Factors affecting patient's perception of anticancer treatments side-effects: an observational study.

PubMed

Russo, Stefania; Cinausero, Marika; Gerratana, Lorenzo; Bozza, Claudia; Iacono, Donatella; Driol, Pamela; Deroma, Laura; Sottile, Roberta; Fasola, Gianpiero; Puglisi, Fabio

2014-02-01

Analysis of relative importance of side effects of anticancer therapy is extremely useful in the process of clinical decision making. There is evidence that patients' perception of the side effects of anticancer treatments changes over time. Aim of this study was to evaluate the cancer patients' perceptions of physical and non-physical side effects of contemporary anticancer therapy. Four hundred and sixty-four patients entered the study (153 men and 311 women). Participants were asked to rank their side effects in order of distress by using two sets of cards naming physical and non-physical effects, respectively. Influencing factors, including treatment and patient characteristics, were also analysed. Patients ranked the non-physical side effect 'Affects my family or partner' first. 'Constantly tired' and 'Loss of hair' were ranked second and third, respectively. Significant differences from previous studies on this topic emerged. In particular, 'Vomiting', a predominant concern in previous studies, almost disappeared, whereas 'Nausea' and 'Loss of hair' remained important side effects in the patients' perception. Interestingly, marital status was predominant in driving patients' perception, being associated with several side effects ('Constantly tired', 'Loss of appetite', 'Affects my work/Home duties', 'Affects my social activities', 'Infertility'). Other significant factors influencing patient's perception of side effects included age, disease characteristics and ongoing anticancer therapy. This study provided information on current status of patients' perceptions of side effects of anticancer treatment. These results could be used in pre-treatment patient education and counselling.

Physical Activity Mode and Mental Distress in Adulthood.

PubMed

Sciamanna, Christopher N; Smyth, Joshua M; Doerksen, Shawna E; Richard, Barrett R; Kraschnewski, Jennifer L; Mowen, Andrew J; Hickerson, Benjamin D; Rovniak, Liza S; Lehman, Erik B; Yang, Chengwu

2017-01-01

Nearly one fifth of American adults suffer from mental health issues, yet many treatments have side effects and stigma attached. Physical activity can be an effective treatment for mental health disorders, but most promotion efforts fail. One understudied aspect of physical activity is the specific mode, including if it engages others, and how this may relate to mental health. This study examined the potential relationship between different modes of physical activity and the frequency of mental distress. Data from the 2000 Behavioral Risk Factor Surveillance System were analyzed in 2015 to determine the relationship between participation in different modes of physical activity and frequent mental distress. Data were obtained on physical activity and frequent mental distress from 183,341 adults (aged 18-99 years, 51.9% female, 57.4% overweight/obese, 9.5% frequent mental distress). Prevalence of mental distress for those reporting activities was contrasted against walking alone. People who participated in tennis had 46% lower odds (95% CI=0.35, 0.84) of frequent mental distress. Approaching significance, non-team play sports were associated with 18% lower odds (95% CI=0.66, 1.01) of frequent mental distress, compared with walking alone. Activity modes are associated with mental health outcomes above and beyond the frequency and duration of activity. Given the social and play nature of the activities, this may reflect the relational aspect, enjoyment, or a combination of both. These results suggest that adding social or affective components to physical activity may enhance engagement and retention in activity promotion efforts and their benefits on mental health. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Hypnosis decreases presurgical distress in excisional breast biopsy patients.

PubMed

Schnur, Julie B; Bovbjerg, Dana H; David, Daniel; Tatrow, Kristin; Goldfarb, Alisan B; Silverstein, Jeffrey H; Weltz, Christina R; Montgomery, Guy H

2008-02-01

Excisional breast biopsy is associated with presurgical psychological distress. Such distress is emotionally taxing, and may have negative implications for postsurgical side effects and satisfaction with anesthesia. We investigated the ability of a brief hypnosis session to reduce presurgical psychological distress in excisional breast biopsy patients. Ninety patients presenting for excisional breast biopsy were randomly assigned to receive either a 15-minute presurgery hypnosis session (n = 49, mean age: 46.4 (95% CI: 42.3-50.4)) or a 15-minute presurgery attention control session (n = 41, mean age: 45.0 (95% CI: 40.8-49.2)). The hypnosis session involved suggestions for increased relaxation and decreased distress. The attention control session involved nondirective empathic listening. Presurgery distress was measured using visual analog scales (VAS) and the short version of the Profile of Mood States (SV-POMS). Data were analyzed using analysis of variance and chi2 procedures. Groups did not differ in terms of the following: demographics (age, education, ethnicity, marital status, all P's > 0.28); medical variables (presurgery diagnosis, previous excisional biopsy, previous breast cancer, all P's > 0.11); or preintervention distress (SV-POMS P > 0.74) assessed on the day of surgery. Postintervention, and before surgery, patients in the hypnosis group had significantly lower mean values for presurgery VAS emotional upset (16.5 vs 38.2, P < 0.0001, d = .85), VAS depressed mood (6.6 vs 19.9, P < 0.02, d = .67), and SV-POMS anxiety (10.0 vs 5.0, P < 0.0001, d = 0.85); and significantly higher levels for VAS relaxation (75.7 vs 54.2, P < 0.001, d = -0.76) than attention controls. The study results indicate that a brief presurgery hypnosis intervention can be an effective means of controlling presurgical distress in women awaiting diagnostic breast cancer surgery.

Is pain relief equally efficacious and free of side effects with repeated doses of oral sucrose in preterm neonates?

PubMed

Gaspardo, Cláudia Maria; Miyase, Catia Isumi; Chimello, Juliana Thomazatti; Martinez, Francisco Eulógio; Martins Linhares, Maria Beatriz

2008-07-01

The aim of the present study was to examine the efficacy and potential side effects of repeated doses of oral sucrose for pain relief during procedures in NICU. Thirty-three preterm neonates were randomly allocated in blind fashion into two groups, the sucrose group (SG=17) and the control group (CG=16). The responses of neonates to pain and distress were assessed during blood collection on four consecutive assessment (ass.) days. For the first assessment, the neonates did not receive any solution before the blood collection procedure. During the next three days, the SG received oral sucrose (25%; 0.5 ml/kg) and the CG received sterile water, 2 min before each minor acute painful procedure. The neonates were evaluated during blood collection each morning. The assessment was divided into five phases: Baseline (BL), Antisepsis (A), Puncture (P), Dressing (D), and Recovery (R). The neonates' facial activity (NFCS), behavioral state, and heart rate were evaluated. The data analysis used cut-off scores for painful and distressful responses. No side effects of using sucrose were detected. There were significantly fewer SG neonates with facial actions signaling pain than CG neonates in P (ass.2) and in A (ass.3). We found significantly fewer SG neonates in the awake state than CG neonates in P (ass.2 and ass.4). There were significantly fewer SG neonates crying during A (ass.2), P (ass.2 and ass.4), and D (ass.3). There was no statistical difference between-groups for physiological response. The efficacy of sucrose was maintained for pain relief in preterm neonates with no side effects.

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

Pavlovian conditioning of nausea and vomiting.

PubMed

Stockhorst, Ursula; Steingrueber, Hans-Joachim; Enck, Paul; Klosterhalfen, Sibylle

2006-10-30

Cancer patients undergoing cytotoxic drug treatment often experience side-effects, the most distressing being nausea and vomiting. Despite antiemetic drugs, 25-30% of the chemotherapy patients report these side-effects when being re-exposed to the stimuli that usually signal the chemotherapy session and its drug infusion. These symptoms are called anticipatory nausea and anticipatory vomiting. The present paper summarizes the evidence that anticipatory vomiting is acquired by Pavlovian conditioning, and, consequently, may be alleviated by conditioning techniques. To explore the mechanisms that induce and alleviate conditioned nausea and vomiting further, a conditioned nausea model was established in healthy humans using body rotation as the nausea-inducing treatment. The validity of this motion sickness model to examine conditioning mechanisms in the acquisition and alleviation of conditioned nausea was demonstrated. Cortisol and tumor-necrosis factor-alpha were elevated as endocrine and immunological correlates of nausea. Data in the rotation-induced motion sickness model indicated that gender is an important moderator variable to be considered in further studies. The paper concludes with a review of applications of the demonstrated conditioning principles as interventions to ameliorate distressing anticipatory nausea or anticipatory vomiting in cancer patients undergoing chemotherapy.

Prone position in patients with acute respiratory distress syndrome

PubMed Central

Setten, Mariano; Plotnikow, Gustavo Adrián; Accoce, Matías

2016-01-01

Acute respiratory distress syndrome occupies a great deal of attention in intensive care units. Despite ample knowledge of the physiopathology of this syndrome, the focus in intensive care units consists mostly of life-supporting treatment and avoidance of the side effects of invasive treatments. Although great advances in mechanical ventilation have occurred in the past 20 years, with a significant impact on mortality, the incidence continues to be high. Patients with acute respiratory distress syndrome, especially the most severe cases, often present with refractory hypoxemia due to shunt, which can require additional treatments beyond mechanical ventilation, among which is mechanical ventilation in the prone position. This method, first recommended to improve oxygenation in 1974, can be easily implemented in any intensive care unit with trained personnel. Prone position has extremely robust bibliographic support. Various randomized clinical studies have demonstrated the effect of prone decubitus on the oxygenation of patients with acute respiratory distress syndrome measured in terms of the PaO2/FiO2 ratio, including its effects on increasing patient survival. The members of the Respiratory Therapists Committee of the Sociedad Argentina de Terapia Intensiva performed a narrative review with the objective of discovering the available evidence related to the implementation of prone position, changes produced in the respiratory system due to the application of this maneuver, and its impact on mortality. Finally, guidelines are suggested for decision-making. PMID:27925054

Cognitive-Behavioral Therapy Plus Hypnosis for Distress During Breast Radiotherapy: A Randomized Trial.

PubMed

Montgomery, Guy H; Sucala, Madalina; Dillon, Matthew J; Schnur, Julie B

2017-10-01

Radiotherapy is a common and effective treatment for women with breast cancer. However, radiotherapy has also been shown to adversely affect patients' emotional well-being. Currently, few mind-body interventions are designed to improve patients' quality of life during radiotherapy. One intervention which has demonstrated clinical efficacy in the breast cancer radiotherapy setting is Cognitive-Behavioral Therapy plus Hypnosis. The goal of this study was to investigate the impact of Cognitive-Behavioral Therapy plus Hypnosis on emotional distress in women with breast cancer undergoing radiotherapy. One hundred patients were randomly assigned to either the Cognitive-Behavioral Therapy plus Hypnosis (n = 50) or Attention Control (n = 50) group. Results revealed significant benefits of Cognitive-Behavioral Therapy plus Hypnosis on emotional distress at the mid-point (d = 0.54), the conclusion (d = 0.64), and 4 weeks following the conclusion (d = 0.65) of radiotherapy (all ps < 0.05). In summary, results support further study of Cognitive-Behavioral Therapy plus Hypnosis as an evidence-based intervention to reduce emotional distress in women with breast cancer. Cognitive-Behavioral Therapy plus Hypnosis has the benefits of being brief, noninvasive, lacking side-effects, and producing beneficial effects which last beyond the conclusion of radiotherapy. Given these strengths, we propose that Cognitive-Behavioral Therapy plus Hypnosis is a strong candidate for greater dissemination and implementation in cancer populations.

Patient-reported symptom distress, and most bothersome issues, before and during cancer treatment

PubMed Central

Hong, Fangxin; Blonquist, Traci M; Halpenny, Barbara; Berry, Donna L

2016-01-01

Introduction Frequently reported symptoms and treatment side effects may not be the most bothersome issues to patients with cancer. The purpose of this study was to investigate patient-reported symptom distress and bothersome issues among participants with cancer. Methods Participants completed the Symptom Distress Scale-15 before treatment (T1) and during cancer treatment (T2) and reported up to two most bothersome issues among symptoms rated with moderate-to-severe distress. We compared symptom ratings and perceived bother and explored two approaches predicting patients’ most bothersome issues: worst absolute symptom score or worst change from pretreatment. Results Significantly, (P≤0.0002) more patients reported moderate-to-severe distress at T2 for eight of 13 symptoms. At T1, 81% of patients reported one and 56% reported multiple symptoms with moderate-to-severe distress, while at T2, 89% reported one and 69% reported multiple symptoms with moderate-to-severe distress. Impact on sexual activity/interest, pain, fatigue, and insomnia were the most prevalent symptoms with moderate-to-severe distress. Fatigue, pain, and insomnia were perceived most often as bothersome. When one symptom was rated moderate-to-severe, predictive accuracy of the absolute score was 46% and 48% (T1 & T2) and 38% with the change score (T2–T1). When two or more symptoms were rated moderate-to-severe, predictive accuracy of the absolute score was 76% and 79% (T1 & T2) and 70% with the change score (T2–T1). Conclusion More patients experienced moderate-to-severe symptom distress after treatment initiation. Patient identification of bothersome issues could not be assumed based on prevalence of symptoms reported with moderate-to-severe distress. The absolute symptom distress scores identified patients’ most bothersome issues with good accuracy, outperforming change scores. PMID:27672346

Treatment decision-making strategies and influences in patients with localized prostate carcinoma.

PubMed

Gwede, Clement K; Pow-Sang, Julio; Seigne, John; Heysek, Randy; Helal, Mohamed; Shade, Kristin; Cantor, Alan; Jacobsen, Paul B

2005-10-01

Patients diagnosed with localized prostate carcinoma need to interpret complicated medical information to make an informed treatment selection from among treatments that have comparable efficacy but differing side effects. The authors reported initial results for treatment decision-making strategies among men receiving definitive treatment for localized prostate carcinoma. One hundred nineteen men treated with radical prostatectomy (44%) or brachytherapy (56%) consented to participate. Guided by a cognitive-affective theoretic framework, the authors assessed differences in decision-making strategies, and treatment and disease-relevant beliefs and affects, in addition to demographic and clinical variables. Approximately half of patients reported difficulty (49%) and distress (45%) while making treatment decisions, but no regrets (74%) regarding the treatment choice they made. Patients who underwent prostatectomy were younger, were more likely to be employed, had worse tumor grade, and had a shorter time since diagnosis (P < 0.01) compared with patients who did not undergo prostatectomy. In multivariate analyses, compared with patients who received radical prostatectomy, patients who received brachytherapy were more likely to say that they chose this treatment because it was "the least invasive" and they "wanted to avoid surgery" (P < 0.0001). In general, patients who received brachytherapy chose this treatment because of quality of life considerations, whereas "cure" and complete removal of the tumor were the main motivations for patients selecting radical prostatectomy. Long-term data are needed to evaluate distress and decisional regret as patients experience treatment-related chronic side effects and efficacy outcomes. Decision-making aids or other interventions to reduce decisional difficulty and emotional distress during decision making were indicated.

Airway compromise secondary to vagus nerve stimulator: case report and implications for otolaryngologists.

PubMed

Bhatt, Y M; Hans, P S; Belloso, A

2010-05-01

Vagus nerve stimulators are devices used in the management of patients with drug-refractory epilepsy unsuitable for resective or disconnective surgery. Implanted usually by neurosurgeons, these devices are infrequently encountered by otolaryngologists. Despite significant anti-seizure efficacy, side effects related to laryngopharyngeal stimulation are not uncommon. A 28-year-old man with a history of effective vagus nerve stimulator use presented with a cluster of seizures and respiratory distress associated with intermittent stridor. The duration of stridor corresponded to the period of vagus nerve stimulation. Endoscopy revealed forced adduction of the left vocal fold against a medialised right vocal fold. The device was switched off and the stridor immediately resolved. Airway compromise is an under-recognised side effect of vagus nerve stimulation. We describe the first known case of stridor and contralateral vocal fold palsy in a vagus nerve stimulator user. We highlight the need for better understanding amongst otolaryngologists of the laryngopharyngeal side effects of this technology.

Investigation of Body Image as a Mediator of the Effects of Bowel and GI Symptoms on Psychological Distress in Female Survivors of Rectal and Anal Cancer

PubMed Central

Benedict, Catherine; Rodriguez, Vivian M.; Carter, Jeanne; Temple, Larissa; Nelson, Christian; DuHamel, Katherine

2016-01-01

Purpose Treatment for rectal and anal cancer (RACa) can result in persistent bowel and gastrointestinal (GI) dysfunction. Body image problems may develop over time and exacerbate symptom-related distress. RACa survivors are an understudied group, however, and factors contributing to post-treatment well-being are not well understood. This study examined whether poorer body image explained the relation between symptom severity and psychological distress. Methods Participants (N=70) completed the baseline assessment of a sexual health intervention study. Bootstrap methods tested body image as a mediator between bowel and GI symptom severity and two indicators of psychological distress (depressive and anxiety symptoms), controlling for relevant covariates. Measures included the EORTC-QLQ-CR38 Diarrhea, GI Symptoms, and Body Image subscales and Brief Symptom Index Depression and Anxiety subscales. Results Women averaged 55 years old (SD=11.6), White (79%), and 4-years post-treatment. Greater Depression related to poorer body image (r=−.61) and worse diarrhea (r=.35) and GI symptoms (r=.48). Greater Anxiety related to poorer body image (r=−.42) and worse GI symptoms (r=.45), but not diarrhea (r=.20). Body image mediated the effects of bowel and GI symptoms on Depression, but not on Anxiety. Conclusions Long-term bowel and GI dysfunction are distressing and affect how women perceive and relate to their bodies, exacerbating survivorship difficulties. Interventions to improve adjustment post-treatment should address treatment side effects, but also target body image problems to alleviate depressive symptoms. Reducing anxiety may require other strategies. Body image may be a key modifiable factor to improve well-being in this understudied population. Longitudinal research is needed to confirm findings. PMID:26446699

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, more severe consequences, greater illness identity and less illness coherence increases cancer-specific distress (ps < .001) only if women were also more anxiously preoccupied with their diagnosis. Screening women for anxious preoccupation may help identify women with screen-detected breast cancer at risk of experiencing high levels of cancer-related distress; whilst illness perceptions and coping could be targeted for use in future interventions to reduce distress.

A face a mother could love: depression-related maternal neural responses to infant emotion faces.

PubMed

Laurent, Heidemarie K; Ablow, Jennifer C

2013-01-01

Depressed mothers show negatively biased responses to their infants' emotional bids, perhaps due to faulty processing of infant cues. This study is the first to examine depression-related differences in mothers' neural response to their own infant's emotion faces, considering both effects of perinatal depression history and current depressive symptoms. Primiparous mothers (n = 22), half of whom had a history of major depressive episodes (with one episode occurring during pregnancy and/or postpartum), were exposed to images of their own and unfamiliar infants' joy and distress faces during functional neuroimaging. Group differences (depression vs. no-depression) and continuous effects of current depressive symptoms were tested in relation to neural response to own infant emotion faces. Compared to mothers with no psychiatric diagnoses, those with depression showed blunted responses to their own infant's distress faces in the dorsal anterior cingulate cortex. Mothers with higher levels of current symptomatology showed reduced responses to their own infant's joy faces in the orbitofrontal cortex and insula. Current symptomatology also predicted lower responses to own infant joy-distress in left-sided prefrontal and insula/striatal regions. These deficits in self-regulatory and motivational response circuits may help explain parenting difficulties in depressed mothers.

Psychological effects of a cosmetic education programme in patients with breast cancer.

PubMed

Park, H Y; Kim, J H; Choi, S; Kang, E; Oh, S; Kim, J Y; Kim, S W

2015-07-01

Treatments for breast cancer often include interventions related to psychosocial issues such as negative body image, loss of femininity, and low self-esteem. We identified the psychological effects of a cosmetics education programme in patients with breast cancer. Cosmetic programme is a specific care designed to help patients handle appearance-related side effects. Thirty-one women with breast cancer at a university hospital in South Korea who received a cosmetics education programme were compared with 29 subjects in a control group who received the treatment as usual. Psychological factors including distress, self-esteem, and sexual functioning were assessed three times (before and after the programme, and at the 1-month follow-up). After the programme, patients in the treatment group were significantly less likely than those in the control group to rely on distress (P = 0.038) and avoidance coping (P < 0.001) but not on self-esteem. The mean scores in the treatment group for sexual functioning were higher than those in the control group after the treatment. Our results suggest the potential usefulness of a brief cosmetics education programme for reducing distress and reliance on negative coping strategies. Implementing a cosmetics programme for patients with breast cancer may encourage patients to control negative psychological factors. © 2015 John Wiley & Sons Ltd.

[The impact of globalization on mental health].

PubMed

de la Fuente, Juan Ramón

2012-01-01

Psychosis, dementias, anxiety, depression, suicide and suicide attempts, as well as psychiatric disorders associated to violence and poverty have increased the global burden of disease. Other related problems associated to special diets, body image, compulsive use of computers and mobile phones, and those frequently observed in migrants subjected to intense distress are reviewed as well. Information and communication technologies may have undesirable side effects affecting some individuals in their conduct and social interactions.

The medical necessity for medicinal cannabis: prospective, observational study evaluating the treatment in cancer patients on supportive or palliative care.

PubMed

Bar-Sela, Gil; Vorobeichik, Marina; Drawsheh, Saher; Omer, Anat; Goldberg, Victoria; Muller, Ella

2013-01-01

Background. Cancer patients using cannabis report better influence from the plant extract than from synthetic products. However, almost all the research conducted to date has been performed with synthetic products. We followed patients with a medicinal cannabis license to evaluate the advantages and side effects of using cannabis by cancer patients. Methods. The study included two interviews based on questionnaires regarding symptoms and side effects, the first held on the day the license was issued and the second 6-8 weeks later. Cancer symptoms and cannabis side effects were documented on scales from 0 to 4 following the CTCAE. The distress thermometer was used also. Results. Of the 211 patients who had a first interview, only 131 had the second interview, 25 of whom stopped treatment after less than a week. All cancer or anticancer treatment-related symptoms showed significant improvement (P < 0.001). No significant side effects except for memory lessening in patients with prolonged cannabis use (P = 0.002) were noted. Conclusion. The positive effects of cannabis on various cancer-related symptoms are tempered by reliance on self-reporting for many of the variables. Although studies with a control group are missing, the improvement in symptoms should push the use of cannabis in palliative treatment of oncology patients.

Feasibility of an expressive-disclosure group intervention for post-treatment colorectal cancer patients: results of the Healthy Expressions study.

PubMed

Carmack, Cindy L; Basen-Engquist, Karen; Yuan, Ying; Greisinger, Anthony; Rodriguez-Bigas, Miguel; Wolff, Robert A; Barker, Trina; Baum, George; Pennebaker, James W

2011-11-01

Adjusting to cancer requires effective cognitive and emotional processing. Written and verbal disclosure facilitate processing and have been studied independently in cancer survivors. Combined written and verbal expression may be more effective than either alone, particularly for patients with difficult to discuss or embarrassing side effects. Thus, the authors developed and tested the efficacy of a 12-session combined written and verbal expression group program for psychologically distressed colorectal cancer (CRC) patients. Forty post-treatment patients with CRC (stages I-III) identified as psychologically distressed using the Brief Symptom Inventory (BSI) were randomized to an intervention group (Healthy Expressions; n = 25) or standard care (control group; n = 15). Assessments were completed at baseline, Month 2, and Month 4 (postintervention). Primary outcomes were psychological functioning and quality of life (QOL). Most participants were women (63%), white (63%), and non-Hispanic (75%). The Healthy Expressions group demonstrated significantly greater changes in distress compared with the control group at Month 2 on the BSI Global Severity Index (GSI) and the Centers for Epidemiologic Studies Depression scale (CES-D) scores (P < .05 for each); differences in the European Organization for Research and Treatment of Cancer (EORTC) global QOL scores approached significance (P = .063). The BSI GSI and Positive Symptom Total, CES-D, and EORTC emotional functioning subscale scores were all significant at Month 4 (P < .05 for each). The Healthy Expressions program improved psychological functioning in CRC patients who reported experiencing distress. Findings demonstrate the program's feasibility and provide strong support for conducting a larger randomized trial. Copyright © 2011 American Cancer Society.

The Social Side Effects of Acetaminophen

NASA Astrophysics Data System (ADS)

Mischkowski, Dominik

About 23% of all adults in the US take acetaminophen during an average week (Kaufman, Kelly, Rosenberg, Anderson, & Mitchell, 2002) because acetaminophen is an effective physical painkiller and easily accessible over the counter. The physiological side effects of acetaminophen are well documented and generally mild when acetaminophen is consumed in the appropriate dosage. In contrast, the psychological and social side effects of acetaminophen are largely unknown. Recent functional neuroimaging research suggests that the experience of physical pain is fundamentally related to the experience of empathy for the pain of other people, indicating that pharmacologically reducing responsiveness to physical pain also reduces cognitive, affective, and behavioral responsiveness to the pain of others. I tested this hypothesis across three double-blind between-subjects drug intervention studies. Two experiments showed that acetaminophen had moderate effects on empathic affect, specifically personal distress and empathic concern, and a small effect on empathic cognition, specifically perceived pain, when facing physical and social pain of others. The same two experiments and a third experiment also showed that acetaminophen can increase the willingness to inflict pain on other people, i.e., actual aggressive behavior. This effect was especially pronounced among people low in dispositional empathic concern. Together, these findings suggest that the physical pain system is more involved in the regulation of social cognition, affect, and behavior than previously assumed and that the experience of physical pain and responsiveness to the pain of others share a common neurochemical basis. Furthermore, these findings suggest that acetaminophen has unappreciated but serious social side effects, and that these side effects may depend on psychological characteristics of the drug consumer. This idea is consistent with recent theory and research on the context-dependency of neurochemical processes. Finally, public health and legal implications of the social side effects of acetaminophen are discussed.

Mechanical ventilation in acute respiratory distress syndrome: The open lung revisited.

PubMed

Amado-Rodríguez, L; Del Busto, C; García-Prieto, E; Albaiceta, G M

2017-12-01

Acute respiratory distress syndrome (ARDS) is still related to high mortality and morbidity rates. Most patients with ARDS will require ventilatory support. This treatment has a direct impact upon patient outcome and is associated to major side effects. In this regard, ventilator-associated lung injury (VALI) is the main concern when this technique is used. The ultimate mechanisms of VALI and its management are under constant evolution. The present review describes the classical mechanisms of VALI and how they have evolved with recent findings from physiopathological and clinical studies, with the aim of analyzing the clinical implications derived from them. Lastly, a series of knowledge-based recommendations are proposed that can be helpful for the ventilator assisted management of ARDS at the patient bedside. Copyright © 2017 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

Investigation of body image as a mediator of the effects of bowel and GI symptoms on psychological distress in female survivors of rectal and anal cancer.

PubMed

Benedict, Catherine; Rodriguez, Vivian M; Carter, Jeanne; Temple, Larissa; Nelson, Christian; DuHamel, Katherine

2016-04-01

Treatment for rectal and anal cancer (RACa) can result in persistent bowel and gastrointestinal (GI) dysfunction. Body image problems may develop over time and exacerbate symptom-related distress. RACa survivors are an understudied group, however, and factors contributing to post-treatment well-being are not well understood. This study examined whether poorer body image explained the relation between symptom severity and psychological distress. Participants (N = 70) completed the baseline assessment of a sexual health intervention study. Bootstrap methods tested body image as a mediator between bowel and GI symptom severity and two indicators of psychological distress (depressive and anxiety symptoms), controlling for relevant covariates. Measures included the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC-QLQ-CR38) Diarrhea, GI Symptoms, and Body Image subscales and Brief Symptom Index Depression and Anxiety subscales. Women averaged 55 years old (SD = 11.6), White (79 %), and were 4 years post-treatment. Greater Depression was related to poorer Body Image (r = -.61) and worse Diarrhea (r = .35) and GI Symptoms (r = .48). Greater Anxiety was related to poorer Body Image (r = -.42) and worse GI Symptoms (r = .45), but not Diarrhea (r = .20). Body Image mediated the effects of bowel and GI symptoms on Depression, but not on Anxiety. Long-term bowel and GI dysfunction are distressing and affect how women perceive and relate to their bodies, exacerbating survivorship difficulties. Interventions to improve adjustment post-treatment should address treatment side effects, but also target body image problems to alleviate depressive symptoms. Reducing anxiety may require other strategies. Body image may be a key modifiable factor to improve well-being in this understudied population. Longitudinal research is needed to confirm findings.

Association of Type D personality to perceived side effects and adherence in CPAP-treated patients with OSAS.

PubMed

Broström, Anders; Strömberg, Anna; Mårtensson, Jan; Ulander, Martin; Harder, Lena; Svanborg, Eva

2007-12-01

Continuous positive airway pressure (CPAP) is the treatment of choice for obstructive sleep apnoea syndrome (OSAS), but side effects are common and long-term adherence low. The Type D (distressed) personality is defined as a combination of negative affectivity and social inhibition. The association of Type D personality with adherence has not been studied in CPAP-treated patients with OSAS. This study aimed to describe the prevalence of Type D personality in OSAS patients with CPAP treatment longer than 6 months and the association with self-reported side effects and adherence. A cross-sectional descriptive design was used. A total of 247 OSAS patients with a mean use of CPAP treatment for 55 months (6-182 months) were included. Data collection was achieved by two questionnaires; the Type D scale 14 (DS14) (Type D personality), SECI (side effects of CPAP), as well as from medical records (clinical variables and objective adherence to CPAP treatment). Type D personality occurred in 30% of the patients with OSAS and significantly (P < 0.05-0.001) increased the perceived frequency and severity of a broad range of side effects. The objective adherence was significantly lower (P < 0.001) for OSAS patients with Type D compared to OSAS patients without Type D, both with regard to a mean use of 4 h per night and 85% of the self-rated sleep time per night. The additional effect of a Type D personality on perceived side effects and adherence to CPAP treatment found in this study could be used by healthcare personnel when evaluating patients waiting for treatment.

The effects of contact with Asians and Asian Americans on White American college students: attitudes, awareness of racial discrimination, and psychological adjustment.

PubMed

Dinh, Khanh T; Weinstein, Traci L; Nemon, Melissa; Rondeau, Sara

2008-12-01

On the basis of acculturation theory, explicating mutual influences between different cultural or ethnic groups coming into contact, this study focused "on the other side of acculturation" theory by examining the effects of intercultural contact with Asians and Asian Americans on the psychosocial experiences of White American college students. Participants (N = 315), undergraduates attending a public university located within the state of Massachusetts, completed a survey that assessed demographic and personal characteristics, acculturation (extent of intercultural contact with Asian people and Asian cultures), attitudes towards Asians and Asian Americans, awareness of institutional discrimination and blatant racial issues, and psychological distress. Results indicated that White American students' intercultural contact with Asians and Asian Americans contributed significant variance to the prediction of their attitudes towards this ethnic group and awareness of discrimination and racial issues, but not to psychological distress. This study provides implications for understanding mutual acculturative influences between different ethnic groups in the United States.

The Effect of Reflexology on Chemotherapy-induced Nausea, Vomiting, and Fatigue in Breast Cancer Patients

PubMed Central

Özdelikara, Afitap; Tan, Mehtap

2017-01-01

Objective: Patients receiving chemotherapy struggle with the side effects of this treatment. These side effects obligate the patients to use not only the pharmacological methods but also non-pharmacological relaxing methods. This study was conducted to determine the effect of reflexology on chemotherapy-induced nausea, vomiting, and fatigue in breast cancer patients. Methods: The study was conducted as a pretest–posttest experimental design. The study was conducted with sixty patients, thirty as the control and thirty as the experimental groups. A sociodemographic form, Rhodes index of nausea, vomiting, and retching (INVR), and Brief Fatigue Inventory (BFI) were used to collect the data. Analysis of variance, t-test, percentage calculations, and Chi-square methods were used to evaluate the data. The data obtained were assessed using the “Statistical Package for Social Science 21.0” software. Results: It was determined that the difference between the total mean scores of INVR in the experimental and control groups was significant on the onset and first and second measurements, and the difference between total mean scores of development and distress between the groups was statistically significant in the third measurement (P < 0.05). The results of the study showed that the BFI mean scores of patients in the experimental group gradually decreased in the first, second, and third measurements (P < 0.05). Conclusions: The present study proved that reflexology decreased the experience, development, distress of nausea, vomiting, and retching as well as fatigue in the experimental group. Hence, the use of reflexology is recommended for chemotherapy-induced nausea, vomiting, and fatigue. PMID:28695171

The Medical Necessity for Medicinal Cannabis: Prospective, Observational Study Evaluating the Treatment in Cancer Patients on Supportive or Palliative Care

PubMed Central

Bar-Sela, Gil; Vorobeichik, Marina; Drawsheh, Saher; Omer, Anat; Goldberg, Victoria; Muller, Ella

2013-01-01

Background. Cancer patients using cannabis report better influence from the plant extract than from synthetic products. However, almost all the research conducted to date has been performed with synthetic products. We followed patients with a medicinal cannabis license to evaluate the advantages and side effects of using cannabis by cancer patients. Methods. The study included two interviews based on questionnaires regarding symptoms and side effects, the first held on the day the license was issued and the second 6–8 weeks later. Cancer symptoms and cannabis side effects were documented on scales from 0 to 4 following the CTCAE. The distress thermometer was used also. Results. Of the 211 patients who had a first interview, only 131 had the second interview, 25 of whom stopped treatment after less than a week. All cancer or anticancer treatment-related symptoms showed significant improvement (P < 0.001). No significant side effects except for memory lessening in patients with prolonged cannabis use (P = 0.002) were noted. Conclusion. The positive effects of cannabis on various cancer-related symptoms are tempered by reliance on self-reporting for many of the variables. Although studies with a control group are missing, the improvement in symptoms should push the use of cannabis in palliative treatment of oncology patients. PMID:23956774

Complementary Therapies for Symptom Management in Cancer Patients

PubMed Central

Satija, Aanchal; Bhatnagar, Sushma

2017-01-01

Cancer patients are often poly-symptomatic which distressingly affects their quality of lives (QOLs). Alhough, conventional management provides adequate symptom control, yet is coupled with some limitations. Complementary therapies (CTs) have shown beneficial effects in cancer patients for symptomatic relief. The aim of this article is to provide evidence-based review of commonly used CTs for symptom management in cancer care. Hypnosis has promising evidence to be used for managing symptoms such as pain, chemotherapy-induced nausea/vomiting, distress, fatigue, and hot flashes. Guided imagery increases comfort and can be used as a psycho-supportive therapy. Meditation substantially improves psychological function, mental health, and QOL. Cognitive behavioral therapies effectively reduce pain, distress, fatigue, anxiety, and depression; and improve subjective sleep outcomes along with mood and QOL. Yoga has short term beneficial effects for anxiety, depression, fatigue, perceived stress, QOL, and well-being. T'ai Chi and qigong are beneficial adjunctive therapies for supportive cancer care, but their role in reducing cancer pain is not well proven. Acupuncture is effective for reducing treatment related side-effects, pain and fatigue. Other therapies such as massage techniques, energy therapies, and spiritual interventions have also demonstrated positive role in managing cancer-related symptoms and improve overall well-being. However, the clinical effectiveness of these therapies for symptom management in cancer patients cannot be concluded due to poor strength of evidence. Nonetheless, these are relatively free from risks and hence can be given along with conventional treatments. Only by tailoring these therapies as per patient's beliefs and preferences, optimal patient-centered holistic care can be provided. PMID:29123357

[Exploration of the Care Needs of Post-Chemotherapy Lung Cancer Patients and Related Factors].

PubMed

Chiu, Hui-Ying; Lin, Yu-Hua; Wang, Chin-Chou; Chen, Wan-Yi; Chang, Huang-Chih; Lin, Meng-Chih

2016-06-01

Chemotherapy (CT) is the first priority treatment for advanced stage lung cancer. However, symptom distress, impaired ability to conduct daily activities, and post-CT care needs are potential side effects of CT. To explore the factors related to the care needs of post-chemotherapy lung cancer patients. A cross-sectional study was used. One hundred and twenty-one adult patients who had been diagnosed with advanced-stage lung cancer and who had undergone CT using the Platinum and Docetaxel doublet regimen were recruited from a medical center in southern Taiwan. The instruments used included a nursing care needs survey, symptoms distress scale, daily activity interference scale, and patient characteristics datasheet. Participants self-prioritized their emergency management, health consultation, and emotional support activities based on their perceived care needs. The top three post-CT symptoms in terms of severity were: fatigue, appetite change, and sleep disorder. Primary disruptions in daily activities during the post-CT period related to: holding social activities, work, and stair climbing. Significant and positive correlations were found among daily activity interference (r = .30, p < .01), symptoms distress (r = .23, p < .01), and care needs. The regression model indicated daily activity interference as a predictor of care needs, accounting for 10.7% of the total variance. These results highlight the relationships among care needs, symptom distress, and daily activity interference in post-chemotherapy lung-cancer patients. The present study provides a reference for nursing care to reduce the symptom distress, to enhance the performance of daily activities, and to meet the care needs of lung-cancer patients.

Deconstructing Decisions to Initiate, Maintain, or Discontinue Adjuvant Endocrine Therapy in Breast Cancer Survivors: A Mixed-Methods Study

PubMed Central

Bluethmann, Shirley M.; Murphy, Caitlin C.; Tiro, Jasmin A.; Mollica, Michelle A.; Vernon, Sally W.; Bartholomew, Leona Kay

2017-01-01

Purpose/Objectives Adjuvant endocrine therapy (AET) has been shown to improve survival in hormone receptor–positive breast cancer survivors, but as many as half do not complete recommended treatment. Management of medication-related side effects and engagement with providers are two potentially modifiable factors, but their associations with adherence are not well understood. The aims were to build on survey results to qualitatively explore survivors’ experiences with prescribed AET to (a) describe appraisal and management of AET side effects and (b) deconstruct decisions to initiate, discontinue, or maintain AET. Research Approach The authors used a mixed-methods explanatory sequence research design with a qualitative emphasis. Setting Survivors were recruited from a clinical cancer registry maintained at the University of Texas Southwestern Medical Center, which includes the Harold C. Simmons Comprehensive Cancer Center (National Cancer Institute–designated), in Dallas. Participants 452 survivors completed a survey, and 30 took part in telephone interviews. Methodologic Approach Qualitative methods were used in which the authors recorded and transcribed interviews for analysis and used open coding to reduce data into themes. Findings Among adherent survivors, the themes of tolerance of side effects and perseverance were strong. Nonadherent survivors expressed more difficulty managing side effects and perceived fewer benefits when side effects were bothersome. The most common side effects mentioned by all survivors were menopausal symptoms and joint pain; less common side effects were cognitive decline and cardiac distress. Some sought advice from their oncology team. Nonadherent survivors appeared initially motivated to maintain AET but identified a tolerance limit for side effects after which a provider’s recommendation was less influential in their decision to maintain or discontinue AET. Interpretation This study elucidated adherence as a complex continuum of behaviors, appraisals, and decision points. These insights may be particularly useful in counseling survivors taking AET and promoting timely delivery of clinical interventions to enhance adherence. Implications for Nursing Nurses should be involved in the planning and implementation of clinical interventions to manage side effects and other barriers to AET adherence. PMID:28635973

Emerging Hyperprolactinemic Galactorrhea in Obsessive Compulsive Disorder with a Stable Dose of Fluoxetine.

PubMed

Chatterjee, Seshadri Sekhar; Mitra, Sayantanava; Mallik, Nitu

2015-12-31

While fluoxetine (FXT) is a frequently prescribed selective serotonin reuptake inhibitor (SSRI), with few major side-effects; altered serotonergic transmissions in hypothalamic pathways might lead to a distressing, and often embarrassing, manifestation of galactorrhea by altering prolactin release in those on FXT. We report here a case of FXT-induced hyperprolactinemic galactorrhea developing late into treatment on a stable regimen, who responded well to subsequent replacement with sertraline. Based on present finding, we suggest that while SSRIs may share similar mechanisms of action, there exist individual differences in their effects on prolactin secretion pathways.

[The clinical study on labor pain relief using two kinds of segmental block anesthesia].

PubMed

Zhang, Z; Zhang, Y; Bi, L

1998-07-01

To study the pain relief effectiveness of combined subarachnoid peridural segmental block and simple peridural anesthesia, and their influences on the mothers and the infants. 100 pregnants women were administered combined subarachnoid and peridural segmental block during labor and delivery (study group). 40 pregnant women received simple peridural anesthesia (control group). The degree of labour pain, side effects, labor course, the mode of delivery and the incidences of postpartum hemorrhage, fetal distress and neonatal asphyxia were observed in two groups respectively. The pain relief effect in the study group was much better than that of the control group (P < 0.01). There were no significant differences of the mean time of labor course and the mode of delivery between the two groups (P > 0.05). The incidences of postpartum hemorrhage, fetal distress and neonatal asphyxia were similar (P > 0.05). The analgesic delivery of combined subarachnoid and peridural segmental block is safe and effective, which has no influences on the labour course and the mothers and infants. Its pain relief effectiveness is more positive and satisfactory than that of simple peridural anesthesia. We suggest that it should be performed in the medical units under optimal conditions.

Effects of Screening for Psychological Distress on Patient Outcomes in Cancer: a Systematic Review

PubMed Central

Meijer, Anna; Roseman, Michelle; Delisle, Vanessa C.; Milette, Katherine; Levis, Brooke; Syamchandra, Achyuth; Stefanek, Michael E.; Stewart, Donna E.; de Jonge, Peter; Coyne, James C.; Thombs, Brett D.

2013-01-01

Objective Several practice guidelines recommend routine screening for psychological distress in cancer care. The objective was to evaluate the effect of screening cancer patients for psychological distress by assessing the (1) effectiveness of interventions to reduce distress among patients identified as distressed; and (2) effects of screening for distress on distress outcomes. Methods CINAHL, Cochrane, EMBASE, ISI, MEDLINE, PsycINFO, and SCOPUS databases were searched through April 6, 2011 with manual searches of 45 relevant journals, reference list review, citation tracking of included articles, and trial registry reviews through June 30, 2012. Articles in any language on cancer patients were included if they (1) compared treatment for patients with psychological distress to placebo or usual care in a randomized controlled trial (RCT); or (2) assessed the effect of screening on psychological distress in a RCT. Results There were 14 eligible RCTs for treatment of distress, and 1 RCT on the effects of screening on patient distress. Pharmacological, psychotherapy and collaborative care interventions generally reduced distress with small to moderate effects. One study investigated effects of screening for distress on psychological outcomes, and it found no improvement. Conclusion Treatment studies reported modest improvement in distress symptoms, but only a single eligible study was found on the effects of screening cancer patients for distress, and distress did not improve in screened patients versus those receiving usual care. Because of the lack of evidence of beneficial effects of screening cancer patients for distress, it is premature to recommend or mandate implementation of routine screening. PMID:23751231

Effects of web-based interventions on cancer patients' symptoms: review of randomized trials.

PubMed

Fridriksdottir, N; Gunnarsdottir, S; Zoëga, S; Ingadottir, B; Hafsteinsdottir, E J G

2018-02-01

Symptom management is of high priority in cancer care. Information and communication technology allows interventions to be provided through the internet to enhance the delivery of care. This study aimed to review the effects of web-based interventions on cancer patients' symptoms. MEDLINE, PSychINFO, PubMed, CINAHL, and Cochrane databases were systematically searched. Included were randomized controlled trials (RCTs), pilot RCTs, or quasi-experimental (QE) studies focusing on web-based interventions in adult cancer patients with at least one outcome primary or secondary, in terms of symptoms, treatment side effects, or distress. Data were analyzed study by study. Twenty studies were identified. All web interventions included information, 16 included self-management support, 14 included self-monitoring, 13 included feedback/tailored information, 12 used communication with health-care professionals, and eight used communication with other patients. Overall, 13 studies reported positive symptom outcomes. Psychological distress was reported in eight studies with positive intervention effects in three. Symptoms of anxiety/depression were reported in ten studies with positive intervention effects in five. Somatic symptom severity was reported in ten studies with intervention effects found in six, and symptom distress was reported in six studies with intervention effects found in all. This review shows the promising potential of web-based interventions for cancer symptom management, although it was limited by considerable heterogeneity in the interventions tested and targeted outcomes. The multidimensional nature of symptoms was partly addressed; only one study was guided by a comprehensive theoretical model of cancer symptom management. It can only be speculated which web elements are important for effective symptom outcomes. Further testing is needed for web-based cancer symptom management.

Vaginal progesterone pessaries for pregnant women with a previous preterm birth to prevent neonatal respiratory distress syndrome (the PROGRESS Study): A multicentre, randomised, placebo-controlled trial.

PubMed

Crowther, Caroline A; Ashwood, Pat; McPhee, Andrew J; Flenady, Vicki; Tran, Thach; Dodd, Jodie M; Robinson, Jeffrey S

2017-09-01

Neonatal respiratory distress syndrome, as a consequence of preterm birth, is a major cause of early mortality and morbidity. The withdrawal of progesterone, either actual or functional, is thought to be an antecedent to the onset of labour. There remains limited information on clinically relevant health outcomes as to whether vaginal progesterone may be of benefit for pregnant women with a history of a previous preterm birth, who are at high risk of a recurrence. Our primary aim was to assess whether the use of vaginal progesterone pessaries in women with a history of previous spontaneous preterm birth reduced the risk and severity of respiratory distress syndrome in their infants, with secondary aims of examining the effects on other neonatal morbidities and maternal health and assessing the adverse effects of treatment. Women with a live singleton or twin pregnancy between 18 to <24 weeks' gestation and a history of prior preterm birth at less than 37 weeks' gestation in the preceding pregnancy, where labour occurred spontaneously or in association with cervical incompetence or following preterm prelabour rupture of the membranes, were eligible. Women were recruited from 39 Australian, New Zealand, and Canadian maternity hospitals and assigned by randomisation to vaginal progesterone pessaries (equivalent to 100 mg vaginal progesterone) (n = 398) or placebo (n = 389). Participants and investigators were masked to the treatment allocation. The primary outcome was respiratory distress syndrome and severity. Secondary outcomes were other respiratory morbidities; other adverse neonatal outcomes; adverse outcomes for the woman, especially related to preterm birth; and side effects of progesterone treatment. Data were analysed for all the 787 women (100%) randomised and their 799 infants. Most women used their allocated study treatment (740 women, 94.0%), with median use similar for both study groups (51.0 days, interquartile range [IQR] 28.0-69.0, in the progesterone group versus 52.0 days, IQR 27.0-76.0, in the placebo group). The incidence of respiratory distress syndrome was similar in both study groups-10.5% (42/402) in the progesterone group and 10.6% (41/388) in the placebo group (adjusted relative risk [RR] 0.98, 95% confidence interval [CI] 0.64-1.49, p = 0.912)-as was the severity of any neonatal respiratory disease (adjusted treatment effect 1.02, 95% CI 0.69-1.53, p = 0.905). No differences were seen between study groups for other respiratory morbidities and adverse infant outcomes, including serious infant composite outcome (155/406 [38.2%] in the progesterone group and 152/393 [38.7%] in the placebo group, adjusted RR 0.98, 95% CI 0.82-1.17, p = 0.798). The proportion of infants born before 37 weeks' gestation was similar in both study groups (148/406 [36.5%] in the progesterone group and 146/393 [37.2%] in the placebo group, adjusted RR 0.97, 95% CI 0.81-1.17, p = 0.765). A similar proportion of women in both study groups had maternal morbidities, especially those related to preterm birth, or experienced side effects of treatment. In 9.9% (39/394) of the women in the progesterone group and 7.3% (28/382) of the women in the placebo group, treatment was stopped because of side effects (adjusted RR 1.35, 95% CI 0.85-2.15, p = 0.204). The main limitation of the study was that almost 9% of the women did not start the medication or forgot to use it 3 or more times a week. Our results do not support the use of vaginal progesterone pessaries in women with a history of a previous spontaneous preterm birth to reduce the risk of neonatal respiratory distress syndrome or other neonatal and maternal morbidities related to preterm birth. Individual participant data meta-analysis of the relevant trials may identify specific women for whom vaginal progesterone might be of benefit. Current Clinical Trials ISRCTN20269066.

Symptom Experience Associated With Immunosuppressive Medications in Chinese Kidney Transplant Recipients.

PubMed

Teng, Sha; Zhang, Shuping; Zhang, Wenxin; Lin, Xiaohong; Shang, Yabin; Peng, Xiao; Liu, Hongxia

2015-09-01

Kidney transplant recipients require lifelong treatment with immunosuppressive medications to avoid graft rejection and graft loss. Symptoms experienced may influence recipients' perceived quality of life and medication adherence. The purpose of this study was to evaluate the symptom experience associated with immunosuppressive medications in adult kidney transplant recipients and to explore the association between the symptom experience and adherence to immunosuppressive medications. A cross-sectional design was used. The study was conducted in a general hospital in China from October 2013 to September 2014. A total of 231 recipients with a follow-up of at least 1 year after kidney transplantation were included. Symptom experience associated with immunosuppressive medications was measured by the 13-item Symptom Experience of Immunosuppressive-related Side Effects Scale. Self-reported adherence to immunosuppressive medications was assessed using the Adherence with Immunosuppressive Medication Scale. Ridit analysis was used to rank symptom distress items. A proportion of 60.6% of recipients were male; the time after kidney transplantation was arbitrarily divided into a short-term cohort (1-4 years) and a long-term cohort (4-16 years) according to the median duration of follow-up (4 years). High blood pressure, hair loss, and tiredness were the three most distressing symptoms over all items of the whole sample. High blood pressure was the most distressing symptom for the 1- to 4-year cohort and the 4- to 16-year cohort. For men high blood pressure was the most distressing symptom, whereas for women hair loss was the most distressing symptom. Recipients in the 4- to 16-year cohort perceived a higher level of symptom distress compared with those in the 1- to 4-year cohort, especially in excess hair growth and difficulty sleeping. A negative relationship was found between symptom distress and adherence to immunosuppressive medications (r = -.541, p = .000). Recipients in the 4- to 16-year cohort perceived a higher level of symptom distress compared with those in the 1- to 4-year cohort, especially in excess hair growth and difficulty sleeping. No significant difference was found between gender groups. Recipients who reported a higher level of symptom distress were more likely to be nonadherent. Understanding symptom experience of immunosuppressive medications is of importance for healthcare providers to offer sophisticated education and develop strategies to improve quality of life and medication adherence during follow-up post-transplantation. © 2015 Sigma Theta Tau International.

Identifying cancer patients who alter care or lifestyle due to treatment-related financial distress.

PubMed

Nipp, Ryan D; Zullig, Leah L; Samsa, Gregory; Peppercorn, Jeffrey M; Schrag, Deborah; Taylor, Donald H; Abernethy, Amy P; Zafar, S Yousuf

2016-06-01

Cancer patients may experience financial distress as a side effect of their care. Little is known about which patients are at greatest risk for altering their care or lifestyle due to treatment-related financial distress. We conducted a cross-sectional survey study to determine which patients are at greatest risk for altering their care or lifestyle due to treatment-related financial distress. Eligible patients were adults receiving cancer treatment enrolled between June 2010 and May 2011. We grouped coping strategies as lifestyle altering or care altering. We assessed coping strategies and relationships between covariates using descriptive statistics and analysis of variance. Among 174 participants, 89% used at least one lifestyle-altering coping strategy, while 39% used a care-altering strategy. Care-altering coping strategies adopted by patients included the following: not filling a prescription (28%) and taking less medication than prescribed (23%). Lifestyle-altering strategies included the following: spending less on leisure activities (77%), spending less on basics like food and clothing (57%), borrowing money (54%), and spending savings (50%). Younger patients were more likely than older patients to use coping strategies (p < 0.001). Lower-income patients adopted care-altering strategies more than higher-income patients (p = 0.03). Participants with more education and shorter duration of chemotherapy used lifestyle-altering strategies more than their counterparts (both p < 0.05). As a means of coping with treatment-related financial distress, patients were more likely to use lifestyle-altering approaches, but more than one-third adopted potentially harmful care-altering strategies. Younger age, lower income, higher education, and shorter duration of chemotherapy were characteristics associated with greater use of coping strategies. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Survivorship Challenges and Information Needs after Radiotherapy for Oral Cancer.

PubMed

Badr, Hoda; Lipnick, Daniella; Gupta, Vishal; Miles, Brett

2017-12-01

Oral cancer (OC) treatment can lead to considerable functional impairment, psychological distress, and decrements in quality of life. Given that limited information and support services are available for cancer survivors, many are turning to the Internet. However, little is known about the specific information and service needs of OC survivors. We conducted a descriptive study to (1) characterize the associations between OC survivor functional problems and distress and (2) describe the Internet use of OC survivors, their satisfaction with existing sources of information/support, and their unmet information and service needs. Ninety-three oral cancer survivors completed cross-sectional surveys within 1-year of completing radiotherapy. Clinical levels of distress were 10 % for depression and 16 % for anxiety. Dental health, smell, and range of motion problems were significant (p < .05) determinants of both depression and anxiety symptoms. Eighty-three percent of survivors used the Internet; most used it to obtain health-related information or support. Unmet information needs included how to live a healthy lifestyle after treatment (87 %), strategies for dealing with eating and speaking problems (81 %), and information about what to expect in terms of side effects after treatment (76 %). Findings suggest that interventions that teach survivors coping and problem-solving skills to manage and cope with functional impairments may help to alleviate distress. Results of this study support the need for psychoeducational interventions for this population and showcase the potential of the Internet as a feasible mode for future dissemination.

Brain responses to erotic and other emotional stimuli in breast cancer survivors with and without distress about low sexual desire: a preliminary fMRI study.

PubMed

Versace, Francesco; Engelmann, Jeffrey M; Jackson, Edward F; Slapin, Aurelija; Cortese, Kristin M; Bevers, Therese B; Schover, Leslie R

2013-12-01

Many breast cancer survivors report a loss of sexual desire and arousability, consonant with the new DSM-V category of female sexual interest/arousal disorder. The cause of decreased sexual desire and pleasure after treatment for cancer is unknown. One possibility is that cancer, or treatment for cancer, damages brain circuits that are involved in reward-seeking. To test the hypothesis that brain reward systems are involved in decreased sexual desire in breast cancer survivors, we used functional magnetic resonance imaging (fMRI) to compare brain responses to erotica and other emotional stimuli in two groups of women previously treated for breast cancer with chemotherapy: those who were distressed about a perceived loss of sexual desire and those who may have had low desire, but were not distressed about it. Women distressed about their desire had reduced brain responses to erotica in the anterior cingulate and dorsolateral prefrontal cortex, which are part of the brain reward system. This study is the first to demonstrate, in cancer survivors, that problems with sexual desire/arousability are associated with blunted brain responses to erotica in reward systems. Future research is necessary to determine whether brain responses differ as a result of chemotherapy, hormone therapy, and menopausal status. This may contribute to the development of new, evidence-based interventions for one of the most prevalent and enduring side effects of cancer treatment.

Targeting the Psychosexual Challenges Faced by Couples with Breast Cancer: Can Couples Group Psychotherapy Help?

PubMed Central

Lagana, Luciana; Fobair, Patricia; Spiegel, David

2016-01-01

The need for the psychosexual rehabilitation of breast cancer survivors and their intimate partners is underscored by the high prevalence of multiple psychosexual difficulties encountered by this patient population. Concerns about health, sexuality, and emotional distress are common among women with breast cancer and are often related to the side effects of cancer treatment. Additionally, both intimate relationship problems and partners’ distress are likely to influence patients’ psychosexual health. A clearer understanding of these complex clinical issues is needed in order to implement effective psychosexual rehabilitation interventions. In this article, we extended the use of the manualized and empirically validated Supportive-Expressive Group Therapy (SEGT) model to target the specific psychosexual needs of couples with breast (as well as other types of) cancer. In view of the pertinent literature in this area and based on our clinical experience utilizing this group therapy model with different patient populations, we have discussed how clinicians involved in the psychosexual care of oncology patients could apply such a model within a couples group therapy format. PMID:27239398

The desire to survive: the adaptation process of adult cancer patients undergoing radiotherapy.

PubMed

Chao, Yu Huan; Wang, Shou-Yu; Hsu, Tsui Hua; Wang, Kai Wei K

2015-01-01

Radiotherapy is one of the primary treatment strategies for cancer. However, patients not only deal with the side-effects of radiotherapy, but they must also endure the psychological distress caused by cancer. This study explores how cancer patients adapt to the treatment process when receiving radiotherapy. This study used a grounded theory approach, and eight in-depth interviews were conducted with newly diagnosed cancer patients who received radiotherapy as a primary treatment. The core category that emerged from this study was "the desire to survive". The categories and subcategories that emerged from the data include facing unknown situations (e.g. searching for relevant information and decision-making considerations, and listening to healthcare professionals' suggestions), experiencing the pain of treatment (e.g. tolerating side-effects, tolerating inconvenience during the treatment, accepting support during the treatment, and adjusting lifestyles), and chances to extend life (e.g. accepting fate, determination to undergo the treatment, and adjusting negative emotions). The study results provide a better understanding of the experiences of cancer patients undergoing radiotherapy. Healthcare professionals should provide effective medical management for side-effects and psychological support to cancer patients during the journey of radiotherapy. © 2014 The Authors. Japan Journal of Nursing Science © 2014 Japan Academy of Nursing Science.

Satisfaction with quality of life varies with temperament types of patients with schizophrenia.

PubMed

Ritsner, Michael; Farkas, Herman; Gibel, Anatoly

2003-10-01

We sought to explore the relationships of three temperament factors with domain-specific subjective quality of life (QOL) of patients with schizophrenia. Ninety patients with schizophrenia were evaluated using the Quality of Life Enjoyment and Life Satisfaction Questionnaire, the Tridimensional Personality Questionnaire, the Positive and Negative Syndromes Scale, the Distress Scale for Adverse Symptoms, the Insight and Treatment Attitudes Questionnaire, the Insight Self-Report Scale, and standardized questionnaires for self-reported emotional distress and stress process-related variables. Predictors of domain-specific QOL were identified using multiple regression techniques. Temperament factors explain 6% to 16% of variability in QOL domain scores among patients with schizophrenia after controlling for the remaining variables (emotional distress, social support, self-esteem, avoidance coping, age, side effects, and depression). We found that higher levels of novelty seeking are associated with better general QOL, physical health, and more positive subjective feelings, whereas higher levels of reward dependence are related to better satisfaction from social relationships. Higher levels of harm avoidance are associated with poorer satisfaction with general activities, and medication. Thus, temperament factors, as assessed by the Tridimensional Personality Questionnaire, substantially influence satisfaction with life quality in schizophrenia. Novelty seeking, reward dependence, and harm avoidance are associated with different domains of QOL.

The Patient Remote Intervention and Symptom Management System (PRISMS) - a Telehealth- mediated intervention enabling real-time monitoring of chemotherapy side-effects in patients with haematological malignancies: study protocol for a randomised controlled trial.

PubMed

Breen, Sibilah; Ritchie, David; Schofield, Penelope; Hsueh, Ya-Seng; Gough, Karla; Santamaria, Nick; Kamateros, Rose; Maguire, Roma; Kearney, Nora; Aranda, Sanchia

2015-10-19

Outpatient chemotherapy is a core treatment for haematological malignancies; however, its toxicities frequently lead to distressing/potentially life-threatening side-effects (neutropenia/infection, nausea/vomiting, mucositis, constipation/diarrhoea, fatigue). Early detection/management of side-effects is vital to improve patient outcomes, decrease morbidity and limit lengthy/costly hospital admissions. The ability to capture patient-reported health data in real-time, is regarded as the 'gold-standard' to allow rapid clinical decision-making/intervention. This paper presents the protocol for a Phase 3 multi-site randomised controlled trial evaluating a novel nurse-led Telehealth intervention for remote monitoring/management of chemotherapy side-effects in Australian haematological cancer patients. Two hundred and twenty-two patients will be recruited from two hospitals. Eligibility criteria include: diagnosis of chronic lymphocytic leukaemia/Hodgkin's/non-Hodgkin's lymphoma; aged ≥ 18 years; receiving ≥ 2 cycles chemotherapy. Patients will be randomised 1:1 to either the control or intervention arm with stratification by diagnosis, chemotherapy toxicity (high versus low), receipt of previous chemotherapy and hospital. Patients allocated to the control arm will receive 'Usual Care' whilst those allocated to the intervention will receive the intervention in addition to 'Usual Care'. Intervention patients will be provided with a computer tablet and software prompting twice-daily completion of physical/emotional scales for up to four chemotherapy cycles. Should patient data exceed pre-determined limits an Email alert is delivered to the treatment team, prompting nurses to view patient data, and contact the patient to provide clinical intervention. In addition, six scheduled nursing interventions will be completed to educate/support patients in use of the software. Patient outcomes will be measured cyclically (midpoint and end of cycles) via pen-and-paper self-report alongside review of the patient medical record. The primary outcome is burden due to nausea, mucositis, constipation and fatigue. Secondary outcomes include: burden due to vomiting and diarrhoea; psychological distress; ability to self-manage health; level of cancer information/support needs and; utilisation of health services. Analyses will be intention-to-treat. A cost-effectiveness analysis is planned. This trial is the first in the world to test a remote monitoring/management intervention for adult haematological cancer patients receiving chemotherapy. Future use of such interventions have the potential to improve patient outcomes/safety and decrease health care costs by enabling early detection/clinical intervention. ACTRN12614000516684 . Date registered: 12 March 2014 (registered retrospectively).

Coping with losses, grief, and mourning in prostate cancer.

PubMed

Wittmann, Daniela

2015-01-01

Prostate cancer is a highly prevalent disease with a high likelihood of survival. If treated, survivors live with significant and lasting treatment-related side effects. Surgical treatment is associated with urinary incontinence and erectile dysfunction, and radiation leads to urinary and bowel irritability as well as erectile dysfunction. Patients who undergo hormonal treatment cope with sexual dysfunction, bone density loss, hot flashes, mood symptoms, and cardiac and metabolic disorders. Functional losses have a significant impact on patients and their partners' quality of life and are associated with distress and psychosocial morbidity. Psychosocial treatment is largely unavailable in usual care, but has been shown to reduce distress, to increase positive reappraisal of the illness, and to contribute to the recovery of sexual intimacy. Treatment for grief and mourning, typical reactions to loss, has not been introduced into psychosocial interventions but is increasingly recognized as a path toward a 'new normal' after prostate cancer treatment. © 2015 S. Karger AG, Basel.

Evaluation of amino-oxyacetic acid as a palliative in tinnitus.

PubMed

Guth, P S; Risey, J; Briner, W; Blair, P; Reed, H T; Bryant, G; Norris, C; Housley, G; Miller, R

1990-01-01

Amino-oxyacetic acid (AOAA) was evaluated as a palliative in tinnitus. Sixty-six patients with tinnitus presumed to be of cochlear origin were given either a placebo or 75 mg of AOAA four times a day for 1 week. Response was evaluated by both audiometric measurement of tinnitus loudness and subjective rating by patients of change or no change in tinnitus severity. Because loudness measurements and self-rating have not been shown to be independent, and since the aim of clinical treatment of tinnitus is the alleviation of subjective distress, greater weight was given to the patient's self-rating. A total of 21% of all patients reported a subjective decrease in tinnitus severity, usually within 3 to 4 days after the start of AOAA use. Patients with tinnitus caused by presbycusis or Meniere's disease were the most likely to respond to AOAA treatment with a reduction in tinnitus severity, whereas those with drug-induced tinnitus were the least likely to respond. Nausea and dysequilibrium were the most common side effects of AOAA use. Of the 21% of patients who responded to AOAA, 71% developed some type of side effect. Amino-oxyacetic acid produces a reduction in the severity of tinnitus in about 20% of patients; however, the incidence of side effects makes the drug unacceptable for clinical use.

An investigation of enhanced capability thermal barrier coating systems for diesel engine components

NASA Technical Reports Server (NTRS)

Holtzman, R. L.; Layne, J. L.; Schechter, B.

1984-01-01

Material systems and processes for the development of effective and durable thermal barriers for heavy duty diesel engines were investigated. Seven coating systems were evaluated for thermal conductivity, erosion resistance, corrosion/oxidation resistance, and thermal shock resistance. An advanced coating system based on plasma sprayed particle yttria stabilized zirconia (PS/HYSZ) was judged superior in these tests. The measured thermal conductivity of the selected coating was 0.893 W/m C at 371 C. The PS/HYSZ coating system was applied to the piston crown, fire deck and valves of a single cylinder low heat rejection diesel engine. The coated engine components were tested for 24 hr at power levels from 0.83 MPa to 1.17 MPa brake mean effective pressure. The component coatings survived the engine tests with a minimum of distress. The measured fire deck temperatures decreased 86 C (155 F) on the intake side and 42 C (75 F) on the exhaust side with the coating applied.

New insights into frequency and contents of fear of cancer progression/recurrence (FOP/FCR) in outpatients with colorectal carcinoma (CRC) receiving oral capecitabine: a pilot study at a comprehensive cancer center.

PubMed

Hefner, Jochen; Berberich, Sara; Lanvers, Elena; Sanning, Maria; Steimer, Ann-Kathrin; Kunzmann, Volker

2017-01-01

Fear of cancer progression/recurrence (FOP/FCR) is considered one of the most prevalent sources of distress in cancer survivors and associated with lower quality of life and functional impairment. Detailed measures of FOP/FCR are needed because little is known about the knowledge of FOP/FCR, its associations with the patient-doctor relationship, and the rate of adequate therapy. Colorectal cancer (CRC) is one of the most prevalent cancer entities, and oral capecitabine is widely prescribed as treatment. Therefore, we initiated a pilot study to expand the literature on FOP/FCR in CRC outpatients receiving capecitabine and to generate hypotheses for future investigations. This study included 58 patients treated at a comprehensive cancer center. FOP/FCR was assessed with the Fear of Progression Questionnaire (FOP-Q-SF). Satisfaction with the relationships with doctors was assessed with the Patient-Doctor Relationship Questionnaire-9 (PRDQ-9). Levels of side effects were rated by the patients on a visual analog scale. Clinical data were extracted from the charts. A total of 19 out of 58 patients (36%) suffered from FOP/FCR according to our assessment. Levels of FOP/FCR seemed to be mostly moderate to high. Only four out of the 19 distressed patients (21%) were treated accordingly. Typical side effects of oncological treatment were associated with higher FOP/FCR. Satisfaction with doctor-patient relationships was not associated with FOP/FCR. Regarding single items of FOP/FCR, three out of the five most prevalent fears were associated with close relatives. FOP/FCR occurred frequently in more than one in three patients, but was mostly untreated in this sample of consecutive outpatients with CRC receiving oral capecitabine. In detail, most fears were related to family and friends. In addition to an unmet need of patients, our data indicate sources of distress not considered thus far. If replicated in larger studies, results may help to inform intervention development and improve patient care.

Efficacy of Intense Pulsed Light Therapy in the Treatment of Facial Acne Vulgaris: Comparison of Two Different Fluences

PubMed Central

Patidar, Monika V; Deshmukh, Ashish Ramchandra; Khedkar, Maruti Yadav

2016-01-01

Background: Acne vulgaris is the most common disease of the skin affecting adolescents and young adults causing psychological distress. The combination of antibiotic resistance, adverse effects of topical and systemic anti acne medications and desire for high tech approaches have all led to new enthusiasm for light based acne treatment. Intense pulse light (IPL) therapy has three modes of action in acne vulgaris i.e., photochemical, photo thermal and photo immunological. Aims: (1) to study efficacy of IPL therapy in facial acne vulgaris. (2) To compare two fluences - one normal and other subnormal on right and left side of face respectively. Methods: (Including settings and design and statistical analysis used). Total 45 patients in age group 16 to 28 years with inflammatory facial acne vulgaris were included in prospective study. Baseline data for each patient was recorded. All patients were given 4 sittings of IPL at 2 weeks interval and were followed for 2 months every 2 weeks. Fluence used was 35J/cm2 on right and 20J/cm2 on left side. Percentage reduction in lesion count was calculated at each sitting and follow up and graded as mild (0-25%), moderate (26-50%), good (51-75%) and excellent (76-100%). Side effects were noted. The results were analysed using Mann-Whitney Test. Results: On right side, excellent results were achieved in 10(22%), good in 22(49%) and moderate in 13(29%) patients. On left side excellent were results achieved in 7(15%), good in 19(42%) and moderate in 16(43%) patients. There was no statically significant difference noted in efficacy of two fluences used in treatment of facial acne vulgaris. Conclusions: IPL is a effective and safe option for inflammatory acne vulgaris with minimal reversible side effects. Subnormal fluence is as effective as normal fluence in Indian skin. PMID:27688446

Efficacy of Intense Pulsed Light Therapy in the Treatment of Facial Acne Vulgaris: Comparison of Two Different Fluences.

PubMed

Patidar, Monika V; Deshmukh, Ashish Ramchandra; Khedkar, Maruti Yadav

2016-01-01

Acne vulgaris is the most common disease of the skin affecting adolescents and young adults causing psychological distress. The combination of antibiotic resistance, adverse effects of topical and systemic anti acne medications and desire for high tech approaches have all led to new enthusiasm for light based acne treatment. Intense pulse light (IPL) therapy has three modes of action in acne vulgaris i.e., photochemical, photo thermal and photo immunological. (1) to study efficacy of IPL therapy in facial acne vulgaris. (2) To compare two fluences - one normal and other subnormal on right and left side of face respectively. (Including settings and design and statistical analysis used). Total 45 patients in age group 16 to 28 years with inflammatory facial acne vulgaris were included in prospective study. Baseline data for each patient was recorded. All patients were given 4 sittings of IPL at 2 weeks interval and were followed for 2 months every 2 weeks. Fluence used was 35J/cm(2) on right and 20J/cm(2) on left side. Percentage reduction in lesion count was calculated at each sitting and follow up and graded as mild (0-25%), moderate (26-50%), good (51-75%) and excellent (76-100%). Side effects were noted. The results were analysed using Mann-Whitney Test. On right side, excellent results were achieved in 10(22%), good in 22(49%) and moderate in 13(29%) patients. On left side excellent were results achieved in 7(15%), good in 19(42%) and moderate in 16(43%) patients. There was no statically significant difference noted in efficacy of two fluences used in treatment of facial acne vulgaris. IPL is a effective and safe option for inflammatory acne vulgaris with minimal reversible side effects. Subnormal fluence is as effective as normal fluence in Indian skin.

Psychosocial distress and stroke risk in older adults.

PubMed

Henderson, Kimberly M; Clark, Cari J; Lewis, Tené T; Aggarwal, Neelum T; Beck, Todd; Guo, Hongfei; Lunos, Scott; Brearley, Ann; Mendes de Leon, Carlos F; Evans, Denis A; Everson-Rose, Susan A

2013-02-01

To investigate the association of psychosocial distress with risk of stroke mortality and incident stroke in older adults. Data were from the Chicago Health and Aging Project, a longitudinal population-based study conducted in 3 contiguous neighborhoods on the south side of Chicago, IL. Participants were community-dwelling black and non-Hispanic white adults, aged 65 years and older (n=4120 for stroke mortality; n=2649 for incident stroke). Psychosocial distress was an analytically derived composite measure of depressive symptoms, perceived stress, neuroticism, and life dissatisfaction. Cox proportional hazards models examined the association of distress with stroke mortality and incident stroke over 6 years of follow-up. Stroke deaths (151) and 452 incident strokes were identified. Adjusting for age, race, and sex, the hazard ratio (HR) for each 1-SD increase in distress was 1.47 (95% confidence interval [CI]=1.28-1.70) for stroke mortality and 1.18 (95% CI=1.07-1.30) for incident stroke. Associations were reduced after adjustment for stroke risk factors and remained significant for stroke mortality (HR=1.29; 95% CI=1.10-1.52) but not for incident stroke (HR=1.09; 95% CI=0.98-1.21). Secondary analyses of stroke subtypes showed that distress was strongly related to incident hemorrhagic strokes (HR=1.70; 95% CI=1.28-2.25) but not ischemic strokes (HR=1.02; 95% CI=0.91-1.15) in fully adjusted models. Increasing levels of psychosocial distress are related to excess risk of both fatal and nonfatal stroke in older black and white adults. Additional research is needed to examine pathways linking psychosocial distress to cerebrovascular disease risk.

A biopsychosocial approach to sexual recovery after prostate cancer surgery: the role of grief and mourning.

PubMed

Wittmann, Daniela; Foley, Sallie; Balon, Richard

2011-01-01

Erectile dysfunction is a common side-effect of prostate cancer surgery that causes men suffering and hinders their sexual recovery. There are studies that describe men's and partners' distress and couples' difficulties engaging in sexual recovery. A few studies show a short-term benefit of brief psycho-social interventions such as psychoeducation and counseling. However, there is no conceptual framework to guide psychosocial treatments. We propose a model of intervention in sexual recovery that incorporates grief and mourning as a gateway to new and satisfying sexuality after prostate cancer treatment.

Respiratory dyskinesia--an under-recognized side-effect of neuroleptic medications.

PubMed

Bhimanil, Mukesh Mohan; Bhimani, Mukesh; Khan, Murad Moosa; Khan, Muhammad Faheem Ashraf; Waris, Muhammad Shiraz

2011-09-01

Respiratory dyskinesia is an under-recognized side effect of neuroleptic administration. There are only few studies that have addressed the prevalence of respiratory dyskinesia in patients with tardive dyskinesia. Our case report highlights the need to regularly examine patients on antipsychotics for any evidence of dyskinetic movements including respiratory musculature. Since RD is underrecognized and misdiagnosed, early detection can improve long term prognosis as treatment options are few and usually of only limited effect. A 62-year-old Asian male, retired civil engineer, had more than 20 years history of depressive illness, developed antidepressant induced hypomania, and was given risperidone upto 1 mg per day. He developed extrapyrmidal side effects as tremors, rigidity and later dyskinetic movements of lips with shortness of breathing, dyspnoea, grunting or gasping. He was referred to the pulmonologist who got the neccessary medical work up done, which was normal. A diagnosis of respiratory dyskinesia was made. Respiratory dyskinesia is an under-recognised and distressing condition that clinicians need to be aware of when treating patients with anti-psychotic medications. And also there is a need to regularly examine patients on antipsychotics for any evidence of dyskinetic movements including respiratory musculature for early diagnosis and better outcome. This case report also is worth reading for professionals of other specialties also because of the presentation of this patient, it can be easily misdiagnosed and result in poor outcome.

Impact of job characteristics on psychological health of Chinese single working women.

PubMed

Yeung, D Y; Tang, C S

2001-01-01

This study aims at investigating the impact of individual and contextual job characteristics of control, psychological and physical demand, and security on psychological distress of 193 Chinese single working women in Hong Kong. The mediating role of job satisfaction in the job characteristics-distress relation is also assessed. Multiple regression analysis results show that job satisfaction mediates the effects of job control and security in predicting psychological distress; whereas psychological job demand has an independent effect on mental distress after considering the effect of job satisfaction. This main effect model indicates that psychological distress is best predicted by small company size, high psychological job demand, and low job satisfaction. Results from a separate regression analysis fails to support the overall combined effect of job demand-control on psychological distress. However, a significant physical job demand-control interaction effect on mental distress is noted, which reduces slightly after controlling the effect of job satisfaction.

Religion, Purpose in Life, Social Support, and Psychological Distress in Chinese University Students.

PubMed

Wang, Zhizhong; Koenig, Harold G; Ma, Hui; Shohaib, Saad Al

2016-06-01

We examined the relationship between religious involvement and psychological distress and explored the mediating effects of social support and purpose in life in university students in western, mid-western, and eastern China. Cross-sectional survey of a representative sample of 1812 university students was conducted. The Purpose in Life scale, Duke Social Support Index, and Religious Commitment Inventory-10 were administered, along with Kessler's Psychological Distress Scale. Structural equation modeling was used to test two models of the mediation hypothesis, examining direct, indirect, and total effects. Model 1 (with direction of effect hypothesized from religiosity to psychological distress) indicated that religious involvement had a direct effect on increasing psychological distress (β = 0.23, p < .01) with minor mediated effects. However, Model 2 (with direction of effect hypothesized from psychological distress to religiosity) indicated strong indirect protective effects of religiosity on psychological distress through purpose in life and social support (β = -.40, p < .01). The findings are consistent with the hypothesis that psychological distress increases religious involvement, which then increases purpose in life and social support that then lead to lower psychological distress.

Acute Respiratory Distress Syndrome after Onyx Embolization of Arteriovenous Malformation

PubMed Central

Tawil, Isaac; Carlson, Andrew P.; Taylor, Christopher L.

2011-01-01

Purpose. We report a case of a 60-year-old male who underwent sequential Onyx embolizations of a cerebral arteriovenous malformation (AVM) which we implicate as the most likely etiology of subsequent acute respiratory distress syndrome (ARDS). Methods. Case report and literature review. Results. Shortly after the second Onyx embolization procedure, the patient declined from respiratory failure secondary to pulmonary edema. Clinical entities typically responsible for pulmonary edema including cardiac failure, renal failure, iatrogenic volume overload, negative-pressure pulmonary edema, and infectious etiologies were evaluated and excluded. The patient required mechanical ventilatory support for several days, delaying operative resection. The patient met clinical and radiographic criteria for ARDS. After excluding other etiologies of ARDS, we postulate that ARDS developed as a result of Onyx administration. The Onyx copolymer is dissolved in dimethyl sulfoxide (DMSO), a solvent excreted through the lungs and has been implicated in transient pulmonary side effects. Additionally, a direct toxic effect of the Onyx copolymer is postulated. Conclusion. Onyx embolization and DMSO toxicity are implicated as the etiology of ARDS given the lack of other inciting factors and the close temporal relationship. A strong physiologic rationale provides further support. Clinicians should consider this uncommon but important complication. PMID:21687580

Erectile Dysfunction after Radical Prostatectomy: Prevalence, Medical Treatments, and Psychosocial Interventions

PubMed Central

Emanu, Jessica C.; Avildsen, Isabelle K.; Nelson, Christian J.

2016-01-01

Purpose of review This review will discuss erectile dysfunction (ED) in prostate cancer patients following radical prostatectomy (RP). It will focus on the prevalence and current treatments for ED as well as the emotional impact of ED and the current psychosocial interventions designed to help patients cope with this side effect. Recent findings While there is a large discrepancy in prevalence rates of ED after RP, several recent studies have cited rates as high as 85%. The concept of “penile rehabilitation” is now the standard of practice to treat ED following RP. However, many men avoid seeking help or utilizing ED treatments. This avoidance is related to the shame, frustration, and distress many men with ED and their partners experience. Recent psychosocial interventions have been developed to facilitate the use of treatments and help men cope with ED. These interventions have shown initial promise, however, continued intervention development is needed to reduce distress and improve long-term erectile function (EF) outcomes. Summary ED is a significant problem following prostate cancer surgery. While there are effective medical treatments, the development of psychosocial interventions should continue to evolve to maximize the assistance we can give to men and their partners. PMID:26808052

Nonnarcotic analgesics and tricyclic antidepressants for the treatment of chronic nonmalignant pain.

PubMed

Richlin, D M

1991-05-01

Chronic nonmalignant pain is often characterized by multiple treatment failures, a pattern of maladaptive behavior, and depression. Often there is a history of inappropriate and excessive use of medications for pain. Prior and ongoing use of narcotics and sedatives acts to compound and aggravate the chronic pain syndrome. A first step in treatment is controlled withdrawal of these agents. Nonnarcotic analgesics, NSAIDs, and tricyclic antidepressants are commonly employed in patients with chronic pain. Effective use of these agents requires understanding of their pharmacokinetic and pharmacodynamic properties. Use of a fixed-time schedule is necessary to achieve an effective, sustained therapeutic response. Careful patient education and monitoring for side effects and toxicity are necessary, particularly in the elderly and patients with coexisting medical disorders. Incidence of side effects and toxicity may be reduced by choice of drug and modification of dosing regimen. Nonnarcotic analgesics, TCAs, and NSAIDs are seldom effective by themselves in resolving the pain and distress of patients with chronic nonmalignant pain. This is particularly true when maladaptive behavior coexists. A comprehensive multimodal pain management program encompassing additional pain-relieving strategies and behavior-modifying techniques should be considered and utilized in conjunction with medication.

Adolescent adjustment and well-being: effects of parental divorce and distress.

PubMed

Størksen, Ingunn; Røysamb, Espen; Holmen, Turid L; Tambs, Kristian

2006-02-01

This study investigates the long-term effects of parental divorce on adolescent psychological adjustment and well-being, and to what extent the effects are accounted for by parental psychological distress. Data were collected among 8,984 Norwegian adolescents (13-19 years) and their parents. Outcome variables were symptoms of anxiety and depression, subjective well-being, and three areas of school problems. Parental divorce was found to be associated with both higher mean levels and larger variances in adolescent problems. Divorce and parental distress contributed independently to adolescent distress, supporting the notion of "double exposure" effects. The prevalence of adolescents with substantial distress symptoms was 14% among those with non-distressed non-divorced parents and 30% among those with divorced and distressed parents. In general effects remained when controlling for demographic factors. Long-term effects of divorce on symptoms of anxiety and depression were stronger among girls than among boys.

Heterogeneity and the Effect of Mental Health Parity Mandates on the Labor Market*

PubMed Central

Andersen, Martin

2015-01-01

Health insurance benefit mandates are believed to have adverse effects on the labor market, but efforts to document such effects for mental health parity mandates have had limited success. I show that one reason for this failure is that the association between parity mandates and labor market outcomes vary with mental distress. Accounting for this heterogeneity, I find adverse labor market effects for non-distressed individuals, but favorable effects for moderately distressed individuals and individuals with a moderately distressed family member. On net, I conclude that the mandates are welfare increasing for moderately distressed workers and their families, but may be welfare decreasing for non-distressed individuals. PMID:26210944

Cancer-related symptoms predict psychological wellbeing among prostate cancer survivors: results from the PiCTure study.

PubMed

Sharp, Linda; O'Leary, Eamonn; Kinnear, Heather; Gavin, Anna; Drummond, Frances J

2016-03-01

Prostate cancer treatments are associated with a range of symptoms and physical side-effects. Cancer can also adversely impact on psychological wellbeing. Because many prostate cancer-related symptoms and side-effects are potentially modifiable, we investigated associations between symptoms and psychological wellbeing among prostate cancer survivors. Postal questionnaires were distributed to men diagnosed with prostate cancer 2-18 years previously identified through cancer registries. General and prostate cancer-specific symptoms were assessed using the EORTC QLQ-C30 and QLQ-PR25, with higher symptom scores indicating more/worse symptomatology. Psychological wellbeing was assessed by the DASS-21. Associations between symptoms and each outcome were investigated using multivariate logistic regression, controlling for socio-demographic and clinical factors. A total 3348 men participated (response rate = 54%). Seventeen percent (95%CI 15.2%-17.9%), 16% (95%CI 15.1%-17.8%) and 11% (95%CI 9.5%-11.8%) of survivors scored in the range for depression, anxiety and distress on the DASS scales, respectively. In multivariate models, risk of depression on the DASS scale was significantly higher in men with higher urinary and androgen deprivation therapy (ADT)-related symptoms, and higher scores for fatigue, insomnia and financial difficulties. Risk of anxiety on the DASS scale was higher in men with higher scores for urinary, bowel and ADT-related symptoms and fatigue, dyspnoea and financial difficulties. Risk of distress on the DASS scale was positively associated with urinary, bowel and ADT-related symptoms, fatigue, insomnia and financial difficulties. Cancer-related symptoms significantly predict psychological wellbeing among prostate cancer survivors. Greater use of interventions and medications and to alleviate symptoms might improve psychological wellbeing of prostate cancer survivors. Copyright © 2015 John Wiley & Sons, Ltd.

Mental distress predicts divorce over 16 years: the HUNT study.

PubMed

Idstad, Mariann; Torvik, Fartein Ask; Borren, Ingrid; Rognmo, Kamilla; Røysamb, Espen; Tambs, Kristian

2015-04-01

The association between mental distress and divorce is well established in the literature. Explanations are commonly classified within two different frameworks; social selection (mentally distressed people are selected out of marriage) and social causation (divorce causes mental distress). Despite a relatively large body of literature on this subject, selection effects are somewhat less studied, and research based on data from both spouses is scarce. The purpose of the present study is to investigate selection effects both at the individual level and the couple level. The current study is based on couple-level data from a Norwegian representative sample including 20,233 couples. Long-term selection effects were tested for by means of Cox proportional hazard models, using mental distress in both partners at baseline as predictors of divorce the next 16 years. Three identical sets of analyses were run. The first included the total sample, whereas the second and third excluded couples who divorced within the first 4 or 8 years after baseline, respectively. An interaction term between mental distress in husband and in wife was specified and tested. Hazard of divorce was significantly higher in couples with one mentally distressed partner than in couples with no mental distress in all analyses. There was also a significant interaction effect showing that the hazard of divorce for couples with two mentally distressed partners was higher than for couples with one mentally distressed partner, but lower than what could be expected from the combined main effects of two mentally distressed partners. Our results suggest that mentally distressed individuals are selected out of marriage. We also found support for a couple-level effect in which spouse similarity in mental distress to a certain degree seems to protect against divorce.

Relationships Among Financial Distress, Emotional Distress, and Overall Distress in Insured Patients With Cancer.

PubMed

Meeker, Caitlin R; Geynisman, Daniel M; Egleston, Brian L; Hall, Michael J; Mechanic, Karen Y; Bilusic, Marijo; Plimack, Elizabeth R; Martin, Lainie P; von Mehren, Margaret; Lewis, Bianca; Wong, Yu-Ning

2016-07-01

Recent studies have demonstrated increasing rates of financial toxicities and emotional distress related to cancer treatment. This study assessed and characterized the relationships among financial distress, emotional symptoms, and overall distress in patients with cancer. A cross-sectional sample of patients with cancer who visited our outpatient medical oncology and psychiatry clinics completed a pen-and-paper survey. The survey assessed demographics; cost concerns; and financial, emotional, and overall distress. One hundred twenty insured patients completed the survey. Sixty-five percent reported clinically significant overall distress scores, with the same percentage reporting at least one emotional problem (worry, anxiety, depression, etc). Twenty-nine percent scored in the range of high to overwhelming financial distress. By using structural equation modeling, we found that financial distress was associated with overall distress. This association was both direct (accounting for 76% of the effect) and indirect (accounting for 24% of the effect) via mediation by emotional distress. This cohort of patients with cancer reported significant levels of emotional distress, financial distress, and overall distress. These factors were interrelated, with both financial and emotional distress contributing to overall distress. Interventions targeted at alleviating financial distress may help to decrease levels of overall distress. Copyright © 2016 by American Society of Clinical Oncology.

Relationships Among Financial Distress, Emotional Distress, and Overall Distress in Insured Patients With Cancer

PubMed Central

Meeker, Caitlin R.; Geynisman, Daniel M.; Egleston, Brian L.; Hall, Michael J.; Mechanic, Karen Y.; Bilusic, Marijo; Plimack, Elizabeth R.; Martin, Lainie P.; von Mehren, Margaret; Lewis, Bianca

2016-01-01

Purpose: Recent studies have demonstrated increasing rates of financial toxicities and emotional distress related to cancer treatment. This study assessed and characterized the relationships among financial distress, emotional symptoms, and overall distress in patients with cancer. Methods: A cross-sectional sample of patients with cancer who visited our outpatient medical oncology and psychiatry clinics completed a pen-and-paper survey. The survey assessed demographics; cost concerns; and financial, emotional, and overall distress. Results: One hundred twenty insured patients completed the survey. Sixty-five percent reported clinically significant overall distress scores, with the same percentage reporting at least one emotional problem (worry, anxiety, depression, etc). Twenty-nine percent scored in the range of high to overwhelming financial distress. By using structural equation modeling, we found that financial distress was associated with overall distress. This association was both direct (accounting for 76% of the effect) and indirect (accounting for 24% of the effect) via mediation by emotional distress. Conclusion: This cohort of patients with cancer reported significant levels of emotional distress, financial distress, and overall distress. These factors were interrelated, with both financial and emotional distress contributing to overall distress. Interventions targeted at alleviating financial distress may help to decrease levels of overall distress. PMID:27328795

The mediating effect of psychological distress on functional dependence in stroke patients.

PubMed

Huang, Hui-Chuan; Huang, Li-Kai; Hu, Chaur-Jong; Chang, Chien-Hung; Lee, Hsin-Chien; Chi, Nai-Fang; Shyu, Meei-Ling; Chang, Hsiu-Ju

2014-12-01

To explore varied forms of psychological distress and to determine the mediating influence of psychological distress on functional outcomes in stroke patients. Previous studies attest to the influence of depression on poststroke functional recovery. While there is evidence for neuropathological deficits that occur after stroke to be associated with psychological distress, few studies have explored the effect of various types of psychological distress on functional recovery. A cross-sectional study was used. Data were collected from 178 first-time stroke patients. Study variables included demographic and disease characteristics (stroke location and stroke syndrome classification), psychological distress (the Chinese language version of the Emotional and Social Dysfunction Questionnaire) and functional outcome (Barthel index). Regression and mediation models were used to evaluate the effect of psychological distress on functional outcome. Results revealed that stroke patients experience various forms of mild psychological distress, including anger, helplessness, emotional dyscontrol, indifference, inertia and euphoria, after stroke. Regression and mediation analyses further confirmed that various forms of psychological distress significantly mediated the effect of severe stroke syndromes on functional dependence. The various forms of psychological distress after stroke might play a mediating role in functional recovery and explain how stroke severity affects functional dependence. By understanding the nature of various forms of psychological distress, healthcare professionals should adopt appropriate assessment instruments and design effective interventions to help improve mental and physical function of stroke patients. © 2014 John Wiley & Sons Ltd.

A Case of Chronic Total Occlusion of the Left Anterior Descending Artery Successfully Treated with Side Branch Technique Using the Soutenir CV

PubMed Central

Niizeki, Takeshi; Ikeno, Eiichiro; Kubota, Isao

2017-01-01

Patient: Male, 54 Final Diagnosis: Old myocardial infarction Symptoms: Lower extremity swelling • respiratory distress Medication: — Clinical Procedure: Success Specialty: Cardiology Objective: Unusual setting of medical care Background: Success rates for treatment of chronic total occlusion (CTO) have dramatically improved in recent years with the development of new CTO guidewires and development of new techniques such as the retrograde approach. In the antegrade approach, a guidewire is occasionally passed through a side branch despite successful wire crossing of the CTO lesion. In order to pass a wire through the main artery, there are a few side branch techniques such as a reverse wire technique. Case Report: A 54-year-old man with symptoms of heart failure was admitted to our hospital. Coronary angiography showed CTO of the proximal left anterior descending artery. Percutaneous coronary intervention with an antegrade approach was started. We succeeded in passing the wire through a side branch but not the main artery. Unfortunately, a reverse wire technique failed in this case. Next, the wire passed through a side branch was exchanged with the Soutenir CV, and a retrograde approach was started. The wire crossing from retrograde was entwined around the Soutenir CV. After that, the retrograde wire was snared and guided to the antegrade guiding catheter, which resulted in successful wiring into the main artery easily. Conclusions: The side branch technique using the Soutenir CV may be an effective strategy in some cases. PMID:28082733

Heterogeneity and the effect of mental health parity mandates on the labor market.

PubMed

Andersen, Martin

2015-09-01

Health insurance benefit mandates are believed to have adverse effects on the labor market, but efforts to document such effects for mental health parity mandates have had limited success. I show that one reason for this failure is that the association between parity mandates and labor market outcomes vary with mental distress. Accounting for this heterogeneity, I find adverse labor market effects for non-distressed individuals, but favorable effects for moderately distressed individuals and individuals with a moderately distressed family member. On net, I conclude that the mandates are welfare increasing for moderately distressed workers and their families, but may be welfare decreasing for non-distressed individuals. Copyright © 2015 Elsevier B.V. All rights reserved.

Spiritual Struggles and Psychological Distress: Is There a Dark Side of Religion?

ERIC Educational Resources Information Center

Ellison, Christopher G.; Lee, Jinwoo

2010-01-01

A growing literature examines the correlates and sequelae of spiritual struggles. Particular attention has been focused on three specific types of such struggles: (a) divine, or troubled relationships with God; (b) interpersonal, or negative social encounters in religious settings; and (c) intrapsychic, or chronic religious doubting. To date,…

Effect of subjective economic status on psychological distress among farmers and non-farmers of rural China.

PubMed

Feng, Danjun; Ji, Linqin; Xu, Lingzhong

2015-08-01

This study aims to compare the prevalence of psychological distress between farmers and non-farmers of rural China. Further, this examines the effect of subjective economic status on psychological distress and whether this effect varies between farmers and non-farmers. The study design is a cross-sectional survey. The study was conducted in 27 villages of Dongying City in Shandong Province. Rural employed people included 1433 farmers and 584 non-farmers. Psychological distress was assessed by the Kessler 10 questionnaire, and subjective economic status was assessed by a single question. Overall, the farmers did not report significantly higher prevalence of psychological distress than non-farmers (31.13% versus 30.01%). However, the farmers aged 51-70 years did report significantly higher psychological distress than their non-farmer counterparts (33.4% versus 24.2%, P = 0.04). Second, subjective economic status had a significant (β = -0.28, P < 0.001) effect on psychological distress. Finally, subjective economic status exerted a stronger effect on psychological distress among farmers (β = 0.30, P < 0.001) than among non-farmers (β = 0.20, P < 0.001). The farmers had a comparable prevalence of psychological distress when compared with non-farmers in rural China. Subjective economic status exerted a significant effect on the psychological distress of rural employed people, and this effect was stronger for the farmers than for the non-farmers. © 2015 National Rural Health Alliance Inc.

Maternal side-effects after multiple courses of antenatal corticosteroids (MACS): the three-month follow-up of women in the randomized controlled trial of MACS for preterm birth study.

PubMed

Murphy, Kellie E; Hannah, Mary E; Willan, Andrew R; Ohlsson, Arne; Kelly, Edmond N; Matthews, Stephen G; Saigal, Saroj; Asztalos, Elizabeth; Ross, Sue; Delisle, Marie-France; Tomat, Laura; Amankwah, Kofi; Guselle, Patricia; Gafni, Amiram; Lee, Shoo K; Armson, B Anthony

2011-09-01

A single course of antenatal corticosteroids (ACS) is associated with a reduction in respiratory distress syndrome and neonatal death. Multiple Courses of Antenatal Corticosteroids Study (MACS), a study involving 1858 women, was a multicentre randomized placebo-controlled trial of multiple courses of ACS, given every 14 days until 33+6 weeks or birth, whichever came first. The primary outcome of the study, a composite of neonatal mortality and morbidity, was similar for the multiple ACS and placebo groups (12.9% vs. 12.5%), but infants exposed to multiple courses of ACS weighed less, were shorter, and had smaller head circumferences. Thus for women who remain at increased risk of preterm birth, multiple courses of ACS (every 14 days) are not recommended. Chronic use of corticosteroids is associated with numerous side effects including weight gain and depression. The aim of this postpartum assessment was to ascertain if multiple courses of ACS were associated with maternal side effects. Three months postpartum, women who participated in MACS were asked to complete a structured questionnaire that asked about maternal side effects of corticosteroid use during MACS and included the Edinburgh Postnatal Depression Scale. Women were also asked to evaluate their study participation. Of the 1858 women randomized, 1712 (92.1%) completed the postpartum questionnaire. There were no significant differences in the risk of maternal side effects between the two groups. Large numbers of women met the criteria for postpartum depression (14.1% in the ACS vs. 16.0% in the placebo group). Most women (94.1%) responded that they would participate in the trial again. In pregnancy, corticosteroids are given to women for fetal lung maturation and for the treatment of various maternal diseases. In this international multicentre randomized controlled trial, multiple courses of ACS (every 14 days) were not associated with maternal side effects, and the majority of women responded that they would participate in such a study again.

Breast cancer and fatigue: issues for the workplace.

PubMed

Mock, V

1998-09-01

1. Women with breast cancer are at high risk for fatigue as a side effect of treatment with surgery, radiation, and chemotherapy. The risk is compounded by the multiple roles of women who return to work during treatment. 2. The fatigue experience includes a physical component of decreased functional status, an affective component of emotional distress, and a cognitive component of difficulty concentrating. These characteristics of fatigue may present significant challenges for employees. 3. The Family Medical Leave Act provides 12 weeks of unpaid leave to receive medical treatment and/or recover from treatment for breast cancer. 4. The nurse in the workplace can assess and monitor the effects of fatigue and teach employees to manage fatigue through energy conservation, effective use of energy, and health promotion activities to restore energy levels.

Gynaecomastia in two men on stable antiretroviral therapy who commenced treatment for tuberculosis.

PubMed

Kratz, Jeremy D; El-Shazly, Ahmad Y; Mambuque, Santos G; Demetria, Elpidio; Veldkamp, Peter; Anderson, Timothy S

2016-12-01

Gynaecomastia is a common clinical presentation that varies from benign presentations in stages of human development to hormonal pathology, mainly due to hepatic dysfunction, malignancy, and adverse pharmacologic effects. We describe the development of significant bilateral gynaecomastia after starting treatment for pulmonary tuberculosis (TB) in two males with WHO stage III Human Immunodeficiency Virus (HIV) infection on stable antiretroviral regimens. Emerging reports suggest that distinct hepatic impairment in efavirenz metabolism modulates oestrogenic activity, which may be potentiated by anti-tuberculosis therapy. Clinical application includes early recognition of efavirenz-induced gynaecomastia, especially after commencing tuberculosis treatment. To avoid decreased adherence resulting from the distressing side effect of gynecomastia, transition to an alternative ART regimen over the course of tuberculosis treatment should be considered.

The Safety and efficacy of a new self-expandable intratracheal nitinol stent for the tracheal collapse in dogs

PubMed Central

Kim, Joon-young; Han, Hyun-jung; Yun, Hun-young; Lee, Bora; Jang, Ha-young; Eom, Ki-dong; Park, Hee-myung

2008-01-01

To evaluate the potential utility of a self-expandable intratracheal nitinol stent with flared ends for the treatment of tracheal collapse in dogs, endotracheal stenting therapy was performed under fluoroscopic guidance in four dogs with severe tracheal collapse. During the 4 to 7 month follow-up, after stent implantation, clinical signs, including dyspnea and respiratory distress, dramatically improved in all dogs. The radiographs showed that the implanted stents improved the tracheal collapse, and there were no side effects such as collapse, shortening or migration of the stents. In conclusion, the self-expandable intratracheal nitinol stents provided adequate stability to the trachea and were effective for attenuating the clinical signs associated with severe tracheal collapse. PMID:18296893

Association between socioeconomic status and altered appearance distress, body image, and quality of life among breast cancer patients.

PubMed

Chang, Oliver; Choi, Eun-Kyung; Kim, Im-Ryung; Nam, Seok-Jin; Lee, Jeong Eon; Lee, Se Kyung; Im, Young-Hyuck; Park, Yeon Hee; Cho, Juhee

2014-01-01

Breast cancer patients experience a variety of altered appearance--such as loss or disfigurement of breasts, discolored skin, and hair loss--which result in psychological distress that affect their quality of life. This study aims to evaluate the impact of socioeconomic status on the altered appearance distress, body image, and quality of life among Korean breast cancer patients. A cross-sectional survey was conducted at advocacy events held at 16 different hospitals in Korea. Subjects were eligible to participate if they were 18 years of age or older, had a histologically confirmed diagnosis of breast cancer, had no evidence of recurrence or metastasis, and had no psychological problems at the time of the survey. Employment status, marital status, education, and income were assessed for patient socioeconomic status. Altered appearance distress was measured using the NCI's cancer treatment side effects scale; body image and quality of life were measured by the EORTC QLC-C30 and BR23. Means and standard deviations of each outcome were compared by socioeconomic status and multivariate linear regression models for evaluating the association between socioeconomic status and altered appearance distress, body image, and quality of life. A total of 126 breast cancer patients participated in the study; the mean age of participants was 47.7 (SD=8.4). Of the total, 83.2% were married, 85.6% received more than high school education, 35.2% were employed, and 41% had more than $3000 in monthly household income. About 46% had mastectomy, and over 30% were receiving either chemotherapy or radiation therapy at the time of the survey. With fully adjusted models, the employed patients had significantly higher altered appearance distress (1.80 vs 1.48; p<0.05) and poorer body image (36.63 vs 51.69; p<0.05) compared to the patients who were unemployed. Higher education (10.58, standard error (SE)=7.63) and family income (12.88, SE=5.08) was positively associated with better body image after adjusting for age, disease stage at diagnosis, current treatment status, and breast surgery type. Similarly, patients who were married and who had higher education had better quality of life were statistically significant in the multivariate models. Socioeconomic status is significantly associated with altered appearance distress, body image, and quality of life in Korean women with breast cancer. Patients who suffer from altered appearance distress or lower body image are much more likely to experience psychosocial, physical, and functional problems than women who do not, therefore health care providers should be aware of the changes and distresses that these breast cancer patients go through and provide specific information and psychosocial support to socioeconomically more vulnerable patients.

Can physical activity help to maintain cognitive functioning and psychosocial well-being among breast cancer patients treated with chemotherapy? A randomised controlled trial: study protocol.

PubMed

Gokal, Kajal; Munir, Fehmidah; Wallis, Deborah; Ahmed, Samreen; Boiangiu, Ion; Kancherla, Kiran

2015-04-23

Evidence suggests chemotherapy treatment for breast cancer is associated with side effects such as cognitive impairment in domains of memory, attention, concentration and executive function. Cognitive impairments reported by patients have been associated with higher levels of emotional distress. To date, intervention studies to alleviate cognitive impairment associated with chemotherapy have focused on psycho-educational techniques or cognitive training. Studies have not yet considered physical activity as a potential for alleviating cognitive problems. Physical activity interventions are reported to be effective in alleviating emotional distress and fatigue in those with breast cancer. They have also been reported to improve cognitive functioning in the elderly, in those suffering with dementia and in children. We propose that physical activity could also help to alleviate cognitive impairments in women diagnosed with breast cancer. The study has been designed using a recently developed taxonomy of behaviour change techniques to reliably report the content of the intervention to allow future replication. This study will deliver a home-based moderate intensity walking intervention to women diagnosed with breast cancer mid-way through their chemotherapy treatment and will compare them to patients receiving usual care alone. The primary outcome measure for this intervention is changes in an objective measure of memory assessed using the Digit Span. Secondary outcome measures include: objective measures of executive function; attention; visual spatial skills; self report cognitive function; self-report fatigue; anxiety; depression; mood and self-esteem. As emotional distress has been associated with self-reporting of cognitive problems, this intervention will further test whether emotional distress mediates between the amount of walking undertaken during the intervention period and levels of self-reported cognitive functioning. The development of an effective intervention for preventing difficulties in emotional and cognitive functioning of cancer patients' post-treatment will help to guide health care professionals to improve patients' overall quality of life. It will also provide direction for future research, ultimately to improve the day to day functioning of breast cancer survivors. Current Controlled Trials ISRCTN50709297.

Perceptions of coping behaviors by persons with cancer and health care providers.

PubMed

Merluzzi, T V; Martinez Sanchez, M A

1997-09-01

We studied perceptions of the importance and difficulty of coping behaviors, from the perspectives of cancer patients (n = 33) and health care providers (i.e. nursing and technical personnel, n = 24). They rated the importance and difficulty of 43 behaviors that correspond to six domains of coping with cancer. Generally, ratings of importance were similar for both patients and providers. However, patients rated the domains of Coping with Treatment Related Side Effects and Seeking Support as less important than staff. Ratings of difficulty were quite divergent. Patients perceived coping as less difficult than the medical staff in the following domains: Maintenance of Activity and Independence, Coping With Treatment-Related Side-Effects, Accepting Cancer/Maintaining Positive Attitude, and Seeking Support. These differences in difficulty ratings between patients and health care providers may reflect distinct perspectives or schemas about coping. That is, patients may hold 'positive illusions' about their coping capacity and, therefore, rate coping as less difficult. Health care providers may overestimate patients' distress and, therefore, underestimate patients' coping capacity. An understanding of these different perspectives may assist medical staff in fostering self-efficacy expectations for coping behaviors.

A new early cognitive screening measure to detect cognitive side-effects of electroconvulsive therapy?

PubMed

Martin, Donel M; Katalinic, Natalie; Ingram, Anna; Schweitzer, Isaac; Smith, Deidre J; Hadzi-Pavlovic, Dusan; Loo, Colleen K

2013-12-01

Cognitive side-effects from electroconvulsive therapy (ECT) can be distressing for patients and early detection may have an important role in guiding treatment decisions over the ECT course. This prospective study examined the utility of an early cognitive screening battery for predicting cognitive side-effects which develop later in the ECT course. The screening battery, together with the Mini Mental Status Examination (MMSE), was administered to 123 patients at baseline and after 3 ECT treatments. A more detailed cognitive battery was administered at baseline, after six treatments (post ECT 6) and after the last ECT treatment (post treatment) to assess cognitive side-effects across several domains: global cognition, anterograde memory, executive function, speed and concentration, and retrograde memory. Multivariate analyses examined the predictive utility of change on items from the screening battery for later cognitive changes at post ECT 6 and post treatment. Results showed that changes on a combination of items from the screening battery were predictive of later cognitive changes at post treatment, particularly for anterograde memory (p < 0.01), after controlling for patient and treatment factors. Change on the MMSE predicted cognitive changes at post ECT 6 but not at post treatment. A scoring method for the new screening battery was tested for discriminative ability in a sub-sample of patients. This study provides preliminary evidence that a simple and easy-to-administer measure may potentially be used to help guide clinical treatment decisions to optimise efficacy and cognitive outcomes. Further development of this measure and validation in a more representative ECT clinical population is required. Copyright © 2013 Elsevier Ltd. All rights reserved.

Video Material as an Effective Educational Tool to Address Informational and Educational Needs of Cancer Patients Undergoing Radiation Therapy.

PubMed

Nathoo, Dilshad

2017-06-01

With increasing rates of cancer patients undergoing radiation therapy, the treatment itself can cause patients significant amounts of anxiety and distress. This can be attributed to the diagnosis of the disease, lack of knowledge of what radiation therapy is, expectations and management of side effects, and the lack of knowledge of supportive care for patients and their families. Providing patients with effective educational tools to meet the informational needs of cancer patients undergoing radiation therapy can empower patients and allow them to participate in treatment decision-making and their own healthcare. This discussion paper will evaluate several studies on the psychological impact of cancer patients undergoing radiation therapy and how video material can effectively meet the informational and educational needs of this patient population group.

The longitudinal causal directionality between body image distress and self-esteem among Korean adolescents: the moderating effect of relationships with parents.

PubMed

Park, Woochul; Epstein, Norman B

2013-04-01

This study examined the longitudinal relationship between self-esteem and body image distress, as well as the moderating effect of relationships with parents, among adolescents in Korea, using nationally representative prospective panel data. Regarding causal direction, the findings supported bi-directionality for girls, but for boys the association was unidirectional, in that their self-esteem predicted body image distress, but not vice versa. A gender difference also emerged in the moderating effect of quality of relationships with parents. For girls, relationships with parents moderated the effect of body image distress on self-esteem, such that when relationships with parents were better, the effect of greater body image distress on subsequent lower self-esteem was stronger than when relationships with parents were less positive. For boys, relationships with parents moderated the influence of self-esteem on body image distress, such that self-esteem reduced body image distress more when boys had better relationships with parents. Copyright © 2013. Published by Elsevier Ltd.

Review: Medicinal plants combating against hypertension: A green antihypertensive approach.

PubMed

Sultana, Sabira; Asif, Hafiz Muhammad

2017-11-01

Hypertension (HTN) or high blood pressure is a medical condition that accounts 9.4 million deaths all over the world every year. It is leading cause of morbidity and mortality worldwide. It increases the risk of cardiovascular diseases, including heart failure, diffuse atherosclerosis, cognitive impairment and dementia. Clinically, synthetic antihypertensive drugs have been used to treat hypertension. However, the efficacy of these drugs is low and also produces side effects which include dry mouth, dizziness, emotional distress, gastrointestinal disturbance, visual disorders etc. These distressing side effects adversely affect health-related quality of life. Therefore, there is a need to search natural, cheaper and non-toxic compound. Plant are widely use in traditional systems of medicine for the treatment of several diseases. About 80% of the world population relies on traditional medicine for primary healthcare. In the last three decades, a lot of research has been done on local medicinal plants for hypotensive and antihypertensive potentials. Plants are the rich source of secondary metabolites which have been found in vivo to have antihypertensive properties. The current study is focused on reviewing the antihypertensive property of medicinal plants and their metabolites. In the current review, we conducted a literature search using Elsevier, Science direct, Springer Link (Springer), Pub Med and Google Scholar. The search included the keywords "plants", "medicinal plants", "plant extracts", cross-referenced with the keywords "hypertension" "antihypertensive activity". The use of plant origin natural compounds as cardio protective and antihypertensive agents is an interesting strategy for discovering bioactive products. Plants are rich in a variety of secondary metabolites, such as flavonoids, alkaloids, tannins and terpenoids. These have been found in vivo to have antihypertensive effects. The present review therefore; stand for a good basis to choose exact molecules belonging to the indicated categories that in the forthcoming future will become useful therapeutic tools.

The effectiveness of bibliotherapy in alleviating tinnitus-related distress.

PubMed

Malouff, John M; Noble, William; Schutte, Nicola S; Bhullar, Navjot

2010-03-01

The present study examined the efficacy of bibliotherapy in assisting individuals experiencing distress related to tinnitus. One hundred sixty-two tinnitus sufferers from Australia participated in a study designed to examine the effectiveness of a cognitive-behaviorally based self-help book in reducing distress. To maximize the ecological validity of the findings, we excluded no individuals interested in treatment for tinnitus-related distress. The experimental condition lost 35% of participants at postassessment, compared to 10% in the control group. In an analysis of participants who completed postintervention assessment, those assigned to the intervention condition, who received a tinnitus self-help book, showed significantly less tinnitus-related distress and general distress 2 months later compared to those assigned to the waiting list control condition. The intervention group's reduction in tinnitus-related distress and general distress from preintervention to postintervention 2 months later was significant, and these participants maintained a significant reduction in distress on follow-up 4 months after they received the tinnitus self-help book. A long-term follow-up of all participants, who at that time had received the book at least a year previously, showed a significant reduction in tinnitus distress. Although these group differences and pre-post changes were significant, effect sizes were small. Intention-to-treat analyses showed no significant effect for between-groups analyses, but did show a significant effect for the 1-year follow-up pre-post analysis. Information on the effectiveness of using a self-help book, without therapist assistance, in alleviating distress is important, as bibliotherapy can provide inexpensive treatment that is not bound by time or place. Copyright 2010 Elsevier Inc. All rights reserved.

Efficacy of 694-nm fractional Q-switched ruby laser (QSRL) combined with sonophoresis on levorotatory vitamin C for treatment of melasma in Chinese patients.

PubMed

Zhou, H L; Hu, B; Zhang, C

2016-07-01

Melasma is a common acquired and distressing pigmentary disorder presenting to dermatology clinics. It is notably difficult to cure and has a tendency to relapse. The efficacy of classical Q-switched laser in treatment of melasma remains controversial. This study aims to investigate the efficacy and safety of 694-nm fractional QSRL combined with sonophoresis on levorotatory vitamin C for the treatment of melasma patients. Twenty-six patients with melasma were enrolled. Each patient received four to six fractional QSRL treatments at pulse energies of 2.5 to 4 J/cm(2) combined with sonophoresis on levorotatory vitamin C at 2-week intervals. The severity and the area of melasma were assessed by two investigators using the melasma area and severity index (MASI). Side effects were documented. Mean MASI score decreased from 15.51 ± 3.00 before treatment to 10.02 ± 4.39 3 months after the final treatment (P < 0.01). Side effects were few and transient. High-density coverage fractional QSRL combined with sonophoresis on levorotatory vitamin C is safe and effective for the treatment of melasma in Chinese patients.

Impact and safety of open lung biopsy in patients with acute respiratory distress syndrome (ARDS).

PubMed

Ortiz, G; Garay, M; Mendoza, D; Cardinal-Fernández, P

2018-02-28

Acute respiratory distress syndrome (ARDS) is an inflammatory lung disorder, and its pathological hallmark is diffuse alveolar damage (DAD). Given that open lung biopsy (OLB) can sometimes result in severe side effects, it is rarely performed in patients with ARDS. The aims of this study were to describe: (a) the rate of treatment change associated with the histological result; and (b) the incidence of side effects induced by OLB. A retrospective, single-center, descriptive observational study was carried out in Hospital Santa Clara (Bogotá, Colombia) from February 2007 to January 2014. Critically ill patients over 18 years of age, undergoing invasive mechanical ventilation, diagnosed with ARDS of unknown etiology, and with OLB performed at the bedside. ARDS was diagnosed according to the Berlin definition. DAD was defined by the presence of a hyaline membrane plus at least one of the following: intra-alveolar edema, alveolar type I cell necrosis, alveolar type II cell (cuboidal cells) proliferation progressively covering the denuded alveolar-capillary membrane, interstitial proliferation of fibroblasts and myofibroblasts, or organizing interstitial fibrosis. The rate of treatment change (RTC) was established according to whether the OLB pathology report resulted in: a) the prescription or discontinuation of an antimicrobial; b) the indication of new procedures; c) medical interconsultation; or d) limitation of therapeutic effort. Patients were followed-up until death or hospital discharge. This study was approved by the Ethics Committee. A total of 32 OLBs were performed during the study period; 17 were ruled out as they did not involve ARDS, and 15 were considered for further analysis. A histological diagnosis was reached in 14 of the 15 patients (12 DAD, one case of bronchiolitis obliterans organizing pneumonia and one case of Wegener's granulomatosis with alveolar hemorrhage). The RTC rate was 0.73. The most frequent intervention was discontinuation of antimicrobial or corticosteroid treatment. No deaths but four side effects (3 airway leaks and one hemothorax) were associated with the OLB procedure. All were resolved before ICU discharge. The information provided by OLB performed at the bedside in ARDS patients of unknown etiology could be relevant, as it may optimize treatment. The risk associated with OLB seems to be acceptable. Copyright © 2018 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

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.

Diagnosis of Exclusion: A Case Report of Probable Glatiramer Acetate-Induced Eosinophilic Myocarditis

PubMed Central

Michaud, Christopher J.; Bockheim, Heather M.; Daum, Timothy E.

2014-01-01

Importance. Medication-induced eosinophilia is an acknowledged, often self-limiting occurrence. Glatiramer acetate, a biologic injection used in the management of relapsing-remitting multiple sclerosis, is widely regarded as a safe and effective medication and lists eosinophilia as an infrequent side effect in its package insert. Contrary to reports of transient, benign drug-induced eosinophilia, we describe a case of probable glatiramer acetate-induced eosinophilia that ultimately culminated in respiratory distress, shock, and eosinophilic myocarditis. Observations. A 59-year-old female was admitted to the hospital after routine outpatient labs revealed leukocytosis (43,000 cells/mm3) with pronounced hypereosinophilia (63%). This patient had been using glatiramer acetate without complication for over 10 years prior to admission. Leukocytosis and hypereosinophilia persisted as a myriad of diagnostic evaluations returned negative, ultimately leading to respiratory depression, shock, and myocarditis. Glatiramer acetate was held for the first time on day 6 of the hospital stay with subsequent resolution of leukocytosis, hypereosinophilia, respiratory distress, and shock. Conclusions and Relevance. Glatiramer acetate was probably the cause of this observed hypereosinophilia and the resulting complications. Reports of glatiramer-induced eosinophilia are rare, and few case reports regarding medication-induced hypereosinophilia describe the severe systemic manifestations seen in this patient. PMID:25105037

Diagnosis of exclusion: a case report of probable glatiramer acetate-induced eosinophilic myocarditis.

PubMed

Michaud, Christopher J; Bockheim, Heather M; Nabeel, Muhammad; Daum, Timothy E

2014-01-01

Importance. Medication-induced eosinophilia is an acknowledged, often self-limiting occurrence. Glatiramer acetate, a biologic injection used in the management of relapsing-remitting multiple sclerosis, is widely regarded as a safe and effective medication and lists eosinophilia as an infrequent side effect in its package insert. Contrary to reports of transient, benign drug-induced eosinophilia, we describe a case of probable glatiramer acetate-induced eosinophilia that ultimately culminated in respiratory distress, shock, and eosinophilic myocarditis. Observations. A 59-year-old female was admitted to the hospital after routine outpatient labs revealed leukocytosis (43,000 cells/mm(3)) with pronounced hypereosinophilia (63%). This patient had been using glatiramer acetate without complication for over 10 years prior to admission. Leukocytosis and hypereosinophilia persisted as a myriad of diagnostic evaluations returned negative, ultimately leading to respiratory depression, shock, and myocarditis. Glatiramer acetate was held for the first time on day 6 of the hospital stay with subsequent resolution of leukocytosis, hypereosinophilia, respiratory distress, and shock. Conclusions and Relevance. Glatiramer acetate was probably the cause of this observed hypereosinophilia and the resulting complications. Reports of glatiramer-induced eosinophilia are rare, and few case reports regarding medication-induced hypereosinophilia describe the severe systemic manifestations seen in this patient.

Efficacy of the nurse ethicist in reducing moral distress: what can the NHS learn from the USA?

PubMed

Morley, Georgina

Having first been introduced to nursing 30 years ago, 'moral distress' is not a new concept. Despite this, original research exploring moral distress has been largely absent from nursing literature produced in the UK, yet it has received increasing interest in the USA. Nurse researchers there have sought to explore, measure and understand moral distress. They are now beginning to develop and test ways in which the effects of moral distress can be reduced. The author of this article travelled to various institutions on the east coast of the USA to meet nurses leading the field of research into moral distress. This is the first of two interrelated articles that seek to explore the concept of moral distress. Drawing on both the author's experiences while in the USA and current literature, moral distress will be defined, its known effects described, and ways that nurses can mitigate its effects at a personal level discussed.

Dyadic Effects of Stigma and Discrimination on Distress in Chinese HIV Discordant Couples.

PubMed

Yu, Nancy Xiaonan; Chan, Cecilia L W; Zhang, Jianxin

2016-08-01

The present study investigated the dyadic effects of stigma and discrimination on distress in Chinese couples affected by HIV. Chinese people living with HIV (PLHIV) and their seronegative spouses (N = 119 couples) participated in this study. The PLHIV completed measures on stigma beliefs about being better off dead and dignity-related distress. The spouses completed measures on perceived discrimination and exclusion and caregiver distress. The results showed that there was no significant correlation between the PLHIV's stigma beliefs and the spouses' perceived discrimination and exclusion. The couples showed significant associations in their dignity-related distress and caregiver distress. Analyses using the actor-partner interdependence model showed that PLHIV's stigma beliefs and the spouses' perceived discrimination and exclusion both had significant actor and partner effects on distress within the dyad. Psychosocial interventions aiming for distress reduction in the context of HIV should tackle stigma and discrimination and target the couples rather than solely the patient or spouse.

Parecoxib, propacetamol, and their combination for analgesia after total hip arthroplasty: a randomized non-inferiority trial.

PubMed

Camu, F; Borgeat, A; Heylen, R J; Viel, E J; Boye, M E; Cheung, R Y

2017-01-01

This study assessed non-inferiority of parecoxib vs. combination parecoxib+propacetamol and compared the opioid-sparing effects of parecoxib, propacetamol, and parecoxib+propacetamol vs. placebo after total hip arthroplasty. In this randomized, placebo-controlled, parallel-group, non-inferiority study, patients received one of four IV treatments after surgery: parecoxib 40 mg bid (n = 72); propacetamol 2 g qid (n = 71); parecoxib 40 mg bid plus propacetamol 2 g qid (n = 72); or placebo (n = 38) with supplemental IV patient-controlled analgesia (morphine). Patients and investigators were blinded to treatment. Pain intensity at rest and with movement was assessed regularly, together with functional recovery (modified Brief Pain Inventory-Short Form) and opioid-related side effects (Opioid-Related Symptom Distress Scale) questionnaires up to 48 h. After 24 h, cumulative morphine consumption was reduced by 59.8% (P < 0.001), 38.9% (P < 0.001), and 26.8% (P = 0.005) in the parecoxib+propacetamol, parecoxib, and propacetamol groups, respectively, compared with placebo. Parecoxib did not meet criteria for non-inferiority to parecoxib+propacetamol. Parecoxib+propacetamol and parecoxib significantly reduced least-squares mean pain intensity scores at rest and with movement compared with propacetamol (P < 0.05). One day after surgery, parecoxib+propacetamol significantly reduced opioid-related symptom distress and decreased pain interference with function compared with propacetamol or placebo. Parecoxib and parecoxib+propacetamol provided significant opioid-sparing efficacy compared with placebo; non-inferiority of parecoxib to parecoxib+propacetamol was not demonstrated. Opioid-sparing efficacy was accompanied by significant reductions in pain intensity on movement, improved functional outcome, and less opioid-related symptom distress. Study medications were well tolerated. © 2016 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Controlled outcome studies of child clinical hypnosis.

PubMed

Adinolfi, Barbara; Gava, Nicoletta

2013-09-01

Background Hypnosis is defined as "as an interaction in which the hypnotist uses suggested scenarios ("suggestions") to encourage a person's focus of attention to shift towards inner experiences". Aim of the work The focus of this review is to summarize the findings of controlled outcome studies investigating the potential of clinical hypnosis in pediatric populations. We will examine the following themes: anesthesia, acute and chronic pain, chemotherapy-related distress, along with other specific medical issues. Results Hypnosis is an effective method to reduce pain and anxiety before, during and after the administration of anesthetics, during local dental treatments, invasive medical procedures and in burn children. Hypnosis can be successfully used to manage recurrent headaches, abdominal pain, irritable bowel syndrome and chemotherapy-related distress. Hypnosis has an important role in managing symptoms and improving the quality of life of children suffering from asthma and cystic fibrosis and in facilitating the treatment of insomnia in school-age children. Finally, hypnosis can be effectively used for the treatment of some habitual disorders such as nocturnal enuresis and dermatologic conditions, including atopic dermatitis and chronic eczema Conclusions Clinical hypnosis seems to be a useful, cheap and side-effects free tool to manage fear, pain and several kinds of stressful experiences in pediatric populations. Children who receive self-hypnosis trainings achieve significantly greater improvements in their physical health, quality of life, and self-esteem.

Coping Self-Efficacy Mediates the Effects of Negative Cognitions on Posttraumatic Distress

PubMed Central

Cieslak, Roman; Benight, Charles C.; Lehman, Victoria Caden

2008-01-01

Although cognitive distortions have predicted posttraumatic distress after various types of traumatic events, the mechanisms through which cognitive distortions influence posttraumatic distress remain unclear. We hypothesized that coping self-efficacy, the belief in one’s own ability to manage posttraumatic recovery demands, would operate as a mediator between negative cognitions (about self, about the world, and self-blame beliefs) and posttraumatic distress. In the cross-sectional Study 1, data collected among 66 adult female victims of child sexual abuse indicated that coping self-efficacy mediated the effects of negative cognitions about self and about the world on posttraumatic distress. The same pattern of results was found in a longitudinal Study 2, conducted among 70 survivors of motor vehicle accidents. Coping self-efficacy measured at 1 month after the trauma mediated the effects of 7-day negative cognitions about self and about the world on 3-month posttraumatic distress. In both studies self-blame was not related to posttraumatic distress and the effect of self-blame on posttraumatic distress was not mediated by coping self-efficacy. The results provide insight into a mechanism through which negative cognitions may affect posttraumatic distress and highlight the potential importance of interventions aimed at enhancing coping self-efficacy beliefs. PMID:18456241

The protective role of self-esteem, perceived social support and job satisfaction against psychological distress among Chinese nurses.

PubMed

Feng, Danjun; Su, Shan; Wang, Lu; Liu, Fang

2018-05-01

To determine the prevalence of psychological distress, and to explore the combined protective roles of self-esteem, perceived social support and job satisfaction against psychological distress. Few studies have explored the combined protective effect of self-esteem, perceived social support and job satisfaction on nurses' mental health in the same theoretical framework. The Rosenberg Self-Esteem Scale, the Multidimensional Scale of Perceived Social Support, a self-developed Job Satisfaction Questionnaire and the Kessler Psychological Distress Scale were used to survey 581 nurses. The hypothesized model of the relationships among self-esteem, perceived social support, job satisfaction and psychological distress was tested with structural equation modelling. The prevalence of psychological distress was 92.3%. Job satisfaction exerted the strongest direct protective effect against psychological distress, with perceived social support and self-esteem exerting the second and third strongest direct protective effects, respectively. Additionally, self-esteem had an indirect protective effect. Chinese nurses showed a surprisingly high prevalence of psychological distress. Job satisfaction, self-esteem and perceived social support were identified, in this order of importance, as protective factors against psychological distress. Nurse administrators should take measures to improve nurses' job satisfaction and social support, and hire individuals with high self-esteem as nurses. © 2018 John Wiley & Sons Ltd.

Psychological Distress Among Caregivers of Individuals With a Diagnosis of Schizophrenia or Schizoaffective Disorder.

PubMed

Lerner, Debra; Chang, Hong; Rogers, William H; Benson, Carmela; Lyson, Mercedes C; Dixon, Lisa B

2018-02-01

The aim was to quantify caregiver distress among informal caregivers of individuals with schizophrenia or schizoaffective disorder and identify its correlates. From December 2014 through April 2015, ads posted with mental health advocates and the media recruited informal caregivers, age ≥21 years, to complete an online questionnaire. It included the ten-item Perceived Stress Scale (PSS) (0, no distress; 39, highest) and hypothesized distress correlates in four groups: caregiver and care recipient characteristics; caregiver role demands; caregiver social supports; and caregiver cognitive appraisals of caregiving. Three hypotheses were tested: first, distress is significantly related to variables from each group; second, social supports moderate the effects of role demands on distress; and third, cognitive appraisals mediate the effects of role demands on distress. Hypotheses were tested with multiple linear regression equations and structural equation models (SEMs). Of 2,338 Web site "hits," 1,708 individuals consented, 1,398 were eligible, and 1,142 had complete data. Most caregivers were women (83%), white (89%), and college educated (59%), with a mean±SD age of 55.6±13.0. Compared with U.S. norms on the PSS (13.4±6.5), mean caregiver distress was high (18.9±7.1). According to SEMs, variables from each group were associated with distress. Contributing most to greater distress were caregiver health problems, providing frequent caregiving assistance, monitoring medication, having limited social support, and appraising caregiving negatively. Cognitive appraisals mediated the effects of demands on distress. Social support had a significant direct effect only. Caregiver distress was relatively high and related to multiple variables, some of which are potentially modifiable.

Job strain and psychological distress among employed pregnant Thai women: role of social support and coping strategies.

PubMed

Sanguanklin, Natthananporn; McFarlin, Barbara L; Finnegan, Lorna; Park, Chang Gi; Giurgescu, Carmen; White-Traut, Rosemary; Engstrom, Janet L

2014-08-01

Most Thai women continue to work throughout their pregnancy; however, little is known about job strain and its relation to psychological distress. This study aimed to examine: (1) the direct effects of job strain, perceived workplace support, perceived family support, and coping strategies on psychological distress and (2) the moderating effect of perceived workplace support, perceived family support, and coping strategies on the relationship between job strain and psychological distress. Lazarus and Folkman's transactional model of stress and coping guided this cross-sectional study. Full-time employed pregnant women (N = 300) were recruited from three antenatal clinics in Thailand. Thai versions of the following instruments were used: the State-Anxiety Inventory and Center for Epidemiological Studies-Depression Scale (psychological distress), the Job Content Questionnaire (job strain and perceived workplace support), the Medical Outcome Study Social Support Survey (perceived family support), and the Ways of Coping Checklist-Revised (coping strategies). Job strain with other predictors explained 54% of the variance in psychological distress. In the separate hierarchical multiple linear regression models, two types of coping strategies, seeking social support and wishful thinking, moderated the effects of job strain on psychological distress. Perceived family support had a direct effect in reducing psychological distress. Job strain is a significant contributor to psychological distress. The average levels of seeking social support and wishful thinking were most beneficial in moderating the negative impact of job strain on psychological distress. Since perceived workplace and family support did not have moderating effects, stress management programs for decreasing the levels of job strain should be developed.

The Effectiveness of Couple and Individual Relationship Education: Distress as a Moderator.

PubMed

Carlson, Ryan G; Rappleyea, Damon L; Daire, Andrew P; Harris, Steven M; Liu, Xiaofeng

2017-03-01

Current literature yields mixed results about the effectiveness of relationship education (RE) with low-income participants and those who experience a high level of individual or relational distress. Scholars have called for research that examines whether initial levels of distress act as a moderator of RE outcomes. To test whether initial levels of relationship and/or individual distress moderate the effectiveness of RE, this study used two samples, one of couples who received couple-oriented relationship education with their partner (n = 192 couples) and one of individuals in a relationship who received individual-oriented RE by themselves (n = 60 individuals). We delivered RE in a community-based setting serving primarily low-income participants. For those attending with a partner, there was a significant interaction between gender, initial distress, and time. Findings indicate that women who were relationally distressed before RE reported the largest pre-postgains. Those who attended an individual-oriented RE program reported significant decreases in individual distress from pre to post, but no significant relationship gains. Findings also suggest that initial levels of distress did not moderate the effectiveness of individual-oriented RE. © 2015 Family Process Institute.

Somatoform symptoms and treatment nonadherence in depressed family medicine outpatients.

PubMed

Keeley, R; Smith, M; Miller, J

2000-01-01

To examine whether somatoform symptoms, specifically symptoms of conversion, somatization, and hypochondriasis, are associated with side-effect reporting and treatment nonadherence in depressed family medicine outpatients, and to measure whether symptoms improve with pharmacotherapy. Inception cohort study with 14-week follow-up. Inner-city family medicine residency clinic. Thirty-nine consecutive adults with major depressive disorder were asked to participate, and 30 consented. Antidepressants for 14 weeks. The Personality Assessment Inventory (PAI) was administered before treatment. The PAI is a self-reported inventory compatible with the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, designed to measure a broad range of personality characteristics. After 14 weeks, the side-effect incidence and treatment nonadherence rates were determined, and 12 patients were readministered the PAI. Depressed family medicine patients demonstrated trends toward elevated Somatic Complaints scale and conversion subscale scores and a lower Suicidal Ideation scale score relative to those of a standardized depressed psychiatric patient profile. Conversion and hypochondriacal symptoms were associated with side-effect reporting and treatment nonadherence. Somatization and hypochondriacal symptoms improved clinically and statistically during treatment for depression. Somatoform distress is a complex, common, and understudied phenomenon in primary care that can adversely affect the treatment of depression. Somatoform symptoms of conversion and hypochondriasis, but not somatization, were found to be risk factors for treatment nonadherence. Somatization and hypochondriacal symptoms may represent personality states that improve with pharmacotherapy, and conversion symptoms may be a personality trait resistant to medical treatment for depression.

Mediating effect of coping styles on the association between psychological capital and psychological distress among Chinese nurses: a cross-sectional study.

PubMed

Zhou, H; Peng, J; Wang, D; Kou, L; Chen, F; Ye, M; Deng, Y; Yan, J; Liao, S

2017-03-01

WHAT IS KNOWN ON THE SUBJECT?: Studies show that psychological capital (PsyCap) is a protective factor against psychological distress, such as depressive symptoms. However, few have attempted to address the role of coping styles in the relationship between PsyCap and psychological distress. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: Our study found moderate levels of PsyCap among nurses in China. Among the subcategories of PsyCap, optimism and hope were most highly correlated with psychological distress. Psychological distress was positively associated with negative coping and negatively associated with positive coping. This study confirmed the partial mediating effect of coping styles in PsyCap and psychological distress among Chinese nurses. In other words, this study found direct and indirect effects of PsyCap on psychological distress mediated via coping styles. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The significant mediating effect of negative and positive coping styles between PsyCap and psychological distress has implications for hospital administrators, especially nurse leaders. Effective strategies should be implemented to improve PsyCap and coping styles among Chinese nurses, and alleviate psychological distress. Optimism and hope should be emphasized in PsyCap investment. Different styles of coping are influenced and modified by teaching and experience. Therefore, it is essential that nurse managers organize educational and training programmes to provide nurses with relative coping knowledge and techniques, and improve their coping ability. Several studies suggest that coping styles are affected by social support. Thus, nurse managers should assist nurses with social support and enhance coping strategies to reduce psychological distress. Introduction PsyCap includes four categories namely self-efficacy, hope, optimism and resilience. Research has demonstrated that PsyCap and coping styles affect current psychological distress. Nevertheless, few studies have explored the role of coping styles in PsyCap and psychological distress. Aim This study investigated the role of coping styles as a mediator in PsyCap and psychological distress among Chinese nurses. Methods Participants included 538 nurses who completed self-report questionnaires assessing PsyCap, coping styles and psychological distress. Linear regression analyses were used to explore the role of coping styles. Results PsyCap, coping styles and psychological distress were significantly correlated. Among the subcategories of PsyCap, optimism and hope were most highly correlated with psychological distress. Coping styles is a partial mediator of PsyCap and psychological distress. Implications for mental health nursing The significant role of negative and positive coping styles in PsyCap and psychological distress has implications for hospital administrators, especially nurse leaders. Effective strategies should be implemented to improve PsyCap and coping styles among Chinese nurses, to alleviate psychological distress. Optimism and hope should be the focus of the improvement. Different styles of coping are developed from education and experience. Therefore, it is necessary for nurse managers to organize educational and training programmes to improve coping skills among nurses. Studies suggest that coping styles are affected by social support. Thus, nurse managers should also assist nurses with social support and enhance coping strategies to reduce psychological distress. © 2017 John Wiley & Sons Ltd.

Moderating effect of self-efficacy on the relation between behavior problems in persons with dementia and the distress they cause in caregivers.

PubMed

Nogales-González, C; Romero-Moreno, R; Losada, A; Márquez-González, M; Zarit, S H

2015-01-01

Behavioral and psychological symptoms in dementia (BPSD) are the principal sources of stress in caregivers. The aim of the present work is to analyze the moderating effect of self-efficacy for managing BPSD on the distress these problems generate in family caregivers. The participants were 231 family caregivers of people with dementia. We assessed the frequency and caregiver distress associated with three dimensions of BPSD (depressive, disruptive and memory problems). In addition, we assessed the moderating effect of self-efficacy for dealing with BPSD in the relationship between the dementia patient's frequency of BPSD and caregiver distress through hierarchical regression analyses, one for each of the dimensions of BPSD. We found a moderating effect of self-efficacy on the relation between the frequency of BPSD and the distress in caregivers for the dimensions of depressive and disruptive behaviors. Caregivers having to deal with a high frequency of behavior problems but with high levels of self-efficacy presented significantly lower levels of distress associated with depressive and disruptive behavior problems compared to those caregivers with low levels of self-efficacy. No differences in the effects of self-efficacy were found for distress levels of caregivers who dealt with low frequency of BPSD. Also, we did not find a moderating effect of self-efficacy on the relation between the frequency of memory problems and caregivers' distress. The results suggest that self-efficacy for managing BPSD attenuates the relation between the frequency of behavior problems – both disruptive and depressive – and the distress they cause in caregivers.

The effects of workplace occupational mental health and related activities on psychological distress among workers: a multilevel cross-sectional analysis.

PubMed

Eguchi, Hisashi; Tsuda, Yoko; Tsukahara, Teruomi; Washizuka, Shinsuke; Kawakami, Norito; Nomiyama, Tetsuo

2012-08-01

To investigate the association of workplace occupational mental health (OMH) and related activities with psychological distress of workers in Japan. A total of 121 workplaces and their 3540 workers were surveyed using questionnaires assessing selected workplace OMH activities, demographic characteristics, psychological distress, and psychosocial work environment of the workers. A multilevel analysis was conducted. Promotion of communication correlated significantly and negatively with psychological distress among workers after adjusting for the covariates (P < 0.01). Occupational mental health activities correlated marginally significantly and negatively with psychological distress (P = 0.06). Their moderating effect for the worker-level association between psychosocial work environment and psychological distress was not significant. The findings suggest that promotion of communication in the workplace is associated with reduced psychological distress among workers. In addition, OMH activities may also be useful in reducing psychological distress.

Posttraumatic distress in security guards and the various effects of social support.

PubMed

Declercq, Frédéric; Vanheule, Stijn; Markey, Samuel; Willemsen, Jochem

2007-12-01

This study investigates the effects of six types of social support on distress and posttraumatic stress disorders in security guards who did and did not encounter a critical incident. Three types of social support were significantly related to distress and posttraumatic stress disorder: emotional support in problem situations, instrumental support, and social companionship. Emotional support in problem situations paradoxically appeared to have an aggravating effect on distress and posttraumatic stress, whereas instrumental support and social companionship had a mitigating outcome.

Screening and treatment of psychological distress in patients with metastatic colorectal cancer: study protocol of the TES trial.

PubMed

Schuurhuizen, Claudia S E W; Braamse, Annemarie M J; Beekman, Aartjan T F; Bomhof-Roordink, Hanna; Bosmans, Judith E; Cuijpers, Pim; Hoogendoorn, Adriaan W; Konings, Inge R H M; van der Linden, Mecheline H M; Neefjes, Elisabeth C W; Verheul, Henk M W; Dekker, Joost

2015-04-17

Psychological distress occurs frequently in patients with cancer. Psychological distress includes mild and severe forms of both anxious and depressive mood states. Literature indicates that effective management of psychological distress seems to require targeted selection of patients (T), followed by enhanced care (E), and the application of evidence based interventions. Besides, it is hypothesized that delivering care according to the stepped care (S) approach results in an affordable program. The aim of the current study is to evaluate the (cost)-effectiveness of the TES program compared to usual care in reducing psychological distress in patients with metastatic colorectal cancer (mCRC). This study is designed as a cluster randomized trial with 2 treatment arms: TES program for screening and treatment of psychological distress versus usual care. Sixteen hospitals participate in this study, recruiting patients with mCRC. Outcomes are evaluated at the beginning of chemotherapy and after 3, 10, 24, and 48 weeks. Primary outcome is the difference in treatment effect over time in psychological distress, assessed with the Hospital Anxiety and Depression Scale. Secondary outcomes include quality of life, patient evaluation of care, recognition and management of psychological distress, and societal costs. We created optimal conditions for an effective screening and treatment program for psychological distress in patients with mCRC. This involves targeted selection of patients, followed by enhanced and stepped care. Our approach will be thoroughly evaluated in this study. We expect that our results will contribute to the continuing debate on the (cost-) effectiveness of screening for and treatment of psychological distress in patients with cancer. This trial is registered in the Netherlands Trial Register NTR4034.

Help-Seeking among Male Employees in Japan: Influence of Workplace Climate and Distress

PubMed Central

Maekawa, Yumiko; Ramos-Cejudo, Juan; Kanai, Atsuko

2016-01-01

Objectives: Although using mental health services is an effective way to cope with work-related stressors and diseases, many employees do not utilize these services despite service improvements in recent years. The present study aimed to investigate the interaction effects of workplace climate and distress on help-seeking attitudes, and elucidate the reasons for mental health service underutilization in Japan. Methods: A questionnaire was distributed to 650 full-time male Japanese employees. Hierarchical multiple regression analysis was used to investigate interaction effects of workplace climate and distress on help-seeking. Results: Results showed that the association between workplace climate and help-seeking attitudes differed depending on employee distress level. For employees experiencing low levels of distress, openness to seeking treatment increased with a higher evaluation of the mental health services available at the workplace. However, the same did not hold true for employees experiencing high levels of distress. Instead, openness to seeking treatment decreased with perceived risk for career disadvantage for high distress employees. Additionally, negative values for seeking treatment in highly distressed employees decreased only when services were perceived as valuable, and the risk to their career was perceived as low. Conclusions: Overall, these findings indicate that distress distorts the perception of social support, which may lead to underutilization of available services. Assessing employees' distress levels and tailoring adequate interventions could facilitate help-seeking in male employees. PMID:27725378

Happiness, Pain Intensity, Pain Interference, and Distress in Individuals with Physical Disabilities.

PubMed

Müller, Rachel; Terrill, Alexandra L; Jensen, Mark P; Molton, Ivan R; Ravesloot, Craig; Ipsen, Catherine

2015-12-01

The aim of this study was to examine how the construct of happiness is related to pain intensity, pain interference, and distress in individuals with physical disabilities. This study involves cross-sectional analyses of 471 individuals with a variety of health conditions reporting at least mild pain. The first hypothesis that happiness mediates the relationship between pain intensity and two outcomes, pain interference and distress, was not supported. The second hypothesis was supported by a good fitting model (χ2(10) = 12.83, P = 0.23, root-mean-square error of approximation = 0.025) and indicated that pain intensity significantly mediated the effect of happiness on pain interference (indirect effect: β = -0.13, P < 0.001) and on distress (indirect effect: β = 0.10, P = 0.01). Happiness showed a significant direct effect on pain intensity (β = -0.20, P < 0.001). A third model exploring the happiness components meaning, pleasure, and engagement fitted well (χ2(4) = 9.65, P = 0.05, root-mean-square error of approximation = 0.055). Pain intensity acted as a significant mediator but only mediated the effect of meaning on pain interference (indirect effect: β = -0.07, P = 0.05) and on distress (indirect effect via pain interference: β = -0.04, P = 0.05). Only meaning (β = -0.10, P = 0.05), but neither pleasure nor engagement, had a significant direct effect on pain intensity. Participants who reported greater happiness reported lower pain interference and distress through happiness' effects on pain intensity. Experiencing meaning and purpose in life seems to be most closely (and negatively) associated with pain intensity, pain interference, and distress. Findings from this study can lay the groundwork for intervention studies to better understand how to more effectively decrease pain intensity, pain interference, and distress.

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 stable component of glycaemic control and does not account for within-individual change in glycaemic control over 1–3 years. Elevated diabetes-specific emotional distress may be an important marker for risk of prolonged suboptimum glycaemic control. PMID:25865313

Civil war, social integration and mental health in Croatia.

PubMed

Kunovich, R M; Hodson, R

1999-12-01

Research has shown that social relationships are generally beneficial for mental health (Thoits 1995). However, few scholars have examined this association after the occurrence of a significant shock to the social system as a whole. The purpose of this article is to examine the relationship between social integration and war-related distress in Croatia immediately following the recent civil war. Does social integration decrease war-related distress? Does social integration buffer the effect of traumatic events on war-related distress? We analyze these questions using nationally representative survey data collected in Croatia in 1996. Results suggest that social integration has both positive and negative direct effects on distress. Being a member of informal organizations, such as sports clubs, and participating in social activities are beneficial for mental health. On the other hand, being a member of some formal organizations, such as church organizations and unions, is detrimental to mental health. There is little support for the idea that social integration buffers the effect of traumatic events on distress. Only one of thirty-six possible interactions is significant and supports the buffer hypothesis. Frequent participation in social activities buffers the effect of experiencing violence on war-related distress. Also, some forms of social integration appear to aggravate the effect of traumatic events on war-related distress. In sum, social integration does affect war-related distress after a system shock, but in complex and sometimes unexpected ways.

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 Reduction of Distress Using Therapeutic Geothermal Water Procedures in a Randomized Controlled Clinical Trial

PubMed Central

Rapolienė, Lolita; Razbadauskas, Artūras; Jurgelėnas, Antanas

2015-01-01

Stress is an element of each human's life and an indicator of its quality. Thermal mineral waters have been used empirically for the treatment of different diseases for centuries. Aim of the Study. To investigate the effects of highly mineralised geothermal water balneotherapy on distress and health risk. Methodology. A randomized controlled clinical trial was performed with 130 seafarers: 65 underwent 2 weeks of balneotherapy with 108 g/L full-mineralisation bath treatment; the others were in control group. The effect of distress was measured using the General Symptoms Distress Scale. Factorial and logistic regression analyses were used for statistical analysis. Results. A significant positive effect on distress (P < 0.001) was established after 2 weeks of treatment: the number of stress symptoms declined by 60%, while the intensity of stress symptoms reduced by 41%, and the control improved by 32%. Health risks caused by distress were reduced, and resources increased, whereas the probability of general health risk decreased by 18% (P = 0.01). Conclusion. Balneotherapy with highly mineralised geothermal water reduces distress, by reducing the health risk posed by distress by 26%, increasing the health resources by 11%, and reducing probability of general health risk by 18%. Balneotherapy is an effective preventive tool and can take a significant place in integrative medicine. PMID:25866680

Comparison of the Long-Term Effect of Positioning the Cathode in tDCS in Tinnitus Patients

PubMed Central

Rabau, Sarah; Shekhawat, Giriraj S.; Aboseria, Mohamed; Griepp, Daniel; Van Rompaey, Vincent; Bikson, Marom; Van de Heyning, Paul

2017-01-01

Objective: Transcranial direct current stimulation (tDCS) is one of the methods described in the literature to decrease the perceived loudness and distress caused by tinnitus. However, the main effect is not clear and the number of responders to the treatment is variable. The objective of the present study was to investigate the effect of the placement of the cathode on the outcome measurements. Methods: Patients considered for the trial were chronic non-pulsatile tinnitus patients with complaints for more than 3 months and a Tinnitus Functional Index (TFI) score that exceeded 25. The anode was placed on the right dorsolateral prefrontal cortex (DLPFC). In the first group—“bifrontal”—the cathode was placed on the left DLPFC, while in the second group—“shoulder”—the cathode was placed on the shoulder. Each patient received two sessions of tDCS weekly and eight sessions in total. Evaluations took place on the first visit for an ENT consultation, at the start of therapy, after eight sessions of tDCS and at the follow-up visit, which took place 84 days after the start of the therapy. Subjective outcome measures such as TFI, Visual Analog Scales (VAS) for loudness and percentage of consciousness of tinnitus were administered in every patient. Results: There was no difference in the results for tinnitus loudness and the distress experienced between the placement of the cathode on the left DLPFC or on the shoulder. In addition, no statistically significant overall effect was found between the four test points. However, up to 39.1% of the patients experienced a decrease in loudness, measured by the VAS for loudness. Moreover, 72% of those in the bifrontal group, but only 46.2% of those in the shoulder group reported some improvement in distress. Conclusion: While some improvement was noted, this was not statistically significant. Both electrode placements stimulated the right side of the hippocampus, which could be responsible for the effect found in both groups. Further research should rule out the placebo effect and investigate alternative electrode positions. PMID:28804455

The Patient Assessment Questionnaire: initial validation of a measure of treatment effectiveness for patients with schizophrenia and schizoaffective disorder.

PubMed

Mojtabai, Ramin; Corey-Lisle, Patricia K; Ip, Edward Hak-Sing; Kopeykina, Irina; Haeri, Sophia; Cohen, Lisa Janet; Shumaker, Sally

2012-12-30

Investigation of patients' subjective perspective regarding the effectiveness - as opposed to efficacy - of antipsychotic medication has been hampered by a relative shortage of self-report measures of global clinical outcome. This paper presents data supporting the feasibility, inter-item consistency, and construct validity of the Patient Assessment Questionnaire (PAQ)-a self-report measure of psychiatric symptoms, medication side effects and general wellbeing, ultimately intended to assess effectiveness of interventions for schizophrenia-spectrum patients. The original 53-item instrument was developed by a multidisciplinary team which utilized brainstorming sessions for item generation and content analysis, patient focus groups, and expert panel reviews. This instrument and additional validation measures were administered, via Audio Computer-Assisted Self-Interviewing (ACASI), to 300 stable, medicated outpatients diagnosed with schizophrenia or schizoaffective disorder. Item elimination was based on psychometric properties and Item-Response Theory information functions and characteristic curves. Exploratory factor analysis of the resulting 40-item scale yielded a five factor solution. The five subscales (General Distress, Side Effects, Psychotic Symptoms, Cognitive Symptoms, Sleep) showed robust convergent (β's=0.34-0.75, average β=0.49) and discriminant validity. The PAQ demonstrates feasibility, reliability, and construct validity as a self-report measure of multiple domains pertinent to effectiveness. Future research needs to establish the PAQ's sensitivity to change. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

The effect of distressing imagery on attention to and persuasiveness of an antialcohol message: a gaze-tracking approach.

PubMed

Brown, Stephen L; Richardson, Miles

2012-02-01

Distressing imagery may inhibit health communications by inducing audiences to reduce distress by avoiding attention to persuasive messages. This study used eye-tracking methods to compare gaze time allocated to a persuasive textual message, accompanied by either distressing high-resolution color images or less distressing two-color images with degraded outline and detail. Participants in the distressing images condition showed lower intentions to reduce drinking in the following 3 months, which may have been mediated by lower gaze time to textual elements of the message. The effect was stronger in participants who both scored lower on dispositional mental disengagement and were more vulnerable to alcohol-related problems. These findings suggest that distressing imagery may inhibit persuasion by reducing audience attention to message components. Implications for message design are discussed.

Fatigue and quality of life in women treated for various types of gynaecological cancers: a cross-sectional study

PubMed Central

Sekse, Ragnhild Johanne Tveit; Hufthammer, Karl Ove; Vika, Margrethe Elin

2015-01-01

Aims and objectives To examine the prevalence of cancer-related fatigue in women treated for various types of gynaecological cancers and, for these cancers, to assess fatigue in relation to distress, health-related quality of life, demography and treatment characteristics. Background Advances in treatment of cancer have improved the likelihood of survival. Consequently, there are a growing number of patients who become survivors after cancer and who face side effects even years after treatment. One of the most frequently reported side effects across all types and stages of the disease is cancer-related fatigue. Design A descriptive cross-sectional study. Methods One hundred and twenty women treated for gynaecological cancers who were participants in an intervention study were included. Fatigue, psychological distress, health-related QoL and demographics were assessed by questionnaires. Disease and treatment characteristics were extracted from medical records. Results Cancer-related fatigue was reported in 53% of the women treated for gynaecological cancers, with a higher proportion in the group of cervical cancer, followed by ovarian cancer. Younger participants reported fatigue more frequently than older participants. When adjusting for age, the type of cancer a woman experiences was shown to have little impact on her risk of experiencing fatigue. The participants with fatigue reported higher levels of anxiety and depression than participants without fatigue. There was a relationship between fatigue and quality of life as measured by SF-36 domains. Conclusion The findings underscore the importance of screening for fatigue, patient education and symptom management. This should be included in a standard procedure during treatment and follow-up. Both somatic and psychological aspects of fatigue should be emphasised. Relevance to clinical practice The findings imply the need for health personnel to have focus on fatigue during the entire cancer trajectory of women after gynaecological cancers, as well as the need for screening, information, guidance and symptom management. PMID:25040957

Real-world experience with colorectal cancer chemotherapies: patient web forum analysis.

PubMed

Beusterien, Kathleen; Tsay, Sarah; Gholizadeh, Shadi; Su, Yun

2013-01-01

In contrast to clinical trials, patient web forums provide a unique opportunity for patients to spontaneously post their experiences and thoughts about diseases and treatments. This study explored the impact of colorectal cancer (CRC) treatments in these forums. This was a systematic cross-sectional qualitative analysis. Two active CRC web forums were identified based on four criteria: active for ≥five years, >12,000 total posts, >20 individuals currently browsing, and ≥10 new posts/day. All relevant threads (set of messages focusing on a topic) relating to treatment posted in July and December 2010 and February to March 2011 were reviewed and coded using MaxQDA software. A content analysis was performed identifying key themes. The threads included 1522 posts by 264 individuals. Demographics were identified for 83% of the posters. Of these, 83% were CRC patients and 17% were family members; 76% were females, and the mean patient age was 49 years. The majority had advanced cancer (44% stage IV or metastatic, 40% stage III). The most common themes were side effects (62.3% of posts), treatment response (13%), and impact on personal, social, and work lives, and emotional distress (23.9%). The posters came to the online forums to have an emotional outlet, share experience, and seek advice. The emotional impacts primarily exemplified resilience and positive coping strategies. Formal knowledge regarding the likelihood of treatment response, magnitude of benefit, or side effects was lacking, which lead to uncertainty and anxiety. However, patients expressed appreciation for the availability of treatment options and the hope they provide. Online CRC communities provide patients with convenient and valuable emotional support and disease information. CRC and treatments may have profound impacts beyond efficacy and toxicity. Systematic information and decision tools may help to minimise uncertainties and help patients manage expectations and emotional distress.

Survivors of childhood cancer and comparison peers: the influence of early family factors on distress in emerging adulthood.

PubMed

Robinson, Kristen E; Gerhardt, Cynthia A; Vannatta, Kathryn; Noll, Robert B

2009-02-01

This prospective study examines family predictors of distress among survivors of childhood cancer and comparison peers during the transition to emerging adulthood. Children with cancer (n = 55), comparison peers (n = 60), and parents completed measures of distress, family environment, social support, and demographic characteristics during initial treatment, as well as follow-up measures of young adult distress and demographic characteristics soon after participants turned 18 years old. Severity of initial treatment and late effects were rated by healthcare providers for participants with cancer. For all participants, mother and father report of initial parent distress was associated with their report of young adult distress at follow-up. Young adult gender moderated this association. For survivors of childhood cancer, severity of initial treatment and late effects also moderated the association between parent and young adult distress. Improving parent distress may help reduce child distress in general. For survivors specifically, ameliorating the impact of initial treatment and long-term physical problems may be beneficial. Copyright 2009 APA, all rights reserved.

Concealing Concealment: The Mediating Role of Internalized Heterosexism in Psychological Distress Among Lesbian, Gay, and Bisexual Older Adults

PubMed Central

Hoy-Ellis, Charles P.

2016-01-01

Recent population-based studies indicate that sexual minorities aged 50 and older experience significantly higher rates of psychological distress than their heterosexual age-peers. The minority stress model has been useful in explaining disparately high rates of psychological distress among younger sexual minorities. The purpose of this study is to test a hypothesized structural relationship between two minority stressors—internalized heterosexism and concealment of sexual orientation—and consequent psychological distress among a sample of 2,349 lesbian, gay, and bisexual adults aged 50 to 95 years old. Structural equation modeling indicates that concealment has a nonsignificant direct effect on psychological distress but a significant indirect effect that is mediated through internalized heterosexism; the effect of concealment is itself concealed. This may explain divergent results regarding the role of concealment in psychological distress in other studies, and the implications will be discussed. PMID:26322654

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.

Peer victimization as a mediator of the relationship between disability status and psychosocial distress.

PubMed

McGee, Marjorie G

2015-04-01

Youth with disabilities experience greater levels of peer victimization and psychosocial distress than non-disabled youth. However, the extent to which exposure to peer victimization mediates the relationship between disability status and psychosocial distress is unknown. To determine whether the relationship between disability status and psychological distress was mediated by exposure to peer victimization, and if so, whether the mediation effects of peer victimization on psychosocial distress was moderated by sex. This cross-sectional study involved a series of regressions to test for mediation and moderated mediation using complex survey data from 6664 Oregon 11th graders. Peer victimization partially mediated the relationship between disability status and psychosocial distress. Sex, however, did not significantly moderate the mediating effects of peer victimization on psychosocial distress. Exposure to peer victimization mediated the relationship between disability status and psychosocial distress; there was little support for sex as a moderator. Copyright © 2015 Elsevier Inc. All rights reserved.

Attachment to God, Images of God, and Psychological Distress in a Nationwide Sample of Presbyterians.

PubMed

Bradshaw, Matt; Ellison, Christopher G; Marcum, Jack P

2010-01-01

Drawing broadly on insights from attachment theory, the present study outlines a series of theoretical arguments linking styles of attachment to God, perceptions of the nature of God (i.e., God imagery), and stressful life events with psychological distress. Main effects and potential stress-moderator effects are then evaluated using data from a nationwide sample of elders and rank-and-file members of the Presbyterian Church (U.S.A.). Key findings indicate that secure attachment to God is inversely associated with distress, whereas both anxious attachment to God and stressful life events are positively related to distress. Once variations in patterns of attachment to God are controlled, there are no net effects of God imagery on levels of distress. There is only modest support for the hypothesis that God images moderate the effects of stressful life events on psychological distress, but no stress-moderator effects were found for attachment to God. Study limitations are identified, and findings are discussed in terms of their implications for religion-health research, as well as recent extensions of attachment theory.

Attachment to God, Images of God, and Psychological Distress in a Nationwide Sample of Presbyterians

PubMed Central

Bradshaw, Matt; Ellison, Christopher G.; Marcum, Jack P.

2012-01-01

Drawing broadly on insights from attachment theory, the present study outlines a series of theoretical arguments linking styles of attachment to God, perceptions of the nature of God (i.e., God imagery), and stressful life events with psychological distress. Main effects and potential stress-moderator effects are then evaluated using data from a nationwide sample of elders and rank-and-file members of the Presbyterian Church (U.S.A.). Key findings indicate that secure attachment to God is inversely associated with distress, whereas both anxious attachment to God and stressful life events are positively related to distress. Once variations in patterns of attachment to God are controlled, there are no net effects of God imagery on levels of distress. There is only modest support for the hypothesis that God images moderate the effects of stressful life events on psychological distress, but no stress-moderator effects were found for attachment to God. Study limitations are identified, and findings are discussed in terms of their implications for religion-health research, as well as recent extensions of attachment theory. PMID:23329878

Direct and indirect effects of sociocultural influences on disordered eating among Malaysian male and female university students. A mediation analysis of psychological distress.

PubMed

Gan, Wan Ying; Mohd Nasir, Mohd Taib; Zalilah, Mohd Shariff; Hazizi, Abu Saad

2011-06-01

This study aimed to examine the role of psychological distress in the relationships between sociocultural influences (social pressure to be thin and weight teasing) and disordered eating. Data were collected from 584 university students (59.4% females and 40.6% males), aged 18-24 years old (M=20.6, SD=1.4), selected from four universities in the Klang Valley, Malaysia. Participants completed four standardized questionnaires which measured social pressure to be thin, weight-related teasing, psychological distress and disordered eating. A good fit structural equation modeling (SEM) model was developed for both sexes. For males, the SEM model revealed that sociocultural influences showed an indirect effect on disordered eating through psychological distress. For females, the model showed an indirect effect of sociocultural influences on disordered eating through psychological distress, as well as a direct effect of sociocultural influences on disordered eating. In conclusion, psychological distress mediated the relationships between sociocultural influences and disordered eating in both males and females. Our results suggest that disordered eating intervention programs on reducing psychological distress in university students may be beneficial. Copyright © 2011 Elsevier Ltd. All rights reserved.

Frustrated Fertility: Infertility and Psychological Distress among Women.

ERIC Educational Resources Information Center

McQuillan, Julia; Greil, Arthur L.; White, Lynn; Jacob, Mary Casey

2003-01-01

Tests the hypothesis that women who have experienced infertility report higher psychological distress. Examines whether roles or resources condition the effects of infertility or whether its effects are limited to childless women. Infertility combined with involuntary childlessness is associated with significantly greater distress. For women in…

Satisfaction with support versus size of network: differential effects of social support on psychological distress in parents of pediatric cancer patients.

PubMed

Harper, Felicity W K; Peterson, Amy M; Albrecht, Terrance L; Taub, Jeffrey W; Phipps, Sean; Penner, Louis A

2016-05-01

This study examined the direct and buffering effects of social support on longer-term global psychological distress among parents coping with pediatric cancer. In both sets of analyses, we examined whether these effects depended on the dimension of social support provided (i.e., satisfaction with support versus size of support network). Participants were 102 parents of pediatric cancer patients. At study entry, parents reported their trait anxiety, depression, and two dimensions of their social support network (satisfaction with support and size of support network). Parents subsequently reported their psychological distress in 3- and 9-month follow-up assessments. Parents' satisfaction with support had a direct effect on longer-term psychological distress; satisfaction was negatively associated with distress at both follow-ups. In contrast, size of support network buffered (moderated) the impact of trait anxiety and depression on later distress. Parents with smaller support networks and higher levels of trait anxiety and depression at baseline had higher levels of psychological distress at both follow-ups; for parents with larger support networks, there was no relationship. Social support can attenuate psychological distress in parents coping with pediatric cancer; however, the nature of the effect depends on the dimension of support. Whereas interventions that focus on increasing satisfaction with social support may benefit all parents, at-risk parents will likely benefit from interventions that ensure they have an adequate number of support resources. Copyright © 2015 John Wiley & Sons, Ltd.

Satisfaction with support versus size of network: Differential effects of social support on psychological distress in parents of pediatric cancer patients

PubMed Central

Harper, Felicity W. K.; Peterson, Amy M.; Albrecht, Terrance L.; Taub, Jeffrey W.; Phipps, Sean; Penner, Louis A.

2016-01-01

Objective This study examined the direct and the buffering effects of social support on longer-term global psychological distress among parents coping with pediatric cancer. In both sets of analyses we examined whether these effects depended on the dimension of social support provided (i.e., satisfaction with support versus size of support network). Method Participants were 102 parents of pediatric cancer patients. At study entry, parents reported their trait anxiety, depression, and two dimensions of their social support network (satisfaction with support and size of support network). Parents subsequently reported their psychological distress in 3- and 9-month follow-up assessments. Results Parents’ satisfaction with support had a direct effect on longer-term psychological distress; satisfaction was negatively associated with distress at both follow-ups. In contrast, size of support network buffered (moderated) the impact of trait anxiety and depression on later distress. Parents with smaller support networks and higher levels of trait anxiety and depression at baseline had higher levels of psychological distress at both follow-ups; for parents with larger support networks, there was no relationship. Conclusion Social support can attenuate psychological distress in parents coping with pediatric cancer; however, the nature of the effect depends on the dimension of support. Whereas, interventions that focus on increasing satisfaction with social support may benefit all parents, at-risk parents will likely benefit from interventions that ensure they have an adequate number of support resources. PMID:27092714

Examining the independent protective effect of subjective well-being on severe psychological distress among Canadian adults with a history of child maltreatment.

PubMed

Baiden, Philip; Tarshis, Sarah; Antwi-Boasiako, Kofi; den Dunnen, Wendy

2016-08-01

The purpose of this study was to examine the independent protective effect of subjective well-being on severe psychological distress among adult Canadians with a history of child maltreatment. Data for this study were obtained from the 2012 Canadian Community Health Survey-Mental Health (CCHS-MH). A sample of 8126 respondents aged 20-69 years old who experienced at least one child maltreatment event was analyzed using binary logistic regression with severe psychological distress as the outcome variable. Of the 8126 respondents with a history of child maltreatment, 3.9% experienced severe psychological distress within the past month. Results from the multivariate logistic regression revealed that emotional and psychological well-being each had a significant effect on severe psychological distress. For each unit increase in emotional well-being, the odds of a respondent having severe psychological distress were predicted to decrease by a factor of 28% and for each unit increase in psychological well-being, the odds of a respondent having severe psychological distress were predicted to decrease by a factor of 10%, net the effect of demographic, socioeconomic, and health factors. Other factors associated with psychological distress included: younger age, poor self-perceived physical health, and chronic condition. Having post-secondary education, having a higher income, and being non-White predicted lower odds of severe psychological distress. Although, child maltreatment is associated with stressful life events later in adulthood, subjective well-being could serve as a protective factor against severe psychological distress among adults who experienced maltreatment when they were children. Copyright © 2016 Elsevier Ltd. All rights reserved.

Causes and consequences of psychological distress among orphans in eastern Zimbabwe

PubMed Central

Nyamukapa, C.A.; Gregson, S.; Wambe, M.; Mushore, P.; Lopman, B.; Mupambireyi, Z.; Nhongo, K.; Jukes, M.C.H.

2010-01-01

Substantial resources are invested in psychological support for children orphaned or otherwise made vulnerable in the context of HIV/AIDS (OVC). However, there is still only limited scientific evidence for greater psychological distress amongst orphans and even less evidence for the effectiveness of current support strategies. Furthermore, programmes that address established mechanisms through which orphanhood can lead to greater psychological distress should be more effective. We use quantitative and qualitative data from Eastern Zimbabwe to measure the effects of orphanhood on psychological distress and to test mechanisms for greater distress amongst orphans suggested in a recently published theoretical framework. Orphans were found to suffer greater psychological distress than non-orphans (sex- and age-adjusted co-efficient: 0.15; 95% CI 0.03–0.26; P = 0.013). Effects of orphanhood contributing to their increased levels of distress included trauma, being out-of-school, being cared for by a non-parent, inadequate care, child labour, physical abuse, and stigma and discrimination. Increased mobility and separation from siblings did not contribute to greater psychological distress in this study. Over 40% of orphaned children in the sample lived in households receiving external assistance. However, receipt of assistance was not associated with reduced psychological distress. These findings and the ideas put forward by children and caregivers in the focus group discussions suggest that community-based programmes that aim to improve caregiver selection, increase support for caregivers, and provide training in parenting responsibilities and skills might help to reduce psychological distress. These programmes should be under-pinned by further efforts to reduce poverty, increase school attendance and support out-of-school youth. PMID:20552465

Coping with interpersonal stress and psychological distress at work: comparison of hospital nursing staff and salespeople.

PubMed

Kato, Tsukasa

2014-01-01

Hospital nurses frequently experience relationships with patients as stressors in the workplace. Nurses' coping behavior is one potential buffering factor that can reduce the effects of job stress on their psychological functioning and well-being. In this study, the association between nurses' strategies for coping with interpersonal stress from patients and their psychological distress was examined. Participants included 204 hospital nurses and 142 salespeople, who were used as a comparison group. Participants completed measures of coping with interpersonal stress and psychological distress. Hospital nurses reported more psychological distress than did salespeople. Moreover, distancing coping was correlated with high psychological distress in both nurses and salespeople, and reassessing coping was correlated with low psychological distress in nurses. For nurses only, constructive coping appeared to be an effective strategy for reducing psychological distress. It is important for nurses to understand the role of constructive coping in nurse-patient communication and interaction.

Cognitive and Social Processes Predicting Partner Psychological Adaptation to Early Stage Breast Cancer

PubMed Central

Manne, Sharon; Ostroff, Jamie; Fox, Kevin; Grana, Generosa; Winkel, Gary

2009-01-01

Introduction The diagnosis and subsequent treatment for early stage breast cancer is stressful for partners. Little is known about the role of cognitive and social processes predicting the longitudinal course of partners’ psychosocial adaptation. This study evaluated the role of cognitive and social processing in partner psychological adaptation to early stage breast cancer, evaluating both main and moderator effect models. Moderating effects for meaning-making, acceptance, and positive reappraisal on the predictive association of searching for meaning, emotional processing, and emotional expression on partner psychological distress were examined. Materials and Methods Partners of women diagnosed with early stage breast cancer were evaluated shortly after the ill partner’s diagnosis (n= 253), nine (n = 167), and 18 months (n = 149) later. Partners completed measures of emotional expression, emotional processing, acceptance, meaning-making, and general and cancer-specific distress at all time points. Results Lower satisfaction with partner support predicted greater global distress, and greater use of positive reappraisal was associated with greater distress. The predicted moderator effects for found meaning on the associations between the search for meaning and cancer-specific distress were found and similar moderating effects for positive reappraisal on the associations between emotional expression and global distress and for acceptance on the association between emotional processing and cancer-specific distress were found. Conclusions Results indicate several cognitive-social processes directly predict partner distress. However, moderator effect models in which the effects of partners’ processing depends upon whether these efforts result changes in perceptions of the cancer experience may add to the understanding of partners’ adaptation to cancer. PMID:18435865

Cognitive and social processes predicting partner psychological adaptation to early stage breast cancer.

PubMed

Manne, Sharon; Ostroff, Jamie; Fox, Kevin; Grana, Generosa; Winkel, Gary

2009-02-01

The diagnosis and subsequent treatment for early stage breast cancer is stressful for partners. Little is known about the role of cognitive and social processes predicting the longitudinal course of partners' psychosocial adaptation. This study evaluated the role of cognitive and social processing in partner psychological adaptation to early stage breast cancer, evaluating both main and moderator effect models. Moderating effects for meaning making, acceptance, and positive reappraisal on the predictive association of searching for meaning, emotional processing, and emotional expression on partner psychological distress were examined. Partners of women diagnosed with early stage breast cancer were evaluated shortly after the ill partner's diagnosis (N=253), 9 (N=167), and 18 months (N=149) later. Partners completed measures of emotional expression, emotional processing, acceptance, meaning making, and general and cancer-specific distress at all time points. Lower satisfaction with partner support predicted greater global distress, and greater use of positive reappraisal was associated with greater distress. The predicted moderator effects for found meaning on the associations between the search for meaning and cancer-specific distress were found and similar moderating effects for positive reappraisal on the associations between emotional expression and global distress and for acceptance on the association between emotional processing and cancer-specific distress were found. Results indicate several cognitive-social processes directly predict partner distress. However, moderator effect models in which the effects of partners' processing depends upon whether these efforts result in changes in perceptions of the cancer experience may add to the understanding of partners' adaptation to cancer.

The ethics of distress: toward a framework for determining the ethical acceptability of distressing health promotion advertising.

PubMed

Brown, Stephen L; Whiting, Demian

2014-04-01

Distressing health promotion advertising involves the elicitation of negative emotion to increase the likelihood that health messages will stimulate audience members to adopt healthier behaviors. Irrespective of its effectiveness, distressing advertising risks harming audience members who do not consent to the intervention and are unable to withdraw from it. Further, the use of these approaches may increase the potential for unfairness or stigmatization toward those targeted, or be considered unacceptable by some sections of the public. We acknowledge and discuss these concerns, but, using the public health ethics literature as a guide, argue that distressing advertising can be ethically defensible if conditions of effectiveness, proportionality necessity, least infringement, and public accountability are satisfied. We do not take a broad view as to whether distressing advertising is ethical or unethical, because we see the evidence for both the effectiveness of distressing approaches and their potential to generate iatrogenic effects to be inconclusive. However, we believe it possible to use the current evidence base to make informed estimates of the likely consequences of specific message presentations. Messages can be pre-tested and monitored to identify and deal with potential problems. We discuss how advertisers can approach the problems of deciding on the appropriate intensity of ethical review, and evaluating prospective distressing advertising campaigns against the conditions outlined. © 2013 International Union of Psychological Science.

Psychological distress in young adults exposed to war-related trauma in childhood.

PubMed

Llabre, Maria M; Hadi, Fawzyiah; La Greca, Annette M; Lai, Betty S

2015-01-01

We tested a conceptual model of the effect of war-trauma exposure in childhood on psychological distress in young adulthood. Participants included 151 urban Kuwaiti children (51% female; M age = 10.62 years) exposed to the 1990-1991 Gulf crisis (assessed in 1993); participants also included 140 parents (81% female; M age mothers = 36.50 years; M age fathers = 41 years). In 2003, 120 participants were reassessed as young adults (50% female; M age = 21.19 years). The conceptual model was evaluated with structural equations. War-trauma exposure was associated with psychological distress in children and parents, but parents reported larger effects than children. Parents' psychological distress did not contribute to children's psychological distress. Children's psychological distress did not dissipate over time. Social support may function as a potential mediator of the effect of war-trauma exposure on psychological distress. Findings support the importance of early detection and treatment of children exposed to war trauma. Findings also implicate social support as a factor to consider in clinical interventions for children exposed to war trauma.

Diabetes Distress and Glycemic Control: The Buffering Effect of Autonomy Support From Important Family Members and Friends.

PubMed

Lee, Aaron A; Piette, John D; Heisler, Michele; Rosland, Ann-Marie

2018-06-01

To examine whether autonomy support (defined as social support for an individual's personal agency) for diabetes management from informal health supporters (family/friends) reduces the detrimental effects of diabetes distress on glycemic control. Three hundred eight veterans with type 2 diabetes and one or more risk factors for diabetes complications completed a survey that included measures of diabetes distress and perceived autonomy support from their main informal health supporter. Hemoglobin A 1c (HbA 1c ) data from 12 months before and after the survey were extracted from electronic medical records. Linear mixed modeling examined the main effects and interaction of autonomy support and diabetes distress on repeated measures of HbA 1c over the 12 months after the survey, controlling for mean prior 12-month HbA 1c , time, insulin use, age, and race/ethnicity. Diabetes distress ( B = 0.12 [SE 0.05]; P = 0.023) was associated with higher and autonomy support ( B = -0.16 [SE 0.07]; P = 0.032) with lower subsequent HbA 1c levels. Autonomy support moderated the relationship between diabetes distress and HbA 1c ( B = -0.13 [SE 0.06]; P = 0.027). Greater diabetes distress was associated with higher HbA 1c at low ( B = 0.21 [SE 07]; P = 0.002) but not high ( B = 0.01 [SE 0.07]; P = 0.890) levels of autonomy support. Autonomy support from main health supporters may contribute to better glycemic control by ameliorating the effects of diabetes distress. Interventions that reduce diabetes distress and enhance the autonomy supportiveness of informal supporters may be effective approaches to improving glycemic control. © 2018 by the American Diabetes Association.

The effect of spirituality and religious attendance on the relationship between psychological distress and negative life events

PubMed Central

Mancha, Brent E.; Brown, Qiana L.; Eaton, William W.

2014-01-01

Purpose The aim of this study was to assess the effect of religious attendance and spirituality on the relationship between negative life events and psychological distress. Methods This was a cross-sectional study of 1,071 community dwelling adults from East Baltimore, Maryland who participated in the fourth (2004–2005) wave of the Baltimore Epidemiologic Catchment Area study. The 20-item General Health Questionnaire (GHQ-20) was used to measure psychological distress. Multiple regression models were used to assess the association between negative life events and distress as well as to measure the effect of religious attendance and spirituality on the association between psychological distress and negative events while adjusting for demographic variables, past distress and social support from friends and relatives. Results In pooled analysis, negative events were significant predictors of distress, b = 1.00, β = 0.072, p < 0.05. Religious attendance and spirituality did not affect or modify the association between negative events and distress. However, religious attendance was inversely associated with distress with higher frequency of attendance associated with lower distress after controlling for demographic and social support factors, b = −2.10, β = −.110, p < 0.01 for attending 1–3 times a month; b = −2.39, β = −0.156, p < 0.01 for attending weekly; and b = −3.13, β = −0.160, p < 0.001 for attending more than once per week. In stratified analysis, negative events were associated with distress for those who were low on spirituality, b = 1.23, β = 0.092, p < .05, but not for those who were high on spirituality; the association between religious attendance and decreased distress was true only for those scoring high in spirituality. Social support accounted for some of the inverse association between religious and distress. Conclusion Religious attendance and spirituality may play a role in how people experience and deal with difficult life situations. PMID:23732707

Management of foetal asphyxia by intrauterine foetal resuscitation

PubMed Central

Velayudhareddy, S.; Kirankumar, H

2010-01-01

Management of foetal distress is a subject of gynaecological interest, but an anaesthesiologist should know about resuscitation, because he should be able to treat the patient, whenever he is directly involved in managing the parturient patient during labour analgesia and before an emergency operative delivery. Progressive asphyxia is known as foetal distress; the foetus does not breathe directly from the atmosphere, but depends on maternal circulation for its oxygen requirement. The oxygen delivery to the foetus depends on the placental (maternal side), placental transfer and foetal circulation. Oxygen transport to the foetus is reduced physiologically during uterine contractions in labour. Significant impairment of oxygen transport to the foetus, either temporary or permanent may cause foetal distress, resulting in progressive hypoxia and acidosis. Intrauterine foetal resuscitation comprises of applying measures to a mother in active labour, with the intention of improving oxygen delivery to the distressed foetus to the base line, if the placenta is functioning normally. These measures include left lateral recumbent position, high flow oxygen administration, tocolysis to reduce uterine contractions, rapid intravenous fluid administration, vasopressors for correction of maternal hypotension and amnioinfusion for improving uterine blood flow. Intrauterine Foetal Resuscitation measures are easy to perform and do not require extensive resources, but the results are encouraging in improving the foetal well-being. The anaesthesiologist plays a major role in the application of intrauterine foetal resuscitation measures. PMID:21189876

Financial Toxicity of Cancer Care: It's Time to Intervene.

PubMed

Zafar, S Yousuf

2016-05-01

Evidence suggests that a considerably large proportion of cancer patients are affected by treatment-related financial harm. As medical debt grows for some with cancer, the downstream effects can be catastrophic, with a recent study suggesting a link between extreme financial distress and worse mortality. At least three factors might explain the relationship between extreme financial distress and greater risk of mortality: 1) overall poorer well-being, 2) impaired health-related quality of life, and 3) sub-par quality of care. While research has described the financial harm associated with cancer treatment, little has been done to effectively intervene on the problem. Long-term solutions must focus on policy changes to reduce unsustainable drug prices and promote innovative insurance models. In the mean time, patients continue to struggle with high out-of-pocket costs. For more immediate solutions, we should look to the oncologist and patient. Oncologists should focus on the value of care delivered, encourage patient engagement on the topic of costs, and be better educated on financial resources available to patients. For their part, patients need improved cost-related health literacy so they are aware of potential costs and resources, and research should focus on how patients define high-value care. With a growing list of financial side effects induced by cancer treatment, the time has come to intervene on the "financial toxicity" of cancer care. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

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.

Relationships among neighborhood environment, racial discrimination, psychological distress, and preterm birth in African American women.

PubMed

Giurgescu, Carmen; Zenk, Shannon N; Dancy, Barbara L; Park, Chang G; Dieber, William; Block, Richard

2012-01-01

To (a) examine the relationships among objective and perceived indicators of neighborhood environment, racial discrimination, psychological distress, and gestational age at birth; (b) determine if neighborhood environment and racial discrimination predicted psychological distress; (c) determine if neighborhood environment, racial discrimination, and psychological distress predicted preterm birth; and (d) determine if psychological distress mediated the effects of neighborhood environment and racial discrimination on preterm birth. Descriptive correlational comparative. Postpartum unit of a medical center in Chicago. African American women (n(1)  = 33 with preterm birth; n(2)  = 39 with full-term birth). Women completed the instruments 24 to 72 hours after birth. Objective measures of the neighborhood were derived using geographic information systems (GIS). Women who reported higher levels of perceived social and physical disorder and perceived crime also reported higher levels of psychological distress. Women who reported more experiences of racial discrimination also had higher levels of psychological distress. Objective social disorder and perceived crime predicted psychological distress. Objective physical disorder and psychological distress predicted preterm birth. Psychological distress mediated the effect of objective social disorder and perceived crime on preterm birth. Women's neighborhood environments and racial discrimination were related to psychological distress, and these factors may increase the risk for preterm birth. © 2012 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

Distress and Its Effect on Adherence to Antidiabetic Medications Among Type 2 Diabetes Patients in Coastal South India

PubMed Central

Kumar, Nithin; Unnikrishnan, Bhaskaran; Thapar, Rekha; Mithra, Prasanna; Kulkarni, Vaman; Holla, Ramesh; Bhagawan, Darshan; Kumar, Avinash; Aithal, Shodhan

2017-01-01

Background: Distress can bring about an unfavorable attitude among the patients toward tackling their disease which can affect adherence to medications. The purpose of this study was to assess the effect of distress on adherence to medication among patients with diabetes. Methodology: In this cross-sectional study, 124 type 2 diabetes patients above 18 years, attending the hospitals affiliated to Kasturba Medical College, Mangalore, selected using nonprobability sampling were interviewed to assess the presence of diabetes-related distress (DRD) and their level of adherence to medications. Distress was assessed using diabetes distress scale. Morisky Adherence Questionnaire was used to assess the level of adherence. Approval was obtained from the Institutional Ethics Committee. Multivariate logistic regression was conducted to assess the influence of domains of distress on adherence to antidiabetic medication and P < 0.05 was considered statistically significant. Results: In our study, 41.9% (n = 52) of the participants had high diabetes distress. Exactly 43.5% (n = 54) of the participants had low adherence to antidiabetic medications. On univariate analysis, participants with low regimen distress, low physician distress, and low interpersonal distress were found to have good adherence to antidiabetic medication. However, on multivariate analysis, only low regimen distress was found to be significantly associated with good adherence to medication among the study participants. Conclusion: DRD is a problem in our study participants which affects the adherence to medications. Identifying distress at an early stage can help doctors formulate and implement remedial measures, thereby improving adherence to medications. PMID:28781491

The interactive role of income (material position) and income rank (psychosocial position) in psychological distress: a 9-year longitudinal study of 30,000 UK parents.

PubMed

Garratt, Elisabeth A; Chandola, Tarani; Purdam, Kingsley; Wood, Alex M

2016-10-01

Parents face an increased risk of psychological distress compared with adults without children, and families with children also have lower average household incomes. Past research suggests that absolute income (material position) and income status (psychosocial position) influence psychological distress, but their combined effects on changes in psychological distress have not been examined. Whether absolute income interacts with income status to influence psychological distress are also key questions. We used fixed-effects panel models to examine longitudinal associations between psychological distress (measured on the Kessler scale) and absolute income, distance from the regional mean income, and regional income rank (a proxy for status) using data from 29,107 parents included in the UK Millennium Cohort Study (2003-2012). Psychological distress was determined by an interaction between absolute income and income rank: higher absolute income was associated with lower psychological distress across the income spectrum, while the benefits of higher income rank were evident only in the highest income parents. Parents' psychological distress was, therefore, determined by a combination of income-related material and psychosocial factors. Both material and psychosocial factors contribute to well-being. Higher absolute incomes were associated with lower psychological distress across the income spectrum, demonstrating the importance of material factors. Conversely, income status was associated with psychological distress only at higher absolute incomes, suggesting that psychosocial factors are more relevant to distress in more advantaged, higher income parents. Clinical interventions could, therefore, consider both the material and psychosocial impacts of income on psychological distress.

Social class, Mexican culture, and fatalism: their effects on psychological distress.

PubMed

Ross, C E; Mirowsky, J; Cockerham, W C

1983-08-01

We examine the causes and consequences of fatalism in a cross-cultural setting, focusing on the ways in which a fatalistic world view may mediate the effects of social class and Mexican ethnic identity on psychological distress. We find that persons in the lower social classes and Mexicans tend to be more fatalistic than persons in the upper classes and Anglos, and that fatalism, in turn, increases psychological distress. We attempt to integrate research on the social and cultural determinants of cognitive orientations with studies of the effects of social class and Mexican culture on distress.

Longitudinal relationships between workplace bullying and psychological distress.

PubMed

Nielsen, Morten Birkeland; Hetland, Jørn; Matthiesen, Stig Berge; Einarsen, Ståle

2012-01-01

The aims of this study were to examine reciprocal longitudinal associations between exposure to workplace bullying and symptoms of psychological distress and to investigate how self-labeled victimization from bullying explains the effects of bullying on health. Logistic regression analysis was employed to examine the longitudinal relationships between workplace bullying and psychological distress in a representative cohort sample of 1775 Norwegian employees. The time-lag between baseline and follow-up was two years. Exposure to bullying behavior was measured with the revised version of the Negative Acts Questionnaire. Perceived victimization from bullying was measured by a single self-labeling question. Psychological distress was measured with the 25-item Hopkins Symptom Checklist. All variables were measured at both baseline and follow-up. After adjustment for psychological distress at baseline, exposure to bullying behavior [odds ratio (OR) 1.68, 95% confidence interval (95% CI) 1.07-2.62) was found to predict subsequent psychological distress. This effect of bullying behaviors disappeared when victimization from bullying (OR 2.47, 95% CI 1.17-5.22) was entered into the regression. Both psychological distress (OR 2.49, 95% CI 1.64-3.80) and victimization (OR 2.61, 95% CI 1.42-4.81) at baseline were associated with increased risks of being a target of bullying behaviors at follow-up. Psychological distress (OR 2.51, 95% CI 1.39-4.52) and bullying behaviors (OR 2.95, 95% CI 1.39-4.52) at follow-up were associated with victimization. The mutual relationship between bullying and psychological distress indicates a vicious circle where bullying and distress reinforce their own negative effects. This highlights the importance of early interventions to stop workplace bullying and provide treatment options to employees with psychological distress.

Reasons for Distress Among Burn Survivors at 6, 12, and 24 Months Postdischarge: A Burn Injury Model System Investigation.

PubMed

Wiechman, Shelley A; McMullen, Kara; Carrougher, Gretchen J; Fauerbach, Jame A; Ryan, Colleen M; Herndon, David N; Holavanahalli, Radha; Gibran, Nicole S; Roaten, Kimberly

2017-12-16

To identify important sources of distress among burn survivors at discharge and 6, 12, and 24 months postinjury, and to examine if the distress related to these sources changed over time. Exploratory. Outpatient burn clinics in 4 sites across the country. Participants who met preestablished criteria for having a major burn injury (N=1009) were enrolled in this multisite study. Participants were given a previously developed list of 12 sources of distress among burn survivors and asked to rate on a 10-point Likert-type scale (0=no distress to 10=high distress) how much distress each of the 12 issues was causing them at the time of each follow-up. The Medical Outcomes Study 12-Item Short-Form Health Survey was administered at each time point as a measure of health-related quality of life. The Satisfaction With Appearance Scale was used to understand the relation between sources of distress and body image. Finally, whether a person returned to work was used to determine the effect of sources of distress on returning to employment. It was encouraging that no symptoms were worsening at 2 years. However, financial concerns and long recovery time are 2 of the highest means at all time points. Pain and sleep disturbance had the biggest effect on ability to return to work. These findings can be used to inform burn-specific interventions and to give survivors an understanding of the temporal trajectory for various causes of distress. In particular, it appears that interventions targeted at sleep disturbance and high pain levels can potentially effect distress over financial concerns by allowing a person to return to work more quickly. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

The relationship between perceived discrimination and psychological distress among Chinese pulmonary tuberculosis patients: the moderating role of self-esteem.

PubMed

Feng, Danjun; Xu, Lingzhong

2015-01-01

This study described the prevalence of psychological distress and examined the moderating effect of self-esteem in the relationship between perceived discrimination and psychological distress among Chinese pulmonary tuberculosis (TB) patients. Seven hundred and twenty patients with TB from three cities of Shandong Province in eastern China participated in a cross-sectional survey. Patients were measured with the Kessler 10 (K10), the Rosenberg self-esteem scale, and a self-developed perceived discrimination questionnaire. A total of 58.6% of patients with TB scored above 16 on the K10, indicating moderate and serious psychological distress. Chi-square test revealed that female patients reported higher psychological distress than male patients. The structural equation modeling (SEM) analysis among the whole sample indicated that perceived discrimination was significantly related with psychological distress (β = .28, p ≤ .01). The multiple group analysis of SEM showed that perceived discrimination had a significantly substantial (β = .50, p ≤ .001), significantly moderate (β = .15, p ≤ .01), and insignificant effect (β = .05, p ≥ .05) on psychological distress among low self-esteem, moderate self-esteem, and high self-esteem patients with TB, respectively, which verified the moderating effect of self-esteem in the relationship between perceived discrimination and psychological distress.

The Effectiveness of Somatization in Communicating Distress in Korean and American Cultural Contexts

PubMed Central

Choi, Eunsoo; Chentsova-Dutton, Yulia; Parrott, W. Gerrod

2016-01-01

Previous research has documented that Asians tend to somatize negative experiences to a greater degree than Westerners. It is posited that somatization may be a more functional communication strategy in Korean than American context. We examined the effects of somatization in communications of distress among participants from the US and Korea. We predicted that the communicative benefits of somatic words used in distress narratives would depend on the cultural contexts. In Study 1, we found that Korean participants used more somatic words to communicate distress than US participants. Among Korean participants, but not US participants, use of somatic words predicted perceived effectiveness of the communication and expectations of positive reactions (e.g., empathy) from others. In Study 2, we found that when presented with distress narratives of others, Koreans (but not Americans) showed more sympathy in response to narratives using somatic words than narratives using emotional words. These findings suggest that cultural differences in use of somatization may reflect differential effectiveness of somatization in communicating distress across cultural contexts. PMID:27047414

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.

Effects of a Family-based Diabetes Intervention on Behavioral and Biological Outcomes for Mexican American Adults.

PubMed

McEwen, Marylyn Morris; Pasvogel, Alice; Murdaugh, Carolyn; Hepworth, Joseph

2017-06-01

Purpose The purpose of the study was to investigate the effects of a family-based self-management support intervention for adults with type 2 diabetes (T2DM). Methods Using a 2-group, experimental repeated measures design, 157 dyads (participant with T2DM and family member) were randomly assigned to an intervention (education, social support, home visits, and telephone calls) or a wait list control group. Data were collected at baseline, postintervention (3 months), and 6 months postintervention. A series of 2 × 3 repeated measures ANOVAs were used to test the hypotheses with interaction contrasts to assess immediate and sustained intervention effects. Results Significant changes over time were reported in diet self-management, exercise self-management, total self-management, diabetes self-efficacy for general health and total diabetes self-efficacy, physician distress, regimen distress, interpersonal distress, and total distress. There were likewise sustained effects for diet self-management, total self-management, diabetes self-efficacy for general health, total self-efficacy, physician distress, regimen distress, and interpersonal distress. Conclusions Results support and extend prior research documenting the value of culturally relevant family-based interventions to improve diabetes self-management and substantiate the need for intensive, longer, tailored interventions to achieve glycemic control.

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.

Effects of early maternal distress and parenting on the development of children's self-regulation and externalizing behavior.

PubMed

Choe, Daniel Ewon; Olson, Sheryl L; Sameroff, Arnold J

2013-05-01

Emotional distress experienced by mothers increases young children's risk of externalizing problems through suboptimal parenting and child self-regulation. An integrative structural equation model tested hypotheses that mothers' parenting (i.e., low levels of inductive discipline and maternal warmth) would mediate adverse effects of early maternal distress on child effortful control, which in turn would mediate effects of maternal parenting on child externalizing behavior. This longitudinal study spanning ages 3, 6, and 10 included 241 children, mothers, and a subset of teachers. The hypothesized model was partially supported. Elevated maternal distress was associated with less inductive discipline and maternal warmth, which in turn were associated with less effortful control at age 3 but not at age 6. Inductive discipline and maternal warmth mediated adverse effects of maternal distress on children's effortful control. Less effortful control at ages 3 and 6 predicted smaller relative decreases in externalizing behavior at 6 and 10, respectively. Effortful control mediated effects of inductive discipline, but not maternal warmth, on externalizing behavior. Findings suggest elevated maternal distress increases children's risk of externalizing problems by compromising early parenting and child self-regulation.

A randomized controlled trial of mindfulness meditation versus relaxation training: effects on distress, positive states of mind, rumination, and distraction.

PubMed

Jain, Shamini; Shapiro, Shauna L; Swanick, Summer; Roesch, Scott C; Mills, Paul J; Bell, Iris; Schwartz, Gary E R

2007-02-01

Although mindfulness meditation interventions have recently shown benefits for reducing stress in various populations, little is known about their relative efficacy compared with relaxation interventions. This randomized controlled trial examines the effects of a 1-month mindfulness meditation versus somatic relaxation training as compared to a control group in 83 students (M age = 25; 16 men and 67 women) reporting distress. Psychological distress, positive states of mind, distractive and ruminative thoughts and behaviors, and spiritual experience were measured, while controlling for social desirability. Hierarchical linear modeling reveals that both meditation and relaxation groups experienced significant decreases in distress as well as increases in positive mood states over time, compared with the control group (p < .05 in all cases). There were no significant differences between meditation and relaxation on distress and positive mood states over time. Effect sizes for distress were large for both meditation and relaxation (Cohen's d = 1.36 and .91, respectively), whereas the meditation group showed a larger effect size for positive states of mind than relaxation (Cohen's d =.71 and .25, respectively). The meditation group also demonstrated significant pre-post decreases in both distractive and ruminative thoughts/behaviors compared with the control group (p < .04 in all cases; Cohen's d = .57 for rumination and .25 for distraction for the meditation group), with mediation models suggesting that mindfulness meditation's effects on reducing distress were partially mediated by reducing rumination. No significant effects were found for spiritual experience. The data suggest that compared with a no-treatment control, brief training in mindfulness meditation or somatic relaxation reduces distress and improves positive mood states. However, mindfulness meditation may be specific in its ability to reduce distractive and ruminative thoughts and behaviors, and this ability may provide a unique mechanism by which mindfulness meditation reduces distress.

An evaluation of the effectiveness of psychological therapy in reducing general psychological distress for adults with autism spectrum conditions and comorbid mental health problems.

PubMed

Blainey, Sarah H; Rumball, Freya; Mercer, Louise; Evans, Lauren Jayne; Beck, Alison

2017-11-01

To investigate the effectiveness of psychological therapy in reducing psychological distress for adults with autism spectrum conditions (ASC) and co-morbid mental health conditions in routine clinical practice. To explore the effect of individual characteristics and service factors on change in general distress. In a specialist psychological therapies service for adults with ASC, the Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) self-report questionnaire of psychological distress is completed by clients at start and end of therapy. Change over time and reliable and clinical change was assessed for 81 of a total of 122 clients (66.4%). Factors which may influence change over time were explored using available clinical information. Overall, there was a significant reduction in CORE-OM score during therapy with a small effect size. Most clients showed an improvement in psychological distress over therapy (75.4% improved, with 36.9% of these showing reliable changes). Significant and comparable reductions from pre-therapy to post-therapy were seen across the sample, showing that individual differences did not mediate therapy effectiveness. CORE-OM scores mediate the association between age of ASD diagnosis and hours of therapeutic input required, with greater age at diagnosis and higher distress associated with longer therapy duration. Our preliminary findings suggest that psychological therapy may be effective in reducing general distress for clients with ASC and co-morbid mental health conditions and should be routinely offered. Individuals who are diagnosed with ASD in adulthood are likely to require a longer course of therapy when their general distress scores are high. Copyright © 2017 John Wiley & Sons, Ltd.

Stigma of persons with disabilities in Afghanistan: Examining the pathways from stereotyping to mental distress.

PubMed

Trani, Jean-Francois; Ballard, Ellis; Peña, Juan B

2016-03-01

Despite evidence that stigma of disability is frequently reflected through stereotyping and often results in mental distress, very limited literature demonstrates the pathways through which stereotyping has an impact on mental health. Drawing from a large sample of 1449 participants interviewed between December 2012 and September 2013 from an Afghan community-based rehabilitation program, we examined the structure of stigma associated with disability in Afghanistan. Labeling and negative stereotypes, associated with a specific cause of disability, result in social exclusion that in turn impacts mental health. Using structural equation modeling with latent variables, we examined the mediation effect of stereotypes associated with disability on mental distress and anxiety. We found a mediating role of social exclusion between stereotypes and mental distress but only in the case of persons with disabilities from birth. Comparing the total effect of 'disabled at birth' and mental distress 0.195 (95% CI: 0.018-0.367) the effect size of this mediation effect was 0.293 (95% CI: 0.173-0.415). There was no significant direct effect between 'disabled at birth' and mental distress once mediation effect was accounted for in our model. These findings suggest that a multipronged policy approach that recognizes the driving forces of stigma and promotes social participation directly alongside psychosocial interventions on mental distress of persons with disabilities is necessary to achieve wellbeing for a group that has been historically and systematically excluded from development interventions. Copyright © 2016 Elsevier Ltd. All rights reserved.

Nebulized anticoagulants in lung injury in critically ill patients—an updated systematic review of preclinical and clinical studies

PubMed Central

Juschten, Jenny; Tuinman, Pieter R.; Juffermans, Nicole P.; Dixon, Barry; Levi, Marcel

2017-01-01

Pneumonia, inhalation trauma and acute respiratory distress syndrome (ARDS), typical causes of lung injury in critically ill patients, are all three characterized by dysregulated inflammation and coagulation in the lungs. Nebulized anticoagulants are thought to have beneficial effects as they could attenuate pulmonary coagulopathy and maybe even affect pulmonary inflammation. A systematic search of the medical literature was performed using terms referring to aspects of the condition (‘pneumonia’, ‘inhalation trauma’ and ‘ARDS’), the intervention (‘nebulized’, ‘vaporized’, and ‘aerosolized’) and anticoagulants limited to agents that are commercially available and frequently given or tested in critically ill patients [‘heparin’, ‘danaparoid’, ‘activated protein C’ (APC), ‘antithrombin’ (AT) and ‘tissue factor pathway inhibitor’ (TFPI)]. The systematic search identified 16 articles reporting on preclinical studies and 11 articles reporting on human trials. All nebulized anticoagulants attenuate pulmonary coagulopathy in preclinical studies using various models for lung injury, but the effects on inflammation are less consistent. Nebulized heparin, danaparoid and TFPI, but not APC and AT also reduced systemic coagulation. Nebulized heparin in lung injury patients shows contradictory results, and there is concern over systemic side effects of this strategy. Future studies need to focus on the way to nebulize anticoagulants, as well as on efficient but safe dosages, and other side effects. PMID:29264361

Bilateral Pneumothoraces Following Central Venous Cannulation

PubMed Central

Pazos, F.; Masterson, K.; Inan, C.; Robert, J.; Walder, B.

2009-01-01

We report the occurrence of a bilateral pneumothoraces after unilateral central venous catheterization of the right subclavian vein in a 70-year-old patient. The patient had no history of pulmonary or pleural disease and no history of cardiothoracic surgery. Two days earlier, she had a median laparotomy under general and epidural anaesthesia. Prior to the procedure, the patient was hemodynamically stable and her transcutaneous oxygen saturation was 97% in room air. We punctured the right pleural space before cannulation of the right subclavian vein. After the procedure, the patient slowly became hemodynamically instable with respiratory distress. A chest radiograph revealed a complete left-side pneumothorax and a mild right-side pneumothorax. The right-side pneumothorax became under tension after left chest tube insertion. The symptoms finally resolved after insertion of a right chest tube. After a diagnostic work-up, we suspect a congenital “Buffalo chests” explaining bilateral pneumothoraces and a secondary tension pneumothorax. PMID:19901997

Distributive justice, procedural justice, and psychological distress: the moderating effect of coworker support and work autonomy.

PubMed

Rousseau, Vincent; Salek, Salwa; Aubé, Caroline; Morin, Estelle M

2009-07-01

Recent research has demonstrated that the perception of injustice at work may increase psychological health-related problems. The purpose of this study is to examine the moderating effect of coworker support and work autonomy on the relationships between both distributive and procedural justice and psychological distress. Results, on the basis of responses to questionnaires given to 248 prison employees, show that coworker support moderates the relationships between both forms of justice and psychological distress. Specifically, these relationships are weakened when employees benefit from a high level of coworker support. Furthermore, work autonomy moderates the relationship between procedural justice and psychological distress but not the relationship between distributive justice and psychological distress. Thus, procedural injustice is less likely to increase psychological distress when the level of work autonomy is high. (c) 2009 APA, all rights reserved.

Sequencing the threat and recommendation components of persuasive messages differentially improves the effectiveness of high- and low-distressing imagery in an anti-alcohol message in students.

PubMed

Brown, Stephen L; West, Charlotte

2015-05-01

Distressing imagery is often used to improve the persuasiveness of mass-reach health promotion messages, but its effectiveness may be limited because audiences avoid attending to content. Prior self-affirmation or self-efficacy inductions have been shown to reduce avoidance and improve audience responsiveness to distressing messages, but these are difficult to introduce into a mass-reach context. Reasoning that a behavioural recommendation may have a similar effect, we reversed the traditional threat-behavioural recommendation health promotion message sequence. 2 × 2 experimental design: Factor 1, high- and low-distress images; Factor 2, threat-recommendation and recommendation-threat sequences. Ninety-one students were exposed to an identical text message accompanied by high- or low-distress imagery presented in threat-recommendation and recommendation-threat sequences. For the high-distress message, greater persuasion was observed for the recommendation-threat than the threat-recommendation sequence. This was partially mediated by participants' greater self-exposure to the threat component of the message, which we attribute to the effect of sequence in reducing attentional avoidance. For the low-distress message, greater persuasion was observed for the threat-recommendation sequence, which was not mediated by reading time allocated to the threat. Tailoring message sequence to suit the degree of distress that message developers wish to induce provides a tool that could improve persuasive messages. These findings provide a first step in this process and discuss further steps needed to consolidate and expand these findings. Statement of contribution What is already known on this subject? Health promotion messages accompanied by distressing imagery might, under some circumstances, persuade individuals to engage in healthier behaviour. Audiences can respond defensively to distressing imagery, but may be less inclined to do so when an easily followed behavioural recommendation is presented before imagery. Current literature is divided on whether presenting a behavioural recommendation before a threat component accompanied by distressing images will improve the persuasiveness of messages. What does this study add? We show that, when a behavioural recommendation precedes a threat containing distressing images, persuasiveness of a threatening message is stronger than a threat-recommendation sequence. We show that a recommendation-threat sequence improves persuasiveness of distressing imagery because it reduces attentional avoidance. © 2014 The British Psychological Society.

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.

When hard times take a toll: the distressing consequences of economic hardship and life events within the family-work interface.

PubMed

Young, Marisa; Schieman, Scott

2012-03-01

Using two waves of data from a national survey of working Americans (N = 1,122), we examine the associations among economic hardship, negative life events, and psychological distress in the context of the family-work interface. Our findings demonstrate that family-to-work conflict mediates the effects of economic hardship and negative events to significant others on distress (net of baseline distress and hardship). Moreover, economic hardship and negative events to significant others moderate the association between family-to-work conflict and distress. While negative events to others exacerbate the positive effect of family-to-work conflict on distress, we find the opposite for economic hardship: The positive association between hardship and distress is weaker at higher levels of family-to-work conflict. These patterns hold across an array of family, work, and sociodemographic conditions. We discuss how these findings refine and extend ideas of the stress process model, including complex predictions related to processes of stress-buffering, resource substitution, and role multiplication.

Weight-based stigmatization, psychological distress, & binge eating behavior among obese treatment-seeking adults.

PubMed

Ashmore, Jamile A; Friedman, Kelli E; Reichmann, Simona K; Musante, Gerard J

2008-04-01

To evaluate the associations between weight-based stigmatization, psychological distress, and binge eating behavior in a treatment-seeking obese sample. Ninety-three obese adults completed three questionnaires: 1) Stigmatizing Situations Inventory, 2) Brief Symptoms Inventory, and 3) Binge Eating Questionnaire. Correlational analyses were used to evaluate the association between stigmatizing experiences, psychological distress and binge eating behavior. Stigmatizing experiences predicted both binge eating behavior (R(2)=.20, p<.001) and overall psychological distress (R(2)=.18, p<.001). A substantial amount of the variance in binge eating predicted by weight-based stigmatization was due to the effect of psychological distress. Specifically, of the 20% of the variance in binge eating accounted for by stigmatizing experiences, between 7% and 34% (p<.01) was due to the effects of various indicators of psychological distress. These data suggest that weight-based stigmatization predicts binge eating behavior and that psychological distress associated with stigmatizing experiences may be an important mediating factor.

The relationship between moral distress, professional stress, and intent to stay in the nursing profession.

PubMed

Borhani, Fariba; Abbaszadeh, Abbas; Nakhaee, Nouzar; Roshanzadeh, Mostafa

2014-01-01

Moral distress and professional stress are common problems that can have adverse effects on nurses, patients, and the healthcare system as a whole. Thus, this cross-sectional study aims to examine the relationship between moral distress, professional stress, and intent to stay in the nursing profession. Two hundred and twenty full-time nurses employed at teaching hospitals in the eastern regions of Iran were studied. A 52-item questionnaire based on Corley's Moral Distress Scale, Wolfgang's Health Professions Stress Inventory and Nedd Questionnaire on Intent to Stay in the Profession was used in the study. Additionally, demographic details of the study population were collected. No significant correlation was observed between the intensity and frequency of moral distress, professional stress, and intent to stay in the profession among nurses (P > 0.05). There was a significant correlation between moral distress, professional stress, and age, number of years in service and work setting (P < 0.05). Given the important effect of moral distress and professional stress on nurses, in addition to the educational programs for familiarization of nurses with these concepts, it is recommended that strategies be formulated by the healthcare system to increase nurses' ability to combat their adverse effects.

Nurse moral distress: A survey identifying predictors and potential interventions.

PubMed

Rathert, Cheryl; May, Douglas R; Chung, Hye Sook

2016-01-01

Ethical dilemmas and conflicts are inherent in today's health care organizations and may lead to moral distress, which is often associated with physical and psychological symptoms. Although the existence of moral distress has been observed by scholars for decades, most of the research has been descriptive and has examined what types of health care conflicts lead to distress. This study tested a comprehensive model, underpinned by Social Cognitive Theory, that examined work environment and intrapersonal variables that may influence moral distress. We surveyed nursing staff employed in a U.S. acute care hospital (response rate=45%; n=290). More than half of the respondents reported they experience ethical dilemmas and conflicts from several times a month to daily, and nearly half reported they experience moral distress at least several times a month. Structural equation modeling analysis simultaneously examined the effects of five independent variables on moral distress and moral voice: (a) frequency of ethical dilemmas and conflicts; (b) moral efficacy; (c) ethics communication; (d) ethical environment; and (e) organizational ethics support. Results revealed significant independent effects of the frequency of ethics issues and organizational ethics support on moral distress. Bootstrapping analysis indicated that voice fully mediated the relationship between moral efficacy and moral distress, and partially mediated the relationship between organizational ethics support and distress. Supplemental analysis revealed that organizational ethics support moderated the moral efficacy-voice-moral distress relationship such that when organizational support was low, moral efficacy was negatively related to moral distress via voice. Although it may be impossible to eliminate all ethical dilemmas and conflicts, leaders and organizations may wish to help improve nurses' moral efficacy, which appears to give rise to voice, and reduced moral distress. Increasing organizational ethics support may be a key approach. Copyright © 2015 Elsevier Ltd. All rights reserved.

Design Criteria for Aggregate-Surfaced Roads and Airfields

DTIC Science & Technology

1989-04-01

functional failure conditions and their effects are tabulated in Table 4. It indicates that many distress factors may act on the gravel surface to increase...displacements. Table 4 Major Distress Types of Low-Volume Roads Distress Factor Effect on ..... Dusting Safety, environment Surface looseness Safety, roughness...will be less than that assumed as the design objective. Frost Considerations 9. The detrimental effects of frost action in subsurface materials of

Effects of vitamin C and vitamin D administration on mood and distress in acutely hospitalized patients.

PubMed

Wang, Yifan; Liu, Xing Jian; Robitaille, Line; Eintracht, Shaun; MacNamara, Elizabeth; Hoffer, L John

2013-09-01

Hypovitaminosis C and D are highly prevalent in acute-care hospitals. Malnutrition with regard to these vitamins has been linked to mood disturbance and cognitive dysfunction. The objective was to determine whether vitamin C or D supplementation improves mood state or reduces psychological distress in acutely hospitalized patients with a high prevalence of hypovitaminosis C and D. A randomized, double-blind, active-control clinical trial compared the effects of vitamin C (500 mg twice daily) with those of high-dose vitamin D (5000 IU/d) on mood (Profile of Mood States) and psychological distress (Distress Thermometer). Vitamin C provided for a mean of 8.2 d increased plasma vitamin C concentrations to normal (P < 0.0001) and was associated with a 71% reduction in mood disturbance (P = 0.0002) and a 51% reduction in psychological distress (P = 0.0002). High-dose vitamin D provided for a mean of 8.1 d increased plasma 25-hydroxyvitamin D [25(OH)D] concentrations (P < 0.0001), but not into the normal range, and had insignificant effects on mood (P = 0.067) and distress (P = 0.45). The changes in mood and distress in the vitamin C group were greater than those in the vitamin D group (P = 0.045 for mood; P = 0.009 for distress). Short-term therapy with vitamin C improves mood and reduces psychological distress in acutely hospitalized patients with a high prevalence of hypovitaminosis C and D. No conclusion is possible regarding the effects of vitamin D because the dose and duration of therapy were insufficient to raise 25(OH)D concentrations into the normal range. This trial was registered at clinicaltrials.gov as NCT01630720.

The Impact of a Mobile Diabetes Health Intervention on Diabetes Distress and Depression Among Adults: Secondary Analysis of a Cluster Randomized Controlled Trial

PubMed Central

Swasey, Krystal K; Crabbe, J Christopher F; Shardell, Michelle D; Terrin, Michael L; Barr, Erik A; Gruber-Baldini, Ann L

2017-01-01

Background Diabetes is a complex, demanding disease that requires the constant attention of patients. The burden of self-management, including different medication regimens, routine self-care activities, and provider visits, has an impact on patients’ emotional well-being. Diabetes distress and depression are two important components of emotional well-being that may negatively affect diabetes outcomes. Objective The aim was to determine the impact of the 1-year Mobile Diabetes Intervention Study cluster randomized clinical trial on emotional well-being measured by diabetes distress and depression among adults with type 2 diabetes (T2D). Methods A total of 163 adults with not-well-managed T2D were enrolled from community primary care practices. Primary care practices were cluster randomized into either a usual care control group or intervention group. Intervention participants were given a mobile phone with coaching software including a Web portal to communicate with providers. A priori established secondary outcomes included distress measured by the Diabetes Distress Scale (DDS), with subscales measuring emotional burden, interpersonal distress, physician-related distress, and regimen-related distress, as well as depression measured by the Patient Health Questionnaire (PHQ-9). Linear mixed models were used to calculate the effect of the intervention on diabetes distress levels over time, both overall and separately by sex, and to determine if the intervention affected distress or depression. The impact of total DDS on changes in HbA1c was also studied. Results There were no significant treatment group effects for DDS total (baseline: P=.07; differences over time: P=.38) or for depression (P=.06 over time). Significant declines in total DDS were observed over the 12-month intervention period (P=.01). Regimen-related distress significantly decreased for all study participants (P<.001), but no significant change over time was observed for emotional burden (P=.83), interpersonal distress (P=.64), or physician-related distress (P=.73). Women in both the usual care and intervention groups were more likely to have higher overall DDS, emotional burden, physician-related distress, and regimen-related distress, but not interpersonal distress. Women also reported higher baseline depression compared to men (P=.006). Overall, depression decreased over the treatment period (P=.007), but remained unaffected by group assignment (P=.06) or by sex (P=.97). Diabetes distress had no effect on the change in HbA1c (P=.91) over the treatment period. Conclusions Although we found no definitive overall or sex-specific effect of the intervention on diabetes distress or depression, this study makes an important contribution to the understanding of mobile health interventions and the impact on emotional health. Our study verified previous work that although diabetes distress and depression are highly correlated, these measures are not evaluating the same construct. Design of future mobile technology provides an opportunity to personalize, contextualize, and intervene in the emotional well-being of persons with diabetes. Trial Registration Clinicaltrials.gov NCT01107015; https://clinicaltrials.gov/ct2/show/NCT01107015 (Archived by WebCite at http://www.webcitation.org/6vVgRCLAF) PMID:29217502

Longitudinal Influence of Paternal Distress on Children’s Representations of Fathers, Family Cohesion, and Family Conflict

PubMed Central

Adamsons, Kari L.; Robinson, JoAnn L.; Sabatelli, Ronald M.

2014-01-01

A parent’s distress is known to color children’s experiences of their families. Studies, however, have rarely focused on the levels of distress experienced by fathers, and in particular, as they affect the emotional experiences of their children. We examine the impact that fathers’ experience of distress throughout their children’s early years has on children’s emerging narrative representations of father-child relationships and of family conflict and cohesion. In this longitudinal investigation, fathers of young children reported their distress on two occasions in relation to self, the marital relationship, and the family climate. Fathers also concurrently reported on their children’s temperament, specifically negative emotionality. Children responded to story stem beginnings about challenging situations in the family and their narratives were scored for dysregulated negative-disciplinary and positive parental behaviors of fathers, family conflict themes, and family harmony themes. It was hypothesized that children of more distressed fathers would represent greater dysregulated fathering and higher levels of family conflict, and lower levels of positive fathering and family harmony than children of less distressed fathers. Further, the study examined whether this effect was mediated through the fathers’ reports of their children’s negative emotionality. Results partially supported the hypothesized direct and indirect effects. Children’s narratives of negative-disciplinary fathering and family conflict were more common in boys when fathers reported greater distress, and temperament ratings fully mediated this effect. However, their narratives of positive fathering and family harmony were not significantly affected. That positive family features were preserved in children’s narratives even in the face of greater father distress suggests that families may be able to build resilience to internalized distress through these positive narrative features. PMID:25995610

Psychological Interventions for Vaccine Injections in Young Children 0 to 3 Years

PubMed Central

Pillai Riddell, Rebecca; Taddio, Anna; McMurtry, C. Meghan; Chambers, Christine; Shah, Vibhuti; Noel, Melanie

2015-01-01

Background: This systematic review evaluated the effectiveness of distraction for reducing infant distress during vaccinations in young children aged 0 to 3 years. Design/Methods: Database searches identified relevant randomized and quasi-randomized controlled trials. Three separate clinical questions related to variants of the psychological strategy of distraction (directed video; directed toy; nondirected toy) were pursued. Distress was identified as the critical outcome to assess the benefits of distraction and extracted from relevant trials. Distress was analyzed by phase of procedure (distress preprocedure; distress acute; distress recovery; idiosyncratic phases based on some or all of the 3 aforementioned phases). Results: Ten studies were included in the review. Significant results are presented herein. For directed video distraction, moderate quality evidence suggested that distress was lowered in the treatment group standardized mean difference (SMD −0.68 lower [95% confidence interval (CI), −1.04 to −0.32]) for the acute+recovery phase as well as the preprocedure phase (SMD −0.49 lower [95% CI, −7.6 to −0.22]). For directed toy distraction, the analysis of low-quality evidence for a combined preprocedure+acute+recovery phase of distress (analysis n=81), suggested that distress was lowered in the treatment group (SMD −0.47 lower [95% CI, −0.91 to −0.02]). An effect for nondirected toy distraction was also seen, analyzing very–low-quality evidence, for the acute distress phase (n=290; SMD −0.93 lower [95% CI, −1.86 to 0.00]). Conclusion: Generally low-quality to very–low-quality evidence suggests that there may be an effect of directed (toy and video) and nondirected toy distraction for children aged 0 to 3 years, for certain phases of the vaccination. PMID:26201014

Childhood disadvantage, education, and psychological distress in adulthood: A three-wave population-based study.

PubMed

Sheikh, Mashhood Ahmed

2018-03-15

We assessed the mediating role of education in the association between childhood disadvantage and psychological distress in adulthood using longitudinal data collected in three waves, from 1994 to 2008, in the framework of the Tromsø Study (N = 4530), a cohort that is representative of men and women from Tromsø. Education was measured at a mean age of 54.7 years, and psychological distress in adulthood was measured at a mean age of 61.7 years. Ordinary least square regression analysis was used to assess the associations between childhood disadvantage, education, and psychological distress in adulthood. The indirect effects and the proportion (%) of indirect effects of childhood disadvantage (via education) on psychological distress in adulthood were assessed by mediation analysis. Childhood disadvantage was associated with lower education and higher psychological distress in adulthood (p < 0.05). Lower education was associated with a higher psychological distress in adulthood (p < 0.05). A minor proportion (7.51%, p < 0.05) of the association between childhood disadvantage and psychological distress in adulthood was mediated by education. Childhood disadvantages were measured retrospectively. The association between childhood disadvantage and psychological distress in adulthood is primarily independent of education. Copyright © 2017 Elsevier B.V. All rights reserved.

HIV-Associated Orphanhood and Children’s Psychosocial Distress: Theoretical Framework Tested With Data From Zimbabwe

PubMed Central

Nyamukapa, Constance A.; Gregson, Simon; Lopman, Ben; Saito, Suzue; Watts, Helen J.; Monasch, Roeland; Jukes, Matthew C.H.

2008-01-01

Objectives. We measured the psychosocial effect of orphanhood in a sub-Saharan African population and evaluated a new framework for understanding the causes and consequences of psychosocial distress among orphans and other vulnerable children. Methods. The framework was evaluated using data from 5321 children aged 12 to 17 years who were interviewed in a 2004 national survey in Zimbabwe. We constructed a measure of psychosocial distress using principle components analysis. We used regression analyses to obtain standardized parameter estimates of psychosocial distress and odds ratios of early sexual activity. Results. Orphans had more psychosocial distress than did nonorphans. For both genders, paternal, maternal, and double orphans exhibited more-severe distress than did nonorphaned, nonvulnerable children. Orphanhood remained associated with psychosocial distress after we controlled for differences in more-proximate determinants. Maternal and paternal orphans were significantly more likely than were nonorphaned, nonvulnerable children to have engaged in sexual activity. These differences were reduced after we controlled for psychosocial distress. Conclusions. Orphaned adolescents in Zimbabwe suffer greater psychosocial distress than do nonorphaned, nonvulnerable children, which may lead to increased likelihood of early onset of sexual intercourse and HIV infection. The effect of strategies to provide psychosocial support should be evaluated scientifically. PMID:18048777

Distress tolerance is linked to unhealthy eating through pain catastrophizing.

PubMed

Emami, Ashley S; Woodcock, Anna; Swanson, Heidi E; Kapphahn, Teresa; Pulvers, Kim

2016-12-01

Low distress tolerance, an important component of emotion regulation, is a risk factor for unhealthy eating. Identifying factors which explain the link between distress tolerance and unhealthy eating can advance the understanding of problematic eating and inform prevention and treatment of obesity and eating disorders. The present study examines pain catastrophizing as a mediator between distress tolerance and unhealthy eating in a nonclinical population, which has received little attention despite being a risk factor for unhealthy eating behaviors. The Distress Tolerance Scale (DTS), Pain Catastrophizing Scale (PCS), and the Dutch Eating Behavior Questionnaire (DEBQ), were administered to 171 college students (62.6% female, 38.6% White, 28.1% Hispanic). There was no evidence of a significant direct effect of distress tolerance on unhealthy eating. However, as hypothesized, there was a significant indirect or mediated effect of pain catastrophizing on the relationship between distress tolerance and unhealthy eating. Individuals low in distress tolerance reported higher pain catastrophizing, and a result, these individuals also reported higher levels of unhealthy eating. These findings introduce pain catastrophizing as an influential variable in the link between distress tolerance and unhealthy eating. Findings suggest that reducing catastrophic thinking about pain may be a worthy target of intervention in reducing unhealthy eating. Copyright © 2016 Elsevier Ltd. All rights reserved.

Symptom-Management Self-efficacy Mediates the Effects of Symptom Distress on the Quality of Life Among Taiwanese Oncology Outpatients With Breast Cancer.

PubMed

Liang, Shu-Yuan; Chao, Ta-Chung; Tseng, Ling-Ming; Tsay, Shiow-Luan; Lin, Kuan-Chia; Tung, Heng-Hsin

2016-01-01

Theory has suggested that self-efficacy plays an important role in facilitating health behaviors and, in turn, promoting healthy outcomes. However, limited research has focused on the mechanisms through which symptom-management self-efficacy acts as a mediator between symptom distress and quality of life (QOL) for patients with breast cancer who have undergone chemotherapy. The purpose of this study is to examine the association between symptom distress and QOL among Taiwanese oncology outpatients with breast cancer and proposed symptom-management self-efficacy as a mediator between symptom distress and QOL. This cross-sectional study included 201 oncology outpatients in 1 teaching hospital in the Taipei area of Taiwan. The research instruments included the Symptom-Management Self-Efficacy Scale-Breast Cancer, the symptom distress scale, and the European Organization for Research and Treatment of Cancer Quality of Life Group Questionnaire. Bootstrapping was used to statistically assess the possible mediating effects of self-efficacy on QOL. Symptom-management self-efficacy mediated the association between symptom distress and global QOL (indirect effect, -6.33; 95% confidence interval [CI], -9.63 to -3.74), functional QOL (indirect effect, -4.47; 95% CI, -7.05 to -2.36), and symptom QOL (indirect effect, 2.59; 95% CI, 1.07-4.83). All of the 95% CIs were significant. The lower symptom distress that patients experienced was indirectly associated with better QOL through higher self-efficacy. Symptom management self-efficacy may be a crucial mechanism through which symptom distress influences patients' QOL. Clinicians may incorporate strategies focused on improving patients' self-efficacy in relation to managing their symptoms caused by chemotherapy to improve patients' QOL.

Financial strain, social relations, and psychological distress among older people: a cross-cultural analysis.

PubMed

Ferraro, K F; Su, Y

1999-01-01

This article examines how financial strain and social relations may independently and jointly influence psychological distress among older people in four nations. Data from four Western Pacific nations (N = 3,277) are used to test additive and multiplicative models of the relationships between financial strain, social relations, and psychological distress. Financial strain is associated with higher levels of psychological distress in three of the four nations. Interactive models of the effects of financial strain and social relations on distress were uncovered in three of the four nations, but the type of social relation influencing the strain-distress relationship varied. Subjective-health and IADLs were significant predictors of psychological distress in all four nations. Findings suggest that although financial strain is quite likely to lead to psychological distress among elders, this can be mitigated, at least in part, by social relationships. Modernization was not associated with higher psychological distress.

Correlates of psychological distress, burnout, and resilience among Chinese female nurses

PubMed Central

ZOU, Guiyuan; SHEN, Xiuying; TIAN, Xiaohong; LIU, Chunqin; LI, Guopeng; KONG, Linghua; LI, Ping

2016-01-01

The present survey investigated the association between resilience, burnout and psychological distress among Chinese female nurses. A total of 366 female nurses were enrolled in our study. A series of self-reported questionnaires that dispose of the following constructs: psychological distress, burnout, and resilience were estimated. The hierarchical linear regression models were used to evaluate the mediating effect of resilience on the relationship between burnout and psychological distress. Results of the survey showed 85.5% nurses experienced psychological distress. Resilience was negatively related to psychological distress and burnout whereas burnout was positively associated with psychological distress. Mediation analysis revealed that resilience could partially mediate the relationship between the dimensions of emotional exhaustion, depersonalization, and psychological distress. This study highlights the mediator of resilience between burnout and psychological distress of female nurses. As such, interventions that attend to resilience training may be the focus for future clinical and research endeavors. PMID:27021058

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.

Social support as a mediator between symptom distress and quality of life in women with breast cancer.

PubMed

Manning-Walsh, Juanita

2005-01-01

To examine relationships between symptom distress and quality of life when religious support and personal support were introduced as mediating variables. Cross-sectional, correlational. Internet recruitment following university institutional review board approval. Mailed questionnaires from 100 women with breast cancer, mean age 46, length of time since surgery 1 to 24 months, predominantly White. Symptom Distress Scale, Religious Support Scale, FACT-B, and Facit-Sp-12. Personal support was positively related to quality of life and partially mediated the effects of symptom distress. Religious support did not mediate symptom distress and was not directly related to quality of life. Social support from family members and friends helped to decrease the negative effects of symptoms on quality of life. This study underscores the need to continue to assess for symptom distress and adequacy of personal support throughout the cancer trajectory and to facilitate the garnering of support resources when needed.

Piracetam for fetal distress in labour.

PubMed

Hofmeyr, G Justus; Kulier, Regina

2012-06-13

Piracetam is thought to promote the metabolism of brain cells when they are hypoxic. It has been used to prevent adverse effects of fetal distress. The objective of this review was to assess the effects of piracetam for suspected fetal distress in labour on method of delivery and perinatal morbidity. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (15 February 2012). Randomised trials of piracetam compared with placebo or no treatment for suspected fetal distress in labour. Both review authors assessed eligibility and trial quality. One study of 96 women was included. Piracetam compared with placebo was associated with a trend to reduced need for caesarean section (risk ratio 0.57, 95% confidence interval 0.32 to 1.03). There were no statistically significant differences between the piracetam and placebo group for neonatal morbidity (measured by neonatal respiratory distress) or Apgar score. There is not enough evidence to evaluate the use of piracetam for fetal distress in labour.

Psychological distress and the perception of radiation risks: the Fukushima health management survey

PubMed Central

Yabe, Hirooki; Yasumura, Seiji; Ohira, Tetsuya; Niwa, Shin-Ichi; Ohtsuru, Akira; Mashiko, Hirobumi; Maeda, Masaharu; Abe, Masafumi

2015-01-01

Abstract Objective To assess relationships between the perception of radiation risks and psychological distress among evacuees from the Fukushima nuclear power plant disaster. Methods We analysed cross-sectional data from a survey of evacuees conducted in 2012. Psychological distress was classified as present or absent based on the K6 scale. Respondents recorded their views about the health risks of exposure to ionizing radiation, including immediate, delayed and genetic (inherited) health effects, on a four-point Likert scale. We examined associations between psychological distress and risk perception in logistic regression models. Age, gender, educational attainment, history of mental illness and the consequences of the disaster for employment and living conditions were potential confounders. Findings Out of the 180 604 people who received the questionnaire, we included 59 807 responses in our sample. There were 8717 respondents reporting psychological distress. Respondents who believed that radiation exposure was very likely to cause health effects were significantly more likely to be psychologically distressed than other respondents: odds ratio (OR) 1.64 (99.9% confidence interval, CI: 1.42–1.89) for immediate effects; OR: 1.48 (99.9% CI: 1.32–1.67) for delayed effects and OR: 2.17 (99.9% CI: 1.94–2.42) for genetic (inherited) effects. Similar results were obtained after controlling for individual characteristics and disaster-related stressors. Conclusion Among evacuees of the Fukushima nuclear disaster, concern about radiation risks was associated with psychological distress. PMID:26478623

Evaluation of tamoxifen in persistent or recurrent nonsquamous cell carcinoma of the cervix: a Gynecologic Oncology Group study.

PubMed

Bigler, L R; Tate Thigpen, J; Blessing, J A; Fiorica, J; Monk, B J

2004-01-01

This study was undertaken to estimate the antitumor activity of tamoxifen in patients with persistent or recurrent nonsquamous cell carcinoma of the cervix. Furthermore, the nature and degree of adverse effects from tamoxifen in this cohort of individuals was examined. Tamoxifen citrate was to be administered at a dose of 10 mg per orally twice a day until disease progression or unacceptable side effects prevented further therapy. A total of 34 patients (median age: 49 years) were registered to this trial; two were declared ineligible. Thirty-two patients were evaluable for adverse effects and 27 were evaluable for response. There were only six grades 3 and 4 adverse effects reported: leukopenia (in one patient), anemia (in two), emesis (in one), gastrointestinal distress (in one), and neuropathy (in one). The objective response rate was 11.1%, with one complete and two partial responses. In conclusion, tamoxifen appears to have minimal activity in nonsquamous cell carcinoma of the cervix.

Distress in Couples Coping with Cancer: A Meta-Analysis and Critical Review of Role and Gender Effects

ERIC Educational Resources Information Center

Hagedoorn, Mariet; Sanderman, Robbert; Bolks, Hilde N.; Tuinstra, Jolanda; Coyne, James C.

2008-01-01

Research concerning distress in couples coping with cancer was integrated using meta-analysis and narrative critical appraisal. Individual levels of distress were determined more by gender than by the role of being the person with cancer versus that person's partner. That is, women reported consistently more distress than men regardless of their…

Distressing situations in the intensive care unit: a descriptive study of nurses' responses.

PubMed

McClendon, Heather; Buckner, Ellen B

2007-01-01

Moral distress is a significant stressor for nurses in critical care. Feeling that they are doing the "right thing" is important to nurses, and situations of moral distress can make them question their work. The purpose of this study was to describe critical care nurses' levels of moral distress, the effects of that distress on their personal and professional lives, and nurses' coping strategies. The study consisted of open-ended questions to elicit qualitatively the nurses' feelings about moral distress and a quantitative measure of the degree of distress caused by certain types of situations. The questionnaires were then analyzed to assess the nurses' opinions regarding moral distress, how their self-perceived job performance is affected, and what coping methods they use to deal with moral distress. The most frequently encountered moral distress situations involved critically ill patients whose families wished to continue aggressive treatment when it probably would not benefit the patient in the end.

Influence of depressive symptoms on distress related to positive psychotic-like experiences in women.

PubMed

Brañas, Antía; Barrigón, María Luisa; Lahera, Guillermo; Canal-Rivero, Manuel; Ruiz-Veguilla, Miguel

2017-12-01

The Community Assessment of Psychic Experiences (CAPE) is an effective instrument for detection of the presence of psychotic symptoms and associated distress in the general population. However, little research has studied distress associated with positive psychotic-like experiences (PLEs). Our aim is to study PLE-related distress using the CAPE. In this study we analysed factors associated with differences in PLE-related distress in a sample of 200 non-clinical participants recruited by snowball sampling. Presence of PLEs and related psychological distress was measured using the CAPE questionnaire. The influence of age, gender, educational level and drug use was studied. In univariate analysis we found that gender and CAPE positive, depressive and negative scores, were associated with CAPE positive distress. Using multiple linear regression, we found that only the effect of gender, and the interaction between frequency of depression and gender, remained statistically significant. In our sample interaction between gender and depressive symptoms is a determining factor in distress associated with positive PLEs. The results of this study may be useful for the implementation of prevention programs. Copyright © 2017 Elsevier B.V. All rights reserved.

Occupational stress and suicidality among firefighters: Examining the buffering role of distress tolerance.

PubMed

Stanley, Ian H; Boffa, Joseph W; Smith, Lia J; Tran, Jana K; Schmidt, N Brad; Joiner, Thomas E; Vujanovic, Anka A

2018-05-24

Past research indicates that firefighters are at increased risk for suicide. Firefighter-specific occupational stress may contribute to elevated suicidality. Among a large sample of firefighters, this study examined if occupational stress is associated with multiple indicators of suicide risk, and whether distress tolerance, the perceived and/or actual ability to endure negative emotional or physical states, attenuates these associations. A total of 831 firefighters participated (mean [SD] age = 38.37y[8.53y]; 94.5% male; 75.2% White). The Sources of Occupational Stress-14 (SOOS-14), Distress Tolerance Scale (DTS), and Suicidal Behaviors Questionnaire-Revised (SBQ-R) were utilized to examine firefighter-specific occupational stress, distress tolerance, and suicidality, respectively. Consistent with predictions, occupational stress interacted with distress tolerance, such that the effects of occupational stress on suicide risk, broadly, as well as lifetime suicide threats and current suicidal intent, specifically, were attenuated at high levels of distress tolerance. Distress tolerance may buffer the effects of occupational stress on suicidality among firefighters. Pending replication, findings suggest that distress tolerance may be a viable target for suicide prevention initiatives within the fire service. Copyright © 2018 Elsevier B.V. All rights reserved.

Testing a mediation model of psychotherapy process and outcome in psychodynamic psychotherapy: Previous client distress, psychodynamic techniques, dyadic working alliance, and current client distress.

PubMed

Kivlighan, Dennis M; Hill, Clara E; Ross, Katherine; Kline, Kathryn; Furhmann, Amy; Sauber, Elizabeth

2018-01-05

To test a sequential model of psychotherapy process and outcome, we included previous client distress, therapist psychodynamic techniques, dyadic working alliance, and current client distress. For 114 sets of eight-session segments in 40 cases of psychodynamic psychotherapy, clients completed the Outcome Questionnaire-45 and Inventory of Interpersonal Problems-32 after the first and final session, judges reliably coded one middle sessions on the Psychodynamic subscale of the Multitheoretical List of Therapeutic Interventions, and clients and therapists completed the Working Alliance Inventory after every session. Results indicated that higher use of psychodynamic techniques was associated with higher levels of the working alliance, which in turn was associated decreased client distress; and working alliance was higher later in psychotherapy. There was a significant indirect effect of psychodynamic techniques on decreases in distress mediated by the working alliance. Implications for theory, practice, and research are provided. Clinical or methodological significance of this article: Conducted a longitudinal, latent variable examination of the relationships of psychodynamic techniques and working alliance on client distress. Psychodynamic techniques have an indirect effect on decreases in client distress through the dyadic working alliance.

A prospective study of the impact of child maltreatment and friend support on psychological distress trajectory: From adolescence to emerging adulthood.

PubMed

Dion, Jacinthe; Matte-Gagné, Célia; Daigneault, Isabelle; Blackburn, Marie-Eve; Hébert, Martine; McDuff, Pierre; Auclair, Julie; Veillette, Suzanne; Perron, Michel

2016-01-01

Transition into adulthood is a critical developmental period that may be influenced by adverse life events as well as by protective factors. This study aimed at investigating the effect of different forms of child maltreatment experienced prior to age 14 (i.e., sexual abuse, physical abuse and exposure to intimate partner violence), and of friend support at age 14 on the psychological distress trajectory from age 14 to 24. Participants were 605 adolescents from the general population involved in a 10-year longitudinal study. Psychological distress was evaluated at ages 14, 16, 18 and 24. Child maltreatment prior to 14 years was retrospectively assessed at 14 and 24 years while perception of support from friends was evaluated at age 14. Multilevel growth modeling indicated that psychological distress followed a significant decreasing curvilinear trajectory, with participants reporting fewer distressing psychological symptoms after 18 years. All three forms of child maltreatment, as well as their cumulative effect, predicted more psychological distress over 10 years above and beyond the protective effect of support from friends. Higher support from friends at age 14 was related to lower distress at baseline andover 10 years, beyond the effect of child maltreatment. Self-report nature of all measures, attrition, and measures of child maltreatment forms. Psychological distress decreased during the transition from adolescence to emerging adulthood. Results also revealed the detrimental impact of child maltreatment and the promotive role of friend support, which underscore the importance of early intervention. Copyright © 2015 Elsevier B.V. All rights reserved.

Neurokinin-1 receptor antagonists for chemotherapy-induced nausea and vomiting.

PubMed

Aziz, Fahad

2012-07-01

Chemotherapy can be a life-prolonging treatment for many cancer patients, but it is often associated with profound nausea and vomiting that is so distressing that patients may delay or decline treatment to avoid these side effects. The discovery of several NK1 receptor antagonists is a big revolution to dealt this problem. NK1 receptor antagonists prevent both acute and delayed chemotherapy-induced nausea and vomiting (CINV). These agents act centrally at NK-1 receptors in vomiting centers within the central nervous system to block their activation by substance P released as an unwanted consequence of chemotherapy. By controlling nausea and vomiting, these agents help improve patients' daily living and their ability to complete multiple cycles of chemotherapy. They are effective for both moderately and highly emetogenic chemotherapy regimens. Their use might be associated with increased infection rates; however, additional appraisal of specific data from RCTs is needed.

The Moderating Effect of Health-Improving Workplace Environment on Promoting Physical Activity in White-Collar Employees: A Multi-Site Longitudinal Study Using Multi-Level Structural Equation Modeling.

PubMed

Watanabe, Kazuhiro; Otsuka, Yasumasa; Shimazu, Akihito; Kawakami, Norito

2016-02-01

This longitudinal study aimed to investigate the moderating effect of health-improving workplace environment on relationships between physical activity, self-efficacy, and psychological distress. Data were collected from 16 worksites and 129 employees at two time-points. Health-improving workplace environment was measured using the Japanese version of the Environmental Assessment Tool. Physical activity, self-efficacy, and psychological distress were also measured. Multi-level structural equation modeling was used to investigate the moderating effect of health-improving workplace environment on relationships between psychological distress, self-efficacy, and physical activity. Psychological distress was negatively associated with physical activity via low self-efficacy. Physical activity was negatively related to psychological distress. Physical activity/fitness facilities in the work environment exaggerated the positive relationship between self-efficacy and physical activity. Physical activity/fitness facilities in the workplace may promote employees' physical activity.

Exploring the mental health effects of political trauma with newly arrived refugees.

PubMed

Shannon, Patricia J; Wieling, Elizabeth; McCleary, Jennifer Simmelink; Becher, Emily

2015-04-01

We explored the mental health effects of war trauma and torture as described by 111 refugees newly arrived in the United States. We used ethnocultural methodologies to inform 13 culture-specific focus groups with refugees from Bhutan (34), Burma (23), Ethiopia (27), and Somalia (27). Contrary to the belief that stigma prevents refugees from discussing mental health distress, participants readily described complex conceptualizations of degrees of mental health distress informed by political context, observation of symptoms, cultural idioms, and functional impairment. Recommendations for health care providers include assessment processes that inquire about symptoms in their political context, the degree of distress as it is culturally conceptualized, and its effect on functioning. Findings confirm the cross-cultural recognition of symptoms associated with posttraumatic stress disorder; however, refugees described significant cultural variation in expressions of distress, indicating the need for more research on culture-bound disorders and idioms of distress. © The Author(s) 2014.

Effects of Psychological and Social Factors in Shiftwork on Symptoms of Anxiety and Depression in Nurses: A 1-Year Follow-Up.

PubMed

Berthelsen, Mona; Pallesen, Ståle; Magerøy, Nils; Tyssen, Reidar; Bjorvatn, Bjørn; Moen, Bente Elisabeth; Knardahl, Stein

2015-10-01

The aim of the current study was to elucidate prospective effects of both shift schedules and work environment on mental distress. A total of 2059 nurses participated at baseline (38.1%), and 1582 nurses completed wave 2 of the survey (76.8%). Psychosocial work factors were measured by the General Nordic Questionnaire for Psychological and Social factors at work and the Swedish Demand-Control-Support Questionnaire. Mental distress was measured by Hospital Anxiety and Depression Scale. Shiftwork was not associated with "caseness" anxiety or depression. Effects of shiftwork on mental distress were not moderated by psychosocial work factors. Mental distress predicted role clarity, role conflict, fair leadership, and social support. Job demands predicted symptoms of depression. Whether psychosocial working conditions buffer mental health effects of shiftwork remains undecided. Prospective studies with multiple measurement points are needed to elucidate potential mutual relationships between work factors and mental distress.

Effect of Audiovisual Distraction on Distress and Oxygenation Status in Children Receiving Aerosol Therapy.

PubMed

Shinta Devi, Ni Luh Putu; Nurhaeni, Nani; Hayati, Happy

Aerosol therapy, a treatment for children with disorders of the respiratory system, often causes distress, especially in young children. Distress during aerosol therapy can decrease the effectiveness of the treatment. This study aimed to determine the effect of audiovisual distraction on distress levels and oxygenation status (measured by oxygen saturation and respiratory frequency) in children who receive aerosol therapy for disorders of the respiratory system. A quasi-experimental design was employed, specifically a non-equivalent control group, pre-test-post-test design. The study sample consisted of 38 children who were divided into 2 groups (control and intervention), each group consisting of 19 children. The results of this study showed that there were significant differences in distress scores between the control group and the intervention group (p = .0001). There were also significant differences in the mean value changes in oxygenation status before and after intervention between the control and intervention groups. These findings could be used to prevent distress and increase oxygenation status in children who receive aerosol therapy.

Chronic exposure to adverse psychosocial work factors and high psychological distress among white-collar workers: A 5-year prospective study.

PubMed

Ndjaboue, Ruth; Brisson, Chantal; Talbot, Denis; Vézina, Michel

2017-03-01

Prospective studies which evaluated whether the effects of chronic exposure to psychosocial work factors on mental health persisted over time are scarce. For the first time, this study evaluated: 1) the effect of chronic exposure to effort-reward imbalance over 5years on the prevalence of high psychological distress among men and women, and 2) the persistence of this effect over time. Overall, 1747 white-collar workers from three public organizations participated in a prospective study. Psychological distress and effort-reward imbalance were measured using validated questionnaires at baseline, and at 3- and 5-year follow-ups. Prevalence ratios (PRs) of high psychological distress were estimated using log-binomial regression according to baseline and repeated exposure. Compared to unexposed workers, those with repeated exposure to effort-reward imbalance had a higher prevalence of high psychological distress. Workers exposed only at some time-points also had a higher prevalence. The deleterious effect of repeated exposure observed at the 3-year follow-up persisted at the 5-year follow-up among women (PR=2.48 95% confidence interval (CI) 1.97-3.11) and men (PR=1.91 95% CI 1.20-3.04). These effects were greater than those found using a single baseline measurement. The current study supported a deleterious effect of repeated exposure to effort-reward imbalance on psychological distress, and a lack of adaptation to these effects over time among men and women. Since psychological distress may later lead to severe mental problems, current results highlight the need to consider exposure to these adverse work factors in primary and secondary preventions aimed at reducing mental health problems at work. Copyright © 2017 Elsevier Inc. All rights reserved.

Psychological distress of adolescents exposed to Hurricane Hugo.

PubMed

Hardin, S B; Weinrich, M; Weinrich, S; Hardin, T L; Garrison, C

1994-07-01

To ascertain the effects of a natural disaster on adolescents, 1482 South Carolina high school students who were exposed to Hurricane Hugo were surveyed 1 year after the disaster. Subjects completed a self-administered questionnaire measuring Hugo exposure, nonviolent and violent life events, social support, self-efficacy, and psychological distress. Results showed that the students reported minimal exposure to the hurricane and psychological distress variables approximated national norms. As exposure increased, adolescents reported increased symptoms of psychological distress; i.e., anger, depression, anxiety, and global mental distress. Females and white students experienced higher levels of distress. In most cases, other stressful life events were at least as strong a predictor of psychological distress as was exposure to the hurricane. Self-efficacy and social support were protective.

Reversible pulmonary hypertension in a cat.

PubMed

Baron Toaldo, M; Guglielmini, C; Diana, A; Giunti, M; Dondi, F; Cipone, M

2011-05-01

A 13-year-old, neutered female domestic shorthair cat was presented for sudden respiratory distress following palliative radiotherapy and the combined administration of a single dose of carboplatin for the treatment of recurrent fibrosarcoma. Clinical and radiographic findings were suggestive of pleural effusion. Echocardiography revealed marked right-sided cardiac enlargement associated with tricuspid regurgitation and Doppler evidence of pulmonary hypertension. After 25 days of treatment for congestive heart failure and suspected pulmonary thromboembolism, clinical signs and echocardiographic and Doppler evidence of right-sided cardiac enlargement and pulmonary hypertension had completely resolved. To the best of the authors' knowledge, this is the first report of reversible pulmonary hypertension, likely secondary to pulmonary thromboembolism, in a cat. © 2011 British Small Animal Veterinary Association.

Maternal psychological distress and child decision-making.

PubMed

Flouri, Eirini; Ioakeimidi, Sofia; Midouhas, Emily; Ploubidis, George B

2017-08-15

There is much research to suggest that maternal psychological distress is associated with many adverse outcomes in children. This study examined, for the first time, if it is related to children's affective decision-making. Using data from 12,080 families of the Millennium Cohort Study, we modelled the effect of trajectories of maternal psychological distress in early-to-middle childhood (3-11 years) on child affective decision-making, measured with a gambling task at age 11. Latent class analysis showed four longitudinal types of maternal psychological distress (chronically high, consistently low, moderate-accelerating and moderate-decelerating). Maternal distress typology predicted decision-making but only in girls. Specifically, compared to girls growing up in families with never-distressed mothers, those exposed to chronically high maternal psychological distress showed more risk-taking, bet more and exhibited poorer risk-adjustment, even after correction for confounding. Most of these effects on girls' decision-making were not robust to additional controls for concurrent internalising and externalising problems, but chronically high maternal psychological distress was associated positively with risk-taking even after this adjustment. Importantly, this association was similar for those who had reached puberty and those who had not. Given the study design, causality cannot be inferred. Therefore, we cannot propose that treating chronic maternal psychological distress will reduce decision-making pathology in young females. Our study suggests that young daughters of chronically distressed mothers tend to be particularly reckless decision-makers. Copyright © 2017. Published by Elsevier B.V.

Association between age, distress, and orientations to happiness in individuals with disabilities.

PubMed

Terrill, Alexandra L; Müller, Rachel; Jensen, Mark P; Molton, Ivan R; Ipsen, Catherine; Ravesloot, Craig

2015-02-01

To determine how age and distress are associated in individuals with disabilities, and how happiness and its components (meaning, pleasure, and engagement) mediate or moderate this relationship. These were cross-sectional analyses of survey data from 508 community-dwelling adults with a variety of self-reported health conditions and functional disabilities. Measures included the Orientations to Happiness Questionnaire and items from the Behavior Risk Factor Surveillance System. Greater distress was associated with lower global happiness in both mediation and moderation models. The mediation model showed that middle-aged participants (age: 45-64) scored lowest in global happiness, and the effect of age on distress was partially mediated by happiness. None of the happiness components mediated the relationship of age on distress. The moderation model showed a significant interaction effect for age and global happiness on distress, where younger participants low on happiness were significantly more distressed. Of the three happiness components, only meaning was significantly associated with distress. There was a significant interaction between age and meaning, where participants who were younger and scored low on the meaning scale reported significantly higher distress. Findings from this study lay groundwork for the development of clinical interventions to address distress in individuals with functional disabilities. Middle-aged and younger people with disabilities may be particularly affected by lower levels of happiness and might benefit from psychological interventions that focus on increasing overall well-being and providing meaning and purpose in life. PsycINFO Database Record (c) 2015 APA, all rights reserved.

Risk and protective factors for psychological distress among adolescents: a family study in the Nord-Trøndelag Health Study.

PubMed

Myklestad, Ingri; Røysamb, Espen; Tambs, Kristian

2012-05-01

The study aimed to investigate potential adolescent and parental psychosocial risk and protective factors for psychological distress among adolescents and, in addition, to examine potential gender and age differences in the effects of risk factors on adolescent psychological distress. Data were collected among 8,984 Norwegian adolescents (13-19 years) and their parents in the Nord-Trøndelag Health Study (HUNT). The outcome measure was psychological distress (SCL-5). Bivariate regression analysis with generalized estimating equation (GEE) model showed that all parental self-reported variables (mental distress, substance use, social network, economic problems, unemployment and family structure) and adolescents' self-reported variables (leisure activities, social support from friends, school-related problems and substance use) were significantly associated with psychological distress among adolescents. Results revealed that in a multiple regression analysis with a GEE model, adolescent psychosocial variables, specifically academic-related problems and being bullied at school, emerged as the strongest predictors of psychological distress among adolescents after controlling for age, gender, and all parental and adolescent variables. The following psychosocial risk factors were significantly more important for girl's psychological distress compared to boys: problems with academic achievement, conduct problems in school, frequency of being drunk, smoking, dissatisfaction in school, living alone and seen parents being drunk. Academic achievement and being bullied at school were the psychosocial factors most strongly associated with psychological distress among adolescents. Parental factors had an indirect effect on adolescent psychological distress, through adolescents' psychosocial factors.

Effect of foot and hand massage in post-cesarean section pain control: a randomized control trial.

PubMed

Abbaspoor, Zahra; Akbari, Malihe; Najar, Shanaz

2014-03-01

One of the problems for mothers in the post-cesarean section period is pain, which disturbs the early relationship between mothers and newborns; timely pain management prevents the side effects of pain, facilitates the recovery of patient, reduces the costs of treatment by minimizing or eliminating the mother's distress, and increases mother-infant interactions. The aim of this study was to determine the effect of hand and foot massage on post-cesarean section pain. This study is a randomized and controlled trial which was performed in Mustafa Khomeini Hospital, Elam, Iran, April 1 to July 30, 2011; it was carried out on 80 pregnant women who had an elective cesarean section and met inclusion criteria for study. The visual analog scale was used to determine the pain intensity before, immediately, and 90 minutes after conducting 5 minutes of foot and hand massage. Vital signs were measured and recorded. The pain intensity was found to be reduced after intervention compared with the intensity before the intervention (p < .001). Also, there was a significant difference between groups in terms of the pain intensity and requests for analgesic (p < .001). According to these findings, the foot and hand massage can be considered as a complementary method to reduce the pain of cesarean section effectively and to decrease the amount of medications and their side effects. Copyright © 2014 American Society for Pain Management Nursing. Published by Elsevier Inc. 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.

Use of preoperative hypnosis to reduce postoperative pain and anesthesia-related side effects.

PubMed

Lew, Michael W; Kravits, Kathy; Garberoglio, Carlos; Williams, Anna Cathy

2011-01-01

The purpose of this pilot project was to test the feasibility of hypnosis as a preoperative intervention. The unique features of this study were: (a) use of a standardized nurse-delivered hypnosis protocol, (b) intervention administration immediately prior to surgery in the preoperative holding area, and (c) provision of hypnosis to breast cancer surgery patients receiving general anesthesia. A mixed-method design was used. Data collected from the intervention group and historical control group included demographics, symptom assessments, medication administration, and surgical, anesthesia, and recovery minutes. A semi-structured interview was conducted with the intervention group. A reduction in anxiety, worry, nervousness, sadness, irritability, and distress was found from baseline to postintervention while pain and nausea increased. The results support further exploration of the use of nurse-led preoperative hypnosis.

A safety review of the medications used to treat atopic dermatitis.

PubMed

Shukla, Shweta; Feldman, Steven R; Strowd, Lindsay C

2018-02-01

Atopic dermatitis (AD) is a common disease in children and adults which causes severe physical discomfort and psychosocial distress. Recently novel therapies for AD have been FDA approved for use which creates the need to review the safety surrounding current FDA approved AD medications. Areas covered: Published clinical studies involving topical and oral FDA approved medications for AD are included in this review. Authors used PubMed research database to search for clinical trials involving AD patients. Expert opinion: AD is a common disease which currently has limited FDA approved medications. Given the chronicity of this disease, medications are needed which control disease while minimizing side effects to allow for long term use. Newer approved medications show promise but safety data is limited given their relatively new utilization for AD.

Toxicological assessment of drugs that affect the endocrine system in puberty-related disorders.

PubMed

Maranghi, Francesca; Tassinari, Roberta; Mantovani, Alberto

2013-10-01

Toxicologists must ensure that clinical risk-to-benefit analysis should be made both for genders and age groups, with any treatment. Puberty concerns physiological changes leading to organism's maturation. Pubertal growth disorders are increasing in last decades: besides causing physical and psychological distress, they may signal underlying endocrine-metabolic abnormalities with serious health consequences later on. Therapeutic approaches for some health conditions in childhood and adolescence are considered. The authors discuss how some diseases and treatments can impact pubertal growth. The authors look at particular immunological disorders such as asthma and how both the disease and treatment affects pubertal growth. They also discuss how the provision of available data can help to assess the dose-response of the drug, in these cases, and minimize the chance of side effects. The authors also discuss pediatric inflammatory bowel disease and how both the disease and treatment can mitigate the growth delay. Last, but not least, the authors discuss how the effects of the drugs used in the treatment of psychiatric disorders may accentuate endocrine issues in juvenile patients. Hyperprolactinemia induction by some antipsychotics is highlighted as an example. Appropriate risk-benefit analysis of drugs prescribed during childhood and adolescence and intended to be used in the long term is required. Furthermore, future treatment strategies and safer compounds development should be supported by the knowledge of mechanisms underlying adverse side effects in pubertal growth and development.

Direct and moderating effects of community context on the psychological well-being of African American women.

PubMed

Cutrona, C E; Russell, D W; Hessling, R M; Brown, P A; Murry, V

2000-12-01

The effects of community characteristics on well-being were examined among 709 African American women. Direct and moderating effects of neighborhood characteristics on distress were tested. Aggregate-level ratings of neighborhood cohesion and disorder were significantly related to distress, although the relation between cohesion and distress became nonsignificant when individual risk factors were statistically controlled. Aggregate-level neighborhood variables interacted significantly with individual risk and resource variables in the prediction of distress, consistent with trait-situation interaction theories (D. Magnusson & N. S. Endler, 1977). Community cohesion intensified the benefits of a positive life outlook. Community disorder intensified both the benefits of personal resources and the detrimental effects of personal risk factors. Results showed evidence of resilience among African American women.

Direct and Moderating Effects of Community Context on the Psychological Well-Being of African American Women

PubMed Central

Cutrona, Carolyn E.; Russell, Daniel W.; Hessling, Robert M.; Brown, P. Adama; Murry, Velma

2007-01-01

The effects of community characteristics on well-being were examined among 709 African American women. Direct and moderating effects of neighborhood characteristics on distress were tested. Aggregate-level ratings of neighborhood cohesion and disorder were significantly related to distress, although the relation between cohesion and distress became nonsignificant when individual risk factors were statistically controlled. Aggregate-level neighborhood variables interacted significantly with individual risk and resource variables in the prediction of distress, consistent with trait-situation interaction theories (D. Magnusson & N. S. Endler, 1977). Community cohesion intensified the benefits of a positive life outlook. Community disorder intensified both the benefits of personal resources and the detrimental effects of personal risk factors. Results showed evidence of resilience among African American women. PMID:11138756

Virtual Reality as a Distraction Intervention to Relieve Pain and Distress During Medical Procedures: A Comprehensive Literature Review.

PubMed

Indovina, Paola; Barone, Daniela; Gallo, Luigi; Chirico, Andrea; De Pietro, Giuseppe; Antonio, Giordano

2018-02-26

This review aims to provide a framework for evaluating the utility of virtual reality (VR) as a distraction intervention to alleviate pain and distress during medical procedures. We firstly describe the theoretical bases underlying the VR analgesic and anxiolytic effects and define the main factors contributing to its efficacy, which largely emerged from studies on healthy volunteers. Then, we provide a comprehensive overview of the clinical trials using VR distraction during different medical procedures, such as burn injury treatments, chemotherapy, surgery, dental treatment, and other diagnostic and therapeutic procedures. A broad literature search was performed using as main terms "virtual reality", "distraction" and "pain". No date limit was applied and all the retrieved studies on immersive VR distraction during medical procedures were selected. VR has proven to be effective in reducing procedural pain, as almost invariably observed even in patients subjected to extremely painful procedures, such as patients with burn injuries undergoing wound care and physical therapy. Moreover, VR seemed to decrease cancer-related symptoms in different settings, including during chemotherapy. Only mild and infrequent side effects were observed. Despite these promising results, future long-term randomized controlled trials with larger sample sizes and evaluating not only self-report measures but also physiological variables are needed. Further studies are also required both to establish predictive factors to select patients who can benefit from VR distraction and to design hardware/software systems tailored to the specific needs of different patients and able to provide the greatest distraction at the lowest cost.

Keep your mind off negative things: coping with long-term effects of acute myeloid leukemia (AML).

PubMed

Ghodraty-Jabloo, Vida; Alibhai, Shabbir M H; Breunis, Henriette; Puts, Martine T E

2016-05-01

Acute myeloid leukemia (AML) is characterized by sudden onset, intensive treatment, a poor prognosis, and significant relapse risk. Quality of life (QOL) and well-being among AML survivors have been extensively studied during the 6 months of active treatment. However, it is not clear what survivors experience after active treatment. The purpose of our study was to explore how AML survivors describe their longer-term physical and psychosocial well-being and how they cope with these challenges. We conducted a prospective qualitative study and interviewed 19 adult participants (11 had completed treatment, 8 were receiving maintenance chemotherapy). Data were collected using semi-structured interviews that were audio-recorded and transcribed verbatim. The grounded theory approach was used for data analysis. A marked improvement in physical health was reported; however, psychosocial well-being was compromised by enduring emotional distress. A range of emotion- and problem-focused coping strategies were reported. Keeping one's mind off negative things through engaging in formal work or informal activities and seeking control were the two most commonly used coping strategies. Seeking social support for reassurance was also common. Problem-focused strategies were frequently described by the ongoing treatment group to manage treatment side effects. Although physical symptoms improved after completion of treatment, psychosocial distress persisted over longer period of time. In addition, essential needs of AML survivors shifted across survivorship as psychological burden gradually displaced physical concerns. The integral role of coping mechanisms in the adaptation process suggests a need for effective and ongoing psychological interventions.

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

Impact of Prophylactic Continuous Positive Airway Pressure on Transient Tachypnea of the Newborn and Neonatal Intensive Care Admission in Newborns Delivered by Elective Cesarean Section.

PubMed

Celebi, Miray Yilmaz; Alan, Serdar; Kahvecioglu, Dilek; Cakir, Ufuk; Yildiz, Duran; Erdeve, Omer; Arsan, Saadet; Atasay, Begum

2016-01-01

This study aims to evaluate the effect of the prophylactic continuous positive airway pressure (CPAP) administration in the delivery room to newborns who were delivered by elective cesarean section (CS). Inborn infants with gestational age between 34(0/7) to 38(6/7) and born by elective CS were prospectively randomized to receive either prophylactic CPAP for 20 minutes via face mask or standardized care without CPAP in the delivery room. Primary outcomes were the incidence of transient tachypnea of the newborn (TTN) and neonatal intensive care unit (NICU) admission due to respiratory distress. A total of 259 infants with a mean gestational age of 37.7 ± 0.8 weeks and birth weight of 3,244 ± 477 g were included. A total of 134 infants received prophylactic CPAP and 125 received control standard care. The rate of NICU admission was significantly lower in prophylactic CPAP group (p = 0.045). Although the rate of TTN was lower in the prophylactic CPAP group, the difference was not statistically significant (p = 0.059). The rate of NICU admission due to respiratory distress was significantly higher in late-preterm cohort than early-term cohort (p < 0.0001). Prophylactic CPAP administration decreases the rate of NICU admission without any side effect in late-preterm and early-term infants delivered by elective CS. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Vitiligo: concise evidence based guidelines on diagnosis and management.

PubMed

Gawkrodger, David J; Ormerod, Anthony D; Shaw, Lindsay; Mauri-Sole, Inma; Whitton, Maxine E; Watts, M Jane; Anstey, Alex V; Ingham, Jane; Young, Katharine

2010-08-01

Vitiligo is a common disease that causes a great degree of psychological distress. In its classical forms it is easily recognised and diagnosed. This review provides an evidence based outline of the management of vitiligo, particularly with the non-specialist in mind. Treatments for vitiligo are generally unsatisfactory. The initial approach to a patient who is thought to have vitiligo is to make a definite diagnosis, offer psychological support, and suggest supportive treatments such as the use of camouflage cosmetics and sunscreens, or in some cases after discussion the option of no treatment. Active therapies open to the non-specialist, after an explanation of potential side effects, include the topical use of potent or highly potent steroids or calcineurin inhibitors for a defined period of time (usually 2 months), following which an assessment is made to establish whether or not there has been a response. Patients whose condition is difficult to diagnose, unresponsive to straightforward treatments, or is causing psychological distress, are usually referred to a dermatologist. Specialist dermatology units have at their disposal phototherapy, either narrow band ultraviolet B or in some cases photochemotherapy, which is the most effective treatment presently available and can be considered for symmetrical types of vitiligo. Depigmenting treatments and possibly surgical approaches may be appropriate for vitiligo in selected cases. There is no evidence that presently available systemic treatments are helpful and safe in vitiligo. There is a need for further research into the causes of vitiligo, and into discovering better treatments.

History of macrolide use in pediatrics.

PubMed

Klein, J O

1997-04-01

Erythromycin, the prototypical macrolide, has been widely used since the 1950s in the management of pediatric infections. Erythromycin is the drug of choice for infants and children with Legionnaire's disease, pertussis, diphtheria, lower respiratory tract infections caused by Mycoplasma pneumoniae, Chlamydia pneumoniae and Chlamydia trachomatis and enteritis caused by Campylobacter jejuni. It is also indicated for treatment of syphilis; for streptococcal, staphylococcal and pneumococcal infections; genital infections caused by Ureaplasma urealyticum; and for the prevention of rheumatic fever and endocarditis in patients who are allergic to beta-lactam antibiotics. The new macrolides azithromycin and clarithromycin are also active against Borrelia burgdorferi, Helicobacter pylori, Mycobacterium avium-intracellulare complex, Cryptosporidium spp. and Toxoplasma gondii. Erythromycin is associated with a low risk of serious side effects, although gastric distress occurs in a significant proportion of patients. Drug interactions with theophylline, carbamazepine, warfarin, cyclosporine, terfenadine and digoxin limit erythromycin use. The newer macrolides azithromycin and clarithromycin are more stable, better absorbed and better tolerated than erythromycin. Azithromycin is more active than erythromycin against Haemophilus influenzae. Excellent tissue and intracellular penetration may contribute to their clinical efficacy. In children both azithromycin and clarithromycin are indicated for acute otitis media caused by Streptococcus pneumoniae, H. influenzae and Moraxella catarrhalis and for pharyngitis/tonsillitis caused by Streptococcus pyogenes. (As of December, 1996, azithromycin for oral suspension was approved for community-acquired pneumonia in children caused by C. pneumoniae, H. influenzae, M. pneumoniae and S. pneumoniae.) Claritromycin is also indicated for acute maxillary sinusitis, uncomplicated skin and skin structure infections, pneumonia and disseminated mycobacterial infections. Azithromycin and clarithromycin are associated with a lower incidence of gastrointestinal side effects, a low rate of drug discontinuation caused by side effects and a low potential for interaction with other drugs.

Predicting Retrograde Autobiographical Memory Changes Following Electroconvulsive Therapy: Relationships between Individual, Treatment, and Early Clinical Factors.

PubMed

Martin, Donel M; Gálvez, Verònica; Loo, Colleen K

2015-06-19

Loss of personal memories experienced prior to receiving electroconvulsive therapy is common and distressing and in some patients can persist for many months following treatment. Improved understanding of the relationships between individual patient factors, electroconvulsive therapy treatment factors, and clinical indicators measured early in the electroconvulsive therapy course may help clinicians minimize these side effects through better management of the electroconvulsive therapy treatment approach. In this study we examined the associations between the above factors for predicting retrograde autobiographical memory changes following electroconvulsive therapy. Seventy-four depressed participants with major depressive disorder were administered electroconvulsive therapy 3 times per week using either a right unilateral or bitemporal electrode placement and brief or ultrabrief pulse width. Verbal fluency and retrograde autobiographical memory (assessed using the Columbia Autobiographical Memory Interview - Short Form) were tested at baseline and after the last electroconvulsive therapy treatment. Time to reorientation was measured immediately following the third and sixth electroconvulsive therapy treatments. Results confirmed the utility of measuring time to reorientation early during the electroconvulsive therapy treatment course as a predictor of greater retrograde amnesia and the importance of assessing baseline cognitive status for identifying patients at greater risk for developing later side effects. With increased number of electroconvulsive therapy treatments, older age was associated with increased time to reorientation. Consistency of verbal fluency performance was moderately correlated with change in Columbia Autobiographical Memory Interview - Short Form scores following right unilateral electroconvulsive therapy. Electroconvulsive therapy treatment techniques associated with lesser cognitive side effects should be particularly considered for patients with lower baseline cognitive status or older age. © The Author 2015. Published by Oxford University Press on behalf of CINP.

Predicting Retrograde Autobiographical Memory Changes Following Electroconvulsive Therapy: Relationships between Individual, Treatment, and Early Clinical Factors

PubMed Central

Gálvez, Verònica; Loo, Colleen K.

2015-01-01

Background: Loss of personal memories experienced prior to receiving electroconvulsive therapy is common and distressing and in some patients can persist for many months following treatment. Improved understanding of the relationships between individual patient factors, electroconvulsive therapy treatment factors, and clinical indicators measured early in the electroconvulsive therapy course may help clinicians minimize these side effects through better management of the electroconvulsive therapy treatment approach. In this study we examined the associations between the above factors for predicting retrograde autobiographical memory changes following electroconvulsive therapy. Methods: Seventy-four depressed participants with major depressive disorder were administered electroconvulsive therapy 3 times per week using either a right unilateral or bitemporal electrode placement and brief or ultrabrief pulse width. Verbal fluency and retrograde autobiographical memory (assessed using the Columbia Autobiographical Memory Interview – Short Form) were tested at baseline and after the last electroconvulsive therapy treatment. Time to reorientation was measured immediately following the third and sixth electroconvulsive therapy treatments. Results: Results confirmed the utility of measuring time to reorientation early during the electroconvulsive therapy treatment course as a predictor of greater retrograde amnesia and the importance of assessing baseline cognitive status for identifying patients at greater risk for developing later side effects. With increased number of electroconvulsive therapy treatments, older age was associated with increased time to reorientation. Consistency of verbal fluency performance was moderately correlated with change in Columbia Autobiographical Memory Interview – Short Form scores following right unilateral electroconvulsive therapy. Conclusions: Electroconvulsive therapy treatment techniques associated with lesser cognitive side effects should be particularly considered for patients with lower baseline cognitive status or older age. PMID:26091817

Buffering effect of workplace social capital on the association of job insecurity with psychological distress in Japanese employees: a cross-sectional study.

PubMed

Inoue, Akiomi; Kawakami, Norito; Eguchi, Hisashi; Tsutsumi, Akizumi

2016-09-30

The present study aimed to examine the buffering effect of workplace social capital (WSC) on the association of job insecurity with psychological distress in Japanese employees. 2,971 employees from two factories of a manufacturing company in Japan completed a self-administered questionnaire including the scales on job insecurity, WSC, psychological distress, demographic and occupational characteristics, and quantitative workload. Using psychological distress (defined as a total score of the K6 scale ≥5) as a dependent variable, multiple logistic regression analyses were conducted. In a series of analyses, interaction term of job insecurity×WSC was included in the model. After adjusting for demographic and occupational characteristics as well as for quantitative workload and interaction effect of quantitative workload×WSC, high job insecurity and low WSC were significantly associated with psychological distress. Furthermore, a significant interaction effect of job insecurity×WSC was observed. Specifically, the association of job insecurity with psychological distress was greater among those who perceived lower levels of WSC (prevalence odds ratio=3.79 [95% confidence interval=2.70-5.32] for high vs. low job insecurity subgroup) than among those who perceived higher levels of WSC (prevalence odds ratio=2.96 [95% confidence interval=2.19-4.01] for high vs. low job insecurity subgroup). These findings were replicated among permanent male employees in the gender-stratified analyses. The present study suggests that WSC has a buffering effect on the association of job insecurity with psychological distress at least among Japanese permanent male employees.

Buffering effect of workplace social capital on the association of job insecurity with psychological distress in Japanese employees: a cross-sectional study

PubMed Central

Inoue, Akiomi; Kawakami, Norito; Eguchi, Hisashi; Tsutsumi, Akizumi

2016-01-01

Objectives: The present study aimed to examine the buffering effect of workplace social capital (WSC) on the association of job insecurity with psychological distress in Japanese employees. Methods: 2,971 employees from two factories of a manufacturing company in Japan completed a self-administered questionnaire including the scales on job insecurity, WSC, psychological distress, demographic and occupational characteristics, and quantitative workload. Using psychological distress (defined as a total score of the K6 scale ≥5) as a dependent variable, multiple logistic regression analyses were conducted. In a series of analyses, interaction term of job insecurity×WSC was included in the model. Results: After adjusting for demographic and occupational characteristics as well as for quantitative workload and interaction effect of quantitative workload×WSC, high job insecurity and low WSC were significantly associated with psychological distress. Furthermore, a significant interaction effect of job insecurity×WSC was observed. Specifically, the association of job insecurity with psychological distress was greater among those who perceived lower levels of WSC (prevalence odds ratio=3.79 [95% confidence interval=2.70-5.32] for high vs. low job insecurity subgroup) than among those who perceived higher levels of WSC (prevalence odds ratio=2.96 [95% confidence interval=2.19-4.01] for high vs. low job insecurity subgroup). These findings were replicated among permanent male employees in the gender-stratified analyses. Conclusions: The present study suggests that WSC has a buffering effect on the association of job insecurity with psychological distress at least among Japanese permanent male employees. PMID:27488045

Health services utilization of women following a traumatic birth.

PubMed

Turkstra, E; Creedy, D K; Fenwick, J; Buist, A; Scuffham, P A; Gamble, J

2015-12-01

This cohort study compared 262 women with high childbirth distress to 138 non-distressed women. At 12 months, high distress women had lower health-related quality of life compared to non-distressed women (EuroQol five-dimensional (EQ-5D) scale 0.90 vs. 0.93, p = 0.008), more visits to general practitioners (3.5 vs. 2.6, p = 0.002) and utilized more additional services (e.g. maternal health clinics), with no differences for infants. Childbirth distress has lasting adverse health effects for mothers and increases health-care utilization.

Side-to-Side Tracheobronchoplasty to Reconstruct Complex Congenital Tracheobronchial Stenosis.

PubMed

Ragalie, William S; Chun, Robert H; Martin, Timothy; Ghanayem, Nancy S; Berens, Richard J; Beste, David J; Mitchell, Michael E

2017-08-01

Long segment tracheobronchial stenosis is a rare congenital anomaly that can also occur in combination with abnormal bronchial arborization. Long segment tracheal reconstruction in the setting of a supernumerary bridging bronchus has been reported; however, these repairs can be particularly complex. We present our experience using the bridging bronchus to augment long segment tracheal stenosis with a side-to-side tracheobronchoplasty. Four patients with complex long segment tracheobronchial stenosis involving a bronchus suis (right upper lobe bronchus) and a bridging bronchus presented with refractory respiratory distress requiring urgent tracheal reconstruction. Patient 1 was initially managed with modified slide tracheoplasty and tracheostomy. Patients 2, 3, and 4 were managed with single-stage procedures. All patients underwent definitive long segment tracheobronchoplasty consisting of a side-to-side anastomosis between the bridging bronchus and the right upper lobe bronchus. Age at surgery was 569, 69, 24, and 142 days, respectively. Weight at surgery was 9.3, 4.3, 2.7, and 5.9 kg. All patients were weaned from mechanical ventilation at 84, 13, 47, and 8 days after side-to-side tracheobronchoplasty. All patients were alive and free from tracheostomy at follow-up of 6.7, 3.8, 2.7, and 0.5 years. Side-to-side tracheal reconstruction is feasible in severe cases of long segment tracheal stenosis with a right upper lobe bronchus and a bridging bronchus. This technique can be successfully applied in high-risk patients and in the neonatal period and can provide excellent midterm results. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Quality of life differences in patients with right- versus left-sided facial paralysis: Universal preference of right-sided human face recognition.

PubMed

Ryu, Nam Gyu; Lim, Byung Woo; Cho, Jae Keun; Kim, Jin

2016-09-01

We investigated whether experiencing right- or left-sided facial paralysis would affect an individual's ability to recognize one side of the human face using hybrid hemi-facial photos by preliminary study. Further investigation looked at the relationship between facial recognition ability, stress, and quality of life. To investigate predominance of one side of the human face for face recognition, 100 normal participants (right-handed: n = 97, left-handed: n = 3, right brain dominance: n = 56, left brain dominance: n = 44) answered a questionnaire that included hybrid hemi-facial photos developed to determine decide superiority of one side for human face recognition. To determine differences of stress level and quality of life between individuals experiencing right- and left-sided facial paralysis, 100 patients (right side:50, left side:50, not including traumatic facial nerve paralysis) answered a questionnaire about facial disability index test and quality of life (SF-36 Korean version). Regardless of handedness or hemispheric dominance, the proportion of predominance of the right side in human face recognition was larger than the left side (71% versus 12%, neutral: 17%). Facial distress index of the patients with right-sided facial paralysis was lower than that of left-sided patients (68.8 ± 9.42 versus 76.4 ± 8.28), and the SF-36 scores of right-sided patients were lower than left-sided patients (119.07 ± 15.24 versus 123.25 ± 16.48, total score: 166). Universal preference for the right side in human face recognition showed worse psychological mood and social interaction in patients with right-side facial paralysis than left-sided paralysis. This information is helpful to clinicians in that psychological and social factors should be considered when treating patients with facial-paralysis. Copyright © 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Pre-Hurricane Perceived Social Support Protects Against Psychological Distress: A Longitudinal Analysis of Low-Income Mothers

PubMed Central

Lowe, Sarah R.; Chan, Christian S.; Rhodes, Jean E.

2013-01-01

Objective In this study, we examined the influence of pre-disaster perceived social support on post-disaster psychological distress among survivors of Hurricane Katrina. Method Participants (N = 386) were low-income mothers between 18 and 34 years of age at baseline (M = 26.4, SD = 4.43). The majority (84.8%) was African American; 10.4% identified as Caucasian, 3.2% identified as Hispanic, and 1.8% identified as other. Participants were enrolled in an educational intervention study in 2004 and 2005. Those who had completed a 1-year follow-up assessment prior to Hurricane Katrina were reassessed approximately 1 year after the hurricane. Measures of perceived social support and psychological distress were included in pre-and post-disaster assessments. Using structural equation modeling and multiple mediator analysis, we tested a model wherein pre-disaster perceived social support predicted post-disaster psychological distress both directly and indirectly through its effects on pre-disaster psychological distress, exposure to hurricane-related stressors, and post-disaster perceived social support. We predicted that higher pre-disaster perceived social support would be predictive of lower pre-disaster psychological distress, lower hurricane-related stressors, and higher post-disaster perceived social support, and that these variables would, in turn, predict lower post-disaster psychologically distress. Results Our analyses provide partial support for the hypothesized model. Although pre-disaster perceived social support did not exert a direct effect on post-disaster psychological distress, the indirect effects of all 3 proposed mediators were significant. Conclusions Pre-disaster social support can decrease both exposure to natural disasters and the negative psychological effects of natural disaster exposure. These findings underscore the importance of bolstering the post-disaster social support networks of low-income mothers. PMID:20658811

Examining the mediating effect of work-to-family conflict on the associations between job stressors and employee psychological distress: a prospective cohort study

PubMed Central

Oshio, Takashi; Inoue, Akiomi; Tsutsumi, Akizumi

2017-01-01

Objectives The mediating effect of work-to-family conflict (WFC) on the associations between eight types of job stressors (measured based on the job demands-control, effort–reward imbalance and organisational justice models) and psychological distress in employees was examined. Design This study employed a prospective design. Setting An occupational cohort study in Japan (Japanese Study of Health, Occupation, and Psychosocial Factors Related Equity; J-HOPE). Participants 5859 men and 1560 women who were working for 11 firms and participated at three consecutive waves of J-HOPE, at 1-year intervals, from 2010 to 2013. Main outcome measures Psychological distress, as measured by Kessler 6 scores. Results Mediation analysis using data on job stressors at baseline, WFC at 1-year follow-up and psychological distress at 2-year follow-up showed that WFC mediated 39.1% (95% CI 29.1% to 49.1%) and 44.5% (95% CI 31.4% to 51.7%) of the associations of psychological distress with job demands and effort, respectively, for men. The mediating effect of WFC was smaller for job stressors indicating reduced job resources, compared with job demands and effort. The mediating effect of WFC was somewhat larger for women than it was for men, with WFC mediating 47.5% (95% CI 22.5% to 72.6%) and 64.0% (95% CI 24.3% to 100.0%) of the associations of psychological distress with job demands and effort, respectively. Conclusions WFC was a key mediator in the associations between most job stressors and employee psychological distress. Results suggest that policy measures and support from supervisors, to prevent job stressors from adding to WFC, are needed to reduce employee psychological distress. PMID:28775183

Effects of a randomized exercise trial on physical activity, psychological distress and quality of life in older adults.

PubMed

Awick, Elizabeth A; Ehlers, Diane K; Aguiñaga, Susan; Daugherty, Ana M; Kramer, Arthur F; McAuley, Edward

2017-11-01

Evidence suggests improvements in positive psychological health indices (e.g., self-esteem) may explain the relationship between physical activity and quality of life (QoL) in older adults. Less is known about the role of reductions in negative psychological health indices (e.g., depression). The present study examined the effects of changes in moderate-to-vigorous physical activity (MVPA) and psychological distress on change in QoL in older adults enrolled in an exercise program. Older adults (N=247, Mage=65.68±4.59) participated in a six-month randomized exercise trial. Participants wore accelerometers and completed questionnaires to measure MVPA, psychological health, and QoL at baseline and post-intervention. Psychological distress was modeled as a latent factor comprised of anxiety, depression, sleep dysfunction, and stress. Structural models were used to examine the effects of changes in MVPA and distress on change in QoL. Increases in MVPA predicted reductions in distress from baseline to post-intervention (B=-0.10, p=0.05). In turn, reductions in distress predicted increases in QoL (B=-0.51, p=0.001). The indirect effect of MVPA on QoL through distress was also significant (p=0.05; 90% CI=0.005, 0.125). Findings extend previous research on the mediators of the MVPA-QoL relationship in older adults, suggesting reductions in negative psychological health outcomes may also mediate this pathway. Copyright © 2017 Elsevier Inc. All rights reserved.

Mindfulness-based stress reduction added to care as usual for lung cancer patients and/or their partners: A multicentre randomized controlled trial.

PubMed

Schellekens, M P J; van den Hurk, D G M; Prins, J B; Donders, A R T; Molema, J; Dekhuijzen, R; van der Drift, M A; Speckens, A E M

2017-12-01

Lung cancer patients report among the highest distress rates of all cancer patients. Partners report similar distress rates. The present study examined the effectiveness of additional mindfulness-based stress reduction (care as usual [CAU] + MBSR) versus solely CAU to reduce psychological distress in lung cancer patients and/or their partners. We performed a multicentre, parallel-group, randomized controlled trial. Mindfulness-based stress reduction is an 8-week group-based intervention, including mindfulness practice and teachings on stress. Care as usual included anticancer treatment, medical consultations, and supportive care. The primary outcome was psychological distress. Secondary outcomes included quality of life, caregiver burden, relationship satisfaction, mindfulness skills, self-compassion, rumination, and posttraumatic stress symptoms. Outcomes were assessed at baseline, post-intervention, and 3-month follow-up. Linear mixed modeling was conducted on an intention-to-treat sample. Moderation (gender, disease stage, baseline distress, participation with/without partner) and mediation analyses were performed. A total of 31 patients and 21 partners were randomized to CAU + MBSR and 32 patients and 23 partners to CAU. After CAU + MBSR patients reported significantly less psychological distress (p = .008, d = .69) than after CAU. Baseline distress moderated outcome: those with more distress benefitted most from MBSR. Additionally, after CAU + MBSR patients showed more improvements in quality of life, mindfulness skills, self-compassion, and rumination than after CAU. In partners, no differences were found between groups. Our findings suggest that psychological distress in lung cancer patients can be effectively treated with MBSR. No effect was found in partners, possibly because they were more focused on patients' well-being rather than their own. Copyright © 2017 John Wiley & Sons, Ltd.

Distress among young adult cancer survivors: a cohort study.

PubMed

Yanez, Betina; Garcia, Sofia F; Victorson, David; Salsman, John M

2013-09-01

Being diagnosed with cancer as a young adult can lead to significant psychological distress and impaired quality of life. Compared to children and older adults diagnosed with cancer, fewer studies have addressed psychological distress among young adult cancer survivors. This study sought to identify the prevalence of, and factors associated with, distress among young adult cancer survivors (ages 18-39). Young adult cancer survivors (N = 335, mean age = 31.8, women = 68.4%) were recruited from an online research panel and stratified by cohort (time postactive treatment: 0-12, 13-24, and 25-60 months). Participants completed measures assessing demographic and clinical characteristics, global impact of cancer, cancer-related education and work interruption, and cancer-specific distress using the impact of event scale (IES). The mean score on the IES (M = 31.0, range = 0-75) was above the cut point of 20, suggesting clinically elevated distress. Analysis of covariance revealed significant main effects for cohort, global impact and cancer-related education/work interruption, and an interaction between cohort and cancer-related education/work interruption on distress. Although there was no significant effect of education/work interruption on distress for those in the 0-12 month cohort (p = .88), survivors in the 13-24 and 25-60 month cohorts reporting education/work interruption were significantly more distressed than those not reporting education/work interruption in the respective cohorts (p < .05). Young adult cancer survivors face unique challenges. These data underscore the importance of attending to cancer-related distress beyond the completion of treatment and may help inform targeted interventions to prevent or reduce significant distress and related sequelae in this population.

Perfectionism, procrastination, and psychological distress.

PubMed

Rice, Kenneth G; Richardson, Clarissa M E; Clark, Dustin

2012-04-01

Using a cross-panel design and data from 2 successive cohorts of college students (N = 357), we examined the stability of maladaptive perfectionism, procrastination, and psychological distress across 3 time points within a college semester. Each construct was substantially stable over time, with procrastination being especially stable. We also tested, but failed to support, a mediational model with Time 2 (mid-semester) procrastination as a hypothesized mechanism through which Time 1 (early-semester) perfectionism would affect Time 3 (end-semester) psychological distress. An alternative model with Time 2 perfectionism as a mediator of the procrastination-distress association also was not supported. Within-time analyses revealed generally consistent strength of effects in the correlations between the 3 constructs over the course of the semester. A significant interaction effect also emerged. Time 1 procrastination had no effect on otherwise high levels of psychological distress at the end of the semester for highly perfectionistic students, but at low levels of Time 1 perfectionism, the most distressed students by the end of the term were those who were more likely to have procrastinated earlier in the semester. Implications of the stability of the constructs and their association over time, as well as the moderating effects of procrastination, are discussed in the context of maladaptive perfectionism and problematic procrastination.

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.

Pokémon GO and psychological distress, physical complaints, and work performance among adult workers: a retrospective cohort study.

PubMed

Watanabe, Kazuhiro; Kawakami, Norito; Imamura, Kotaro; Inoue, Akiomi; Shimazu, Akihito; Yoshikawa, Toru; Hiro, Hisanori; Asai, Yumi; Odagiri, Yuko; Yoshikawa, Etsuko; Tsutsumi, Akizumi

2017-09-07

The effects of Pokémon GO, a new mobile game application which utilizes augmented reality, on risky behavior and health have already been discussed in anecdotal evidence. However, there have been no studies about its effects on mental health. This study investigated the relationships between Pokémon GO and psychological distress from an existing workers' cohort in Japan. Online surveys were conducted to 3,915 full-time workers, at baseline (Nov 26, 2015-Feb 18, 2016) and at follow-up (Dec 1-4, 2016), using a self-report questionnaire. Pokémon GO players were defined as participants who had played Pokémon GO for one month or longer. Psychological distress was measured using validated scales. Of the completers, 246 (9.7%) had continued to play Pokémon GO. They were significantly younger than non-players. From the results of the general linear modeling, improvement in psychological distress was significantly greater among Pokémon GO players than among non-players (p = 0.025). Cohen's d for the difference in psychological distress was -0.20 (95% CI, -0.33, -0.07). Pokémon GO may be effective for improving psychological distress among workers. Although its effect size is small, the game could have positive effects on the mental health of the adult working population.

Training Resident Assistants to Make Effective Referrals to Counseling

ERIC Educational Resources Information Center

Taub, Deborah J.; Servaty-Seib, Heather L.

2011-01-01

Increasing numbers of college and university students are experiencing psychological distress, including depression, anxiety, and suicide ideation. Yet students in distress are unlikely to seek counseling services. Resident assistants (RAs) can serve an important function in identifying and referring students in distress. However, adequate…

Main and interactive effects of a nonclinical panic attack history and distress tolerance in relation to PTSD symptom severity.

PubMed

Marshall-Berenz, Erin C; Vujanovic, Anka A; Zvolensky, Michael J

2011-03-01

The current study investigated the main and interactive effects of a nonclinical panic attack history and distress tolerance in relation to PTSD symptoms. The sample consisted of 91 adults (62.6% women; M(age)=23.45, SD=9.56) who met DSM-IV criteria for trauma exposure, 53.8% of whom met criteria for a recent (past 2 years) history of nonclinical panic attacks. Results indicated that distress tolerance, as measured by the Distress Tolerance Scale (Simons & Gaher, 2005), was significantly related to all PTSD symptom clusters, and a nonclinical panic attack history was significantly related to PTSD re-experiencing and hyperarousal symptoms. The interaction of a nonclinical panic attack history and distress tolerance significantly predicted unique variance in only PTSD hyperarousal symptoms. Implications and future directions are discussed for the role of nonclinical panic attacks and distress tolerance in PTSD symptom expression. Copyright © 2010 Elsevier Ltd. All rights reserved.

Outcomes of mandated treatment for women with histories of abuse and co-occurring disorders.

PubMed

Clark, Colleen; Young, M Scott

2009-12-01

Although there is much momentum for behavioral health policies supporting mandated treatment, there is little evidence supporting its safety and effectiveness for individuals with complex issues. The authors used a national study of women with co-occurring psychiatric, substance use disorders and histories of trauma to compare mandated and voluntary treatment by examining psychiatric, substance use, and trauma-related outcomes following treatment. This quasi-experimental study included 2,726 women, with measures completed at baseline, 6-month, and 12-month follow-up. Two-way analyses of covariance examined the main and interactive effects of coercive status (mandated vs. voluntary) and condition (integrated treatment vs. services as usual) on psychiatric distress, trauma-related symptoms, and substance use outcomes. Women did better with integrated treatment and with mandated treatment regardless of treatment condition for psychiatric, trauma, and substance use outcomes at both follow-ups. Further research clarifying unintended side effects and change mechanisms of mandated treatment is needed to inform policy decisions.

The influence of music during mechanical ventilation and weaning from mechanical ventilation: A review

PubMed Central

Hetland, Breanna; Lindquist, Ruth; Chlan, Linda L.

2015-01-01

Background Mechanical ventilation (MV) causes many distressing symptoms. Weaning, the gradual decrease in ventilator assistance leading to termination of MV, increases respiratory effort, which may exacerbate symptoms and prolong MV. Music, a non-pharmacological intervention without side effects may benefit patients during weaning from mechanical ventilatory support. Methods A narrative review of OVID Medline, PsychINFO, and CINAHL databases was conducted to examine the evidence for the use of music intervention in MV and MV weaning. Results Music intervention had a positive impact on ventilated patients; 16 quantitative and 2 qualitative studies were identified. Quantitative studies included randomized clinical trials (10), case controls (3), pilot studies (2) and a feasibility study. Conclusions Evidence supports music as an effective intervention that can lesson symptoms related to MV and promote effective weaning. It has potential to reduce costs and increase patient satisfaction. However, more studies are needed to establish its use during MV weaning. PMID:26227333

Financial strain and birth weight: the mediating role of psychological distress.

PubMed

Mitchell, Amanda M; Christian, Lisa M

2017-02-01

The effects of financial strain during pregnancy have received limited attention. In addition, data examining the pathways by which SES indicators contribute to birth weight are lacking. The objective of the current study was to examine the potential pathway of psychological distress in the relationship between financial strain and birth weight. Participants consisted of 138 pregnant women who completed measures assessing financial strain, depressive symptoms, pregnancy-specific distress, perceived stress, and general anxiety during pregnancy (mean gestational age = 18.5, SD = 7.2). Birth outcome data were obtained via medical record review. Simple and parallel mediation models were conducted using PROCESS. Simple mediation models showed that depressive symptoms (95% CI -24.65, -0.90) and pregnancy-specific distress (95% CI -37.31, -5.91), but not perceived stress (95% CI -31.17, 4.69) or anxiety (95% CI -25.84, 5.57), served as mediators in the relationship between financial strain and birth weight. When depressive symptoms and pregnancy-specific distress were included in the same mediation model, only pregnancy-specific distress remained significant. Financial strain was positively associated with all facets of psychological distress and negatively associated with birth weight during pregnancy. The current study demonstrated the mechanistic role of pregnancy-specific distress in the link between financial strain and birth weight in a racially diverse sample. Interventions targeting pregnancy-specific distress may mitigate the effects of financial strain on birth weight. Studies examining whether pregnancy-specific distress accounts for the relationship between other types of stressor exposures and birth weight would be informative.

Dynamic Indices of Methamphetamine Dependence and HIV Infection Predict Fluctuations in Affective Distress: A Five-year Longitudinal Analysis

PubMed Central

Montoya, Jessica L.; Umlauf, Anya; Abramson, Ian; Badiee, Jayraan; Woods, Steven Paul; Atkinson, J. Hampton; Grant, Igor; Moore, David J.

2013-01-01

Background Methamphetamine (METH) use and human immunodeficiency virus (HIV) infection are highly comorbid, and both are associated with increased prevalence of affective distress. Delineating the trajectory of affective distress in the context of METH dependence and HIV infection is important given the implications for everyday functional impairment, adverse health behaviors, and increased risk for adverse health outcomes. Methods We conducted a five-year longitudinal investigation involving 133 METH-dependent (74 HIV seropositive) and 163 non-METH-dependent (90 HIV seropositive) persons to examine both long-standing patterns and transient changes in affective distress. Mixed-effect regression models with random subject-specific slopes and intercepts evaluated the effect of METH dependence, HIV serostatus, and related variables on affective distress, as measured by the Profile of Mood States. Results Transient changes in affective distress were found to be greater among those with a diagnosis of current MDD, briefer durations of abstinence from METH, and higher quantity of METH consumed. Weak associations were observed among static (time-independent predictors) covariates and long-standing patterns in affective distress. Limitations Study lacked data pertaining to the participants’ involvement in METH treatment and relied on respondent-driven sampling. Conclusions Our longitudinal investigation of the trajectory of affective distress indicated that specific and dynamic indices of current METH use were associated with greater transient changes in mood. In the evaluation and treatment of affective distress, recency and quantity of current METH use are important to consider given their association with heightened affective distress and mood instability over time. PMID:24012068

Dynamic indices of methamphetamine dependence and HIV infection predict fluctuations in affective distress: a five-year longitudinal analysis.

PubMed

Montoya, Jessica L; Umlauf, Anya; Abramson, Ian; Badiee, Jayraan; Woods, Steven Paul; Atkinson, J Hampton; Grant, Igor; Moore, David J

2013-11-01

Methamphetamine (METH) use and human immunodeficiency virus (HIV) infection are highly comorbid, and both are associated with increased prevalence of affective distress. Delineating the trajectory of affective distress in the context of METH dependence and HIV infection is important given the implications for everyday functional impairment, adverse health behaviors, and increased risk for adverse health outcomes. We conducted a five-year longitudinal investigation involving 133 METH-dependent (74 HIV seropositive) and 163 non-METH-dependent (90 HIV seropositive) persons to examine both long-standing patterns and transient changes in affective distress. Mixed-effect regression models with random subject-specific slopes and intercepts evaluated the effect of METH dependence, HIV serostatus, and related variables on affective distress, as measured by the Profile of Mood States. Transient changes in affective distress were found to be greater among those with a diagnosis of current MDD, briefer durations of abstinence from METH, and higher quantity of METH consumed. Weak associations were observed among static (time-independent predictors) covariates and long-standing patterns in affective distress. Study lacked data pertaining to the participants' involvement in METH treatment and relied on respondent-driven sampling. Our longitudinal investigation of the trajectory of affective distress indicated that specific and dynamic indices of current METH use were associated with greater transient changes in mood. In the evaluation and treatment of affective distress, recency and quantity of current METH use are important to consider given their association with heightened affective distress and mood instability over time. © 2013 Elsevier B.V. All rights reserved.

Psychosocial factors and caregivers' distress: effects of familism and dysfunctional thoughts.

PubMed

Losada, Andres; Marquez-Gonzalez, Maria; Knight, Bob G; Yanguas, Javier; Sayegh, Philip; Romero-Moreno, Rosa

2010-03-01

Caring for a relative with dementia is linked with negative psychological and physical consequences for the caregiver. The number of studies analyzing the influence of specific values and thoughts on caregivers' distress remains sparse. The aim of this study is to analyze the influence of both familism dimensions and dysfunctional thoughts specific to caregiving on depression in a sample of 334 dementia caregivers. The results of this study suggest that familism can have positive influences on caregiving distress when the family is perceived as a source of support. However, the dimensions of familism pertaining to a strong adherence to values regarding both feelings of obligation to provide support as well as behaviors and attitudes that should be followed by different members of a family were linked with caregivers' distress through their influence on dysfunctional thoughts. This study provides support for the importance of conceptualizing familism as a multidimensional construct with both positive and negative effects on caregivers' emotional distress and suggests that familism affects emotional distress through dysfunctional thoughts rather than through burden appraisals. Clinical implications include attending to both the positive and negative effects of familism values and the potential value of targeting dysfunctional thoughts in cognitive-behavioral interventions with caregivers.

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.

[The effect of "hospital clowns" on distress and maladaptive behaviours of children who are undergoing minor surgery].

PubMed

Meisel, Victoria; Chellew, Karin; Ponsell, Esperança; Ferreira, Ana; Bordas, Leonor; García-Banda, Gloria

2009-11-01

The presence of clowns in health care settings is a program used in many countries to reduce distress in children who are undergoing surgery. The aim of the present study is to determine the effect of the presence of clowns on children's distress and maladaptive behaviours while in hospital for minor surgery. The sample consisted of 61 pediatric patients (aged 3-12 years) undergoing general anesthesia for minor surgery. Participants were assigned to two groups: experimental and control group. The child's distress was assessed using FAS (Facial Affective Scale). Postoperative maladaptive behaviors were evaluated one week after surgery, using the PHBQ (Post-Hospital Behavior Questionnaire). Our results suggest that clowns are not able to reduce the child's level of distress. However, postoperative maladaptive behaviours in the experimental group decreased, but the decrease was not statistically significant. Further research is needed to determine the effects of clowns in hospitals, taking into account age, sex, parents' presence, and diverse hospital settings.

Trait self-esteem moderates the effect of initiator status on emotional and cognitive responses to romantic relationship dissolution.

PubMed

Waller, Katherine L; MacDonald, Tara K

2010-08-01

We hypothesized that the effect of initiator status on post breakup distress would vary as a function of trait self-esteem, such that individuals with low self-esteem would experience more distress after being rejected by their partners, whereas, among individuals with high self-esteem, initiator status would not predict distress. We used a prospective design in which university students (N=66) were assessed for emotional responses following the dissolution of their real-life romantic relationships, as well as a laboratory design in which students (N=190) imagined breaking up with their partners. As predicted, participants with lower trait self-esteem exhibited greater distress after experiencing or imagining a romantic rejection than after ending or imagining themselves ending their relationships. Conversely, distress experienced by those with high trait self-esteem did not differ as a function of who ended the relationship. Implications for understanding self-esteem processes and the effects of romantic rejection are discussed.

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

The Effects of the Second Victim Phenomenon on Work-Related Outcomes: Connecting Self-Reported Caregiver Distress to Turnover Intentions and Absenteeism.

PubMed

Burlison, Jonathan D; Quillivan, Rebecca R; Scott, Susan D; Johnson, Sherry; Hoffman, James M

2016-11-02

Second victim experiences can affect the well-being of healthcare providers and compromise patient safety. The purpose of this study was to assess the relationships between self-reported second victim-related distress to turnover intention and absenteeism. Organizational support was examined concurrently because it was hypothesized to explain the potential relationships between distress and work-related outcomes. A cross-sectional, self-report survey (the Second Victim Experience and Support Tool) of nurses directly involved in patient care (N = 155) was analyzed by using hierarchical linear regression. The tool assesses organizational support, distress due to patient safety event involvement, and work-related outcomes. Second victim distress was significantly associated with turnover intentions (P < 0.001) and absenteeism (P < 0.001), while controlling for the effects of demographic variables. Organizational support fully mediated the distress-turnover intentions (P < 0.05) and distress-absenteeism (P < 0.05) relationships, which indicates that perceptions of organizational support may explain turnover intentions and absenteeism related to the second victim experience. Involvement in patient safety events and the important role of organizational support in limiting caregiver event-related trauma have been acknowledged. This study is one of the first to connect second victim distress to work-related outcomes. This study reinforces the efforts health care organizations are making to develop resources to support their staff after patient safety events occur. This study broadens the understanding of the negative effects of a second victim experience and the need to support caregivers as they recover from adverse event involvement.

Women with advanced breast cancer and their spouses: diversity of support and psychological distress.

PubMed

Hasson-Ohayon, Ilanit; Goldzweig, Gil; Braun, Michal; Galinsky, Daliah

2010-11-01

The current study examines the effect of perceived support from different agents (spouse, family, friends, religion-spirituality) on psychological distress experienced by women with advanced breast cancer and their male spouses. In all, 150 couples consisting of women with advanced breast cancer and their spouses completed the Cancer Perceived Agent of Support Questionnaire and the Brief Symptom Inventory Scale. Spouses reported more psychological distress (global, depression and anxiety) than patients. Both patients and spouses report a similar level of spousal support, and spouses reported a lower level of support provided from family and friends. Perceived support in the current study contributed significantly to the explanations of global psychological distress, depression and anxiety both for patients and their spouses. However, the specific agents of support that were significant in explaining these outcomes varied between patients and their spouses. For patients, family support received by both patient and partner was the most important source of support, protecting from psychological distress, while for the male partners, support from friends was most important. Religious-based support was found to contribute negatively to the psychological distress of the patient and spouse. This study emphasizes the role of breast cancer spouses as care receivers in parallel to their role as caregivers, which is especially important in light of the high psychological distress reported by the spouses. The findings support the buffering effect, which different agents of support have against psychological distress while facing cancer for both patients and spouses. Patients and spouses differ with regard to the agents of support possessing this buffering effect. Copyright © 2009 John Wiley & Sons, Ltd.

Effects of work-family conflict and job insecurity on psychological distress.

PubMed

Mutambudzi, M; Javed, Z; Kaul, S; Prochaska, J; Peek, M K

2017-12-02

Work-family conflict (WFC) and job insecurity are important determinants of workers' mental health. To examine the relationship between WFC and psychological distress, and the co-occurring effects of WFC and job insecurity on distress in US working adults. This study used cross-sectional data from the 2010 National Health Interview Survey (NHIS) for adults aged 18-64 years. The 2010 NHIS included occupational data from the National Institute for Occupational Safety and Health (NIOSH) sponsored Occupational Health Supplement. Logistic regression models were used to examine the independent and co-occurring effects of WFC and job insecurity on distress. The study group consisted of 12059 participants. In the model fully adjusted for relevant occupational, behavioural, sociodemographic and health covariates, WFC and job insecurity were independently significantly associated with increased odds of psychological distress. Relative to participants reporting WFC only, participants reporting no WFC and no job insecurity had lower odds of moderate and severe distress. Co-occurring WFC and job insecurity was associated with significantly higher odds of both moderate [odds ratio (OR) = 1.55; 95% confidence interval (CI) 1.25-1.9] and severe (OR = 3.57; 95% CI 2.66-4.79) distress. Rates of WFC and job insecurity were influenced by differing factors in working adults; however, both significantly increased risk of adverse mental health outcomes, particularly when experienced jointly. Future studies should explore the temporal association between co-occurring WFC and job insecurity and psychological distress. © The Author 2017. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Distress and Diabetes Treatment Adherence: A Mediating Role for Perceived Control

PubMed Central

Gonzalez, Jeffrey S.; Shreck, Erica; Psaros, Christina; Safren, Steven A.

2014-01-01

Objective To understand independent pathways linking emotional distress, medication adherence and glycemic control in adults with type 2 diabetes, as well as the potential mediating effects of perceived control over illness and self-efficacy. Methods Adults with type 2 diabetes (N = 142) were recruited for an intervention study evaluating cognitive behavioral therapy for adherence and depression. Depressive symptom severity was assessed via semi-structured interview. Validated self-reports assessed diabetes-related distress, perceived control over diabetes (perceived control), self-efficacy for diabetes self-management and medication adherence. Glycemic control was evaluated by hemoglobin A1c (A1C). Only baseline data were included in correlational and linear regression analyses. Results Perceived control was an important mediator for both medication adherence and A1C outcomes. Specifically, regression analyses demonstrated that diabetes distress, but not depression severity, was significantly related to medication adherence and A1C. Self-efficacy and perceived control were also independently associated with medication adherence and A1C. Mediation analyses demonstrated a significant indirect effect for diabetes distress and medication adherence, through perceived control and self-efficacy. The relationship between distress and A1C was accounted for by an indirect effect through perceived control. Conclusion Results demonstrate that diabetes-related emotional distress is associated with poorer treatment adherence and glycemic control among adults with type 2 diabetes; these relationships were partially mediated through perceived control over diabetes. Perceptions of one’s personal ability to influence diabetes may be important in understanding the pathway between emotional distress and poor diabetes treatment outcomes. PMID:25110840

Social class, income, education, area of residence and psychological distress: does social class have an independent effect on psychological distress in Antalya, Turkey?

PubMed

Belek, I

2000-02-01

The aim of this study is to determine the separate effects of social class, income, education and area of residence on psychological distress. The study also assesses whether the association between prevalence of high score on the 12-item General Health Questionnaire (GHQ 12) and social class is independent of other variables. Psychological distress was assessed by means of the GHQ 12. The study covered 1,092 adults aged 15 years or more living in two different quarters of Antalya. Social class status was defined by occupational position, with income, education and area of residence treated as confounders. Chi-square and logistic regression analyses were used to evaluate the data. Large inequalities in psychological distress by all variables were observed. Psychological distress was significantly associated with class status, after adjusting for income, education, area of residence and other potential confounders (age, sex and marital status). Class inequalities in psychological distress were observed between blue-collar workers/unqualified employees and bourgeoisie. These findings support the view that the recent widening of inequalities among social classes in Turkey pose a substantial threat to health.

Psychological distress in the workforce: a multilevel and longitudinal analysis of the case of regulated occupations in Canada.

PubMed

Cadieux, Nathalie; Marchand, Alain

2014-08-07

This study uses a multidimensional theoretical model to evaluate the role of regulated occupations and working conditions in explaining psychological distress. Various multilevel regression analyses were conducted on longitudinal data for which measures repeated over time (n1 = 36,166) were nested in individuals (n2 = 7007). Results showed that when we controlled for working conditions, family situation, the social network outside the workplace, and personal characteristics, the level of psychological distress was significantly lower among professional workers in regulated occupations than among professionals not in regulated occupations. Among the working conditions studied, skill utilisation, psychological demands, and job insecurity were positively associated with psychological distress levels, whereas social support in the workplace was inversely related to distress. Finally, our results suggest that self-esteem reduced the effect of social support in the workplace on psychological distress levels in the workforce. These results support our hypothesis that working in regulated occupations exerts a direct effect on mental health. These results also make clear the importance of developing new tools for measuring psychological distress among upper-level professional workers. Such tools will be much better suited to the realities characterising today's knowledge-based economies.

Interaction effect of job insecurity and role ambiguity on psychological distress in Japanese employees: a cross-sectional study.

PubMed

Inoue, Akiomi; Kawakami, Norito; Eguchi, Hisashi; Tsutsumi, Akizumi

2018-05-01

We examined the interaction effect of job insecurity (JI) and role ambiguity (RA) on psychological distress in Japanese employees. Overall, 2184 male and 805 female employees from two factories of a manufacturing company in Japan completed a self-administered questionnaire comprising the scales measuring JI (Job Content Questionnaire), RA (National Institute for Occupational Safety and Health Generic Job Stress Questionnaire), psychological distress (K6 scale), and potential confounders (i.e., age, education, family size, occupational class, and work shift). Taking psychological distress as a dependent variable, hierarchical multiple regression analyses were conducted by gender and employment status (i.e., permanent and non-permanent employees). An interaction term of JI × RA was included in the model. After adjusting for potential confounders, the main effects of JI and RA on psychological distress were significant regardless of gender or employment status. Furthermore, the significant interaction effect of JI × RA on psychological distress was observed among permanent male employees (β = 0.053, p = 0.010). Post hoc simple slope analyses showed that the simple slope of JI was greater at higher levels of RA (i.e., one standard deviation [SD] above the mean) (β = 0.300, p < 0.001) compared to lower levels of RA (i.e., one SD below the mean) (β = 0.212, p < 0.001). On the other hand, the interaction effect of JI × RA was not significant among permanent or non-permanent female employees. The present study suggests that higher levels of RA strengthen the association of JI with psychological distress, at least among Japanese permanent male employees.

The effects of individually tailored nurse navigation for patients with newly diagnosed breast cancer: a randomized pilot study.

PubMed

Mertz, Birgitte Goldschmidt; Dunn-Henriksen, Anne Katrine; Kroman, Niels; Johansen, Christoffer; Andersen, Kenneth Geving; Andersson, Michael; Mathiesen, Ulla Breitenstein; Vibe-Petersen, Jette; Dalton, Susanne Oksbjerg; Envold Bidstrup, Pernille

2017-12-01

Our aim was to determine the feasibility and effectiveness of an individual, nurse-navigator intervention for relieving distress, anxiety, depression and health-related quality of life in women who have been treated for breast cancer (BC) and are experiencing moderate-to-severe psychological and physical symptoms. Fifty women with newly diagnosed BC who reported distress (score ≥7 on distress thermometer) before surgery were included consecutively in a pilot study and randomized 1:1 to the intervention or the control group. The intervention comprised repeated screening with patient reported outcome measures and nurse navigation. A total of 66 women who were not distressed (score <7) were followed longitudinally as an observational group. Participants filled in four questionnaires, at baseline, after 6 months and 12 months. The primary outcome was psychological distress and the secondary outcomes were anxiety, depression, health-related quality of life and feasibility of the intervention. Women in the intervention group reported significantly greater satisfaction with treatment and rehabilitation and lower levels of distress (mean 2.7 vs. 5.1, p<.01), anxiety (mean 5.1 vs. 7.8, p = .02) and depression (mean 2.2 vs. 4.4, p = .04) after 12 months compared to the control group. No significant effects were seen on health-related quality of life. The study shows promising feasibility of the individually tailored nurse-navigation intervention and while no significant effects were observed after 6 months, we did find statistically significant effects on distress, anxiety and depression 12 months after diagnosis. Our results will assist in developing rehabilitation to the most vulnerable patients.

Parents' Marital Distress, Divorce, and Remarriage: Links with Daughters' Early Family Formation Transitions

ERIC Educational Resources Information Center

Amato, Paul R.; Kane, Jennifer B.

2011-01-01

The authors used data from the Add Health study to estimate the effects of parents' marital status and relationship distress on daughters' early family formation transitions. Outcomes included traditional transitions (marriage and marital births) and nontraditional transitions (cohabitation and nonmarital births). Relationship distress among…

Traditional Versus Integrative Behavioral Couple Therapy for Significantly and Chronically Distressed Married Couples.

ERIC Educational Resources Information Center

Christensen, Andrew; Atkins, David C.; Berns, Sara; Wheeler, Jennifer; Baucom, Donald H.; Simpson, Lorelei E.

2004-01-01

A randomized clinical trial compared the effects of traditional behavioral couple therapy (TBCT) and integrative behavioral couple therapy (IBCT) on 134 seriously and chronically distressed married couples, stratified into moderately and severely distressed groups. Couples in IBCT made steady improvements in satisfaction throughout the course of…

The influence of social stigma and discriminatory experience on psychological distress and quality of life among rural-to-urban migrants in China.

PubMed

Wang, Bo; Li, Xiaoming; Stanton, Bonita; Fang, Xiaoyi

2010-07-01

The global literature has revealed a potential negative impact of social stigma on both physical and mental health among stigmatized individuals; however, the mechanisms through which social stigma affects the individual's quality of life and mental health are not well understood. This research simultaneously examines the relationships of several determinants and mediating factors of psychological distress and quality of life. Data were collected through a cross-sectional survey among 1006 adult (predominantly male) rural-to-urban migrants in 2004-2005 in Beijing, China. Participants reported on their perceived social stigma, discriminatory experiences in daily life, preparation for migration, discrepancy between expectation and reality, coping with stigma-related stress, psychological distress, and quality of life. Structural equation modeling was performed. We found that perceived social stigma and discriminatory experiences had direct negative effects on psychological distress and quality of life among rural-to-urban migrants. Expectation-reality discrepancy mediated the effects of perceived social stigma and discriminatory experiences on psychological distress and quality of life; coping mediated the effect of social stigma on quality of life. Psychological distress was associated with quality of life. Preparation prior to migration was positively related to coping skills, which were positively related to quality of life. We conclude that perceived social stigma and daily discriminatory experiences have a significant influence on psychological distress and quality of life among rural-to-urban migrants. Pre-migration training with a focus on establishment of effective coping skills and preparation of migration may be helpful to improve their quality of life and mental health.

The psychological effects of work experiences and disagreements about gender role beliefs in dual-earner couples: a longitudinal study.

PubMed

James, J B; Barnett, R C; Brennan, R T

1998-01-01

Using an economically diverse random sample of 300 full-time employed men and women in dual-earner couples from two communities in the Northeast, we estimated the relation between the direction and magnitude of disagreement about gender role ideology (GRI) within couples and psychological distress. We conceptualized GRI within couples as both the couple mean or stable gender-role ideology (the "couple ideology") and as each partner's deviation from the other partner's score. Moreover, for each partner, we estimated the relation between both the stable (i.e., mean) component and the change (i.e., time-varying) component of GRI and distress. Finally, for each partner we estimated the moderating effect of GRI on the relation between job-role quality and distress. Findings are: (a) the more egalitarian the husband's average GRI is relative to his wife's, the less distressed he is; (b) if over time a wife's GRI becomes less egalitarian relative to her husband's, then her distress will be more affected by changes in her job-role quality; (c) for husbands, as the couple's average GRI becomes more egalitarian over time, the effect of job-role quality on distress is lessened; and (d) for a man in a couple with a more egalitarian stable GRI, the effects of change in job-role quality on distress are less pronounced than for a man in a couple with a less egalitarian stable GRI. Results are discussed in terms of new conceptions of GRI revealing the dynamic interaction of within-couples' gender-role ideologies.

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.

Psychosocial Risk Factors for Upper Respiratory Infections: Effects of Upper Respiratory Illness on Academic Performance in U.S. Navy Basic Training

DTIC Science & Technology

1989-03-15

training which take the form of somatisized distress or situational hypochondriasis . If so, URI-performance associations would be spurious. This...indications of hypochondriasis or symptom reporting as a form of psychological distress. General Synptom Reporting was used in the present study to test...the distress hypothesis was not supported. General Symptom Reporting did affect URI, but somatically -expressed distress could not be a cause of

Acute Effects of Cannabis on Breath-Holding Duration

PubMed Central

Farris, Samantha G.; Metrik, Jane

2016-01-01

Distress intolerance (an individual’s perceived or actual inability to tolerate distressing psychological or physiological states) is associated with cannabis use. It is unknown whether a bio-behavioral index of distress intolerance, breath-holding duration, is acutely influenced (increased or decreased) by cannabis. Such information may further inform understanding of the expression of psychological or physiological distress post-cannabis use. This within-subjects study examined whether smoked marijuana with 2.7–3.0 % delta-9-tetrahydrocannabinol (THC), relative to placebo, acutely changed duration of breath-holding. Participants (n = 88; 65.9% male) were non-treatment seeking frequent cannabis users who smoked placebo or active THC cigarette on two separate study days and completed breath-holding task. Controlling for baseline breath-holding duration and participant sex, THC produced significantly lower breath-holding durations relative to placebo. There was a significant interaction of drug administration x frequency of cannabis use, such that THC decreased breath-holding time among less frequent but not among more frequent users. Findings indicate that cannabis may be exacerbating distress intolerance (via breath-holding duration). As compared to less frequent cannabis users, frequent users display tolerance to cannabis’ acute effects including increased ability to tolerate respiratory distress when holding breath. Objective measures of distress intolerance are sensitive to contextual factors such as acute drug intoxication, and may inform the link between cannabis use and the expression of psychological distress. PMID:27454678

Does Negative Interaction in the Church Increase Psychological Distress? Longitudinal Findings from the Presbyterian Panel Survey*

PubMed Central

Ellison, Christopher G.; Zhang, Wei; Krause, Neal; Marcum, John P.

2009-01-01

This study examines the effects of negative interaction in church on psychological distress. After outlining a series of theoretical arguments linking negative interaction with health and well-being, relevant hypotheses are tested using longitudinal data from two surveys of the 1997–1999 Presbyterian Panel, a nationwide panel of members and elders (lay leaders) in congregations of the Presbyterian Church (USA). Findings confirm that negative interaction appears to foster or exacerbate distress over the study period. In addition, specific dimensions of social negativity have distinctive effects; the impact of criticisms on distress surface only in cross-sectional models, while the effects of excessive demands emerge only in the longitudinal models. No subgroup variations in these effects are detected. Implications of these findings are discussed with regard to (a) research on religion and health and (b) congregational life, and a number of promising directions for future research are elaborated. PMID:20694051

Intermittent fasting could ameliorate cognitive function against distress by regulation of inflammatory response pathway.

PubMed

Shojaie, Marjan; Ghanbari, Farzane; Shojaie, Nasrin

2017-11-01

Undesirable and desirable effects of stressors on the body are assigned to distress and eustress, respectively. Immune system and brain are the most susceptible parts to stressful conditions, whereas long-lasting alterations in putative immune proteins involved in tension such as corticosterone (CORT), interleukin 6 (IL-6), and tumor necrosis factor-alpha (TNF-α) can impact learning and memory. Intermittent fasting (IF) is a repeated regular cycle of dietary restriction with well-known beneficial properties on the body. The aim of this study was to identify the eustress effects of IF on cognitive function by assessing the critical inflammatory factors in chronic distress. Forty male mice were divided into four groups (n = 10/group). Distress and control normally received food and water, whereas IF and IF with distress groups were daily deprived of food and water for two hours. In the second week, the electrical foot shock was induced to distress and IF with distress groups. Finally, the cognitive functions of all mice were evaluated by Barnes maze, their blood samples were taken to determine the plasma level of CORT, IL-6 and TNF-α, and the removed brain and adrenal glands were weighed in the third week. A significant gain in plasma level of CORT, IL-6 and TNF-α with a considerable brain hypotrophy and adrenal hypertrophy was found in distress group, whereas IF caused a remarkable reduction of the plasma inflammatory factors, especially in IF with distress mice ( P  ≤ 0.05). In conclusion, IF could improve cognitive function and preserve the brain against distress by regulation of inflammatory response pathway.

Psychological distress as a mediator of the association between disease severity and occupational functioning among employed spouses of women recently diagnosed with breast cancer.

PubMed

Manne, Sharon L; Siegel, Scott; Heckman, Carolyn J; Kashy, Deborah A

2015-11-01

The purpose was to evaluate whether patient and spouse cancer-specific distress mediated the association between cancer severity and occupational functioning among employed spouses of women diagnosed with breast cancer. We examined whether sociodemographic characteristics, lower spouse-reported marital quality, and lower spouse self-rated health were associated with poorer spouse occupational functioning. One hundred forty-three currently employed spouses of women diagnosed with breast cancer were administered measures of socioeconomic status, occupational functioning (work absenteeism, low productivity, and poor performance), cancer-specific distress, marital quality, and self-rated health. Patients completed measures of cancer-related distress and functional impairment and cancer stage were collected from medical charts. In the model evaluating work absenteeism, greater patient functional impairment was associated with more absenteeism, but there was no evidence of a mediating effect for either partners' cancer-specific distress. Higher cancer stage and more functional impairment were associated with higher spouse cancer-specific distress, which in turn predicted poorer work productivity. Patient cancer-specific distress did not mediate the association between patient functional impairment or cancer stage and spouse work productivity. Finally, higher cancer stage was associated with more spouse cancer-specific distress, which in turn predicted poorer work performance. There were no direct or indirect effects of the patient's functional impairment on spouse work performance. Distressed spouses are more likely to have poorer work productivity after their partners' breast cancer diagnosis. These spouses may need assistance in managing their distress and the patient's functional impairment to ensure that their work productivity is not adversely affected. Copyright © 2015 John Wiley & Sons, Ltd.

Effect of education based on the “4A Model” on the Iranian nurses’ moral distress in CCU wards

PubMed Central

Molazem, Zahra; Tavakol, Nahid; Sharif, Farkhondeh; Keshavarzi, Sareh; Ghadakpour, Soraya

2013-01-01

Complexity of health care has caused ethical dilemmas and moral distress to be quite unavoidable for nurses. Moral distress is a major, highly prevalent problem in the nursing profession. The study aims to investigate the effect of education based on the “4A model” on the rate of moral distress among the nurses working in Cardiac Care Units (CCU). The participants consisted of 60 nurses working in Cardiac Care Units (CCU), 30 in the control and 30 in the intervention group. Those in the intervention group took part in the educational workshop about “moral distress” and “4A model”. The moral distress questionnaire was completed by both study groups 1 and 2 months after the intervention. After the intervention, the results of repeated measures analysis of variance revealed a significant difference in the moral distress mean scores between the intervention and the control groups (P<0.001) and within the two groups (P<0.001). Moreover, a significant difference was found between the two study groups regarding the mean score of moral distress 1 and 2 months after the intervention. The findings of the current study revealed a decreasing trend in the moral distress mean score in the intervention group, while there was an increasing trend in the control group after the intervention. It can be concluded that the “4A model” can be used for reducing moral distress and educational interventions can reduce the rate of moral distress among nurses. Authors of this study recommend that more studies with larger sample sizes be conducted in different hospital wards as well. PMID:23967371

The Moderating Role of Experiential Avoidance in the Relationships Between Internal Distress and Smoking Behavior During a Quit Attempt

PubMed Central

Minami, Haruka; Bloom, Erika Litvin; Reed, Kathleen M. Palm; Hayes, Steven C.; Brown, Richard A.

2015-01-01

Recent smoking cessation studies have shown that decreasing experiential avoidance (EA) (i.e., tendency to reduce or avoid internal distress) improves success, but to date none have examined the moderating effect of EA on the role of specific internal distress in smoking cessation. This study examined whether pre-quit general EA (Acceptance & Action Questionnaire) and smoking-specific EA (Avoidance and Inflexibility Scale) moderated the relations between four measures of post-quit internal distress (depressive symptoms, negative affect, physical withdrawal symptoms, craving), and smoking. Participates: 40 adult smokers who participated in a randomized controlled trial of Distress Tolerance treatment for smokers with a history of early lapse. Results: Multilevel models showed that pre-quit smoking-specific EA, but not general EA, significantly moderated the relationship between all measures of internal distress, except craving, and smoking over 13 weeks post-quit. When examined over 26 weeks, these relations remained unchanged for all, but the moderating effect became trend-level for depressive symptoms. Significant associations between post-quit internal distress and smoking were found only in those with high pre-quit smoking-specific EA. Moreover, pre-quit smoking-specific EA did not predict post-quit levels or changes in internal distress, suggesting that decreasing smoking-specific EA pre-quit may not reduce internal distress, but may instead reduce smoking risk in response to such distress during a quit attempt. Conclusions: Results mainly supported hypothesized relations, but only for smoking-specific EA. Smoking cessation interventions focusing on EA reduction may especially benefit those vulnerable to greater post-quit depressive and withdrawal symptoms, and those who smoke to regulate aversive internal states. PMID:25347023

Linking family cohesion and flexibility with expressed emotion, family burden and psychological distress in caregivers of patients with psychosis: A path analytic model.

PubMed

Koutra, Katerina; Simos, Panagiotis; Triliva, Sofia; Lionis, Christos; Vgontzas, Alexandros N

2016-06-30

The present study aimed to evaluate a path analytic model accounting for caregivers' psychological distress that takes into account perceived family cohesion and flexibility, expressed emotion and caregiver's burden associated with the presence of mental illness in the family. 50 first-episode and 50 chronic patients diagnosed with schizophrenia or bipolar disorder (most recent episode manic severe with psychotic features) recruited from the Inpatient Psychiatric Unit of the University Hospital of Heraklion, Crete, Greece, and their family caregivers participated in the study. Family functioning was assessed in terms of cohesion and flexibility (FACES-IV), expressed emotion (FQ), family burden (FBS) and caregivers' psychological distress (GHQ-28). Structural equation modelling was used to evaluate the direct and indirect effects of family dynamics on caregivers' psychological distress. The results showed that neither family cohesion nor family flexibility exerted significant direct effects on caregivers' psychological distress. Instead, the effect of flexibility was mediated by caregivers' criticism and family burden indicating an indirect effect on caregivers' psychological distress. These results apply equally to caregivers of first episode and chronic patients. Family interventions aiming to improve dysfunctional family interactions by promoting awareness of family dynamics could reduce the burden and improve the emotional well-being of family caregivers. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Effect of trauma on quality of life as mediated by mental distress and moderated by coping and social support among postconflict displaced Ethiopians.

PubMed

Araya, Mesfin; Chotai, Jayanti; Komproe, Ivan H; de Jong, Joop T V M

2007-08-01

An understanding of how quality of life is affected by severe trauma and mental distress may facilitate better intervention strategies for postconflict internally displaced persons, by identifying mediators, moderators, and independent risk factors. We investigate the pathways involved in this process and also study the moderating roles of coping strategies and perceived social support. A random sample of 1193 (62% women) internally displaced Ethiopian adults living in shelters in Addis Ababa were interviewed with instruments capturing the relevant concepts, including SCL-90-R and WHOQOL-BREF. Path analysis was employed to elaborate the mediating and moderating effects. Self-reported living conditions were also assessed. Mental distress increased and quality of life decreased with age. Mental distress mediated the effects of trauma in reducing the quality of life, and some trauma also reduced quality of life directly. These effects remained after adjusting for living conditions. Living conditions were related to quality of life also on their own. Coping strategies and perceived social support influenced mental distress and quality of life directly as well as indirectly by moderation, in part gender specific. Intervention strategies aimed at reducing mental distress, modifying coping strategies, and encouraging social support may turn out to be useful in increasing the overall quality of life in postconflict situations, and are worth considering as complements to strategies that improve the living conditions.

Effects of communication styles on marital satisfaction and distress of parents of pediatric cancer patients: a prospective longitudinal study.

PubMed

Wijnberg-Williams, Barbara J; Van de Wiel, Harry B M; Kamps, Willem; Hoekstra-Weebers, Josette E H M

2015-01-01

The aim of this study was to examine the longitudinal effects of communication styles on marital satisfaction and distress of parents of children treated for cancer. Marital dissatisfaction (Maudsley Marital Questionnaire), intimacy, avoidance, destructive and incongruent communication (Communication Skills Inventory) and psychological distress (General Health Questionnaire) were assessed in 115 parents of pediatric cancer patients shortly after diagnosis (T1) and 5 years later (T2). Only mothers' marital dissatisfaction increased significantly over time. No gender differences in dissatisfaction were found. Mothers had a significantly higher lack of intimacy score than fathers. All T1 communication styles were significantly univariately related to fathers' and mothers' T2 marital dissatisfaction, while not to T2 distress. Mothers' T1 marital dissatisfaction accounted for 67% and fathers' for 12% in the explained variance of T2 dissatisfaction. T1 destructive communication uniquely affected fathers' T2 marital dissatisfaction and T1 avoidant communication that of mothers. Five years after cancer diagnosis in their children, the quality of parents' marital relationships seemed largely unchanged. Parents' use of communication skills at diagnosis appeared to have limited effect on their marital dissatisfaction and no effect on their distress 5 years later. While avoidant communication seemed indicative of mothers' marital distress, fathers' seemed affected by destructive communication. Copyright © 2014 John Wiley & Sons, Ltd.

An acceptance-oriented cognitive-behavioral therapy in multimodal rehabilitation: a pre-post test evaluation in highly distressed patients with rheumatic diseases.

PubMed

Vriezekolk, Johanna E; Eijsbouts, Agnes M M; van Lankveld, Wim G J M; Beenackers, Hanneke; Geenen, Rinie; van den Ende, Cornelia H M

2013-06-01

To examine the potential effectiveness of a multimodal rehabilitation program including an acceptance-oriented cognitive-behavioral therapy for highly distressed patients with rheumatic diseases. An observational study employing a one-group pre-post test design (N=25). The primary outcome was psychological distress. Secondary outcomes were quality of life, illness acceptance, and coping flexibility. Group pre-to-post and pre-to-12 months follow-up treatment changes were evaluated by paired-samples t-tests and Cohen's effect sizes (d). Individual changes were evaluated by the reliable change index (RCI) and clinically significant change (CSC) parameters. Significant effects were found post-treatment and maintained at 12 months in psychological distress (d>0.80), illness acceptance (d=1.48) and the SF-36 subscales role physical, vitality, and mental health (d ≥ 0.65). No significant effects were found for coping flexibility and the SF-36 subscales physical functioning, bodily pain, social functioning, and role emotional. Both a reliable (RCI) and clinically significant (CSC) improvement was observed for almost half of the highly distressed patients. The patients enrolled in the multimodal rehabilitation program showed improved psychological health status from pre to post-treatment. A randomized clinical trial is needed to confirm or refute the added value of an acceptance-oriented cognitive-behavioral therapy for highly distressed patients in rehabilitation. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Buffering effects of job resources on the association of overtime work hours with psychological distress in Japanese white-collar workers.

PubMed

Hino, Ayako; Inoue, Akiomi; Kawakami, Norito; Tsuno, Kanami; Tomioka, Kimiko; Nakanishi, Mayuko; Mafune, Kosuke; Hiro, Hisanori

2015-07-01

The purpose of the present study was to investigate the buffering effects of job resources, utilizing the job demands-control (or demand-control-support) and effort-reward imbalance models (i.e., job control, workplace social support, and extrinsic reward), on the association of overtime work hours with psychological distress in Japanese employees. A total of 1,198 participants (valid response rate = 93.7 %) from five branches of a manufacturing company in Japan completed a self-administered questionnaire comprising the scales assessing job resources, psychological distress, and demographic characteristics. We obtained the information on working hours in the most recent month from the personnel records of the surveyed company. Multiple logistic regression analyses were conducted. In a series of analyses, interaction term of overtime work hours with each job resource was included in the model. Significant interaction effect of overtime work hours with job control was observed. Among the low job control group, the long overtime (80 h or more) subgroup had a significantly higher prevalence odds ratio of psychological distress compared to the short overtime (44 h or less) subgroup. No significant association of overtime work hours with psychological distress was found among the high job control group. On the other hand, there was no significant interaction effect of overtime work hours with workplace social support or extrinsic reward. The present findings suggest that high job control has an effect on reducing psychological distress in relation to overtime work hours in Japanese employees.

Sex differences in mediating and moderating processes linking economic stressors, psychological distress, and drinking.

PubMed

Lewis Brown, Robyn; Richman, Judith A

2012-09-01

Given the recent downturn in the U.S. economy, we considered in this study the processes linking economic stressors, psychological distress, and two alcohol-related outcomes (past-month drinking and problematic drinking). Data were drawn from a mail survey of a national sample of 663 respondents. Structural equation modeling was used to assess whether psychological distress mediates the associations between economic stressors and the alcohol-related outcomes considered and whether these associations varied by gender. Controlling for correlations among the outcomes and the effects of the sociodemographic control variables, psychological distress was found to partly explain the association between economic stressors and problematic drinking. The mediating effects on problematic drinking were significantly greater for men than women. The findings demonstrate the utility of considering interrelationships among alcohol-related outcomes and, in this context, reveal the circumstances in which gender matters most for understanding the associations among economy-related stressors, psychological distress, and drinking.

Continuous positive airway pressure (CPAP) to treat respiratory distress in newborns in low- and middle-income countries.

PubMed

Dewez, Juan Emmanuel; van den Broek, Nynke

2017-01-01

Severe respiratory distress is a serious complication common to the three major causes of neonatal mortality and morbidity (prematurity, intra-partum-related hypoxia and infections). In low- and middle-income countries (LMICs), 20% of babies presenting with severe respiratory distress die.Continuous positive airway pressure (CPAP), is an effective intervention for respiratory distress in newborns and widely used in high-income countries. Following the development of simple, safe and relatively inexpensive CPAP devices, there is potential for large-scale implementation in the developing world.In this article, we describe existing CPAP systems and present a review of the current literature examining the effectiveness of CPAP compared to standard care (oxygen) in newborns with respiratory distress. We also discuss the evidence gap which needs to be addressed prior to its integration into health systems in LMICs. © The Author(s) 2016.

Continuous positive airway pressure (CPAP) to treat respiratory distress in newborns in low- and middle-income countries

PubMed Central

van den Broek, Nynke

2016-01-01

Severe respiratory distress is a serious complication common to the three major causes of neonatal mortality and morbidity (prematurity, intra-partum-related hypoxia and infections). In low- and middle-income countries (LMICs), 20% of babies presenting with severe respiratory distress die. Continuous positive airway pressure (CPAP), is an effective intervention for respiratory distress in newborns and widely used in high-income countries. Following the development of simple, safe and relatively inexpensive CPAP devices, there is potential for large-scale implementation in the developing world. In this article, we describe existing CPAP systems and present a review of the current literature examining the effectiveness of CPAP compared to standard care (oxygen) in newborns with respiratory distress. We also discuss the evidence gap which needs to be addressed prior to its integration into health systems in LMICs. PMID:26864235

Effects of a brief worksite stress management program on coping skills, psychological distress and physical complaints: a controlled trial.

PubMed

Shimazu, Akihito; Umanodan, Rino; Schaufeli, Wilmar B

2006-10-01

To examine the effects of single-session, small-group stress management program on knowledge about stress, coping skills, and psychological and physical distress. A total of 300 employees from a company in western Japan were invited to participate in the study. Those who consented to enter the study were assigned to an intervention (n=149) or waiting list control group (n=151). Participants in the intervention group received a small-group stress management program. The program was primarily aimed at increasing knowledge about stress and improving coping skills. To investigate the intervention effect, change scores in outcome variables were calculated by subtracting the scores at pre-intervention from those at post-intervention (8 weeks after the pre-intervention survey). Next, the difference in the scores between groups was examined using analyses of covariance (ANCOVA) with the pre-intervention score as the covariate. Favorable intervention effects were found on knowledge about stress and on coping skills (P<0.001 and P=0.012, respectively) and adverse effects on psychological distress (P=0.022). However, this adverse effect on psychological distress did not exist among those who initially perceived higher levels of job control. The single-session stress management program was effective on improving knowledge about stress, and coping skills, where job control moderated the effect of the program on psychological distress.

Resilience and Psychological Distress in Psychology and Medical Students.

PubMed

Bacchi, Stephen; Licinio, Julio

2017-04-01

The authors investigated levels of resilience and psychological distress in medical and psychology students, factors that may affect these levels, the relationship between resilience and psychological distress, and student opinion on causes of stress and possible interventions. A voluntary anonymous online survey was distributed to University of Adelaide medical and psychology students. Medical and psychology students (n = 560; response rate = 24.7%) had similar mean resilience and psychological distress scores, and 47.9% of medical students and 55.1% of psychology students were psychologically distressed. Higher levels of resilience were associated with lower levels of distress (p < 0.001). Students supported resilience-based interventions, greater financial support, clearer learning objectives and more continuous assessment as potential means to reduce the effects of stress. Higher levels of resilience were associated with lower levels of psychological distress. Further studies are required to determine the efficacy of resilience-based interventions in these groups.

Psychological distress among homeless adults.

PubMed

Gelberg, L; Linn, L S

1989-05-01

Recent studies have reported a high prevalence of mental illness among the homeless. As part of a community-based survey of 529 homeless adults, we developed and tested a model to increase our understanding of the factors related to their psychological distress. Using a previously validated and reliable scale of perceived psychological distress, we found that homeless adults were more likely to report psychological distress than the general population (80% vs. 49%). Distress levels were not associated with most demographic or homeless characteristics or general appearance. However, distress was related to unemployment, greater cigarette and alcohol use, worse physical health, fewer social supports, and perceived barriers to obtaining needed medical care. Since mental, physical, and social health are strongly related among homeless adults, alleviating distress among them may be most effectively done by implementing a broad-based health services package coupled with employment programs provided in an accessible service delivery setting.

Psychological Distress and Mortality: Are Women More Vulnerable?

ERIC Educational Resources Information Center

Ferraro, Kenneth F.; Nuriddin, Tariqah A.

2006-01-01

Does psychological distress increase mortality risk? If it does, are women more vulnerable than men to the effect of distress on mortality? Drawing from cumulative disadvantage theory, these questions are addressed with data from a 20-year follow-up of a national sample of adults ages 25-74. Event history analyses were performed to examine…

Children’s positive dispositional attributes, parents’ empathic responses, and children’s responses to painful pediatric oncology treatment procedures

PubMed Central

Harper, Felicity W. K.; Penner, Louis A.; Peterson, Amy; Albrecht, Terrance L.; Taub, Jeffrey

2012-01-01

Pain/distress during pediatric cancer treatments has substantial psychosocial consequences for children and families. We examined relationships between children’s positive dispositional attributes, parents’ empathic responses, and children’s pain/distress responses to treatment procedures. Participants were 41 pediatric cancer patients and parents. Several weeks before treatment, parents rated children’s resilience and positive dimensions of temperament. Parents’ pre-treatment empathic affective responses to their children were assessed. Children’s pain/distress during treatments was rated by multiple independent raters. Children’s resilience was significantly and positively associated with parents’ empathic affective responses and negatively associated with children’s pain/distress. Children’s adaptability and attention focusing also showed positive relationships (p<.10) with parents’ empathic responses. Parents’ empathic responses mediated effects of children’s resilience on children’s pain/distress. Children’s positive dispositional attributes influence their pain/distress during cancer treatments; however, these effects may be mediated by parents’ empathic responses. These relationships provide critical understanding of the influence of parent-child relationships on coping with treatment. PMID:22963185

Terrorism, distress, and drinking: vulnerability and protective factors.

PubMed

Richman, Judith A; Rospenda, Kathleen M; Cloninger, Lea

2009-12-01

Research has demonstrated effects of 9/11 on distress and drinking outcomes in individuals directly affected and indirectly affected across the United States. Fewer studies have addressed vulnerability and protective factors shown to moderate the effects of stress exposure. We report findings from a Midwestern workplace cohort study. Respondents to a 6 wave longitudinal mail survey completed questionnaires prior to September 11, 2001 and again in 2003 and 2005. Regression analyses encompassed measures of terrorism-related beliefs and fears, workplace stressors (sexual harassment, generalized abuse and low decision latitude), marital and parental status, and perceived social support in 2003, and distress and deleterious drinking outcomes in 2005. Analyses showed that terrorism-related fears significantly interacted with workplace stressors and interpersonal social relationships in predicting distress, drinking or both, controlling for pre-9/11 distress and drinking. Gender differences were also found. This article suggests that certain individuals may be at heightened risk for distressful reactions to and/or deleterious drinking resulting from terrorism-related issues and fears due to additional risk factors involving workplace stressors and inadequate interpersonal bonds. However, limitations of the study were noted and future research was recommended.

Psychosocial Mechanisms of Psychological Health Disparity in Japanese Workers

PubMed Central

SHIMAZU, Akihito; KAWAKAMI, Norito; KUBOTA, Kazumi; INOUE, Akiomi; KURIOKA, Sumiko; MIYAKI, Koichi; TAKAHASHI, Masaya; TSUTSUMI, Akizumi

2013-01-01

Recent epidemiologic research has shown that people with higher socioeconomic status (SES) (e.g., educational attainment) have better psychological health than those with lower SES. However, the psychosocial mechanisms of underlying this relationship remain unclear. To fill this gap, the current study examines the mediating effects of job demands and job resources in the relationship between educational attainment and psychological distress. The hypothesized model was tested using large data sets from two different studies: a cross-sectional study of 9,652 Japanese employees from 12 workplaces (Study 1), and a longitudinal study of 1,957 Japanese employees (Study 2). Structural equation modeling revealed that (1) educational attainment was positively related to psychological distress through job demands, (2) educational attainment was negatively related to psychological distress through job resources, and (3) educational attainment was not directly related to psychological distress. These results suggest that educational attainment has an indirect effect, rather than a direct one, on psychological distress among workers; educational attainment had both a positive and a negative relationship to psychological distress through job demands and job resources, respectively. PMID:23892903

Physical Practice and Wellness Courses Reduce Distress and Improve Wellbeing in Police Officers.

PubMed

Acquadro Maran, Daniela; Zedda, Massimo; Varetto, Antonella

2018-03-23

The aim of this work was to evaluate a course to reduce distress in an Italian police force. Based on the findings from the first investigations on this population, courses to improve the ability to manage distress were tailored by management. Several free courses were proposed, including physical efficiency (e.g., total body conditioning) and wellness (e.g., autogenic training) classes. The goal of this research was to evaluate the courses and their impact on the perceived distress and general health of the participants, as well as the effectiveness in increasing the use of adaptive coping strategies. A descriptive investigation was conducted involving a sample of 105 police officers before (time 1) and after (time 2) they had participated in the courses. Findings confirmed both physical and wellness courses affected, in participants, the perceived distress, thereby increasing the perception of wellbeing. The participants expressed having mental health benefits, the use of adaptive coping strategies increased, while the maladaptive coping strategies decreased. This study confirms that these courses could effectively reduce the risk of chronic disease, a consequence of persistent exposure to distress.

Communications with health professionals and psychological distress in family caregivers to cancer patients: A model based on stress-coping theory.

PubMed

Oh, Young Sam

2017-02-01

In cancer care settings, family caregivers often experience negative or little communication with the health professionals, and this negative communication and limited health-related information causes psychological distress in family caregivers to cancer patients. The first aim of this research is to investigate the relationship between communication with health professionals and psychological distress in family caregivers. The second aim is to investigate the mediating effects of self-efficacy in this hypothetical model. A total of 1397 family caregivers were included in this research. A structural equation model was then applied, in order to examine the hypothesized model based on the stress-coping model. More negative communication with health professionals was associated with higher psychological distress. Self-efficacy in health information seeking significantly mediated the relationship between communication with health professionals and psychological distress. This study indicates that as a coping resource, self-efficacy in health information seeking, plays a significant role in reducing the effects of negative communication with health professionals on psychological distress in family caregivers. Copyright © 2016 Elsevier Inc. All rights reserved.

A pilot study: evaluation of a psychosocial program for women with gynecological cancers.

PubMed

Levine, Ellen G; Silver, Barbara

2007-01-01

Ovarian cancer is the fourth highest cause of cancer deaths in the US. Psychosocial issues may be prevalent among these women. This study examined the efficacy of a gynecological cancer resource program. Fifty-three women completed questionnaires over a year's time. The women felt positively about the program, and used several of the services. The most used services were that of the center coordinator/nurse practitioner, the GYN support group, the hair consultant, and the imagery sessions. The social worker, massage therapist, and the nutritionist seemed to be important at the beginning of the cancer experience but not so much at later stages. Having a nurse practitioner who could talk about treatment side effects, menopause, body image, sexuality, etc., was helpful to at least half of the women. Psychological distress decreased over time, as did quality of life.

Association between weight perception and psychological distress.

PubMed

Atlantis, E; Ball, K

2008-04-01

Obesity is a well-known cause of cardiovascular disease burden and premature death, but effects on depressive symptoms remain equivocal. Depressive symptoms may be more common among the obese individuals who perceive themselves as overweight, rather than those who perceive themselves as having an acceptable weight. Our aim was to determine whether weight status and weight perceptions are independently associated with psychological distress. We conducted a cross-sectional study using data from the Australian National Health Survey 2004-2005 (N=17 253). All variables were collected by self-report. Adjusted multinomial logistic regression analysis was conducted to generate prevalence odds ratios with 95% confidence intervals (95% CI) for medium (Kessler Psychological Distress Scale (K10) scores of 20-29) and high (K10 scores of 30-50) psychological distress (compared with K10 scores of 10-19 as the reference) associated with weight status (standard body mass index (BMI) cutoffs for underweight, overweight and obesity vs normal weight), weight perception (perceived underweight and overweight vs acceptable weight) and weight misperception (incorrect with BMI vs correct with BMI) adjusting for numerous important covariates. Overweight and underweight perception increased the odds of medium (40 and 50%) and high (50 and 120%) psychological distress, whereas weight status and weight misperception were not associated with psychological distress in adjusted analysis. Gender, alcohol consumed per week and post-school education were not significant covariates (at P<0.10 level). Overweight and underweight perception rather than weight status or weight misperception are significant risk factors associated with medium and high psychological distress prevalence and effects appear to be uniform for men and women. Well-designed prospective studies are still needed to determine whether weight perceptions cause psychological distress, and if so, whether symptoms are significantly reduced following effective intervention.

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.

A longitudinal examination of dyadic distress patterns following a skills intervention for carers of adolescents with anorexia nervosa.

PubMed

Salerno, Laura; Rhind, Charlotte; Hibbs, Rebecca; Micali, Nadia; Schmidt, Ulrike; Gowers, Simon; Macdonald, Pamela; Goddard, Elizabeth; Todd, Gillian; Tchanturia, Kate; Lo Coco, Gianluca; Treasure, Janet

2016-12-01

Family interventions in anorexia nervosa (AN) have been developed to ameliorate maladaptive patterns of patient-carer interaction that can play a role in illness maintenance. The primary aim of this study is to examine the inter-relationship between baseline and post-treatment distress in dyads of carers and patients with AN to examine the interdependence between carers and patients. The secondary aim is to examine whether a carer skills intervention [Experienced Carer Helping Others (ECHO)] impacts on this inter-relationship. Dyads consisting of treatment-seeking adolescents with AN and their primary carer (n = 149; mostly mothers) were randomised to receive a carer skills intervention (ECHO) in addition to treatment as usual (TAU), or TAU alone, as part of a larger clinical trial. Carers and patients completed a standardised measure of psychological distress (The Depression, Anxiety, and Stress Scale) at baseline and 12 months post-treatment. The Actor Partner Interdependence Model was used to examine longitudinal changes in interdependence by treatment group. As expected, post-treatment levels of distress were related to baseline levels in both groups (actor effects). Moreover, carer distress at 12 months was related to patient distress at baseline for the TAU (partner effects), but not for the ECHO group. Finally, carers' distress change was not a significant predictor of patients' body mass index (BMI) change in the two treatment conditions. These findings are limited to predominantly mother-offspring dyads and may not generalise to other relationships. The ECHO intervention which is designed to teach carers skills in illness management and emotion regulation may be an effective addition to TAU for ameliorating interdependence of distress in patients and their primary carers over time.

Perceived impact of cancer among adolescents and young adults: Relationship with health-related quality of life and distress.

PubMed

Husson, O; Zebrack, B J

2017-09-01

To examine whether perceptions of the impact of cancer are related to health-related quality of life (HRQoL) and psychological distress among survivors of cancer in adolescence and young adulthood (AYA). One hundred seventy-three AYA cancer survivors (aged 18-35 and 15-29 years at time of diagnosis) completed a mailed survey assessing impact of cancer (IOC-AYA), HRQoL (SF-36), and distress (BSI-18). Hierarchical linear regression models analyzed the independent effects of perceived impacts of cancer on HRQoL and distress after controlling for clinical and sociodemographic characteristics. Multivariate analyses also examined the extent to which positive and negative perceptions attenuated the effects of control variables on HRQoL and distress. Being unemployed or not in school, and self-reported health problems were significantly associated with worse physical HRQoL. Mental HRQoL and psychological distress appeared as a function of reporting both positive and negative impacts of cancer; mental health outcomes were better in AYAs reporting more positive and less negative impact of cancer in their lives. Perceived impact of cancer, in both positive and negative ways, attenuated the effects of sociodemographic and clinical factors on mental HRQoL and psychological distress. Results suggest that mental HRQoL and psychological distress, but not physical HRQoL, are a function of survivors' perceptions of how cancer has affected them and continues to affect them in both positive and negative ways. Findings suggest that opportunities for AYA cancer survivors to reframe or better understand the context of cancer in their lives may result in improved mental health outcomes. Copyright © 2016 John Wiley & Sons, Ltd.

Psychological impact of serial prostate-specific antigen tests in Japanese men waiting for prostate biopsy.

PubMed

Kobayashi, Minoru; Nukui, Akinori; Kamai, Takao

2017-02-01

It is common to repeat prostate-specific antigen (PSA) measurements for men with intermediate PSA elevation before prostate biopsy. In this scenario, men with persistently elevated PSA values may have considerable psychological distress. We attempted to determine whether elevated PSA values have psychological effects on these men in association with the timing of measurement, PSA kinetics, and biopsy results. In order to investigate the initial and late effects of PSA tests on psychological distress during serial measurements, two groups of men with screen-positive results (PSA ≥3 ng/ml) were studied-205 men whose first questionnaires regarding anxiety and depression were taken at initial screening (group A), and 103 men whose questionnaires were taken at repeated measurement for prior PSA elevation (group B). The level of distress was generally low. There were no significant differences in distress between the two groups, suggesting a constant psychological effect by elevated PSA values over a long period of time. The distress of men in group A increased significantly as PSA levels rose and decreased when they fell to normal range. On the other hand, the distress of men in group B did not change regardless of PSA kinetics, indicating that their psychological condition seemed susceptible to subtle PSA change only in the initial phase of measurements. Unexpectedly, men with benign results showed insignificant but higher distress after prostate biopsy. Although a small fraction of men have psychological distress caused by changes in PSA levels, the benefits, risks (psychological and physical), and limitations of PSA tests must be adequately explained to the patients before entering the screening program.

Work-family spillover among Japanese dual-earner couples: a large community-based study.

PubMed

Shimada, Kyoko; Shimazu, Akihito; Bakker, Arnold B; Demerouti, Evangelia; Kawakami, Norito

2010-01-01

To examine the effects of multiple types of work-family spillover (work-to-family negative spillover, WFNS; family-to-work negative spillover, FWNS; and work-family positive spillover, WFPS) on psychological distress among Japanese dual-earner couples with preschool children. 2,346 parents completed questionnaires measuring work-family spillover, work- and family-specific variables (i.e., job demands and resources, family demands and resources), and psychological distress. A hierarchical multiple regression analysis was conducted by entering demographic characteristics (gender, age, age of the youngest child, and job contract) in step 1, job demands and resources in step 2, family demands and resources in step 3, work-family spillover in step 4, and three two-way interactions between types of work-family spillover and gender in the final step. Both WFNS and FWNS were positively related to psychological distress after controlling for demographic characteristics and domain specific variables (i.e. job and family demands/resources), and FWNS (β=0.26) had a stronger relation with psychological distress than WFNS (β=0.16). Although WFPS was significantly and negatively related to psychological distress, the relationship was weak (β=-0.05). In addition, two-way interactions of WFNS and FWNS with gender were found; the impact of both WFNS and FWNS on psychological distress is stronger for females than for males. No significant interaction effect was observed between WFPS and gender. In this study of Japanese dual-earner couples with preschool children, work-family negative spillover had a stronger relationship with psychological distress than positive spillover. Gender had a moderating effect on the relationship between negative spillover and psychological distress.

Adolescent psychological distress, unemployment, and the Great Recession: Evidence from the National Longitudinal Study of Youth 1997.

PubMed

Egan, Mark; Daly, Michael; Delaney, Liam

2016-05-01

Several studies have shown a link between psychological distress in early life and subsequent higher unemployment, but none have used sibling models to account for the unobserved family background characteristics which may explain the relationship. This paper uses the National Longitudinal Study of Youth 1997 data to examine whether adolescent psychological distress in 2000 predicts higher unemployment over 2000-11, whether this relationship changed in the period following the Great Recession, and whether it is robust to adjustment for family effects. 7125 cohort members (2986 siblings) self-reported their mental health in 2000 and employment activities over 2000-11. This association was examined using Probit and ordinary least squares regressions controlling for intelligence, physical health, other sociodemographic characteristics and family background. After adjustment for covariates and compared to those with low distress, highly distressed adolescents were 2.7 percentage points (32%) more likely to be unemployed, 5.1 points (26%) more likely to be unemployed or out of the labor force and experienced 11 weeks (28%) more unemployment. The impact of high distress was similar to a one standard deviation decrease in intelligence, and double the magnitude of having a serious physical health problem, and these estimates were robust to adjustment for family fixed-effects. The highly distressed were also disproportionately more likely to become unemployed or exit the labor force in the years following the Great Recession. These findings provide strong evidence of the unemployment penalty of early-life psychological distress and suggest that this relationship may be intensified during economic recessions. Investing in mental health in early life may be an effective way to reduce unemployment. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

A model of work-family conflict and well-being among Malaysian working women.

PubMed

Aazami, Sanaz; Akmal, Syaqirah; Shamsuddin, Khadijah

2015-01-01

Work and family are the two most important domains in a person's life. Lack of balance between work and family can lead to adverse consequences such as psychological distress; however, the effect of work-family conflict on psychological distress might be mediated by job and family dissatisfaction. This study examines a model of the four dimensions of work-family conflict and their consequences on psychological distress. In particular, we test whether job and family satisfaction mediate the effect of the four dimensions of work-family conflict on psychological distress. This cross-sectional study was conducted among 567 Malaysian women who are working in the public services. Structural Equation Modeling confirmed the mediating role of family satisfaction in the effect of strain-based work interference into family and time-based family interference into work on psychological distress. In addition, our results revealed a significant path that links job to family satisfaction. Moreover, time-based work interference into family and strain-based family interference into work significantly and negatively affect job satisfaction, which in turn influence family satisfaction and eventually affect psychological distress. The results of our study show that organizations need to develop and adapt family friendly policies to mitigate level of employees' work-family conflict.

Life after cancer: how does public stigma increase psychological distress of childhood cancer survivors?

PubMed

Kim, Min Ah; Yi, Jaehee

2014-12-01

Public stigma is a major source of stress for cancer survivors. However, factors that buffer or exacerbate the negative effects of public stigma on psychological distress have not been elucidated. This study examined how perceived public stigma affects psychological distress as mediated by cancer disclosure, internalized reactions to stigma, and social support availability. Cross-sectional study. The study was conducted in South Korea. The study sample was 223 adolescent and young adult survivors of childhood cancer diagnosed before the age of 19 and currently between 15 and 39 years old. Psychological distress was assessed using the Brief Symptom Inventory-18. Structural equation modeling was used with 1000 bootstrap samples. The goodness of model fit was acceptable. Public stigma perceived by cancer survivors influenced psychological distress via cancer disclosure, internalized shame, and social support availability. Higher levels of perceived public stigma predicted higher levels of internalized shame and self-blame and lower levels of social support availability, which subsequently increased psychological distress. Higher levels of perceived public stigma predicted lower levels of disclosure about cancer history and experiences. Cancer disclosure indirectly ameliorated psychological distress by reducing internalized shame. This study offers evidence that cognitive and social factors play important roles in mediating the effects of perceived public stigma on psychological distress in Korean cancer survivors. A greater understanding of factors that influence psychological distress may help psychosocial oncology service providers to identify childhood cancer survivors in need of psychosocial services and provide them with appropriate resources and interventions. Copyright © 2014 Elsevier Ltd. All rights reserved.

Childhood risk factors for alcohol abuse and psychological distress among adult lesbians.

PubMed

Hughes, Tonda L; Johnson, Timothy P; Wilsnack, Sharon C; Szalacha, Laura A

2007-07-01

This study examined the relationships between childhood and family background variables, including sexual and physical abuse, and subsequent alcohol abuse and psychological distress in adult lesbians. Structural equation modeling was used to evaluate relationships between childhood sexual and physical abuse and parenting variables and latent measures of lifetime alcohol abuse and psychological distress in a large community-based sample of lesbians. Childhood sexual abuse (CSA) directly predicted lifetime alcohol abuse, and childhood physical abuse (CPA) directly predicted lifetime psychological distress. In addition, CSA indirectly increased the risk of lifetime alcohol abuse through its negative effect on age at first heterosexual intercourse. Childhood physical abuse had only indirect effects on lifetime alcohol abuse through its strong relationship to lifetime psychological distress. Parental drinking problems and parental strictness directly predicted lifetime psychological distress; parental drinking problems indirectly predicted lifetime alcohol abuse through the mediators of age of drinking onset and lifetime psychological distress. White lesbians, younger lesbians, and those with lower levels of education were at greatest risk of psychological distress. While the cross-sectional design precludes causal conclusions, study findings--especially those related to CSA--are consistent with previous research on predominantly heterosexual women in the general population. Lesbians who experienced CSA were at heightened risk of lifetime alcohol abuse and those who experienced CPA were at heightened risk of lifetime psychological distress relative to lesbians without abuse histories. Given the dearth of research on childhood abuse and sexual orientation, studies are needed that examine the similarities and differences between lesbians' and heterosexual women's experiences of, and responses to, childhood abuse.

Physiological changes associated with routine nursing procedures in critically ill are common: an observational pilot study.

PubMed

Engström, J; Bruno, E; Reinius, H; Fröjd, C; Jonsson, H; Sannervik, J; Larsson, A

2017-01-01

Nursing procedures that are routinely performed in the intensive care unit (ICU) are assumed to have minimal side effects. However, these procedures may sometimes cause physiological changes that negatively affect the patient. We hypothesized that physiological changes associated with routine nursing procedures in the ICU are common. A clinical observational study of 16 critically ill patients in a nine-bed mixed university hospital ICU. All nursing procedures were observed, and physiological data were collected and subsequently analyzed. Minor physiological changes were defined as minimal changes in respiratory or circulatory variables, and major physiological changes were marked as hyper/hypotension, bradycardia/tachycardia, bradypnea/tachypnea, ventilatory distress, and peripheral blood oxygen desaturation. In the 16 patients, 668 procedures generated 158 major and 692 minor physiological changes during 187 observational hours. The most common procedure was patient position change, which also generated the majority of the physiological changes. The most common major physiological changes were blood oxygen desaturation, ventilatory distress, and hypotension, and the most common minor changes were arterial pressure alteration, coughing, and increase in respiratory rate. In this pilot study, we examined physiological changes in connection with all regular routine nursing procedures in the ICU. We found that physiological changes were common and sometimes severe. © 2016 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Health-related quality of life during adjuvant treatment for breast cancer among postmenopausal women.

PubMed

Browall, Maria; Ahlberg, Karin; Karlsson, Per; Danielson, Ella; Persson, Lars-Olof; Gaston-Johansson, Fannie

2008-07-01

The purpose of the present study was twofold: first, to describe changes of Health-Related Quality of Life (HRQoL) during the adjuvant treatment among postmenopausal women with breast cancer; second, in the same population to identify the best predictors of Overall Quality of Life (QoL) after treatment, from perceived functioning, symptoms, emotional distress and clinical/demographic variables measured at baseline. The study group was 150 women (> or = 55 years of age) scheduled for adjuvant chemotherapy (CT, n=75) or radiotherapy (RT, n=75). They were examined before (baseline), during and after completing the treatment. Data about QoL, perceived functioning, symptoms and emotional distress were collected with the European Organisation for Research and Treatment of Cancer (EORTC)-QLQ-C30, BR23 and Hospital Anxiety and Depression Scale (HADS) questionnaires. The general finding was that the adjuvant treatments were associated with decrease in overall QoL, physical and role functioning, anxiety and body image, as well as with increase in fatigue, dyspnoea, pain, nausea/vomiting, constipation and systemic therapy side effects measured over time. For women receiving CT, better emotional functioning and less pain at baseline predicted better overall QoL at the end of the treatment. For women receiving RT, better physical and emotional functioning, less breast symptoms and lower tumour stage at baseline predicted better overall QoL at the end of the treatment.

Optimal management of fatigue in patients with systemic lupus erythematosus: a systematic review

PubMed Central

Yuen, Hon K; Cunningham, Melissa A

2014-01-01

Among the host of distressing pathophysiological and psychosocial symptoms, fatigue is the most prevalent complaint in patients with systemic lupus erythematosus (SLE). This review is to update the current findings on non-pharmacological, pharmacological, and modality strategies to manage fatigue in patients with SLE and to provide some recommendations on optimal management of fatigue based on the best available evidence. We performed a systematic literature search of the PubMed and Scopus databases to identify publications on fatigue management in patients with SLE. Based on the studies reported in the literature, we identified nine intervention strategies that have the potential to alleviate fatigue in patients with SLE. Of the nine strategies, aerobic exercise and belimumab seem to have the strongest evidence of treatment efficacy. N-acetylcysteine and ultraviolet-A1 phototherapy demonstrated low-to-moderate levels of evidence. Psychosocial interventions, dietary manipulation (low calorie or glycemic index diet) aiming for weight loss, vitamin D supplementation, and acupuncture all had weak evidence. Dehydroepiandrosterone is not recommended due to a lack of evidence for its efficacy. In addition to taking treatment efficacy and side effects into consideration, clinicians should consider factors such as cost of treatment, commitments, and burden to the patient when selecting fatigue management strategies for patients with SLE. Any comorbidities, such as psychological distress, chronic pain, sleep disturbance, obesity, or hypovitaminosis D, associated with fatigue should be addressed. PMID:25328393

Life-course pathways to psychological distress: a cohort study

PubMed Central

von Stumm, Sophie; Deary, Ian J; Hagger-Johnson, Gareth

2013-01-01

Objectives Early life factors, like intelligence and socioeconomic status (SES), are associated with health outcomes in adulthood. Fitting comprehensive life-course models, we tested (1) the effect of childhood intelligence and SES, education and adulthood SES on psychological distress at midlife, and (2) compared alternative measurement specifications (reflective and formative) of SES. Design Prospective cohort study (the Aberdeen Children of the 1950s). Setting Aberdeen, Scotland. Participants 12 500 live-births (6282 boys) between 1950 and 1956, who were followed up in the years 2001–2003 at age 46–51 with a postal questionnaire achieving a response rate of 64% (7183). Outcome measures Psychological distress at age 46–51 (questionnaire). Results Childhood intelligence and SES and education had indirect effects on psychological distress at midlife, mediated by adult SES. Adult SES was the only variable to have a significant direct effect on psychological distress at midlife; the effect was stronger in men than in women. Alternative measurement specifications of SES (reflective and formative) resulted in greatly different model parameters and fits. Conclusions Even though formative operationalisations of SES are theoretically appropriate, SES is better specified as reflective than as a formative latent variable in the context of life-course modelling. PMID:23667162

Life-course pathways to psychological distress: a cohort study.

PubMed

von Stumm, Sophie; Deary, Ian J; Hagger-Johnson, Gareth

2013-05-09

Early life factors, like intelligence and socioeconomic status (SES), are associated with health outcomes in adulthood. Fitting comprehensive life-course models, we tested (1) the effect of childhood intelligence and SES, education and adulthood SES on psychological distress at midlife, and (2) compared alternative measurement specifications (reflective and formative) of SES. Prospective cohort study (the Aberdeen Children of the 1950s). Aberdeen, Scotland. 12 500 live-births (6282 boys) between 1950 and 1956, who were followed up in the years 2001-2003 at age 46-51 with a postal questionnaire achieving a response rate of 64% (7183). Psychological distress at age 46-51 (questionnaire). Childhood intelligence and SES and education had indirect effects on psychological distress at midlife, mediated by adult SES. Adult SES was the only variable to have a significant direct effect on psychological distress at midlife; the effect was stronger in men than in women. Alternative measurement specifications of SES (reflective and formative) resulted in greatly different model parameters and fits. Even though formative operationalisations of SES are theoretically appropriate, SES is better specified as reflective than as a formative latent variable in the context of life-course modelling.

Prospective effect of community distress and subcultural orientation on mortality following life-threatening diseases in later life.

PubMed

Wen, Ming; Christakis, Nicholas A

2006-07-01

We conducted a prospective and contextual study to examine the effects of community social-economic-physical distress and subcultural orientation on mortality following onset of 13 life-threatening diseases in later life. We also examined the inter-relationship between the effects of community social, economic and physical distress (i.e. poverty, physical disorder and low collective efficacy) and subcultural orientation (i.e. anomie and tolerance of risk behaviour) on the survival chances of seriously ill older patients. Three data sources were combined to construct the working sample: 1990 Census data, the 1994-95 PHDCN-CS, and the COSI data. Fifty-one ZIP code areas in Chicago and 12,672 elderly patients were studied. Community distress (HR = 1.04; 95% CI = (1.01, 1.07)) and anomie (HR = 1.26; 95% CI = (1.02, 1.54)) are found to be significantly and positively associated with a higher hazard of death. Moreover, community anomie contributes to the effect of community distress on post-hospitalisation mortality. The social, economic, physical and cultural environment in which people live appears to exert a significant impact on whether older people facing life-threatening illness live or die.

Attitudes toward mental illness in adults by mental illness-related factors and chronic disease status: 2007 and 2009 Behavioral Risk Factor Surveillance System.

PubMed

Kobau, Rosemarie; Zack, Matthew M

2013-11-01

We examined how attitudes toward mental illness treatment and its course differ by serious psychological distress, mental illness treatment, chronic disease, and sociodemographic factors using representative state-based data. Using data from jurisdictions supporting the Behavioral Risk Factor Surveillance System's Mental Illness and Stigma Module (35 states, the District of Columbia, and Puerto Rico), we compared adjusted proportions of adults agreeing that "Treatment can help people with mental illness lead normal lives" (treatment effectiveness) and that "People are generally caring and sympathetic to people with mental illness" (supportive environment), by demographic characteristics, serious psychological distress, chronic disease status, and mental illness treatment. Attitudes regarding treatment effectiveness and a supportive environment for people with mental illness varied within and between groups. Most adults receiving mental illness treatment agreed that treatment is effective. Fewer adults with serious psychological distress than those without such distress agreed that treatment is effective. Fewer of those receiving treatment, those with psychological distress, and those with chronic disease perceived the environment as supportive. These data can be used to target interventions for population subgroups with less favorable attitudes and for surveillance.

Mechanisms involved in the psychological distress of Black Caribbeans in the United States

NASA Astrophysics Data System (ADS)

Govia, Ishtar O.

The mental health of ethnic minorities in the United States is of urgent concern. The accelerated growth of groups of ethnic minorities and immigrants in the United States and the stressors to which they are exposed, implores academic researchers to investigate more deeply health disparities and the factors that exacerbate or minimize such inequalities. This dissertation attended to that concern. It used data from the National Survey of American Life (NSAL), the first survey with a national representative sample of Black Caribbeans, to explore mechanisms that involved in the psychological distress of Black Caribbeans in the United States. In a series of three studies, the dissertation investigated the role and consequence of (1) chronic discrimination, immigration factors, and closeness to ethnic and racial groups; (2) personal control and social support; and (3) family relations and social roles in the psychological distress of Black Caribbeans. Study 1 examined how the associations between discrimination and psychological distress were buffered or exacerbated by closeness to ethnic group and closeness to racial group. It also examined how these associations differed depending on immigration factors. Results indicated that the buffering or exacerbating effect of ethnic and racial group closeness varied according to the type of discrimination (subtle or severe) and were more pronounced among those born in the United States. Using the stress process framework, Study 2 tested moderation and mediation models of the effects of social support and personal control in the association between discrimination and distress. Results from a series of analyses on 579 respondents suggested that personal control served as a mediator in this relationship and that emotional support exerted a direct distress deterring function. Study 3 investigated sex differences in the associations between social roles, intergenerational family relationship perceptions and distress. Results suggested that positive relationships with an adult son/daughter and with a father, and negative relationships with a mother increased men's distress. Few social roles increased the negative effect that women and men's relationships with an adult son/daughter had on their distress. Multiple roles also increased the negative effect that women's relationships with an adult son/daughter had on their distress. On the other hand, few social roles decreased the distress associated with men's high conflict relationships with mothers. The findings from these three studies suggested that modeling immigrant and ethnic minority mental health requires sensitivity to their immigrant and ethnic minority statuses and to the contexts in which these group members carry out their daily activities.

Examining the mediating effect of work-to-family conflict on the associations between job stressors and employee psychological distress: a prospective cohort study.

PubMed

Oshio, Takashi; Inoue, Akiomi; Tsutsumi, Akizumi

2017-08-03

The mediating effect of work-to-family conflict (WFC) on the associations between eight types of job stressors (measured based on the job demands-control, effort-reward imbalance and organisational justice models) and psychological distress in employees was examined. This study employed a prospective design. An occupational cohort study in Japan (Japanese Study of Health, Occupation, and Psychosocial Factors Related Equity; J-HOPE). 5859 men and 1560 women who were working for 11 firms and participated at three consecutive waves of J-HOPE, at 1-year intervals, from 2010 to 2013. Psychological distress, as measured by Kessler 6 scores. Mediation analysis using data on job stressors at baseline, WFC at 1-year follow-up and psychological distress at 2-year follow-up showed that WFC mediated 39.1% (95% CI 29.1% to 49.1%) and 44.5% (95% CI 31.4% to 51.7%) of the associations of psychological distress with job demands and effort, respectively, for men. The mediating effect of WFC was smaller for job stressors indicating reduced job resources, compared with job demands and effort. The mediating effect of WFC was somewhat larger for women than it was for men, with WFC mediating 47.5% (95% CI 22.5% to 72.6%) and 64.0% (95% CI 24.3% to 100.0%) of the associations of psychological distress with job demands and effort, respectively. WFC was a key mediator in the associations between most job stressors and employee psychological distress. Results suggest that policy measures and support from supervisors, to prevent job stressors from adding to WFC, are needed to reduce employee psychological distress. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Effects of listening to music on pain intensity and pain distress after surgery: an intervention.

PubMed

Vaajoki, Anne; Pietilä, Anna-Maija; Kankkunen, Päivi; Vehviläinen-Julkunen, Katri

2012-03-01

To evaluate the effects of music listening on pain intensity and pain distress on the first and second postoperative days in abdominal surgery patients and the long-term effects of music on the third postoperative day. Music has been found to relieve pain intensity in surgery patients. There are only a few studies on music intervention in abdominal surgery. Music intervention studies assessing multidimensional pain such as pain intensity and pain distress are also scarce. Prospective clinical study with two parallel groups. Patients undergoing elective abdominal surgery (n = 168) were divided into either a music group (n = 83) or a control group (n = 85). Patients assessed pain intensity and pain distress in bed rest, during deep breathing and in shifting position once in the evening of the operation day and on the first and second postoperative days in the morning, at noon and in the evening. On the third postoperative day, the patients assessed their pain intensity and pain distress only once. In the music group, the patients' pain intensity and pain distress in bed rest, during deep breathing and in shifting position were significantly lower on the second postoperative day compared with control group of patients. On the third postoperative day, when long-term effects of music on pain intensity and pain distress were assessed, there were no significant differences between music and control groups. This study demonstrates that the use of music alleviates pain intensity and pain distress in bed rest, during deep breathing and in shifting position after abdominal surgery on the second postoperative day. Music intervention is safe, inexpensive and easily used to improve the healing environment for abdominal surgery patients. Music intervention should be offered as an adjunct alternative to pharmacological pain relief after abdominal surgery in nursing practice. © 2011 Blackwell Publishing Ltd.

The importance of social support in the associations between psychological distress and somatic health problems and socio-economic factors among older adults living at home: a cross sectional study

PubMed Central

2012-01-01

Background Little is known of the importance of social support in the associations between psychological distress and somatic health problems and socio-economic factors among older adults living at home. The objectives of the present study were to investigate the associations of social support, somatic health problems and socio-economic factors with psychological distress. We also examined changes in the association of somatic health problems and socio-economic factors with psychological distress after adjusting for social support. Methods A random sample of 4,000 persons aged 65 years or more living at home in Oslo was drawn. Questionnaires were sent by post, and the total response was 2,387 (64%). Psychological distress was assessed using Hopkins Symptom Checklist (HSCL-10) and social support with the Oslo-3 Social Support Scale (OSS-3). A principal component analysis (PCA) included all items of social support and psychological distress. Partial correlations were used, while associations were studied by logistic regression. Results After adjusting for socio-demographics and somatic health problems, we reported a statistically significant association between psychological distress and social support: “Number of close friends”, OR 0.61; 95% CI 0.47-0.80; “Concern and interest”, OR 0.68; 95% CI 0.55-0.84. A strong association between lack of social support and psychological distress, irrespective of variables adjusted for, indicated a direct effect. The associations between psychological distress and physical impairments were somewhat reduced when adjusted for social support, particularly for hearing, whereas the associations between somatic diagnoses and psychological distress were more or less eliminated. Income was found to be an independent determinant for psychological distress. Conclusions Lack of social support and somatic health problems were associated with psychological distress in elders. Social support acted as a mediator, implying that the negative effect of somatic health problems, especially hearing, on psychological distress was mediated by low social support. We hypothesize that physical impairments reduced social support, thereby increasing psychological distress to a greater extent than the selected diagnoses. The combination of poor social support, poor somatic health and economic problems may represent a vulnerable situation with respect to the mental health of older persons. Free interventions that highlight social support should be considered in mental health promotion. PMID:22682023

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 distress in men and women. Good partner relationship, both as perceived by the individual him(her)self and by the spouse, quite strongly moderates adverse effects of various types of emotional strain. PMID:22264243

The effects of perceived racism on psychological distress mediated by venting and disengagement coping in Native Hawaiians.

PubMed

Kaholokula, Joseph Keawe'aimoku; Antonio, Mapuana C K; Ing, Claire K Townsend; Hermosura, Andrea; Hall, Kimberly E; Knight, Rebecca; Wills, Thomas A

2017-01-12

Studies have linked perceived racism to psychological distress via certain coping strategies in several different racial and ethnic groups, but few of these studies included indigenous populations. Elucidating modifiable factors for intervention to reduce the adverse effects of racism on psychological well-being is another avenue to addressing health inequities. We examined the potential mediating effects of 14 distinct coping strategies on the relationship between perceived racism and psychological distress in a community-based sample of 145 Native Hawaiians using structural equation modeling. Perceived racism had a significant indirect effect on psychological distress, mediated through venting and behavioral disengagement coping strategies, with control for age, gender, educational level, and marital status. The findings suggest that certain coping strategies may exacerbate the deleterious effects of racism on a person's psychological well-being. Our study adds Native Hawaiians to the list of U.S. racial and ethnic minorities whose psychological well-being is adversely affected by racism.

Family Cohesion and its Relationship to Psychological Distress among Latino Groups

PubMed Central

Rivera, Fernando I.; Guarnaccia, Peter J.; Mulvaney-Day, Norah; Lin, Julia Y.; Torres, Maria; Alegria, Margarita

2009-01-01

This paper presents analyses of a representative sample of US Latinos (N=2540) to investigate whether family cohesion moderates the effects of cultural conflict on psychological distress. The results for the aggregated Latino group suggests a significant association between family cohesion and lower psychological distress and the combination of strong family cohesion with presence of family cultural conflict was associated with higher psychological distress. However, this association differed by Latino groups. We found no association for Puerto Ricans, Cuban results were similar to the aggregate group, family cultural conflict in Mexicans was associated with higher psychological distress, while family cohesion in Other Latinos was associated with higher psychological distress. Implications of these findings are discussed to unravel the differences in family dynamics across Latino subethnic groups. PMID:19444326

Meta-analysis of studies assessing the efficacy of projective techniques in discriminating child sexual abuse.

PubMed

West, M M

1998-11-01

This meta-analysis of 12 studies assesses the efficacy of projective techniques to discriminate between sexually abused children and nonsexually abused children. A literature search was conducted to identify published studies that used projective instruments with sexually abused children. Those studies that reported statistics that allowed for an effect size to be calculated, were then included in the meta-analysis. There were 12 studies that fit the criteria. The projectives reviewed include The Rorschach, The Hand Test, The Thematic Apperception Test (TAT), the Kinetic Family Drawings, Human Figure Drawings, Draw Your Favorite Kind of Day, The Rosebush: A Visualization Strategy, and The House-Tree-Person. The results of this analysis gave an over-all effect size of d = .81, which is a large effect. Six studies included only a norm group of nondistressed, nonabused children with the sexual abuse group. The average effect size was d = .87, which is impressive. Six studies did include a clinical group of distressed nonsexually abused subjects and the effect size lowered to d = .76, which is a medium to large effect. This indicates that projective instruments can discriminate distressed children from nondistressed subjects, quite well. In the studies that included a clinical group of distressed children who were not sexually abused, the lower effect size indicates that the instruments were less able to discriminate the type of distress. This meta-analysis gives evidence that projective techniques have the ability to discriminate between children who have been sexually abused and those who were not abused sexually. However, further research that is designed to include clinical groups of distressed children is needed in order to determine how well the projectives can discriminate the type of distress.

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.

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.

Do distress responses to a traumatic film predict susceptibility to the misinformation effect?

PubMed

Monds, Lauren A; Paterson, Helen M; Kemp, Richard I; Bryant, Richard A

2013-01-01

The misinformation effect is defined as an impairment in memory for past events due to exposure to misleading information (E. F. Loftus, 2005 ). Some people may be more susceptible to the misinformation effect than others, and this may also depend on their response to a distressing event. The purpose of the current study was to investigate several key factors that may contribute to misinformation susceptibility for distressing events, namely posttraumatic stress disorder symptoms such as avoidance, intrusions, and dissociation. Participants watched either a neutral or trauma film, rated their level of distress, and completed measures of trait and state dissociation. When participants returned a week later, misinformation was introduced via an eyewitness statement and free recall was assessed. Findings indicated that dissociation was related to higher distress ratings following the film but was not related to acceptance of misinformation. However, avoidance scores were related to increased recall of misinformation items, and reported experiences of intrusions were related to greater accuracy. These results are discussed in light of the paradoxical negative emotion hypothesis.

The Effects of the Second Victim Phenomenon on Work-Related Outcomes: Connecting Self-reported Caregiver Distress to Turnover Intentions and Absenteeism

PubMed Central

Burlison, Jonathan D.; Quillivan, Rebecca R.; Scott, Susan D.; Johnson, Sherry; Hoffman, James M.

2016-01-01

Objectives Second victim experiences can affect the well-being of healthcare providers and compromise patient safety. The purpose of this study was to assess the relationships between self-reported second victim-related distress to turnover intention and absenteeism. Organizational support was examined concurrently because it was hypothesized to explain the potential relationships between distress and work-related outcomes. Methods A cross-sectional, self-report survey of nurses directly involved in patient care (N = 155) was analyzed by using hierarchical linear regression. The Second Victim Experience and Support Tool, which assesses organizational support, distress due to patient safety event involvement, and work-related outcomes, was also used. Results Second victim distress was significantly associated with intentions to turnover (β = .377, p < .001) and absenteeism (β = .316, p < .001), while controlling for the effects of demographic variables. Organizational support also fully mediated the distress–intentions to turnover (Sobel = 2.11, p < .05) and distress–absenteeism (Sobel = 2.40, p < .05) relationships. Conclusions The personal effects of involvement in patient safety events and the important role of organizational support in limiting caregiver event-related trauma have been acknowledged. This study is one of the first to connect second victim distress to work-related outcomes. It also demonstrated that the relationships among distress and work outcomes can be explained by perceptions of organizational support. This reinforces the efforts health care organizations are making to develop resources to support their staff after patient safety events occur. This study broadens the understanding of the negative effects of a second victim experience and the need to support caregivers as they recover from adverse event involvement. PMID:27811593

Intelligence and neuroticism in relation to depression and psychological distress: Evidence from two large population cohorts.

PubMed

Navrady, L B; Ritchie, S J; Chan, S W Y; Kerr, D M; Adams, M J; Hawkins, E H; Porteous, D; Deary, I J; Gale, C R; Batty, G D; McIntosh, A M

2017-06-01

Neuroticism is a risk factor for selected mental and physical illnesses and is inversely associated with intelligence. Intelligence appears to interact with neuroticism and mitigate its detrimental effects on physical health and mortality. However, the inter-relationships of neuroticism and intelligence for major depressive disorder (MDD) and psychological distress has not been well examined. Associations and interactions between neuroticism and general intelligence (g) on MDD, self-reported depression, and psychological distress were examined in two population-based cohorts: Generation Scotland: Scottish Family Health Study (GS:SFHS, n=19,200) and UK Biobank (n=90,529). The Eysenck Personality Scale Short Form-Revised measured neuroticism and g was extracted from multiple cognitive ability tests in each cohort. Family structure was adjusted for in GS:SFHS. Neuroticism was strongly associated with increased risk for depression and higher psychological distress in both samples. Although intelligence conferred no consistent independent effects on depression, it did increase the risk for depression across samples once neuroticism was adjusted for. Results suggest that higher intelligence may ameliorate the association between neuroticism and self-reported depression although no significant interaction was found for clinical MDD. Intelligence was inversely associated with psychological distress across cohorts. A small interaction was found across samples such that lower psychological distress associates with higher intelligence and lower neuroticism, although effect sizes were small. From two large cohort studies, our findings suggest intelligence acts a protective factor in mitigating the effects of neuroticism on psychological distress. Intelligence does not confer protection against diagnosis of depression in those high in neuroticism. Copyright © 2017 The Authors. Published by Elsevier Masson SAS.. All rights reserved.

Interpersonal goals and change in anxiety and dysphoria in first-semester college students.

PubMed

Crocker, Jennifer; Canevello, Amy; Breines, Juliana G; Flynn, Heather

2010-06-01

Two longitudinal studies examined the associations between interpersonal goals (i.e., self-image and compassionate goals) and anxiety and dysphoria (i.e., distress). In Study 1, 199 college freshmen (122 women, 77 men) completed 12 surveys over 12 weeks. Compassionate goals predicted decreased distress, and self-image goals predicted increased distress from pretest to posttest when distress was assessed as anxiety, dysphoria, or a composite, and when the goals were worded as approach goals, avoidance goals, or a composite. In Study 2, 115 first-semester roommate pairs (86 female and 29 male pairs) completed 12 surveys over 12 weeks. Compassionate and self-image goals predicted distress in same-week, lagged-week, and pretest-to-posttest analyses; effects of compassionate goals remained significant when the authors controlled for several known risk factors. Having clear goals consistently explained the association between compassionate goals but not self-image goals and distress. Results supported a path model in which compassionate goals predict increased support given to roommates, which predicts decreased distress. Results also supported a reciprocal association; chronic distress predicted decreased compassionate and increased self-image goals from pretest to posttest, and weekly distress predicted decreased compassionate goals the subsequent week. The results suggest that compassionate goals contribute to decreased distress because they provide meaning and increase support given to others. Distress, in turn, predicts change in goals, creating the potential for upward and downward spirals of goals and distress. (c) 2010 APA, all rights reserved).

Longitudinal study of the protective effect of hope on reducing body image distress in cancer patients.

PubMed

Liu, Jianlin; Griva, Konstadina; Lim, Haikel A; Tan, Joyce Y S; Mahendran, Rathi

2017-01-01

Body image distress is well-documented in patients with cancer, but little is known about the course of body image distress over time and the role of psychosocial resources such as hope. This prospective study sought to explore the dynamics between trajectories of body image distress and hope across time. Cancer patients receiving outpatient treatment at a cancer center completed self-reported measures of body image distress (Body Image Scale) and hope (Adult Hope Scale) at baseline (within three months of their cancer diagnosis) and follow-up (six months post-baseline; N = 111). Trajectories of intra-individual change (improved, stable, and declined) for body image distress were calculated based on the minimal clinically important difference (±0.5 baseline SD). There was a significant increase in body image distress at follow-up (p < .05); hope remained stable. Rank-transformed mixed-factor repeated measures analyses of variance revealed significant interactions between body image distress trajectory groups and time on hope, suggesting that patients experiencing improvements in body image distress reported higher levels of hope than those who had stable or deteriorating levels of body image distress F(2,108) = 3.25, p < .05. The findings of this exploratory study suggest that psychosocial resources like hope may also reduce body image distress across time in a sample of cancer patients, although the mechanisms of interaction require further examination. Supportive care could lend greater focus to improving patients' hope to alleviating body image distress.

Partner relationship, social support and perinatal distress among pregnant Icelandic women.

PubMed

Jonsdottir, Sigridur Sia; Thome, Marga; Steingrimsdottir, Thora; Lydsdottir, Linda Bara; Sigurdsson, Jon Fridrik; Olafsdottir, Halldora; Swahnberg, Katarina

2017-02-01

It is inferred that perinatal distress has adverse effects on the prospective mother and the health of the foetus/infant. More knowledge is needed to identify which symptoms of perinatal distress should be assessed during pregnancy and to shed light on the impact of women's satisfaction with their partner relationship on perinatal distress. The current study aimed to generate knowledge about the association of the partner relationship and social support when women are dealing with perinatal distress expressed by symptoms of depression, anxiety and stress. A structured interview was conducted with 562 Icelandic women who were screened three times during pregnancy with the Edinburgh Depression Scale and the Depression, Anxiety, Stress Scale. Of these, 360 had symptoms of distress and 202 belonged to a non-distress group. The women answered the Multidimensional Scale of Perceived Social Support and the Dyadic Adjustment Scale. The study had a multicentre prospective design allowing for exploration of association with perinatal distress. Women who were dissatisfied in their partner relationship were four times more likely to experience perinatal distress. Women with perinatal distress scored highest on the DASS Stress Subscale and the second highest scores were found on the Anxiety Subscale. Satisfaction in partner relationship is related to perinatal distress and needs to be assessed when health care professionals take care of distressed pregnant women, her partner and her family. Assessment of stress and anxiety should be included in the evaluation of perinatal distress, along with symptoms of depression. Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Understanding Women's Differing Experiences of Distress after Colposcopy: A Qualitative Interview Study.

PubMed

O'Connor, Mairead; Waller, Jo; Gallagher, Pamela; Martin, Cara M; O'Leary, John J; D'Arcy, Tom; Prendiville, Walter; Flannelly, Grainne; Sharp, Linda

2015-01-01

Women who have an abnormal cervical cytology test may be referred for a colposcopy. Accumulating evidence suggests some women may experience distress after colposcopy. This exploratory study examined women's differing experiences of post-colposcopy distress with the aim of identifying factors that are predictive of, or protective against, distress. We carried out semistructured, qualitative interviews with 23 women who had undergone colposcopies. Interviews were transcribed verbatim, coded, and analyzed thematically. The Framework Approach was used to summarize and organize the data and identify emerging higher order themes. Two forms of post-colposcopy distress emerged: 1) short term and 2) long term. Short-term distress was experienced immediately after the colposcopy and in the days afterward, and was usually related to the physical experience of the colposcopy. Long-term distress typically persisted over time and was related to concerns about fertility, cervical cancer, and sexual intercourse. The drivers of short-term and long-term distress differed. Factors related to short-term distress were feeling unprepared for the procedure, having a negative experience of the procedure, and attending the clinic alone. Factors related to long-term distress were future intentions to have (more) children, having physical after-effects of the procedure that impacted on the woman's life, and being under on-going clinic surveillance. Absence of these factors (e.g., being accompanied to the clinic) was protective against short- and long-term distress. Colposcopy can lead to short- and long-term post-procedural distress for some women. We identified a range of factors, some potentially modifiable, that seem to influence the chances of experiencing distress. These results may inform the development of strategies or interventions aimed at preventing or minimizing distress after colposcopy and related procedures. Copyright © 2015 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

The association between malnutrition and psychological distress in patients with advanced head-and-neck cancer

PubMed Central

Ma, L.; Poulin, P.; Feldstain, A.; Chasen, M.R.

2013-01-01

Objective Malnutrition and psychological distress are often seen in patients with head-and-neck cancer, but little is known about the interrelationships between those two symptoms. The present study examined the relationship between malnutrition and psychological distress in patients with advanced head-and-neck cancer. Methods Using the Patient-Generated Subjective Global Assessment, 99 patients with advanced-stage head-and-neck cancer were screened for nutrition status. The patients were also screened for psychosocial distress (using the Distress Thermometer) and for psychosocial issues (using the Problem Checklist). Any relationship between malnutrition and psychosocial distress was determined by regression and correlation analysis. We also used t-tests to compare distress levels for patients with and without specific nutrition-related symptoms. Results The study group included 80 men and 19 women [mean age: 58.4 ± 10.9 years (range: 23–85 years)]. The correlation between poorer nutrition status and level of psychological distress was significant r = 0.37 (p < 0.001). Specifically, reduced food intake and symptoms were both positively associated with distress: r = 0.27 and r = 0.29 respectively, both significant at p < 0.01. After controlling for the effects of psychosocial problems and pain, nutrition status remained a significant predictor of distress, explaining 3.8% of the variance in the distress scores of the patients (p < 0.05). Conclusions Malnutrition and symptoms were strongly related to distress in patients with advanced head-and-neck cancer. Our results suggest the need for further research into the complex relationship between nutrition status and distress and into the management of both nutrition and distress in cancer care. PMID:24311956

Can live music therapy reduce distress and pain in children with burns after wound care procedures? A randomized controlled trial.

PubMed

van der Heijden, Marianne J E; Jeekel, Johannes; Rode, Heinz; Cox, Sharon; van Rosmalen, Joost; Hunink, Myriam G M; van Dijk, Monique

2018-06-01

Burn wound care procedures are very painful and lead to distress. Live music therapy has shown beneficial effects on distress and pain in specific pediatric patient populations. In this study we measured whether live music therapy has beneficial effects in terms of less distress and pain in children with burns after wound care procedures. This randomized assessor-blinded controlled trial (RCT) took place at the burns unit of the Red Cross War Memorial Children's Hospital, Cape Town, South Africa. It included newly admitted inpatients between the ages of 0 and 13 years undergoing their first or second wound care procedures. Excluded were children with a hearing impairment or low level of consciousness. The intervention group received one live music therapy session directly after wound care in addition to standard care. The control group received standard care only. The primary outcome was distress measured with the Observational Scale of Behavioral Distress-revised (OSBD-r). The secondary outcome was pain measured with the COMFORT-behavioral scale (COMFORT-B). In addition, in children older than 5 years self-reported distress with the validated Wong-Baker scale (FACES) and pain with the Faces Pain Scale-Revised (FPS-R) were measured. Patients in both groups were videotaped for three minutes before wound care; during the music therapy or the control condition; and for two minutes thereafter. Two researchers, blinded to the study condition, independently scored the OSBD-r and the COMFORT-B from the video footage before and after music therapy. We included 135 patients, median age 22.6 months (IQR 15.4-40.7 months). Change scores did not significantly differ between the intervention and the control groups for either distress (p=0.53; d=0.11; 95% CI -0.23 to 0.45) or pain (p=0.99; d=0.04; 95% CI -0.30 to 0.38). Self-reported distress in a small group of children (n=18) older than 5 years indicated a significant reduction in distress after live music therapy (p=0.05). Live music therapy was not found effective in reducing distress and pain in young children after burn wound care. Older children might be more responsive to this intervention. Copyright © 2018 Elsevier Ltd and ISBI. All rights reserved.

Acculturation and Acculturative Stress as Predictors of Psychological Distress and Quality-of-Life Functioning in Hispanic Psychiatric Patients

ERIC Educational Resources Information Center

Thoman, Lisa Vinuesa; Suris, Alina

2004-01-01

This study examined acculturation level and type, acculturative stress, and several demographic variables as predictors of psychological distress and health-related quality of life in a sample of 101 Hispanic patients at a community psychiatric clinic. Acculturative stress was predictive of psychological distress beyond the effects of the…

Cryotherapy effect on oral mucositis severity among recipients of bone marrow transplantation: a literature review.

PubMed

Tayyem, Abdel-Qader Mahmoud

2014-08-01

Oral mucositis is a distressing toxic effect of cancer therapy and one of the major side effects of the myeloablative conditioning used to prepare patients for bone marrow transplantation (BMT). Oral cryotherapy is one of the recent modalities used to prevent and manage oral mucositis. The purpose of this review is to clarify the cryotherapy effect on oral mucositis severity among patients receiving myeloablative conditioning followed by BMT. A literature search was performed using six different electronic databases: CINAHL®, MEDLINE®, Nursing Ovid, PubMed, Springer, and Science Direct. Six articles were deemed relevant and included in this review. Oral mucositis increases mortality rate, length of hospital stay, opioid use, and the need for parenteral nutrition usage. It also decreases patient's quality of life and his or her desire to complete treatment. However, oral cryotherapy significantly minimizes the incidence and severity of oral mucositis and decreases secondary oral mucositis complications. Using oral cryotherapy concurrently with a regular oral care protocol can improve its efficacy for preventing and managing oral mucositis. Additional studies should be conducted to create standard oral cryotherapy protocols.

Attachment and Temperament Revisited: Infant Distress, Attachment Disorganization, and the Serotonin Transporter Polymorphism.

PubMed

Brumariu, Laura E; Bureau, Jean-François; Nemoda, Zsofia; Sasvari-Szekely, Maria; Lyons-Ruth, Karlen

This study's aim was to evaluate whether infant disorganized attachment and infant proneness to distress exhibited differential relations to infant genetic factors as indexed by the serotonin transporter polymorphism. The role of the short allele of the serotonin transporter polymorphism (5-HTTLPR) in enhancing sensitivity to fearful and negative affect has been well-established (Canli & Lesch, 2007). In the current study, we used this known property of the short allele to provide a test of an important postulate of attachment theory, namely that infant attachment security or disorganization is not a function of the infant's proneness to distress. Participants were 39 parents and infants assessed between 12 and 18 months in the Strange Situation procedure. Genotype categories for the 5-HTTLPR (and rs25531) were created by both the original and the reclassified grouping system; infant proneness to distress was assessed directly in the Strange Situation Procedure. We also assessed maternal behavior at 18 months to evaluate whether any observed genetic effect indicated a passive effect through the mother. Consistent with previous findings, the 5-HTTLPR short allele was significantly related to the infant's wariness and distress, but was not related to attachment security or attachment disorganization. In addition, maternal disrupted interaction with the infant was not related to infant genotype or infant distress. Results support the concept that infant proneness to distress is associated with serotonergic factors while infant attachment security or disorganization is not a function of either 5-HTTLPR or behaviorally rated proneness to distress.

Family caregivers' attributions about care-recipient behaviour: does caregiver relationship satisfaction mediate the attribution-distress relationship?

PubMed

Hui, Siu-Kuen Azor; Elliott, Timothy R; Martin, Roy; Uswatte, Gitendra

2011-09-01

The relations of caregiver attributions about care-recipient's problem behaviour to caregiving relationship satisfaction and caregiver distress were examined. This is a cross sectional study. Seventy-five family caregivers of individuals diagnosed with various disabling health conditions were recruited and interviewed. Caregiver attributions (internality, intentionality, responsibility, and controllability), caregiving relationship satisfaction, and caregiver distress variables were measured. Structural equation techniques tested an a priori model of the latent constructs of caregiver attributions and caregiver relationship satisfaction to caregiver distress. Maladaptive caregiver attributions (i.e., more trait, higher intentionality, higher responsibility, and higher controllability) about care-recipients' problem behaviours predicted lower caregiving relationship satisfaction, which in turn was predictive of higher caregiver distress. Unexpectedly, caregiver attributions were not directly related to caregiver distress. However, attributions had an indirect effect on distress through relationship satisfaction. Younger caregivers experienced higher caregiver distress. Caregivers' explanations about care-recipient's problem behaviour are indicative of their satisfaction in the relationship with the care recipient, and poor caregiving relationship satisfaction is predictive of caregiver distress. Caregiver attributions and relationship quality may be considered in interventions with family caregivers. ©2010 The British Psychological Society.

Direct-to-consumer pharmacogenomic testing is associated with increased physician utilisation.

PubMed

Bloss, Cinnamon S; Schork, Nicholas J; Topol, Eric J

2014-02-01

Direct-to-consumer (DTC) genomic testing has generated controversy, however the actual impact of testing on consumer behaviour has been understudied, particularly for pharmacogenomic (PGx) testing. We recruited a sample of adults who purchased a DTC genomic test and had previously received their genomic test results for complex disease risk. All participants additionally underwent PGx testing. At follow-up, to assess the impact of PGx testing on consumer behaviour, healthcare utilisation and psychological status were compared between approximately a third of participants who had received their PGx results and the remaining two-thirds of participants who were still awaiting results. The PGx test included genetic testing for drug effectiveness or risk of side effects for 12 medications. At follow-up, there were 481 PGx test recipients and 844 non-recipients still awaiting results. PGx test recipients had more physician visits (p=0.04) and were more likely to share their results with their physician (p=0.001). Both groups showed a decrease in anxiety symptoms from baseline to follow-up, with a trend for PGx recipients to show less of a decrease compared with non-recipients (p=0.10). PGx recipients were more likely to report that their physician ordered additional tests (p=0.01) based on their genomic test. There were no group differences in follow-up test-related distress (p=0.67). DTC PGx risk profiling among a selected sample of individuals was associated with increased physician utilisation and did not result in any adverse changes in psychological health or follow-up test-related distress.

Paternal and maternal alcohol abuse and offspring mental distress in the general population: the Nord-Trøndelag health study

PubMed Central

2012-01-01

Background The degree to which parental alcohol abuse is a risk factor for offspring mental distress is unclear, due to conflicting results of previous research. The inconsistencies in previous findings may be related to sample characteristics and lack of control of confounding or moderating factors. One such factor may be the gender of the abusing parent. Also, other factors, such as parental mental health, divorce, adolescent social network, school functioning or self-esteem, may impact the outcome. This study examines the impact of maternal and paternal alcohol abuse on adolescent mental distress, including potentially confounding, mediating or moderating effects of various variables. Methods Data from the Nord-Trøndelag Health Study (HUNT), a Norwegian population based health survey, from 4012 offspring and their parents were analyzed. Parental alcohol abuse was measured by numerical consumption indicators and CAGE, whereas offspring mental distress was measured by SCL-5, an abbreviated instrument tapping symptoms of anxiety and depression. Statistical method was analysis of variance. Results Maternal alcohol abuse was related to offspring mental distress, whereas no effect could be shown of paternal alcohol abuse. Effects of maternal alcohol abuse was partly mediated by parental mental distress, offspring social network and school functioning. However, all effects were relatively small. Conclusions The results indicate graver consequences for offspring of alcohol abusing mothers compared to offspring of alcohol abusing fathers. However, small effect sizes suggest that adolescent offspring of alcohol abusing parents in general manage quite well. PMID:22708789

The effectiveness of solution-focused brief therapy for psychological distress among Chinese parents of children with a cancer diagnosis: a pilot randomized controlled trial.

PubMed

Zhang, Anao; Ji, QingYing; Currin-McCulloch, Jennifer; Solomon, Phyllis; Chen, YuTing; Li, Yaxi; Jones, Barbara; Franklin, Cynthia; Nowicki, Jack

2018-08-01

Given the critical role of parental care for pediatric cancer patients, this pilot study evaluated the feasibility and effectiveness of a hospital-based solution-focused brief therapy (SFBT) intervention for reducing psychological distress among parents of pediatric cancer patients in China. Differences between treatment and active control (AC) groups were assessed on dimensions of psychological distress. Parents' level of hope was also assessed. Participants (N = 44) were randomly assigned to SFBT or AC. Parents received four sessions of SFBT twice a week delivered by graduate-level hospital social workers. Pre- and post-intervention assessments measured change in distress (depression, anxiety, and somatization symptoms) of parents as well as their level of hope. Analysis of covariance (ANCOVA) indicated the SFBT group had better outcomes than the AC group on overall distress of somatic, anxiety, depression symptoms and level of hope. Within- and between-group treatment effects reported significantly greater effect of the SFBT group than of the AC group. Considering the inherent limits of a pilot feasibility study, results suggest that SFBT is a feasible, culturally compatible, and promising intervention for alleviating distress among Chinese parents of children with cancer. Additional comprehensive trials are needed to draw more definitive conclusions. SFBT may be beneficial for improving the critical support systems of parents of pediatric cancer patients. Thus, SFBT may have the potential to enhance children's well-being during cancer treatment and recovery.

Disentangling body image: The relative associations of overvaluation, dissatisfaction, and preoccupation with psychological distress and eating disorder behaviors in male and female adolescents.

PubMed

Mitchison, Deborah; Hay, Phillipa; Griffiths, Scott; Murray, Stuart B; Bentley, Caroline; Gratwick-Sarll, Kassandra; Harrison, Carmel; Mond, Jonathan

2017-02-01

The distinctiveness and relative clinical significance of overvaluation, dissatisfaction, and preoccupation with body weight/shape remains inconclusive. This study sought to add to the evidence by testing associations between these three body image constructs and indicators of clinical significance. Male and female secondary students (N = 1,666) aged 12-18 years completed a survey that included measures of dissatisfaction with, overvaluation of, and preoccupation with weight/shape, psychological distress, eating disorder behaviors, and basic demographic information. Conditional process analysis was employed to test the independent and mediating effects of overvaluation, dissatisfaction, and preoccupation on distress, dietary restraint, and objective binge eating. Overvaluation, dissatisfaction, and preoccupation were highly correlated (r = 0.47-0.84). In girls, preoccupation demonstrated the strongest independent and mediating effects on distress, dietary restraint, and binge eating; whereas neither the direct or indirect effects of dissatisfaction on distress and overvaluation on binge eating were significant. Among boys however, the direct and indirect effects of overvaluation, dissatisfaction, and preoccupation on distress and eating disorder behaviors were relatively equal. Preoccupation with weight/shape may be particularly clinically significant in girls, whereas all constructs of body image disturbance may be equally clinically significant in boys. The findings are consistent with the view that these constructs, while closely related, are distinct. © 2016 Wiley Periodicals, Inc.(Int J Eat Disord 2017; 50:118-126). © 2016 Wiley Periodicals, Inc.

Pregnancy with bilateral tubercular pleural effusion: challenges.

PubMed

Ahuja, Vanita; Gombar, Satinder; Kumar, Navneet; Goyal, Nitika; Gupta, Kanika

2014-04-01

Pulmonary tuberculosis (TB) during pregnancy mimics some of the physiological changes that occur during pregnancy. Diagnosis is challenging, especially when the patient presents with acute respiratory distress. The incidence of pleural effusion in TB is 3-25% and in the majority of patients, is unilateral. We describe the intensive care management of a 27-year-old pregnant woman admitted to our hospital with life threatening respiratory distress and circulatory shock. She continued to have severe metabolic and respiratory acidosis with shock in spite of the resuscitative measures undertaken. At that point, a bedside lung ultrasonography showed bilateral pleural effusion which was followed with therapeutic thoracocentesis of the right side. This resulted in the stabilization of the respiratory mechanics and haemodynamics of the patient. The pleural fluid culture tested positive for acid fast bacilli after 4 weeks in the intensive care unit. Anti-TB therapy was started and she made a rapid recovery with liberation from mechanical ventilation. The early use of bedside lung ultrasonography was instrumental in the successful management of this patient.

Effects and feasibility of a multi-disciplinary orientation program for newly registered cancer patients: design of a randomised controlled trial.

PubMed

Chan, Raymond; Webster, Joan; Bennett, Linda

2009-11-11

Diagnosis and treatment of cancer can contribute to psychological distress and anxiety amongst patients. Evidence indicates that information giving can be beneficial in reducing patient anxiety, so oncology specific information may have a major impact on this patient group. This study investigates the effects of an orientation program on levels of anxiety and self-efficacy amongst newly registered cancer patients who are about to undergo chemotherapy and/or radiation therapy in the cancer care centre of a large tertiary Australian hospital. The concept of interventions for orienting new cancer patients needs revisiting due to the dynamic health care system. Historically, most orientation programs at this cancer centre were conducted by one nurse. A randomised controlled trial has been designed to test the effectiveness of an orientation program with bundled interventions; a face-to-face program which includes introduction to the hospital facilities, introduction to the multi-disciplinary team and an overview of treatment side effects and self care strategies. The aim is to orientate patients to the cancer centre and to meet the health care team. We hypothesize that patients who receive this orientation will experience lower levels of anxiety and distress, and a higher level of self-efficacy. An orientation program is a common health care service provided by cancer care centres for new cancer patients. Such programs aim to give information to patients at the beginning of their encounter at a cancer care centre. It is clear in the literature that interventions that aim to improve self-efficacy in patients may demonstrate potential improvement in health outcomes. Yet, evidence on the effects of orientation programs for cancer patients on self-efficacy remains scarce, particularly with respect to the use of multidisciplinary team members. This paper presents the design of a randomised controlled trial that will evaluate the effects and feasibility of a multidisciplinary orientation program for new cancer patients. Current Controlled Trials ACTRN12609000018213.

Do I feel ill because I crave for work or do I crave for work because I feel ill? A longitudinal analysis of work craving, self-regulation, and health

PubMed Central

Wojdylo, Kamila; Karlsson, Wilhelm; Baumann, Nicola

2016-01-01

Background The theory of work craving defines workaholism as a pathological work addiction which comprises: (a) obsessive–compulsive desire to work, (b) anticipation of self-worth compensatory incentives from working, (c) anticipation of reduction of negative emotions or withdrawal symptoms from working, and (d) neurotic perfectionism. Research has shown that workaholism is associated with adverse health outcomes. However, the antecedents of workaholism and the causal direction of the relationship with health have been largely neglected. Aims In the present longitudinal study, we expect that work craving is predicted by deficits in emotional self-regulation (i.e., low action orientation) and mediates the relationship between self-regulation deficits and symptoms of psychological distress. We expected work craving to have an effect on later psychological distress symptoms, but not psychological distress symptoms to have an effect on later work craving. Methods In a sample of 170 German employees, a half-longitudinal design using two times of measurement was implemented to specify the paths of two different structural equation models of mediation: (a) action orientation to later work craving and work craving to later psychological distress, and alternatively, (b) the temporal order of action orientation to later distress and distress to later work craving. Results Our data indicated that work craving partially mediated the relationship between self-regulation deficits and psychological distress, but psychological distress symptoms were not found to increase later work craving. Conclusions The presented longitudinal study indicates important mechanisms of work craving, especially by highlighting the influence of self-regulation deficits on work craving and, in turn, psychological distress. PMID:28092192

Personality and mortality after myocardial infarction.

PubMed

Denollet, J; Sys, S U; Brutsaert, D L

1995-01-01

Previous research showed: a) emotional distress is a risk factor for mortality after myocardial infarction (MI) and b) emotional distress is linked to stable personality traits. In this study, we examined the role of these personality traits in mortality after MI. Subjects were 105 men, 45 to 60 years of age, who survived a recent MI. Baseline assessment included biomedical and psychosocial risk factors, as well as each patient's personality type. After 2 to 5 (mean, 3.8) years of follow-up, 15 patients (14%) had died. Rate of death for patients with a distressed personality type (11/28 = 39%) was significantly greater than that for patients with other personality types (4/77 = 5%) (p < .0001). Patients with this personality type tend simultaneously to experience distress and inhibit expression of emotions. Low exercise tolerance, previous MI (p < .005), anterior MI, smoking, and age (p < .05) were also associated with mortality. A logistic regression model including these biomedical factors had a sensitivity for mortality of only 27%. The addition of distressed personality type in this model more than doubled its sensitivity. Of note, among patients with poor physical health, those with a distressed personality type had a five-fold mortality risk (p < .005). Consistent with the findings of other investigators, depression (p < .005), life stress, use of benzodiazepines (p < .01), and somatization (p < .05) were also related to post-MI mortality. These psychosocial risk factors were more prevalent in the distressed personality type than in the other personality types (p < .001-.05). Multiple logistic regression indicated that these psychosocial factors did not add to the predictive value of the distressed personality type. Hence, an important personality effect was observed despite the low power. This suggests that personality traits may play a role in the detrimental effect of emotional distress in MI patients.

Do I feel ill because I crave for work or do I crave for work because I feel ill? A longitudinal analysis of work craving, self-regulation, and health.

PubMed

Wojdylo, Kamila; Karlsson, Wilhelm; Baumann, Nicola

2016-03-01

Background The theory of work craving defines workaholism as a pathological work addiction which comprises: (a) obsessive-compulsive desire to work, (b) anticipation of self-worth compensatory incentives from working, (c) anticipation of reduction of negative emotions or withdrawal symptoms from working, and (d) neurotic perfectionism. Research has shown that workaholism is associated with adverse health outcomes. However, the antecedents of workaholism and the causal direction of the relationship with health have been largely neglected. Aims In the present longitudinal study, we expect that work craving is predicted by deficits in emotional self-regulation (i.e., low action orientation) and mediates the relationship between self-regulation deficits and symptoms of psychological distress. We expected work craving to have an effect on later psychological distress symptoms, but not psychological distress symptoms to have an effect on later work craving. Methods In a sample of 170 German employees, a half-longitudinal design using two times of measurement was implemented to specify the paths of two different structural equation models of mediation: (a) action orientation to later work craving and work craving to later psychological distress, and alternatively, (b) the temporal order of action orientation to later distress and distress to later work craving. Results Our data indicated that work craving partially mediated the relationship between self-regulation deficits and psychological distress, but psychological distress symptoms were not found to increase later work craving. Conclusions The presented longitudinal study indicates important mechanisms of work craving, especially by highlighting the influence of self-regulation deficits on work craving and, in turn, psychological distress.

The role of stress sensitization in progression of posttraumatic distress following deployment.

PubMed

Smid, Geert E; Kleber, Rolf J; Rademaker, Arthur R; van Zuiden, Mirjam; Vermetten, Eric

2013-11-01

Military personnel exposed to combat are at risk for experiencing post-traumatic distress that can progress over time following deployment. We hypothesized that progression of post-traumatic distress may be related to enhanced susceptibility to post-deployment stressors. This study aimed at examining the concept of stress sensitization prospectively in a sample of Dutch military personnel deployed in support of the conflicts in Afghanistan. In a cohort of soldiers (N = 814), symptoms of post-traumatic stress disorder (PTSD) were assessed before deployment as well as 2, 7, 14, and 26 months (N = 433; 53 %) after their return. Data were analyzed using latent growth modeling. Using multiple group analysis, we examined whether high combat stress exposure during deployment moderated the relation between post-deployment stressors and linear change in post-traumatic distress after deployment. A higher baseline level of post-traumatic distress was associated with more early life stressors (standardized regression coefficient = 0.30, p < 0.001). In addition, a stronger increase in posttraumatic distress during deployment was associated with more deployment stressors (standardized coefficient = 0.21, p < 0.001). A steeper linear increase in posttraumatic distress post-deployment (from 2 to 26 months) was predicted by more post-deployment stressors (standardized coefficient = 0.29, p < 0.001) in high combat stress exposed soldiers, but not in a less combat stress exposed group. The group difference in the predictive effect of post-deployment stressors on progression of post-traumatic distress was significant (χ²(1) = 7.85, p = 0.005). Progression of post-traumatic distress following combat exposure may be related to sensitization to the effects of post-deployment stressors during the first year following return from deployment.

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.

Case study: videogame distraction reduces behavioral distress in a preschool-aged child undergoing repeated burn dressing changes: a single-subject design.

PubMed

Sil, Soumitri; Dahlquist, Lynnda M; Burns, Andrew J

2013-04-01

This single-subject design study evaluated the feasibility and efficacy of passive and interactive videogame distraction on behavioral distress for a preschool-aged child receiving repeated burn dressing changes. A 4-year-old girl underwent 3 baseline and 10 videogame distraction sessions (5 passive and 5 interactive) using a restricted alternating treatments design. Observed behavioral distress was coded, and parents and nurses rated the child's distress and cooperative behavior. Relative to baseline, behavioral distress decreased and cooperative behavior increased immediately after the onset of videogame distraction. Single Case Randomization Tests revealed significantly lower behavioral distress and greater cooperation during interactive videogame distraction relative to passive videogame distraction. Interactive videogame distraction appears to be a feasible and effective pain management strategy for a preschool-aged child undergoing repeated painful medical procedures.

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.

Evidence-based treatments for low sexual desire in women.

PubMed

Brotto, Lori A

2017-04-01

Low sexual desire is the most common sexual complaint in women, with multinational studies finding that at least a third of women experience low sexual desire. No single etiology for the development of Female Sexual Interest/Arousal Disorder, the diagnosis laid out by the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders, has been established. There has been considerable interest in pharmacological approaches to improving low desire, and agents targeting a range of neurotransmitters have been examined. To date, only flibanserin, a centrally acting medication targeting the serotonin, dopamine, and norepinephrine systems, has been approved by the Food and Drug Administration (FDA). Despite statistically significant effects on sexual desire, sexual distress, and sexually satisfying events, side-effects are significant, and flibanserin is completely contraindicated with alcohol. As such, there has been renewed interest in advancing the science of psychological approaches to low desire, including cognitive behavioral and mindfulness therapies. Copyright © 2017 Elsevier Inc. All rights reserved.

Web-Delivered Cognitive Behavioral Therapy for Distressed Cancer Patients: Randomized Controlled Trial

PubMed Central

Ritterband, Lee M; Thorndike, Frances; Nielsen, Lisa; Aitken, Joanne F; Clutton, Samantha; Scuffham, Paul A; Youl, Philippa; Morris, Bronwyn; Baade, Peter D; Dunn, Jeff

2018-01-01

Background Web-based interventions present a potentially cost-effective approach to supporting self-management for cancer patients; however, further evidence for acceptability and effectiveness is needed. Objective The goal of our research was to assess the effectiveness of an individualized Web-based cognitive behavioral therapy (CBT) intervention on improving psychological and quality of life outcomes in cancer patients with elevated psychological distress. Methods A total of 163 distressed cancer patients (111 female, 68.1%) were recruited through the Queensland Cancer Registry and the Cancer Council Queensland Cancer Helpline and randomly assigned to either a Web-based tailored CBT intervention (CancerCope) (79/163) or a static patient education website (84/163). At baseline and 8-week follow-up we assessed primary outcomes of psychological and cancer-specific distress and unmet psychological supportive care needs and secondary outcomes of positive adjustment and quality of life. Results Intention-to-treat analyses showed no evidence of a statistically significant intervention effect on primary or secondary outcomes. However, per-protocol analyses found a greater decrease for the CancerCope group in psychological distress (P=.04), cancer-specific distress (P=.02), and unmet psychological care needs (P=.03) from baseline to 8 weeks compared with the patient education group. Younger patients were more likely to complete the CancerCope intervention. Conclusions This online CBT intervention was associated with greater decreases in distress for those patients who more closely adhered to the program. Given the low costs and high accessibility of this intervention approach, even if only effective for subgroups of patients, the potential impact may be substantial. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12613001026718; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=364768&isReview=true (Archived by WebCite at http://www.webcitation.org/6uPvpcovl) PMID:29386173

Work-family conflict, locus of control, and women's well-being: tests of alternative pathways.

PubMed

Noor, Noraini M

2002-10-01

The author tested for the 3 possible pathways (i.e., direct, moderator, and mediator effects) in which locus of control can influence the relationship between work-family conflict and well-being. The author predicted that work-family conflict would be negatively correlated with well-being. In a sample of 310 Malaysian employed women with families, work-family conflict was a significant predictor of both job satisfaction and distress--negatively related to job satisfaction and positively related to symptoms of distress. More important, the results provided support for the effects of all 3 pathways of control on the relationship between work-family conflict and well-being, depending on the outcome measure: For job satisfaction, locus of control had direct effects, acted as a partial mediator, and played a significant moderating role. In contrast, only the direct effect of locus of control predicted distress. The author discusses those findings with reference to the literature on work-family conflict, locus of control, and the issue of stress-distress specificity.

The Mediating Role of Self-Exertion on the Effects of Effort on Learning Virtues and Emotional Distress in Academic Failure in a Confucian Context

PubMed Central

Fwu, Bih-Jen; Chen, Shun-Wen; Wei, Chih-Fen; Wang, Hsiou-Huai

2017-01-01

Previous studies have found that in East Asian Confucian societies, hardworking students are often trapped in a dilemma of enjoying a positive moral image while suffering from emotional distress due to academic failure. This study intends to further explore whether the cultural-specific belief in self-exertion acts as a psychological mechanism to lessen these students’ negative emotions. A group of 288 college students in Taiwan were administered a questionnaire to record their responses to past academic failures. The results from structural equation modeling showed that self-exertion functioned as a mediator between the effects of effort on learning virtues and emotional distress. Self-exertion to fulfill one’s duty to oneself positively mediated the effect of effort on learning virtues, whereas self-exertion to fulfill one’s duty to one’s parents negatively mediated the effect of effort on emotional distress. Theoretical and cultural implications are further discussed. PMID:28119648

Predictive genetic testing for hereditary breast and ovarian cancer: psychological distress and illness representations 1 year following disclosure.

PubMed

Claes, E; Evers-Kiebooms, G; Denayer, L; Decruyenaere, M; Boogaerts, A; Philippe, K; Legius, E

2005-10-01

This prospective study evaluates emotional functioning and illness representations in 68 unaffected women (34 carriers/34 noncarriers) 1 year after predictive testing for BRCA1/2 mutations when offered within a multidisciplinary approach. Carriers had higher subjective risk perception of breast cancer than noncarriers. Carriers who did not have prophylactic oophorectomy had the highest risk perception of ovarian cancer. No differences were found between carriers and noncarriers regarding perceived seriousness and perceived control of breast and ovarian cancer. Mean levels of distress were within normal ranges. Only few women showed an overall pattern of clinically elevated distress. Cancer-specific distress and state-anxiety significantly decreased in noncarriers from pre- to posttest while general distress remained about the same. There were no significant changes in distress in the group of carriers except for ovarian cancer distress which significantly decreased from pre- to posttest. Our study did not reveal adverse effects of predictive testing when offered in the context of a multidisciplinary approach.

Factors associated with financial distress of nonprofit hospitals.

PubMed

Kim, Tae Hyun

2010-01-01

Financial distress can have a detrimental influence on the performance of hospitals. Hospital management needs to monitor potential financial distress effectively and know how it will respond depending on the severity of the circumstances. This study examined the multiple factors that may explain the financial distress of nonprofit hospitals during 1998 to 2001 and discussed their importance. To obtain more robust results, financial distress was assessed in 2 ways: first, financial strength index was used to incorporate 4 financial dimensions including profitability, liquidity, leverage, and physical facilities; second, cash flow (CF) was used to address the issues of accrual-based accounting in hospitals. This study finds that decrease in occupancy rate and increase in Medicaid payer mix, health maintenance organization penetration, market competition, physician supply, and percentage of the elderly are associated with increased likelihood of financial distress of urban hospitals. Increases in both Medicare and Medicaid payer mix, however, are related to higher likelihood of financial distress of rural hospitals.

Self-evaluative appraisals of coping capability and posttraumatic distress following motor vehicle accidents.

PubMed

Benight, Charles C; Cieslak, Roman; Molton, Ivan R; Johnson, Lesley E

2008-08-01

This study tested the importance of coping self-efficacy (CSE) perceptions and change in perceptions of CSE for recovery from motor vehicle accident (MVA) trauma. Data were collected 7 days following the accident (Time 1; n = 163), 1 month after the accident (Time 2; n = 91), and 3 months after the accident (Time 3; n = 70). Early changes in CSE (i.e., from Time 1 to Time 2) predicted posttraumatic distress at 3 months after MVA trauma, even after controlling for Time 1 or Time 2 posttraumatic distress and other trauma-related variables (i.e., accident responsibility, litigation involvement, and peritraumatic dissociation). Early changes in CSE perceptions, however, neither moderated nor mediated the effects of early posttraumatic distress (Time 1) on 3-month posttraumatic distress. Time 2 CSE levels, however, did mediate the relationship between acute posttraumatic distress (Time 1) and 3-month posttraumatic distress (Time 3). These findings highlight the importance of early interventions aimed at strengthening self-efficacy after MVA trauma. Copyright 2008 APA, all rights reserved.

Relationship of external influence to parental distress in decision making regarding children with a life-threatening illness.

PubMed

Miller, Victoria A; Luce, Mary Frances; Nelson, Robert M

2011-01-01

To examine the relationship of external influence to parental distress when making a decision about research or treatment for a child with a life-threatening illness and to test potential moderators of this relationship. Parents (n = 219) who made a decision about research or treatment for a child completed measures of external influence, distress, decision-making preference, and coping. More external influence was associated with more hostility, uncertainty, and confusion. Decision-making preference and coping style moderated the relationship between external influence and distress: More external influence was associated with more distress when decision-making preference was low and task-focused coping was high. External influence appears to be related to distress in parents making research and treatment decisions for children with life-threatening illnesses. However, it is important to consider parent characteristics, such as decision-making preference and coping style, when examining the effects of contextual factors on distress during decision making.

Leveraging iPads to introduce meditation and reduce distress among cancer patients undergoing chemotherapy: a promising approach.

PubMed

Millegan, Jeffrey; Manschot, Bernard; Dispenzieri, Monica; Marks, Benjamin; Edwards, Ayesha; Raulston, Vanessa; Khatiwoda, Yojana; Narro, Marlo

2015-12-01

Distress is common among cancer patients. Regular meditation practice has the potential to mitigate this distress and improve quality of life for this population. Introducing meditation to cancer patients can be particularly challenging given the demands on patients' time from treatment and normal life events. This internal process improvement study examined the potential benefit of utilizing iPads during chemotherapy sessions to introduce meditation and reduce distress. Patients undergoing chemotherapy infusion were offered iPads with various meditation videos and audio files during the session. Levels of distress were measured using the distress thermometer at the beginning of chemotherapy and at the conclusion of chemotherapy. Seventy-three patients accepted the meditation iPads during the chemotherapy session. Among those who accepted the iPads, average distress dropped 46% by the end of the session (p < 0.0001). The use of iPads during chemotherapy is a potentially effective way to introduce meditation as a stress management tool for people with cancer.

The effect of self-selected complementary therapies on cancer patients' quality of life and symptom distress: A prospective cohort study in an integrative oncology setting.

PubMed

Stomski, N J; Petterson, A; Kristjanson, L; Lobb, E A; Phillips, M; Williams, A; Morrison, P; Joske, D

2018-04-01

To examine the effectiveness of a multifaceted complementary therapies intervention, delivered in a systematic manner within an Australian public hospital setting, on quality of life and symptom distress outcomes for cancer patients. Adults receiving treatment for any form of cancer were eligible to participate in this study. Self-referred participants were offered a course of six complementary therapy sessions. Measures were administered at baseline, and at the third and sixth visit. The primary outcomes were quality of life and symptom distress. Linear mixed models were used to assess change in the primary outcomes. In total, 1376 cancer patients participated in this study. The linear mixed models demonstrated that there were significant improvements in quality of life and significant reductions in symptom distress over six sessions. Body-based therapies demonstrated significantly superior improvement in quality of life over counselling, but no other differences between therapies were identified. Reduced symptom distress was not significantly associated with any particular type of therapy. A self-selected complementary therapies intervention, provided in an Australian public hospital by accredited therapists, for cancer patients significantly mproved quality of life and reduced symptom distress. The effect of this intervention on quality of life has particular salience, since cancer impacts on many areas of people's lives and impairs quality of life. Copyright © 2018 Elsevier Ltd. All rights reserved.

Education and Psychological Distress of Older Chinese: Exploring the Longitudinal Relationship and Its Subgroup Variations.

PubMed

Zhang, Wei; Chen, Huashuai; Feng, Qiushi

2015-10-01

The goal of this study is to examine whether and how education predicts distress for older Chinese and whether this association varies by age, gender, and rural/urban residence. The random-effect panel model and Heckman selection model were used to analyze four waves of data with a total sample size of 54,405 from the Chinese Longitudinal Healthy Longevity Survey. We found the following: (a) There is a persistent and negative association between education and distress among older Chinese; (b) education predicts lower levels of distress over time and this is particularly true for males, urban residents, and the young-old; and (c) the effect of education on distress is largely explained by physical health, economic conditions, and a three-dimensional framework of leisure-time activities. Our findings strengthen the external validity of the relationship between education and health and suggest the dynamic patterns on the subgroup variations within the association in China. © The Author(s) 2015.

Sex Differences in Mediating and Moderating Processes Linking Economic Stressors, Psychological Distress, and Drinking

PubMed Central

Brown, Robyn Lewis; Richman, Judith A.

2012-01-01

Objective: Given the recent downturn in the U.S. economy, we considered in this study the processes linking economic stressors, psychological distress, and two alcohol-related outcomes (past-month drinking and problematic drinking). Method: Data were drawn from a mail survey of a national sample of 663 respondents. Structural equation modeling was used to assess whether psychological distress mediates the associations between economic stressors and the alcohol-related outcomes considered and whether these associations varied by gender. Results: Controlling for correlations among the outcomes and the effects of the sociodemographic control variables, psychological distress was found to partly explain the association between economic stressors and problematic drinking. The mediating effects on problematic drinking were significantly greater for men than women. Conclusions: The findings demonstrate the utility of considering interrelationships among alcohol-related outcomes and, in this context, reveal the circumstances in which gender matters most for understanding the associations among economy-related stressors, psychological distress, and drinking. PMID:22846245

Perceived Discrimination and Psychological Distress Among Asian Americans: Does Education Matter?

PubMed Central

Zhang, Wei; Hong, Seunghye

2017-01-01

Using data from the National Latino and Asian American Study, this work examines if and how perceived everyday discrimination is associated with psychological distress among Asian Americans and whether this association varies by important structural factors as education and place of education. Findings reveal that perception of discrimination is associated with increased levels of psychological distress. Most importantly, education moderates the discrimination-distress association such that the detrimental effect of discrimination is stronger for Asian Americans with college or more levels of education than for Asian Americans with less than college levels of education. Place of education further conditions the moderating effect of education: The foreign-educated Asian Americans with higher levels of education are affected most negatively by discrimination compared to others. This study highlights (1) the significant joint role of education and place of education in conditioning the relationship between perceived discrimination and psychological distress, and (2) unique features of education in improving our understanding of Asian Americans’ mental health. PMID:22767300

Perceived discrimination and psychological distress among Asian Americans: does education matter?

PubMed

Zhang, Wei; Hong, Seunghye

2013-10-01

Using data from the National Latino and Asian American Study, this work examines if and how perceived everyday discrimination is associated with psychological distress among Asian Americans and whether this association varies by important structural factors as education and place of education. Findings reveal that perception of discrimination is associated with increased levels of psychological distress. Most importantly, education moderates the discrimination-distress association such that the detrimental effect of discrimination is stronger for Asian Americans with college or more levels of education than for Asian Americans with less than college levels of education. Place of education further conditions the moderating effect of education: The foreign-educated Asian Americans with higher levels of education are affected most negatively by discrimination compared to others. This study highlights (1) the significant joint role of education and place of education in conditioning the relationship between perceived discrimination and psychological distress, and (2) unique features of education in improving our understanding of Asian Americans' mental health.

Life strain and psychological distress of older women and older men in Hong Kong.

PubMed

Boey, K W; Chiu, H F K

2005-11-01

This study examined the life strain and psychological distress among a group of older adults (N = 1034, 51.2% female) in Hong Kong. Data were collected through individual interviews in which a standardized questionnaire was administered. The results indicated that older women had more somatic complaints and poorer self-rated health. Family network and interdependent relationships were significantly poorer among the older women than in the older men. Women were also found to experience a higher level of psychological distress (as measured by GDS-15 and GHQ-12) than did men. Perceived financial strain and poor physical health had similar direct effect on the psychological distress of both older women and older men. In contrast to Western findings, a poor family network was observed to exert a greater direct effect on psychological distress than an inadequate social network of friends. Generally, a good social network was found to mitigate the negative impact of life strain factors among older men, but not among older women.

The Effect of Acculturation and Immigration on the Victimization and Psychological Distress Link in a National Sample of Latino Women

ERIC Educational Resources Information Center

Cuevas, Carlos A.; Sabina, Chiara; Bell, Kristin A.

2012-01-01

Distinct bodies of research have examined the link between victimization and psychological distress and cultural variables and psychological health, but little is known about how cultural variables affect psychological distress among Latino victims. Substantial research has concluded that Latino women are more likely than non-Latino women to…

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…

Effects of Art Therapy on Distress Levels of Adults with Cancer: A Proxy Pretest Study

ERIC Educational Resources Information Center

Glinzak, Leara

2016-01-01

This study identified decreased distress after art therapy in a proxy pretest study with a convenience sample of 73 patients being treated for cancer. Art therapy outcomes from 4 settings (oncology unit, infusion clinic, individual sessions, and open studio) were measured via the self-report Distress Thermometer, which was collected as part of an…

Developing a medical picture book for reducing venipuncture distress in preschool-aged children.

PubMed

Tsao, Ying; Kuo, Hui-Chen; Lee, Hsui-Chuan; Yiin, Shuenn-Jiun

2017-10-01

Distress associated with needle-related procedures is a major concern in preschool-aged children nursing. This study developed a medical picture book for supporting preschool-aged children facing a venipuncture and determined the effectiveness of such a book intervention in decreasing behavioural distress. The picture book was designed in 3 stages: developing stories on medical situations, penning the text, and drafting the book. We conducted a quasiexperimental study to examine the effectiveness of the book. The behavioural distress of the control and picture book groups were assessed before, during, and after the intervention by using the Observational Scale of Behavioral Distress-Revised (OSBD-R). We created a 12-page picture book, Sick Rui-Rui Bear, in which cartoon characters were depicted undergoing venipunctures, as a guide for vein injection and for facilitating positive venipuncture outcomes in preschool-aged children. Over time, the OSBD-R scores of the picture book group were significantly lower than those of the control group (P < .001). We recommend the picture book be routinely read and used during venipunctures to decrease procedural distress in preschool-aged children. © 2017 John Wiley & Sons Australia, Ltd.

The Role of Ethnic and National Identifications in Perceived Discrimination for Asian Americans: Toward a Better Understanding of the Buffering Effect of Group Identifications on Psychological Distress

PubMed Central

Huynh, Que-Lam; Devos, Thierry; Goldberg, Robyn

2013-01-01

A robust relationship between perceived racial discrimination and psychological distress has been established. Yet, mixed evidence exists regarding the extent to which ethnic identification moderates this relationship, and scarce attention has been paid to the moderating role of national identification. We propose that the role of group identifications in the perceived discrimination–psychological distress relationship is best understood by simultaneously and interactively considering ethnic and national identifications. A sample of 259 Asian American students completed measures of perceived discrimination, group identifications (specific ethnic identification stated by respondents and national or “mainstream American” identification), and psychological distress (anxiety and depression symptoms). Regression analyses revealed a significant three-way interaction of perceived discrimination, ethnic identification, and national identification on psychological distress. Simple-slope analyses indicated that dual identification (strong ethnic and national identifications) was linked to a weaker relationship between perceived discrimination and psychological distress compared with other group identification configurations. These findings underscore the need to consider the interconnections between ethnic and national identifications to better understand the circumstances under which group identifications are likely to buffer individuals against the adverse effects of racial discrimination. PMID:25258674

The perceived impact of cancer on quality of life for post-treatment survivors of childhood cancer.

PubMed

Zebrack, Brad J; Landier, Wendy

2011-12-01

To examine whether childhood cancer survivors' perceptions of the impact of cancer are related to quality of life (QOL) and psychological distress. 621 survivors (aged 18-39 years) completed a mailed survey assessing distress and QOL. Hierarchical linear regression models analyzed the independent effects of perceived impacts of cancer on distress and QOL and the extent to which positive and negative perceptions attenuated the effects of covariates on outcomes. After accounting for perceptions of cancer's impact on their lives, employment/occupation status, marital/relationship status, and health problems were observed to be significant predictors of QOL and distress. Psychological distress and the mental health component of QOL appeared to be less influenced by sociodemographic status and health problems and more a function of how survivors perceive cancer as impacting their lives. Results suggest that distress and QOL are partially a function of survivors' perceptions of how cancer has affected them and continues to affect them in both positive and negative ways. Future research is needed to examine combinations of pharmacological, psychological and/or social interventions that are likely to result in better outcomes in this population.

Screening for psychological late effects in childhood, adolescent and young adult cancer survivors: a systematic review.

PubMed

Michel, Gisela; Vetsch, Janine

2015-07-01

In the past years, increasing evidence showed that many childhood cancer survivors suffer from psychological distress long after treatment ended. However, psychosocial issues are often neglected during follow-up care. Including screening for psychological distress before follow-up appointments might help addressing the topic in survivors who need support. Our aim was to systematically review the available evidence on screening for psychological distress in childhood cancer survivors. We found eight studies that investigated different screening tools for their utility in detecting psychological distress in childhood cancer survivors. The Brief Symptom Inventory-18 with an adapted cutoff score for childhood cancer survivors, and the newly developed short form of the Beck Depression Index were both shown to be of a potential benefit as brief screening tools in follow-up care. We identified promising screening tools to be used to detect psychological distress in childhood cancer survivors. However, there is still a lack of studies addressing applicability and effectiveness when screening is routinely implemented into follow-up care. To improve quality of follow-up care, and identify and treat survivors with psychological distress, screening tools should now be implemented and their adequacy further tested in day-to-day clinic life.

Psychological Distress following Injury in a Large Cohort of Thai Adults

PubMed Central

Yiengprugsawan, Vasoontara; Seubsman, Sam-Ang; Sleigh, Adrian

2016-01-01

Introduction Injury and psychological distress are public health priorities because of their high occurrence in the population. This study examines the longitudinal effects of injury characteristics on psychological distress. Methods Study participants were enrolled distance learning Thai adults (N = 42,785 at 2013 follow-up) residing nationwide. We analysed 2009 and 2013 data. Injury questions included injury prevalence, causes and levels of severity. Distress was measured using the standard Kessler-6. To assess the risk for post-injury distress, we used multinomial logistic regression investigating psychological distress in 2013 as an outcome including injury categories in both 2009 and 2013 as predictors, adjusted for sociodemographic factors. Results Overall injury was predictive of psychological distress. Both types of injury (traffic and non- traffic) associated with increasing psychological distress. Those that had experienced both types of injuries in the previous year had higher odds of developing psychological distress compared to those who experienced just one type. In 2013, adjusted psychological distress odds ratios were 1.46 [95% Confidence Interval 1.14–1.87] for traffic injury only; 1.26 [1.13–1.40] for non-traffic injury only; and 2.71 [2.19–3.35] for both traffic and non-traffic injuries. Increasing frequency of injury and increasing injury severity were also linked to elevated psychological distress among our Thai cohort members. Conclusions Our results revealed a significantly high risk of psychological distress following injury. With increasing occurrence of injury, especially traffic injuries in low and middle income countries such as Thailand, future policies should not only focus on physical care but also address psychological distress as an important consequence of injury. PMID:27776133

Household food insecurity and mental distress among pregnant women in Southwestern Ethiopia: a cross sectional study design.

PubMed

Jebena, Mulusew G; Taha, Mohammed; Nakajima, Motohiro; Lemieux, Andrine; Lemessa, Fikre; Hoffman, Richard; Tesfaye, Markos; Belachew, Tefera; Workineh, Netsanet; Kebede, Esayas; Gemechu, Teklu; Tariku, Yinebeb; Segni, Hailemariam; Kolsteren, Patrick; al'Absi, Mustafa

2015-10-08

There are compelling theoretical and empirical reasons that link household food insecurity to mental distress in the setting where both problems are common. However, little is known about their association during pregnancy in Ethiopia. A cross-sectional study was conducted to examine the association of household food insecurity with mental distress during pregnancy. Six hundred and forty-two pregnant women were recruited from 11 health centers and one hospital. Probability proportional to size (PPS) and consecutive sampling techniques were employed to recruit study subjects until the desired sample size was obtained. The Self Reporting Questionnaire (SRQ-20) was used to measure mental distress and a 9-item Household Food Insecurity Access Scale was used to measure food security status. Descriptive and inferential statistics were computed accordingly. Multivariate logistic regression was used to estimate the effect of food insecurity on mental distress. Fifty eight of the respondents (9%) were moderately food insecure and 144 of the respondents (22.4%) had mental distress. Food insecurity was also associated with mental distress. Pregnant women living in food insecure households were 4 times more likely to have mental distress than their counterparts (COR = 3.77, 95% CI: 2.17, 6.55). After controlling for confounders, a multivariate logistic regression model supported a link between food insecurity and mental distress (AOR = 4.15, 95% CI: 1.67, 10.32). The study found a significant association between food insecurity and mental distress. However, the mechanism by which food insecurity is associated with mental distress is not clear. Further investigation is therefore needed to understand either how food insecurity during pregnancy leads to mental distress or weather mental distress is a contributing factor in the development of food insecurity.

Immigration distress and associated factors among Vietnamese women in transnational marriages in Taiwan.

PubMed

Yang, Yung-Mei; Wang, Hsiu-Hung; Anderson, Debra

2010-12-01

The purpose of this study was to explore the types and predictors of immigration distress among Vietnamese women in transnational marriages in Taiwan. A cross-sectional survey with face-to-face interviews was conducted for data collection. A convenient sample of 203 Vietnamese women in transnational marriages in southern Taiwan was recruited. The Demographic Inventory measured the participants' age, education, employment status, religion, length of residency and number of children, as well as their spouse's age, education, employment status and religion. The Demand of Immigration Specific Distress scale measured the level of distress and had six subscales: loss, novelty, occupational adjustment, language accommodation, discrimination and alienation. Among the 203 participants, 6.4% had a high level of immigration distress; 91.1% had moderate distress; and 2.5% had minor distress. Higher mean scores were found for the loss, novelty and language accommodation subscales of the Demand of Immigration Specific Distress scale. Participant's (r = 0.321, p < 0.01) and spouse's (r = 0.375, p < 0.01) unemployment, and more children (r = 0.129, p < 0.05) led to greater immigration distress. Length of residency in Taiwan (r = 0.576, p < 0.001) was an effective predictor of immigration distress. It indicated that the participants who had stayed fewer years in Taiwan had a higher level of immigrant distress. Health care professionals need to be aware that the female newcomers in transnational marriages are highly susceptible to immigration distress. The study suggests that healthcare professionals need to provide a comprehensive assessment of immigration distress to detect health problems early and administer culturally appropriate healthcare for immigrant women in transnational marriages. Copyright © 2010 Elsevier. Published by Elsevier B.V. All rights reserved.

Gender and the experience of moral distress in critical care nurses.

PubMed

O'Connell, Christopher B

2015-02-01

Nursing practice is complex, as nurses are challenged by increasingly intricate moral and ethical judgments. Inadequately studied in underrepresented groups in nursing, moral distress is a serious problem internationally for healthcare professionals with deleterious effects to patients, nurses, and organizations. Moral distress among nurses has been shown to contribute to decreased job satisfaction and increased turnover, withdrawal from patients, physical and psychological symptoms, and intent to leave current position or to leave the profession altogether. Do significant gender differences exist in the moral distress scores of critical care nurses? This study utilized a quantitative, descriptive methodology to explore moral distress levels in a sample of critical care nurses to determine whether gender differences exist in their mean moral distress scores. Participants (n = 31) were critical care nurses from an American Internet nursing community who completed the Moral Distress Scale-Revised online over a 5-day period in July 2013. Institutional review board review approved the study, and accessing and completing the survey implied informed consent. The results revealed a statistically significant gender difference in the mean moral distress scores of participants. Females reported statistically significantly higher moral distress scores than did males. Overall, the moral distress scores for both groups were relatively low. The findings of a gender difference have not previously been reported in the literature. However, other findings are consistent with previous studies on moral distress. Although the results of this study are not generalizable, they do suggest the need for continuing research on moral distress in underrepresented groups in nursing, including cultural and ethnic groups. © The Author(s) 2014.

Negative Affect Mediates the Relation Between Trait Urgency and Behavioral Distress Tolerance

PubMed Central

Borges, Allison M.; Dahne, Jennifer; Lim, Aaron C.; MacPherson, Laura

2017-01-01

Distress tolerance is associated with a range of psychopathology and risk-taking behavior. Current research suggests that the behavioral ability to persist at goal-directed behavior when distressed may be malleable. However, little is known about the contributing factors that underlie individual differences in distress tolerance. Trait urgency, or the tendency to act impulsively in the context of acute changes in affect, may predict distress tolerance because the prepotent response to avoid or remove an aversive state may undermine persistence. To date, most research has examined the role of negative urgency, a valenced subfactor of urgency, in relation to distress tolerance. However, the broad trait of urgency may be associated with a greater change in affect that precedes the inability to tolerate distress. The current study examined whether greater changes in negative affect was indeed a mediator in the relationship between trait urgency and behavioral distress tolerance. The effects of both positive and negative urgency on affect change were examined to investigate the potential contribution of the broader urgency trait. The results suggest that a greater change in negative affect over the course of a stressor mediated the association between both subfactors of urgency and distress tolerance. These findings suggest that trait urgency, regardless of valence, may be associated with experiencing greater changes in affect that ultimately undermine the ability to tolerate distress. These findings also highlight important components of distress tolerance that could inform behavioral interventions. PMID:28080084

Negative affect mediates the relation between trait urgency and behavioral distress tolerance.

PubMed

Borges, Allison M; Dahne, Jennifer; Lim, Aaron C; MacPherson, Laura

2017-06-01

Distress tolerance is associated with a range of psychopathology and risk-taking behavior. Current research suggests that the behavioral ability to persist at goal-directed behavior when distressed may be malleable. However, little is known about the contributing factors that underlie individual differences in distress tolerance. Trait urgency, or the tendency to act impulsively in the context of acute changes in affect, may predict distress tolerance because the prepotent response to avoid or remove an aversive state may undermine persistence. To date, most research has examined the role of negative urgency, a valenced subfactor of urgency, in relation to distress tolerance. However, the broad trait of urgency may be associated with a greater change in affect that precedes the inability to tolerate distress. The current study examined whether greater changes in negative affect was indeed a mediator in the relationship between trait urgency and behavioral distress tolerance. The effects of both positive and negative urgency on affect change were examined to investigate the potential contribution of the broader urgency trait. The results suggest that a greater change in negative affect over the course of a stressor mediated the association between both subfactors of urgency and distress tolerance. These findings suggest that trait urgency, regardless of valence, may be associated with experiencing greater changes in affect that ultimately undermine the ability to tolerate distress. These findings also highlight important components of distress tolerance that could inform behavioral interventions. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Incidence and Predictors of Acute Psychological Distress and Dissociation after Motor Vehicle Collision: a Cross-Sectional Study

PubMed Central

Lewis, Gemma C.; Platts-Mills, Timothy F.; Liberzon, Israel; Bair, Eric; Swor, Robert; Peak, David; Jones, Jeffrey; Rathlev, Niels; Lee, David; Domeier, Robert; Hendry, Phyllis; McLean, Samuel A.

2014-01-01

Objective The authors examined the incidence and predictors of peritraumatic distress and dissociation after one of the most common forms of civilian trauma exposure: motor vehicle collision (MVC). Methods In this study, patients presenting to the emergency department after MVC who were without serious injury and discharged to home after evaluation (n = 935) completed an emergency department interview evaluating sociodemographic, collision-related, and psychological characteristics. Results The incidence and predictors of distress (Peritraumatic Distress Inventory score ≥ 23) and dissociation (Michigan Critical Events Perception Scale score >3) were assessed. Distress was present in 355 of 935 patients (38%) and dissociation was present in 260 of 942 patients (28%). These outcomes showed only moderate correlation (r = 0.45), and had both shared and distinct predictors. Female gender, anxiety symptoms prior to MVC, and vehicle damage severity predicted both distress and dissociation. Higher socioeconomic status (higher education, higher income, full time employment) had a protective effect against distress but not dissociative symptoms. Better physical health and worse overall mental health were associated with increased risk of dissociation, but not distress. Distress but not dissociation was associated with lower patient confidence in recovery and a longer expected duration of recovery. Conclusion There are unique predictors of peritraumatic distress and dissociation. Further work is needed to better understand the neurobiology of peritraumatic distress and dissociation, and the influence of these peritraumatic outcomes on persistent psychological sequelae. PMID:24983475

Effects of Poly-Victimization on Adolescent Social Support, Self-Concept, and Psychological Distress.

PubMed

Turner, Heather A; Shattuck, Anne; Finkelhor, David; Hamby, Sherry

2015-06-01

Past research has demonstrated the particularly damaging effects of exposure to multiple forms of victimization, or "poly-victimization," on youth mental health. The primary objective of the present study is to begin to identify the mechanisms that help explain its powerful impact. Analyses are based on two waves of longitudinal data from the National Survey of Children's Exposure to Violence (NatSCEV), conducted in 2008 and 2010, that comprised a telephone sample of 1,186 youth ages 10 to 17. Using structural equation modeling, we examine direct and indirect effects on distress symptoms of increased, decreased, and stable high poly-victimization between Waves 1 and 2 compared to no or low victimization in both waves. Specifically, we consider the extent to which reductions in core psychosocial resources, including family support, peer support, self-esteem, and mastery, mediate the relationship between these poly-victimization conditions and distress. Relative to stable low victimization, both increased poly-victimization and stable high poly-victimization were associated with declines in all four resources. However, only self-esteem and mastery significantly mediated the association between poly-victimization and distress, with mastery showing the strongest effect. Although significant indirect effects were evident, poly-victimization still had a strong direct effect on distress with resource factors controlled. Findings support the hypothesis that the potent effect of poly-victimization on youth mental health is, in part, due to its damaging influence on core psychosocial resources. © The Author(s) 2015.

It is not Black and White: Discrimination and distress in Hawai'i.

PubMed

Mossakowski, Krysia N; Wongkaren, Turro; Uperesa, Fàanofo Lisaclaire

2017-10-01

This study investigates whether the strength of the relationship between perceived discrimination and psychological distress varies by race/ethnicity, gender, and the number of years of residence in Hawai'i. Our sample consisted of 1,036 undergraduate students at a university in Hawai'i and the survey was conducted in 2012-2013. The sample was composed of 55% women and the average age was 21. The students reported their racial/ethnic backgrounds as White (19%), Japanese (21%), Filipino (16%), Chinese (10%), Native Hawaiian (14%), Pacific Islander (4%), other Asian (6%), and other race/ethnicity (10%). Interaction effect results revealed that Whites who had experienced everyday discrimination had higher levels of psychological distress than racial ethnic minorities. Women who had experienced everyday discrimination were more distressed than men and more distressed by a lower threshold level of discrimination. Furthermore, those who had lived in Hawai'i for a longer duration and experienced everyday discrimination were more distressed. Our findings draw attention to how the psychological effects of discrimination vary by racial/ethnic group, gender, and location in the United States. The relationship between everyday discrimination and higher levels of psychological distress especially among those who have lived in Hawai'i longer, women, and Whites indicates that targeted medical and social interventions are needed to protect the mental health of college students. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Parental childhood adversity, depressive symptoms, and parenting quality: Effects on toddler self-regulation in Child Welfare Services-involved families

PubMed Central

Spieker, Susan J.; Oxford, Monica L.; Fleming, Charles B.; Lohr, Mary Jane

2018-01-01

Parents who are child welfare services-involved (CWSI) often have a history of childhood adversity and depressive symptoms. Both affect parenting quality, which in turn influences child adaptive functioning. We tested a model of the relations between parental depression and child regulatory outcomes first proposed by Lyons-Ruth and colleagues (2002). We hypothesized that both parental depression and parenting quality mediate the effects of parental early adversity on offspring regulatory outcomes. Participants were 123 CWSI parents and their toddlers who were assessed three times over a period of six months. At T1, parents reported on their childhood adversity and current depressive symptoms. At T2, parents’ sensitivity to their child’s distress and non-distress cues were rated from a videotaped teaching task. At T3, observers rated children’s emotional regulation, orientation/engagement, and secure base behavior. The results of a path model partly supported hypotheses. Parent childhood adversity was associated with current depressive symptoms, which in turn was related to parent sensitivity to child distress but not non-distress. Sensitivity to distress also predicted secure base behavior. Depression directly predicted orientation/engagement, also predicted by sensitivity to non-distress. Sensitivity to distress predicted emotion regulation and orientation/engagement. Results are discussed in terms of intervention approaches for CWSI families. PMID:29266280

Patients' and clinicians' experiences of holistic needs assessment using a cancer distress thermometer and problem list: A qualitative study.

PubMed

Biddle, Lucy; Paramasivan, Sangeetha; Harris, Susan; Campbell, Rona; Brennan, James; Hollingworth, William

2016-08-01

Psychosocial needs assessment is recommended for patients undergoing cancer treatment, but trials of effectiveness of assessment tools provide mixed results. This qualitative study aimed to understand how such tools are experienced by patients and clinicians in order to optimise use in the future. Qualitative interviews were used in a mixed-methods sequential design following a randomised controlled trial of needs assessment using the Distress Thermometer and Problem List (DT&PL), and explored patients' and clinicians' evaluations of the needs assessment process. Benefits of needs assessment using the DT&PL included the potential to detect hidden distress, allow opportunity for distress to be discussed, and to deliver outcomes to address problems. However, effectiveness and patient willingness to report all forms of distress could be hindered by: clinicians feeling ill-equipped to deal with 'non-physical' distress and patients questioning their appropriateness to do so; time constraints; insufficient support services and referral guidelines; inappropriate timing; and lack of follow-up. The benefits of a holistic needs assessment cannot be realised without matching time and frequency of administration to the dynamic nature of distress during cancer, and making changes to the context of delivery - for instance, providing protected time, increasing referral options and clinician training. Significant investment is needed to optimise potential benefits for patients. Copyright © 2016 Elsevier Ltd. All rights reserved.

Examining behavioural coping strategies as mediators between work-family conflict and psychological distress.

PubMed

Aazami, Sanaz; Shamsuddin, Khadijah; Akmal, Syaqirah

2015-01-01

We examined the mediating role of behavioral coping strategies in the association between work-family conflict and psychological distress. In particular, we examined the two directions of work-family conflict, namely, work interference into family and family interference into work. Furthermore, two coping styles in this study were adaptive and maladaptive coping strategies. This cross-sectional study was conducted among 429 Malaysian working women using self-reported data. The results of mediational analysis in the present study showed that adaptive coping strategy does not significantly mediate the effect of work-family conflict on psychological distress. However, maladaptive coping strategies significantly mediate the effect of work-family conflict on psychological distress. These results show that adaptive coping strategies, which aimed to improve the stressful situation, are not effective in managing stressor such as work-family conflict. We found that experiencing interrole conflict steers employees toward frequent use of maladaptive coping strategies which in turn lead to psychological distress. Interventions targeted at improvement of coping skills which are according to individual's needs and expectation may help working women to balance work and family demands. The important issue is to keep in mind that effective coping strategies are to control the situations not to eliminate work-family conflict.

Examining Behavioural Coping Strategies as Mediators between Work-Family Conflict and Psychological Distress

PubMed Central

Shamsuddin, Khadijah

2015-01-01

We examined the mediating role of behavioral coping strategies in the association between work-family conflict and psychological distress. In particular, we examined the two directions of work-family conflict, namely, work interference into family and family interference into work. Furthermore, two coping styles in this study were adaptive and maladaptive coping strategies. This cross-sectional study was conducted among 429 Malaysian working women using self-reported data. The results of mediational analysis in the present study showed that adaptive coping strategy does not significantly mediate the effect of work-family conflict on psychological distress. However, maladaptive coping strategies significantly mediate the effect of work-family conflict on psychological distress. These results show that adaptive coping strategies, which aimed to improve the stressful situation, are not effective in managing stressor such as work-family conflict. We found that experiencing interrole conflict steers employees toward frequent use of maladaptive coping strategies which in turn lead to psychological distress. Interventions targeted at improvement of coping skills which are according to individual's needs and expectation may help working women to balance work and family demands. The important issue is to keep in mind that effective coping strategies are to control the situations not to eliminate work-family conflict. PMID:25695097

Self-construal, mental distress, and family relations: a mediated moderation analysis with Asian American adolescents.

PubMed

Liu, Freda F; Goto, Sharon G

2007-04-01

The interactive effects between interdependent and independent self-construal on family cohesion and mental distress were examined. Survey responses from 153 Asian American high school students supported the hypothesized moderation of interdependence by independence on family cohesion, which was found to further mediate the relationship between self-construal and mental distress. Specifically, interdependence was positively associated with family cohesion when independence was high and negatively associated with family cohesion when independence was low. Accounting for the mediator effects of family cohesion, mental distress was positively associated with interdependence and more so for those low on independence than those high on independence. The benefits of biculturalism and research implications for the bidimensional conceptualization of self-construal for ethnic minority populations are discussed. (c) 2007 APA, all rights reserved.

Do spouses matter? Discrimination, social support, and psychological distress among Asian Americans.

PubMed

Rollock, David; Lui, P Priscilla

2016-01-01

Perceived discrimination poses risks for psychological distress among Asian Americans, but the differential impact of general unfair treatment and racial discrimination has not been examined. Although social support from distal sources reduces discrimination-related distress either directly or as a buffer, the unique roles of spousal support have remained understudied. Nativity status was examined as another moderator of these relationships to resolve previous inconsistent findings regarding its relationship to the discrimination-distress link. Data were from 1,626 U.S.- and foreign-born Asian American adults (Mage = 42.17 years; n = 1,142 married/cohabiting) in the nationally representative National Latino and Asian American Study, who reported on experiences of unfair treatment, racial discrimination, social supports from spouses, family, friends, and neighborhood, and psychological distress. Hierarchical multiple regressions showed that both unfair treatment and racial discrimination predicted psychological distress, and spousal support predicted distress above and beyond distal forms of social support in the context of perceived discrimination. Moderation analyses revealed that spousal support buffered against negative psychological consequences of unfair treatment, but not racial discrimination. Spousal support was not differentially protective as a function of nativity; however, U.S.-born respondents reacted with greater distress to unfair treatment than their foreign-born counterparts. Psychological effects of both general and race-based discrimination, and the unique contributions of distinct sources of social support, are important to understanding adjustment and cultural transition among Asian Americans. Nativity differentially influences effects of unfair treatment. Implications for future research are discussed. (c) 2016 APA, all rights reserved).

Maternal distress and the development of hypertensive disorders of pregnancy.

PubMed

Garza-Veloz, Idalia; Castruita-De la Rosa, Claudia; Ortiz-Castro, Yolanda; Flores-Morales, Virginia; Castañeda-Lopez, Maria E; Cardenas-Vargas, Edith; Hernandez-Delgadillo, Gloria P; Ortega-Cisneros, Vicente; Luevano, Martha; Rodriguez-Sanchez, Iram P; Trejo-Vazquez, Fabiola; Delgado-Enciso, Ivan; Cid-Baez, Miguel A; Trejo-Ortiz, Perla M; Ramos-Del Hoyo, Maria G; Martinez-Fierro, Margarita L

2017-11-01

Despite the implementation of programmes to improve maternal health, maternal and foetal mortality rates still remain high. The presence of maternal distress and its association with the development of pregnancy hypertensive disorders is not well established. The aim of this study was to evaluate the association between maternal distress and the development of hypertensive disorders in pregnancy in a prospective cohort of 321 Mexican women. Symptoms of maternal distressing were evaluated at week 20th of gestation using the General Health Questionnaire. The presence of acute somatic symptoms, social dysfunction, anxiety and insomnia increased the odds of developing a pregnancy hypertensive disorder by 5.1-26.4 times in study population (p values < .05). Our results support the participation of maternal distress in the development of hypertensive disorders of pregnancy. The implementation of effective programmes prioritising risk factors during pregnancy including the presence of maternal distressing factors is recommended. Impact statement What is already known on this subject: Changes in the nervous, endocrine, and immune systems have been observed in pregnant women with distress conditions leading to gestational disorders. What do the results of this study add: The presence of acute somatic symptoms, social dysfunction, anxiety and insomnia increased the developing of hypertensive disorders in Mexican population. What are the implications of these findings for clinical practice and/or further research: These findings may contribute to a better understanding of the role of the maternal stress in the development of hypertensive disorders of pregnancy, and in the implementation of effective programmes for clinical practice prioritising risk factors during pregnancy, including the presence of maternal distressing factors.

Attachment and Temperament Revisited: Infant Distress, Attachment Disorganization, and the Serotonin Transporter Polymorphism

PubMed Central

Brumariu, Laura E.; Bureau, Jean-François; Nemoda, Zsofia; Sasvari-Szekely, Maria; Lyons-Ruth, Karlen

2015-01-01

Objective This study's aim was to evaluate whether infant disorganized attachment and infant proneness to distress exhibited differential relations to infant genetic factors as indexed by the serotonin transporter polymorphism. Background The role of the short allele of the serotonin transporter polymorphism (5-HTTLPR) in enhancing sensitivity to fearful and negative affect has been well-established (Canli & Lesch, 2007). In the current study, we used this known property of the short allele to provide a test of an important postulate of attachment theory, namely that infant attachment security or disorganization is not a function of the infant's proneness to distress. Methods Participants were 39 parents and infants assessed between 12 and 18 months in the Strange Situation procedure. Genotype categories for the 5-HTTLPR (and rs25531) were created by both the original and the reclassified grouping system; infant proneness to distress was assessed directly in the Strange Situation Procedure. We also assessed maternal behavior at 18 months to evaluate whether any observed genetic effect indicated a passive effect through the mother. Results Consistent with previous findings, the 5-HTTLPR short allele was significantly related to the infant's wariness and distress, but was not related to attachment security or attachment disorganization. In addition, maternal disrupted interaction with the infant was not related to infant genotype or infant distress. Conclusion Results support the concept that infant proneness to distress is associated with serotonergic factors while infant attachment security or disorganization is not a function of either 5-HTTLPR or behaviorally rated proneness to distress. PMID:26912941

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.

Moms growing together: Piloting action methods and expressive arts in a therapeutic group for teen mothers.

PubMed

SmithBattle, Lee; Chantamit-O-Pas, Chutima; Freed, Patricia; McLaughlin, Dorcas; Schneider, Joanne K

2017-05-01

The purpose of this pilot study was to test the safety, acceptability, feasibility, and effectiveness of Moms Growing Together (MGT), an intervention to prevent and reduce psychological distress in teen mothers. A mixed method design was used. The primary outcomes were reported satisfaction with MGT (acceptance); successful recruitment and retention of teen mothers (feasibility); and prevention or reduction of psychological distress (safety and effectiveness). Summary scores on each of three symptom measures operationally defined psychological distress. Sixteen African-American teen mothers participated in the study: eight in MGT and eight in a comparison group. MGT was considered safe and acceptable. MGT had a negative small effect (effect size [ES] = -0.028) on decreasing depression in participants and a moderate effect in reducing anxiety (ES = 0.395) and trauma symptoms (ES = 0.521-0.554) relative to the comparison group. Prolonged recruitment limited feasibility. Because psychological distress casts a long shadow on teen mothers' well-being, developing teen-friendly clinical programs that address their mental health is a high priority. © 2017 Wiley Periodicals, Inc.

Gendered Sources of Distress and Resilience among Afghan Refugees in Northern California: A Cross-Sectional Study.

PubMed

Stempel, Carl; Sami, Nilofar; Koga, Patrick Marius; Alemi, Qais; Smith, Valerie; Shirazi, Aida

2016-12-28

Recent studies have emphasized the influence of resettlement factors on the mental health of refugees resettling in developed countries. However, little research has addressed gender differences in the nature and influence of resettlement stressors and sources of resilience. We address this gap in knowledge by investigating how gender moderates and mediates the influence of several sources of distress and resilience among 259 Afghan refugees residing in Northern California (USA). Gender moderated the effects of four factors on levels of distress. Intimate and extended family ties have little correlation with men's distress levels, but are strongly associated with lower distress for women. English ability is positively associated with lower distress for women, but not men. In terms of gender ideology, traditionally oriented women and egalitarian men have lower levels of distress. And experiencing greater dissonant acculturation increases distress for men, but not women. The influence of gender interaction terms is substantial and patterns may reflect difficulty adapting to a different gender order. Future studies of similar populations should investigate gender differences in sources of distress and resilience, and efforts to assist new arrivals might inform them of changes in gender roles they may experience, and facilitate opportunities to renegotiate gender roles.

Shift schedules, work factors, and mental health among onshore and offshore workers in the Norwegian petroleum industry

PubMed Central

BERTHELSEN, Mona; PALLESEN, Ståle; BJORVATN, Bjørn; KNARDAHL, Stein

2015-01-01

The purpose of the present study was to answer the following research questions: (1) Do workers in different shift schedules differ in mental distress? (2) Do workers in different shift schedules differ in neuroticism? (3) Do shift schedules differ in psychosocial work exposures? (4) Do psychosocial work exposures contribute to mental distress among onshore- and offshore workers? (5) Does neuroticism confound the association between work exposures and mental distress? Workers on six shift-schedules answered a questionnaire (1,471 of 2,628 employees). Psychological and social work factors were measured by QPSNordic, mental distress was measured by HADS and neuroticism was measured by EPQ. The results showed 1) No differences in mental distress between workers in different shift schedules, 2) Revolving-shift workers reported higher neuroticism compared to day workers, 3) Swing-shift workers and revolving-shift workers reported lower job control compared to permanent-night and -day workers, 4) Job demands and role conflict were associated with more mental distress. Job control, role clarity, support, and leadership were associated with lower mental distress, 5) Neuroticism influenced the relationship between psychosocial work factors and mental distress. The present study did not find differences in mental distress between shift schedules. Job characteristics may be contributing factors when determining health effects of shift work. PMID:25740007

Shift schedules, work factors, and mental health among onshore and offshore workers in the Norwegian petroleum industry.

PubMed

Berthelsen, Mona; Pallesen, Ståle; Bjorvatn, Bjørn; Knardahl, Stein

2015-01-01

The purpose of the present study was to answer the following research questions: (1) Do workers in different shift schedules differ in mental distress? (2) Do workers in different shift schedules differ in neuroticism? (3) Do shift schedules differ in psychosocial work exposures? (4) Do psychosocial work exposures contribute to mental distress among onshore- and offshore workers? (5) Does neuroticism confound the association between work exposures and mental distress? Workers on six shift-schedules answered a questionnaire (1,471 of 2,628 employees). Psychological and social work factors were measured by QPSNordic, mental distress was measured by HADS and neuroticism was measured by EPQ. The results showed 1) No differences in mental distress between workers in different shift schedules, 2) Revolving-shift workers reported higher neuroticism compared to day workers, 3) Swing-shift workers and revolving-shift workers reported lower job control compared to permanent-night and -day workers, 4) Job demands and role conflict were associated with more mental distress. Job control, role clarity, support, and leadership were associated with lower mental distress, 5) Neuroticism influenced the relationship between psychosocial work factors and mental distress. The present study did not find differences in mental distress between shift schedules. Job characteristics may be contributing factors when determining health effects of shift work.

Gendered Sources of Distress and Resilience among Afghan Refugees in Northern California: A Cross-Sectional Study

PubMed Central

Stempel, Carl; Sami, Nilofar; Koga, Patrick Marius; Alemi, Qais; Smith, Valerie; Shirazi, Aida

2016-01-01

Recent studies have emphasized the influence of resettlement factors on the mental health of refugees resettling in developed countries. However, little research has addressed gender differences in the nature and influence of resettlement stressors and sources of resilience. We address this gap in knowledge by investigating how gender moderates and mediates the influence of several sources of distress and resilience among 259 Afghan refugees residing in Northern California (USA). Gender moderated the effects of four factors on levels of distress. Intimate and extended family ties have little correlation with men’s distress levels, but are strongly associated with lower distress for women. English ability is positively associated with lower distress for women, but not men. In terms of gender ideology, traditionally oriented women and egalitarian men have lower levels of distress. And experiencing greater dissonant acculturation increases distress for men, but not women. The influence of gender interaction terms is substantial and patterns may reflect difficulty adapting to a different gender order. Future studies of similar populations should investigate gender differences in sources of distress and resilience, and efforts to assist new arrivals might inform them of changes in gender roles they may experience, and facilitate opportunities to renegotiate gender roles. PMID:28036054

Benefits and limits of anticholinergic use in schizophrenia: focusing on its effect on cognitive function.

PubMed

Ogino, Shin; Miyamoto, Seiya; Miyake, Nobumi; Yamaguchi, Noboru

2014-01-01

All currently available antipsychotic drugs are the dopamine D2 receptor antagonists and are capable of producing extrapyramidal side-effects (EPS). Anticholinergic drugs are primarily used to treat EPS or prevent EPS induced by antipsychotics in the treatment of psychosis and schizophrenia. However, they can cause a variety of distressing peripheral side-effects (e.g. dry mouth, urinary disturbances, and constipation) and central adverse effects (e.g. cognitive impairment, worsening of tardive dyskinesia, and delirium). Disturbances in cognitive abilities are cardinal features of schizophrenia from its earliest phases and account for much of the functional disability associated with the illness. It is likely that long-term concomitant administration of anticholinergics exacerbates the underlying cognitive impairment in patients with schizophrenia and subsequently affects patients' quality of life. Thus, current treatment guidelines for schizophrenia generally do not recommend the prophylactic and long-term use of anticholinergics. However, the high use of long-term anticholinergic drugs with antipsychotics has been identified as an important issue in the treatment of schizophrenia in several countries. To assess the benefits and limits of anticholinergic use in psychosis and schizophrenia, this article will provide a brief review of the pharmacology and clinical profiles of anticholinergic drugs and will focus on their effects on cognitive function in schizophrenia, particularly during the course of the early phase of the illness. In addition, we will address the effects of discontinuation of anticholinergics on cognitive function in patients with schizophrenia and provide a strategy for adjunctive anticholinergic use in patients treated with long-acting injectable antipsychotics. © 2013 The Authors. Psychiatry and Clinical Neurosciences © 2013 Japanese Society of Psychiatry and Neurology.

Case Study: Videogame Distraction Reduces Behavioral Distress in a Preschool-Aged Child Undergoing Repeated Burn Dressing Changes: A Single-Subject Design

PubMed Central

Sil, Soumitri; Burns, Andrew J.

2013-01-01

Objective This single-subject design study evaluated the feasibility and efficacy of passive and interactive videogame distraction on behavioral distress for a preschool-aged child receiving repeated burn dressing changes. Method A 4-year-old girl underwent 3 baseline and 10 videogame distraction sessions (5 passive and 5 interactive) using a restricted alternating treatments design. Observed behavioral distress was coded, and parents and nurses rated the child’s distress and cooperative behavior. Results Relative to baseline, behavioral distress decreased and cooperative behavior increased immediately after the onset of videogame distraction. Single Case Randomization Tests revealed significantly lower behavioral distress and greater cooperation during interactive videogame distraction relative to passive videogame distraction. Conclusions Interactive videogame distraction appears to be a feasible and effective pain management strategy for a preschool-aged child undergoing repeated painful medical procedures. PMID:23248343

Unique Roles of Antisocial Personality Disorder and Psychopathic Traits in Distress Tolerance

PubMed Central

Sargeant, Marsha N.; Daughters, Stacey B.; Curtin, John J.; Schuster, Randi; Lejuez, C.W.

2011-01-01

Previous research indicates that individuals with antisocial personality disorder (ASPD) evidence low distress tolerance, which signifies impaired ability to persist in goal-directed behavior during an aversive situation, and is associated with a variety of poor interpersonal and drug use outcomes. Based on theory and research indicating that psychopathic traits are associated with hypo-reactivity in emotional responding, a unique hypothesis emerges where psychopathic traits should have the opposite effect of ASPD and be related to high levels of distress tolerance. In a sample of 107 substance-dependent patients in an inner-city substance use residential treatment facility, this hypothesis was supported. ASPD was related to lower distress tolerance, while psychopathic traits were related to higher distress tolerance, with each contributing unique variance. Findings are discussed in relation to different presentations of distress tolerance as a function of psychopathic traits among those with an ASPD diagnosis. PMID:21668082

Psychological Distress among Victimized Women on Probation and Parole: A Latent Class Analysis

PubMed Central

Golder, Seana; Engstrom, Malitta; Hall, Martin T.; Higgins, George; Logan, TK

2015-01-01

Latent class analysis was used to identify subgroups of victimized women (N=406) on probation and parole differentiated by levels of general psychological distress. The nine primary symptom dimensions from the Brief Symptom Inventory (BSI) were used individually as latent class indicators (Derogatis, 1993). Results identified three classes of women characterized by increasing levels of psychological distress; classes were further differentiated by posttraumatic stress disorder symptoms, cumulative victimization, substance use and other domains of psychosocial functioning (i.e., sociodemographic characteristics; informal social support and formal service utilization; perceived life stress; and resource loss). The present research was effective in uncovering important heterogeneity in psychological distress using a highly reliable and easily accessible measure of general psychological distress. Differentiating levels of psychological distress and associated patterns of psychosocial risk can be used to develop intervention strategies targeting the needs of different subgroups of women. Implications for treatment and future research are presented. PMID:25915692

Unique roles of antisocial personality disorder and psychopathic traits in distress tolerance.

PubMed

Sargeant, Marsha N; Daughters, Stacey B; Curtin, John J; Schuster, Randi; Lejuez, C W

2011-11-01

Previous research indicates that individuals with antisocial personality disorder (ASPD) evidence low distress tolerance, which signifies impaired ability to persist in goal-directed behavior during an aversive situation, and is associated with a variety of poor interpersonal and drug use outcomes. Based on theory and research indicating that psychopathic traits are associated with hypo-reactivity in emotional responding, a unique hypothesis emerges where psychopathic traits should have the opposite effect of ASPD and be related to high levels of distress tolerance. In a sample of 107 substance-dependent patients in an inner-city substance use residential treatment facility, this hypothesis was supported. ASPD was related to lower distress tolerance, while psychopathic traits were related to higher distress tolerance, with each contributing unique variance. Findings are discussed in relation to different presentations of distress tolerance as a function of psychopathic traits among those with an ASPD diagnosis.

The Epidemiology of Transfusion-related Acute Lung Injury Varies According to the Applied Definition of Lung Injury Onset Time.

PubMed

Vande Vusse, Lisa K; Caldwell, Ellen; Tran, Edward; Hogl, Laurie; Dinwiddie, Steven; López, José A; Maier, Ronald V; Watkins, Timothy R

2015-09-01

Research that applies an unreliable definition for transfusion-related acute lung injury (TRALI) may draw false conclusions about its risk factors and biology. The effectiveness of preventive strategies may decrease as a consequence. However, the reliability of the consensus TRALI definition is unknown. To prospectively study the effect of applying two plausible definitions of acute respiratory distress syndrome onset time on TRALI epidemiology. We studied 316 adults admitted to the intensive care unit and transfused red blood cells within 24 hours of blunt trauma. We identified patients with acute respiratory distress syndrome, and defined acute respiratory distress syndrome onset time two ways: (1) the time at which the first radiographic or oxygenation criterion was met, and (2) the time both criteria were met. We categorized two corresponding groups of TRALI cases transfused in the 6 hours before acute respiratory distress syndrome onset. We used Cohen's kappa to measure agreement between the TRALI cases and implicated blood components identified by the two acute respiratory distress syndrome onset time definitions. In a nested case-control study, we examined potential risk factors for each group of TRALI cases, including demographics, injury severity, and characteristics of blood components transfused in the 6 hours before acute respiratory distress syndrome onset. Forty-two of 113 patients with acute respiratory distress syndrome were TRALI cases per the first acute respiratory distress syndrome onset time definition and 63 per the second definition. There was slight agreement between the two groups of TRALI cases (κ = 0.16; 95% confidence interval, -0.01 to 0.33) and between the implicated blood components (κ = 0.15, 95% confidence interval, 0.11-0.20). Age, Injury Severity Score, high plasma-volume components, and transfused plasma volume were risk factors for TRALI when applying the second acute respiratory distress syndrome onset time definition but not when applying the first definition. The epidemiology of TRALI varies when applying two plausible definitions of acute respiratory distress syndrome onset time to severely injured trauma patients. A TRALI definition that standardizes acute respiratory distress syndrome onset time might improve reliability and align efforts to understand epidemiology, biology, and prevention.

Effects of cognitive-behavioural therapy (CBT) and positive psychological intervention (PPI) on female offenders with psychological distress in Hong Kong.

PubMed

Mak, Vivian W M; Chan, Calais K Y

2018-04-01

Despite rapid growth in the female prison population, there is little research on effectiveness of psychological interventions for them. To test the hypotheses that (1) each of two psychological interventions administered separately - cognitive behavioural therapy (CBT) or positive psychology intervention (PPI) - would be more effective than 'treatment-as-usual' alone in reducing psychological distress and enhancing psychological well-being; (2) outcomes would differ according to intervention; and (3) combining the interventions would be more effective than delivering either alone. We recruited 40 women in a special Hong Kong prison unit for female offenders with psychological distress. Half of them received eight sessions of CBT followed by eight sessions of PPI; the other half received the same interventions in the reverse order. We recruited another 35 women who received only 'treatment as usual' (TAU) in the same unit. We used various clinical scales to assess the women's psychological distress or well-being before and after the interventions or at similar time points for the comparison women. All intervention group women showed a significant reduction in psychological distress and enhancement in psychological well-being after each intervention alone compared to the TAU women. There were no significant differences between CBT and PPI in this respect. Receiving both treatments, however, did yield significantly more improvement than either intervention alone in reducing depressive thoughts and enhancing global judgement of life satisfaction, self-perceived strengths and hopeful thinking style. Our findings provide preliminary empirical support for the effectiveness of psychological interventions with psychologically distressed women in prison. It would be important now to conduct a full, randomised trial to determine optimal length and combinations of treatment. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

Emotional Risks to Respondents in Survey Research: Some Empirical Evidence

PubMed Central

Labott, Susan M.; Johnson, Timothy P.; Fendrich, Michael; Feeny, Norah C.

2014-01-01

Some survey research has documented distress in respondents with pre-existing emotional vulnerabilities, suggesting the possibility of harm. In this study, respondents were interviewed about a personally distressing event; mood, stress, and emotional reactions were assessed. Two days later, respondents participated in interventions to either enhance or alleviate the effects of the initial interview. Results indicated that distressing interviews increased stress and negative mood, although no adverse events occurred. Between the interviews, moods returned to baseline. Respondents who again discussed a distressing event reported moods more negative than those who discussed a neutral or a positive event. This study provides evidence that, among nonvulnerable survey respondents, interviews on distressing topics can result in negative moods and stress, but they do not harm respondents. PMID:24169422

Couple resilience to economic pressure.

PubMed

Conger, R D; Rueter, M A; Elder, G H

1999-01-01

Over 400 married couples participated in a 3-year prospective study of economic pressure and marital relations. The research (a) empirically evaluated the family stress model of economic stress influences on marital distress and (b) extended the model to include specific interactional characteristics of spouses hypothesized to protect against economic pressure. Findings provided support for the basic mediational model, which proposes that economic pressure increases risk for emotional distress, which, in turn, increases risk for marital conflict and subsequent marital distress. Regarding resilience to economic stress, high marital support reduced the association between economic pressure and emotional distress. In addition, effective couple problem solving reduced the adverse influence of marital conflict on marital distress. Overall, the findings provided substantial support for the extended family stress model.

Psychological distress of patients suffering from restless legs syndrome: a cross-sectional study

PubMed Central

2011-01-01

Background Restless legs syndrome (RLS) is a chronic disorder with substantial impact on quality of life similar to that seen in diabetes mellitus or osteoarthritis. Little is known about the psychological characteristics of RLS patients although psychological factors may contribute to unfavourable treatment outcome. Methods In an observational cross-sectional design, we evaluated the psychological features of 166 consecutive RLS patients from three outpatient clinics, by means of the Symptom Checklist 90-R (SCL-90-R) questionnaire. Additionally, the Beck Depression Inventory-II (BDI-II) and the International RLS Severity Scale (IRLS) were measured. Both treated and untreated patients were included, all patients sought treatment. Results Untreated patients (n = 69) had elevated but normal scores on the SCL-90-R Global Severity Index (GSI; p = 0.002) and on the sub-scales somatisation (p < 0.001), compulsivity (p = 0.003), depression (p = 0.02), and anxiety (p = 0.004) compared with a German representative sample. In the treated group, particularly in those patients who were dissatisfied with their actual treatment (n = 62), psychological distress was higher than in the untreated group with elevated scores for the GSI (p = 0.03) and the sub-scales compulsivity (p = 0.006), depression (p = 0.012), anxiety (p = 0.031), hostility (p = 0.013), phobic anxiety (p = 0.024), and paranoid ideation (p = 0.012). Augmentation, the most serious side effect of dopaminergic, i.e. first-line treatment of RLS, and loss of efficacy were accompanied with the highest psychological distress, as seen particularly in the normative values of the sub-scales compulsivity and anxiety. Generally, higher RLS severity was correlated with higher psychological impairment (p < 0.001). Conclusion Severely affected RLS patients show psychological impairment in multiple psychological domains which has to be taken into account in the treatment regimen. PMID:21933380

Reducing children's pain and distress towards flu vaccinations: a novel and effective application of humanoid robotics.

PubMed

Beran, Tanya N; Ramirez-Serrano, Alex; Vanderkooi, Otto G; Kuhn, Susan

2013-06-07

Millions of children in North America receive an annual flu vaccination, many of whom are at risk of experiencing severe distress. Millions of children also use technologically advanced devices such as computers and cell phones. Based on this familiarity, we introduced another sophisticated device - a humanoid robot - to interact with children during their vaccination. We hypothesized that these children would experience less pain and distress than children who did not have this interaction. This was a randomized controlled study in which 57 children (30 male; age, mean±SD: 6.87±1.34 years) were randomly assigned to a vaccination session with a nurse who used standard administration procedures, or with a robot who was programmed to use cognitive-behavioral strategies with them while a nurse administered the vaccination. Measures of pain and distress were completed by children, parents, nurses, and researchers. Multivariate analyses of variance indicated that interaction with a robot during flu vaccination resulted in significantly less pain and distress in children according to parent, child, nurse, and researcher ratings with effect sizes in the moderate to high range (Cohen's d=0.49-0.90). This is the first study to examine the effectiveness of child-robot interaction for reducing children's pain and distress during a medical procedure. All measures of reduction were significant. These findings suggest that further research on robotics at the bedside is warranted to determine how they can effectively help children manage painful medical procedures. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

Work-Family Conflict, Resources, and Role Set Density: Assessing Their Effects on Distress among Working Mothers

ERIC Educational Resources Information Center

Kulik, Liat; Liberman, Gabriel

2013-01-01

We explored the relationships between the experience of work-family conflict and levels of distress in the family and at work among a sample of 227 Israeli working mothers. We also examined how role set density (RSD, the number of roles they perform) and personal and environmental resources are related to the women's experience of distress.…

Transient hiccups associated with oral dexamethasone.

PubMed

Peacock, Mark E

2013-01-01

Hiccups, or singulata (hiccup is singultus), are commonly experienced by most people at one time or another and are usually brief and self-limiting. Although pharmacotherapeutic agents are not generally considered causal in the etiology of hiccups, many clinicians empirically associate episodic hiccups in their patients as being drug induced. The two classes of drugs most often cited as causing hiccups are corticosteroids and benzodiazepines. This report involved a patient who was given preoperative dexamethasone and developed hiccups before anesthesia and surgery commenced. He at no time was in distress, and the surgical procedure was completed without complication. By the second postsurgical day his hiccups were resolved completely. Although the association may be anecdotal, many clinicians consider hiccups a potential side effect of steroid therapy, especially high doses of steroids. Of interest in this case is the relatively low dose of corticosteroid used, albeit apparently linked to his hiccups. Practitioners should be aware of this potential condition.

The devil is in the details: an analysis of the subtleties between phosphodiesterase inhibitors for erectile dysfunction.

PubMed

Smith-Harrison, L I; Patel, Abhishek; Smith, Ryan P

2016-04-01

Erectile dysfunction (ED) is a common sexual disorder with numerous etiologies involving multiple organ systems that leads to significant distress and decreased quality of life for the affected men. Fortunately, there are several modalities and interventions for treating ED. Oral medications, intra-urethral compounds, intracorporeal injections, vacuum-assist devices and surgically implanted prostheses are all part of the treatment algorithm. One of the first-lines and certainly the most widely used options for treating ED is the family of oral phosphodiesterase type 5 inhibitors (PDE5I). The introduction of these medications in the late 1990s revolutionized the field of sexual medicine. Currently there are no guidelines and minimal literature to help providers choose among drugs in this class. This review will address differences in efficacy and side effects between various members of the oral selective phosphodiesterase-5 inhibitor class of drugs.

Eva Between Anxiety and Hope: Integrating Anthroposophic Music Therapy in Supportive Oncology Care

PubMed Central

Ben-Arye, Eran; Ben-Arye, Yotam; Barak, Yael

2015-01-01

Music therapy is a significant modality in the treatment of patients with cancer, who suffer emotional and spiritual distress as well as chemotherapy side effects that impair their quality of life. In this article, we present a case study of a patient challenged with recurrent ovarian cancer who received, concomitant with chemotherapy, a special form of music therapy based on anthroposophic medicine (AM) aimed at alleviating anxiety and improving her general well-being. AM-centered music therapy goals are discussed in regard to two modes of treatment: receptive listening and clinical composition. Next, these two treatment modes are discussed in a broader context by reviewing conventional music therapy interventions during chemotherapy on two axes: a. standardized vs. individualized treatment; b. patient’s involvement on a passive to active continuum. In conclusion, psycho-oncology care can be enriched by adding anthroposophic medicine-oriented music therapy integrated within patients’ supportive care. PMID:26973967

[Could it be a little less? Let the dose of thiopental in euthanasia depend on the body weight].

PubMed

Sprij, Bram

2010-01-01

The Dutch 'euthanasia and assisted suicide' practice guideline advises using 2000 mg thiopental to induce coma, followed by a muscle relaxant to cause death by respiratory paralysis. However, when a doctor administers such a high dose of thiopental as a bolus injection to a cachectic patient, there is a high likelihood of immediate death and other side effects, which can be distressing for the family. Doctors who administered less than 2000 mg have been reprimanded for not working according to current standards. Arguments are given concerning in which circumstances it is reasonable to use the advised dose of 2000 mg of thiopental and when to use less thiopental to induce coma by direct intravenous injection. The author suggests that it may be better to adjust the dose of thiopental according to the body weight of the patient. The current practice guideline needs revision.

Congenital lobar emphysema: a case report

PubMed Central

2009-01-01

Congenital lobar emphysema is a rare variety of congenital malformation of lung characterized by over distension of a lobe of a lung due to partial obstruction of the bronchus. We are reporting a neonate admitted in the pediatric emergency ward with the respiratory distress since 16th day of life. Investigation revealed the overexpansion of the left upper lobe with mediastinal herniation, shifting of the mediastinum to the opposite side and collapse of the ipsilateral lower lobe. The baby was treated with conservative treatment and the condition of the baby was improved. PMID:19154591

The buffering effect of family functioning on the psychological consequences of headache.

PubMed

Mohammadi, Somayyeh; Zandieh, Sara; Dehghani, Mohsen; Assarzadegan, Farhad; Sanderman, Robbert; Hagedoorn, Mariët

2017-02-01

The current study aimed to examine whether high family functioning mitigates the association between headache intensity and distress. The sample consisted of 124 patients with chronic or recurrent headache. Patients completed validated questionnaires about headache intensity, family functioning, and distress. Hierarchical regression analyses were performed to examine the interaction between headache intensity and family functioning on distress. Headache intensity was positively associated with distress (r = .28, p = .002). As hypothesized, family functioning moderated this association (B = -.01, p = .023). More specifically, the positive association between headache intensity and distress was significant only among patients with lower family functioning (B = .01, p < .001) and not among patients with higher levels of family functioning (B = .006, p = .075). Functional families appear to buffer the distress level in patients; they showed relatively low levels of distress regardless of the severity of their headache. In contrast, patients with dysfunctional families who experienced more pain reported more distress, presumably because they did not receive adequate help and support from these families. This study underlines the importance of a broader perspective on family dynamics in coping with pain.

Indicators of distress in newly diagnosed breast cancer patients

PubMed Central

Lucidi, Fabio; Mallia, Luca; D’Aiuto, Massimiliano; Merluzzi, Thomas V.

2015-01-01

Background. The diagnosis, treatment, and long-term management of cancer can present individuals with a multitude of stressors at various points in that trajectory. Psychosocial distress may appear early in the diagnostic process and have negative effects on compliance with treatment and subsequent quality of life. Purpose. The aim of the study was to determine early-phase predictors of distress before any medical treatment. Method. Consistent with the goals of the study, 123 newly diagnosed breast cancer patients (20 to 74 years old) completed multiple indicators of knowledge about breast cancer management and treatment, attitudes toward cancer, social support, coping efficacy, and distress. Results. SEM analysis confirmed the hypothesized model. Age was negatively associated with the patient’s knowledge (β = − 0.22), which, in turn, was positively associated with both attitudes toward breast cancer (β = 0.39) and coping self-efficacy (β = 0.36). Self-efficacy was then directly related to psychological distress (β = − 0.68). Conclusions. These findings establish indicators of distress in patients early in the cancer trajectory. From a practical perspective, our results have implications for screening for distress and for the development of early interventions that may be followed by healthcare professionals to reduce psychological distress. PMID:26244115

Economic evaluation of a psychological intervention for high distress cancer patients and carers: costs and quality-adjusted life years.

PubMed

Chatterton, Mary Lou; Chambers, Suzanne; Occhipinti, Stefano; Girgis, Afaf; Dunn, Jeffrey; Carter, Rob; Shih, Sophy; Mihalopoulos, Cathrine

2016-07-01

This study compared the cost-effectiveness of a psychologist-led, individualised cognitive behavioural intervention (PI) to a nurse-led, minimal contact self-management condition for highly distressed cancer patients and carers. This was an economic evaluation conducted alongside a randomised trial of highly distressed adult cancer patients and carers calling cancer helplines. Services used by participants were measured using a resource use questionnaire, and quality-adjusted life years were measured using the assessment of quality of life - eight-dimension - instrument collected through a computer-assisted telephone interview. The base case analysis stratified participants based on the baseline score on the Brief Symptom Inventory. Incremental cost-effectiveness ratio confidence intervals were calculated with a nonparametric bootstrap to reflect sampling uncertainty. The results were subjected to sensitivity analysis by varying unit costs for resource use and the method for handling missing data. No significant differences were found in overall total costs or quality-adjusted life years (QALYs) between intervention groups. Bootstrapped data suggest the PI had a higher probability of lower cost and greater QALYs for both carers and patients with high distress at baseline. For patients with low levels of distress at baseline, the PI had a higher probability of greater QALYs but at additional cost. Sensitivity analysis showed the results were robust. The PI may be cost-effective compared with the nurse-led, minimal contact self-management condition for highly distressed cancer patients and carers. More intensive psychological intervention for patients with greater levels of distress appears warranted. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Factors associated with psychological distress in women with breast cancer-related lymphoedema.

PubMed

Alcorso, Jessica; Sherman, Kerry A

2016-07-01

Previous research has shown that lymphoedema impacts negatively on an individual, including psychological distress and body image disturbance, particularly for younger women. This study identified psychological factors associated with distress in women with breast cancer-related lymphoedema and determined whether age moderated the specific relationship between body image disturbance and distress. Australian women (n = 166) diagnosed with breast cancer-related lymphoedema were recruited through a community-based breast cancer organisation and lymphoedema treatment clinics. Participants completed an online survey assessing lymphoedema-related cognitions (personal control, perceived treatment effectiveness, and consequences of lymphoedema), perceived ability to self-regulate lymphoedema-related negative affect, body image disturbance, psychological distress (depression, anxiety and stress), and demographic/medical information. Beliefs about the consequences, perceived effectiveness of treatment and controllability of lymphoedema, perceived ability to self-regulate negative affect, body image disturbance, and number of lymphoedema symptoms were correlated with depression, anxiety, and stress scores. Multivariate regression analyses indicated that body image disturbance was significantly associated with depression, anxiety, and stress, and perceived treatment effectiveness was associated with stress. Age was a significant moderator of the relationship between body image disturbance and depression and anxiety, with older women with greater body image disturbance more distressed. Health professionals need to be aware that women diagnosed with lymphoedema are at risk of experiencing psychological distress, particularly arising from body image disturbance and beliefs that treatment cannot control lymphoedema. Furthermore, older women may be at an increased risk of anxiety and depression arising from body image disturbance. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Effect of unaffordable medical need on distress level of family member: analyses of 1997-2013 United States National Health Interview Surveys.

PubMed

Chih, Hui Jun; Liang, Wenbin

2017-09-02

Reduced funding to public health care systems during economic downturns is a common phenomenon around the world. The effect of health care cost on family members of the patients has not been established. This paper aims to explore the relationship between affordability of health care and vulnerability of family members to distress levels. Data of a total of 262,843 participants were obtained from 17 waves (1997-2013) of the United States National Health Interview Survey. Multinomial logistic regression was used to investigate psychological distress level as a result of having family members who experienced unmet medical needs due to cost. Among participants without family members who experienced unmet needs for medical care due to cost, risks of having 'moderate' (score of 5-12) or 'serious' (score of 13 or above) level of psychological distress were 1.0% and 11.5%, respectively. Risks of having 'moderate' or 'serious' level of psychological distress were 3.1% and 23.4%, respectively among participants with family members who experienced unmet needs. The adjusted relative risk ratio of 'moderate' and 'serious', as compared to 'normal' level of psychological distress, were 1.58 (95% confidence interval: 1.47-1.69) and 2.09 (95% confidence interval: 1.78-2.45) if one's family members experienced unmet medical needs. Unmet medical needs due to cost increases risk of distress levels experienced by family members. Careful planning and adequate funding to public health care system could be implemented to prevent any unnecessary detrimental effect on mental health among family members of the unwell and any further increment of the prevalence of mental illnesses. This recommendation aligns with the World Health Organization Mental Health Action Plan 2013-2020.

A philosophical taxonomy of ethically significant moral distress.

PubMed

Thomas, Tessy A; McCullough, Laurence B

2015-02-01

Moral distress is one of the core topics of clinical ethics. Although there is a large and growing empirical literature on the psychological aspects of moral distress, scholars, and empirical investigators of moral distress have recently called for greater conceptual clarity. To meet this recognized need, we provide a philosophical taxonomy of the categories of what we call ethically significant moral distress: the judgment that one is not able, to differing degrees, to act on one's moral knowledge about what one ought to do. We begin by unpacking the philosophical components of Andrew Jameton's original formulation from his landmark 1984 work and identify two key respects in which that formulation remains unclear: the origins of moral knowledge and impediments to acting on that moral knowledge. We then selectively review subsequent literature that shows that there is more than one concept of moral distress and that explores the origin of the values implicated in moral distress and impediments to acting on those values. This review sets the stage for identifying the elements of a philosophical taxonomy of ethically significant moral distress. The taxonomy uses these elements to create six categories of ethically significant moral distress: challenges to, threats to, and violations of professional integrity; and challenges to, threats to, and violations of individual integrity. We close with suggestions about how the proposed philosophical taxonomy of ethically significant moral distress sheds light on the concepts of moral residue and crescendo effect of moral distress and how the proposed taxonomy might usefully guide prevention of and future qualitative and quantitative empirical research on ethically significant moral distress. © The Author 2014. Published by Oxford University Press, on behalf of the Journal of Medicine and Philosophy Inc. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Effectiveness of school-based humanistic counselling for psychological distress in young people: Pilot randomized controlled trial with follow-up in an ethnically diverse sample.

PubMed

Pearce, Peter; Sewell, Ros; Cooper, Mick; Osman, Sarah; Fugard, Andrew J B; Pybis, Joanne

2017-06-01

The aim of this study was to pilot a test of the effectiveness of school-based humanistic counselling (SBHC) in an ethnically diverse group of young people (aged 11-18 years old), with follow-up assessments at 6 and 9 months. Pilot randomized controlled trial, using linear-mixed effect modelling and intention-to-treat analysis to compare changes in levels of psychological distress for participants in SBHC against usual care (UC). ISRCTN44253140. In total, 64 young people were randomized to either SBHC or UC. Participants were aged between 11 and 18 (M = 14.2, SD = 1.8), with 78.1% of a non-white ethnicity. The primary outcome was psychological distress at 6 weeks (mid-therapy), 12 weeks (end of therapy), 6-month follow-up and 9-month follow-up. Secondary measures included emotional symptoms, self-esteem and attainment of personal goals. Recruitment and retention rates for the study were acceptable. Participants in the SBHC condition, as compared with participants in the UC condition, showed greater reductions in psychological distress and emotional symptoms, and greater improvements in self-esteem, over time. However, at follow-up, only emotional symptoms showed significant differences across groups. The study adds to the pool of evidence suggesting that SBHC can be tested and that it brings about short-term reductions in psychological and emotional distress in young people, across ethnicities. However, there is no evidence of longer-term effects. School-based humanistic counselling can be an effective means of reducing the psychological distress experienced by young people with emotional symptoms in the short term. The short-term effectiveness of school-based humanistic counselling is not limited to young people of a White ethnicity. There is no evidence that school-based humanistic counselling has effects beyond the end of therapy. © 2016 The British Psychological Society.

Association between body mass index and health outcomes among adolescents: the mediating role of traditional and cyber bullying victimization.

PubMed

Lee, Byung; Jeong, Seokjin; Roh, Myunghoon

2018-05-30

It is well-documented that obese children and adolescents tend to experience a variety of negative physical and psychological health consequences. Despite the association between obesity and physical and psychological well-being, few studies have examined the role of off-line and on-line forms of bullying victimization in this link. The main objective of the current study is to investigate the direct and mediating effects of traditional and cyber bullying victimization in explaining the relationship between the body mass index (BMI) and physical/psychological distress. A nationally representative sample of 10,160 school children (mean age = 12.95 ± 1.75) were collected from the 2009 Health Behavior in School-aged Children (HBSC) study. Data were collected on body mass index, physical and psychological health, bullying victimization experience, and demographic information. A seemingly unrelated regression (SUR) was employed to assess and compare the indirect effects in multiple mediation models. While a significant direct association was found between BMI and both physical and psychological health, the indirect effect of BMI on physical distress was significant only via traditional bullying victimization. Both forms of bullying victimization had a mediating impact between BMI and psychological distress. However, the indirect effect on psychological distress was manifested through a negative mediating role of cyberbullying victimization. The negative relation between cyberbullying victimization and psychological distress warrants further exploration. Obesity represents a serious risk to adolescent health and well-being, both physically and psychologically. If becoming a victim of traditional bullying mediates (specifically exacerbates) the level of physical and psychological distress among obese and overweight adolescents, health professionals need to focus on raising awareness of the importance of weight-based victimization for children and adolescents with obesity. School administrators and teachers could increase the efforts to identify school-age children who are stigmatized for their weight and recommend coping strategies for distressed victims of traditional and cyberbullying.

Interventions to improve screening and appropriate referral of patients with cancer for psychosocial distress: systematic review

PubMed Central

Britton, Ben; Baker, Amanda L; Halpin, Sean A; Beck, Alison K; Carter, Gregory; Wratten, Chris; Bauer, Judith; Forbes, Erin; Booth, Debbie

2018-01-01

Objectives The primary aim of the review was to determine the effectiveness of strategies to improve clinician provision of psychosocial distress screening and referral of patients with cancer. Design Systematic review. Data sources Electronic databases (Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, PsycINFO and Cumulative Index to Nursing and Allied Health Literature (CINAHL)) were searched until July 2016. Inclusion criteria Population: adult patients with cancer and clinical staff members. Intervention: any strategy that aimed to improve the rate of routine screening and referral for detected distress of patients with cancer. Comparison: no intervention controls, ‘usual’ practice or alternative interventions. Outcome: (primary) any measure of provision of screening and/or referral for distress, (secondary) psychosocial distress, unintended adverse effects. Design: trials with or without a temporal comparison group, including randomised and non-randomised trials, and uncontrolled pre–post studies. Data extraction and analysis Two review authors independently extracted data. Heterogeneity across studies precluded quantitative assessment via meta-analysis and so a narrative synthesis of the results is presented. Results Five studies met the inclusion criteria. All studies were set in oncology clinics or departments and used multiple implementation strategies. Using the Grades of Recommendation, Assessment, Development and Evaluation, the overall rating of the certainty of the body of evidence reported in this review was assessed as very low. Three studies received a methodological quality rating of weak and two studies received a rating of moderate. Only one of the five studies reported a significant improvement in referrals. Conclusions The review identified five studies of predominantly poor quality examining the effectiveness of strategies to improve the routine implementation of distress screening and referral for patients with cancer. Future research using robust research designs, including randomised assignment, are needed to identify effective support strategies to maximise the potential for successful implementation of distress screening and referral for patients with cancer. PROSPERO registration number CRD42015017518. PMID:29306881

Adolescent Survivors of Childhood Sexual Abuse: The Mediating Role of Attachment Style and Coping in Psychological and Interpersonal Functioning.

ERIC Educational Resources Information Center

Shapiro, Deborah L.; Levendosky, Alytia A.

1999-01-01

A study of 80 adolescent females found that attachment style mediates the effects of child sexual abuse (CSA) and child abuse and neglect on coping and psychological distress. The indirect effects of CSA and other abuse through attachment accounted for most of the effects on coping and psychological distress. (Author/CR)

'I'm more sick than my doctors think': ethical issues in managing somatization in developing countries.

PubMed

Chandra, Prabha S; Satyanarayana, Veena A

2013-02-01

Several ethical issues confront the healthcare professional who is managing somatization in developing countries where cost constraints, low literacy, poverty, poor nutrition and infections and inadequate access to healthcare are common. The paper discusses these in the context of the ethical principles of autonomy, beneficence, non-maleficence and justice. Some of the ethical issues in managing somatization include being influenced by patient distress rather than rational medical decision-making, inadequate attention to the cultural meaning of symptoms, psychologizing versus medicalizing, the ethics of nomenclature and labels, communicating ethically with patients, and managing them adequately given lack of evidence and training. An ethical approach to managing somatization in this context would include using an integrated and simultaneous medical and psychiatric approach. To ensure patient beneficence, the medical, psychological and social assessment should be undertaken side-by-side as much as possible and should be cost effective. Respecting patient autonomy by using adequate communication methods and the patient's cultural model of the illness as part of management is also integral to ethical practice. In the developing world, issues of equity are also an important ethical concern. When more serious illnesses are the health priority, functional syndromes may not get equal importance or resources.

Moral distress and structural empowerment among a national sample of Israeli intensive care nurses.

PubMed

Ganz, Freda DeKeyser; Raanan, Ofra; Khalaila, Rabia; Bennaroch, Kochav; Scherman, Shiri; Bruttin, Madeleine; Sastiel, Ziva; Fink, Naomi Farkash; Benbenishty, Julie

2013-02-01

The aim of this study was to determine levels of structural empowerment, moral distress, and the association between them among intensive care nurses. Structural empowerment is the ability to access sources of power. Moral distress is the painful feelings experienced when a person knows the right thing to do but cannot do so due to external constraints. Several studies suggest a theoretical relationship between these concepts. Cross-sectional, descriptive correlational study. Members of the Evidence Based Nursing Practice Committee of the Israeli Society for Cardiology and Critical Care Nurses recruited a convenience sample of intensive care nurses from their respective institutions and units. Nurses were asked to complete three questionnaires (demographic and work characteristics, Moral Distress Scale, and the Conditions of Work Effectiveness Questionnaire-II). Data were collected between May-September 2009. Intensive Care nurses had moderate levels of structural empowerment, low levels of moral distress frequency, and moderately high moral distress intensity. A weak correlation was found between moral distress frequency and structural empowerment. No other structural empowerment component was associated with moral distress. Work characteristics as opposed to demographic characteristics were more associated with the study variables. This study weakly supports the association between structural empowerment and moral distress. It also provides further evidence to the theory of structural empowerment as characterized in the critical care environment. Further studies are indicated to determine what other factors might be associated with moral distress. © 2012 Blackwell Publishing Ltd.

Resources, stressors and psychological distress among older adults in Chennai, India.

PubMed

Chokkanathan, Srinivasan

2009-01-01

Scant information exists on the complex interaction between resources and stressors and their subsequent influence on the psychological distress of older adults in India. Within the framework of resource theory, the present study examined the various pathways through which resources and stressors influence psychological distress by testing four models - the independence model, the stress-suppression model, the counteractive model and the resource-deterioration model. The independence model posits that resources and stressors have a direct relationship with psychological distress. The stress-suppression model hypothesizes that stressors mediate the influence of resources on psychological distress. The counteractive model postulates that stressors mobilize resources, which in turn influence psychological distress. The resource-deterioration model states that stressors deplete resources and subsequently exacerbate distress. In the present study, resources include social support, religiosity and mastery; stressors include life events, abuse and health problems. Psychological distress was measured using the Center for Epidemiological Studies Depression scale and Geriatric Depression Scale. Interviews were conducted among 400 adults aged 65 years and above, randomly selected from the electoral list of urban Chennai, India. The battery of instruments was translated into Tamil (local language) by back-translation. Structural Equation Modeling was conducted to test the three models. The results supported the stress-suppressor model. Resources had an indirect, negative relationship with psychological distress, and stressors had a direct, positive effect on distress. As such there is a need to identify and strengthen the resources available to older adults in India.

Rumination in migraine: Mediating effects of brooding and reflection between migraine and psychological distress

PubMed Central

Kokonyei, Gyongyi; Szabo, Edina; Kocsel, Natalia; Edes, Andrea; Eszlari, Nora; Pap, Dorottya; Magyar, Mate; Kovacs, David; Zsombok, Terezia; Elliott, Rebecca; Anderson, Ian Muir; William Deakin, John Francis; Bagdy, Gyorgy; Juhasz, Gabriella

2016-01-01

Objective: The relationship between migraine and psychological distress has been consistently reported in cross-sectional and longitudinal studies. We hypothesised that a stable tendency to perseverative thoughts such as rumination would mediate the relationship between migraine and psychological distress. Design and Main Outcomes Measures: Self-report questionnaires measuring depressive rumination, current psychological distress and migraine symptoms in two independent European population cohorts, recruited from Budapest (N = 1139) and Manchester (N = 2004), were used. Structural regression analysis within structural equation modelling was applied to test the mediational role of brooding and reflection, the components of rumination, between migraine and psychological distress. Sex, age and lifetime depression were controlled for in the analysis. Results: Migraine predicted higher brooding and reflection scores, and brooding proved to be a mediator between migraine and psychological distress in both samples, while reflection mediated the relationship significantly only in the Budapest sample. Conclusions: Elevated psychological distress in migraine is partially attributed to ruminative response style. Further studies are needed to expand our findings to clinical samples and to examine how rumination links to the adjustment to migraine. PMID:27616579

Time-lagged relationships between leadership behaviors and psychological distress after a workplace terrorist attack.

PubMed

Birkeland, Marianne Skogbrott; Nielsen, Morten Birkeland; Knardahl, Stein; Heir, Trond

2016-05-01

The impact of leadership practices on employee health may be especially evident after extreme events that have physical, psychological, or material consequences for the members of an organization. In this prospective study, we aimed to examine the association between leadership behavior and psychological distress in employees who had experienced a workplace terror attack. Ten and 22 months after the 2011 Oslo bombing attack targeting their workplace, ministerial employees (n = 2272) responded to a questionnaire assessing fair, empowering, supportive, and laissez-faire leadership, as well as psychological distress. Cross-sectional and time-lagged associations between the constructs were tested using structural equation modeling. Cross-sectionally, higher levels of supportive leadership were associated with lower levels of psychological distress. Longitudinally, negative relationships were found between psychological distress and subsequent ratings of fair and empowering leadership. Supportive leadership was associated with employees' psychological health after trauma, but seems not to have long-term effects on subsequent psychological distress. Rather, psychological distress may lead the employees to perceive their leaders as more negative across time.

Self-reported discrimination, diabetes distress, and continuous blood glucose in women with type 2 diabetes.

PubMed

Wagner, Julie A; Tennen, Howard; Feinn, Richard; Osborn, Chandra Y

2015-04-01

We investigated whether self-reported racial discrimination was associated with continuous glucose levels and variability in individuals with diabetes, and whether diabetes distress mediated these associations. Seventy-four Black and White women with type 2 diabetes completed the Experience of Discrimination scale, a measure of lifetime racial discrimination, and the Problem Areas in Diabetes, a measure of diabetes distress. Participants wore a continuous glucose monitor for 24 h after 8 h of fasting, a standard meal, and a 4-h run in period. Higher discrimination predicted higher continuous mean glucose and higher standard deviation of glucose. For both mean and standard deviation of glucose, a race × discrimination interaction indicated a stronger relationship between discrimination and glucose for Whites than for Blacks. Diabetes distress mediated the discrimination-mean glucose relationship. Whites who report discrimination may be uniquely sensitive to distress. These preliminary findings suggest that racial discrimination adversely affects glucose control in women with diabetes, and does so indirectly through diabetes distress. Diabetes distress may be an important therapeutic target to reduce the ill effects of racial discrimination in persons with diabetes.

The relationship between neurobehavioural problems of severe traumatic brain injury (TBI), family functioning and the psychological well-being of the spouse/caregiver: path model analysis.

PubMed

Anderson, Malcolm I; Parmenter, Trevor R; Mok, Magdalena

2002-09-01

This study used a modern theory of stress as a framework to strengthen the understanding of the relationship between neurobehavioural problems of TBI, family functioning and psychological distress in spouse/caregivers. The research was an ex post facto design utilising a cross-sectional methodology. Path analysis was used to determine the structural effect of neurobehavioural problems on family functioning and psychological distress. Forty-seven female and 17 male spouse/caregivers of partners with severe TBI were recruited. Spouse/caregivers who reported partners with TBI as having high levels of behavioural and cognitive problems experienced high levels of unhealthy family functioning. High levels of unhealthy family functioning were related to high levels of distress in spouse/caregivers, as family functioning had a moderate influence on psychological distress. Furthermore, indirect effects of behavioural and cognitive problems operating through family functioning intensified the level of psychological distress experienced by spouse/caregivers. Additionally, spouse/caregivers who reported high levels of behavioural, communication and social problems in their partners also experienced high levels of psychological distress. This study was significant because the impact of TBI on the spouse/caregiver from a multidimensional perspective is an important and under-researched area in the brain injury and disability field.

Partner Violence and Psychosocial Distress among Female Sex Workers in China

PubMed Central

Hong, Yan; Zhang, Chen; Li, Xiaoming; Liu, Wei; Zhou, Yuejiao

2013-01-01

Background Despite recognized vulnerability of female sex workers (FSW), most data on this population are focused on their HIV and STI prevalence; studies on their experience of partner violence and psychosocial distress are limited, especially FSW in China. Methods and Findings A cross-sectional survey was administered among 1,022 FSW recruited from 9 different types of commercial sex venues in Southwest China. Partner violence scales were adapted from WHO's Women's Health and Domestic Violence scale and psychosocial distress was measured by five indicators, including alcohol intoxication, drug use, suicidal behavior, depression, and loneliness. Random effects modeling was used to control for cluster effects. Findings: About 58% of FSW ever experienced violence from their stable partners, and 45% suffered it from their clients. Partner violence was strongly associated with each of the five measures of psychosocial distress, even after controlling for potential confounders. Conclusion This study is one of the first to examine the association between partner violence and psychosocial distress among FSW in China. The high prevalence of violence experience and distress in this population suggests urgency for intervention. The public health programs targeting FSW should go beyond the focus on HIV/STI prevention and care for the fundamental health and human rights of millions of FSW in China. PMID:23626798

A basic need theory approach to problematic Internet use and the mediating effect of psychological distress

PubMed Central

Wong, Ting Yat; Yuen, Kenneth S. L.; Li, Wang On

2015-01-01

The Internet provides an easily accessible way to meet certain needs. Over-reliance on it leads to problematic use, which studies show can be predicted by psychological distress. Self-determination theory proposes that we all have the basic need for autonomy, competency, and relatedness. This has been shown to explain the motivations behind problematic Internet use. This study hypothesizes that individuals who are psychologically disturbed because their basic needs are not being met are more vulnerable to becoming reliant on the Internet when they seek such needs satisfaction from online activities, and tests a model in which basic needs predict problematic Internet use, fully mediated by psychological distress. Problematic Internet use, psychological distress, and basic needs satisfaction were psychometrically measured in a sample of 229 Hong Kong University students and structural equation modeling was used to test the hypothesized model. All indices showed the model has a good fit. Further, statistical testing supported a mediation effect for psychological distress between needs satisfaction and problematic Internet use. The results extend our understanding of the development and prevention of problematic Internet use based on the framework of self-determination theory. Psychological distress could be used as an early predictor, while preventing and treating problematic Internet use should emphasize the fulfillment of unmet needs. PMID:25642201

[Effects of Home Care Services Use by Older Adults on Family Caregiver Distress].

PubMed

Kim, Jiyeon; Kim, Hongsoo

2016-12-01

The purpose of this study was to examine the association between utilization of home care services under the national long-term care insurance system and family caregiver distress. A secondary data analysis was conducted in this study using data collected in 2011 and 2012 from the Korean version of International Resident Assessment Instrument (interRAI) Home Care assessment system. The study sample included 228 clients receiving community based home care and their family caregivers in Korea. Descriptive statistics, χ² test, t-test, and Heckman selection model analysis were conducted using SAS 9.3. Presence of family caregiver distress was significantly associated with days of nurse visits (β=-.89, p=<.001) and home helper visits (β=-.53, p=.014). Level of caregiver distress was also significantly associated with days of nurse visits (β=-.66, p=.028). Other factors which were significantly associated with caregiver distress were depression, cognitive function, inadequate pain control, social support for older adult, and caregiver relationship to the older adult. The results of this study show that visiting nurse service and appropriate support programs for Older Adults and family caregivers experiencing caregiver distress should be developed and provided to families based on the health care needs of older adults and their family caregivers for effective and sustainable home care.

A Relational Model of Sexual Minority Mental and Physical Health: The Negative Effects of Shame on Relationships, Loneliness, and Health

PubMed Central

Mereish, Ethan H.; Poteat, V. Paul

2015-01-01

Sexual minorities (e.g., lesbians, gay men, bisexual individuals) are at higher risk for mental and physical health disparities than heterosexuals, and some of these disparities relate to minority stressors such as discrimination. Yet, there is little research elucidating pathways that predict health or that promote resiliency among sexual minorities. Building on the minority stress model, the present study utilized relational cultural theory to situate sexual minority health within a relational framework. Specifically, the study tested mediators of the relationships between distal (i.e., discrimination, rejection, victimization) and proximal stressors (i.e., internalized homophobia, sexual orientation concealment) and psychological and physical distress for sexual minorities. Among 719 sexual minority adults, structural equation modeling analyses were used to test four models reflecting the mediating effects of shame, poorer relationships with a close peer and the LGBT community, and loneliness on the associations between minority stressors and psychological distress (i.e., depression and anxiety) and physical distress (i.e., distressing physical symptoms). As hypothesized, the associations between distal and proximal minority stressors and distress were mediated by shame, poorer relationships with a close peer and the LGBT community, and loneliness. Findings underscore the possible relational and interpersonal mechanisms by which sexual minority stressors lead to psychological and physical distress. PMID:26010289

A meta-analysis of the relationship between rational beliefs and psychological distress.

PubMed

Oltean, Horea-Radu; David, Daniel Ovidiu

2018-06-01

 Rational emotive behavior therapy (REBT) model of psychological health assumes that rational beliefs cause functional emotions and adaptive behavior, but the presumed role of rational beliefs as protective factor against psychological distress/disorders is still in debate. An important step in validating an evidence-based therapy is to investigate the underling theoretical assumptions. Thus, the aim of the present meta-analysis is to investigate the direction and magnitude of the relationship between rational beliefs and psychological distress.  Our search identified 26 studies that met our criteria. We evaluated the effect size using the random-effects model and we tested the moderator role of several variables. The overall results revealed a medium negative association between rational beliefs and psychological distress, r = -0.31. The strongest association was found for unconditional acceptance beliefs (r = -0.41). The results add empirical evidence for the underling theory of REBT and revealed that the strength of the association between rational beliefs and distress is robust for a wide range of emotional problems. Therefore, rational beliefs could be a trans-diagnostic protective factor against distress. Moreover, results emphasized that rational beliefs type is an important factor, suggesting an increased focus in therapy on the developing of unconditional acceptance and self-acceptance beliefs. © 2017 Wiley Periodicals, Inc.

A basic need theory approach to problematic Internet use and the mediating effect of psychological distress.

PubMed

Wong, Ting Yat; Yuen, Kenneth S L; Li, Wang On

2014-01-01

The Internet provides an easily accessible way to meet certain needs. Over-reliance on it leads to problematic use, which studies show can be predicted by psychological distress. Self-determination theory proposes that we all have the basic need for autonomy, competency, and relatedness. This has been shown to explain the motivations behind problematic Internet use. This study hypothesizes that individuals who are psychologically disturbed because their basic needs are not being met are more vulnerable to becoming reliant on the Internet when they seek such needs satisfaction from online activities, and tests a model in which basic needs predict problematic Internet use, fully mediated by psychological distress. Problematic Internet use, psychological distress, and basic needs satisfaction were psychometrically measured in a sample of 229 Hong Kong University students and structural equation modeling was used to test the hypothesized model. All indices showed the model has a good fit. Further, statistical testing supported a mediation effect for psychological distress between needs satisfaction and problematic Internet use. The results extend our understanding of the development and prevention of problematic Internet use based on the framework of self-determination theory. Psychological distress could be used as an early predictor, while preventing and treating problematic Internet use should emphasize the fulfillment of unmet needs.

Perceived ethnic discrimination, acculturation, and psychological distress in women of Turkish origin in Germany.

PubMed

Aichberger, Marion C; Bromand, Zohra; Rapp, Michael A; Yesil, Rahsan; Montesinos, Amanda Heredia; Temur-Erman, Selver; Heinz, Andreas; Schouler-Ocak, Meryam

2015-11-01

Discrimination is linked to various health problems, including mental disorders like depression and also has a negative effect on the access to mental health care services. Little is known about factors mitigating the association between ethnic discrimination and mental distress. The present study examined the extent of the relationship between perceived ethnic discrimination and psychological distress among women of Turkish origin residing in Berlin, and explored whether this association is moderated by acculturation strategies while controlling for known predictors of distress in migrant populations. A total of 205 women of Turkish origin participated in the study. 55.1% of the participants reported some degree of ethnic discrimination. The degree of reported discrimination varied according to acculturation. The highest level of ethnic discrimination was found in the second generation separated group and both generations of the marginalized group. Further, the results indicate an association between ethnic discrimination and distress while adjusting for known socio-demographic predictors of distress, migration-related factors, and neuroticism (B = 5.56, 95% CI 2.44-8.68, p < 0.001). However, the relationship did vary as a function of acculturation strategy, showing an association only in the separated group. The findings highlight the effects of ethnic discrimination beyond the influence of known risk factor for psychological distress in migrants, such as unemployment, being single, having a limited residence permit or the presence of personality structures that may increase vulnerability for stress responses and mental disorders.

The roles of acculturative stress and social constraints on psychological distress in Hispanic/Latino and Asian immigrant college students.

PubMed

Wong, Celia Ching Yee; Correa, Alma; Robinson, Kendall; Lu, Qian

2017-07-01

Acculturative stress has been linked to psychological distress, but few studies have explored the moderating role of social constraints on this relationship. Social constraints are the perception that social networks are unsupportive to stressor-related discussions. In the present study, the relationship between acculturative stress and psychological distress in Hispanic/Latino and Asian immigrants and the moderating role of social constraints in this relationship were examined. Participants were 306 college students (169 Hispanics/Latinos, 137 Asians; 33.9% first-generation immigrants, 66.1% second-generation immigrants) from two Texas universities. Correlation results showed that acculturative stress and social constraints were significantly associated with higher levels of psychological distress in Hispanics/Latinos and Asians. In addition, regression results indicated a significant three-way interaction effect among acculturative stress, social constraints, and racial/ethnic groups. Social constraints were found to moderate the relationship between acculturative stress and psychological distress in Asians but not in Hispanics/Latinos. Significant association between acculturative stress and psychological distress was found in Asians with higher levels of social constraints but not in Asians with lower levels of social constraints. These findings suggested that the interaction effect of acculturative stress and social constraints on psychological distress may be subject to cultural influences, and social constraints may have differential roles in Hispanics/Latinos and Asians. Potential implications on the development of culturally adaptive interventions for different racial/ethnic minority groups were discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Dopamine agonist withdrawal syndrome: implications for patient care.

PubMed

Nirenberg, Melissa J

2013-08-01

Dopamine agonists are effective treatments for a variety of indications, including Parkinson's disease and restless legs syndrome, but may have serious side effects, such as orthostatic hypotension, hallucinations, and impulse control disorders (including pathological gambling, compulsive eating, compulsive shopping/buying, and hypersexuality). The most effective way to alleviate these side effects is to taper or discontinue dopamine agonist therapy. A subset of patients who taper a dopamine agonist, however, develop dopamine agonist withdrawal syndrome (DAWS), which has been defined as a severe, stereotyped cluster of physical and psychological symptoms that correlate with dopamine agonist withdrawal in a dose-dependent manner, cause clinically significant distress or social/occupational dysfunction, are refractory to levodopa and other dopaminergic medications, and cannot be accounted for by other clinical factors. The symptoms of DAWS include anxiety, panic attacks, dysphoria, depression, agitation, irritability, suicidal ideation, fatigue, orthostatic hypotension, nausea, vomiting, diaphoresis, generalized pain, and drug cravings. The severity and prognosis of DAWS is highly variable. While some patients have transient symptoms and make a full recovery, others have a protracted withdrawal syndrome lasting for months to years, and therefore may be unwilling or unable to discontinue DA therapy. Impulse control disorders appear to be a major risk factor for DAWS, and are present in virtually all affected patients. Thus, patients who are unable to discontinue dopamine agonist therapy may experience chronic impulse control disorders. At the current time, there are no known effective treatments for DAWS. For this reason, providers are urged to use dopamine agonists judiciously, warn patients about the risks of DAWS prior to the initiation of dopamine agonist therapy, and follow patients closely for withdrawal symptoms during dopamine agonist taper.

The Effect of Economic, Physical, and Psychological Abuse on Mental Health: A Population-Based Study of Women in the Philippines

PubMed Central

Antai, Diddy; Oke, Ayo; Braithwaite, Patrick; Lopez, Gerald Bryan

2014-01-01

Background. The comparative effect of economic abuse and other forms of abuse in predicting depression and other mental health disorders has not been previously investigated despite its relevance for mental illness prevention. Objective. To determine the differential association of economic abuse on psychological distress and suicide attempts. Study Design. We used cross-sectional data from women aged 15–49 years in the 2008 Philippines Demographic and Health Surveys (PDHS) (N = 9,316). Results. Adjusting for sociodemographic confounders revealed positive associations between economic, physical, or psychological abuse and suicide attempts and psychological distress. Psychological and economic abuse were the strongest predictors of suicide attempts and psychological distress, respectively. Economic abuse was also negatively associated with psychological distress. Comorbidity with one mental health disorder greatly increased the odds of reporting the other mental health disorder. Conclusion. Overall, the results elucidate the differential effects of these forms of abuse on women's mental health. PMID:25525517

Counseling women with breast cancer using principles developed by Albert Bandura.

PubMed

Lev, E L; Owen, S V

2000-01-01

Although researchers suggest treatments that provide patients with an active coping strategy may increase patients' sense of self-efficacy, previous studies have not measured patients' self-efficacy. Eighteen women receiving chemotherapy for breast cancer were randomized to efficacy-enhancing experimental (n = 10) and usual-care control (n = 8) groups. The experimental group received five interventions delivered monthly. Variables--quality of life, symptom distress, and self-care self-efficacy--were measured at baseline and at 4 and 8 months later. At 4 and 8 months the interaction effects for the Functional Assessment of Cancer Treatment-Breast, used to measure quality of life, ranged from small for functional concerns to large for social concerns. Interaction effects for symptom distress, measured by the Symptom Distress Scale, were large. Interaction effects for self-care self-efficacy ranged from small for Enjoying Life and Stress Reduction, medium for Stress Reduction, and large for Making Decisions. Interventions to promote self-efficacy may increase quality of life and decrease distress for women diagnosed with breast cancer.

Hypnosis for procedure-related pain and distress in pediatric cancer patients: a systematic review of effectiveness and methodology related to hypnosis interventions.

PubMed

Richardson, Janet; Smith, Joanna E; McCall, Gillian; Pilkington, Karen

2006-01-01

The aim of this study was to systematically review and critically appraise the evidence on the effectiveness of hypnosis for procedure-related pain and distress in pediatric cancer patients. A comprehensive search of major biomedical and specialist complementary and alternative medicine databases was conducted. Citations were included from the databases' inception to March 2005. Efforts were made to identify unpublished and ongoing research. Controlled trials were appraised using predefined criteria. Clinical commentaries were obtained for each study. Seven randomized controlled clinical trials and one controlled clinical trial were found. Studies report positive results, including statistically significant reductions in pain and anxiety/distress, but a number of methodological limitations were identified. Systematic searching and appraisal has demonstrated that hypnosis has potential as a clinically valuable intervention for procedure-related pain and distress in pediatric cancer patients. Further research into the effectiveness and acceptability of hypnosis for pediatric cancer patients is recommended.

Secondary distress in violence researchers: a randomised trial of the effectiveness of group debriefings.

PubMed

Grundlingh, Heidi; Knight, Louise; Naker, Dipak; Devries, Karen

2017-06-02

Secondary distress including emotional distress, vicarious trauma (VT) and secondary traumatic stress (STS) due to exposure to primary trauma victims have been described in helping professionals and in violence researchers. To our knowledge, there are few prevalence studies, and no tailored interventions have been tested to reduce secondary distress in violence researchers. The study aims to (1) describe the epidemiology of secondary distress experienced by violence researchers; to (2) assess the effectiveness of group debriefings in mitigating secondary distress; to (3) assess risk and protective factors. We conducted an un-blinded, individually randomised trial with parallel assignment. Eligible participants were 59 Ugandan researchers employed by the Good Schools Study to interview children who experienced violence in a district of Uganda. Fifty-three researchers agreed to participate and were randomly allocated. The intervention group (n = 26) participated in three group debriefings and the control group (n = 27) in three leisure sessions (film viewings). The primary outcome was change in levels of emotional distress (SRQ-20); secondary outcomes were levels of VT and STS at end-line. A paired t-test assessed the difference in mean baseline and end-line emotional distress. Un-paired t-tests compared the change in mean emotional distress (baseline vs. end-line), and compared levels of VT and STS at end-line. Separate logistic regression models tested the association between end-line emotional distress and a-priori risk or protective factors. Baseline and end-line levels of emotional distress were similar in control (p = 0.47) and intervention (p = 0.59) groups. The superiority of group debriefing over leisure activities in lowering levels of emotional distress in the intervention group (n = 26; difference in SRQ-20 = 0.23 [SD = 2.18]) compared to the control group (n = 26; difference in SRQ-20 = 0.23 [SD = 1.63]) could not be detected (p = 1). In regression analysis (n = 48), baseline distress increased the odds of end-line distress (OR = 16.1, 95%CI 2.82 to 92.7, p = 0.002). Perceived organisational support (OR = 0.09, 95%CI 0.01 to 0.69, p = 0.02) and belief in God (OR = 0.21, 95%CI 0.03 to 1.26, p = 09) was protective against end-line distress. We found no evidence that violence researchers experienced elevated emotional distress after doing violence research. There was no difference between group debriefings and leisure activities in reducing distress in our sample. However, the hypotheses presented should not be ruled out in other violence research settings. Our findings suggest that organisational support is a significant protective factor and belief in God may be an important coping mechanism. Clinical Trials NCT02390778 . Retrospectively registered 19 March 2015. The Good Schools Trial was registered at ( NCT01678846 ), on August 24, 2012.

Transitional Instability, Psychological Health, and Sexual Risk Taking among College Students

ERIC Educational Resources Information Center

Bowers, Jill R.; Segrin, Chris

2017-01-01

This study examined the effects of transitional instability on college students' (n = 402) psychological distress and sexual risk taking at two different time points over one year. Tested through structural equation models, the data revealed transitional instability had significant positive effects on psychological distress and sexual risk taking…

Efficacy of fractional lasers in treating alopecia: a literature review.

PubMed

Perper, Marina; Aldahan, Adam S; Fayne, Rachel A; Emerson, Christopher P; Nouri, Keyvan

2017-11-01

Hair loss stemming from different types of alopecia, such as androgenic alopecia and alopecia areata, negatively affects over half the population and, in many circumstances, causes serious psychosocial distress. Current treatment options for alopecia, such as minoxidil, anthralin, and intralesional corticosteroids, vary efficacy and side effect profiles. It is known that low-level laser/light therapies (LLLT), or photobiomodulations, such as the US FDA-cleared HairMax Lasercomb®, He-Ne laser, and excimer laser, are relatively affordable, user-friendly, safe, and effective forms of treatment for hair loss. While less is known about the effectiveness of fractional lasers for combating hair loss, research suggests that by creating microscopic thermal injury zones, fractional lasers may cause an increase in hair growth from a wound healing process, making them potential therapeutic options for alopecia. A literature review was performed to evaluate the effectiveness of fractional lasers on hair regrowth. The specific fractional laser therapies include the 1550-nm nonablative fractional erbium-glass laser, the ablative fractional 2940-nm erbium:YAG laser, and the ablative fractional CO 2 fractional laser. Additional randomized controlled trials are necessary to further evaluate the effectiveness of the lasers, as well as to establish appropriate parameters and treatment intervals.

Psychiatric Disorders and Labor Market Outcomes: Evidence from the National Latino and Asian American Study

PubMed Central

Chatterji, Pinka; Alegria, Margarita; Lu, Mingshan; Takeuchi, David

2009-01-01

This paper investigates to what extent psychiatric disorders and mental distress affect labor market outcomes in two rapidly growing populations that have not been studied to date – ethnic minorities of Latino and Asian descent, most of whom are immigrants. Using data from the National Latino and Asian American Study (NLAAS), we examine the labor market effects of having any psychiatric disorder in the past 12 months as well as the effects of experiencing psychiatric distress in the past 12 months. The labor market outcomes analyzed are current employment status, the number of weeks worked in the past year among those who are employed, and having at least one work absence in the past month among those who are employed. Our results show that among Latinos, psychiatric disorders and mental distress are associated with large, detrimental effects on employment and absenteeism, similar to effects found in analyses of mostly white, American born populations. Among Asians, we find more mixed evidence that psychiatric disorders and mental distress detract from labor market outcomes. PMID:17294497

Discrimination and distress among Afghan refugees in northern California: The moderating role of pre- and post-migration factors

PubMed Central

2018-01-01

This study investigates the effect of perceived discrimination on the mental health of Afghan refugees, and secondly, tests the distress moderating effects of pre-migration traumatic experiences and post-resettlement adjustment factors. In a cross-sectional design, 259 Afghans completed surveys assessing perceived discrimination and a number of other factors using scales developed through inductive techniques. Multivariable analyses consisted of a series of hierarchical regressions testing the effect of perceived discrimination on distress, followed by a sequential analysis of moderator variables. Perceived discrimination was significantly associated with higher distress, and this relationship was stronger among those with a strong intra-ethnic identity and high pre-resettlement traumatic experiences. The expected buffering effects of civic engagement, ethnic orientation (e.g. integration), and social support were not significant. Discrimination is a significant source of stress for Afghan refugees, which may exacerbate stresses associated with other pre- and post-migration stressors. Future research is needed to tailor interventions that can help mitigate the stress associated with discrimination among this highly vulnerable group. PMID:29782531

Acute Stress Symptoms in Seriously Injured Patients: Precipitating Versus Cumulative Trauma and the Contribution of Peritraumatic Distress.

PubMed

Briere, John; Dias, Colin P; Semple, Randye J; Scott, Catherine; Bigras, Noémie; Godbout, Natacha

2017-08-01

The relationship between type of trauma exposure, cumulative trauma, peritraumatic distress, and subsequent acute stress disorder (ASD) symptoms was examined prospectively in 96 individuals presenting with acute medical injuries to a Level 1 emergency/trauma department. Common precipitating traumas included motor vehicle-related events, stabbings, shootings, and physical assaults. At 2 to 3 weeks follow-up, 22.9% of participants had developed ASD. Univariate analysis revealed no relationship between type of precipitating trauma and ASD symptoms, whereas robust path analysis indicated direct effects of gender, lifetime cumulative trauma exposure, and peritraumatic distress. Peritraumatic distress did not mediate the association between cumulative trauma and symptoms, but did mediate the association between gender and symptomatology. These results, which account for 23.1% of the variance in ASD symptoms, suggest that ASD may be more due to cumulative trauma exposure than the nature of the precipitating trauma, but that cumulative trauma does not exert its primary effect by increasing peritraumatic distress to the most recent trauma. Copyright © 2017 International Society for Traumatic Stress Studies.

Effects of scheduled qigong exercise on pupils' well-being, self-image, distress, and stress.

PubMed

Terjestam, Yvonne; Jouper, John; Johansson, Caroline

2010-09-01

Psychologic problems is increasing among pupils and has become a major problem in Sweden as well as in other Western countries. The aim of this study was to explore whether scheduled qigong exercise could have an effect on well-being at school, psychologic distress, self-image, and general stress. Pupils, 13-14 years, were assigned to either a qigong group or a control group. The qigong group had scheduled qigong 2 times a week for 8 weeks. Self-reported well-being at school, psychologic distress, self-image, and stress were measured pre- and postintervention. The control group had reduced well-being at school during the semester and the qigong group was stable. The qigong group reduced psychologic distress and stress, and had a tendency to improved self-image, whereas no changes were found in the control group. Self-image explains 47% (R(2) = 0.47) of well-being at school, and stress explains 29% (R(2) = 0.29) of psychologic distress. Scheduled qigong, meditative movement, is a possible way to improve well-being at school.

Alleviating psychological distress of suicide survivors: evaluation of a volunteer care programme.

PubMed

Lu, Y-J; Chang, H-J; Tung, Y-Y; Hsu, M-C; Lin, M-F

2011-06-01

The crisis level in the worldwide suicide rate has revealed a severe suicide problem in Taiwan that is now well above the world average of 16 per 100,000 individuals. Many countries have relied on suicide care volunteers training programmes to conduct suicide prevention programmes. However, there is a dearth of research evaluating the effect of volunteers on psychological distress and the impact of volunteer experience level. An evaluation of the impact of experienced and novice volunteers in alleviating psychological distress of suicide survivors was conducted. A supervised programme trained 15 volunteers at Years 1 and 2. Year 1 volunteers completed 400 h of service with continuing education. Programme evaluation occurred after Year 2 volunteers had completed training. Eighty-two suicide survivors were recruited. With 60 suicide survivors completing 3 month of volunteer care, a significant group difference with time interaction in suicide survivors who exhibited moderate to severe distress between the veteran care and novice care groups was found. Compared with novice volunteers, veteran volunteers with at least 1 year of experience are more effective with suicide survivors reporting higher psychological distress. © 2011 Blackwell Publishing.

Childhood trauma, psychosis liability and social stress reactivity: a virtual reality study.

PubMed

Veling, W; Counotte, J; Pot-Kolder, R; van Os, J; van der Gaag, M

2016-12-01

Childhood trauma is associated with higher risk for mental disorders, including psychosis. Heightened sensitivity to social stress may be a mechanism. This virtual reality study tested the effect of childhood trauma on level of paranoid ideations and distress in response to social stress, in interaction with psychosis liability and level of social stress exposure. Seventy-five individuals with higher psychosis liability (55 with recent onset psychotic disorder and 20 at ultra-high risk for psychosis) and 95 individuals with lower psychosis liability (42 siblings and 53 controls) were exposed to a virtual café in five experiments with 0-3 social stressors (crowded, other ethnicity and hostility). Paranoid ideation was measured after each experiment. Subjective distress was self-rated before and after experiments. Multilevel random regression analyses were used to test main effects of childhood trauma and interaction effects. Childhood trauma was more prevalent in individuals with higher psychosis liability, and was associated with higher level of (subclinical) psychotic and affective symptoms. Individuals with a history of childhood trauma responded with more subjective distress to virtual social stress exposures. The effects of childhood trauma on paranoia and subjective distress were significantly stronger when the number of virtual environmental stressors increased. Higher psychosis liability increased the effect of childhood trauma on peak subjective distress and stress reactivity during experiments. Childhood trauma is associated with heightened social stress sensitivity and may contribute to psychotic and affective dysregulation later in life, through a sensitized paranoid and stress response to social stressors.

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.

Bisexual-Specific Minority Stressors, Psychological Distress, and Suicidality in Bisexual Individuals: the Mediating Role of Loneliness.

PubMed

Mereish, Ethan H; Katz-Wise, Sabra L; Woulfe, Julie

2017-08-01

Bisexual individuals are at higher risk for poor mental health outcomes compared to heterosexual as well as lesbian and gay individuals and experience minority stressors, such as discrimination, from both heterosexual and sexual minority communities. However, there is little research examining the negative effects of bisexual-specific minority stressors on bisexual individuals' mental health as well as psychological factors that might help explain minority stressors' deleterious effects. This research examined the effects of distal minority stressors (i.e., anti-bisexual experiences from both heterosexual as well as lesbian and gay people) and proximal stressors (i.e., internalized heterosexism and sexual orientation concealment) on psychological distress and suicidality among bisexual adults (N = 503). Building on the relational framing of the minority stress model, we also tested one relational factor (i.e., loneliness) as a mediator of the associations between distal and proximal minority stressors and poor mental health (i.e., psychological distress and suicidality). Structural equation modeling analyses were used to test the mediating effects of loneliness on the associations between minority stressors and psychological distress and suicidality. Although distal and proximal minority stressors were not associated with each other, loneliness mediated the effects of distal and proximal minority stressors on psychological distress and suicidality. The results of this study underscore the importance of targeting bisexual-specific minority stressors as well as loneliness in preventive interventions to improve the mental health of bisexual individuals.

Types of social participation and psychological distress in Japanese older adults: A five-year cohort study.

PubMed

Amagasa, Shiho; Fukushima, Noritoshi; Kikuchi, Hiroyuki; Oka, Koichiro; Takamiya, Tomoko; Odagiri, Yuko; Inoue, Shigeru

2017-01-01

The most effective type of social participation against psychological distress in older adults is not well documented. The aim of this study was to examine whether different types of social participation are associated with changes in psychological distress level in older men and women in Japan. Two thousand seven hundred community-dwelling older adults (aged 65-74 years, 50% women) were randomly selected from the resident registry of three cities. Of these, participants who reported social participation and psychological distress level in the baseline survey in 2010 were followed up. Psychological distress was evaluated based on K6 scales at baseline and follow-up (in 2015). Social participation level was examined using question items from the National Health and Nutrition Survey in Japan. Exploratory factor analysis was used to derive the underlying factor structure. Multiple linear regression analysis was used to examine the association between social participation and changes in psychological distress level after adjusting for covariates stratified by both gender and age group or living arrangement. Data from 825 community-dwelling older adults (45.3% women) were analyzed. Social participation was categorized into two types using factor analysis: community involvement (volunteer activities, community events, clubs for the elderly) and individual relationship (friendship, communication with family and friends, hobbies). During the 5-year follow-up, 29.5% of participants reported a deterioration in psychological distress. Higher community involvement was independently associated with lower risk of psychological distress for older women (β = 0.099, p = 0.047), whereas there were no associations with individual relationship for either gender. Furthermore, in older women living with others, higher community involvement was also associated with lower risk of psychological distress (β = 0.110, p = 0.048). Community involvement provides older women with mental health benefits regardless of individual relationship level. Promoting community involvement may be an effective strategy for healthy mental aging.

Positive emotion in distress as a potentially effective emotion regulation strategy for depression: A preliminary investigation.

PubMed

Yamaguchi, Keiko; Ito, Masaya; Takebayashi, Yoshitake

2018-03-12

Emotion regulation utilizing positive emotion during negative emotional states might be one of the effective ways to alleviate depression and anxiety problems among people with emotional disorders. This study examined the psychometric properties and incremental validity of the Positive Emotion In Distress Scale (PEIDS), a newly developed self-report scale, in a sample of university students in Japan. To examine the psychometric properties of the PEIDS, the scale was completed by Japanese university students (396 men and 363 women; mean age of 19.92). Participants additionally answered the Emotion Regulation Questionnaire, Rumination and Reflection Questionnaire - Shorter Version, Affective Style Questionnaire, Positive and Negative Affective Schedule, and Hospital Anxiety and Depression Scale. The survey was conducted at two time points separated by 1 month to assess test-retest reliability and validity of the PEIDS. Exploratory and confirmatory factor analyses confirmed a one-factor structure. Reliability was confirmed by high internal consistency and test-retest stability; the convergent and discriminant validity was confirmed by correlations with related and unrelated variables. The results of hierarchical regression analyses demonstrated that positive emotion in distress might predict depression above and beyond the effect of baseline depression and other common emotion regulation strategies. The PEIDS showed acceptable reliability and validity within young adults and a non-clinical population in Japan. Further research will be needed to examine the effect of positive emotion among clinical populations. Previous research suggests that positive emotions play a key role in recovery from depression and anxiety problems through some forms of psychotherapy. The Positive Emotion In Distress Scale (PEIDS) measures individual differences regarding the extent to which people can experience positive emotions in negative emotional states. Results suggested that the subjective rating of the ability to experience positive emotions in distress might alleviate depression prospectively but not anxiety problems. The effect of positive emotion in distress demonstrated to have beyond the effects of other emotion regulation strategies. © 2018 The British Psychological Society.

Hypnosis in breast cancer care: a systematic review of randomized controlled trials.

PubMed

Cramer, Holger; Lauche, Romy; Paul, Anna; Langhorst, Jost; Kümmel, Sherko; Dobos, Gustav J

2015-01-01

Many breast cancer patients and survivors experience pain and emotional stress related to their disease, its diagnostic procedures, or treatment. Hypnosis has long been used for the treatment of such symptoms. The aim of this review was to systematically assess the effectiveness of hypnosis in women with breast cancer, breast cancer survivors, and in women undergoing diagnostic breast biopsy. PubMed, Scopus, the Cochrane Library, PsycINFO, and CAMBASE were screened through February 2014 for randomized controlled trials (RCTs) of hypnosis in women with breast cancer or undergoing diagnostic breast biopsy. RCTs on postmenopausal women without a history of breast cancer were also eligible. Primary outcomes were pain, distress, fatigue, nausea/vomiting, and hot flashes. Safety was defined as secondary outcome measure. Risk of bias was assessed by 2 reviewers independently using the Cochrane Risk of Bias Tool. Thirteen RCTs with 1357 patients were included. In women undergoing diagnostic breast biopsy (3 RCTs), hypnosis positively influenced pain and distress; 1 RCT on breast cancer surgery found effects of hypnosis on pain, distress, fatigue, and nausea. For women undergoing radiotherapy (3 RCTs), hypnosis combined with cognitive-behavioral therapy improved distress and fatigue. In 3 RCTs on women with and without a history of breast cancer experiencing hot flashes, hypnosis improved hot flashes and distress. Three RCTs on women with metastatic breast cancer found effects on pain and distress. This systematic review found sparse but promising evidence for the effectiveness of hypnosis in breast cancer care. While more research is needed to underpin these results, hypnosis can be considered as an ancillary intervention in the management of breast cancer-related symptoms. © The Author(s) 2014.

A randomized controlled trial of cognitive behavioral therapy (CBT) for adjusting to multiple sclerosis (the saMS trial): does CBT work and for whom does it work?

PubMed

Moss-Morris, Rona; Dennison, Laura; Landau, Sabine; Yardley, Lucy; Silber, Eli; Chalder, Trudie

2013-04-01

The aims were (a) to test the effectiveness of a nurse-led cognitive behavioral therapy (CBT) program to assist adjustment in the early stages of multiple sclerosis (MS) and (b) to determine moderators of treatment including baseline distress, social support (SS), and treatment preference. Ninety-four ambulatory people with MS within 10 years of diagnosis were randomized to receive 8 individual sessions of CBT (n = 48) or supportive listening (n = 46), most delivered on the telephone, in a multicenter randomized controlled trial. The primary outcomes were distress and functional impairment. Secondary outcomes included global improvement, acceptance of illness, and dysfunctional cognitions. Assessments were completed at home and were coordinated by a blind assessor. Data were analyzed by intention-to-treat using multilevel models. The CBT group was significantly less distressed at the end of treatment (estimated General Health Questionnaire group difference = 3.2 points, 95\\% CI 1.1 to 5.4 points) and at the 12-month follow-up (estimated group difference = 2.2 points, 95\\% CI 0.01 to 4.4 points). There were no differences between the groups on functional impairment. The CBT group also demonstrated significantly greater improvements on secondary outcomes at the end of treatment but not at the 12-month follow-up. CBT participants with poor SS and/or clinically defined levels of distress at baseline showed significantly greater gains on both primary outcomes. Treatment preference did not moderate treatment effects. CBT is more effective than supportive listening in reducing distress in people with MS. CBT appears most effective for patients with poor SS and high levels of distress. The loss of gains in the secondary outcomes by 12 months suggests further follow-up sessions may be warranted.

The effectiveness of a serious game to enhance empathy for care workers for people with disabilities: A parallel randomized controlled trial.

PubMed

Sterkenburg, P S; Vacaru, V S

2018-04-04

Empathic care is fundamental in healthcare settings and is associated to several positive outcomes for care workers (i.e. burnout, compassion satisfaction) and patients (i.e. therapeutic alliance, trust, wellbeing). Yet, studies showed a decrease in empathy in care workers, which is argued to be a product of personal distress. Thus, interventions should aim at enhancing empathy in care workers working for vulnerable populations to ensure optimal client-carer relationships. The current study investigates the effectiveness of the serious game "The world of EMPA" in enhancing empathy in care workers for people with disabilities, and tests the effect of personal distress on empathy change post intervention. We conducted a superiority parallel randomized controlled trial (RCT) and tested 224 participants in two conditions: the experimental group (n = 111) played a serious game and the control group (n = 113) read a digital information package about disabilities. Participants were assessed on empathy and personal distress prior to and after the intervention. Main results showed that the serious game did not significantly enhance empathy in care workers, whereas reading a digital information package yield a significant decrease in empathy. Exploratory analysis showed that the serious game decreased significantly personal distress in care-workers. This study showed that while the serious game "The world of EMPA" did not enhance empathy, it resulted in a decrease in personal distress in care workers for people with disabilities. Further evidence should corroborate these findings to unveil the mechanisms of this intervention and the long-term effects on personal distress. Copyright © 2018 Elsevier Inc. All rights reserved.

Web-Delivered Cognitive Behavioral Therapy for Distressed Cancer Patients: Randomized Controlled Trial.

PubMed

Chambers, Suzanne K; Ritterband, Lee M; Thorndike, Frances; Nielsen, Lisa; Aitken, Joanne F; Clutton, Samantha; Scuffham, Paul A; Youl, Philippa; Morris, Bronwyn; Baade, Peter D; Dunn, Jeff

2018-01-31

Web-based interventions present a potentially cost-effective approach to supporting self-management for cancer patients; however, further evidence for acceptability and effectiveness is needed. The goal of our research was to assess the effectiveness of an individualized Web-based cognitive behavioral therapy (CBT) intervention on improving psychological and quality of life outcomes in cancer patients with elevated psychological distress. A total of 163 distressed cancer patients (111 female, 68.1%) were recruited through the Queensland Cancer Registry and the Cancer Council Queensland Cancer Helpline and randomly assigned to either a Web-based tailored CBT intervention (CancerCope) (79/163) or a static patient education website (84/163). At baseline and 8-week follow-up we assessed primary outcomes of psychological and cancer-specific distress and unmet psychological supportive care needs and secondary outcomes of positive adjustment and quality of life. Intention-to-treat analyses showed no evidence of a statistically significant intervention effect on primary or secondary outcomes. However, per-protocol analyses found a greater decrease for the CancerCope group in psychological distress (P=.04), cancer-specific distress (P=.02), and unmet psychological care needs (P=.03) from baseline to 8 weeks compared with the patient education group. Younger patients were more likely to complete the CancerCope intervention. This online CBT intervention was associated with greater decreases in distress for those patients who more closely adhered to the program. Given the low costs and high accessibility of this intervention approach, even if only effective for subgroups of patients, the potential impact may be substantial. Australian New Zealand Clinical Trials Registry ACTRN12613001026718; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=364768&isReview=true (Archived by WebCite at http://www.webcitation.org/6uPvpcovl). ©Suzanne K Chambers, Lee M Ritterband, Frances Thorndike, Lisa Nielsen, Joanne F Aitken, Samantha Clutton, Paul A Scuffham, Philippa Youl, Bronwyn Morris, Peter D Baade, Jeff Dunn. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 31.01.2018.

Psychological distress and quality of life in lung cancer: the role of health-related stigma, illness appraisals and social constraints.

PubMed

Chambers, Suzanne K; Baade, Peter; Youl, Philippa; Aitken, Joanne; Occhipinti, Stefano; Vinod, Shalini; Valery, Patricia C; Garvey, Gail; Fong, Kwun M; Ball, David; Zorbas, Helen; Dunn, Jeff; O'Connell, Dianne L

2015-11-01

Health-related stigma is associated with negative psychological and quality of life outcomes in lung cancer patients. This study describes the impact of stigma on lung cancer patients' psychological distress and quality of life and explores the role of social constraints and illness appraisal as mediators of effect. A self-administered cross-sectional survey examined psychological distress and quality of life in 151 people (59% response rate) diagnosed with lung cancer from Queensland and New South Wales. Health-related stigma, social constraints and illness appraisals were assessed as predictors of adjustment outcomes. Forty-nine percent of patients reported elevated anxiety; 41% were depressed; and 51% had high global distress. Health-related stigma was significantly related to global psychological distress and quality of life with greater stigma and shame related to poorer outcomes. These effects were mediated by illness appraisals and social constraints. Health-related stigma appears to contribute to poorer adjustment by constraining interpersonal discussions about cancer and heightening feelings of threat. There is a need for the development and evaluation of interventions to ameliorate the negative effects of health-related stigma among lung cancer patients. © 2015 The Authors. Psycho-Oncology Published by John Wiley & Sons Ltd.

The role of social capital in the relationship between physical constraint and mental distress in older adults: a latent interaction model.

PubMed

An, Sok; Jang, Yuri

2018-02-01

Building upon the widely known link between physical and mental health, the present study explored the buffering effects of social capital (indicated by social cohesion, social ties, and safety) in the relationship between physical constraint (indicated by chronic conditions and functional disability) and mental distress (indicated by symptoms of depression and anxiety). Using data from 2,264 community-dwelling older adults in the National Social Life, Health, and Aging Project (NSHAP) Wave 2 (M age = 74.51, SD = 6.67), a latent interaction model was tested. The model of mental distress, including both the main effect of physical constraint and social capital and their latent interaction, presented an excellent fit. The latent constructs of physical constraint (β = .54, p < .001) and social capital (β = -.11, p < .01) not only had a direct effect on mental distress, but their interaction was also significant (β = -.26, p < .001). Subgroup analysis showed that the group with a low level of social capital had a heightened vulnerability to mental distress when faced with physical constraint, whereas the group with a high level of social capital demonstrated resilience. Findings call attention to ways to enhance older individuals' social capital in efforts to promote their health and well-being.

Psychological distress and quality of life in lung cancer: the role of health‐related stigma, illness appraisals and social constraints

PubMed Central

Baade, Peter; Youl, Philippa; Aitken, Joanne; Occhipinti, Stefano; Vinod, Shalini; Valery, Patricia C.; Garvey, Gail; Fong, Kwun M.; Ball, David; Zorbas, Helen; Dunn, Jeff; O'Connell, Dianne L.

2015-01-01

Abstract Objective Health‐related stigma is associated with negative psychological and quality of life outcomes in lung cancer patients. This study describes the impact of stigma on lung cancer patients' psychological distress and quality of life and explores the role of social constraints and illness appraisal as mediators of effect. Methods A self‐administered cross‐sectional survey examined psychological distress and quality of life in 151 people (59% response rate) diagnosed with lung cancer from Queensland and New South Wales. Health‐related stigma, social constraints and illness appraisals were assessed as predictors of adjustment outcomes. Results Forty‐nine percent of patients reported elevated anxiety; 41% were depressed; and 51% had high global distress. Health‐related stigma was significantly related to global psychological distress and quality of life with greater stigma and shame related to poorer outcomes. These effects were mediated by illness appraisals and social constraints. Conclusions Health‐related stigma appears to contribute to poorer adjustment by constraining interpersonal discussions about cancer and heightening feelings of threat. There is a need for the development and evaluation of interventions to ameliorate the negative effects of health‐related stigma among lung cancer patients. © 2015 The Authors. Psycho‐Oncology Published by John Wiley & Sons Ltd. PMID:25920906

Effectiveness of the Neonatal Discharge Program for Very Low-Birth-Weight Infants on Parental Efficacy and Psychological Distress.

PubMed

Shandra Bos, Lakshmi; Shorey, Shefaly; Kulantaipian, Tamill Salvee; Sng, Jane S P; Tam, Wilson W S; Koh, Serena S L

2018-05-17

This pilot study aimed to (i) evaluate the effectiveness of a neonatal discharge program, (ii) identify relationships between parent and infant factors and parental efficacy and psychological distress, and (iii) identify ways to improve the neonatal discharge program. A quasiexperimental 1-group pretest/posttest design was used. Through consecutive sampling, 42 participants were recruited. Data were collected using self-report questionnaires. Self-administering instruments gathered data on parental efficacy and psychological distress as well as feedback and recommendations on the intervention. A significant increase in parental efficacy and a reduction in psychological distress were observed from pre- to postdischarge intervention. Significant relationships were found between parental efficacy and infants' gestational age, birth weight, gender, and participants' level of education, and a significant relationship was found between psychological distress and number of children from previous pregnancies. Moreover, an Internet-based program, in addition to the face-to-face teaching, was identified as a preferred option to aid in information retention. It is important to evaluate and enhance the neonatal discharge program to suit the parents of today while providing them with informational and emotional support. Future studies should explore parental coping and the long-term effects of their infant's birth and the intervention.

Effects of appraisal training on responses to a distressing autobiographical event.

PubMed

Woud, Marcella L; Zlomuzica, Armin; Cwik, Jan C; Margraf, Jürgen; Shkreli, Lorika; Blackwell, Simon E; Gladwin, Thomas E; Ehring, Thomas

2018-04-14

Dysfunctional appraisals are a key factor suggested to be involved in the development and maintenance of PTSD. Research has shown that experimental induction of a positive or negative appraisal style following a laboratory stressor affects analogue posttraumatic stress symptoms. This supports a causal role of appraisal in the development of traumatic stress symptoms and the therapeutic promise of modifying appraisals to reduce PTSD symptoms. The present study aimed to extend previous findings by investigating the effects of experimentally induced appraisals on reactions to a naturally occurring analogue trauma and by examining effects on both explicit and implicit appraisals. Participants who had experienced a distressing life event were asked to imagine themselves in the most distressing moment of that event and then received either a positive or negative Cognitive Bias Modification training targeting appraisals (CBM-App). The CBM-App training induced training-congruent appraisals, but group differences in changes in appraisal over training were only seen for explicit and not implicit appraisals. However, participants trained positively reported less intrusion distress over the subsequent week than those trained negatively, and lower levels of overall posttraumatic stress symptoms. These data support the causal relationship between appraisals and trauma distress, and further illuminate the mechanisms linking the two. Copyright © 2018 Elsevier Ltd. All rights reserved.

Interpersonal touch suppresses visual processing of aversive stimuli

PubMed Central

Kawamichi, Hiroaki; Kitada, Ryo; Yoshihara, Kazufumi; Takahashi, Haruka K.; Sadato, Norihiro

2015-01-01

Social contact is essential for survival in human society. A previous study demonstrated that interpersonal contact alleviates pain-related distress by suppressing the activity of its underlying neural network. One explanation for this is that attention is shifted from the cause of distress to interpersonal contact. To test this hypothesis, we conducted a functional MRI (fMRI) study wherein eight pairs of close female friends rated the aversiveness of aversive and non-aversive visual stimuli under two conditions: joining hands either with a rubber model (rubber-hand condition) or with a close friend (human-hand condition). Subsequently, participants rated the overall comfortableness of each condition. The rating result after fMRI indicated that participants experienced greater comfortableness during the human-hand compared to the rubber-hand condition, whereas aversiveness ratings during fMRI were comparable across conditions. The fMRI results showed that the two conditions commonly produced aversive-related activation in both sides of the visual cortex (including V1, V2, and V5). An interaction between aversiveness and hand type showed rubber-hand-specific activation for (aversive > non-aversive) in other visual areas (including V1, V2, V3, and V4v). The effect of interpersonal contact on the processing of aversive stimuli was negatively correlated with the increment of attentional focus to aversiveness measured by a pain-catastrophizing scale. These results suggest that interpersonal touch suppresses the processing of aversive visual stimuli in the occipital cortex. This effect covaried with aversiveness-insensitivity, such that aversive-insensitive individuals might require a lesser degree of attentional capture to aversive-stimulus processing. As joining hands did not influence the subjective ratings of aversiveness, interpersonal touch may operate by redirecting excessive attention away from aversive characteristics of the stimuli. PMID:25904856

Analysis and comparison of the effects of N-BiPAP and Bubble-CPAP in treatment of preterm newborns with the weight of below 1500 grams affiliated with respiratory distress syndrome: A randomised clinical trial.

PubMed

Sadeghnia, Alireza; Barekateyn, Behzad; Badiei, Zohre; Hosseini, Seyyed Mohsen

2016-01-01

Nowadays, establishment of nCPAP and surfactant administration is considered to be the first level of intervention for newborns engaged in the process of Respiratory Distress Syndrome (RDS). In order to decrease the side effects of the nCPAP management placed in noninvasive-non-cycled respiratory support. Noninvasive-cycled respiratory support mechanism have been developed such as N-BiPAP. Therefore, we compared N-BiPAP with Bubble-CPAP in a clinical trial. This research was done as an on newborns weighing less than 1500 grams affiliated with RDS. A3 The total number of newborns was 70. Newborns were divided into two groups with the sample size of 35 patients in each, according to odd and even document numbers. One group was treated with N-BiPAP and the other with Bubble-CPAP. Patients were compared according to the length of treatment with noninvasive respiratory support, length of oxygen intake, number of surfactant doses administered, need for invasive mechanical ventilation, apnea, patent ductus arteriosus (PDA), chronic lung disease, intraventricular hemorrhage, pneumothorax, and death. Data was recorded and compared. The average duration for noninvasive respiratory support and the average time of need to complementary oxygen was not significantly different in both groups (P value > 0.05). Need for invasive ventilation, also chronic lung disease, intraventricular hemorrhage (IVH), pneumothorax, need for the next dose of surfactant, and the death rate did also have no meaningful difference. (P value > 0.05). In this research N-BiPAP did not show any obvious clinical preference over the Bubble-CPAP in treatment of newborns weighing less than 1500 grams and affiliated with RDS.

The struggle towards 'the New Normal': a qualitative insight into psychosexual adjustment to prostate cancer.

PubMed

Hanly, Narelle; Mireskandari, Shab; Juraskova, Ilona

2014-07-30

Despite the growing body of literature which highlights the potential for significant and enduring side-effects of prostate cancer treatment, there is limited research exploring the experience of living with the treatment-induced side-effects such as sexual dysfunction, and their repercussions for men and their partners. The aim of this qualitative study was to explore factors influencing psychosexual adjustment, self-perception, and unmet information and support needs of prostate cancer patients and their partners. Twenty-one men, recruited via a prostate cancer support group newsletter, participated in face-to-face semi-structured interviews, which were subjected to thematic analysis. The qualitative analysis revealed three inter-connected main themes which contributed to men's psychosexual adjustment: i) Psychosexual impact, ii) Communication and support, and iii) Integration process. Men reported distressing sexual and urinary difficulties, tainted self-perception and altered intimate relationships. Receiving adequate information and support, and having good communication with their doctors and partners facilitated better adjustment to prostate cancer treatment. Coming to terms with the significant impact of treatment had involved making lifestyle changes, coping with emotional struggles and striving to accept and integrate their post-treatment "new normal" self and sexual life. The importance of adequate communication with health professionals and partners, especially regarding treatment effects on sexual function and rehabilitation options, was highlighted as a key factor facilitating the adjustment process. Prostate cancer patients would benefit from improved access to timely and tailored information and decision-making resources, ongoing multidisciplinary care, and support groups, as well as appropriate referrals for sexual and psychological counselling.

Effects of hydrophobic helix length and side chain chemistry on biomimicry in peptoid analogues of SP-C.

PubMed

Brown, Nathan J; Wu, Cindy W; Seurynck-Servoss, Shannon L; Barron, Annelise E

2008-02-12

The hydrophobic proteins of lung surfactant (LS), SP-B and SP-C, are critical constituents of an effective surfactant replacement therapy for the treatment of respiratory distress syndrome. Because of concerns and difficulties associated with animal-derived surfactants, recent investigations have focused on the creation of synthetic analogues of the LS proteins. However, creating an accurate mimic of SP-C that retains its biophysical surface activity is extraordinarily challenging given the lipopeptide's extreme hydrophobicity and propensity to misfold and aggregate. One successful approach that overcomes these difficulties is the use of poly-N-substituted glycines, or peptoids, to mimic SP-C. To develop a non-natural, bioactive mimic of SP-C and to investigate the effects of side chain chemistry and length of the helical hydrophobic region, we synthesized, purified, and performed in vitro testing of two classes of peptoid SP-C mimics: those having a rigid alpha-chiral aromatic helix and those having a biomimetic alpha-chiral aliphatic helix. The length of the two classes of mimics was also systematically altered. Circular dichroism spectroscopy gave evidence that all of the peptoid-based mimics studied here emulated SP-C's secondary structure, forming stable helical structures in solution. Langmuir-Wilhelmy surface balance, fluorescence microscopy, and pulsating bubble surfactometry experiments provide evidence that the aromatic-based SP-C peptoid mimics, in conjunction with a synthetic lipid mixture, have superior surface activity and biomimetic film morphology in comparison to the aliphatic-based mimics and that there is an increase in surface activity corresponding to increasing helical length.

Tailored online cognitive behavioural therapy with or without therapist support calls to target psychological distress in adults receiving haemodialysis: A feasibility randomised controlled trial.

PubMed

Hudson, Joanna L; Moss-Morris, Rona; Norton, Sam; Picariello, Federica; Game, David; Carroll, Amy; Spencer, Jonathan; McCrone, Paul; Hotopf, Matthew; Yardley, Lucy; Chilcot, Joseph

2017-11-01

Psychological distress is prevalent in haemodialysis (HD) patients yet access to psychotherapy remains limited. This study assessed the feasibility and acceptability of online cognitive-behavioural therapy (CBT) tailored for HD patients, with or without therapist support, for managing psychological distress. This feasibility randomised controlled trial recruited patients from a UK HD centre. Following psychological distress screens, patients with mild-moderate psychological distress (Patient Health Questionnaire PHQ-9; score: 5-19 and/or Generalised Anxiety Disorder; GAD-7 score: 5-14) who met remaining inclusion criteria were approached for consent. Consenters were individually randomised (1:1) to online-CBT or online-CBT plus three therapist support calls. Outcomes included recruitment, retention, and adherence rates. Exploratory change analyses were performed for: psychological distress, quality of life (QoL), illness perceptions, and costs. The statistician was blinded to allocation. 182 (44%) out of 410 patients approached completed psychological distress screens. 26% found screening unacceptable; a further 30% found it unfeasible. Psychological distress was detected in 101 (55%) patients, 60 of these met remaining inclusion criteria. The primary reason for ineligibility was poor computer literacy (N=17, 53%). Twenty-five patients were randomised to the supported (N=18) or unsupported arm (N=7); 92% were retained at follow-up. No differences in psychological distress or cost-effectiveness were observed. No trial adverse events occurred. Online CBT appears feasible but only for computer literate patients who identify with the label psychological distress. A definitive trial using the current methods for psychological distress screening and online care delivery is unfeasible. ClinicalTrials.gov Identifier: NCT02352870. Copyright © 2017 Elsevier Inc. All rights reserved.

Is Overall Mortality the Right Composite Endpoint in Clinical Trials of Acute Respiratory Distress Syndrome?

PubMed

Villar, Jesús; Martínez, Domingo; Mosteiro, Fernando; Ambrós, Alfonso; Añón, José M; Ferrando, Carlos; Soler, Juan A; Montiel, Raquel; Vidal, Anxela; Conesa-Cayuela, Luís A; Blanco, Jesús; Arrojo, Regina; Solano, Rosario; Capilla, Lucía; Del Campo, Rafael; Civantos, Belén; Fernández, María Mar; Aldecoa, César; Parra, Laura; Gutiérrez, Andrea; Martínez-Jiménez, Chanel; González-Martín, Jesús M; Fernández, Rosa L; Kacmarek, Robert M

2018-06-01

Overall mortality in patients with acute respiratory distress syndrome is a composite endpoint because it includes death from multiple causes. In most acute respiratory distress syndrome trials, it is unknown whether reported deaths are due to acute respiratory distress syndrome or the underlying disease, unrelated to the specific intervention tested. We investigated the causes of death after contracting acute respiratory distress syndrome in a large cohort. A secondary analysis from three prospective, multicenter, observational studies. A network of multidisciplinary ICUs. We studied 778 patients with moderate-to-severe acute respiratory distress syndrome treated with lung-protective ventilation. None. We examined death in the ICU from individual causes. Overall ICU mortality was 38.8% (95% CI, 35.4-42.3). Causes of acute respiratory distress syndrome modified the risk of death. Twenty-three percent of deaths occurred from refractory hypoxemia due to nonresolving acute respiratory distress syndrome. Most patients died from causes unrelated to acute respiratory distress syndrome: 48.7% of nonsurvivors died from multisystem organ failure, and cancer or brain injury was involved in 37.1% of deaths. When quantifying the true burden of acute respiratory distress syndrome outcome, we identified 506 patients (65.0%) with one or more exclusion criteria for enrollment into current interventional trials. Overall ICU mortality of the "trial cohort" (21.3%) was markedly lower than the parent cohort (relative risk, 0.55; 95% CI, 0.43-0.70; p < 0.000001). Most deaths in acute respiratory distress syndrome patients are not directly related to lung damage but to extrapulmonary multisystem organ failure. It would be challenging to prove that specific lung-directed therapies have an effect on overall survival.

A longitudinal analysis of intimacy processes and psychological distress among couples coping with head and neck or lung cancers.

PubMed

Manne, Sharon; Badr, Hoda; Kashy, Deborah A

2012-06-01

Individuals diagnosed with lung and head and neck (HN) cancers and their spouses are at increased risk for distress. This study assessed whether the way couples communicate about cancer and their perceptions of relationship intimacy influenced both partners' adjustment. One-hundred thirty-nine patients and their spouses [For purposes of clarity, we refer to the patients' intimate partner as the spouse, regardless of actual marital status and we reserve the term partner to refer to the other person in the couple (i.e., the patient's partner is the spouse and the spouse's partner is the patient)] completed measures of spousal communication, intimacy, and distress at three time points over 6 months. Using multilevel modeling, an over-time actor-partner interdependence model was specified that examined whether intimacy mediated associations between one's own and one's partner's reports of communication at baseline and later distress. Patients and spouses who reported greater baseline distress reported more negative baseline communication as well as lower levels of intimacy and greater distress over time. Mediation analyses showed patients' and spouses' reports of positive spousal communication were associated with less subsequent distress largely through their effects on intimacy. Clinicians working with head and neck or lung cancer patients should assess communication and intimacy because both impact couples' distress.

Students’ psychological distress in an English program embedded in a medical school in a non-English speaking country

PubMed Central

Loureiro, Elizabete; Klugar, Miloslav; Tancred, Adam; Ivanova, Katerina; Oborna, Ivana

2013-01-01

Objectives To clarify if medical students in an English program in a non-English speaking country are exposed to a higher risk of psychological distress compared to comparable local medical students. Methods An online survey was conducted for all medical students both in the English program exclusively for international students (n=235) and in the local program (n=1043) at the Palacky University in the Czech Republic. The Medical Student Well-Being Index (MSWBI) was used to define the student’s psychological distress. Logistic regressions were conducted to find an effect of the study program on the students’ psychological distress, adjusted by age, study year, marital status, residential status, and frequency of contact with significant others, stratified by gender. Results 44% (n=68) of the respondents in the English program screened positive for psychological distress, and 53% (n=221) in the local program. There was an interaction between gender and program in the association with psychological distress. The higher prevalence of psychological distress in the local program was likely attributed to female students who had frequent contacts with their significant others. Conclusions Psychological distress was highly prevalent in a Czech medical school, but there was no overall difference between the international students in the English program and the comparable local medical students.

Examining the Role of Psychological Distress in Linking Childhood Maltreatment and Alcohol Use in Young Adulthood

PubMed Central

Shin, Sunny H.; Hassamal, Sameer; Groves, Lauren Peasley

2017-01-01

Background and Objectives Childhood maltreatment is related to alcohol use as well as psychological distress in young adulthood. Few studies have examined whether psychological distress mediates the relationship between child maltreatment and alcohol use. We examined the role of psychological distress in linking child maltreatment subtypes (ie, emotional abuse, physical abuse, sexual abuse, neglect) to four patterns of alcohol use, including frequency of alcohol use, binge drinking, alcohol-related problems, and alcohol dependence. Methods We used a community sample of young adults (N=337), who completed an interview assessing exposure to childhood maltreatment, current psychological distress, and drinking behaviors. Results Emotional abuse was associated with psychological distress, whereas psychological distress was related to more pathological drinking behaviors such as alcohol-related problems and alcohol dependence. Subsequent analyses indicated significant mediated effects between emotional abuse and alcohol-related problems and alcohol dependence via psychological distress, even after controlling for demographic factors, other maltreatment subtypes, parental alcoholism, and peer alcohol use. Conclusions and Scientific Significance Findings suggest that among four types of childhood maltreatment, emotional abuse might be the major driver of pathological drinking among child maltreatment victims. Interventions aimed at negative emotionality may be useful in preventing and treating problematic drinking among the victims of childhood emotional abuse. PMID:26346173

Identity Distress among Youth Exposed to Natural Disasters: Associations with Level of Exposure, Posttraumatic Stress, and Internalizing Problems.

PubMed

Scott, Brandon G; Sanders, Ashley F P; Graham, Rebecca A; Banks, Donice M; Russell, Justin D; Berman, Steven L; Weems, Carl F

2014-10-01

Identity distress involves intense or prolonged upset or worry about personal identity issues including long-term goals, career choice, friendships, sexual orientation and behavior, religion, values and beliefs, and group loyalties. Research suggests that trauma exposure and subsequent PTSD symptoms may negatively impact identity development and psychological adjustment. However, little is known about their specific associations with identity distress and internalizing problems among disaster-exposed adolescents. The purpose of this study was to examine these relationships in a sample of 325 adolescents (60% female; 89% African American) who experienced a major natural disaster and its aftermath. The results indicated that identity distress was positively associated with age, hurricane exposure, PTSD symptoms, and internalizing problems. Linear regression analyses also showed that identity distress was uniquely associated with internalizing symptoms and that there was an indirect effect of hurricane exposure on identity distress via PTSD symptoms. Finally, PTSD symptoms moderated the link between identity distress and internalizing symptoms, with a significant positive slope found for youth with more PTSD symptoms. Findings were generally consistent with previous work and predictions, and add to the extant knowledge about identity distress by providing data on the linkages between disaster exposure, posttraumatic stress and internalizing problems in adolescents.

The Mediating and Moderating Effects of Workplace Social Capital on the Associations between Adverse Work Characteristics and Psychological Distress among Japanese Workers

PubMed Central

OSHIO, Takashi; INOUE, Akiomi; TSUTSUMI, Akizumi

2014-01-01

Our current study investigated how workplace social capital (WSC) mediates and moderates the associations between adverse work characteristics and psychological distress among Japanese workers. We collected cross-sectional data (N=9,350) from a baseline survey of an occupational Japanese cohort study. We focused on individual WSC and considered job demands/control, effort/reward, and two types (i.e., procedural and interactional) of organizational justice as work-characteristic variables. We defined psychological distress as a score of ≥5 on the Kessler Psychological Distress Scale (K6 scale). Multivariate logistic regression analyses predicted a binary variable of psychological distress by individual WSC and adverse work characteristics, adjusting for individual-level covariates. Individual WSC mediated the associations between adverse work characteristics and psychological distress in almost all model specifications. Additionally, individual WSC moderated the associations of psychological distress with high job demands, high effort, and low interactional justice when we used a high WSC cutoff point. In contrast, individual WSC did not moderate such interactions with low job control, reward, or procedural justice. We concluded that individual WSC mediated the associations between adverse work characteristics and psychological distress among Japanese workers while selectively moderating their associations at high levels of WSC. PMID:24705803

A case of Clostridium difficile infection complicated by acute respiratory distress syndrome treated with fecal microbiota transplantation.

PubMed

Kim, Ji Eun; Gweon, Tae-Geun; Yeo, Chang Dong; Cho, Young-Seok; Kim, Gi Jun; Kim, Jae Young; Kim, Jong Wook; Kim, Hyunho; Lee, Hye Won; Lim, Taeseok; Ham, Hyoju; Oh, Hyun Jin; Lee, Yeongbok; Byeon, Jaeho; Park, Sung Soo

2014-09-21

Acute respiratory distress syndrome is a life-threatening disorder caused mainly by pneumonia. Clostridium difficile infection (CDI) is a common nosocomial diarrheal disease. Disruption of normal intestinal flora by antibiotics is the main risk factor for CDI. The use of broad-spectrum antibiotics for serious medical conditions can make it difficult to treat CDI complicated by acute respiratory distress syndrome. Fecal microbiota transplantation is a highly effective treatment in patients with refractory CDI. Here we report on a patient with refractory CDI and acute respiratory distress syndrome caused by pneumonia who was treated with fecal microbiota transplantation.

Relational health, alexithymia, and psychological distress in college women: testing a mediator model.

PubMed

Liang, Belle; West, Jennifer

2011-04-01

Relational health refers to interpersonal interactions that are growth-fostering or mutually empathic and empowering. Poor relational health increases an individual's risk for developing psychological distress. Alexithymia is the inability to recognize and express one's own internal emotional experience. In this study, the associations of relational health, psychological distress, and alexithymia were examined by surveying 197 female undergraduate psychology students. Support was found for the hypothesis that alexithymic symptoms mediate the direct effect of poor relational health on psychological distress. The importance of assessing relational health and tailoring counseling interventions for people with low relational health and alexithymic symptoms is discussed. © 2011 American Orthopsychiatric 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

Rates and impact of trauma and current stressors among Darfuri refugees in Eastern Chad.

PubMed

Rasmussen, Andrew; Nguyen, Leanh; Wilkinson, John; Vundla, Sikhumbuzo; Raghavan, Sumithra; Miller, Kenneth E; Keller, Allen S

2010-04-01

Darfur refugees face hardships associated with chronic displacement, including lack of basic needs and safety concerns. Psychiatric research on refugees has focused on trauma, but daily stressors may contribute more to variance in distress. This article reports rates of past trauma and current stressors among Darfur refugees and gauges the contribution of each to psychological distress and functional impairment. A representative sample of 848 Darfuris in 2 refugee camps were interviewed about traumatic events, stressors faced in the camps, psychological distress, and functional impairment. Basic needs and safety concerns were more strongly correlated with measures of distress (rs = .19-.31) than were war-related traumatic events (rs = .09-.20). Hierarchical regression supported models in which effects of trauma on distress were mediated by current stressors. Although war-related traumatic events are the initial causes of refugees' hardship, findings suggest that the day-to-day challenges and concerns in camps mediate psychological distress associated with these events.

Financial crisis and collapsed banks: psychological distress and work related factors among surviving employees--a nation-wide study.

PubMed

Snorradóttir, Ásta; Vilhjálmsson, Rúnar; Rafnsdóttir, Guðbjörg Linda; Tómasson, Kristinn

2013-09-01

The study considered psychological distress among surviving bank employees differently entangled in downsizing and restructuring following the financial crisis of 2008. A cross-sectional, nationwide study was conducted among surviving employees (N = 1880, response rate 68%). Multivariate analysis was conducted to assess factors associated with psychological distress. In the banks, where all employees experienced rapid and unpredictable organizational changes, psychological distress was higher among employees most entangled in the downsizing and restructuring process. Being subjected to downsizing within own department, salary cut, and transfer to another department, was directly related to increased psychological distress, controlling for background factors. The associations between downsizing, restructuring, and distress were reduced somewhat by adding job demands, job control, and empowering leadership to the model, however, adding social support had little effect on these associations. Employees most entangled in organizational changes are the most vulnerable and should be prioritized in workplace interventions during organizational changes. Copyright © 2013 Wiley Periodicals, Inc.

Rates and Impact of Trauma and Current Stressors Among Darfuri Refugees in Eastern Chad

PubMed Central

Rasmussen, Andrew; Nguyen, Leanh; Wilkinson, John; Vundla, Sikhumbuzo; Raghavan, Sumithra; Miller, Kenneth E.; Keller, Allen S.

2010-01-01

Darfur refugees face hardships associated with chronic displacement, including lack of basic needs and safety concerns. Psychiatric research on refugees has focused on trauma, but daily stressors may contribute more to variance in distress. In this article we report rates of past trauma and current stressors among Darfur refugees and gauge the contribution of each to psychological distress and functional impairment. A representative sample of 848 Darfuris in two refugee camps were interviewed about traumatic events, stressors faced in the camps, psychological distress and functional impairment. Basic needs and safety concerns were more strongly correlated with measures of distress (r's = .19–.31) than were war-related traumatic events (r's = .09–.20). Hierarchical regression supported models in which effects of trauma on distress were mediated by current stressors. Although war-related traumatic events are the initial causes of refugees' hardship, findings suggest that the day-to-day challenges and concerns in camps mediate psychological distress associated with these events. PMID:20553516

Internet-Based Acceptance and Commitment Therapy for Psychological Distress Experienced by People With Hearing Problems: Study Protocol for a Randomized Controlled Trial.

PubMed

Molander, Peter; Hesser, Hugo; Weineland, Sandra; Bergwall, Kajsa; Buck, Sonia; Hansson-Malmlöf, Johan; Lantz, Henning; Lunner, Thomas; Andersson, Gerhard

2015-09-01

Psychological distress and psychiatric symptoms are prevalent among people with hearing loss or other audiological conditions, but psychological interventions for these groups are rare. This article describes the study protocol for a randomized controlled trial for evaluating the effect of a psychological treatment delivered over the Internet for individuals with hearing problems and concurrent psychological distress. Participants who are significantly distressed will be randomized to either an 8-week Internet-delivered acceptance-based cognitive behavioral therapy (i.e., acceptance and commitment therapy [ACT]), or wa it-list control. We aim to include measures of distress associated with hearing difficulties, anxiety, and depression. In addition, we aim to measure acceptance associated with hearing difficulties as well as quality of life. The results of the trial may further our understanding of how to best treat people who present problems with both psychological distress and hearing in using the Internet.

Psychological distress, fatigue and long-term sickness absence: prospective results from the Maastricht Cohort Study.

PubMed

Bültmann, Ute; Huibers, Marcus J H; van Amelsvoort, Ludovic P G M; Kant, Ijmert; Kasl, Stanislav V; Swaen, Gerard M H

2005-09-01

Little is known about psychological distress as a risk factor for the onset of long-term sickness absence and even less about the influence of fatigue in this relationship. We examined the relationship between psychological distress and the onset of long-term sickness absence during 18 months of follow-up while considering fatigue. Analyses were based on 6403 employees participating in the Maastricht Cohort Study. Psychological distress was related to the onset of long-term sickness absence (women relative risk 1.45, 95% confidence interval = 1.23-1.72; men 1.33, 1.21-1.46). Adjustment for fatigue weakened the associations, particularly in women. Caseness analyses revealed different effects of psychological distress and fatigue in the onset of long-term sickness absence in men and women. The findings underline the need for interventions aiming at psychological distress and, depending on the gender, also at fatigue, to reduce the risk of long-term sickness absence.

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.

Virtual reality and persecutory delusions: safety and feasibility.

PubMed

Fornells-Ambrojo, Miriam; Barker, Chris; Swapp, David; Slater, Mel; Antley, Angus; Freeman, Daniel

2008-09-01

Virtual reality (VR) has begun to be used to research the key psychotic symptom of paranoia. The initial studies have been with non-clinical individuals and individuals at high risk of psychosis. The next step is to develop the technology for the understanding and treatment of clinical delusions. Therefore the present study investigated the acceptability and safety of using VR with individuals with current persecutory delusions. Further, it set out to determine whether patients feel immersed in a VR social environment and, consequently, experience paranoid thoughts. Twenty individuals with persecutory delusions and twenty non-clinical individuals spent 4 min in a VR underground train containing neutral characters. Levels of simulator sickness, distress, sense of presence, and persecutory ideation about the computer characters were measured. A one-week follow-up was conducted to check longer-term side effects. The VR experience did not raise levels of anxiety or symptoms of simulator sickness. No side effects were reported at the follow-up. There was a considerable degree of presence in the VR scenario for all participants. A high proportion of the persecutory delusions group (65%) had persecutory thinking about the computer characters, although this rate was not significantly higher than the non-clinical group. The study indicates that brief experiences in VR are safe and acceptable to people with psychosis. Further, patients with paranoia can feel engaged in VR scenes and experience persecutory thoughts. Exposure to social situations using VR has the potential to be incorporated into cognitive behavioural interventions for paranoia.

Disclosure of sexual victimization: the effects of Pennebaker's emotional disclosure paradigm on physical and psychological distress.

PubMed

Kearns, Megan C; Edwards, Katie M; Calhoun, Karen S; Gidycz, Christine A

2010-01-01

Research suggests that many sexual assault survivors do not disclose their experience, which may increase associated distress. Pennebaker's emotional disclosure paradigm has been shown to ameliorate psychological and physical distress in individuals exposed to stressful events. The current study assessed the effectiveness of this paradigm with sexual assault survivors (N = 74). College women with a history of sexual assault wrote about their most severe victimization or about how they spend their time (control). Then 73 women (98.6%) completed a 1-month follow-up assessment. Results indicated that across writing sessions, the disclosure group reported greater reductions in negative mood immediately post-writing. However, both groups showed significant reductions in physical complaints, psychological distress, and traumatic stress symptoms at the 1-month follow-up, suggesting no added benefit to disclosure of a sexual assault using a brief written paradigm.

Mental Health Stress, Family Resources and Psychological Distress: A Longitudinal Mediation Analysis in African American Grandmothers Raising Grandchildren.

PubMed

Whitley, Deborah M; Lamis, Dorian A; Kelley, Susan J

2016-06-01

This study examines the effectiveness of a multidisciplinary intervention for African American grandmothers raising grandchildren on the relationship between dichotomized levels of mental health stress (low vs. high) and elevated levels of psychological distress, mediated by perceptions of family resources. A nonrandom sample of African American grandmothers (N = 679) was assessed to test the predictive relations among study constructs in the context of a prospective mediational model. Perception of family resources contributes to lower psychological distress among custodial grandmothers exhibiting low and high levels of mental health stress. There was no significant difference in the strength of the mediated effects between the 2 mental health stress groups. The findings suggest appropriate resource-focused interventions can enhance grandmothers' subjective assessments of family resources and reduce psychological distress. However, additional research is needed to ascertain the consistency and generalizability of findings. © 2016 Wiley Periodicals, Inc.

Stress processes in HIV-positive African American mothers: moderating effects of drug abuse history.

PubMed

Burns, Myron J; Feaster, Daniel J; Mitrani, Victoria B; Ow, Christina; Szapocznik, José

2008-01-01

This study examined the mechanism by which stressors, dissatisfaction with family, perceived control, social support, and coping were related to psychological distress in a sample of HIV-positive African American mothers. Additional analyses explored whether women who had a history of a drug abuse or dependence diagnosis differed either on levels of the study variables or the model pathways. The results indicated that HIV-positive African American mothers who had higher levels of stressors perceived their stressors as a whole to be less controllable. Coping resources, available social support and perceived control, were positively associated with active coping and negatively associated with psychological distress. Avoidant coping was the most important predictor of psychological distress. Furthermore, the effect of avoidant coping on psychological distress was stronger for mothers with a history of drug diagnosis. The implications of these findings for targeting interventions are discussed.

A Nonrandomized Comparison Study of Self-Hypnosis, Yoga, and Cognitive-Behavioral Therapy to Reduce Emotional Distress in Breast Cancer Patients.

PubMed

Bragard, Isabelle; Etienne, Anne-Marie; Faymonville, Marie-Elisabeth; Coucke, Philippe; Lifrange, Eric; Schroeder, Hélène; Wagener, Aurélie; Dupuis, Gilles; Jerusalem, Guy

2017-01-01

The authors asked breast cancer (BC) patients to participate in 1 of 3 mind-body interventions (cognitive-behavioral therapy (CBT), yoga, or self-hypnosis) to explore their feasibility, ease of compliance, and impact on the participants' distress, quality of life (QoL), sleep, and mental adjustment. Ninety-nine patients completed an intervention (CBT: n = 10; yoga: n = 21; and self-hypnosis: n = 68). Results showed high feasibility and high compliance. After the interventions, there was no significant effect in the CBT group but significant positive effects on distress in the yoga and self-hypnosis groups, and, also, on QoL, sleep, and mental adjustment in the self-hypnosis group. In conclusion, mind-body interventions can decrease distress in BC patients, but RCTs are needed to confirm these findings.

Workplace stress: what is the role of positive mental health?

PubMed

Page, Kathryn M; Milner, Allison J; Martin, Angela; Turrell, Gavin; Giles-Corti, Billie; LaMontagne, Anthony D

2014-08-01

To examine whether positive mental health (PMH)-a positively focused well-being construct-moderates the job stress-distress relationship. Longitudinal regression was used to test two waves of matched, population-level data from a sample of older, working Australian adults (n = 3291) to see whether PMH modified the relationship between work stress and later psychological distress. Time 1 work stress was positively associated with distress at both time points. Positive mental health was negatively associated with work stress at both time points. Positive mental health modified the impact of work stress on psychological distress. This effect only occurred for those with the highest levels of PMH. Positive mental health may help protect workers from the effect of workplace stress but only in a small proportion of the population. Therefore, to improve workplace mental health, workplaces need to both prevent stress and promote PMH.

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.

Stress processes in HIV-positive African American mothers: Moderating effects of drug abuse history

PubMed Central

BURNS, MYRON J.; FEASTER, DANIEL J.; MITRANI, VICTORIA B.; OW, CHRISTINA; SZAPOCZNIK, JOSÉ

2008-01-01

This study examined the mechanism by which stressors, dissatisfaction with family, perceived control, social support, and coping were related to psychological distress in a sample of HIV-positive African American mothers. Additional analyses explored whether women who had a history of a drug abuse or dependence diagnosis differed either on levels of the study variables or the model pathways. The results indicated that HIV-positive African American mothers who had higher levels of stressors perceived their stressors as a whole to be less controllable. Coping resources, available social support and perceived control, were positively associated with active coping and negatively associated with psychological distress. Avoidant coping was the most important predictor of psychological distress. Furthermore, the effect of avoidant coping on psychological distress was stronger for mothers with a history of drug diagnosis. The implications of these findings for targeting interventions are discussed. PMID:18027126

Mental health, drug use, and the transition from welfare to work.

PubMed

Montoya, Isaac D; Bell, David C; Atkinson, John S; Nagy, Carl W; Whitsett, Donna D

2002-05-01

This study examines the effects of drug use and work requirements on psychological distress and employment among chronic drug-using and non-drug-using welfare recipients. Using a natural history design, 442 female Temporary Assistance for Needy Families (TANF) recipients (including 251 with chronic drug use problems) were interviewed every 4 months in order to assess changes in psychological functioning, employment status, and wages. Data from the first year (four waves) indicate that employment and wages increased substantially, though less so for drug users than non-drug users. Psychological distress decreased only slightly over the study period. Growth curve analyses show that drug use had no direct effect on wages; however, drug use did significantly increase psychological distress. Both the work mandate and psychological distress contributed to wages. The authors consider the implications of these trends for the mental health service needs of drug-using TANF recipients.

Study of molecular mechanisms of learning and memory impairment in neonatal rats post intrauterine distress via the pathway of Tau protein hyperphosphorylation.

PubMed

Wang, X-S; Huang, H

2018-05-01

To explore the reversion of the excitatory amino acid receptor antagonists against the impairment of learning-memory and the hyperphosphorylation of protein Tau induced by fetal intrauterine distress in neonatal rats. The analysis of variance of factorial design set up two intervention factors, fetal intrauterine distress (two levels: no fetal intrauterine distress and a course of fetal intrauterine distress) and the excitatory amino acid receptor antagonists (three levels: Saline; NMDA receptor antagonist MK-801; astragalosides). Forty-eight pregnant rats were randomly divided into six experimental groups (n=8, in each group). After the end of the fetal intrauterine distress, the pregnant rats continued until the birth of newborn rats. When the neonatal rats grow to 12W, the Morris water maze test started in order to evaluate learning-memory. The hippocampus was removed from newborn rats within 1 day after the Morris water maze test finished. The content of glutamate in the hippocampus of rats was detected by high performance liquid chromatography. Besides, the content of protein Tau including Tau5 (total protein Tau), p-PHF1Ser396/404, p-AT8Ser199/202, p-12E8Ser262 in the hippocampus of rats, was examined with the method of immunohistochemistry (IHC) staining (SP). Fetal intrauterine distress and the glutamate ionic receptor blockers could induce the impairment of learning-memory in neonatal rats, extending the evasive latency time and shorten the space exploration time. Both influences present subtract effect. Fetal intrauterine distress could significantly up-regulate the content of glutamate in the hippocampus of neonatal rats, which was not affected by the glutamate ionic receptor blockers. Fetal intrauterine distress and the glutamate ionic receptor blockers did not affect the total protein Tau in the hippocampus of rats. Moreover, fetal intrauterine distress could increase the hyperphosphorylation of protein Tau in the hippocampus of neonatal rats, which were reduced by the glutamate ionic receptor blockers. Both influences presented subtract effect. We showed that fetal intrauterine distress upregulates the content of glutamate in the hippocampus of neonatal rats, up-regulating the hyperphosphorylation of protein Tau and inducing the impairment of learning-memory in neonatal rats.

Dual Minority Stress and Asian American Gay Men's Psychological Distress

ERIC Educational Resources Information Center

Chen, Yung-Chi; Tryon, Georgiana Shick

2012-01-01

The present study investigated the direct and additive effects of racial minority stress and sexual minority stress on the psychological well-being among a community sample of 139 Asian American gay men. Self-esteem was tested to see whether it moderated or mediated the effects of perceived dual minority stress on psychological distress. Results…

Relationships among Social Support, Perceived Control, and Psychological Distress in Late Life

ERIC Educational Resources Information Center

Nemeroff, Robin; Midlarsky, Elizabeth; Meyer, Joseph F.

2010-01-01

Social support has been shown to buffer the relationship between life stress and psychological distress in late life. However, little attention has been paid to personality variables that are associated with the capacity to effectively utilize social support. Although the buffering effects of social support were replicated in our sample of 134…

Intimate Relationships and Personal Distress: The Invisible Harm of Psychological Aggression.

PubMed

Arriaga, Ximena B; Schkeryantz, Emily L

2015-10-01

Aggression in intimate relationships is pervasive, has been implicated in personal distress, and yet may not be perceived as harmful. Two studies (cross-sectional, longitudinal) examined whether being the target of psychologically aggressive behavior by a partner is uniquely associated with personal distress, beyond the effects of general couple functioning, perpetrating aggression, or experiencing physical aggression. New instances of psychological aggression by a partner predicted increases in personal distress. Study 2 also examined participants' perceptions of what causes them stress. Although psychological aggression by a partner predicted personal distress, participants did not perceive their relationship as a source of stress. This suggests a pattern of "invisible harm" in which individuals victimized by psychological aggression may not recognize the harm they are experiencing. © 2015 by the Society for Personality and Social Psychology, Inc.

Use of Complementary and Alternative Medical Interventions for the Management of Procedure-Related Pain, Anxiety, and Distress in Pediatric Oncology: An Integrative Review

PubMed Central

Landier, Wendy; Tse, Alice M.

2016-01-01

This integrative review aims to identify evidence in four electronic databases (MEDLINE, CINAHL, PsyINFO, and COCHRANE) regarding the effectiveness of complementary and alternative medical interventions, either alone or as an adjunct to pharmacological therapy, in alleviating procedure-related pain, anxiety, and distress in children and adolescents with cancer. A total of 32 articles met inclusion criteria. Results suggest that mind–body interventions, including hypnosis, distraction, and imagery, may be effective, alone or as adjuncts to pharmacological interventions, in managing procedure-related pain, anxiety, and distress in pediatric oncology. PMID:21035021

AFRICAN-AMERICANS’ AND LATINOS’ PERCEPTIONS OF USING HYPNOSIS TO ALLEVIATE DISTRESS BEFORE A COLONOSCOPY

PubMed Central

Miller, Sarah J.; Schnur, Julie B.; Montgomery, Guy H.; Jandorf, Lina

2013-01-01

Although colorectal cancer (CRC) screenings can effectively detect and prevent cancer, a large portion of African-Americans and Latinos do not undergo regular colonoscopy screening. Research suggests that anticipatory distress can significantly hinder minorities’ adherence to colonoscopy recommendations. There is significant promise that hypnosis may effectively reduce such distress. The current study examined African-Americans’ and Latinos’ (n = 213) perceptions of using hypnosis prior to a colonoscopy. Overall, 69.9% of the sample expressed favourable perceptions of using pre-colonoscopy hypnosis, although there was notable variability. The results from this study can guide clinical decision making and inform future research efforts. PMID:26566440

Assessing psychological distress in patients with facial paralysis using the Hospital Anxiety and Depression Scale.

PubMed

Pouwels, Sjaak; Beurskens, Carien H G; Kleiss, Ingrid J; Ingels, Koen J A O

2016-08-01

Anxiety and depression are seen among patients with facial paralysis (FP), but less is known about the exact prevalence. The aim of the current study is to assess the prevalence of anxiety and depressive disorders in the FP population and to investigate possible differences between patients with left- and right-sided FP. Fifty-nine patients with FP and 59 healthy individuals were included in this study between March and December of 2014. The Hospital Anxiety and Depression Scale was used to assess the prevalence of anxiety and depression among these groups. The mean age of the patients and controls was 56 ± 15 and 40 ± 16 years, respectively. Twenty-eight patients had left-sided FP, 30 patients had right-sided FP, and one patient had bilateral FP. In the patient group, approximately 30% had anxiety and 25% had a depressive disorder. Compared with the control group, significantly more patients presented with mild anxiety (p = 0.031), mild depression (p = 0.047), and moderate depression (p = 0.006). No significant differences were found in terms of the prevalence of anxiety between left- and right-sided FP. However, significantly more patients with left-sided FP had mild depression (p = 0.018) than those with right-sided FP. This study found a significant difference in anxiety and depression between patients with FP and healthy controls. No clinically significant difference was noted in the prevalence of anxiety or depression between patients with left- and right-sided FP. Copyright © 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

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

Optimism, Symptom Distress, Illness Appraisal, and Coping in Patients With Advanced-Stage Cancer Diagnoses Undergoing Chemotherapy Treatment.

PubMed

Sumpio, Catherine; Jeon, Sangchoon; Northouse, Laurel L; Knobf, M Tish

2017-05-01

To explore the relationships between optimism, self-efficacy, symptom distress, treatment complexity, illness appraisal, coping, and mood disturbance in patients with advanced-stage cancer.
. Cross-sectional study.
. Smilow Cancer Hospital at Yale New Haven in Connecticut, an outpatient comprehensive cancer center.
. A convenience sample of 121 adult patients with stages III-IV cancer undergoing active chemotherapy.
. Participants completed common self-report questionnaires to measure variables. Treatment hours and visits were calculated from data retrieved from medical record review. Mediation and path analysis were conducted to identify direct and indirect pathways from the significant antecedent variables to mood disturbance.
. Dispositional optimism, self-efficacy, social support, treatment complexity, symptom distress, illness appraisal, coping, and mood disturbance.
. Greater optimism and self-efficacy were associated with less negative illness appraisal, less avoidant coping, and decreased mood disturbance. Conversely, greater symptom distress was associated with greater negative illness appraisal, greater avoidant coping, and greater mood disturbance. In the final model, optimism and symptom distress had direct and indirect effects on mood disturbance. Indirect effects were partially mediated by illness appraisal.
. Mood disturbance resulted from an interaction of disease stressors, personal resources, and cognitive appraisal of illness. Avoidant coping was associated with greater disturbed mood, but neither avoidant nor active coping had a significant effect on mood in the multivariate model. 
. Illness appraisal, coping style, and symptom distress are important targets for intervention. Optimism is a beneficial trait and should be included, along with coping style, in comprehensive nursing assessments of patients with cancer.

Association between Prenatal and Postnatal Psychological Distress and Toddler Cognitive Development: A Systematic Review

PubMed Central

2015-01-01

Purpose Maternal psychological distress is one of the most common perinatal complications, affecting up to 25% of pregnant and postpartum women. Research exploring the association between prenatal and postnatal distress and toddler cognitive development has not been systematically compiled. The objective of this systematic review was to determine the association between prenatal and postnatal psychological distress and toddler cognitive development. Methods Articles were included if: a) they were observational studies published in English; b) the exposure was prenatal or postnatal psychological distress; c) cognitive development was assessed from 13 to 36 months; d) the sample was recruited in developed countries; and e) exposed and unexposed women were included. A university-based librarian conducted a search of electronic databases (Embase, CINAHL, Eric, PsycInfo, Medline) (January, 1990-March, 2014). We searched gray literature, reference lists, and relevant journals. Two reviewers independently evaluated titles/abstracts for inclusion, and quality using the Scottish Intercollegiate Guideline Network appraisal tool for observational studies. One reviewer extracted data using a standardized form. Results Thirteen of 2448 studies were included. There is evidence of an association between prenatal and postnatal distress and cognitive development. While variable effect sizes were reported for postnatal associations, most studies reported medium effect sizes for the association between prenatal psychological distress and cognitive development. Too few studies were available to determine the influence of the timing of prenatal exposure on cognitive outcomes. Conclusion Findings support the need for early identification and treatment of perinatal mental health problems as a potential strategy for optimizing toddler cognitive development. PMID:25996151

Association between Prenatal and Postnatal Psychological Distress and Toddler Cognitive Development: A Systematic Review.

PubMed

Kingston, Dawn; McDonald, Sheila; Austin, Marie-Paule; Tough, Suzanne

2015-01-01

Maternal psychological distress is one of the most common perinatal complications, affecting up to 25% of pregnant and postpartum women. Research exploring the association between prenatal and postnatal distress and toddler cognitive development has not been systematically compiled. The objective of this systematic review was to determine the association between prenatal and postnatal psychological distress and toddler cognitive development. Articles were included if: a) they were observational studies published in English; b) the exposure was prenatal or postnatal psychological distress; c) cognitive development was assessed from 13 to 36 months; d) the sample was recruited in developed countries; and e) exposed and unexposed women were included. A university-based librarian conducted a search of electronic databases (Embase, CINAHL, Eric, PsycInfo, Medline) (January, 1990-March, 2014). We searched gray literature, reference lists, and relevant journals. Two reviewers independently evaluated titles/abstracts for inclusion, and quality using the Scottish Intercollegiate Guideline Network appraisal tool for observational studies. One reviewer extracted data using a standardized form. Thirteen of 2448 studies were included. There is evidence of an association between prenatal and postnatal distress and cognitive development. While variable effect sizes were reported for postnatal associations, most studies reported medium effect sizes for the association between prenatal psychological distress and cognitive development. Too few studies were available to determine the influence of the timing of prenatal exposure on cognitive outcomes. Findings support the need for early identification and treatment of perinatal mental health problems as a potential strategy for optimizing toddler cognitive development.

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

A Randomized Controlled Trial on Effects of the Transcendental Meditation Program on Blood Pressure, Psychological Distress, and Coping in Young Adults

PubMed Central

Nidich, Sanford I.; Rainforth, Maxwell V.; Haaga, David A.F.; Hagelin, John; Salerno, John W.; Travis, Fred; Tanner, Melissa; Gaylord-King, Carolyn; Grosswald, Sarina; Schneider, Robert H.

2009-01-01

Background Psychological distress contributes to the development of hypertension in young adults. This trial assessed the effects of a mind–body intervention on blood pressure (BP), psychological distress, and coping in college students. Methods This was a randomized controlled trial (RCT) of 298 university students randomly allocated to either the Transcendental Meditation (TM) program or wait-list control. At baseline and after 3 months, BP, psychological distress, and coping ability were assessed. A subgroup of 159 subjects at risk for hypertension was analyzed similarly. Results Changes in systolic BP (SBP)/diastolic BP (DBP) for the overall sample were −2.0/−1.2 mm Hg for the TM group compared to +0.4/+0.5 mm Hg for controls (P = 0.15, P = 0.15, respectively). Changes in SBP/DBP for the hypertension risk subgroup were −5.0/−2.8 mm Hg for the TM group compared to +1.3/+1.2 mm Hg for controls (P = 0.014, P = 0.028, respectively). Significant improvements were found in total psychological distress, anxiety, depression, anger/hostility, and coping (P values < 0.05). Changes in psychological distress and coping correlated with changes in SBP (P values < 0.05) and DBP (P values < 0.08). Conclusions This is the first RCT to demonstrate that a selected mind–body intervention, the TM program, decreased BP in association with decreased psychological distress, and increased coping in young adults at risk for hypertension. This mind–body program may reduce the risk for future development of hypertension in young adults. PMID:19798037

A randomized controlled trial on effects of the Transcendental Meditation program on blood pressure, psychological distress, and coping in young adults.

PubMed

Nidich, Sanford I; Rainforth, Maxwell V; Haaga, David A F; Hagelin, John; Salerno, John W; Travis, Fred; Tanner, Melissa; Gaylord-King, Carolyn; Grosswald, Sarina; Schneider, Robert H

2009-12-01

Psychological distress contributes to the development of hypertension in young adults. This trial assessed the effects of a mind-body intervention on blood pressure (BP), psychological distress, and coping in college students. This was a randomized controlled trial (RCT) of 298 university students randomly allocated to either the Transcendental Meditation (TM) program or wait-list control. At baseline and after 3 months, BP, psychological distress, and coping ability were assessed. A subgroup of 159 subjects at risk for hypertension was analyzed similarly. Changes in systolic BP (SBP)/diastolic BP (DBP) for the overall sample were -2.0/-1.2 mm Hg for the TM group compared to +0.4/+0.5 mm Hg for controls (P = 0.15, P = 0.15, respectively). Changes in SBP/DBP for the hypertension risk subgroup were -5.0/-2.8 mm Hg for the TM group compared to +1.3/+1.2 mm Hg for controls (P = 0.014, P = 0.028, respectively). Significant improvements were found in total psychological distress, anxiety, depression, anger/hostility, and coping (P values < 0.05). Changes in psychological distress and coping correlated with changes in SBP (P values < 0.05) and DBP (P values < 0.08). This is the first RCT to demonstrate that a selected mind-body intervention, the TM program, decreased BP in association with decreased psychological distress, and increased coping in young adults at risk for hypertension. This mind-body program may reduce the risk for future development of hypertension in young adults.

Neighborhood deprivation and maternal psychological distress during pregnancy: a multilevel analysis.

PubMed

Yang, Seungmi; Kestens, Yan; Dahhou, Mourad; Daniel, Mark; Kramer, Michael S

2015-05-01

Maternal psychosocial distress is conceptualized as an important factor underlying the association between neighborhood deprivation and pregnancy outcomes. However, empirical studies to examine effects of neighborhood deprivation on psychosocial distress during pregnancy are scant. Based on a large multicenter cohort of pregnant women in Montreal, we examined (1) the extent to which psychosocial distress is clustered at the neighborhood-level, (2) the extent to which the clustering is explained by neighborhood material or social deprivation, and (3) whether associations between neighborhood deprivation and psychosocial distress persist after accounting for neighborhood composition (individual-level characteristics) using multilevel analyses. For 5,218 women residing in 740 neighborhoods, a prenatal interview at 24-26 gestational weeks measured both general and pregnancy-related psychological distress using well-validated scales: perceived stress, social support, depressive symptoms, optimism, commitment to the pregnancy, pregnancy-related anxiety, and maternal locus-of-control. Neighborhood deprivation indices were linked to study participants by their residential postal code. Neighborhood-level clustering (intraclass correlation) ranged from 1 to 2 % for perceived stress (lowest), optimism, pregnancy-related anxiety, and commitment to pregnancy to 4-6 % for perceived social support, depressive symptoms, and maternal locus of control (highest). Neighborhood material deprivation explained far more of the clustering (23-75 %) than did social deprivation (no more than 4 %). Although both material and social deprivation were associated with psychological distress in unadjusted analyses, the associations disappeared after accounting for individual-level socioeconomic characteristics. Our results highlight the importance of accounting for individual-level socioeconomic characteristics in studies of potential neighborhood effects on maternal mental health.

0-6687 : minimize premature distresses in continuously reinforced concrete pavement : [project summary].

DOT National Transportation Integrated Search

2013-08-01

The performance of continuously reinforced concrete : pavement (CRCP) has been quite satisfactory in Texas, : providing one of the most cost-effective pavement systems : for the Texas Department of Transportation (TxDOT). : However, distresses do occ...

Harnessing the Promise of Moral Distress: A Call for Re-Orientation.

PubMed

Carse, Alisa; Rushton, Cynda Hylton

2017-01-01

Despite over three decades of research into the sources and costs of what has become an "epidemic" of moral distress among healthcare professionals, spanning many clinical disciplines and roles, there has been little significant progress in effectively addressing moral distress. We believe the persistent sense of frustration, helplessness, and despair still dominating the clinical moral distress narrative signals a need for re-orientation in the way moral distress is understood and worked with. Most fundamentally, moral distress reveals moral investment and energy. It is the troubled call of conscience, an expression of fidelity to moral commitments seen as imperiled or compromised. It is crucial that we find ways to empower clinicians in heeding this call-to support clinicians' moral agency and voice, foster their moral resilience, and facilitate their ability to contribute to needed reform within the organizations and systems in which they work. These objectives must inform creative expansion in the design of strategies for addressing moral distress in the day-to-day of clinical practice. We include suggestions about promising directions such strategies might take in the hope of spurring further innovation within clinical environments. Copyright 2016 The Journal of Clinical Ethics. All rights reserved.

A multilevel analysis of long-term psychological distress among Belarusians affected by the Chernobyl disaster.

PubMed

Beehler, G P; Baker, J A; Falkner, K; Chegerova, T; Pryshchepava, A; Chegerov, V; Zevon, M; Bromet, E; Havenaar, J; Valdismarsdottir, H; Moysich, K B

2008-11-01

Radiation contamination and sociopolitical instability following the Chernobyl nuclear power plant disaster have had a profound impact on Belarus. To investigate the factors that impact long-term mental health outcomes of this population almost 20 years after the disaster. Cross-sectional study. In-person interviews were conducted with 381 men and women from two geographic areas of differing radiation contamination within Belarus. Participants completed surveys of demographics, psychosocial factors and psychological distress. Individual-level characteristics were combined with household-level measures of radiation contamination exposure and family characteristics to create multilevel predictive models of psychological distress. Between-household effects accounted for 20% of variability in depression and anxiety scores, but only 8% of variability in somatization scores. Degree of chronic daily stressors showed a significant positive relationship with psychological distress, whereas mastery/controllability showed a significant inverse relationship with distress. At household level, perceived family problems, but not level of residential radiation contamination, was the best predictor of distress. Multilevel modelling indicates that long-term psychological distress among Belarusians affected by the Chernobyl disaster is better predicted by stress-moderating psychosocial factors present in one's daily life than by level of residential radiation contamination.