychotherapeutic interventions relying on emotion regulation. Copyright © 2017 Elsevier Ltd. All rights reserved.

Emotional states as mediators between tinnitus loudness and tinnitus distress in daily life: Results from the “TrackYourTinnitus” application

PubMed Central

Probst, Thomas; Pryss, Rüdiger; Langguth, Berthold; Schlee, Winfried

2016-01-01

The psychological process how tinnitus loudness leads to tinnitus distress remains unclear. This cross-sectional study investigated the mediating role of the emotional state “stress level” and of the two components of the emotional state “arousal” and “valence” with N = 658 users of the “TrackYourTinnitus” smartphone application. Stress mediated the relationship between tinnitus loudness and tinnitus distress in a simple mediation model and even in a multiple mediation model when arousal and valence were held constant. Arousal mediated the loudness-distress relationship when holding valence constant, but not anymore when controlling for valence as well as for stress. Valence functioned as a mediator when controlling for arousal and even when holding arousal and stress constant. The direct effect of tinnitus loudness on tinnitus distress remained significant in all models. This study demonstrates that emotional states affect the process how tinnitus loudness leads to tinnitus distress. We thereby could show that the mediating influence of emotional valence is at least equally strong as the influence of stress. Implications of the findings for future research, assessment, and clinical management of tinnitus are discussed. PMID:26853815

Memory bias in health anxiety is related to the emotional valence of health-related words.

PubMed

Ferguson, Eamonn; Moghaddam, Nima G; Bibby, Peter A

2007-03-01

A model based on the associative strength of object evaluations is tested to explain why those who score higher on health anxiety have a better memory for health-related words. Sixty participants observed health and nonhealth words. A recognition memory task followed a free recall task and finally subjects provided evaluations (emotionality, imageability, and frequency) for all the words. Hit rates for health words, d', c, and psychological response times (PRTs) for evaluations were examined using multi-level modelling (MLM) and regression. Health words had a higher hit rate, which was greater for those with higher levels of health anxiety. The higher hit rate for health words is partly mediated by the extent to which health words are evaluated as emotionally unpleasant, and this was stronger for (moderated by) those with higher levels of health anxiety. Consistent with the associative strength model, those with higher levels of health anxiety demonstrated faster PRTs when making emotional evaluations of health words compared to nonhealth words, while those lower in health anxiety were slower to evaluate health words. Emotional evaluations speed the recognition of health words for high health anxious individuals. These findings are discussed with respect to the wider literature on cognitive processes in health anxiety, automatic processing, implicit attitudes, and emotions in decision making.

Self-esteem, body-esteem, emotional intelligence, and social anxiety in a college sample: the moderating role of weight.

PubMed

Abdollahi, Abbas; Abu Talib, Mansor

2016-01-01

To examine the relationships between self-esteem, body-esteem, emotional intelligence, and social anxiety, as well as to examine the moderating role of weight between exogenous variables and social anxiety, 520 university students completed the self-report measures. Structural equation modeling revealed that individuals with low self-esteem, body-esteem, and emotional intelligence were more likely to report social anxiety. The findings indicated that obese and overweight individuals with low body-esteem, emotional intelligence, and self-esteem had higher social anxiety than others. Our results highlight the roles of body-esteem, self-esteem, and emotional intelligence as influencing factors for reducing social anxiety.

[Cognitive and emotional impairments in patients with protracted anxiety-phobic disorders].

PubMed

Chutko, L S; Surushkina, S Iu; Iakovenko, E A; Nikishena, I S; Anisimova, T I; Bondarchuk, Iu L

2014-01-01

To study cognitive and emotional impairments in patients with anxiety-phobic disorders (APDs), to comparatively analyze the clinical manifestations of acute (less than one-year) and protracted (1-to-5-year) forms of this disease, and to evaluate the efficacy of noofen used to treat this pathology. Sixty-two patients aged 18 to 50 years with APDs were examined. The investigators collected clinical history data, performed neurological examination, and assessed autonomic disorders in accordance with the questionnaire to reveal their signs, anxiety using the Hamilton anxiety rating scale, memory impairment employing the methods developed by A.R. Luria, attention disorders applying the test of variables of attention, and diagnosed emotional intelligence using the Mayer-Salovey-Caruso emotional intelligence test. Noofen 1000 mg/day was used to treat the patients. Protracted APDs were shown to be characterized by the higher degree of psychosomatic symptoms and by more pronounced impairments in attention, memory, and emotional intelligence. The data of posttreatment clinical and psychological studiesare indicative of improvements in 73.3% of cases. The findings may lead to the conclusion that noofen is highly effective in the treatment of patients with protracted APDs.

Emotion recognition specialization and context-dependent risk of anxiety and depression in adolescents

PubMed Central

Oldehinkel, Albertine J; Hartman, Catharina A; Van Oort, Floor V A; Nederhof, Esther

2015-01-01

Background Some adolescents function poorly in apparently benign environments, while others thrive despite hassles and difficulties. The aim of this study was to examine if adolescents with specialized skills in the recognition of either positive or negative emotions have a context-dependent risk of developing an anxiety or depressive disorder during adolescence, depending on exposure to positive or harsh parenting. Methods Data came from a large prospective Dutch population study (N = 1539). At age 11, perceived parental rejection and emotional warmth were measured by questionnaire, and emotion recognition skills by means of a reaction-time task. Lifetime diagnoses of anxiety and depressive disorders were assessed at about age 19, using a standardized diagnostic interview. Results Adolescents who were specialized in the recognition of positive emotions had a relatively high probability to develop an anxiety disorder when exposed to parental rejection (Bspecialization*rejection = 0.23, P < 0.01) and a relatively low probability in response to parental emotional warmth (Bspecialization*warmth = −0.24, P = 0.01), while the opposite pattern was found for specialists in negative emotions. The effect of parental emotional warmth on depression onset was likewise modified by emotion recognition specialization (B = −0.13, P = 0.03), but the effect of parental rejection was not (B = 0.02, P = 0.72). In general, the relative advantage of specialists in negative emotions was restricted to fairly uncommon negative conditions. Conclusions Our results suggest that there is no unequivocal relation between parenting behaviors and the probability to develop an anxiety or depressive disorder in adolescence, and that emotion recognition specialization may be a promising way to distinguish between various types of context-dependent reaction patterns. PMID:25642389

Subliminal processing of emotional information in anxiety and depression.

PubMed

Mogg, K; Bradley, B P; Williams, R; Mathews, A

1993-05-01

The study investigated selective processing of emotional information in anxiety and depression using a modified Stroop color naming task. Anxious (n = 19), depressed (n = 18), and normal control (n = 18) subjects were required to name the background colors of anxiety-related, depression-related, positive, categorized, and uncategorized neutral words. Half of the words were presented supraliminally, half subliminally. Anxious subjects, compared with depressed and normal subjects, showed relatively slower color naming for both supraliminal and subliminal negative words. The results suggest a preattentive processing bias for negative information in anxiety.

Emotion Regulation and the Transdiagnostic Role of Repetitive Negative Thinking in Adolescents with Social Anxiety and Depression

PubMed Central

Curtiss, Joshua; McLaughlin, Katie A.; Nolen-Hoeksema, Susan

2016-01-01

Social anxiety and depression are common mental health problems among adolescents and are frequently comorbid. Primary aims of this study were to (1) elucidate the nature of individual differences in specific emotion regulation deficits among adolescents with symptoms of social anxiety and depression, and (2) determine whether repetitive negative thinking (RNT) functions as a transdiagnostic factor. A diverse sample of adolescents (N = 1065) completed measures assessing emotion regulation and symptoms of social anxiety and depression. Results indicated that adolescents with high levels of social anxiety and depression symptoms reported decreased emotional awareness, dysregulated emotion expression, and reduced use of emotion management strategies. The hypothesized structural model in which RNT functions as a transdiagnostic factor exhibited a better fit than an alternative model in which worry and rumination function as separate predictors of symptomatology. Findings implicate emotion regulation deficits and RNT in the developmental psychopathology of youth anxiety and mood disorders. PMID:28579659

The effects of social anxiety on emotional face discrimination and its modulation by mouth salience.

PubMed

du Rocher, Andrew R; Pickering, Alan D

2018-05-21

People high in social anxiety experience fear of social situations due to the likelihood of social evaluation. Whereas happy faces are generally processed very quickly, this effect is impaired by high social anxiety. Mouth regions are implicated during emotional face processing, therefore differences in mouth salience might affect how social anxiety relates to emotional face discrimination. We designed an emotional facial expression recognition task to reveal how varying levels of sub-clinical social anxiety (measured by questionnaire) related to the discrimination of happy and fearful faces, and of happy and angry faces. We also categorised the facial expressions by the salience of the mouth region (i.e. high [open mouth] vs. low [closed mouth]). In a sample of 90 participants higher social anxiety (relative to lower social anxiety) was associated with a reduced happy face reaction time advantage. However, this effect was mainly driven by the faces with less salient closed mouths. Our results are consistent with theories of anxiety that incorporate an oversensitive valence evaluation system.

Neural Basis of Emotional Decision Making in Trait Anxiety

PubMed Central

Xu, Pengfei; Gu, Ruolei; Broster, Lucas S.; Wu, Runguo; Van Dam, Nicholas T.; Jiang, Yang; Fan, Jin

2013-01-01

Although trait anxiety has been associated with risk decision making, whether it is related to risk per se or to the feeling of the risk, as well as the underlying neurocognitive mechanisms, remains unclear. Using a decision-making task with a manipulation of frame (i.e., written description of options as a potential gain or loss) and functional magnetic resonance imaging, we investigated the neurocognitive relationship between trait anxiety and decision making. The classic framing effect was observed: participants chose the safe option when it was described as a potential gain, but they avoided the same option when it was described as a potential loss. Most importantly, trait anxiety was positively correlated with this behavioral bias. Trait anxiety was also positively correlated with amygdala-based “emotional” system activation and its coupling with the ventromedial prefrontal cortex (vmPFC) when decisions were consistent with the framing effect, but negatively correlated with the dorsal anterior cingulate cortex (dACC)-based “analytic” system activation and its connectivity to the vmPFC when decisions ran counter to the framing effect. Our findings suggest that trait anxiety is not associated with subjective risk preference but an evaluative bias of emotional information in decision making, underpinned by a hyperactive emotional system and a hypoactive analytic system in the brain. PMID:24259585

Sleep problems in cancer patients: prevalence and association with distress and pain.

PubMed

Sharma, Neelom; Hansen, Christian Holm; O'Connor, Mark; Thekkumpurath, Parvez; Walker, Jane; Kleiboer, Annet; Murray, Gordon; Espie, Colin; Storey, Dawn; Sharpe, Michael; Fleming, Leanne

2012-09-01

Although it is increasingly recognized that cancer patients often have sleep problems, we lack data on their prevalence and associations in representative clinical populations. We aimed to determine (i) the prevalence of sleep problems amongst outpatients of a cancer centre and (ii) the association with medical variables, emotional distress and pain. Secondary analysis of self-report and medical data on 2862 cancer centre outpatients. Sleep problems were identified using the sleep item from the Patient Health Questionnaire-9: 'Over the last two weeks, how often have you been bothered by trouble falling or staying asleep or sleeping too much?' scored on a four-point frequency scale. Emotional distress was measured using the Hospital Anxiety and Depression Scale and pain using the subscale of the European Organisation for Research and Treatment of Cancer Quality of Life Core 30 questionnaire. Medical data were obtained from the cancer centre clinical database. Sleep problems (bothered more than half the days during the previous 2 weeks) were reported by 30.2% (865/2862, 95% CI = 28.5 to 31.9) of the patients. They were common in both patients with active cancer (34.5%) and in cancer survivors (28.0%). There was only a modest association with cancer site and treatment status, but there was a strong association with pain (odds ratio = 2.7, 95% CI = 2.2 to 3.4) and emotional distress (odds ratio = 4.5, 95% CI = 3.7 to 5.6). Sleep problems are common in cancer outpatients and are strongly associated with pain and emotional distress. A combined approach to the management of sleep, pain and emotional distress is indicated. Copyright © 2011 John Wiley & Sons, Ltd. Copyright © 2011 John Wiley & Sons, Ltd.

Mental Health Prevention in UK Classrooms: The Friends Anxiety Prevention Programme

ERIC Educational Resources Information Center

Stallard, Paul

2010-01-01

Childhood anxiety is a common condition which, if untreated, can cause considerable distress and impairment and increase the likelihood of mental health problems in adulthood. Developing good emotional health in children is therefore an important objective which has been emphasised in recent governmental initiatives and policies. In particular,…

Online self-test identifies women at high familial breast cancer risk in population-based breast cancer screening without inducing anxiety or distress.

PubMed

van Erkelens, A; Sie, A S; Manders, P; Visser, A; Duijm, L E; Mann, R M; Ten Voorde, M; Kroeze, H; Prins, J B; Hoogerbrugge, N

2017-06-01

Identifying high familial breast cancer (FBC) risk improves detection of yet unknown BRCA1/2-mutation carriers, for whom BC risk is both highly likely and potentially preventable. We assessed whether a new online self-test could identify women at high FBC risk in population-based BC screening without inducing anxiety or distress. After their visit for screening mammography, women were invited by email to take an online self-test for identifying highly increased FBC risk-based on Dutch guidelines. Exclusion criteria were previously diagnosed as increased FBC risk or a personal history of BC. Anxiety (State-Trait Anxiety Inventory Dutch Version), distress (Hospital Anxiety Depression Scale) and BC risk perception were assessed using questionnaires, which were completed immediately before and after taking the online self-test and 2 weeks later. Of the 562 women invited by email, 406 (72%) completed the online self-test while 304 also completed questionnaires (response rate 54%). After exclusion criteria, 287 (51%) were included for data analysis. Median age was 56 years (range 50-74). A high or moderate FBC risk was identified in 12 (4%) and three (1%) women, respectively. After completion of the online self-test, anxiety and BC risk perception were decreased while distress scores remained unchanged. Levels were below clinical relevance. Most women (85%) would recommend the self-test; few (3%) would not. The online self-test identified previously unknown women at high FBC risk (4%), who may carry a BRCA1/2-mutation, without inducing anxiety or distress. We therefore recommend offering this self-test to women who attend population-based screening mammography for the first time. Copyright © 2017 Elsevier Ltd. All rights reserved.

Family income, maternal psychological distress and child socio-emotional behaviour: Longitudinal findings from the UK Millennium Cohort Study.

PubMed

Noonan, Katharine; Burns, Richéal; Violato, Mara

2018-04-01

The association between low family income and socio-emotional behaviour problems in early childhood has been well-documented, and maternal psychological distress is highlighted as central in mediating this relationship. However, whether this relationship holds for older children, and the precise mechanisms by which income may influence child behaviour is unclear. This study investigated the relationship between family income and child socio-emotional behaviour at 11 years of age, and examined the mediating role of maternal psychological distress over time using the UK Millennium Cohort Study. The primary outcome was parent-reported behavioural problems, as captured by the Total Difficulties Score (TDS), derived from the Strengths and Difficulties Questionnaire (SDQ). Secondary outcomes were the emotional, peer-related, conduct, and hyperactivity/inattention problems subscales of the SDQ; and teacher-reported TDS. Permanent family income was the primary exposure variable; frequency of poverty up to age 11 years was the secondary exposure variable. Maternal psychological distress was operationalised to reflect the trajectory from child birth to age 11. Multivariable logistic regression models were used to estimate the effect of permanent family income on child behaviour at age 11, controlling for maternal psychological distress and other relevant covariates. Results showed a statistically significant protective effect of increased permanent family income on the likelihood of behavioural problems at age 11. This finding was consistent for all SDQ subscales apart from emotional problems, and was strongest for teacher-reported behavioural problems. Maternal distress was an important mediator in the income-child behaviour relationship for parent-reported, but not teacher-reported, behavioural problems. The results of this study strengthen empirical evidence that the child behaviour-income gradient is maintained in older childhood. Mother's psychological distress

Adult attachment, emotion dysregulation, and symptoms of depression and generalized anxiety disorder.

PubMed

Marganska, Anna; Gallagher, Michelle; Miranda, Regina

2013-01-01

Differences in attachment style have been linked to both emotion regulation and psychological functioning, but the emotion regulatory mechanism through which attachment style might impact symptoms of depression and anxiety is unclear. The present study examined the explanatory role of emotion dysregulation in the relation between adult attachment style and symptoms of depression and generalized anxiety disorder (GAD) in a sample of 284 adults. Secure attachment was associated with lower depression and GAD symptoms and lower emotion dysregulation, whereas insecure attachment styles were generally associated with higher depression and GAD scores and higher emotion dysregulation. Perceived inability to generate effective emotion regulation strategies mediated the relation between insecure attachment and both depression and GAD symptoms. Nonacceptance of negative emotions and inability to control impulsive behaviors emerged as additional mediators of the relation between insecure attachment styles and GAD symptoms. The differential contribution of attachment style and emotion regulation to the prediction of depression and GAD symptoms may reflect differences in vulnerability to depression and GAD. © 2013 American Orthopsychiatric Association.

Quality of life and emotional state in chronic skin disease.

PubMed

Pärna, Ene; Aluoja, Anu; Kingo, Külli

2015-03-01

The aim of this study was to evaluate the associations between chronic inflammatory skin conditions and patients' emotional state and quality of life. The following self-rated questionnaires were used: Emotional State Questionnaire, a self-report scale assessing depression and anxiety symptoms; Dermatology Life Quality Index (DLQI); and RAND-36, a measure of health-related quality of life. The study group comprised 40 patients with psoriasis, 40 with eczema, 40 with acne, 15 with seborrhoeic dermatitis and 40 healthy controls. Patients with chronic skin diseases had lower DLQI and lower RAND-36 physical functioning scores, more perceived physical limitations and pain, and lower emotional well-being and general health ratings compared with the control group. In conclusion, chronic skin diseases are associated with symptoms of emotional distress, in particular insomnia and general anxiety.

Single-item measures for depression and anxiety: Validation of the Screening Tool for Psychological Distress in an inpatient cardiology setting.

PubMed

Young, Quincy-Robyn; Nguyen, Michelle; Roth, Susan; Broadberry, Ann; Mackay, Martha H

2015-12-01

Depression and anxiety are common among patients with cardiovascular disease (CVD) and confer significant cardiac risk, contributing to CVD morbidity and mortality. Unfortunately, due to the lack of screening tools that address the specific needs of hospitalized patients, few cardiac inpatient programs offer routine screening for these forms of psychological distress, despite recommendations to do so. The purpose of this study was to validate single-item measures for depression and anxiety among cardiac inpatients. Consecutive inpatients were recruited from the cardiology and cardiac surgery step-down units at a university-affiliated, quaternary-care hospital. Subjects completed a questionnaire that included: (a) demographics, (b) single-item-measures for depression and anxiety (from the Screening Tool for Psychological Distress (STOP-D)), and (c) Hospital Anxiety and Depression Scale (HADS). One hundred and five participants were recruited with a wide variety of cardiac diagnoses, having a mean age of 66 years, and 28% were women. Both STOP-D items were highly correlated with their corresponding validated measures and demonstrated robust receiver-operator characteristic curves. Severity scores on both items correlated well with established severity cut-off scores on the corresponding subscales of the HADS. The STOP-D is a self-administered, self-report measure using two independent items that provide severity scores for depression and anxiety. The tool performs very well compared with other previously validated measures. Requiring no additional scoring and being free, STOP-D offers a simple and valid method for identifying hospitalized cardiac patients who are experiencing psychological distress. This crucial first step triggers initiation of appropriate monitoring and intervention, thus reducing the likelihood of the adverse cardiac outcomes associated with psychological distress. © The European Society of Cardiology 2014.

Test Anxiety in Spanish Adolescents: Examining the Role of Emotional Attention, and Ruminative Self-focus and Regulation

PubMed Central

Pena, Mario; Losada, Lidia

2017-01-01

Emotional attention has been found as a key predictive dimension of stress. However, very few studies have investigated the relationship between emotional attention and test anxiety. The objective of the present study was to analyze the role of emotional attention, measured using the Trait Meta-Mood Scale (TMMS), on the level of test anxiety, and measured using the Test Anxiety Inventory (TAI). In addition, we examined the potential mediating role of Self-Rumination and Self-Reflection, as measured through the Rumination-Reflection Questionnaire (RRQ), on the relationship between emotional attention and test anxiety. The sample included 385 Spanish adolescents between 14 and 19 years of age. Mediation analysis results are consistent with a model in which Self-Rumination, but no Self-Reflection, mediates the relationship between Emotional Attention and Test Anxiety. Finally, several potential implications of these findings to improve quality of life in adolescents are discussed. PMID:28871234

Neural Bases of Social Anxiety Disorder: Emotional Reactivity and Cognitive Regulation During Social and Physical Threat

PubMed Central

Goldin, Philippe R.; Manber, Tali; Hakimi, Shabnam; Canli, Turhan; Gross, James J.

2014-01-01

Context Social anxiety disorder is thought to involve emotional hyper-reactivity, cognitive distortions, and ineffective emotion regulation. While the neural bases of emotional reactivity to social stimuli have been described, the neural bases of emotional reactivity and cognitive regulation during social and physical threat, and their relationship to social anxiety symptom severity, have yet to be investigated. Objective This study investigated behavioral and neural correlates of emotional reactivity and cognitive regulation in patients and controls during processing of social and physical threat stimuli. Design Participants were trained to implement cognitive-linguistic regulation of emotional reactivity induced by social (harsh facial expressions) and physical (violent scenes) threat while undergoing functional magnetic resonance imaging and providing behavioral ratings of negative emotion experience. Setting Academic psychology department. Participants 15 adults with social anxiety disorder and 17 demographically-matched healthy controls. Main Outcome Measures Blood oxygen level dependent signal and negative emotion ratings. Results Behaviorally, patients reported greater negative emotion than controls during social and physical threat, but showed equivalent reduction in negative emotion following cognitive regulation. Neurally, viewing social threat resulted in greater emotion-related neural responses in patients than controls, with social anxiety symptom severity related to activity in a network of emotion and attention processing regions in patients only. Viewing physical threat produced no between-group differences. Regulation during social threat resulted in greater cognitive and attention regulation-related brain activation in controls compared to patients. Regulation during physical threat produced greater cognitive control-related response (i.e., right DLPFC) in patients compared to controls. Conclusions Compared to controls, patients demonstrated