Evaluation of concrete pavements with materials-related distress : appendix A, part 3.

DOT National Transportation Integrated Search

2010-03-02

An evaluation of cores sampled from six concrete pavements was performed. Factors contributing to pavement distress observed in the field were determined, including expansive alkali-silica reactivity and freeze-thaw deterioration related to poor entr...

Evaluation of concrete pavements with materials-related distress : appendix A, part 2.

DOT National Transportation Integrated Search

2010-03-02

An evaluation of cores sampled from six concrete pavements was performed. Factors contributing to pavement distress observed in the field were determined, including expansive alkali-silica reactivity and freeze-thaw deterioration related to poor entr...

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

Positive and negative affect mediate the bidirectional relationship between emotional processing and symptom severity and impact in irritable bowel syndrome.

PubMed

Sibelli, Alice; Chalder, Trudie; Everitt, Hazel; Chilcot, Joseph; Moss-Morris, Rona

2018-02-01

Individuals with IBS report higher levels of psychological distress compared to healthy controls. Distress has been associated with emotional processing difficulties but studies have not explored how the relationship between distress and emotional processing affects IBS. There is little research on the role of positive affect (PA) in IBS. (a) If difficulties in self-reported emotional processing are associated with affect and IBS measures (i.e., symptom severity, interference in life roles) (b1) If affect mediates the relationship between emotional processing and IBS measures (b2) Alternative model: if affect mediates the relationship between IBS and emotional processing (c) If PA moderates the relationship between distress and IBS. Participants with a confirmed diagnosis of IBS (n=558) completed a questionnaire including measures of emotional processing (i.e., unhelpful beliefs about negative emotions, impoverished emotional experience), distress, PA, and IBS symptoms/interference. Mediation and moderation analyses were conducted with Maximum Likelihood Estimation. Distress and PA mediated or partly mediated the relationship between unhelpful beliefs about negative emotions/impoverished emotional experience and both IBS measures. The alternative models were also valid, suggesting a two-way relationship between emotional processing and IBS through affect. PA did not moderate the relationship between distress and IBS. Future interventions in IBS may benefit from not only targeting the management of physical symptoms and their daily impact but also aspects related to the experience of both negative and positive affect, and the acceptance and expression of negative emotions. Longitudinal studies are needed to confirm causal relationships within the explored models. Copyright © 2017 Elsevier Inc. All rights reserved.

Interpretation bias and anxiety in childhood: stability, specificity and longitudinal associations.

PubMed

Creswell, Cathy; O'Connor, Thomas G

2011-03-01

Biases in the interpretation of ambiguous material are central to cognitive models of anxiety; however, understanding of the association between interpretation and anxiety in childhood is limited. To address this, a prospective investigation of the stability and specificity of anxious cognitions and anxiety and the relationship between these factors was conducted. Sixty-five children (10-11 years) from a community sample completed measures of self-reported anxiety, depression, and conduct problems, and responded to ambiguous stories at three time points over one-year. Individual differences in biases in interpretation of ambiguity (specifically "anticipated distress" and "threat interpretation") were stable over time. Furthermore, anticipated distress and threat interpretation were specifically associated with anxiety symptoms. Distress anticipation predicted change in anxiety symptoms over time. In contrast, anxiety scores predicted change in threat interpretation over time. The results suggest that different cognitive constructs may show different longitudinal links with anxiety. These preliminary findings extend research and theory on anxious cognitions and their link with anxiety in children, and suggest that these cognitive processes may be valuable targets for assessment and intervention.

Materials for helicopter gears

NASA Technical Reports Server (NTRS)

1979-01-01

Some of the power train transmission gears in helicopter drive systems can become critical components as performance requirements are increased; accordingly, increasing attention must be paid to new alloys in order to obtain required performance reliability and survivability. Candidate advanced alloys, with improved high temperature properties, while increasing the resistance to scoring and scuffing, tend to have lower ductility and fracture toughness. An attempt is made to identify design materials, and process problems and requirements. In addition, it is recommended that the characterization of candidate steels be accelerated; preliminary investigation indicates that new alloys may provide improved capability against surface distress.

Investigation of premature distress in conventional asphalt materials on Interstate 10 at Columbus, Texas.

DOT National Transportation Integrated Search

1982-08-01

The primary objectives of the study were to determine the probable causes of the distress and to make recommendations which could alleviate future problems. The investigation involved an analysis of construction records and laboratory test results pe...

Cognitive processing variables in breast cancer: worry and distress at the end of treatment.

PubMed

Costa-Requena, Gema; Rodríguez, Ana; Fernández, Rosina; Palomera, Elisabet; Gil, Francisco L

2011-06-01

This study assessed the influence of cognitive processing variables on cancer worries and distress after breast cancer treatment. In multivariate analyses, while independent variables were intolerance of uncertainty and intrusive thoughts, constructs' variables were anxiety and depression symptoms and cancer-related worries. The intolerance to uncertainty had a tendency to influence on distress and concerns about cancer after the end of treatment (Wilks' λ = 0.687, p = 0.074). Whereas, thought intrusion had a significant influence on distress and cancer related worries (Wilks' λ = 0.228, p = 0.000). Cognitive variables could be addressed by the oncology nurse when considering the patients' concerns related to cancer and psychological distress.

Prevention of the development of psychological distress following a motor vehicle crash: study protocol for a randomized controlled trial.

PubMed

Guest, Rebecca; Tran, Yvonne; Gopinath, Bamini; Cameron, Ian D; Craig, Ashley

2016-07-16

It is estimated that up to 50 % of motor vehicle crash survivors develop significant psychological distress, such as depressive mood and anxiety, within 6 months of the crash. Associated impacts include loss of employment, delayed return to work, financial and familial stress, and increased medical and compensation costs. The major aim of this research is to investigate the efficacy of interventions for preventing the development of psychological distress following a motor vehicle crash. The efficacy of two brief interventions will be examined: a cognitive behaviour therapy (CBT) programme, targeting mood and anxiety, and a lifestyle programme, targeting sleep, diet and physical activity. This is a randomized, controlled multisite study. Participants include at least 180 adults injured in a motor vehicle crash who have entered a compensation process. Research will compare outcomes in three groups randomly assigned to: one group of 60 adults, who receive a brief email-delivered CBT programme, with one session every 2 weeks for 10 weeks and telephone contact every 2 weeks; a second group of 60 adults, who receive a brief email-delivered lifestyle intervention involving one session every 2 weeks for 10 weeks with telephone contact; and an active waiting-list control group of 60 adults who are provided claims processing-related reading material along with telephone contact every 2 weeks for 10 weeks. Participants will be recruited within 12 weeks of the motor vehicle crash, and will be comprehensively assessed before and after treatment, and 6 and 12 months post-injury. Assuming an α probability level of 0.05 and a power of 80 %, at least 180 participants will be recruited. The primary outcome measure is the presence and severity of psychological distress or disorder. Secondary outcome measures include assessment of self-efficacy, resilience employment status, social activity and support, lifestyle and physical health factors, along with process outcome measures of treatment acceptability, feasibility and generalizability. This study will determine whether brief email-delivered interventions distributed soon after the injury and entry into the claims process can be effective in preventing the development of psychological distress. ANZCTR, ACTRN12615000326594 . Registered on 9 April 2015.

Racial discrimination and the stress process.

PubMed

Ong, Anthony D; Fuller-Rowell, Thomas; Burrow, Anthony L

2009-06-01

The unique and combined effects of chronic and daily racial discrimination on psychological distress were examined in a sample of 174 African American doctoral students and graduates. Using a daily process design, 5 models of the stress process were tested. Multilevel random coefficient modeling analyses revealed that chronic exposure to racial discrimination predicted greater daily discrimination and psychological distress. Further, results show that differences in daily discrimination and negative events accounted for meaningful variation in daily distress responses. Finally, findings indicate that daily discrimination and negative events mediated the relationship between chronic discrimination and psychological distress. The study provides support for the need to measure chronic strains as distinctive from daily stressors in the lives of African Americans.

Family-Based Processes Associated with Adolescent Distress, Substance Use and Risky Sexual Behavior in Families Affected by Maternal HIV

PubMed Central

Lester, Patricia; Stein, Judith A.; Bursch, Brenda; Rice, Eric; Green, Sara; Penniman, Typhanye; Rotheram-Borus, Mary Jane

2014-01-01

The present study investigated how maternal HIV and mediating family processes are associated with adolescent distress, substance use, and risky sexual behavior. Mother–adolescent (ages 12–21) dyads (N=264) were recruited from neighborhoods where the HIV-affected families resided (161 had mothers with HIV). Mediating family processes were youth aggressive conflict style, maternal bonding, maternal role reversal expectations, and overall family functioning. Results of structural equation modeling indicated that youth aggressive conflict resolution style was strongly associated with adolescent distress, substance use, and risky sexual behavior. In HIV-affected families, youth less frequently reported using an aggressive conflict resolution style and more frequently reported positive maternal bonds; their mothers reported less positive family functioning than control families. Finally, maternal distress indirectly affected adolescent distress and risk behavior via youth aggressive conflict resolution style. PMID:20419574

Family-based processes associated with adolescent distress, substance use and risky sexual behavior in families affected by maternal HIV.

PubMed

Lester, Patricia; Stein, Judith A; Bursch, Brenda; Rice, Eric; Green, Sara; Penniman, Typhanye; Rotheram-Borus, Mary Jane

2010-01-01

The present study investigated how maternal HIV and mediating family processes are associated with adolescent distress, substance use, and risky sexual behavior. Mother-adolescent (ages 12-21) dyads (N = 264) were recruited from neighborhoods where the HIV-affected families resided (161 had mothers with HIV). Mediating family processes were youth aggressive conflict style, maternal bonding, maternal role reversal expectations, and overall family functioning. Results of structural equation modeling indicated that youth aggressive conflict resolution style was strongly associated with adolescent distress, substance use, and risky sexual behavior. In HIV-affected families, youth less frequently reported using an aggressive conflict resolution style and more frequently reported positive maternal bonds; their mothers reported less positive family functioning than control families. Finally, maternal distress indirectly affected adolescent distress and risk behavior via youth aggressive conflict resolution style.

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.

A Study of Psychological Distress in Two Cohorts of First-Year Medical Students that Underwent Different Admission Selection Processes

PubMed Central

Yusoff, Muhamad Saiful Bahri; Rahim, Ahmad Fuad Abdul; Baba, Abdul Aziz; Ismail, Shaiful Bahari; Esa, Ab Rahman

2012-01-01

Background: Medical training is often regarded as a stressful period. Studies have previously found that 21.6%–50% of medical students experience significant psychological distress. The present study compared the prevalence and levels of psychological distress between 2 cohorts of first-year medical students that underwent different admission selection processes. Methods: A comparative cross-sectional study was conducted by comparing 2 cohorts of first-year medical students; 1 group (cohort 1) was selected based purely on academic merit (2008/2009 cohort) and the other group (cohort 2) was selected based on academic merit, psychometric assessment, and interview performance (2009/2010 cohort). Their distress levels were measured by the General Health Questionnaire, and scores higher than 3 were considered indicative of significant psychological distress. Results: The prevalence (P = 0.003) and levels (P = 0.001) of psychological distress were significantly different between the 2 cohorts. Cohort 1 had 1.2–3.3 times higher risk of developing psychological distress compared to cohort 2 (P = 0.007). Conclusion: Cohort 2 had better psychological health than cohort 1 and was less likely to develop psychological distress. This study provided evidence of a potential benefit of multimodal student selection based on academic merit, psychometric assessment, and interview performance. This selection process might identify medical students who will maintain better psychological health. PMID:23610547

Posttraumatic growth and depreciation six years after the 2004 tsunami.

PubMed

Michélsen, Hans; Therup-Svedenlöf, Charlotte; Backheden, Magnus; Schulman, Abbe

2017-01-01

Background : Posttraumatic growth (PTG) has been reported after various types of potentially traumatic events, as a part of the personal recovery process among survivors. Even negative changes in survivors' life view, known as posttraumatic depreciation (PTD), have been identified as an additional aspect in the personal recovery processes. Objective : To examine how the type of exposure experienced by survivors of a natural disaster, the 2004 Southeast Asia tsunami, influenced self-reported PTG and PTD six years later (T2). Additionally, the study examined the relations between psychological distress and posttraumatic stress symptoms (PTSS) 14 months after the disaster (T1), to PTG and PTD, respectively at T2. Finally, the study examined whether psychological distress and PTSS (T1) could have a mediating effect on PTG and PTD at T2. Method : The participants were 848 tsunami survivors living in Stockholm, Sweden who responded to a questionnaire at 14 months (T1) and six years (T2) after the tsunami. The material was analysed using linear regression and pathway analysis. PTG and PTD were measured on separate scales. Results : The type of exposure was significant related to both PTG and PTD six years later (T2). Those experiencing a combination of various types of exposure (including threat to life and bereavement) reported higher scores for both PTG and PTD. There were significant positive correlations between PTSS at T1 and PTG /PTD at T2, and somewhat lower correlations between psychological distress at T1 and PTG/PTD at T2. Both PTSS and psychological distress at T1 were significant mediating variables for both PTG and PTD at T2. Conclusions : Studying survivors' various types of exposure and subsequent changed view of life - both PTG and PTD - resulted in a broadened understanding of the complexity of reactions and the recovery process among survivors.

Posttraumatic growth and depreciation six years after the 2004 tsunami

PubMed Central

Michélsen, Hans; Therup-Svedenlöf, Charlotte; Backheden, Magnus; Schulman, Abbe

2017-01-01

ABSTRACT Background: Posttraumatic growth (PTG) has been reported after various types of potentially traumatic events, as a part of the personal recovery process among survivors. Even negative changes in survivors’ life view, known as posttraumatic depreciation (PTD), have been identified as an additional aspect in the personal recovery processes. Objective: To examine how the type of exposure experienced by survivors of a natural disaster, the 2004 Southeast Asia tsunami, influenced self-reported PTG and PTD six years later (T2). Additionally, the study examined the relations between psychological distress and posttraumatic stress symptoms (PTSS) 14 months after the disaster (T1), to PTG and PTD, respectively at T2. Finally, the study examined whether psychological distress and PTSS (T1) could have a mediating effect on PTG and PTD at T2. Method: The participants were 848 tsunami survivors living in Stockholm, Sweden who responded to a questionnaire at 14 months (T1) and six years (T2) after the tsunami. The material was analysed using linear regression and pathway analysis. PTG and PTD were measured on separate scales. Results: The type of exposure was significant related to both PTG and PTD six years later (T2). Those experiencing a combination of various types of exposure (including threat to life and bereavement) reported higher scores for both PTG and PTD. There were significant positive correlations between PTSS at T1 and PTG /PTD at T2, and somewhat lower correlations between psychological distress at T1 and PTG/PTD at T2. Both PTSS and psychological distress at T1 were significant mediating variables for both PTG and PTD at T2. Conclusions: Studying survivors’ various types of exposure and subsequent changed view of life – both PTG and PTD – resulted in a broadened understanding of the complexity of reactions and the recovery process among survivors. PMID:28451069

Guidelines for detection, analysis, and treatment of materials-related distress in concrete pavements. Volume 2, Guidelines description and use

DOT National Transportation Integrated Search

2002-08-01

The performance of concrete pavements can be adversely affected by the concrete's inability to resist the environment in which it is placed. This lack of durability can occur even when the structural design of the pavement is adequate. The distresses...

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.

Response to an Abnormal Ovarian Cancer Screening Test Result: Test of the Social Cognitive Processing and Cognitive Social Health Information Processing Models

PubMed Central

Andrykowski, Michael A.; Pavlik, Edward J.

2009-01-01

All cancer screening tests produce a proportion of abnormal results requiring follow-up. Consequently, the cancer screening setting is a natural laboratory for examining psychological and behavioral response to a threatening health-related event. This study tested hypotheses derived from the Social Cognitive Processing and Cognitive-Social Health Information Processing models in trying to understand response to an abnormal ovarian cancer (OC) screening test result. Women (n=278) receiving an abnormal screening test result a mean of 7 weeks earlier were assessed prior to a repeat screening test intended to clarify their previous abnormal result. Measures of disposition (optimism, informational coping style), social environment (social support and constraint), emotional processing, distress, and benefit finding were obtained. Regression analyses indicated greater distress was associated with greater social constraint and emotional processing and a monitoring coping style in women with a family history of OC. Distress was unrelated to social support. Greater benefit finding was associated with both greater social constraint and support and greater distress. The primacy of social constraint in accounting for both benefit-finding and distress was noteworthy and warrants further research on the role of social constraint in adaptation to stressful events. PMID:20419561

Interpersonal Processes and Attachment in Voice-Hearers.

PubMed

Robson, George; Mason, Oliver

2015-11-01

Studies of both clinical and non-clinical voice hearers suggest that distress is rather inconsistently associated with the perceived relationship between voice and hearer. It is also not clear if their beliefs about voices are relevant. This study investigated the links between attachment anxiety/avoidance, interpersonal aspects of the voice relationship, and distress whilst considering the impact of beliefs about voices and paranoia. Forty-four voice-hearing participants completed a number of self-report measures tapping attachment, interpersonal processes in the voice relationship, beliefs about voices, paranoia, distress and depression. Attachment avoidance was related to voice intrusiveness, hearer distance and distress. Attachment anxiety was related to voice intrusiveness, hearer dependence and distress. A series of simple mediation analyses were conducted that suggest that the relationship between attachment and voice related distress may be mediated by interpersonal dynamics in the voice-hearer relationship, beliefs about voices and paranoia. Beliefs about voices, the hearer's relationship with their voices, and the distress voices sometimes engender appear to be meaningfully related to their attachment style. This may be important to consider in therapeutic work.

Psychological vulnerability, burnout, and coping among employees of a business process outsourcing organization

PubMed Central

Machado, Tanya; Sathyanarayanan, Vidya; Bhola, Poornima; Kamath, Kirthi

2013-01-01

Background: The business process outsourcing (BPO) sector is a contemporary work setting in India, with a large and relatively young workforce. There is concern that the demands of the work environment may contribute to stress levels and psychological vulnerability among employees as well as to high attrition levels. Materials and Methods: As part of a larger study, questionnaires were used to assess psychological distress, burnout, and coping strategies in a sample of 1,209 employees of a BPO organization. Results: The analysis indicated that 38% of the sample had significant psychological distress on the General Health Questionnaire (GHQ-28; Goldberg and Hillier, 1979). The vulnerable groups were women, permanent employees, data processors, and those employed for 6 months or longer. The reported levels of burnout were low and the employees reported a fairly large repertoire of coping behaviors. Conclusions: The study has implications for individual and systemic efforts at employee stress management and workplace prevention approaches. The results point to the emerging and growing role of mental health professionals in the corporate sector. PMID:24459370

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.

Acculturative Stress, Psychological Distress, and Religious Coping Among Latina Young Adult Immigrants

PubMed Central

Da Silva, Nicole; Dillon, Frank R.; Rose Verdejo, Toni; Sanchez, Mariana; De La Rosa, Mario

2017-01-01

Religion is a source of strength in Latina/o culture during challenging life transitions, such as the immigration process. Guided by a sociological stress–process model, this study examines relations between dimensions of religious coping, acculturative stress, and psychological distress among 530 young Latina women (ages 18–23 years) who recently immigrated to the United States (i.e., approximately 12 months prior to assessment). Higher levels of acculturative stress were associated with higher levels of psychological distress. Negative religious coping (i.e., the tendency to struggle with faith) moderated the relation between acculturative stress and psychological distress. Participants experiencing higher levels of acculturative stress reported greater psychological distress when they indicated more negative religious coping. Positive religious coping (i.e., the tendency to relate to faith with comfort and certainty) was not linked with acculturative stress or psychological distress. Implications for culturally tailored counseling interventions for this underserved and understudied population are discussed. PMID:29033462

Disability, Health Insurance and Psychological Distress among US Adults: An Application of the Stress Process.

PubMed

Alang, Sirry M; McAlpine, Donna D; Henning-Smith, Carrie E

2014-11-01

Structural resources, including access to health insurance, are understudied in relation to the stress process. Disability increases the likelihood of mental health problems, but health insurance may moderate this relationship. We explore health insurance coverage as a moderator of the relationship between disability and psychological distress. A pooled sample from 2008-2010 (N=57,958) was obtained from the Integrated Health Interview Series. Chow tests were performed to assess insurance group differences in the association between disability and distress. Results indicated higher levels of distress associated with disability among uninsured adults compared to their peers with public or private insurance. The strength of the relationship between disability and distress was weaker for persons with public compared to private insurance. As the Affordable Care Act is implemented, decision-makers should be aware of the potential for insurance coverage, especially public, to ameliorate secondary conditions such as psychological distress among persons who report a physical disability.

Disability, Health Insurance and Psychological Distress among US Adults: An Application of the Stress Process

PubMed Central

Alang, Sirry M.; McAlpine, Donna D.; Henning-Smith, Carrie E.

2014-01-01

Structural resources, including access to health insurance, are understudied in relation to the stress process. Disability increases the likelihood of mental health problems, but health insurance may moderate this relationship. We explore health insurance coverage as a moderator of the relationship between disability and psychological distress. A pooled sample from 2008–2010 (N=57,958) was obtained from the Integrated Health Interview Series. Chow tests were performed to assess insurance group differences in the association between disability and distress. Results indicated higher levels of distress associated with disability among uninsured adults compared to their peers with public or private insurance. The strength of the relationship between disability and distress was weaker for persons with public compared to private insurance. As the Affordable Care Act is implemented, decision-makers should be aware of the potential for insurance coverage, especially public, to ameliorate secondary conditions such as psychological distress among persons who report a physical disability. PMID:25767740

Cognitive processing in the aftermath of relationship dissolution: Associations with concurrent and prospective distress and posttraumatic growth.

PubMed

Del Palacio-González, Adriana; Clark, David A; O'Sullivan, Lucia F

2017-12-01

Non-marital romantic relationship dissolution is amongst the most stressful life events experienced by young adults. Yet, some individuals experience posttraumatic growth following relationship dissolution. Little is known about the specific and differential contribution of trait-like and event-specific cognitive processing styles to each of these outcomes. A longitudinal design was employed in which trait-like (brooding and reflection) and dissolution-specific (intrusive and deliberate) cognitive processing was examined as predictors of growth (Posttraumatic Growth Inventory) and distress (Breakup Distress Scale) following a recent relationship dissolution. Initially, 148 participants completed measures of trait-like and dissolution-specific cognitive processing, growth, and distress (T1). A subsample completed a seven-month follow-up (T2). Higher frequency of relationship-dissolution intrusive thoughts predicted concurrent distress after accounting for brooding and relationship characteristics. Further, higher brooding and lower reflection predicted higher distress prospectively. Concurrent growth was predicted by both higher brooding and more deliberate relationship-dissolution thoughts. Prospectively, T1 dissolution intrusive thoughts predicted higher T2 deliberate thoughts, and the interaction between these two constructs predicted higher T2 growth. Therefore, deliberately thinking of the dissolution was related to positive psychological outcomes. In contrast, intrusive dissolution cognitions and a tendency for brooding had a mixed (paradoxical) association with psychological adjustment. Copyright © 2016 John Wiley & Sons, Ltd.

46 CFR 160.036-3 - Materials, workmanship, construction and performance requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

...) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Hand-Held Rocket... performance requirements. (a) Materials. The materials used in handheld rocket-propelled parachute red flare... protected against corrosion. (b) Workmanship. Handheld rocket-propelled parachute red flare distress signals...

46 CFR 160.036-3 - Materials, workmanship, construction and performance requirements.

Code of Federal Regulations, 2012 CFR

2012-10-01

...) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Hand-Held Rocket... performance requirements. (a) Materials. The materials used in handheld rocket-propelled parachute red flare... protected against corrosion. (b) Workmanship. Handheld rocket-propelled parachute red flare distress signals...

46 CFR 160.036-3 - Materials, workmanship, construction and performance requirements.

Code of Federal Regulations, 2014 CFR

2014-10-01

...) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Hand-Held Rocket... performance requirements. (a) Materials. The materials used in handheld rocket-propelled parachute red flare... protected against corrosion. (b) Workmanship. Handheld rocket-propelled parachute red flare distress signals...

46 CFR 160.036-3 - Materials, workmanship, construction and performance requirements.

Code of Federal Regulations, 2013 CFR

2013-10-01

...) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Hand-Held Rocket... performance requirements. (a) Materials. The materials used in handheld rocket-propelled parachute red flare... protected against corrosion. (b) Workmanship. Handheld rocket-propelled parachute red flare distress signals...

46 CFR 160.036-3 - Materials, workmanship, construction and performance requirements.

Code of Federal Regulations, 2011 CFR

2011-10-01

...) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Hand-Held Rocket... performance requirements. (a) Materials. The materials used in handheld rocket-propelled parachute red flare... protected against corrosion. (b) Workmanship. Handheld rocket-propelled parachute red flare distress signals...

Gender role conflict and emotional approach coping in men with cancer.

PubMed

Hoyt, Michael A

2009-10-01

The utility of emotional approach coping (EAC), or expressing and processing emotions, has been equivocal for men. Gender role conflict, or the negative cognitive, emotional and behavioural consequences associated with male gender role socialisation, likely shape coping responses and may negatively affect the efficacy of men's emotion-directed coping efforts and adjustment to cancer. Perceptions of receptiveness of one's interpersonal environment may be particularly important to the effectiveness of EAC. This study examined the relationships among EAC, gender role conflict, and distress in a group of 183 men with cancer. Structural equation modelling revealed that higher gender role conflict was associated with lower emotional expression, which in turn was associated with greater distress. Gender role conflict was not related to emotional processing. Higher gender role conflict also was associated directly with more distress. In subsequent analyses, social constraints and age were examined as possible moderators of EAC. Emotional expression was related to more psychological distress for those in highly constrained environments; and emotional processing was associated with more distress with younger age. Emotional expression may be particularly affected by social influences related to gender and social receptivity. More research is needed to better distinguish constructive and unconstructive emotional processing.

Defining and addressing moral distress: tools for critical care nursing leaders.

PubMed

Rushton, Cynda Hylton

2006-01-01

Nurse clinicians may experience moral distress when they are unable to translate their moral choices into moral action. The costs of unrelieved moral distress are high; ultimately, as with all unresolved professional conflicts, the quality of patient care suffers. As a systematic process for change, this article offers the AACN's Model to Rise Above Moral Distress, describing four A's: ask, affirm, assess, and act. To help critical care nurses working to address moral distress, the article identifies 11 action steps they can take to develop an ethical practice environment.

Psychological Flexibility as a Buffer against Caregiver Distress in Families with Psychosis.

PubMed

Jansen, Jens E; Haahr, Ulrik H; Lyse, Hanne-Grethe; Pedersen, Marlene B; Trauelsen, Anne M; Simonsen, Erik

2017-01-01

Background: Research has shown that caregivers of persons with psychosis play an invaluable role in recovery, but unfortunately, often report high levels of distress. While cognitive models of caregiver distress have been well-supported, there is still limited knowledge of the psychological factors involved. Recent advances in cognitive behavioral therapy seem to converge on the importance of acceptance- and mindfulness based processes. Aim: To examine the impact of psychological flexibility on caregiver distress in the early phases of psychosis, while controlling for known predictors of caregiver distress. Method: Within a cross-sectional design, 101 caregivers of 38 persons with first-episode psychosis in a clinical epidemiological sample completed a series of self-report measures. Results: A linear mixed model analysis found that, after controlling for caregiver socio-demographic factors, service user symptoms, drug use and global functioning, psychological flexibility was a significant predictor of caregiver distress. Conclusion: Greater level of psychological flexibility in caregivers, seems to be related to lower levels of caregiver distress. This finding corresponds to studies within a broad range of emotional disorders. There may be important clinical implications in terms of facilitating the process of acceptance through interventions from the 'third-wave' or contextual cognitive behavioral therapies.

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.

Pathways of Risk and Resilience: Impact of a Family Resilience Program on Active-Duty Military Parents.

PubMed

Saltzman, William R; Lester, Patricia; Milburn, Norweeta; Woodward, Kirsten; Stein, Judith

2016-12-01

Over the past decade, studies into the impact of wartime deployment and related adversities on service members and their families have offered empirical support for systemic models of family functioning and a more nuanced understanding of the mechanisms by which stress and trauma reverberate across family and partner relationships. They have also advanced our understanding of the ways in which families may contribute to the resilience of children and parents contending with the stressors of serial deployments and parental physical and psychological injuries. This study is the latest in a series designed to further clarify the systemic functioning of military families and to explicate the role of resilient family processes in reducing symptoms of distress and poor adaptation among family members. Drawing upon the implementation of the Families Overcoming Under Stress (FOCUS) Family Resilience Program at 14 active-duty military installations across the United States, structural equation modeling was conducted with data from 434 marine and navy active-duty families who participated in the FOCUS program. The goal was to better understand the ways in which parental distress reverberates across military family systems and, through longitudinal path analytic modeling, determine the pathways of program impact on parental distress. The findings indicated significant cross-influence of distress between the military and civilian parents within families, families with more distressed military parents were more likely to sustain participation in the program, and reductions in distress among both military and civilian parents were significantly mediated by improvements in resilient family processes. These results are consistent with family systemic and resilient models that support preventive interventions designed to enhance family resilient processes as an important part of comprehensive services for distressed military families. © 2016 Family Process Institute.

It’s Not What You Think, It’s How You Relate to It: Dispositional Mindfulness Moderates the Relationship Between Psychological Distress and the Cortisol Awakening Response

PubMed Central

Daubenmier, Jennifer; Hayden, Dara; Chang, Vickie; Epel, Elissa

2014-01-01

Objective The cortisol awakening response (CAR) is a natural metabolic response that can be potentiated by negative cognitive-emotional processes, including stress appraisals, negative affect, and rumination. Psychological distress and the CAR are not consistently related, however. Individual differences in aspects of dispositional mindfulness which reflect how people relate to negative thoughts and emotions may help explain such inconsistencies. We tested whether the tendency to 1) label and describe inner experiences and 2) accept negative thoughts and feelings without judgment moderated the association between psychological distress and the CAR. Methods Self-reported dispositional mindfulness, perceived stress, anxiety, negative affect, and rumination, and the CAR were assessed among overweight/obese women. Regression analyses were conducted to examine whether dispositional mindfulness moderated the relationship between indicators of psychological distress and the CAR. Results While psychological distress was consistently positively related to the CAR, these associations were qualified by significant interactions with both components of dispositional mindfulness. Psychological distress was associated with the CAR at lower levels of dispositional mindfulness but not at higher levels. Conclusion These findings support the idea that the tendency to describe and accept distressing experiences may buffer the impact of psychological distress on physiological arousal. These metacognitive processes may be important moderators in unraveling the complex relationship between psychological distress and physiological stress reactivity. Further research is recommended to replicate this approach in other populations. PMID:24971591

Psychological distress following a motor vehicle crash: preliminary results of a randomised controlled trial investigating brief psychological interventions.

PubMed

Guest, Rebecca; Tran, Yvonne; Gopinath, Bamini; Cameron, Ian D; Craig, Ashley

2018-06-27

The preliminary results of a randomised controlled trial are presented. The aim of the trial is to determine the efficacy, feasibility and acceptability of email-delivered psychological interventions with telephone support, for adults injured in a motor vehicle crash engaged in seeking compensation. The primary intention for this preliminary analysis was to investigate those who were psychologically distressed and to stop the trial midway to evaluate whether the safety endpoints were necessary. The analysis included 90 adult participants randomised to one of three groups, who were assessed at baseline and post-intervention at 3 months. Cognitive behaviour therapy (CBT) or healthy lifestyle interventions were delivered over 10 weeks, involving fortnightly emailed modules plus clinically focussed telephone support, with the aim of reducing psychological distress. An active waiting list of control subjects received non-clinically focussed telephone contact over the same period along with claim-related reading material. Depression Anxiety Stress Scales (DASS) and Impact of Events Scale (Revised) (IES-R) were used to assess psychological distress. Psychiatric interviews were used to diagnose major depressive disorder and post-traumatic stress disorder. Aspects of acceptability and feasibility were also assessed. For those diagnosed with depression at baseline in the CBT group, psychological distress reduced by around 16%. For those with depression in the healthy lifestyle group, distress increased marginally. For those in the control group with depression, distress also decreased (by 18% according to DASS-21 and 1.2% according to IES-R). For those without depression, significant reductions in distress occurred, regardless of group (P < .05). The results suggest that for those with depression, a healthy lifestyle intervention is contraindicated, necessitating the cessation of recruitment to this intervention. The interventions were reported as acceptable by the majority and the data indicated that the study is feasible. CBT with telephone support reduced psychological distress in physically injured people with depression who are engaged in seeking compensation. However, time plus fortnightly telephone contact with claim-related reading material may be sufficient to reduce distress in those who are depressed. For those who were not depressed, time plus telephone support is most likely sufficient enough to assist them to recover. The trial will continue with further recruitment to only the CBT and control groups, over longer follow-up periods. Australian and New Zealand Clinical Trials Registry: Preventing psychological distress following a motor vehicle accident; ACTRN12615000326594 . Registered on 9 April 2015.

Family-Based Processes Associated with Adolescent Distress, Substance Use and Risky Sexual Behavior in Families Affected by Maternal HIV

ERIC Educational Resources Information Center

Lester, Patricia; Stein, Judith A.; Bursch, Brenda; Rice, Eric; Green, Sara; Penniman, Typhanye; Rotheram-Borus, Mary Jane

2010-01-01

The present study investigated how maternal HIV and mediating family processes are associated with adolescent distress, substance use, and risky sexual behavior. Mother-adolescent (ages 12-21) dyads (N = 264) were recruited from neighborhoods where the HIV-affected families resided (161 had mothers with HIV). Mediating family processes were youth…

Prevalence and correlates of mental distress among regular undergraduate students of Hawassa University: a cross sectional survey.

PubMed

Tesfaye, Anteneh

2009-04-01

Mental health is gradually being recognized as an important public health concern. There is high level of mental distress in the community. Student integration in Universities is usually difficult and involves many factors which are potentially stressing. To assess the prevalence of mental distress (Common mental disorders) among regular undergraduate students of Hawassa University, and to study its correlates This cross sectional study was conducted among regular undergraduate students of Hawassa University, during the period May 28-June 6, 2007, which was after the mid semester exam in the second semester of the academic year September, 2006- July, 2007. 'SRQ-20 items' was used to measure the prevalence of common mental disorders among the students. A total of 1198 students were included in the study. There was very high level of mental distress (49.1%). Highest levels of mental distress were observed among students of the Main Campus, in the Faculty of Business and economics, among freshman students and those students who never follow religious programs irrespective of their religion. Difficulty in making friends and dating; active sexual practice; conflicts in the dormitories with fellow students; income and stationary materials inadequacy; lack of adequate access to: academic reference materials; lack of adequate access to sanitary facility and recreational facility; overcrowding and worrying about personal safety were associated with higher levels of mental distress. Detailed and focused study about the campus facilities that were proved to be deficient; correction of the deficiencies and the inclusion of a course in the freshman students' curricula that focuses on the mental well being of the young adult, means of coping with stress, possible challenges in the university life and other related issues (with their solutions) are discussed.

Resolving moral distress when caring for patients who smoke while using home oxygen therapy.

PubMed

Kayser, John W; Nault, Diane; Ostiguy, Gaston

2012-04-01

More than 1 million people in the United States use home oxygen therapy and its demand is growing. However, there are dangers associated with its use, such as burns and home fires, and smoking is the most common cause of these incidents. As a result, home healthcare nurses feel intense emotional distress when caring for patients who smoke while using home oxygen therapy. This distress arises from the nurse's competing sense of moral duties toward these patients. The purpose of this article is to describe this distress, then to propose a 3-step process of taking concrete actions to resolve the distress.

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

Serious Psychological Distress Among African Americans: Findings from the National Survey of American Life

PubMed Central

Taylor, Robert Joseph; Nguyen, Ann W.; Chatters, Linda M.

2015-01-01

Despite their low social standing, there remains a paucity of research on psychological distress among African Americans. We use data from the 2001–2003 National Survey of American Life to explore a wide array of social and economic predictors of psychological distress among African American adults ages 18 and older, including previous incarceration, history of welfare receipt, and having a family member who is either currently incarcerated or homeless. Younger age, lower income, lower educational attainment, and lower self-rated health and childhood health are associated with higher levels of psychological distress among African Americans. We also find a strong association between higher levels of material hardship, previous incarceration history, and the presence of a family member who is either incarcerated or homeless and higher levels of psychological distress. The findings highlight the importance of considering unique types of social disadvantage experienced by African Americans living in a highly stratified society. PMID:27499562

Management of pyothorax.

PubMed

Holmberg, D L

1979-05-01

Pyothorax is a serious disease process which requires both medical and surgical intervention. Late recognition, management problems, and likely recurrence make successful treatment difficult and often frustrating. Aims of therapy should be to avoid undue stress to the patient, to relieve respiratory distress by thoracocentesis, to eliminate infectious agents with antimicrobials, to remove pleural exudate, and to provide supportive care. Close monitoring of the patient is necessary to prevent iatrogenic complications such as pneumothorax, hemothorax, hypothermia, or hypoproteinemia. Exploratory thoracotomy for removal of granulomatous material and fibroelastic pleural "peels" is occasionally necessary to resolve compressive cardiopulmonary lesions.

The crossover of psychological distress from leaders to subordinates in teams: The role of abusive supervision, psychological capital, and team performance.

PubMed

Li, Yuhui; Wang, Zhen; Yang, Liu-Qin; Liu, Songbo

2016-04-01

This study examines the underlying mechanism of the crossover process in work teams. Drawing on conservation of resources theory, we hypothesize that a leader's psychological distress positively influences subordinates' psychological distress through abusive supervision. We further hypothesize that team performance attenuates the association between a leader's psychological distress and abusive supervision. In addition, we expect that psychological capital attenuates the positive relationship between abusive supervision and subordinates' psychological distress. Participants were drawn from 86 business teams, and multisource data were collected. The hypotheses were tested with multilevel analysis. Results supported the crossover of psychological distress from leader to subordinates, and abusive supervision serves as a mediating mechanism. The positive relationship between a leader's distress and abusive supervision is stronger when team performance is lower. In addition, the positive relationship between abusive supervision and subordinates' psychological distress is stronger when subordinates' psychological capital is lower. (c) 2016 APA, all rights reserved).

Understanding Distress in People with Severe Communication Difficulties: Developing and Assessing the Disability Distress Assessment Tool (DisDAT)

ERIC Educational Resources Information Center

Regnard, C.; Reynolds, Joanna; Watson, Bill; Matthews, Dorothy; Gibson, Lynn; Clarke, Charlotte

2007-01-01

Background: Meaningful communication with people with profound communication difficulties depends on the ability of carers to recognize and translate many different verbal cues. Carers appear to be intuitively skilled at identifying distress cues, but have little confidence in their observations. To help in this process, a number of pain tools…

Assessing the Consumer Food Environment in Restaurants by Neighbourhood Distress Level across Saskatoon, Saskatchewan.

PubMed

Wang, Jin; Engler-Stringer, Rachel; Muhajarine, Nazeem

2016-03-01

To assess the consumer food environment in restaurants in Saskatoon, using the Nutrition Environment Measures Survey for Restaurants (NEMS-R), to examine differences by neighbourhood distress level and to reflect on the need for further refinement of the assessment of restaurant consumer food environments. Neighbourhoods were classified as low, middle, or high distress level based on the socioeconomic indicators (income, employment, and education) in the Material Deprivation Index. Differences in restaurant consumer food environments, indicated by mean NEMS-R total and sub-scores, were examined by various restaurant categories and by varying neighbourhood distress levels. Chain coffee shops and pita and sandwich restaurants had higher NEMS-R totals and "Healthy Entrées" sub-scores; however, burger and chicken restaurants and pizza restaurants had more barriers to healthful eating. Although restaurants in lower distress level neighbourhoods generally rated healthier (higher NEMS-R scores), only a few measures (such as "Facilitators" and "Barriers") significantly differed by neighbourhood distress level. The findings highlight the importance of developing interventions to improve restaurant consumer food environments, especially in neighbourhoods with higher distress levels. The results suggest that reliable measures of the consumer food environment could be developed beginning with what can be measured by NEMS-R.

A Scientific Cognitive-Behavioral Model of Tinnitus: Novel Conceptualizations of Tinnitus Distress

PubMed Central

McKenna, Laurence; Handscomb, Lucy; Hoare, Derek J.; Hall, Deborah A.

2014-01-01

The importance of psychological factors in tinnitus distress has been formally recognized for almost three decades. The psychological understanding of why tinnitus can be a distressing condition posits that it becomes problematic when it acquires an emotive significance through cognitive processes. Principle therapeutic efforts are directed at reducing or removing the cognitive (and behavioral) obstacles to habituation. Here, the evidence relevant to a new psychological model of tinnitus is critically reviewed. The model posits that patients’ interpretations of tinnitus and the changes in behavior that result are given a central role in creating and maintaining distress. The importance of selective attention and the possibility that this leads to distorted perception of tinnitus is highlighted. From this body of evidence, we propose a coherent cognitive-behavioral model of tinnitus distress that is more in keeping with contemporary psychological theories of clinical problems (particularly that of insomnia) and which postulates a number of behavioral processes that are seen as cognitively mediated. This new model provides testable hypotheses to guide future research to unravel the complex mechanisms underpinning tinnitus distress. It is also well suited to define individual symptomatology and to provide a framework for the delivery of cognitive-behavioral therapy. PMID:25339938

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

PubMed Central

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

2016-01-01

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

Distress Tolerance and Psychopathological Symptoms and Disorders: A Review of the Empirical Literature among Adults

PubMed Central

Leyro, Teresa M.; Zvolensky, Michael J.; Bernstein, Amit

2010-01-01

In the present paper, we review theory and empirical study of distress tolerance, an emerging risk factor candidate for various forms of psychopathology. Despite the long-standing interest in, and promise of work on, distress tolerance for understanding adult psychopathology, there has not been a comprehensive review of the extant empirical literature focused on the construct. As a result, a comprehensive synthesis of theoretical and empirical scholarship on distress tolerance including integration of extant research on the relations between distress tolerance and psychopathology is lacking. Inspection of the scientific literature indicates that there are a number of promising ways to conceptualize and measure distress tolerance, as well as documented relations between distress tolerance factor(s) and psychopathological symptoms and disorders. Although promising, there also is notable conceptual and operational heterogeneity across the distress tolerance literature(s). Moreoever, a number of basic questions remain unanswered regarding the associations between distress tolerance and other risk and protective factors and processes, as well as its putative role(s) in vulnerability for, and resilience to, psychopathology. Thus, the current paper provides a comprehensive review of past and contemporary theory and research and proposes key areas for future empirical study of this construct. PMID:20565169

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.

Cannabis, alcohol use, psychological distress, and decision-making style.

PubMed

Phillips, James G; Ogeil, Rowan P

2017-09-01

There have been suggestions of hypofrontality in cannabis users. To understand cannabis-related differences in decisional processes, Janis and Mann's conflict model of decision making was applied to recreational cannabis smokers who varied in their alcohol use and level of psychological distress. An online sample of recreational substance users (114 male, 119 female) completed the Melbourne Decision Making Questionnaire, the Alcohol Use Disorders Identification Test (AUDIT), Kessler's Psychological Distress Scale (K10), and the Severity of Dependence Scale (SDS) for cannabis. Multivariate analysis of variance examined self-reported decision-making styles as a function of gender, recent cannabis use, risky alcohol consumption, and levels of psychological distress. Psychological distress was associated with lower decisional self-esteem and higher levels of procrastination and buck-passing. There were gender differences associated with cannabis use. Female cannabis users reported higher levels of hypervigilance, while male cannabis users reported lower levels of buck-passing. Although there was little indication of an avoidant decisional style in cannabis users, the results suggest that cannabis affects decisional processes, contributing to panic in females and impulsivity in males.

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.

Working on the Edge: The Meaning of Work for People Recovering from Severe Mental Distress in Norway

ERIC Educational Resources Information Center

Borg, Marit; Kristiansen, Kristjana

2008-01-01

Most citizens with long-term mental distress want a real job, and both Norway and European policies agree that work is a crucial part of social inclusion goals. Yet we know little about the actual impact of work on the recovery process for people with severe and often enduring mental distress. This article reports findings from a qualitative study…

Different Sources of Dignity-Related Distress in Women Receiving Chemotherapy for Breast Cancer

PubMed Central

Shahhoseini, Somaye; Borhani, Fariba; Shoorideh, Foroozan Atashzadeh; Kavousi, Amir; Bagheri, Hossein; Almasi-Hashiani, Amir

2017-01-01

Background: Identification of different sources of dignity-related distress experienced by people nearing the end of life may help nurses to provide better care services. This study was conducted to determine sources of dignity-related distress from the perspective of women with breast cancer undergoing chemotherapy. Materials and Methods: In this cross sectional study, the participants comprised 207 women with breast cancer undergoing chemotherapy in chemotherapy clinics in hospitals of Tehran, Iran. The Cronbach’s coefficient alpha for the PDI was 0.76. Validity of PDI by confirmatory factor analysis shows that the comparative Fit Index of this instrument is 0.96 and so it is appropriate for application in different setting. Data were analyzed by Stata version 13. Results: Patients were mostly concerned about the distress caused by disease symptoms (mean; 2.4061, S.D.; 0.96), followed by existential distress (mean; 1.8784, S.D.; 0.75), peace of mind (mean; 1.871, S.D.; 0.77), dependence (mean; 1.8647, S.D.; 0.98), and social support (mean; 1.4097, S.D.; 0.99), respectively, in order of highest scores. Conclusion: Considering that the patients were mostly concerned about the distress caused by disease symptoms, followed by existential distress, peace of mind, dependency, and social support, it seems necessary to take further measures toward addressing these issues. PMID:29172264

Distress modeling for DARWin-ME : final report.

DOT National Transportation Integrated Search

2013-12-01

Distress prediction models, or transfer functions, are key components of the Pavement M-E Design and relevant analysis. The accuracy of such models depends on a successful process of calibration and subsequent validation of model coefficients in the ...

You are such a bad child! Appraisals as mechanisms of parental negative and positive affect.

PubMed

Gavita, Oana Alexandra; David, Daniel; DiGiuseppe, Raymond

2014-01-01

Although parent cognitions are considered important predictors that determine specific emotional reactions and parental practices, models on the cognitive strategies for regulating parental distress or positive emotions are not well developed. Our aim was to investigate the nature of cognitions involved in parental distress and satisfaction, in terms of their specificity (parental or general) and their processing levels (inferential or evaluative cognitions). We hypothesized that parent's specific evaluative cognitions will mediate the impact of more general and inferential cognitive structures on their affective reactions. We used bootstrapping procedures in order to test the mediation models proposed. Results obtained show indeed that rather specific evaluative parental cognitions are mediating the relationship between general cognitions and parental distress. In terms of the cognitive processing levels, it seems that when parents hold both low self-efficacy and parental negative global evaluations for the self/child, this adds significantly to their distress.

Linkages between spouses' psychological distress and marital conflict in the home.

PubMed

Papp, Lauren M; Goeke-Morey, Marcie C; Cummings, E Mark

2007-09-01

To elucidate the processes that underlie the established association between psychopathology and marital functioning, researchers have given attention to how symptomatic individuals manage their interpersonal contexts, particularly during the handling of disagreements. In the current study, the authors evaluate the role of marital conflict strategies in relation to wives' and husbands' psychological distress levels. A sample of 100 community-based couples completed assessments of psychological distress and diaries describing marital conflict that occurred at home during a 15-day reporting period. Findings from multilevel modeling of dyadic data revealed associations between both spouses' psychological distress and multiple behavioral and emotional conflict expressions in the home. Psychological symptoms uniquely predicted the occurrence of certain conflict expressions, even when accounting for global negative marital sentiments. The findings encourage subsequent consideration of marital conflict expressions and resolution strategies when studying processes involved in the marriage-psychological adjustment link. PsycINFO Database Record (c) 2007 APA, all rights reserved

The relationship between food frequency and menstrual distress in high school females

PubMed Central

Mohamadirizi, Soheila; Kordi, Masoumeh

2015-01-01

Background: Nutrition pattern is one of the important factors predicting menstrual distress, which varies among different cultures and countries. The purpose of this study is to determine the relationship between food frequency and menstrual distress in high school girls from Mashhad. Materials and Methods: This cross-sectional study was conducted in 2012 using a two-stage sampling method on 407 high school female students from Mashhad who met the inclusion criteria. Subjects completed questionnaires of demographic characteristics, food frequency, and Menstrual Distress Questionnaire (MDQ) during three phases of the menstrual cycle (a week before bleeding, during menstrual bleeding period, and a week after menstruation). The collected data were analyzed by statistical tests such as Pearson correlation coefficient test, independent Student's t-test, and one-way analysis of variance (ANOVA). Results: Results showed that 87.7% of the students were at moderate economic status, 82.2% were exposed to cigarette smoke, 94.8% had mothers without university education, and 9.4% had working mothers. About 71% of the students reported minor pre-menstruation distress, 81% reported minor distress during bleeding, and 39% reported minor post-menstruation distress. In addition, the mean (SD) values for sweet–fatty foods, salty–fatty foods, fast foods, and caffeine were 3.6, 3.3, 1.3, and 10.2 per week, respectively. In addition, Pearson correlation coefficient test showed no significant correlation between total menstruation distress and food frequency (P > 0.05). Conclusions: With regard to the inappropriate food frequency and high intensity of menstrual distress among high school students and as health care and educational efforts for prevention and health promotion in society are among the duties of health workers, the results of this study can help the officials involved in education to emphasize on nutrition and the menstrual health of students. PMID:26793254

Understanding the relationship between stress, distress and healthy lifestyle behaviour: a qualitative study of patients and general practitioners.

PubMed

McKenzie, Suzanne H; Harris, Mark F

2013-11-01

The process of initiating and maintaining healthy lifestyle behaviours is complex, includes a number of distinct phases and is not static. Theoretical models of behaviour change consider psychological constructs such as intention and self efficacy but do not clearly consider the role of stress or psychological distress. General practice based interventions addressing lifestyle behaviours have been demonstrated to be feasible and effective however it is not clear whether general practitioners (GPs) take psychological health into consideration when discussing lifestyle behaviours. This qualitative study explores GPs' and patients' perspectives about the relationship between external stressors, psychological distress and maintaining healthy lifestyle behaviours. Semi-structured telephone interviews were conducted with 16 patients and 5 GPs. Transcripts from the interviews were thematically analysed and a conceptual model developed to explain the relationship between external stressors, psychological distress and healthly lifestyle behaviours. Participants were motivated to maintain a healthy lifestyle however they described a range of external factors that impacted on behaviour in both positive and negative ways, either directly or via their impact on psychological distress. The impact of external factors was moderated by coping strategies, beliefs, habits and social support. In some cases the process of changing or maintaining healthy behaviour also caused distress. The concept of a threshold level of distress was evident in the data with patients and GPs describing a certain level of distress required before it negatively influenced behaviour. Maintaining healthy lifestyle behaviours is complex and constantly under challenge from external stressors. Practitioners can assist patients with maintaining healthy behaviour by providing targeted support to moderate the impact of external stressors.

Moral distress in undergraduate nursing students: A systematic review.

PubMed

Sasso, Loredana; Bagnasco, Annamaria; Bianchi, Monica; Bressan, Valentina; Carnevale, Franco

2016-08-01

Nurses and nursing students appear vulnerable to moral distress when faced with ethical dilemmas or decision-making in clinical practice. As a result, they may experience professional dissatisfaction and their relationships with patients, families, and colleagues may be compromised. The impact of moral distress may manifest as anger, feelings of guilt and frustration, a desire to give up the profession, loss of self-esteem, depression, and anxiety. The purpose of this review was to describe how dilemmas and environmental, relational, and organizational factors contribute to moral distress in undergraduate student nurses during their clinical experience and professional education. The research design was a systematic literature review. The search produced a total of 157 articles published between 2004 and 2014. These were screened with the assessment sheet designed by Hawker and colleagues. Four articles matched the search criteria (one quantitative study and three qualitative), and these were separately read and analyzed by the researchers. The process of review and analysis of the data was supervised by a colleague experienced in moral distress who provided an independent quality check. Since this was a systematic review, no ethical approval was required. From the analysis, it emerged that inequalities and healthcare disparities, the relationship with the mentor, and students' individual characteristics can all impact negatively on the decisions taken and the nursing care provided, generating moral distress. All these factors condition both the clinical experience and learning process, in addition to the professional development and the possible care choices of future nurses. Few studies dealt with moral distress in the setting of nurse education, and there is a knowledge gap related to this phenomenon. The results of this review underline the need for further research regarding interventions that can minimize moral distress in undergraduate nursing students. © The Author(s) 2015.

Effects of Intrinsic and Extrinsic Factors on the Level of Hope and Psychological Health Status of Patients with Cervical Cancer During Radiotherapy.

PubMed

Li, Li-Rong; Lin, Mei-Guang; Liang, Juan; Hu, Qiong-Yan; Chen, Dan; Lan, Meng-Ying; Liang, Wu-Qing; Zeng, Yu-Ting; Wang, Ting; Fu, Gui-Fen

2017-07-19

BACKGROUND This study aimed to explore the factors affecting the level of hope and psychological health status of patients with cervical cancer (CC) during radiotherapy. MATERIAL AND METHODS A total of 480 CC patients were recruited. Psychological distress scale, Herth hope index, functional assessment cancer therapy-cervix, and Jolowiec coping scale were used to conduct surveys on psychological distress, level of hope, quality of life (QOL), and coping style to analyze the factors affecting the level of hope and psychological health status of CC patients. RESULTS The morbidity of significant psychological distress in 480 CC patients during radiotherapy was 68%, and the main factors causing psychological distress were emotional problems and physical problems. During radiotherapy, most patients had middle and high levels of hope, and the psychological distress index of patients was negatively correlated with the level of hope. The QOL of CC patients during radiotherapy were at middle and high levels, and the QOL was positively correlated with confrontment, optimism, appeasement, and self-reliance, but it was negatively correlated with predestination and emotional expression. CONCLUSIONS For CC patients during radiotherapy, the morbidity of psychological distress was high, but they were at middle and high levels of hope.

Effects of Intrinsic and Extrinsic Factors on the Level of Hope and Psychological Health Status of Patients with Cervical Cancer During Radiotherapy

PubMed Central

Li, Li-Rong; Lin, Mei-Guang; Liang, Juan; Hu, Qiong-Yan; Chen, Dan; Lan, Meng-Ying; Liang, Wu-Qing; Zeng, Yu-Ting; Wang, Ting; Fu, Gui-Fen

2017-01-01

Background This study aimed to explore the factors affecting the level of hope and psychological health status of patients with cervical cancer (CC) during radiotherapy. Material/Methods A total of 480 CC patients were recruited. Psychological distress scale, Herth hope index, functional assessment cancer therapy-cervix, and Jolowiec coping scale were used to conduct surveys on psychological distress, level of hope, quality of life (QOL), and coping style to analyze the factors affecting the level of hope and psychological health status of CC patients. Results The morbidity of significant psychological distress in 480 CC patients during radiotherapy was 68%, and the main factors causing psychological distress were emotional problems and physical problems. During radiotherapy, most patients had middle and high levels of hope, and the psychological distress index of patients was negatively correlated with the level of hope. The QOL of CC patients during radiotherapy were at middle and high levels, and the QOL was positively correlated with confrontment, optimism, appeasement, and self-reliance, but it was negatively correlated with predestination and emotional expression. Conclusions For CC patients during radiotherapy, the morbidity of psychological distress was high, but they were at middle and high levels of hope. PMID:28720749

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

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.

Integrating between-session interventions (homework) in therapy: the importance of the therapeutic relationship and cognitive case conceptualization.

PubMed

Cronin, Timothy J; Lawrence, Katherine A; Taylor, Kate; Norton, Peter J; Kazantzis, Nikolaos

2015-05-01

Between-session interventions, or homework, are crucial to a range of psychological therapies, including cognitive behavior therapy (CBT). Therapeutic interventions often involve experiencing emotions and situations, or examining strongly held views about their problems, that clients can find distressing. Hence, the clinician faces a particular challenge in collaborating with the client to carry out these interventions between sessions. In this article, we convey how this process in CBT requires not only a consideration of the theoretically meaningful determinants of adherence behavior but also a sophisticated cognitive case conceptualization. Using case material, we illustrate the interplay between in-session design, planning, and review of between-session interventions and the conceptualization. We also include a distinction between generic elements of the therapeutic relationship and CBT-specific elements. The case material also attends to the person of the therapist, and his or her own cognitive and emotional reactions occurring throughout the process of discussing between-session interventions. © 2015 Wiley Periodicals, Inc.

Mindfulness and the attenuation of post-event processing in social phobia: an experimental investigation.

PubMed

Cassin, Stephanie E; Rector, Neil A

2011-01-01

The present experimental study examined the ability of metacognitive strategies to reduce the distress associated with post-event processing (PEP). Individuals with DSM-IV generalized social phobia (N = 57) were randomly allocated to receive brief training in mindfulness, distraction, or no training (control group). Next, they underwent an experimental PEP induction. Following the induction, they were instructed to apply the metacognitive strategy (mindfulness or distraction) they were taught or to continue thinking about the social event the way they typically would following such an event (control). Participants rated their distress on a visual analogue scale prior to the PEP induction, and then every minute for 5 min while applying the metacognitive strategy. They also rated their affect immediately after applying the metacognitive strategy. Results suggest that mindfulness reduces distress significantly over the post-event period and results in significantly more positive affect than when receiving no training. In contrast, distraction does not reduce distress over the post-event period performs comparable to receiving no training. The results of this experimental investigation suggest that mindfulness has the potential to reduce distress associated with PEP and provide further support for the clinical utility of mindfulness in the treatment of generalized social phobia.

An assessment of the feasibility of developing and implementing an automated pavement distress survey system incorporating digital image processing.

DOT National Transportation Integrated Search

1997-01-01

The rational allocation of pavement maintenance resources requires the periodic assessment of the condition of all pavements. Traditional manual pavement distress surveys, which are based on visual inspection, are labor intensive, slow, and expensive...

Self-distancing Buffers High Trait Anxious Pediatric Cancer Caregivers against Short- and Longer-term Distress

PubMed Central

Penner, Louis A; Guevarra, Darwin A.; Harper, Felicity W. K.; Taub, Jeffrey; Phipps, Sean; Albrecht, Terrance L.; Kross, Ethan

2015-01-01

Pediatric cancer caregivers are typically present at their child’s frequent, invasive treatments, and such treatments elicit substantial distress. Yet, variability exists in how even the most anxious caregivers cope. Here we examined one potential source of this variability: caregivers’ tendencies to self-distance when reflecting on their feelings surrounding their child’s treatments. We measured caregivers’ self-distancing and trait anxiety at baseline, anticipatory anxiety during their child’s treatment procedures, and psychological distress and avoidance three months later. Self-distancing buffered high (but not low) trait anxious caregivers against short- and long-term distress without promoting avoidance. These findings held when controlling for other buffers, highlighting the unique benefits of self-distancing. These results identify a coping process that buffers vulnerable caregivers against a chronic life stressor while also demonstrating the ecological validly of laboratory research on self-distancing. Future research is needed to explicate causality and the cognitive and physiological processes that mediate these results. PMID:27617183

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.

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

PubMed Central

Saravanan, Coumaravelou; Kingston, Rajiah

2014-01-01

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

Cross-cultural re-entry for missionaries: a new application for the Dual Process Model.

PubMed

Selby, Susan; Clark, Sheila; Braunack-Mayer, Annette; Jones, Alison; Moulding, Nicole; Beilby, Justin

Nearly half a million foreign aid workers currently work worldwide, including over 140,000 missionaries. During re-entry these workers may experience significant psychological distress. This article positions previous research about psychological distress during re-entry, emphasizing loss and grief. At present there is no identifiable theoretical framework to provide a basis for assessment, management, and prevention of re-entry distress in the clinical setting. The development of theoretical concepts and frameworks surrounding loss and grief including the Dual Process Model (DPM) are discussed. All the parameters of the DPM have been shown to be appropriate for the proposed re-entry model, the Dual Process Model applied to Re-entry (DPMR). It is proposed that the DPMR is an appropriate framework to address the processes and strategies of managing re-entry loss and grief. Possible future clinical applications and limitations of the proposed model are discussed. The DPMR is offered for further validation and use in clinical practice.

Acculturation, perceived discrimination, and psychological distress: Experiences of South Asians in Hong Kong.

PubMed

Tonsing, Kareen N; Tse, Samson; Tonsing, Jenny C

2016-02-01

Although migration itself may not compromise the mental health of immigrants, the acculturative process can involve highly stressful factors that are specific to immigrant and minority status. Using structural equation modeling, this study examined the relations between acculturation orientations, perceived discrimination, acculturative stress, and psychological distress among 229 Pakistani and 218 Nepalese migrants living in Hong Kong. Although the initial hypothesized model was not confirmed, a modified model with good fit indices showed that acculturation orientation mediated the relationships of perceived discrimination and acculturative stress with psychological distress. Of all the factors in the model, acculturative stress had the strongest association with psychological distress. © The Author(s) 2015.

Predicting Depression from Marital Distress and Attributional Processes.

ERIC Educational Resources Information Center

Heim, Susan Creekmore; Snyder, Douglas K.

1991-01-01

Examined the interaction between marital distress and spouses' attributions and expectancies regarding the marital relationship in predicting depressive symptoms in a mixed sample of 59 clinic and nonclinic couples. Best predictor of depression for both sexes was measure of disaffection, reflecting emotional distance and alienation in the…

Pavement Distress Evaluation Using 3D Depth Information from Stereo Vision

DOT National Transportation Integrated Search

2012-07-01

The focus of the current project funded by MIOH-UTC for the period 9/1/2010-8/31/2011 is to : enhance our earlier effort in providing a more robust image processing based pavement distress : detection and classification system. During the last few de...

Oxytocin reduces separation distress in piglets when given intranasally

USDA-ARS?s Scientific Manuscript database

Oxytocin (OT) is one of the neurobiological foundations of sociality. It acts as a neuropeptide in numerous social processes, from ultra-social to anti-social behaviors. Evidence supports a role for OT in social support, possibly by attenuating separation distress. Nonetheless, research on OT is lac...

Protective Isolation for Patients with Haematological Malignancies: A Pilot Study Investigating Patients' Distress and Use of Time.

PubMed

Annibali, O; Pensieri, C; Tomarchio, V; Biagioli, V; Pennacchini, M; Tendas, A; Tambone, V; Tirindelli, M C

2017-10-01

Background: Patients with haematological malignancies are often hospitalized in protective isolation until full neutrophil recovery in order to prevent infections. This descriptive pilot study evaluate the level of isolation-related distress and the use of free time in a sample of Italian onco-haematological patients who were hospitalized in protective isolation. Materials and Methods: Participants were 18 patients hospitalized in hematologic ward to receive induction therapy (n=12) or autologous stem cell transplant (n=6). They completed a self-report questionnaire before discharge. Results: Participants reported a moderate level of isolation-related distress, anxiety, and boredom: the more the anxiety and the boredom, the more the distress (r=.77; P<.001), (r=.79; P<.001), respectively. The activities performed during isolation were: watching TV (72.2%), reading (55.6%), thinking (33.3%), surfing in Internet or using PC (33.3%), and playing games or making cross-words (16.7%). Participants who reported pessimistic thinking had higher isolation-related distress (P=.004) as well as anxiety (P<.001) and boredom (P=.001). Conclusion: Haematology Units should support isolated patients in spending their time in recreational activities, allowing more contacts with immediate relatives and friends, providing free TV and Wi-Fi connection inside the room. In addition, patients should have to keep themselves physically active. Isolation-related distress could also be reduced by providing psychological support.

Protective Isolation for Patients with Haematological Malignancies: A Pilot Study Investigating Patients’ Distress and Use of Time

PubMed Central

Annibali, O.; Pensieri, C.; Tomarchio, V.; Biagioli, V.; Pennacchini, M.; Tendas, A.; Tambone, V.; Tirindelli, M.C.

2017-01-01

Background: Patients with haematological malignancies are often hospitalized in protective isolation until full neutrophil recovery in order to prevent infections. This descriptive pilot study evaluate the level of isolation-related distress and the use of free time in a sample of Italian onco-haematological patients who were hospitalized in protective isolation. Materials and Methods: Participants were 18 patients hospitalized in hematologic ward to receive induction therapy (n=12) or autologous stem cell transplant (n=6). They completed a self-report questionnaire before discharge. Results: Participants reported a moderate level of isolation-related distress, anxiety, and boredom: the more the anxiety and the boredom, the more the distress (r=.77; P<.001), (r=.79; P<.001), respectively. The activities performed during isolation were: watching TV (72.2%), reading (55.6%), thinking (33.3%), surfing in Internet or using PC (33.3%), and playing games or making cross-words (16.7%). Participants who reported pessimistic thinking had higher isolation-related distress (P=.004) as well as anxiety (P<.001) and boredom (P=.001). Conclusion: Haematology Units should support isolated patients in spending their time in recreational activities, allowing more contacts with immediate relatives and friends, providing free TV and Wi-Fi connection inside the room. In addition, patients should have to keep themselves physically active. Isolation-related distress could also be reduced by providing psychological support. PMID:29340129

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.

Psychological Distress and Coping amongst Higher Education Students: A Mixed Method Enquiry

PubMed Central

Deasy, Christine; Coughlan, Barry; Pironom, Julie; Jourdan, Didier; Mannix-McNamara, Patricia

2014-01-01

Background Psychological distress among higher education students is of global concern. Students on programmes with practicum components such as nursing and teacher education are exposed to additional stressors which may further increase their risk for psychological distress. The ways in which these students cope with distress has potential consequences for their health and academic performance. An in-depth understanding of how nursing/midwifery and teacher education students experience psychological distress and coping is necessary to enable higher education providers to adequately support these students. Methods This mixed method study was employed to establish self-reported psychological distress (General Health Questionnaire), coping processes (Ways of Coping Questionnaire) and lifestyle behaviour (Lifestyle Behaviour Questionnaire) of a total sample (n = 1557) of undergraduate nursing/midwifery and teacher education students in one university in Ireland. Individual interviews (n = 59) provided an in-depth understanding of students experiences of psychological distress and coping. Results A significant percentage (41.9%) of respondents was psychologically distressed. The factors which contributed to their distress, included study, financial, living and social pressures. Students used varied coping strategies including seeking social support, problem solving and escape avoidance. The positive relationship between elevated psychological distress and escape avoidance behaviours including substance use (alcohol, tobacco and cannabis) and unhealthy diet is of particular concern. Statistically significant relationships were identified between “escape-avoidance” and gender, age, marital status, place of residence, programme/year of study and lifestyle behaviours such as diet, substance use and physical inactivity. Conclusion The paper adds to existing research by illuminating the psychological distress experienced by undergraduate nursing/midwifery and teacher education students. It also identifies their distress, maladaptive coping and the relationship to their lifestyle behaviours. The findings can inform strategies to minimise student distress and maladaptive coping during college and in future professional years. PMID:25506825

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

PubMed

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

2018-04-03

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

Distress and patient-centered communication among veterans with incidental (not screen-detected) pulmonary nodules. A cohort study.

PubMed

Slatore, Christopher G; Golden, Sara E; Ganzini, Linda; Wiener, Renda Soylemez; Au, David H

2015-02-01

Incidental pulmonary nodule detection is postulated to cause distress, but the frequency and magnitude of that distress have not been reported. The quality of patient-clinician communication and the perceived risk of lung cancer may influence distress Objectives: To evaluate the association of communication processes with distress and the perceived risk of lung cancer using validated instruments. We conducted a prospective cohort study of patients with incidentally detected nodules who received care at one Department of Veterans Affairs Medical Center. We measured distress with the Impact of Event Scale and patient-centered communication with the Consultation Care Measure, both validated instruments. Risk of lung cancer was self-reported by participants. We used multivariable adjusted logistic regression to measure the association of communication quality with distress. Among 122 Veterans with incidental nodules, 23%, 12%, and 4% reported experiencing mild, moderate, and severe distress, respectively, at the time they were informed of the pulmonary nodule. Participant-reported risk of lung cancer was not associated with distress. In the adjusted model, high-quality communication was associated with decreased distress (odds ratio [OR] = 0.28, 95% confidence interval [CI] = 0.08-1.00, P = 0.05). Among participants who reported a risk of malignancy of 30% or less, high-quality communication was associated with decreased distress (OR = 0.15, 95% CI = 0.02-0.92, P = 0.04), but was not associated with distress for those who reported a risk greater than 30% (OR = 0.12 (95% CI = 0.00-3.97, P = 0.24), although the P value for interaction was not significant. Veterans with incidental pulmonary nodules frequently reported inadequate information exchange regarding their nodule. Many patients experience distress after they are informed that they have a pulmonary nodule, and high-quality patient-clinician communication is associated with decreased distress. Communication strategies that only target improved knowledge of the risk of malignancy may not be sufficient to reduce the distress associated with nodule detection.

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.

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.

Cognitive compensatory processes of older, clinically fit patients with hematologic malignancies undergoing chemotherapy: A longitudinal cohort study.

PubMed

Libert, Yves; Borghgraef, Cindy; Beguin, Yves; Delvaux, Nicole; Devos, Martine; Doyen, Chantal; Dubruille, Stéphanie; Etienne, Anne-Marie; Liénard, Aurore; Merckaert, Isabelle; Reynaert, Christine; Slachmuylder, Jean-Louis; Straetmans, Nicole; Van Den Neste, Eric; Bron, Dominique; Razavi, Darius

2017-12-01

Despite the well-known negative impacts of cancer and anticancer therapies on cognitive performance, little is known about the cognitive compensatory processes of older patients with cancer. This study was designed to investigate the cognitive compensatory processes of older, clinically fit patients with hematologic malignancies undergoing chemotherapy. We assessed 89 consecutive patients (age ≥ 65 y) without severe cognitive impairment and 89 age-, sex-, and education level-matched healthy controls. Cognitive compensatory processes were investigated by (1) comparing cognitive performance of patients and healthy controls in novel (first exposure to cognitive tasks) and non-novel (second exposure to the same cognitive tasks) contexts, and (2) assessing psychological factors that may facilitate or inhibit cognitive performance, such as motivation, psychological distress, and perceived cognitive performance. We assessed cognitive performance with the Trail-Making, Digit Span and FCSR-IR tests, psychological distress with the Hospital Anxiety and Depression Scale, and perceived cognitive performance with the FACT-Cog questionnaire. In novel and non-novel contexts, average cognitive performances of healthy controls were higher than those of patients and were associated with motivation. Cognitive performance of patients was not associated with investigated psychological factors in the novel context but was associated with motivation and psychological distress in the non-novel context. Older, clinically fit patients with hematologic malignancies undergoing chemotherapy demonstrated lower cognitive compensatory processes compared to healthy controls. Reducing distress and increasing motivation may improve cognitive compensatory processes of patients in non-novel contexts. Copyright © 2017 John Wiley & Sons, Ltd.

Compulsive buying in university students: its prevalence and relationships with materialism, psychological distress symptoms, and subjective well-being.

PubMed

Villardefrancos, Estíbaliz; Otero-López, José Manuel

2016-02-01

Compulsive buying has become a severe problem among young people. The prominent role that psychological variables play in this phenomenon support their consideration in establishing a risk profile for compulsive buying that serves as a guide for the development of prevention and treatment programs with guarantees of effectiveness. However, there are only a small number of studies in existence which have explored the compulsive buying prevalence among students, and none of them have been conducted in a Mediterranean country. This study aims to estimate the compulsive buying prevalence in a sample of university students from the region of Galicia (Spain). We also intend to determine if statistically significant differences exist between compulsive buyers and non-compulsive buyers in relation with gender, materialistic values, psychological distress symptoms and subjective well-being. Lastly, the clarification of which of the determinants examined represent risk or protection factors for compulsive buying constitutes another important objective of this paper. A total sample of 1448 university students participated in this study. They answered a battery of self-reports assessing gender, compulsive buying propensity, materialism, distress symptomatology, and well-being. Participants were initially classified as either compulsive buyers or non-compulsive buyers. Both groups were compared for the aforementioned variables through chi-square testing or variance analyses. Then, a multivariate logistic regression analysis was conducted to determine which of these determinants make up a risk profile for compulsive buying. The estimated prevalence of compulsive buying in the sample of university students considered was 7.4%. Statistically significant differences between compulsive buyers and non-compulsive buyers were detected for gender, and each and every one of the psychological variables explored. Specifically, it was confirmed that compulsive buyers obtained significantly higher scores in materialism's dimensions of importance, success, and happiness, and in the psychological distress symptoms of anxiety, depression, obsession-compulsion, hostility, and somatization. On the contrary, they presented significantly lower levels in self-esteem, life satisfaction, and optimism. Results of the logistic regression analysis confirmed that high scores in the importance dimension of materialism, in combination with the experiencing of symptoms of anxiety, depression, obsession-compulsion, hostility, and somatization, would constitute risk factors in relation with this phenomenon, and high levels of life satisfaction would act as a protection factor as for compulsive buying in the sample of students considered. Current findings revealed that 7.4% of the large sample of Spanish university students considered were classified as compulsive buyers. Additionally, it was confirmed that while materialism and psychological distress symptoms would represent vulnerability determinants increasing the propensity for compulsive buying, the high scores in life satisfaction would act to decrease the likelihood of becoming a compulsive buyer. Accordingly, our results suggested that prevention and intervention efforts in relation with compulsive buying among young people should include specific components aimed at the reduction of the importance assigned to money and possessions, and also at the relief of psychological distress symptoms. Copyright © 2015 Elsevier Inc. All rights reserved.

"It's a Burden You Carry": Describing Moral Distress in Emergency Nursing.

PubMed

Wolf, Lisa A; Perhats, Cydne; Delao, Altair M; Moon, Michael D; Clark, Paul R; Zavotsky, Kathleen E

2016-01-01

Moral distress in nursing has been studied in many settings, but there is a paucity of research on moral distress as it manifests in the emergency department. One study suggests a correlation between moral distress and aspects of burnout, and other researchers report that nurses have considered leaving their position or even their profession because of moral distress. Further exploration of these issues may provide insight into their effects on ED patient care and the emergency nursing profession. The purpose of this study was to explore the nature of moral distress as it is experienced and described by emergency nurses. A qualitative, exploratory design was employed using semi-structured focus groups for data collection. Using an iterative process, transcripts were analyzed for emerging themes by the research team. Six researchers analyzed the transcripts using a thematic analysis approach. Themes from the data included dysfunctional practice arena, being overwhelmed, and adaptive/maladaptive coping. Participants described, overall, a profound feeling of not being able to provide patient care as they wanted to. Causes of moral distress in emergency nurses are environment driven, not incident driven, as is described in other settings, and include a high-acuity, high-demand, technical environment with insufficient resources. Interventions should be targeted to improve environmental factors that contribute to the moral distress of emergency nurses. Future research should focus on the development and validation of an instrument to measure moral distress in this setting. Copyright © 2016 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

The relationship between loss of parents in the holocaust, intrusive memories, and distress among child survivors.

PubMed

Letzter-Pouw, Sonia; Werner, Perla

2012-04-01

The prevalence of intrusive memories of the Holocaust and their relationship to distress was examined among 272 child survivors in Israel. Using attachment theory as a conceptual framework, the authors also examined the effects of type of experience and loss of parents in the Holocaust, psychological resources, other life events, and sociodemographic characteristics on distress and symptomatic behavior. Eighty five percent of the participants reported suffering from intrusive memories. Structural equation modeling showed that survivors who lost one or both parents in the Holocaust suffered more distress because of more intrusive memories. These findings suggest that intrusive memories may be part of unfinished mourning processes related to the loss of parents in the Holocaust. © 2012 American Orthopsychiatric Association.

The symbolic power of money: reminders of money alter social distress and physical pain.

PubMed

Zhou, Xinyue; Vohs, Kathleen D; Baumeister, Roy F

2009-06-01

People often get what they want from the social system, and that process is aided by social popularity or by having money. Money can thus possibly substitute for social acceptance in conferring the ability to obtain benefits from the social system. Moreover, past work has suggested that responses to physical pain and social distress share common underlying mechanisms. Six studies tested relationships among reminders of money, social exclusion, and physical pain. Interpersonal rejection and physical pain caused desire for money to increase. Handling money (compared with handling paper) reduced distress over social exclusion and diminished the physical pain of immersion in hot water. Being reminded of having spent money, however, intensified both social distress and physical pain.

The Lexis plot for run-off non-life insurance companies in United Kingdom

NASA Astrophysics Data System (ADS)

Samsudin, Humaida Banu

2014-06-01

This study is intended to look at the company's age to be one of the predictor for financially distressed non-life insurance companies in United Kingdom. Financial distress is a condition where a company has difficulty paying off its obligations to its creditors. For this study, Lexis plot is used to identify either younger companies or older companies are in run-off. Run-off is a process where many insurance companies stop underwriting policies long before they reach financial crisis or financial distress. The study utilises financial data of 22 years from year 1985 to year 2006 for 397 companies. From the study, it is identified that younger companies are more in financial distress than older companies.

Religious Involvement, Coping, Social Support, and Psychological Distress in HIV-Seropositive African American Mothers

PubMed Central

Prado, Guillermo; Feaster, Daniel J.; Schwartz, Seth J.; Pratt, Indira Abraham; Smith, Lila; Szapocznik, Jose

2005-01-01

This study used a cross-sectional design to examine the role of religious involvement within a stress-process framework. Participants were 252 urban, low-income HIV-seropositive African American mothers. The relationships among religious involvement, stress, coping responses, social support, and psychological distress were examined using structural equation modeling. The number of stressors reported by the mother was related to greater religious involvement, which in turn was negatively related to psychological distress. Furthermore, the results suggest that social support, active coping, and avoidant coping responses mediated the relationship between religious involvement and psychological distress. According to the present results, interventions to attenuate psychological distress in HIV-seropositive African American mothers might focus on increasing social support, promoting active coping, and decreasing avoidant coping. The present findings suggest that this may be accomplished, in part, by promoting involvement in religious institutions and practices. However, in light of the cross-sectional design used in the present study, and given that religion may have both positive and negative consequences further research is needed to determine the extent to which promoting religiosity may increase or alleviate distress. PMID:15475672

Dusukasi-The Heart That Cries: An Idiom of Mental Distress Among Perinatal Women in Rural Mali.

PubMed

Lasater, Molly E; Beebe, Madeleine; Warren, Nicole E; Souko, Fatoumata; Keita, Mariam; Murray, Sarah E; Bass, Judith K; Surkan, Pamela J; Winch, Peter J

2018-04-25

Perinatal mental health problems such as depression and anxiety are prevalent in low and middle-income countries. In Mali, the lack of mental health care is compounded by few studies on mental health needs, including in the perinatal period. This paper examines the ways in which perinatal women experience and express mental distress in rural Mali. We describe a process, relying on several different qualitative research methods, to identify understandings of mental distress specific to the Malian context. Participants included perinatal women, maternal health providers, and community health workers in rural southwest Mali. Participants articulated several idioms of distress, including gèlèya (difficulties), tôôrô (pain, suffering), hamin (worries, concerns), and dusukasi (crying heart), that occur within a context of poverty, interpersonal conflict, and gender inequality. These idioms of distress were described as sharing many key features and operating on a continuum of severity that could progress over time, both within and across idioms. Our findings highlight the context dependent nature of experiences and expressions of distress among perinatal women in Mali.

Unaccompanied status as a risk factor in Vietnamese Amerasians.

PubMed

McKelvey, R S; Webb, J A

1995-07-01

This study prospectively evaluates the relationship between unaccompanied status and levels of psychological distress in a group of Vietnamese Amerasians both prior to, and during, migration. Its objective was to determine whether unaccompanied migrant status functions as an independent post-departure risk factor for psychological distress, or if unaccompanied migrants are already at increased risk for, and have higher levels of, psychological distress prior to departure and the acquisition of unaccompanied status. Seventy-five Vietnamese Amerasian youth were evaluated at two points during their migration utilizing Felsman's Personal Information Form, the Hopkins Symptom Checklist-25, and the Youth Self-Report. The first assessment was conducted prior to migration at the Amerasian Transit Center in Vietnam, and the second during migration at the Philippine Refugee Processing Center. Unaccompanied Amerasians were found to have significantly higher risk levels for, and significantly more symptoms of, psychological distress prior to migration than accompanied Amerasians. During migration the difference in levels of psychological distress between accompanied and unaccompanied Amerasians increased beyond that attributable to predeparture risk levels alone. This significant differential increase in levels of psychological distress among unaccompanied Amerasians is attributable to unaccompanied status. Unaccompanied migrant status thus appears to function both as an independent postdeparture risk factor for psychological distress and also as a marker for increased levels of risk and psychological distress prior to migration.

Relationship of social factors including trust, control over life decisions, problems with transport and safety, to psychological distress in the community.

PubMed

Taylor, Anne W; Chittleborough, Catherine; Gill, Tiffany K; Winefield, Helen; Baum, Fran; Hiller, Janet E; Goldney, Robert; Tucker, Graeme; Hugo, Graeme

2012-03-01

Psychological distress encompasses anxiety and depression with the previous studies showing that psychological distress is unequally distributed across population groups. This paper explores the mechanisms and processes which may affect the distribution of psychological distress, including a range of individual and community level socioeconomic determinants. Representative cross-sectional data was collected for respondents aged 16+ from July 2008 to June 2009, as a part of the South Australian Monitoring and Surveillance System (SAMSS) using Computer Assisted Telephone Interviews (CATI). Univariate and multivariate analyses (n = 5,763) were conducted to investigate the variables that were associated with psychological distress. The overall prevalence of psychological distress was 8.9%. In the multivariate model, females, those aged 16-49, respondents single with children, unable to work or unemployed, with a poorer family financial situation, earning $20,000 or less, feeling safe in their home some or none of the time, feeling as though they have less then total control over life decisions and sometimes experiencing problems with transport, were significantly more likely to experience psychological distress. This paper has demonstrated the relationship between low-income, financial pressure, less than optimal safety and control, and high-psychological distress. It is important that the groups highlighted as vulnerable be targeted in policy, planning, and health promotion and prevention campaigns.

Acculturation Process and Distress: Mediating Roles of Sociocultural Adaptation and Acculturative Stress

ERIC Educational Resources Information Center

Wu, Ellery K. Y.; Mak, Winnie W. S.

2012-01-01

The present study applied the theory of planned behavior (TPB) to unfold the social cognitive antecedents of acculturation and investigated the effects of acculturation on psychological distress using a longitudinal design. A total of 180 mainland Chinese university students studying in Hong Kong completed three sets of questionnaires every 2…

Sexual Orientation and Psychological Distress in Adolescence: Examining Interpersonal Stressors and Social Support Processes

ERIC Educational Resources Information Center

Ueno, Koji

2005-01-01

Adolescents with homosexual and bisexual orientations have higher levels of psychological distress than other adolescents. Drawing from previous studies, I hypothesize that this epidemiological pattern is due largely to the interpersonal problems that sexual minorities experience at home and at school. Analysis of longitudinal data based on a…

Acculturation and mental distress among Russian and Iranian migrants in Germany.

PubMed

Haasen, C; Demiralay, C; Reimer, J

2008-01-01

Several studies have stressed a correlation between difficulties in acculturation and mental distress or even mental disorders. The stress related to the process of acculturation can lead to depressive symptoms by way of changes in the activity of the HPA axis. However, it remains difficult to measure acculturation stress, as difficulties in acculturation strongly depend on subjective interpretations of every day experiences. The association between acculturation stress and mental distress was examined in two different migrant groups in Germany, 202 migrants of Russian and 100 of Iranian origin. In both migrant groups a significant correlation between acculturation stress and mental distress was found, yet no significant association between acculturation stress and length of residency in Germany. These findings will have to be replicated with representative samples and also with other migrant groups, both in and out of treatment. Considering the fact that the Russian sample was younger and nonetheless had relatively high acculturation stress scores, prevention of future mental health problems among migrants will have to focus on easing the process of integration into the host society.

Moral distress: a review of the argument-based nursing ethics literature.

PubMed

McCarthy, Joan; Gastmans, Chris

2015-02-01

The aim of this review is to examine the ways in which the concept of moral distress has been delineated and deployed in the argument-based nursing ethics literature. It adds to what we already know about moral distress from reviews of the qualitative and quantitative research. CINAHL, PubMed, Web of Knowledge, EMBASE, Academic Search Complete, PsycInfo, Philosophers' Index and Socindex. A total of 20 argument-based articles published between January 1984 and December 2013 were analysed. We found that like the empirical literature, most authors in this review draw on Jameton's original definition and describe moral distress in psychological-emotional-physiological terms. They also agree that moral distress is linked to the presence of some kind of constraint on nurses' moral agency, and that it is best understood as a two-staged process that can intensify over time. There is also consensus that moral distress has an important normative meaning, although different views concerning the normative meaning of moral distress are expressed. Finally, the authors generally agree that moral distress arises from a number of different sources and that it (mostly) affects negatively on nurses' personal and professional lives and, ultimately, harms patients. However, despite this consensus, many authors take issue with the way in which moral distress is conceptualized and operationalized. Moreover, while some worry that identifying nurses as a group of health professionals whose voices are ignored or marginalized might disempower nurses and encourage them to avoid their moral responsibilities, others take situations involving moral distress as indicative of more fundamental, structural inequities at the heart of contemporary healthcare provision. We conclude that research on moral distress in nursing is timely and important because it highlights the specifically moral labour of nurses. However, we suggest that significant concerns about the conceptual fuzziness and operationalization of moral distress also flag the need to proceed with caution. © The Author(s) 2014.

"One Scar Too Many:" The Associations Between Traumatic Events and Psychological Distress Among Undocumented Mexican Immigrants.

PubMed

Garcini, Luz M; Peña, Juan M; Gutierrez, Angela P; Fagundes, Christopher P; Lemus, Hector; Lindsay, Suzanne; Klonoff, Elizabeth A

2017-10-01

Undocumented immigration often presents with multiple stressors and contextual challenges, which may diminish mental health. This study is the first to provide population-based estimates for the prevalence of traumatic events and its association to clinically significant psychological distress among undocumented Mexican immigrants in the United States. This cross-sectional study used respondent-driven sampling to obtain and analyze data from clinical interviews with 248 undocumented Mexican immigrants residing in high-risk neighborhoods near the California-Mexico border. Overall, 82.7% of participants reported a history of traumatic events, with 47.0% of these meeting the criteria for clinically significant psychological distress. After controlling for relevant covariates, having experienced material deprivation, odds ratio (OR) = 2.26, 95% CI [1.18, 4.31], p = .013, and bodily injury, OR = 2.96, 95% CI [1.50, 5.83], p = .002, and not having a history of deportation, OR = 0.36, 95% CI [0.17, 0.79], p = .011, were associated with clinically significant psychological distress. These results support the need to revisit health and immigration policies and to devise solutions grounded in empirical evidence aimed at preventing the negative effects of trauma and psychological distress in this population. Copyright © 2017 International Society for Traumatic Stress Studies.

47 CFR 80.1125 - Search and rescue coordinating communications.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SPECIAL RADIO SERVICES STATIONS IN THE MARITIME SERVICES Global Maritime Distress and Safety System (GMDSS... Archives and Records Administration (NARA). For information on the availability of this material at NARA...

The neglected role of distress in pain management: qualitative research on a gastrointestinal ward.

PubMed

Drake, Gareth; Williams, Amanda C de C

2018-05-09

Pain management for hospital inpatients remains suboptimal. Previously identified barriers to optimal pain management include staff communication difficulties, confusion around pain management roles and a lack of suitable resources for clinical staff. The emotional, relational and contextual complexities of gastrointestinal (GI) pain create particular challenges for frontline clinical staff attempting to implement a biopsychosocial approach to its management. The current study took place over 2 years, comprised an ethnographic and a feedback phase, and aimed to examine pain management processes with clinical staff in order to generate hypotheses and initiatives for improvement. This paper focuses on two overarching themes identified in the ethnographic phase of the study, centred on the neglected role of both staff and patient distress in GI pain management. Grounded theory and thematic analysis methods were used as part of action research, which involves collaborative working with clinical staff. The study took place on a 60 bed GI ward in a university hospital in London. Participants were clinical staff who were either ward-based or involved in the care of particular patients. This latter group included doctors, nurses, psychologists and physiotherapists from the Acute and Complex Pain Teams. Qualitative data on pain management processes was gathered from staff interviews, consultation groups, and observations of patient-staff interactions. Recruitment was purposive and collaborative in that early participants suggested targets and staff groups for subsequent enquiry. Following the identification of initial ethnographic themes, further analysis and the use of existing literature led to the identification of two overarching pain management processes. As such the results are divided into three sections: (i) illustration of initial ethnographic themes, (ii) summary of relevant theory used, (iii) exploration of hypothesised overarching processes. Initially, two consultation groups, five nursing staff and five junior doctors, provided key issues that were included in subsequent interviews (n=18) and observations (n=5). Initial ethnographic themes were divided into challenges and resources, reflecting the emergent structure of interviews and observations. Drawing on attachment, psychodynamic and evolutionary theories, themes were then regrouped around two overarching processes, centred on the neglected role of distress in pain management. The first process elucidates the lack of recognition during pain assessment of the emotional impact of patient distress on staff decision-making and pain management practice. The second process demonstrates that, as a consequence of resultant staff distress, communication between staff groups was fraught and resources, such as expert team referral and pharmacotherapy, appeared to function, at times, to protect staff rather than to help patients. Interpersonal skills used by staff to relieve patient distress were largely outside systems for pain care. Findings suggest that identified "barriers" to optimal pain management likely serve an important defensive function for staff and organisations. Unless the impact of patient distress on staff is recognised and addressed within the system, these barriers will persist.

The mental healthcare needs of undocumented migrants: an exploratory analysis of psychological distress and living conditions among undocumented migrants in Norway.

PubMed

Myhrvold, Trine; Småstuen, Milada Cvancarova

2017-03-01

To explore undocumented migrants' mental healthcare needs and more specifically to explore how undocumented adults living in Norway perceive psychological distress, to gather insight on their living conditions and to explore associated living condition risk factors. Undocumented migrants are defined both nationally and internationally as an especially vulnerable group with regard to their health status, living conditions and barriers to access to health care and social welfare. An exploratory mixed-methods design using primarily quantitative data with a qualitative component was implemented. Socio-demographic data on 90 undocumented migrants were obtained, and self-report questionnaire on psychological distress was completed, supplemented by qualitative data obtained through interviews. The level of psychological distress was extremely high in our group of undocumented migrants. Leaving their home country because of war or persecution, economic strain, homelessness, hunger and having experienced abuse was significantly positively associated with psychological distress. Contrary to what was predicted, having family and work was not significantly associated with the reduction of psychological distress. Additional qualitative data indicate that having family entails great responsibilities and work implies exploitation to such an extent that any potential positive influence this has on mental health, such as a sense of belonging and a reasonable standard of living, is outweighed. The high level of psychological distress indicates a need of additional diagnostic evaluation and mental health care. The living conditions were so marginal that their day-to-day existence was threatened. We recognised a need for an interdisciplinary and dynamic approach to mental health care. Undocumented migrants are in need of a minimum of psychological and material support assuring basic needs such as shelter and appropriate food and access to health care and social welfare. © 2016 John Wiley & Sons Ltd.

Social support, marital adjustment, and psychological distress among women with primary infertility in Pakistan.

PubMed

Qadir, Farah; Khalid, Amna; Medhin, Girmay

2015-01-01

This study aimed to identify prevalence rates of psychological distress among Pakistani women seeking help for primary infertility. The associations of social support, marital adjustment, and sociodemographic factors with psychological distress were also examined. A total of 177 women with primary infertility were interviewed from one hospital in Islamabad using a Self-Reporting Questionnaire, the Multidimensional Scale of Perceived Social Support, and the Locke-Wallace Marital Adjustment Test. The data were collected between November 2012 and March 2013. The prevalence of psychological distress was 37.3 percent. The results of the logistic regression suggested that marital adjustment and social support were significantly negatively associated with psychological distress in this sample. These associations were not confounded by any of the demographic variables controlled in the multivariable regression models. The role of perceived social support and adjustment in marriage among women experiencing primary infertility are important factors in understanding their psychological distress. The results of this small-scale effort highlight the need for social and familial awareness to help tackle the psychological distress related to infertility. Future research needs to focus on the way the experience of infertility is conditioned by social structural realities. New ways need to be developed to better take into account the process and nature of the infertility experience.

46 CFR 160.028-3 - Materials, workmanship, construction, and performance requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... be corrosion-resistant or properly protected against corrosion. The ejection mechanism shall be of... pistol-projected parachute red flare distress signals of the type covered by Subpart 160.024. The...

46 CFR 160.057-3 - Materials, workmanship, construction, and performance requirements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... when presented with supporting data. Igniter systems shall be of corrosion-resistant metal. The... subjected to frigid or tropical climates, or both. (b) Workmanship. Floating orange smoke distress signals...

46 CFR 160.057-3 - Materials, workmanship, construction, and performance requirements.

Code of Federal Regulations, 2013 CFR

2013-10-01

... when presented with supporting data. Igniter systems shall be of corrosion-resistant metal. The... subjected to frigid or tropical climates, or both. (b) Workmanship. Floating orange smoke distress signals...

46 CFR 160.057-3 - Materials, workmanship, construction, and performance requirements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... when presented with supporting data. Igniter systems shall be of corrosion-resistant metal. The... subjected to frigid or tropical climates, or both. (b) Workmanship. Floating orange smoke distress signals...

46 CFR 160.057-3 - Materials, workmanship, construction, and performance requirements.

Code of Federal Regulations, 2012 CFR

2012-10-01

... when presented with supporting data. Igniter systems shall be of corrosion-resistant metal. The... subjected to frigid or tropical climates, or both. (b) Workmanship. Floating orange smoke distress signals...

Exposure and response prevention process predicts treatment outcome in youth with OCD.

PubMed

Kircanski, Katharina; Peris, Tara S

2015-04-01

Recent research on the treatment of adults with anxiety disorders suggests that aspects of the in-session exposure therapy process are relevant to clinical outcomes. However, few comprehensive studies have been conducted with children and adolescents. In the present study, 35 youth diagnosed with primary obsessive-compulsive disorder (OCD; M age = 12.9 years, 49% male, 63% Caucasian) completed 12 sessions of exposure and response prevention (ERP) in one of two treatment conditions as part of a pilot randomized controlled testing of a family focused intervention for OCD. Key exposure process variables, including youth self-reported distress during ERP and the quantity and quality of ERP completed, were computed. These variables were examined as predictors of treatment outcomes assessed at mid-treatment, post-treatment, and three-month follow-up, partialing treatment condition. In general, greater variability of distress during ERP and completing a greater proportion of combined exposures (i.e., exposures targeting more than one OC symptom at once) were predictive of better outcomes. Conversely, greater distress at the end of treatment was generally predictive of poorer outcomes. Finally, several variables, including within- and between-session decreases in distress during ERP, were not consistently predictive of outcomes. Findings signal potentially important facets of exposure for youth with OCD and have implications for treatment. A number of results also parallel recent findings in the adult literature, suggesting that there may be some continuity in exposure processes from child to adult development. Future work should examine additional measures of exposure process, such as psychophysiological arousal during exposure, in youth.

Like a bridge over troubled water? A longitudinal study of general social support, colleague support, and leader support as recovery factors after a traumatic event

PubMed Central

Birkeland, Marianne Skogbrott; Nielsen, Morten Birkeland; Hansen, Marianne Bang; Knardahl, Stein; Heir, Trond

2017-01-01

ABSTRACT Background: Whereas the association between social support and psychological distress has been well-established through both cross-sectional and longitudinal studies, less is known about whether social support influences rate of change in psychological distress over time. Nor is it clear whether social support predicts baseline psychological distress, or, more importantly, whether social support may contribute to more rapid recovery following trauma exposure. Objective: This study aimed to determine the extent to which social support contributed to the recovery process among individuals with psychological distress after being exposed to trauma. Methods: Prospective survey data from ministry employees were collected 10, 22, and 34 months after the 2011 Oslo bombing that targeted the governmental quarters. We explored recovery in a clinical subsample (N = 238) of individuals with elevated levels of psychological distress (defined as mean 10-item Hopkins symptom checklist score > 1.85) one year after the event. A linear latent growth curve of psychological distress with general social support from friends and family, colleague support, and leader support as predictors was examined. Results: High levels of general social support and leader support were independently associated with a more rapid decline in psychological distress over time. Conclusions: General social support, as well as support from a leader in one’s working life, may facilitate recovery from psychological distress after exposure to a traumatic event. Enhancing social support from family and friends, as well as in work settings, may benefit those with psychological distress following a traumatic workplace event. PMID:28451070

Predictors of emotional distress a year or more after diagnosis of cancer: A systematic review of the literature.

PubMed

Cook, Sharon A; Salmon, Peter; Hayes, Gemma; Byrne, Angela; Fisher, Peter L

2018-03-01

Why some people recover emotionally after diagnosis and treatment of cancer and others do not is poorly understood. To identify factors around the time of diagnosis that predict longer-term distress is a necessary step in developing interventions to reduce patients' vulnerability. This review identified the demographic, clinical, social, and psychological factors available at or within 3 months of diagnosis that are reliable predictors of emotional distress at least 12 months later. A systematic search of literature for prospective studies addressing our research question and predicting a range of distress outcomes was conducted. Thirty-nine papers (reporting 36 studies) were subjected to narrative synthesis of the evidence. There was no consistent evidence that demographic, clinical, or social factors reliably predicted longer-term distress. Of the psychological factors examined, only baseline distress (significant in 26 of 30 relevant papers; 24 of 28 studies) and neuroticism (significant in all 5 papers/studies that examined it) consistently predicted longer-term distress. The heterogeneity of included studies, particularly in populations studied and methodology, precluded meta-analytic techniques. This review supports current clinical guidance advising early assessment of distress as a marker of vulnerability to persistent problems. Additionally, neuroticism is also indicated as a useful marker of vulnerability. However, the review also highlights that more sophisticated research designs, capable of identifying the psychological processes that underlie the association between these marker variables and persistent distress, are needed before more effective early interventions can be developed. © 2018 The Authors. Psycho-Oncology Published by John Wiley & Sons Ltd.

Levels and associations among self-esteem, fertility distress, coping, and reaction to potentially being a genetic carrier in women with diminished ovarian reserve.

PubMed

Cizmeli, Ceylan; Lobel, Marci; Franasiak, Jason; Pastore, Lisa M

2013-06-01

To measure the level of distress and its relationship with other psychologic factors in women with diminished ovarian reserve (DOR) who participated in a fragile X genetics study. Longitudinal data analyzed with structural equation modeling. Four U.S. private and academic fertility centers. Sixty-two infertile patients with DOR. None. Fertility Problem Inventory, Coping Scale for Infertile Couples, Rosenberg Self-Esteem, Health Orientation Scale. Nineteen percent had low fertility distress, 56% had average fertility distress, and 24% had high fertility distress. Thirty-six percent self-reported a "favorable" or "very favorable" emotional response to potentially being a fragile X carrier (termed "emotions"), 53% were "ambivalent," and 11% had an unfavorable reaction. Three months after learning that they were not a carrier, these percentages were 91%, 9%, and 0%, respectively. Emotions at this second time point were significantly more positive than at pretesting. At baseline, higher self-esteem was a significant predictor of reduced fertility distress both directly and indirectly through emotions. Fertility distress was not associated with coping. Self-esteem, fertility distress, pretesting emotions, and coping were unrelated to posttesting emotions. The potential of having an explanation for one's DOR condition may have a beneficial impact on women's psychologic states during the process of genetic testing, and this appeared to be especially true for women with higher self-esteem. Psychologic interventions targeted to women with low self-esteem may reduce distress and improve reactions to genetic testing. Copyright © 2013 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Llaki and ñakary: idioms of distress and suffering among the highland Quechua in the Peruvian Andes.

PubMed

Pedersen, Duncan; Kienzler, Hanna; Gamarra, Jeffrey

2010-06-01

This article examines some of the long-term health outcomes of extreme adversities and the ways in which social inequalities and idioms of distress are historically and socially produced in the Peruvian context. We describe how the highland Quechua of northern Ayacucho construct and experience expressions of distress and suffering such as pinsamientuwan (worrying thoughts, worries), ñakary (suffering) and llaki (sorrow, sadness), in a context of persistent social inequalities, social exclusion and a recent history of political violence. It is concluded that the multiple expressions of distress and suffering are closely related to past and current events, shaped by beliefs, core values and cultural norms and, in this process, transformed, recreated and invested with new meanings and attributions.

Self-medication among traumatized youth: structural equation modeling of pathways between trauma history, substance misuse, and psychological distress

PubMed Central

Pettus-Davis, Carrie; Howard, Matthew O.

2012-01-01

In an effort to self-medicate psychological distress stemming from exposure to traumatic life events, at-risk youth may be likely to seek intoxication via substance use. Concomitantly, self-medication with psychoactive substances is theorized to confer risk of developing future psychiatric and substance use disorders. The present study employed structural equation modeling to examine self-medication among a sample of 723 youth in residential treatment for antisocial behavior via recursive and non-recursive relationships between trauma history, substance misuse, and psychological distress. Results supported study hypotheses that: (a) the effects of trauma history on psychological distress are partially mediated by substance misuse, and (b) exposure to traumatic life events drives a feedback loop between substance misuse and psychological distress. Findings from this large-scale survey of adolescents exhibiting behavioral dysfunction suggest that identification of self-medication processes among traumatized youth may be crucial for developing targeted prevention and treatment initiatives. PMID:22454227

THE INFLUENCE OF SOCIAL SUPPORT ON PSYCHOLOGICAL DISTRESS IN OLDER PERSONS: AN EXAMINATION OF INTERACTION PROCESSES IN AUSTRALIA.

PubMed

Sharpley, Christopher; Hussain, Rafat; Wark, Stuart; Mcevoy, Mark; Attia, John

2015-12-01

Social support is proposed as a coping mechanism against anxiety and depression amongst older persons, but few data have examined how this occurs. This study assessed the contributions of two sub-components of social support as mediators against psychological distress-broadly defined as anxiety and depression. 1,560 men and 1,758 women from the Hunter Community Study (Australia) completed the Duke Social Support Scale and the Kessler Psychological Distress Scale. The Duke Social Support Scale examined the amount of social interaction and satisfaction with social interactions. Significant mediating effects of social support were found in the Kessler Psychological Distress Scale items measuring depression but not anxiety. Satisfaction with social support was a significant predictor of Kessler Psychological Distress Scale total score and Sadness items, but the amount of social support was not a predictor of stress. Social support may assist with symptoms of depression, i.e., specific sadness/depressed mood, but not necessarily with anxiety. Implications for policy and service delivery were discussed.

Correlates and Predictors of Psychological Distress Among Older Asian Immigrants in California.

PubMed

Chang, Miya; Moon, Ailee

2016-01-01

Psychological distress occurs frequently in older minority immigrants because many have limited social resources and undergo a difficult process related to immigration and acculturation. Despite a rapid increase in the number of Asian immigrants, relatively little research has focused on subgroup mental health comparisons. This study examines the prevalence of psychological distress, and relationship with socio-demographic factors, and health care utilization among older Asian immigrants. Weighted data from Asian immigrants 65 and older from 5 countries (n = 1,028) who participated in the California Health Interview Survey (CHIS) were analyzed descriptively and in multiple linear regressions. The prevalence of psychological distress varied significantly across the 5 ethnic groups, from Filipinos (4.83%) to Chinese (1.64%). General health status, cognitive and physical impairment, and health care utilization are all associated (p < .05) with psychological distress in multiple linear regressions. These findings are similar to those from previous studies. The findings reinforce the need to develop more culturally effective mental health services and outreach programs.

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.

Laboratory accelerated stripping simulator for hot mix asphalt.

DOT National Transportation Integrated Search

2005-01-18

Moisture susceptibility of hot mix asphalt (HMA) pavements continues to be a major pavement distress. Past research : has primarily focused on HMA stripping prevention through material component evaluation/testing and addition of : preventative addit...

Regional brain responses in nulliparous women to emotional infant stimuli.

PubMed

Montoya, Jessica L; Landi, Nicole; Kober, Hedy; Worhunsky, Patrick D; Rutherford, Helena J V; Mencl, W Einar; Mayes, Linda C; Potenza, Marc N

2012-01-01

Infant cries and facial expressions influence social interactions and elicit caretaking behaviors from adults. Recent neuroimaging studies suggest that neural responses to infant stimuli involve brain regions that process rewards. However, these studies have yet to investigate individual differences in tendencies to engage or withdraw from motivationally relevant stimuli. To investigate this, we used event-related fMRI to scan 17 nulliparous women. Participants were presented with novel infant cries of two distress levels (low and high) and unknown infant faces of varying affect (happy, sad, and neutral) in a randomized, counter-balanced order. Brain activation was subsequently correlated with scores on the Behavioral Inhibition System/Behavioral Activation System scale. Infant cries activated bilateral superior and middle temporal gyri (STG and MTG) and precentral and postcentral gyri. Activation was greater in bilateral temporal cortices for low- relative to high-distress cries. Happy relative to neutral faces activated the ventral striatum, caudate, ventromedial prefrontal, and orbitofrontal cortices. Sad versus neutral faces activated the precuneus, cuneus, and posterior cingulate cortex, and behavioral activation drive correlated with occipital cortical activations in this contrast. Behavioral inhibition correlated with activation in the right STG for high- and low-distress cries relative to pink noise. Behavioral drive correlated inversely with putamen, caudate, and thalamic activations for the comparison of high-distress cries to pink noise. Reward-responsiveness correlated with activation in the left precentral gyrus during the perception of low-distress cries relative to pink noise. Our findings indicate that infant cry stimuli elicit activations in areas implicated in auditory processing and social cognition. Happy infant faces may be encoded as rewarding, whereas sad faces activate regions associated with empathic processing. Differences in motivational tendencies may modulate neural responses to infant cues.

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

PubMed

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

2011-10-01

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

The significance of employment for chronic stress and psychological distress among rural single mothers.

PubMed

Turner, Heather A

2007-12-01

Considerable research has found elevated levels of stress and psychological distress among single mothers. However, little research has addressed the relevance of employment for stress processes in this population, and few studies have focused on links between employment, stress, and mental health among single mothers living in rural areas. Based on a probability sample of 508 single mothers age 18-39 living in rural Northern New England, this study: (1) documents variations in chronic stress and psychological distress for employed and unemployed single mothers, (2) considers the extent to which different forms of chronic stress mediate or explain the employment-distress relationship, and (3) examines whether employment status modifies associations between chronic stress and psychological distress. Findings indicated that rural single mothers who were employed reported significantly less financial stress, childcare stress, and rural residence stress, relative to mothers who were not employed, independent of variety of other factors. Employed mothers also experienced significantly less psychological distress which was partially mediating by their lower financial stress. However, there was also a statistical interaction between employment status and financial stress such that the harmful effect of financial stress on well-being was greater for employed women. Implications of the findings are discussed.

Informative Disagreements: Associations Between Relationship Distress, Depression, and Discrepancy in Interpersonal Perception Within Couples.

PubMed

Knobloch-Fedders, Lynne M; Critchfield, Kenneth L; Staab, Erin M

2017-06-01

This study evaluated the associations between relationship distress, depression symptoms, and discrepancy in interpersonal perception within couples. After completing a series of discussion tasks, couples (N = 88) rated their behavior using the circumplex-based Structural Analysis of Social Behavior Model (SASB; Benjamin, 1979, 1987, 2000). Overall, couple members were strikingly similar in their interpersonal perceptions, and tended to see themselves as friendly, reciprocal in their focus, and balanced between connection and separateness. As hypothesized, however, perceptual discrepancy was related to relationship distress and depression. Relationship distress was associated with discrepancy regarding transitive behavior focused on the partner, while depression was associated with disagreement about intransitive, self-focused behavior. Analysis of affiliation and autonomy revealed that relationship distress was associated with seeing oneself as reacting with more hostility than the partner sees, and perceiving one's partner as more hostile, more controlling, and less submissive than he or she does. Partners of depressed individuals viewed themselves as more controlling than their mate did. Men's depression was associated with disagreement between partners regarding men's self-focused behavior. Results underscore the importance of considering interpersonal perception when conceptualizing relationship distress and depression within intimate relationships. © 2015 Family Process Institute.

Improvements in Depression and Mental Health After Acceptance and Commitment Therapy are Related to Changes in Defusion and Values-Based Action.

PubMed

Bramwell, Kate; Richardson, Thomas

2018-01-01

Acceptance and commitment therapy (ACT) has been found to be effective for various mental health disorders but the processes through which it affects change remain unclear. Much process research in the area is on physical rather than mental health, and focuses on the broad concept of psychological flexibility with little research on specific mechanisms identified in theory such as fusion and values. This study explored whether there was a relationship between two of the main ACT processes (cognitive defusion and values) and levels of depression and distress. Thirty-three participants completed questionnaires at the start and end of their treatment measuring general mental health and distress, depression, levels of cognitive fusion and how much they were living in line with their values and how important their values were to them. Results showed reductions in levels of fusion and increases in values-based action were significantly related to reductions in distress and depression. There was no correlation between changes in values importance and changes in distress or depression. This study therefore suggests decreased defusion and increased values-based action is an important mechanism in the efficacy of ACT in those with depression and mental health problems. The study is however limited by a small sample size and future research with a sample large enough for mediation analysis would be beneficial.

The Multidimensional Loss Scale: validating a cross-cultural instrument for measuring loss.

PubMed

Vromans, Lyn; Schweitzer, Robert D; Brough, Mark

2012-04-01

The Multidimensional Loss Scale (MLS) represents the first instrument designed specifically to index Experience of Loss Events and Loss Distress across multiple domains (cultural, social, material, and intrapersonal) relevant to refugee settlement. Recently settled Burmese adult refugees (N = 70) completed a questionnaire battery, including MLS items. Analyses explored MLS internal consistency, convergent and divergent validity, and factor structure. Cronbach alphas indicated satisfactory internal consistency for Experience of Loss Events (0.85) and Loss Distress (0.92), reflecting a unitary construct of multidimensional loss. Loss Distress did not correlate with depression or anxiety symptoms and correlated moderately with interpersonal grief and trauma symptoms, supporting divergent and convergent validity. Factor analysis provided preliminary support for a five-factor model: Loss of Symbolic Self, Loss of Interdependence, Loss of Home, Interpersonal Loss, and Loss of Intrapersonal Integrity. Received well by participants, the new scale shows promise for application in future research and practice.

Self-critical perfectionism, dependency, and symptomatic distress in patients with personality disorder during hospitalization-based psychodynamic treatment: A parallel process growth modeling approach.

PubMed

Lowyck, Benedicte; Luyten, Patrick; Vermote, Rudi; Verhaest, Yannic; Vansteelandt, Kristof

2017-07-01

There is growing evidence for the efficacy and effectiveness of psychotherapy in patients with personality disorder (PD), but very little is known about the factors underlying these effects. Two-polarities models of personality development provide an empirically supported approach to studying therapeutic change. Briefly, these models argue that personality pathology is characterized by an imbalance between development of the capacity for self-definition and for relatedness, with an exaggerated emphasis on issues regarding self-definition and relatedness being expressed in high levels of self-critical perfectionism (SCP) and dependency, respectively. This study used data from a study of 111 patients with PD who received long-term hospitalization-based psychodynamic treatment to investigate whether (a) treatment was related to changes in SCP, dependency, and symptomatic distress; (b) these changes could be explained by pretreatment levels of SCP, dependency, and/or symptomatic distress; and (c) changes in these personality dimensions over time were associated with symptomatic improvement. SCP, dependency, and symptomatic distress were assessed at admission (baseline), at 12 and 24 weeks into treatment, and at discharge. Parallel process multilevel growth modeling showed that (a) treatment was associated with a significant decrease in levels of SCP, dependency, and symptomatic distress, whereas (b) pretreatment levels of each of these three factors did not predict the decreases observed, and (c) changes in SCP, but not dependency, were associated with the rate of decrease in symptomatic distress over time. Implications of these findings for our understanding of therapeutic change in the treatment of PD are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Fighting with Spirits: Migration Trauma, Acculturative Stress, and New Sibling Transition-A Clinical Case Study of an 8-Year-Old Girl with Absence Epilepsy.

PubMed

Chartonas, Dimitrios; Bose, Ruma

2015-12-01

In this article, we discuss the impact of migration and acculturation processes on the cultural, personal identity, and mental health of children who immigrate to a Western, multicultural environment, and the challenges clinicians in such environments face, when confronted with non-Western idioms of distress and healing practices. We do that by presenting a challenging clinical case of an 8-year-old girl who presented with very disorganized behavior, which matches a culturally accepted construct of spirit possession, in the context of migration trauma, acculturative stress, and new sibling transition. We identify cultural conflict in school and bullying as major mediators between acculturative stress and mental distress. We also aim at identifying vulnerability, risk and protective factors, and the importance of cultural coping resources. We explore in depth the patient's cultural background and the family's belief system and culturally shaped narratives, in order to arrive at a cultural formulation, which focuses on the significance of idioms of distress in shaping psychopathology and influencing the personal and interpersonal course of trauma- and stress-related disorders. We also call attention to the finding that in children, idioms of distress may manifest themselves in a somatic manner. We argue, together with other researchers, that spirit possession deserves more interest as an idiom of distress and a culture-specific response to traumatizing events. We finally emphasize the importance of an anti-reductionist clinical stance, that is able to use different levels of understanding processes of distress and healing, and seeks to reconciliate cultural divides and integrate different explanatory frameworks and help-seeking practices.

Levels and associations among self-esteem, fertility distress, coping, and reaction to potentially being a genetic carrier in women with diminished ovarian reserve

PubMed Central

Cizmeli, Ceylan; Lobel, Marci; Franasiak, Jason; Pastore, Lisa M.

2013-01-01

Objective To measure the level of distress and its relationship with other psychologic factors in women with diminished ovarian reserve (DOR) who participated in a fragile X genetics study. Design Longitudinal data analyzed with structural equation modeling. Setting Four U.S. private and academic fertility centers. Patient(s) Sixty-two infertile patients with DOR. Intervention(s) None. Main Outcome Measure(s) Fertility Problem Inventory, Coping Scale for Infertile Couples, Rosenberg Self-Esteem, Health Orientation Scale. Result(s) Nineteen percent had low fertility distress, 56% had average fertility distress, and 24% had high fertility distress. Thirty-six percent self-reported a “favorable” or “very favorable” emotional response to potentially being a fragile X carrier (termed “emotions”), 53% were “ambivalent,” and 11% had an unfavorable reaction. Three months after learning that they were not a carrier, these percentages were 91%, 9%, and 0%, respectively. Emotions at this second time point were significantly more positive than at pretesting. At baseline, higher self-esteem was a significant predictor of reduced fertility distress both directly and indirectly through emotions. Fertility distress was not associated with coping. Self-esteem, fertility distress, pretesting emotions, and coping were unrelated to posttesting emotions. Conclusion(s) The potential of having an explanation for one’s DOR condition may have a beneficial impact on women’s psychologic states during the process of genetic testing, and this appeared to be especially true for women with higher self-esteem. Psychologic interventions targeted to women with low self-esteem may reduce distress and improve reactions to genetic testing. PMID:23498890

Stress management skills, neuroimmune processes and fatigue levels in persons with chronic fatigue syndrome

PubMed Central

Lattie, Emily G.; Antoni, Michael H.; Fletcher, Mary Ann; Penedo, Frank; Czaja, Sara; Lopez, Corina; Perdomo, Dolores; Sala, Andreina; Nair, Sankaran; Fu, Shih Hua; Klimas, Nancy

2012-01-01

Objectives Stressors and emotional distress responses impact chronic fatigue syndrome (CFS) symptoms, including fatigue. Having better stress management skills might mitigate fatigue by decreasing emotional distress. Because CFS patients comprise a heterogeneous population, we hypothesized that the role of stress management skills in decreasing fatigue may be most pronounced in the subgroup manifesting the greatest neuroimmune dysfunction. Methods In total, 117 individuals with CFS provided blood and saliva samples, and self-report measures of emotional distress, perceived stress management skills (PSMS), and fatigue. Plasma interleukin-1-beta (IL-1β, IL-2, IL-6, IL-10, and tumor necrosis factor-alpha (TNF-α), and diurnal salivary cortisol were analyzed. We examined relations among PSMS, emotional distress, and fatigue in CFS patients who did and did not evidence neuroimmune abnormalities. Results Having greater PSMS related to less fatigue (p = .019) and emotional distress (p < .001), greater diurnal cortisol slope (p = .023) and lower IL-2 levels (p = .043). PSMS and emotional distress related to fatigue levels most strongly in CFS patients in the top tercile of IL-6, and emotional distress mediated the relationship between PSMS and fatigue most strongly in patients with the greatest circulating levels of IL-6 and a greater inflammatory (IL-6):anti-inflammatory (IL-10) cytokine ratio. Discussion CFS patients having greater PSMS show less emotional distress and fatigue, and the influence of stress management skills on distress and fatigue appear greatest among patients who have elevated IL-6 levels. These findings support the need for research examining the impact of stress management interventions in subgroups of CFS patients showing neuroimmune dysfunction. PMID:22417946

Stress management skills, neuroimmune processes and fatigue levels in persons with chronic fatigue syndrome.

PubMed

Lattie, Emily G; Antoni, Michael H; Fletcher, Mary Ann; Penedo, Frank; Czaja, Sara; Lopez, Corina; Perdomo, Dolores; Sala, Andreina; Nair, Sankaran; Fu, Shih Hua; Klimas, Nancy

2012-08-01

Stressors and emotional distress responses impact chronic fatigue syndrome (CFS) symptoms, including fatigue. Having better stress management skills might mitigate fatigue by decreasing emotional distress. Because CFS patients comprise a heterogeneous population, we hypothesized that the role of stress management skills in decreasing fatigue may be most pronounced in the subgroup manifesting the greatest neuroimmune dysfunction. In total, 117 individuals with CFS provided blood and saliva samples, and self-report measures of emotional distress, perceived stress management skills (PSMS), and fatigue. Plasma interleukin-1-beta (IL-1β, IL-2, IL-6, IL-10, and tumor necrosis factor-alpha (TNF-α), and diurnal salivary cortisol were analyzed. We examined relations among PSMS, emotional distress, and fatigue in CFS patients who did and did not evidence neuroimmune abnormalities. Having greater PSMS related to less fatigue (p=.019) and emotional distress (p<.001), greater diurnal cortisol slope (p=.023) and lower IL-2 levels (p=.043). PSMS and emotional distress related to fatigue levels most strongly in CFS patients in the top tercile of IL-6, and emotional distress mediated the relationship between PSMS and fatigue most strongly in patients with the greatest circulating levels of IL-6 and a greater inflammatory (IL-6):anti-inflammatory (IL-10) cytokine ratio. CFS patients having greater PSMS show less emotional distress and fatigue, and the influence of stress management skills on distress and fatigue appear greatest among patients who have elevated IL-6 levels. These findings support the need for research examining the impact of stress management interventions in subgroups of CFS patients showing neuroimmune dysfunction. Copyright © 2012 Elsevier Inc. All rights reserved.

Intimacy processes and psychological distress among couples coping with head and neck or lung cancers.

PubMed

Manne, Sharon; Badr, Hoda

2010-09-01

Couples coping with head and neck and lung cancers are at increased risk for psychological and relationship distress given patients' poor prognosis and aggressive and sometimes disfiguring treatments. The relationship intimacy model of couples' psychosocial adaptation proposes that relationship intimacy mediates associations between couples' cancer-related support communication and psychological distress. Because the components of this model have not yet been evaluated in the same study, we examined associations between three types of cancer-related support communication (self-disclosure, perceived partner disclosure, and protective buffering), intimacy (global and cancer-specific), and global distress among patients coping with either head and neck or lung cancer and their partners. One hundred and nine patients undergoing active treatment and their partners whose average time since diagnosis was 15 months completed cross-sectional surveys. For both patients and their partners, multilevel analyses using the actor-partner interdependence model showed that global and cancer-specific intimacy fully mediated associations between self- and perceived partner disclosure and distress; global intimacy partially mediated the association between protective buffering and distress. Evidence for moderated mediation was found; specifically, lower levels of distress were reported as a function of global and cancer-specific intimacy, but these associations were stronger for partners than for patients. Enhancing relationship intimacy by disclosing cancer-related concerns may facilitate both partners' adjustment to these illnesses. (c) 2010 John Wiley & Sons, Ltd.

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.

Intimacy Processes and Psychological Distress among Couples Coping with Head and Neck or Lung Cancers

PubMed Central

Manne, Sharon; Badr, Hoda

2009-01-01

Objective Couples coping with head and neck and lung cancers are at increased risk for psychological and relationship distress given patients’ poor prognosis and aggressive and sometimes disfiguring treatments. The relationship intimacy model of couples’ psychosocial adaptation proposes that relationship intimacy mediates associations between couples’ cancer-related support communication and psychological distress. Because the components of this model have not yet been evaluated in the same study, we examined associations between three types of cancer-related support communication (self-disclosure, perceived partner disclosure, and protective buffering), intimacy (global and cancer-specific), and global distress among patients coping with either head and neck or lung cancer and their partners. Method One hundred and nine patients undergoing active treatment and their partners whose average time since diagnosis was 15 months completed cross-sectional surveys. Results For both patients and their partners, multilevel analyses using the Actor-Partner Interdependence Model showed that global and cancer-specific intimacy fully mediated associations between self- and perceived partner disclosure and distress; global intimacy partially mediated the association between protective buffering and distress. Evidence for moderated mediation was found; specifically, lower levels of distress were reported as a function of global and cancer-specific intimacy, but these associations were stronger for partners than for patients. Conclusions Enhancing relationship intimacy by disclosing cancer-related concerns may facilitate both partners’ adjustment to these illnesses. PMID:19885852

Free draining base materials properties : final report.

DOT National Transportation Integrated Search

1992-03-01

The importance of providing a positive drainage system and removing free water from pavement structures has long been recognized. Inadequate drainage of the pavement structures has been identified as one of the primary causes of pavement distress. In...

The effects of chronic exposure to common bedding materials on the metabolic rate and overall health of male CD-1 mice.

PubMed

Becker, Corey E; Mathur, Carolyn F; Rehnberg, Bradley G

2010-01-01

Anecdotes and personal Web pages claim that cedar and pine beddings cause respiratory distress in rodents, although no previous research could be found to support these claims. There have, however, been published studies of respiratory distress in cedar and pine mill workers. That research links exposure to wood dust to asthma and to bronchial and alveolar damage in humans. This study looks at the effects of 3 types of bedding (CareFRESH Original, cedar, and pine) on the growth, food intake, oxygen consumption, IgE antibody concentrations, and general appearance and behavior in male CD-1 mice. Mice who were housed on these beddings for approximately 4 months did not show significant differences in any of these variables. This suggests that these 3 materials provide equally healthy substrates for long-term rearing of mice and possibly other rodents.

Use of a modified bubble continuous positive airway pressure (bCPAP) device for children in respiratory distress in low- and middle-income countries: a safety study.

PubMed

Bjorklund, Ashley R; Odongkara Mpora, Beatrice; Steiner, Marie E; Fischer, Gwenyth; Davey, Cynthia S; Slusher, Tina M

2018-06-18

While bubble continuous positive airway pressure (bCPAP) is commonly used in low- and middle-income countries (LMIC) to support neonates with respiratory distress, there are limited non-invasive support options for non-neonatal children. To demonstrate safety of a new device designed to support children during respiratory distress in LMIC. A paediatric bCPAP device was designed called SEAL-bCPAP (Simplified Ear-plug Adapted-bCPAP). SEAL-bCPAP is constructed from inexpensive, easily obtainable materials. The nasal prong interface was modified from previously described neonatal bCPAP set-ups using commercial ear-plug material to improve nasal seal. A prospective interventional study was conducted to evaluate safety in children with respiratory distress treated with SEAL-bCPAP. Patients aged 30 days to 5 years presenting to a hospital in northern Uganda from July 2015 to June 2016 were screened. Those with moderate-severe respiratory distress and/or hypoxia despite nasal cannula oxygen were eligible for study. Enrolled patients were supported with SEAL-bCPAP until respiratory improvement or death. Complications attributable to SEAL-bCPAP were recorded. Clinical outcomes were compared with historical control pre-trial data. Eighty-three of 87 enrolled patients were included in the final analysis. No patients had significant SEAL-bCPAP complications. Five patients had mild complications which resolved (four with nasal irritation and one with abdominal distention). Trial patients had significant (p < 0.0001) improvement in their TAL score, respiratory rate and O 2 sat after 2 h of SEAL-bCPAP. Fifty-two of 64 patients (62.7%) with severe illness at Time1 did not have severe illness at Time2 (after 2 h of SEAL-bCPAP) (p < 0.0001). Unadjusted mortality rates were 12.2% (6/49) and 9.6% (8/83), respectively, for pre-trial (historical control) and trial patients (p = 0.64); the study was not powered to show efficacy. The SEAL-bCPAP device is safe for treatment of respiratory distress in non-neonatal children in LMIC. There is a trend toward decreased mortality that should be evaluated with adequately powered clinical trials.

[Clinical everyday ethics-support in handling moral distress? : Evaluation of an ethical decision-making model for interprofessional clinical teams].

PubMed

Tanner, S; Albisser Schleger, H; Meyer-Zehnder, B; Schnurrer, V; Reiter-Theil, S; Pargger, H

2014-06-01

High-tech medicine and cost rationing provoke moral distress up to burnout syndromes. The consequences are severe, not only for those directly involved but also for the quality of patient care and the institutions. The multimodal model METAP (Modular, Ethical, Treatment, Allocation, Process) was developed as clinical everyday ethics to support the interprofessional ethical decision-making process. The distinctive feature of the model lays in education concerning ethics competence in dealing with difficult treatment decisions. METAP has been evaluated for quality testing. The research question of interest was whether METAP supports the handling of moral distress. The evaluation included 3 intensive care units and 3 geriatric units. In all, 33 single and 9 group interviews were held with 24 physicians, 44 nurses, and 9 persons from other disciplines. An additional questionnaire was completed by 122 persons (return rate 57%). Two-thirds of the interview answers and 55% of the questionnaire findings show that clinical everyday ethics supports the handling of moral distress, especially for interdisciplinary communication and collaboration and for the explanation and evaluation of treatment goals. METAP does not provide support for persons who are rarely confronted with ethical problems or have not applied the model long enough yet. To a certain degree, moral distress is unavoidable and must be addressed as an interprofessional problem. Herein, clinical everyday ethics may provide targeted support for ethical decision-making competence.

Negative affectivity as a mechanism underlying perceived distress tolerance and cannabis use problems, barriers to cessation, and self-efficacy for quitting among urban cannabis users.

PubMed

Manning, Kara; Paulus, Daniel J; Hogan, Julianna B D; Buckner, Julia D; Farris, Samantha G; Zvolensky, Michael J

2018-03-01

Cannabis use rates continue to rise in the United States and currently cannabis is among the most widely used substances in the world. Cannabis use is associated with several mental health problems, low educational attainment, low income, and underemployment. The current study explored the tendency to experience negative affect (negative affectivity) as a factor accounting for the association between perceived distress tolerance and problems related to the use of cannabis. Participants included 203 urban adult daily cannabis users (29.2% female, M=37.7years, 63% African American). Results indicated that there was a significant indirect effect of distress tolerance via negative affectivity in terms of cannabis use problems (b=-0.58, 95%CI [-1.14, -0.21]), cannabis withdrawal (b=-0.65, 95%CI [-1.36, -0.21]), self-efficacy for quitting (b=-0.83, 95%CI [-1.85, -0.22]), and perceived barriers for cannabis cessation (b=-0.71, 95%CI [-1.51, -0.24]). The present data provide novel empirical evidence suggesting negative affectivity may help explain the relation between perceived distress tolerance and an array of clinically significant cannabis use processes. Intervention programming for daily cannabis users may benefit from targeting negative affectivity to facilitate change in cannabis use processes among users who tend to perceive that they are less capable of tolerating distress. Copyright © 2017 Elsevier Ltd. All rights reserved.

Helping Yourself by Offering Help: Mediators of Expressive Helping in Survivors of Hematopoietic Stem Cell Transplant.

PubMed

Williamson, Timothy J; Stanton, Annette L; Austin, Jane E; Valdimarsdottir, Heiddis B; Wu, Lisa M; Krull, Jennifer L; Rini, Christine M

2017-10-01

A randomized experiment by Rini et al. (Health Psychol. 33(12):1541-1551, 2014) demonstrated that expressive helping, which involves three expressive writing sessions regarding hematopoietic stem cell transplant, followed by one writing session directed toward helping other stem cell transplant recipients, reduced psychological distress and bothersome physical symptoms among stem cell transplant recipients with elevated survivorship problems, relative to a neutral writing control condition. The current study evaluated whether word use reflective of emotional expression, cognitive processing, and change in perspective mediates the effects of expressive helping. The essays of 67 stem cell transplant recipients with high survivorship problems were analyzed with Linguistic Inquiry and Word Count. Multiple mediation modeling was used to test the hypothesized mechanisms of expressive helping on distress and bothersome physical symptoms. Relative to the control condition, expressive helping produced significant reductions in psychological distress and marginal reductions in physical symptom bother in the analyzed subset of participants from the parent study. Results indicated that positive emotion word use significantly mediated effects of expressive helping on reduced distress, but only for participants who used average (compared to above or below average) rates of negative emotion words. Cognitive processing and change in perspective did not significantly mediate benefits of expressive helping. Expressive helping carried its positive effects on distress through participants' higher expression of positive emotions when coupled with moderate rates of negative emotions. Findings highlight the benefit of expressing both positive and negative emotions in stressful situations.

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.

Gender Differences in Pathways to Compulsive Buying in Chinese College Students in Hong Kong and Macau.

PubMed

Ching, Terence H W; Tang, Catherine S; Wu, Anise; Yan, Elsie

2016-06-01

Background and aims The addictive nature of compulsive buying implies that mood disturbances, stress, and cognitive biases that underlie compulsive buying might operate in ways similar in both genders. In the current study, we aimed to test hypothetical pathways of mood compensation and irrational cognitions, which may explain compulsive buying tendencies. We also examined potential gender differences in these pathways. Methods Two-hundred and thirty-two male (age: M = 20.30, SD = 1.74) and 373 female Chinese college students (age: M = 19.97, SD = 1.74) in Hong Kong and Macau completed measures assessing compulsive buying, psychological distress, avoidance coping, materialism, and buying-related cognitions. Mediation analyses via a structural equation modeling approach explained by Cheung (2007, 2009) were conducted, with gender as a grouping variable. Results There was a gender difference in the mood compensation pathway; avoidance coping partially mediated the link between psychological distress and compulsive buying severity in females only. On the other hand, the irrational cognitive pathway, in which irrational buying-related cognitions fully mediated the link between materialism and compulsive buying severity, was supported for both genders. There was no gender difference in the extent of mediation within the irrational cognitive pathway, and the mediation effect within the irrational cognitive pathway was larger than that within the mood compensation pathway for both genders. Conclusions Mood compensation processes in compulsive buying might be female specific, and secondary to irrational cognitions, which were gender invariant. Gender-dependent mechanisms and irrational cognitions should be emphasized in compulsive buying treatment.

Gender Differences in Pathways to Compulsive Buying in Chinese College Students in Hong Kong and Macau

PubMed Central

Ching, Terence H. W.; Tang, Catherine S.; Wu, Anise; Yan, Elsie

2016-01-01

Background and aims The addictive nature of compulsive buying implies that mood disturbances, stress, and cognitive biases that underlie compulsive buying might operate in ways similar in both genders. In the current study, we aimed to test hypothetical pathways of mood compensation and irrational cognitions, which may explain compulsive buying tendencies. We also examined potential gender differences in these pathways. Methods Two-hundred and thirty-two male (age: M = 20.30, SD = 1.74) and 373 female Chinese college students (age: M = 19.97, SD = 1.74) in Hong Kong and Macau completed measures assessing compulsive buying, psychological distress, avoidance coping, materialism, and buying-related cognitions. Mediation analyses via a structural equation modeling approach explained by Cheung (2007, 2009) were conducted, with gender as a grouping variable. Results There was a gender difference in the mood compensation pathway; avoidance coping partially mediated the link between psychological distress and compulsive buying severity in females only. On the other hand, the irrational cognitive pathway, in which irrational buying-related cognitions fully mediated the link between materialism and compulsive buying severity, was supported for both genders. There was no gender difference in the extent of mediation within the irrational cognitive pathway, and the mediation effect within the irrational cognitive pathway was larger than that within the mood compensation pathway for both genders. Conclusions Mood compensation processes in compulsive buying might be female specific, and secondary to irrational cognitions, which were gender invariant. Gender-dependent mechanisms and irrational cognitions should be emphasized in compulsive buying treatment. PMID:27156378

Examining the mediational role of psychological flexibility, pain catastrophizing, and visceral sensitivity in the relationship between psychological distress, irritable bowel symptom frequency, and quality of life.

PubMed

Cassar, G E; Knowles, S; Youssef, G J; Moulding, R; Uiterwijk, D; Waters, L; Austin, D W

2018-06-08

The aim of the current study was to use Structural Equation Modelling (SEM) to examine whether psychological flexibility (i.e. mindfulness, acceptance, valued-living) mediates the relationship between distress, irritable bowel syndrome (IBS) symptom frequency, and quality of life (QoL). Ninety-two individuals participated in the study (12 male, 80 female, M age  = 36.24) by completing an online survey including measures of visceral sensitivity, distress, IBS-related QoL, mindfulness, bowel symptoms, pain catastrophizing, acceptance, and valued-living. A final model with excellent fit was identified. Psychological distress significantly and directly predicted pain catastrophizing, valued-living, and IBS symptom frequency. Pain catastrophizing directly predicted visceral sensitivity and acceptance, while visceral sensitivity significantly and directly predicted IBS symptom frequency and QoL. Symptom frequency also had a direct and significant relationship with QoL. The current findings suggest that interventions designed to address unhelpful cognitive processes related to visceral sensitivity, pain catastrophizing, and psychological distress may be of most benefit to IBS-related QoL.

Bearing fatigue investigation 3

NASA Technical Reports Server (NTRS)

Nahm, A. H.; Bamberger, E. N.; Signer, H. R.

1982-01-01

The operating characteristics of large diameter rolling-element bearings in the ultra high speed regimes expected in advanced turbine engines for high performance aircraft were investigated. A high temperature lubricant, DuPont Krytox 143 AC, was evaluated at bearing speeds to 3 million DN. Compared to the results of earlier, similar tests using a MIL-L-23699 (Type II) lubricant, bearings lubricated with the high density Krytox fluid showed significantly higher power requirements. Additionally, short bearing lives were observed when this fluid was used with AISI M50 bearings in an air atmosphere. The primary mode of failure was corrosion initiated surface distress (fatigue) on the raceways. The potential of a case-carburized bearing to sustain a combination of high-tangential and hertzian stresses without experiencing race fracture was also investigated. Limited full scale bearing tests of a 120 mm bore ball bearing at a speed of 25,000 rpm (3 million DN) indicated that a carburized material could sustain spalling fatigue without subsequent propagation to fracture. Planned life tests of the carburized material had to be aborted, however, because of apparent processing-induced material defects.

Convergence of self-report scales and Rorschach indexes of psychological distress: the moderating role of self-disclosure.

PubMed

Berant, Ety; Newborn, Michal; Orgler, Smadar

2008-01-01

In this study, we addressed the weak associations found in research between self-report measures and the Rorschach test (Exner, 1978, 1991), from the perspective of Bornstein's (2002) "process dissociation framework." Specifically, in the study, we focused on the associations between self-report measures of psychological distress and their corresponding Rorschach indexes while inspecting the moderating role of self-disclosure. A total of 59, nonpatient Israeli adults participated in a 2-session study. In the first session, they completed self-report scales measuring self-disclosure and psychological distress (suicidality, depression, and loneliness). In the second session, the Rorschach test was administered and coded. The participants were divided into high and low self-disclosure groups. A convergence between self-report and Rorschach measures of psychological distress was found only among high self-disclosers. In the discussion, we address the theoretical and clinical implications of these findings.

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.

Stories of Hell and Healing: Internet Users' Construction of Benzodiazepine Distress and Withdrawal.

PubMed

Fixsen, Alison M; Ridge, Damien

2017-11-01

Benzodiazepines are a group of drugs used mainly as sedatives, hypnotics, antiepileptics, and muscle relaxants. Consumption is recommended for 2 to 4 weeks only, due to fast onset of dependency and potentially distressing withdrawal symptoms. Few peer-review studies have drawn on the user experiences and language to appreciate firsthand experiences of benzodiazepine withdrawal or discontinuation syndrome. We looked extensively at patient stories of benzodiazepine withdrawal and recovery on Internet support sites and YouTube. Our analysis indicated that users employ rich metaphors to portray the psychologically disturbing and protracted nature of their suffering. We identified seven major themes: hell and isolation, anxiety and depression, alienation, physical distress, anger and remorse, waves and windows, and healing and renewal. By posting success stories, ex-users make known that "healing" can be a long, unpredictable process, but distress does lessen, and recovery can happen.

If We Build It, They Will Come: Exploring Policy and Practice Implications of Public Support for Couple and Relationship Education for Lower Income and Relationally Distressed Couples.

PubMed

Bradford, Angela B; Hawkins, Alan J; Acker, Jennifer

2015-12-01

Over the past decade, public funding for Couple and Relationship Education programs has expanded. As program administrators have been able to extend their reach to low-income individuals and couples using this support, it has become apparent that greater numbers of relationally distressed couples are attending classes than previously anticipated. Because psychoeducational programs for couples have traditionally served less distressed couples, this dynamic highlights the need to examine the policy and practice implications of more distressed couples accessing these services. This paper reviews some of the most immediate issues, including screening for domestic violence and couple needs, pedagogical considerations, and the potential integration of therapy and education services. We also make suggestions for future research that can inform policy and practice efforts. © 2015 Family Process Institute.

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

Interaction effect of brooding rumination and interoceptive awareness on depression and anxiety symptoms

PubMed Central

Lackner, Ryan J.; Fresco, David M.

2016-01-01

Awareness of the body (i.e., interoceptive awareness) and self-referential thought represent two distinct, yet habitually integrated aspects of self. A recent neuroanatomical and processing model for depression and anxiety incorporates the connections between increased but low fidelity afferent interoceptive input with self-referential and belief-based states. A deeper understanding of how self-referential processes are integrated with interoceptive processes may ultimately aid in our understanding of altered, maladaptive views of the self – a shared experience of individuals with mood and anxiety disorders. Thus, the purpose of the current study was to examine how negative self-referential processing (i.e., brooding rumination) relates to interoception in the context of affective psychopathology. Undergraduate students (N = 82) completed an interoception task (heartbeat counting) in addition to self-reported measures of rumination and depression and anxiety symptoms. Results indicated an interaction effect of brooding rumination and interoceptive awareness on depression and anxiety-related distress. Specifically, high levels of brooding rumination coupled with low levels of interoceptive awareness were associated with the highest levels of depression and anxiety-related distress, whereas low levels of brooding rumination coupled with high levels of interoceptive awareness were associated with lower levels of depression and anxiety-related distress. The findings provide further support for the conceptualization of anxiety and depression as conditions involving the integration of interoceptive processes and negative self-referential processes. PMID:27567108

A Randomized Trial Comparing Efficacy of Bubble and Ventilator Derived Nasal CPAP in Very Low Birth Weight Neonates with Respiratory Distress

PubMed Central

Agarwal, Sheetal; Roy, Mahesh K.; Verma, Ankit

2016-01-01

Introduction Continuous Positive Airway Pressure (CPAP) has an established role in the care of Very Low Birth Weight (VLBW) babies with respiratory distress. Bubble CPAP (BCPAP) is a cheap alternative for countries where resources are limited. However, data comparing efficacy of BCPAP with conventional ventilator derived (VCPAP) is limited. Aim To compare CPAP failure rates between BCPAP and VCPAP among VLBW, with moderate respiratory distress. Secondary objectives were to compare the rates of Intraventricular Haemorrhage (IVH), pulmonary air leaks and deaths between the two groups and determine the predictors of CPAP failure. Materials and Methods VLBW babies with moderate respiratory distress (Silverman Anderson score 4-7), born or admitted in Neonatal Intensive Care Unit (NICU) within 28 days of life were randomized to receive either BCPAP (n=34) or VCPAP (n=34). CPAP failure rate in both the groups was compared. Results The baseline characteristics were similar in both the groups. Five out of 34 (14.70%) babies in BCPAP group and 11 out of 34 (32.35%) in VCPAP failed CPAP (p=0.08). IVH (BCPAP group 24% and VCPAP group 9%, p= 0.10) and mortality (BCPAP group 6% and VCPAP group 9%, p=0.642) were comparable in both the groups. Factors such as gestational age <30 weeks, weight <1000 grams, Respiratory Distress Syndrome (RDS), shock, pulmonary haemorrhage, Disseminated Intravascular Coagulation (DIC) and multi-organ dysfunction were significantly associated with CPAP failure in our study. Conclusion The CPAP failure rates in VLBW babies with moderate respiratory distress were found to be similar whether bubble CPAP or ventilator CPAP was used. There was no difference in complication rates of IVH or mortality with either method of CPAP. PMID:27790540

The relationship of quality of life and distress in prostate cancer patients compared to the general population

PubMed Central

Zenger, Markus; Lehmann-Laue, Antje; Stolzenburg, Jens-Uwe; Schwalenberg, Thilo; Ried, Alexander; Hinz, Andreas

2010-01-01

Background: The aim of this study is two-fold. The first part compares quality of life (QoL) data of prostate cancer patients with those of a representative and age-specific sample of the general population and analyzes the influence of cancer related as well as socio-demographic parameters on QoL. Secondly, differences in QoL depending on the experienced psychological distress will be shown both in prostate cancer patients and in the general population. Material and Methods: A sample of 265 prostate cancer patients completed both the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and the Hospital Anxiety and Depression Scale (HADS) during their stay in the hospital. A total HADS cut off score of 15 was used to indicate psychological distress and significant emotional concerns in patients and men of the general population. The results of the patients were compared with those of the general population (N=444). Results: Prostate cancer patients reported significantly worse levels of social and emotional functioning as well as more symptoms like insomnia, constipation and diarrhea compared to the general population. Patients and men of the general population with a total HADS score ≥15 reported lower QoL in all sub-scales except for diarrhea in comparison to people without distress. Discussion: Psychological distress is accompanied by lower QoL and therefore should be taken into consideration when QoL is assessed. Furthermore, clinicians should be trained by professionals to detect distress in their patients and to pay more attention to their emotional concerns, which are strongly associated with the patients’ well-being and QoL during their stay in hospital. PMID:20628652

Screening for psychological distress in cancer: renewing the research agenda.

PubMed

Salmon, Peter; Clark, Louise; McGrath, Elly; Fisher, Peter

2015-03-01

Although health policy for cancer care promotes screening of patients for emotional distress, the utility and validity of screening have been questioned. Continued research to refine detection of distress or to evaluate outcomes of screening programmes is unlikely to end this controversy. Instead, we need to identify more fundamental research questions that address the validity or utility of screening in this context. We critically and selectively review research and policy literature on psychological screening in cancer care, drawing also from research literature about the nature of psychological needs in cancer care and from relevant literature on psychological screening in mental health. We identify three broad research questions: (i) Apart from intensity of distress, what further information should screening seek about the context of distress, psychological processes that promote distress and patients' own perspective on their needs? (ii) What are the implications of the contextual dependence of disclosure of emotional feelings, given that screening questions can be asked in contexts ranging from an impersonal questionnaire to dialogue with a trusted practitioner? (iii) How should a screen be responded to, given the inherent uncertainty associated with screening results and given that distress in a cancer context can indicate instrumental as well as psychological needs? Examining these questions will mean exchanging a diagnostic framework for screening, in which health need is indicated by the presence of a psychological disorder, for a public health framework, in which health need is identified from multiple perspectives. Copyright © 2014 John Wiley & Sons, Ltd.

Student distress in clinical workplace learning: differences in social comparison behaviours.

PubMed

Janet Raat, A N; Schönrock-Adema, Johanna; van Hell, E Ally; Kuks, Jan B M; Cohen-Schotanus, Janke

2015-03-01

In medical education, student distress is known to hamper learning and professional development. To address this problem, recent studies aimed at helping students cope with stressful situations. Undergraduate students in clinical practice frequently use experiences of surrounding peers to estimate their abilities to master such challenging situations. This use of the experiences of others, known as social comparison, may affect student distress both positively and negatively. To find characteristics of a beneficial use of social comparison, we examined differences in comparison behaviours between students expressing low and high levels of distress. The participants in our study, response rate 93% (N = 301/321), were all medical students in their first year in clinical practice. They completed the General Health Questionnaire (GHQ-12) to measure distress, and three separate questionnaires to measure: (1) orientation to comparison, (2) motive for comparison, and (3) interpretation of comparison. Differences were analysed using multivariate analysis of variance. Although all students were oriented towards social comparison, the analyses showed that this orientation was less apparent among low-distress students. Besides, the low-distress students were less inclined to use motives indicative for comparisons with peers perceived as performing worse and were less negative in the interpretations of their comparisons. As social comparison is frequently used among all students, we recommend to make them aware of their comparison behaviours and inform them about the pros and cons of the distinguished aspects of the comparison process.

Mind-Body Skills Training to Improve Distress Tolerance in Medical Students: A Pilot Study.

PubMed

Kraemer, Kristen M; Luberto, Christina M; O'Bryan, Emily M; Mysinger, Erica; Cotton, Sian

2016-01-01

Medical students face rigorous and stressful work environments, resulting in high rates of psychological distress. However, there has been a dearth of empirical work aimed at modifying risk factors for psychopathology among this at-risk group. Distress tolerance, defined as the ability to withstand emotional distress, is one factor that may be important in promoting psychological well-being in medical students. Thus, the aim of the current mixed-methods study was (a) to describe changes in facets of distress tolerance (i.e., emotional tolerance, absorption, appraisal, regulation) for medical students who completed a mind-body skills training group, and a no-intervention control group of students; (b) to examine the relationship between changes in psychological variables and changes in distress tolerance; and (c) to report students' perceptions of the mind-body group, with an emphasis on how the group may have affected personal and professional functioning due to improvements in distress tolerance. The mind-body program was an 11-week, 2-hour skills training group that focused on introducing, practicing, and processing mind-body skills such as biofeedback, guided imagery, relaxation, several forms of meditation (e.g., mindfulness), breathing exercises, and autogenic training. Participants were 52 first- and second-year medical students (62.7% female, Mage = 23.45, SD = 1.51) who participated in a mind-body group or a no-intervention control group and completed self-report measures before and after the 11-week period. Students in the mind-body group showed a modest improvement in all distress tolerance subscales over time (ΔM = .42-.53, p = .01-.03, d = .44-.53), whereas the control group showed less consistent changes across most subscales (ΔM = .11-.42, p = .10-.65, d = .01-.42). Students in the mind-body group qualitatively reported an improved ability to tolerate affective distress. Overall, improvements in psychological symptoms were associated with improvements in distress tolerance in the mind-body group but not in the control group. These preliminary findings provide support for the notion that improving distress tolerance through mind-body skills training might serve to protect medical students from becoming functionally impaired by psychological distress. Thus, implementing mind-body skills training into medical school education may help to improve the psychological well-being of medical students. Future studies utilizing more methodologically rigorous designs are warranted.

Recommendations and illustrations for combining hypnosis and EMDR in the treatment of psychological trauma.

PubMed

Beere, D B; Simon, M J; Welch, K

2001-01-01

Three experienced therapists, trained in hypnosis and EMDR, distilled some tentative hypotheses about the use of hypnosis in EMDR from fifteen cases, two presented here. When a therapist uses hypnosis with EMDR, it seems that the client is having difficulty or the therapist anticipates that the client will have difficulty managing the experiences processed with EMDR. Hypnosis initiated either during the introduction to EMDR or within a therapy session prior to the initiation of EMDR seems to have served two functions. The first function is to activate inner work that prepares the client to use EMDR successfully, and the second function is to facilitate overtly the processing of the traumatic experience. Clients might have two kinds of difficulties in managing affect or distress: (1) they may have a long-standing, irrational and strongly held belief that interferes with managing affect or distress, and (2) they may never have developed the capacity to tolerate intense affect, distress or pain. Should a therapist use hypnosis during the closing down phase of a session without preparing the client with hypnosis during the introduction to EMDR, the therapist should seriously reconsider the pace and focus of EMDR and the client's resources to manage affect and distress.

Socioeconomic disadvantages and neural sensitivity to infant cry: role of maternal distress.

PubMed

Kim, Pilyoung; Capistrano, Christian; Congleton, Christina

2016-10-01

Socioeconomic disadvantage such as poverty can increase distress levels, which may further make low-income mothers more vulnerable to difficulties in the transition to parenthood. However, little is known about the neurobiological processes by which poverty and maternal distress are associated with risks for adaptations to motherhood. Thus, the current study examined the associations between income and neural responses to infant cry sounds among first-time new mothers (N = 28) during the early postpartum period. Lower income was associated with reduced responses to infant cry in the medial prefrontal gyrus (involved in evaluating emotional values of stimuli), middle prefrontal gyrus (involved in affective regulation) and superior temporal gyrus (involved in sensory information processing). When examining the role of maternal distress, we found a mediating role of perceived stress, but not depressive symptoms, in the links between income and prefrontal responses to infant cry. Reduced neural responses to infant cry in the right middle frontal gyrus and superior temporal gyrus were further associated with less positive perceptions of parenting. The results demonstrate that perceived stress associated with socioeconomic disadvantages may contribute to reduced neural responses to infant cry, which is further associated with less positive perceptions of motherhood. © The Author (2016). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

The contribution of pre- and postdisaster social support to short- and long-term mental health after Hurricanes Katrina: A longitudinal study of low-income survivors.

PubMed

Chan, Christian S; Lowe, Sarah R; Weber, Elyssa; Rhodes, Jean E

2015-08-01

A previous study of Hurricane Katrina survivors found that higher levels of predisaster social support were associated with lower psychological distress one year after the storm, and that this pathway was mediated by lower exposure to hurricane-related stressors. As a follow-up, we examined the impact of pre- and postdisaster social support on longer-term of mental health-both psychological distress and posttraumatic stress. In this three-wave longitudinal study, 492 residents in the region affected by Hurricane Katrina reported levels of perceived social support and symptoms of psychological distress prior to the storm (Wave 1). Subsequently, one year after Hurricane Katrina (Wave 2), they reported levels of exposure, perceived social support, and symptoms of psychological distress and posttraumatic stress. The latter three variables were assessed again four years after the hurricane (Wave 3). Results of mediation analysis indicated that levels of exposure to hurricane-related stressors mediated the relationship between Wave 1 perceived social support and Wave 3 psychological distress as well as postdisaster posttraumatic stress. Results of regression analyses indicated that, controlling for Wave 1 psychological distress and disaster exposure, Wave 2 perceived social support was associated with Wave 2 and Wave 3 psychological distress but not posttraumatic stress. Our results confirmed the social causation processes of social support and suggest that posttraumatic stress might not stem directly from the lack of social support. Rather, preexisting deficits in social resources might indirectly affect longer-term posttraumatic stress and general psychological distress by increasing risk for disaster-related stressors. Copyright © 2015 Elsevier Ltd. All rights reserved.

The Importance of Contextual Factors and Age in Association with Anxiety and Depression in Black Breast Cancer Patients

PubMed Central

Sheppard, Vanessa B.; Harper, Felicity W. K.; Davis, Kimberly; Hirpa, Fikru; Makambi, Kepher

2014-01-01

Objectives Limited research exists on correlates of psychosocial distress in Black breast cancer patients. The goals of the study were to describe the prevalence of distress (anxiety and depression) in Black women with breast cancer and to examine the influence of demographic, clinical, contextual (e.g. self-efficacy, medical mistrust), and process of care factors (e.g., patient satisfaction) on women’s level of anxiety and depression. Methods Eighty-two Black women diagnosed with invasive non- metastatic breast cancer were interviewed by phone. Collected data included demographics, clinical, contextual, and process of care factors. Bivariate correlations were used to examine relationships between those variables. Multiple linear regressions were used to examine predictors of anxiety and depression. Results About one-third of the women (32%) met cut-off thresholds for distress. Medical mistrust and positive attitude had significant influences on anxiety levels while age and positive attitude were determinants of levels of depression. Participants with higher medical mistrust reported more anxiety (r=.379; p<.001) and depression (r=.337 p=.002) while women with higher self-efficacy reported less anxiety (r=−.401; p<.001) and depression (r=−.427; p < .001). Age was inversely related to both anxiety and depression (r=−.224, r=−.296, respectively; p<.05). Conclusions Findings support national recommendations for routine distress screening in the delivery of cancer care particularly in younger Black patients. Interventions targeted to boost self-efficacy or reduce medical mistrust through enhanced patient-provider interactions may decrease psychological distress. Psychosocial needs of younger patients warrant particular attention. PMID:24150907

Repair & Strengthening of Distressed/Damaged Ends of Prestressed Beams with FRP Composites

DOT National Transportation Integrated Search

2018-02-01

Over the past few decades, fiber reinforced polymer (FRP) composites have emerged as a lightweight and efficient material used for the repair and retrofit of concrete infrastructures. FRP can be applied to concrete as either externally bonded laminat...

Onsite use of recycled asphalt pavement materials and geocells to reconstruct pavements damaged by heavy trucks.

DOT National Transportation Integrated Search

2011-07-01

Asphalt pavements deteriorate with traffic (especially heavy trucks) and time. Maintenance and overlaying may solve minor to : medium pavement distress problems. When the condition of a pavement becomes badly deteriorated, reconstruction of the : pav...

46 CFR 160.072-1 - Applicability.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 6 2010-10-01 2010-10-01 false Applicability. 160.072-1 Section 160.072-1 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Distress Signals for Boats, Orange Flag § 160.072-1...

Local responses to trauma: symptom, affect, and healing.

PubMed

Hinton, Devon E; Kirmayer, Laurence J

2013-10-01

This article provides an introduction to the thematic issue of Transcultural Psychiatry on local responses to trauma. To illustrate how local responses to trauma may be therapeutic, we consider the multiple dimensions or domains that may be targeted by healing rituals and interventions. We then outline a theoretical model of the generation of trauma-related symptoms and distress. We present the multiplex model of symptom generation which posits multiple cognitive, social, and physiological mechanisms by which various triggers can lead to severe distress among trauma victims in acute episodes, and which may be targeted in treatment. More persistent forms of distress can be explained in terms of the effects of persistent mood states and associated modes of cognitive processing and behavior that render individuals vulnerable to chronic symptoms and acute exacerbations. The beneficial effects of healing rituals and interventions may occur, in part, by inducing positive affective states associated with a flexible mind-set. We conclude by summarizing some of the contributions of the papers in this issue to understanding local therapeutic processes of healing.

Magical thinking in narratives of adolescent cutters.

PubMed

Gregory, Robert J; Mustata, Georgian T

2012-08-01

Adolescents sometimes cut themselves to relieve distress; however, the mechanism is unknown. Previous studies have linked self-injury to deficits in processing emotions symbolically through language. To investigate expressive language of adolescent cutters, the authors analyzed 100 narratives posted on the Internet. Most narratives (n = 66) displayed idiosyncratic use of language indicating poor differentiation between the real and the symbolic, such as blood substituting for negative emotions, which can then be released from the self; or emotional pain magically transforming into physical pain, which can then be managed. This kind of magical thinking correlated with cutting to relieve distress, to see blood, and to feel pain, but negatively correlated with complex representation of people, understanding social causality, and self-esteem. The results suggest that magical thinking represents a pre-symbolic mental state that processes and organizes distressing emotions through body schema. Magical thinking thus provides a plausible mechanism for why cutting works. Copyright © 2012 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

An integrated approach to an analysis of symptom management in patients with cancer.

PubMed

Fu, Mei R; LeMone, Priscilla; McDaniel, Roxanne W

2004-01-01

To provide a definition, describe uses, and identify essential attributes of symptom management by emphasizing the philosophical base for the concept. 51 references (i.e., books and articles) published from 1980-2003 and located through the Ovid database. Symptoms are subjective and personal phenomena, incorporating the dimensions of symptom occurrence, symptom distress, and symptom experience. Symptom management has been conceptualized and described as self-activity. Symptom status is the direct outcome of symptom management, with symptom distress, quality of life, and performance as major indicators. The essential attributes of symptom management in patients with cancer are subjectivity, experientiality, intentionality, multidimensionality, dynamic process, and positive and negative outcomes. Findings can help oncology nurses and other healthcare professionals to better understand the process of managing a symptom and the influential factors that affect positive outcomes. The information from this analysis can be used to design educational and interventional programs for symptom management. Future research is needed to establish interventions that relieve and decrease the distress from or prevent the occurrence of symptoms.

Psychosocial factors and distress: a comparison between ethnic Norwegians and ethnic Pakistanis in Oslo, Norway.

PubMed

Syed, Hammad Raza; Dalgard, Odd Steffen; Dalen, Ingvild; Claussen, Bjørgulf; Hussain, Akthar; Selmer, Randi; Ahlberg, Nora

2006-07-10

In the Norwegian context, higher mental distress has been reported for the non-Western immigrants compared to the ethnic Norwegians and Western immigrants. This high level of distress is often related to different socio-economic conditions in this group. No efforts have been made earlier to observe the impact of changed psychosocial conditions on the state of mental distress of these immigrant communities due to the migration process. Therefore, the objective of the study was to investigate the association between psychological distress and psychosocial factors among Pakistani immigrants and ethnic Norwegians in Oslo, and to investigate to what extent differences in mental health could be explained by psychosocial and socioeconomic conditions. Data was collected from questionnaires as a part of the Oslo Health Study 2000-2001. 13581 Norwegian born (attendance rate 46%) and 339 ethnic Pakistanis (attendance rate 38%) in the selected age groups participated. A 10-item version of Hopkins Symptom Checklist (HSCL) was used as a measure of psychological distress. Pakistanis reported less education and lower employment rate than Norwegians (p < 0.005). The Pakistani immigrants also reported higher distress, mean HSCL score 1.53(1.48-1.59), compared to the ethnic Norwegians, HSCL score 1.30(1.29-1.30). The groups differed significantly (p < 0.005) with respect to social support and feeling of powerlessness, the Pakistanis reporting less support and more powerlessness. The expected difference in mean distress was reduced from 0.23 (0.19-0.29) to 0.07 (0.01-0.12) and 0.12 (0.07-0.18) when adjusted for socioeconomic and social support variables respectively. Adjusting for all these variables simultaneously, the difference in the distress level between the two groups was eliminated Poor social support and economic conditions are important mediators of mental health among immigrants. The public health recommendations/interventions should deal with both the economic conditions and social support system of immigrant communities simultaneously.

RCT of a Psychological Intervention for Patients With Cancer: I. Mechanisms of Change

PubMed Central

Andersen, Barbara L.; Shelby, Rebecca A.; Golden-Kreutz, Deanna M.

2008-01-01

Little is known about the therapeutic processes contributing to efficacy of psychological interventions for patients with cancer. Data from a randomized clinical trial yielding robust biobehavioral and health effects (B. L. Andersen et al., 2004, 2007) were used to examine associations between process variables, treatment utilization, and outcomes. Novel findings emerged. Patients were highly satisfied with the treatment, but their higher levels of felt support (group cohesion) covaried with lower distress and fewer symptoms. Also, specific. treatment strategies were associated with specific outcomes, including lower distress, improved dietary habits, reduced symptomatology, and higher chemotherapy dose intensity. These data provide a comprehensive test of multiple therapeutic processes and mechanisms for biobehavioral change with an intervention including both intensive and maintenance phases. PMID:18085909

Responding mindfully to distressing psychosis: A grounded theory analysis.

PubMed

Abba, Nicola; Chadwick, Paul; Stevenson, Chris

2008-01-01

This study investigates the psychological process involved when people with current distressing psychosis learned to respond mindfully to unpleasant psychotic sensations (voices, thoughts, and images). Sixteen participants were interviewed on completion of a mindfulness group program. Grounded theory methodology was used to generate a theory of the core psychological process using a systematically applied set of methods linking analysis with data collection. The theory inducted describes the experience of relating differently to psychosis through a three-stage process: centering in awareness of psychosis; allowing voices, thoughts, and images to come and go without reacting or struggle; and reclaiming power through acceptance of psychosis and the self. The conceptual and clinical applications of the theory and its limits are discussed.

Distress, coping, and drug law enforcement in a series of patients using medical cannabis.

PubMed

Aggarwal, Sunil Kumar; Carter, Gregory; Sullivan, Mark; Morrill, Richard; Zumbrunnen, Craig; Mayer, Jonathan

2013-04-01

Patients using medical cannabis in the United States inhabit a conflicting medicolegal space. This study presents data from a dispensary-based survey of patients using medical cannabis in the state of Washington regarding cannabis-specific health behaviors, levels of psychological distress, stress regarding marijuana criminality, past experiences with drug law enforcement, and coping behaviors. Thirty-seven subjects were enrolled in this study, and all but three completed survey materials. The median index of psychological distress, as measured by the Behavioral Symptom Inventory, was nearly 2.5 times higher than that found in a general population sample but one third less than that found in an outpatient sample. The subjects reported a moderate amount of stress related to the criminality of marijuana, with 76% reporting previous exposure to 119 separate drug law enforcement tactics in total. The subjects reported a wide range of coping methods, and their responses to a modified standardized survey showed the confounding influence of legality in assessing substance-related disorders.

Does the psychosocial quality of unpaid family work contribute to educational disparities in mental health among employed partnered mothers?

PubMed

Janzen, Bonnie; Hellsten, Laurie-Ann M

2018-04-24

The contribution of unpaid family work quality to understanding social inequalities in women's mental health has been understudied and further limited by a scarcity of psychometrically sound instruments available to measure family work. Therefore, using a multi-item scale of family work quality with evidence of validity and reliability, the overall aim of the present study was to determine whether psychosocial qualities of unpaid family work contribute to educational inequities in women's mental health. Study participants in this cross-sectional study were 512 employed partnered mothers living in a Canadian province and recruited from an online research panel. The dependent variable was psychological distress. In addition to a 28-item measure assessing five dimensions of unpaid family work quality, independent variables included material deprivation, job decision latitude, job demands and several measures of the work-family interface. Multiple linear regression was the primary analysis. Compared to women with high school or less, university educated women reported lower psychological distress [b = - 2.23 (SE = 0.50) p = 0.001]. The introduction of material deprivation into the model resulted in the largest reduction to the education disparity (51%), followed by equity in responsibility for unpaid family work (25%), family-to-work facilitation (22%), and decision latitude in paid work (21%). When entered simultaneously into the final model, the association between education and psychological distress was reduced by 70% and became statistically non-significant [b = - 0.68 (SE = 0.47) p = 0.10]. In addition to the more established mechanisms of material conditions and decision latitude to explain mental health disparities, inequity in responsibility for unpaid family work may also play a role.

Landscape design strategies for post-disaster reconstructions based on traditional ethical wisdom

NASA Astrophysics Data System (ADS)

Yi, Shouli; Hu, Di; Gao, Suping; Lei, Ting; Chen, Qibin

2018-03-01

In the face of the black swan events which frequently happened globally, I take the earthquake of Ya'an, happened at 4.20 in Sichuan, as an example of my subject. The results indicate that the social responsibility of landscape architects is a post-disaster reconstruction of a material and spiritual homeland for victims and mental care for individuals, which specifically reflected in the process of rebuilding victims' sense of security. The reconstruction of a sense of security must follow certain ethics and moralities which embody the ecological wisdom. We take a typical case of Ya'an Lushan Snow Mountain Village-the earthquake distress area, we found the incidence of disease was up to 68.6% through the PTSD analysis, indicating the overall absence of a sense of security. To solve the problem and reconstruct people's mental and material homeland, the article discussed the strategies and solutions to post-disaster landscape design based on traditional ethical wisdom.

Empathy as a “Risky Strength”: A Multilevel Examination of Empathy and Risk for Internalizing Disorders

PubMed Central

Tone, Erin B.; Tully, Erin C.

2015-01-01

Learning to respond to others’ distress with well-regulated empathy is an important developmental task linked to positive health outcomes and moral achievements. However, this important interpersonal skill set may also, paradoxically, confer risk for depression and anxiety when present at extreme levels and in combination with certain individual characteristics or within particular contexts. The purpose of this review is to describe an empirically-grounded theoretical rationale for the hypothesis that empathic tendencies can be “risky strengths”. We propose a model in which typical development of affective and cognitive empathy can be influenced by complex interplay among intraindividual and interindividual moderators that increase risk for empathic personal distress and excessive interpersonal guilt. These intermediate states, in turn, precipitate internalizing problems that map onto empirically-derived fear/arousal and anhedonia/misery subfactors of internalizing disorders. The intraindividual moderators include a genetically-influenced propensity toward physiological hyperarousal, which is proposed to interact with genetic propensity to empathic sensitivity to contribute to neurobiological processes that underlie personal distress responses others’ pain or unhappiness. This empathic personal distress then increases risk for internalizing problems, particularly fear/arousal symptoms. Similarly, interactions between genetic propensities toward negative thinking processes and empathic sensitivity are hypothesized to contribute to excess interpersonal guilt in response to others’ distress. In turn, this interpersonal guilt increases risk for internalizing problems, especially anhedonia/misery symptoms. Interindividual moderators, such as maladaptive parenting or chronic exposure to parents’ negative affect, further interact with these genetic liabilities to amplify risk for personal distress and interpersonal guilt, as well as for consequent internalizing problems. Age-related increases in the heritability of depression, anxiety, and empathy-related constructs are consistent with developmental shifts toward greater influence of intraindividual moderators throughout childhood and adolescence, with interindividual moderators exerting their greatest influence during early childhood. Efforts to modulate neurobiological and behavioral expressions of genetic dysregulation liabilities and to promote adaptive empathic skills must thus begin early in development. PMID:25422978

Empathy as a "risky strength": a multilevel examination of empathy and risk for internalizing disorders.

PubMed

Tone, Erin B; Tully, Erin C

2014-11-01

Learning to respond to others' distress with well-regulated empathy is an important developmental task linked to positive health outcomes and moral achievements. However, this important interpersonal skill set may also confer risk for depression and anxiety when present at extreme levels and in combination with certain individual characteristics or within particular contexts. The purpose of this review is to describe an empirically grounded theoretical rationale for the hypothesis that empathic tendencies can be "risky strengths." We propose a model in which typical development of affective and cognitive empathy can be influenced by complex interplay among intraindividual and interindividual moderators that increase risk for empathic personal distress and excessive interpersonal guilt. These intermediate states in turn precipitate internalizing problems that map onto empirically derived fear/arousal and anhedonia/misery subfactors of internalizing disorders. The intraindividual moderators include a genetically influenced propensity toward physiological hyperarousal, which is proposed to interact with genetic propensity to empathic sensitivity to contribute to neurobiological processes that underlie personal distress responses to others' pain or unhappiness. This empathic personal distress then increases risk for internalizing problems, particularly fear/arousal symptoms. In a similar fashion, interactions between genetic propensities toward negative thinking processes and empathic sensitivity are hypothesized to contribute to excess interpersonal guilt in response to others' distress. This interpersonal guilt then increases the risk for internalizing problems, especially anhedonia/misery symptoms. Interindividual moderators, such as maladaptive parenting or chronic exposure to parents' negative affect, further interact with these genetic liabilities to amplify risk for personal distress and interpersonal guilt as well as for consequent internalizing problems. Age-related increases in the heritability of depression, anxiety, and empathy-related constructs are consistent with developmental shifts toward greater influence of intraindividual moderators throughout childhood and adolescence, with interindividual moderators exerting their greatest influence during early childhood. Efforts to modulate neurobiological and behavioral expressions of genetic dysregulation liabilities and to promote adaptive empathic skills must thus begin early in development.

Psychological distress following a motor vehicle crash: evidence from a statewide retrospective study examining settlement times and costs of compensation claims.

PubMed

Guest, Rebecca; Tran, Yvonne; Gopinath, Bamini; Cameron, Ian D; Craig, Ashley

2017-09-05

To determine whether psychological distress associated with musculoskeletal injuries sustained in a motor vehicle crash (MVC), regardless of time of onset, impacts compensation outcomes such as claim settlement times and costs. Second, to identify factors routinely collected by insurance companies that contribute to psychological distress during the compensation process. Statewide retrospective study. Analysis of the New South Wales statewide (Australia) injury register for MVC survivors who lodged a compensation claim from 2011 to 2013. 6341 adults who sustained a musculoskeletal injury and who settled a claim for injury after an MVC. Participants included those diagnosed with psychological distress (n=607) versus those not (n=5734). Time to settlement and total costs of claims, as well as socio-demographic and injury characteristics that may contribute to elevated psychological distress, such as socio-economic disadvantage, and injury severity. Psychological distress in those with a musculoskeletal injury was associated with significantly longer settlement times (an additional 17 weeks) and considerably higher costs (an additional $A41 575.00 or 4.3 times more expensive). Multivariate logistic regression analysis identified risk factors for psychological distress including being female, social disadvantage, unemployment prior to the claim, not being at fault in the MVC, requiring ambulance transportation and rehabilitation as part of recovery. Results provide compelling evidence that psychological distress has an adverse impact on people with musculoskeletal injury as they progress through compensation. Findings suggest that additional resources should be directed toward claimants who are at risk (eg, the socially disadvantaged or those unemployed prior to the claim), the major aim being to reduce risk of psychological distress, such as post-traumatic stress disorder, and associated risk of increased settlement times and claim costs. Prospective studies are now required that investigate treatment strategies for those at risk of psychological distress associated with an MVC. © 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.

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.

Determinants of psychological distress over time among older Korean immigrants and Non-Hispanic White elders: evidence from a two-wave panel study.

PubMed

Min, J W; Moon, A; Lubben, J E

2005-05-01

The purpose of this study is to examine racial/ethnic differences in the change of psychological distress as measured by CES-D over time and its associated factors between older Korean immigrants and non-Hispanic White elders, based on a social stress perspective. Data come from a two-wave panel survey of 172 older Korean immigrants and 157 non-Hispanic White elders, with a follow-up period of 12 to 15 months. The sample was drawn from a three-stage probability sampling method. Ordinary least square regressions in a hierarchical process and change score method were used to analyze the two-wave panel data. Older Korean immigrants reported higher levels of psychological distress than the non-Hispanic White elderly at both Time 1 and Time 2. Changes in self-assessed health status and functional limitations were significantly associated with change in psychological distress for both ethnic groups. Increased social support significantly decreased psychological distress at Time 2, for older Korean immigrants only. This study discusses practice and policy implications for service and interventions for older immigrants to assist their adjustment to a host society.

Interaction effect of brooding rumination and interoceptive awareness on depression and anxiety symptoms.

PubMed

Lackner, Ryan J; Fresco, David M

2016-10-01

Awareness of the body (i.e., interoceptive awareness) and self-referential thought represent two distinct, yet habitually integrated aspects of self. A recent neuroanatomical and processing model for depression and anxiety incorporates the connections between increased but low fidelity afferent interoceptive input with self-referential and belief-based states. A deeper understanding of how self-referential processes are integrated with interoceptive processes may ultimately aid in our understanding of altered, maladaptive views of the self - a shared experience of individuals with mood and anxiety disorders. Thus, the purpose of the current study was to examine how negative self-referential processing (i.e., brooding rumination) relates to interoception in the context of affective psychopathology. Undergraduate students (N = 82) completed an interoception task (heartbeat counting) in addition to self-reported measures of rumination and depression and anxiety symptoms. Results indicated an interaction effect of brooding rumination and interoceptive awareness on depression and anxiety-related distress. Specifically, high levels of brooding rumination coupled with low levels of interoceptive awareness were associated with the highest levels of depression and anxiety-related distress, whereas low levels of brooding rumination coupled with high levels of interoceptive awareness were associated with lower levels of depression and anxiety-related distress. The findings provide further support for the conceptualization of anxiety and depression as conditions involving the integration of interoceptive processes and negative self-referential processes. Copyright © 2016 Elsevier Ltd. All rights reserved.

46 CFR 160.066-15 - Production testing.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 6 2011-10-01 2011-10-01 false Production testing. 160.066-15 Section 160.066-15 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Distress Signal for Boats, Red Aerial Pyrotechnic Flare § 160...

46 CFR 160.066-7 - Performance requirements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 6 2011-10-01 2011-10-01 false Performance requirements. 160.066-7 Section 160.066-7 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Distress Signal for Boats, Red Aerial Pyrotechnic Flare § 160...

46 CFR 160.066-10 - Expiration date.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 6 2010-10-01 2010-10-01 false Expiration date. 160.066-10 Section 160.066-10 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Distress Signal for Boats, Red Aerial Pyrotechnic Flare § 160...

46 CFR 160.066-7 - Performance requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 6 2010-10-01 2010-10-01 false Performance requirements. 160.066-7 Section 160.066-7 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Distress Signal for Boats, Red Aerial Pyrotechnic Flare § 160...

46 CFR 160.066-15 - Production testing.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 6 2010-10-01 2010-10-01 false Production testing. 160.066-15 Section 160.066-15 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Distress Signal for Boats, Red Aerial Pyrotechnic Flare § 160...

46 CFR 160.066-10 - Expiration date.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 6 2011-10-01 2011-10-01 false Expiration date. 160.066-10 Section 160.066-10 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Distress Signal for Boats, Red Aerial Pyrotechnic Flare § 160...

46 CFR 160.023-4 - Approval and production tests.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 6 2012-10-01 2012-10-01 false Approval and production tests. 160.023-4 Section 160.023-4 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Hand Combination Flare and Smoke Distress...

46 CFR 160.023-4 - Approval and production tests.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 6 2013-10-01 2013-10-01 false Approval and production tests. 160.023-4 Section 160.023-4 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Hand Combination Flare and Smoke Distress...

46 CFR 160.023-4 - Approval and production tests.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 6 2014-10-01 2014-10-01 false Approval and production tests. 160.023-4 Section 160.023-4 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Hand Combination Flare and Smoke Distress...

46 CFR 160.072-09 - Manufacturer notification.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 6 2010-10-01 2010-10-01 false Manufacturer notification. 160.072-09 Section 160.072-09 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Distress Signals for Boats, Orange Flag § 160.072-09...

Durability study of the US-23 aggregate test road and recent JPCP projects with premature joint deterioration.

DOT National Transportation Integrated Search

2010-12-01

Materials related distress (MRD) characterized by starburst type corner spalling at the longitudinal centerline joint, and occasional transverse joint spalling have developed at a rapid rate in a number of JPCP projects constructed since 1999. ...

A sociocultural stress and coping model for mental health outcomes among African American caregivers in Southern California.

PubMed

Knight, B G; Silverstein, M; McCallum, T J; Fox, L S

2000-05-01

A sociocultural stress and coping model to explain emotional distress among caregivers of family members who have dementia across ethnic and cultural groups is presented and explored in a sample of 41 African American and 128 non-African American caregivers. In this sample, African American caregivers reported lower levels of burden but equal levels of depression and anxiety. In the structural equation model, previous reports that African Americans' lower appraisal of caregiving as burdensome resulted in lower levels of emotional distress were confirmed. However, in this model, this pathway was counterbalanced by a tendency of African American caregivers to use emotion-focused coping and, therefore, increase emotional distress. African American caregivers were also younger and in poorer health, factors which tend to increase both burden and emotional distress outcomes. As suggested by the sociocultural stress and coping model, the influences of ethnic group variables on stress and coping processes are complex and multidirectional.

An examination of processes linking perceived neighborhood disorder and obesity.

PubMed

Burdette, Amy M; Hill, Terrence D

2008-07-01

In this paper, we use data collected from a statewide probability sample of Texas, USA adults to test whether perceptions of neighborhood disorder are associated with increased risk of obesity. Building on prior research, we also test whether the association between neighborhood disorder and obesity is mediated by psychological, physiological, and behavioral mechanisms. We propose and test a theoretical model which suggests that psychological distress is a lynchpin mechanism that links neighborhood disorder with obesity risk through chronic activation of the physiological stress response, poor self-rated overall diet quality, and irregular exercise. The results of our analyses are generally consistent with this theoretical model. We find that neighborhood disorder is associated with increased risk of obesity, and this association is entirely mediated by psychological distress. We also observe that the positive association between psychological distress and obesity is fully mediated by physiological distress and poor self-rated overall diet quality and only partially mediated by irregular exercise.

Depressive disorder among Turkish women in the Netherlands: a qualitative study of idioms of distress.

PubMed

Borra, Ria

2011-11-01

The provision of mental health services to immigrants in the Netherlands is hampered by difficulty in establishing valid diagnoses of psychiatric disorders. To improve the process of diagnosing depressive disorder among Turkish women in Dutch mental healthcare, we conducted a qualitative study of women with depression in Rotterdam. A bilingual Turkish-Dutch diagnostic interview was developed to explore Turkish women's idioms of distress. Interviews were conducted with 20 women with a disputed diagnosis of depression. Results showed that distress among the Turkish women was characterized by a wide range of somatic complaints, with anxiety and agitation occurring as frequently as depressive complaints. Because the range of complaints is so varied, major depression may be underdiagnosed in the Turkish immigrant population.

29 CFR 4041.42 - Administration of plan during termination process.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 9 2010-07-01 2010-07-01 false Administration of plan during termination process. 4041.42... TERMINATIONS TERMINATION OF SINGLE-EMPLOYER PLANS Distress Termination Process § 4041.42 Administration of plan during termination process. (a) General rule. Except to the extent specifically prohibited by this...

Evaluation of Canadian unconfined aggregate freeze-thaw tests for identifying nondurable aggregates.

DOT National Transportation Integrated Search

2012-06-01

Concrete is the most widely used material in construction. Aggregates contribute 60% to 75% of the total volume : of concrete. The aggregates play a key role in concrete durability. The U.S. Midwest has many aggregates that can : show distress in the...

Massive pulmonary cryptococcosis in an immunocompetent patient.

PubMed

Silachamroon, U; Shuangshoti, S

1998-03-01

A 64-year-old man presented with progressive dyspnea. The symptom of severe hypoxia requiring mechanical ventilator, and bilateral pulmonary infiltrates on the chest film led to the clinical diagnosis of adult respiratory distress syndrome. Autopsy demonstrated widespread cryptococci and mucinous material in alveoli with mild inflammatory response.

46 CFR 160.036-7 - Procedure for approval.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 6 2014-10-01 2014-10-01 false Procedure for approval. 160.036-7 Section 160.036-7 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Hand-Held Rocket-Propelled Parachute Red Flare Distress Signals...

46 CFR 160.036-7 - Procedure for approval.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 6 2012-10-01 2012-10-01 false Procedure for approval. 160.036-7 Section 160.036-7 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Hand-Held Rocket-Propelled Parachute Red Flare Distress Signals...

46 CFR 160.036-1 - Incorporation by reference.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 6 2010-10-01 2010-10-01 false Incorporation by reference. 160.036-1 Section 160.036-1 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Hand-Held Rocket-Propelled Parachute Red Flare Distress Signals...

46 CFR 160.036-7 - Procedure for approval.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 6 2010-10-01 2010-10-01 false Procedure for approval. 160.036-7 Section 160.036-7 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Hand-Held Rocket-Propelled Parachute Red Flare Distress Signals...

46 CFR 160.036-1 - Incorporation by reference.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 6 2014-10-01 2014-10-01 false Incorporation by reference. 160.036-1 Section 160.036-1 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Hand-Held Rocket-Propelled Parachute Red Flare Distress Signals...

46 CFR 160.036-1 - Incorporation by reference.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 6 2013-10-01 2013-10-01 false Incorporation by reference. 160.036-1 Section 160.036-1 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Hand-Held Rocket-Propelled Parachute Red Flare Distress Signals...

46 CFR 160.036-7 - Procedure for approval.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 6 2013-10-01 2013-10-01 false Procedure for approval. 160.036-7 Section 160.036-7 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Hand-Held Rocket-Propelled Parachute Red Flare Distress Signals...

46 CFR 160.036-1 - Incorporation by reference.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 6 2012-10-01 2012-10-01 false Incorporation by reference. 160.036-1 Section 160.036-1 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Hand-Held Rocket-Propelled Parachute Red Flare Distress Signals...

46 CFR 160.036-1 - Incorporation by reference.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 6 2011-10-01 2011-10-01 false Incorporation by reference. 160.036-1 Section 160.036-1 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Hand-Held Rocket-Propelled Parachute Red Flare Distress Signals...

46 CFR 160.036-7 - Procedure for approval.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 6 2011-10-01 2011-10-01 false Procedure for approval. 160.036-7 Section 160.036-7 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Hand-Held Rocket-Propelled Parachute Red Flare Distress Signals...

The importance of contextual factors and age in association with anxiety and depression in Black breast cancer patients.

PubMed

Sheppard, Vanessa B; Harper, Felicity W K; Davis, Kimberly; Hirpa, Fikru; Makambi, Kepher

2014-02-01

Limited research exists on correlates of psychosocial distress in Black breast cancer patients. The goals of the study were to describe the prevalence of distress (anxiety and depression) in Black women with breast cancer and to examine the influence of demographic, clinical, contextual (e.g., self-efficacy, medical mistrust), and process of care factors (e.g., patient satisfaction) on women's level of anxiety and depression. Eighty-two Black women diagnosed with invasive non-metastatic breast cancer were interviewed by phone. Collected data included demographic, clinical, contextual, and process of care factors. Bivariate correlations were used to examine relationships between those variables. Multiple linear regressions were used to examine predictors of anxiety and depression. About one-third of the women (32%) met cut-off thresholds for distress. Medical mistrust and positive attitude had significant influences on anxiety levels, whereas age and positive attitude were determinants of levels of depression. Participants with higher medical mistrust reported more anxiety (r = .379; p < .001) and depression (r = .337; p = .002), whereas women with higher self-efficacy reported less anxiety (r = -.401; p < .001) and depression (r = -.427; p < .001). Age was inversely related to both anxiety and depression (r = -.224; r = -.296, respectively; p < .05). Findings support national recommendations for routine distress screening in the delivery of cancer care particularly in younger Black patients. Interventions targeted to boost self-efficacy or reduce medical mistrust through enhanced patient-provider interactions may decrease psychological distress. Psychosocial needs of younger patients warrant particular attention. Copyright © 2013 John Wiley & Sons, Ltd.

Changing mothers' perception of infant emotion: a pilot study.

PubMed

Carnegie, Rebecca; Shepherd, C; Pearson, R M; Button, K S; Munafò, M R; Evans, J; Penton-Voak, I S

2016-02-01

Cognitive bias modification (CBM) techniques, which experimentally retrain abnormal processing of affective stimuli, are becoming established for various psychiatric disorders. Such techniques have not yet been applied to maternal processing of infant emotion, which is affected by various psychiatric disorders. In a pilot study, mothers of children under 3 years old (n =  2) were recruited and randomly allocated to one of three training exercises, aiming either to increase or decrease their threshold of perceiving distress in a morphed continuum of 15 infant facial images. Differences between pre- and post-training threshold were analysed between and within subjects. Compared to baseline thresholds, the threshold for perceiving infant distress decreased in the lowered threshold group (mean difference -1.7 frames, 95 % confidence intervals (CI) -3.1 to -0.3, p = 0.02), increased in the raised threshold group (1.3 frames, 95 % CI 0.6 to 2.1, p < 0.01) and was unchanged in the control group (0.1 frames, 95 % CI -0.8 to 1.1, p = 0.80). Between-group differences were similarly robust in regression models and were not attenuated by potential confounders. The findings suggest that it is possible to change the threshold at which mothers perceive ambiguous infant faces as distressed, either to increase or decrease sensitivity to distress. This small study was intended to provide proof of concept (i.e. that it is possible to alter a mother's perception of infant distress). Questions remain as to whether the effects persist beyond the immediate experimental session, have an impact on maternal behaviour and could be used in clinical samples to improve maternal sensitivity and child outcomes.

The relationship between psychological distress and baseline sports-related concussion testing.

PubMed

Bailey, Christopher M; Samples, Hillary L; Broshek, Donna K; Freeman, Jason R; Barth, Jeffrey T

2010-07-01

This study examined the effect of psychological distress on neurocognitive performance measured during baseline concussion testing. Archival data were utilized to examine correlations between personality testing and computerized baseline concussion testing. Significantly correlated personality measures were entered into linear regression analyses, predicting baseline concussion testing performance. Suicidal ideation was examined categorically. Athletes underwent testing and screening at a university athletic training facility. Participants included 47 collegiate football players 17 to 19 years old, the majority of whom were in their first year of college. Participants were administered the Concussion Resolution Index (CRI), an internet-based neurocognitive test designed to monitor and manage both at-risk and concussed athletes. Participants took the Personality Assessment Inventory (PAI), a self-administered inventory designed to measure clinical syndromes, treatment considerations, and interpersonal style. Scales and subscales from the PAI were utilized to determine the influence psychological distress had on the CRI indices: simple reaction time, complex reaction time, and processing speed. Analyses revealed several significant correlations among aspects of somatic concern, depression, anxiety, substance abuse, and suicidal ideation and CRI performance, each with at least a moderate effect. When entered into a linear regression, the block of combined psychological symptoms accounted for a significant amount of baseline CRI performance, with moderate to large effects (r = 0.23-0.30). When examined categorically, participants with suicidal ideation showed significantly slower simple reaction time and complex reaction time, with a similar trend on processing speed. Given the possibility of obscured concussion deficits after injury, implications for premature return to play, and the need to target psychological distress outright, these findings heighten the clinical importance of screening for psychological distress during baseline and post-injury concussion evaluations.

Psychosocial framework for understanding psychological distress among survivors of the November 26, 2008 Mumbai terror attack: beyond traumatic experiences and emergency medical care.

PubMed

Joseph, Jacquleen; Jaswal, Surinder

2014-06-01

The field of "Public Health in Disasters and Complex Emergencies" is replete with either epidemiological studies or studies in the area of hospital preparedness and emergency care. The field is dominated by hospital-based or emergency phase-related literature, with very little attention on long-term health and mental health consequences. The social science, or the public mental health perspective, too, is largely missing. It is in this context that the case report of the November 26, 2008 Mumbai terror attack survivors is presented to bring forth the multi-dimensional and dynamic long-term impacts, and their consequences for psychological well-being, two years after the incident. Based on literature, the report formulates a theoretical framework through which the lived experiences of the survivors is analyzed and understood from a social science perspective. This report is an outcome of the ongoing work with the survivors over a period of two years. A mixed methodology was used. It quantitatively captures the experience of 231 families following the attack, and also uses a self-reporting questionnaire (SRQ), SRQ20, to understand the psychological distress. In-depth qualitative case studies constructed from the process records and in-depth interviews focus on lived experiences of the survivors and explain the patterns emerging from the quantitative analysis. This report outlines the basic profile of the survivors, the immediate consequences of the attack, the support received, psychological consequences, and the key factors contributing to psychological distress. Through analysis of the key factors and the processes emerging from the lived experiences that explain the progression of vulnerability to psychological distress, this report puts forth a psychosocial framework for understanding psychological distress among survivors of the November 26, 2008 Mumbai terror attack.

A qualitative study of Filipina immigrants' stress, distress and coping: the impact of their multiple, transnational roles as women.

PubMed

Straiton, Melanie L; Ledesma, Heloise Marie L; Donnelly, Tam T

2017-09-05

Migration is associated with a number of stress factors which can affect mental health. Ethnicity, gender and socioeconomic status can intertwine with and influence the process of migration and mental health. Philippine migration to Europe has increased in recent years and has become more feminised. Knowing more about the factors that influence immigrants' mental health and coping can help aid health care delivery and policy planning. The purpose of this qualitative study was to explore the contextual factors that influence the mental health of Filipinas living in Norway and their coping strategies. Individual in-depth interviews were conducted with fourteen Filipinas 24-49 years, living in Norway. The analysis was informed by the post-colonial feminist perspective in order to examine the process by which gender, ethnicity and socioeconomic status interact with contextual factors in these women's lives and influence their wellbeing. Data analysis revealed that all informants experienced some level of stress or distress. Two main factors: Sense of belonging and Securing a future contributed to the women's level of distress associated with living abroad as an immigrant woman. Distress was heighted by the women's multiple, transnational roles they occupied; roles as workers, breadwinners, daughters, wives and mothers. None of the women had sought professional help for their distress. Religion and informal support from friends and family appear to help these women cope with many of the challenges they face as immigrant women living and working abroad. Filipinas face a number of challenges related to their status as immigrant women and the juggling of their transnational lives. Understanding the context of these women's lives may aid the identification of mental health problems. Although the women show resilience and appear to cope successfully, some may benefit from professional help.

Associations between relationship support and psychological reactions of participants and partners to BRCA1 and BRCA2 testing in a clinic-based sample.

PubMed

Manne, Sharon; Audrain, Janet; Schwartz, Marc; Main, David; Finch, Clinton; Lerman, Caryn

2004-12-01

Despite the potential importance of communication about genetic testing between test participants and their significant others, little is known about social support and communication between women undergoing BRCA1 and BRCA2 testing and their partners. The aims of this longitudinal study were to examine communication about genetic testing during and following testing and to evaluate whether communication is associated with psychological distress reported by test participants and their partners. Participants were 153 women who were undergoing genetic testing and 118 partners of women undergoing testing. Relationship communication and distress were evaluated at the time of pretest education and 6 months postdisclosure. Overall, the decision to undergo testing was discussed by the majority of test participants and partners, and most couples felt their partners were supportive. Most women disclosed their results to their partners. Longitudinal analyses suggested that less support and protective buffering were associated with greater distress 6 months postdisclosure among test participants, whereas lower comfort in sharing concerns and partner support were associated with lower distress 6 months postdisclosure among partners. The results of this study suggest that the majority of couples respond supportively during the test experience, but for a small subset of couples the process can strain the relationship. Partner support during this process is important, particularly for test participants dealing with an uninformative test result.

No Evidence for Emotional Empathy in Chickens Observing Familiar Adult Conspecifics

PubMed Central

Edgar, Joanne L.; Paul, Elizabeth S.; Harris, Lauren; Penturn, Sarah; Nicol, Christine J.

2012-01-01

The capacity of animals to empathise is of high potential relevance to the welfare of group-housed domestic animals. Emotional empathy is a multifaceted and multilayered phenomenon which ranges from relatively simple processes such as emotional matching behaviour to more complex processes involving interaction between emotional and cognitive perspective taking systems. Our previous research has demonstrated that hens show clear behavioural and physiological responses to the mild distress of their chicks. To investigate whether this capacity exists outside the mother/offspring bond, we conducted a similar experiment in which domestic hens were exposed to the mild distress of unrelated, but familiar adult conspecifics. Each observer hen was exposed to two replicates of four conditions, in counterbalanced order; control (C); control with noise of air puff (CN); air puff to conspecific hen (APC); air puff to observer hen (APH). During each test, the observer hens' behaviour and physiology were measured throughout a 10 min pre-treatment and a 10 min treatment period. Despite showing signs of distress in response to an aversive stimulus directed at themselves (APH), and using methodology sufficiently sensitive to detect empathy-like responses previously, observer hens showed no behavioural or physiological responses to the mild distress of a familiar adult conspecific. The lack of behavioural and physiological response indicates that hens show no basis for emotional empathy in this context. PMID:22348100

Understandings of psychological difficulties in people with the Huntington's disease gene and their expectations of psychological therapy.

PubMed

Theed, Rachael; Eccles, Fiona J R; Simpson, Jane

2018-06-01

This study sought to investigate how people who had tested positive for the Huntington's disease (HD) gene mutation understood and experienced psychological distress and their expectations of psychological therapy. A qualitative methodology was adopted involving semi-structured interviews and interpretative phenomenological analysis (IPA). A total of nine participants (five women and four men) who had opted to engage in psychological therapy were recruited and interviewed prior to the start of this particular psychological therapeutic intervention. Interviews were transcribed verbatim and analysed using IPA whereby themes were analysed within and across transcripts and classified into superordinate themes. Three superordinate themes were developed: Attributing psychological distress to HD: 'you're blaming everything on that now'; Changes in attributions of distress over time: 'in the past you'd just get on with it'; and Approaching therapy with an open mind, commitment, and hope: 'a light at the end of the tunnel'. Understandings of psychological distress in HD included biological and psychological explanations, with both often being accepted simultaneously by the same individual but with biomedical accounts generally dominating. Individual experience seemed to reflect a dynamic process whereby people's understanding and experience of their distress changed over time. Psychological therapy was accepted as a positive alternative to medication, providing people with HD with hope that their psychological well-being could be enhanced. People with the Huntington's disease gene mutation have largely biomedical understandings of their psychological distress. This largely biomedical understanding does not, however, preclude them for being interested in the potential gains resulting from psychological therapy. The mechanisms of psychological therapy should be explained in detail before therapy and explored along with current attributions of distress. © 2017 The British Psychological Society.

Altered prefrontal cortical function during processing of fear-relevant stimuli in pregnancy.

PubMed

Roos, Annerine; Robertson, Frances; Lochner, Christine; Vythilingum, Bavanisha; Stein, Dan J

2011-09-12

In non-pregnant individuals, the prefrontal cortex (PFC) is involved in the regulation of emotion, and appears to play a role in anxiety. Near-infrared spectroscopy (NIRS) detects cortical neural activation without harmful radiation making it safe for use in pregnancy. The aims of this study were to assess neural circuitry involved in processing fear-relevant stimuli during pregnancy using NIRS, and to determine associations between activation of this circuitry, distress and anxiety symptoms, attention to threat, cortisol, estrogen, progesterone and testosterone levels. There was significant activation of the PFC in response to fearful faces compared to rest in both pregnant and control groups. Within pregnancy, the activation was most pronounced at trimester 2, compared to the other trimesters. In pregnant women only (all trimesters), PFC activation was significantly associated with increased distress and anxiety, but with decreased selective attention to masked fear. PFC activation was also significantly associated with increased levels of cortisol and testosterone in pregnancy. PFC function appears to be altered during processing of fear-relevant stimuli in pregnancy. Changes in hormone levels may lead to changes in PFC function, and in turn to changes in cognitive-affective processing and anxiety. Further work is needed, however, to explore precisely how PFC function is altered in pregnancy; it is possible that certain changes reflect altered processing of threat stimuli, while others reflect attempts to compensate for distressing and anxious symptoms that emerge during pregnancy. Copyright © 2011 Elsevier B.V. All rights reserved.

Rational selective exploitation and distress: employee reactions to performance-based and mobility-based reward allocations.

PubMed

Rusbult, C E; Campbell, M A; Price, M E

1990-09-01

Prior research has demonstrated that allocators frequently distribute greater rewards to persons with high professional and geographic mobility than to persons with constrained mobility, especially among the very competent. This phenomenon has been termed rational selective exploitation. Do the recipients of such allocations actually experience this distribution rule as unjust and distressing, or is it a misnomer to refer to this phenomenon as exploitation? Two studies were conducted to explore this question. Study 1 was a laboratory experiment in which we manipulated relative performance level, relative mobility level, and allocation standard: performance based versus mobility based. Study 2 was a cross-sectional survey of actual employees in which subjects reported the degree to which performance and mobility were the basis for pay decisions at their places of employment, as well as the degree to which they perceived each standard to be fair. Both studies demonstrated that people regard mobility-based allocations as less fair and more distressing than performance-based allocations. Furthermore, the degree of distress resulting from mobility-based allocations is greater among persons who are disadvantaged by that standard: among people with constrained mobility, especially those who perform at high levels. These findings provide good support for the assertion that so-called rational selective exploitation is indeed distressing to employees. Reactions to this form of distress are also explored, and the implications of these findings for the allocation process are discussed.

Distress Intolerance during Smoking Cessation Treatment

PubMed Central

Farris, Samantha G.; Leyro, Teresa M.; Allan, Nicholas P.; Øverup, Camilla S.; Schmidt, Norman B.; Zvolensky, Michael J.

2016-01-01

Distress intolerance is a key vulnerability factor implicated in the maintenance and relapse of cigarette smoking. Yet, past work has not examined changes in these processes during smoking cessation treatment or their relation to smoking cessation outcomes. The aim of the present study was to examine the effect of two smoking cessation interventions on changes in self-report and behavioral distress intolerance indices during treatment, and whether these changes are associated with smoking cessation outcomes. Treatment-seeking smokers (N = 384) were randomly assigned to one of two 4-session smoking cessation treatment programs: Standard Cessation Program (SCP) or Smoking Treatment and Anxiety Management Program (STAMP). Quit dates were scheduled to coincide with the final treatment session. Physical domains of distress intolerance were assessed at baseline and at each weekly session, via the Discomfort Intolerance Scale (DIS; higher scores indicate more intolerance for discomfort) and Breath Holding Duration Task (shorter durations indicate more intolerance for respiratory distress). The STAMP condition produced a greater rate of reduction in DIS scores than did the SCP condition. Changes in DIS scores during treatment mediated the effect of STAMP treatment on 7-day point prevalence abstinence at Month 3 post-quit attempt. There were no treatment conditions differences in changes in Breath-Holding duration. Data suggest self-reported distress intolerance is malleable in the context of stress sensitivity reduction treatment, but not standard smoking cessation treatment, and such reductions may result in promotion of smoking abstinence. PMID:27565398

Is Seeing Believing? The Process of Change During Cognitive-behavioural Therapy for Distressing Visual Hallucinations.

PubMed

Wilson, Rea; Collerton, Daniel; Freeston, Mark; Christodoulides, Thomas; Dudley, Robert

2016-07-01

People with psychosis often report distressing visual hallucinations (VH). In contrast to auditory hallucinations, there is little empirical evidence on effective interventions. The effectiveness of a novel-focused cognitive-behavioural therapy (CBT) intervention for VH was explored using a multiple baseline single case design with four participants. Change to individual appraisals, emotional and behavioural responses to VH were measured with daily diaries kept throughout the baseline and intervention phase lasting up to 16 sessions. Maintenance of change was tracked during a follow-up period of one month. Changes in appraisals, distress and response in accordance with the theory was evident in two out of four of the cases. However, change occurred within the baseline phase that limited the conclusions that change could be attributed to CBT alone. There was some evidence of clinically significant change and reliable change for two out of four of the cases at follow-up on one of the standardized psychiatric assessments. The research reported here has theoretical and clinical implications for refinement of the model and interventions for distressing VH. Copyright © 2015 John Wiley & Sons, Ltd. Distressing visual hallucinations (VH) are a relatively common symptom of psychosis. Visual hallucinations seem to be associated with greater impairment and disability. We have no specific treatment for VH. The appraisal of the visual experience and the behavioural response is important in maintaining the distress. Cognitive-behavioural therapy for VH at present has limited value. Copyright © 2015 John Wiley & Sons, Ltd.

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.

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

PubMed

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

2012-10-01

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

46 CFR 160.037-7 - Procedure for approval.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 6 2010-10-01 2010-10-01 false Procedure for approval. 160.037-7 Section 160.037-7 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Hand Orange Smoke Distress Signals § 160.037-7 Procedure for...

46 CFR 160.057-7 - Procedure for approval.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 6 2014-10-01 2014-10-01 false Procedure for approval. 160.057-7 Section 160.057-7 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Floating Orange Smoke Distress Signals (15 Minutes) § 160.057-7...

46 CFR 160.057-7 - Procedure for approval.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 6 2010-10-01 2010-10-01 false Procedure for approval. 160.057-7 Section 160.057-7 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Floating Orange Smoke Distress Signals (15 Minutes) § 160.057-7...

46 CFR 160.037-7 - Procedure for approval.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 6 2011-10-01 2011-10-01 false Procedure for approval. 160.037-7 Section 160.037-7 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Hand Orange Smoke Distress Signals § 160.037-7 Procedure for...

46 CFR 160.022-7 - Procedure for approval.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 6 2012-10-01 2012-10-01 false Procedure for approval. 160.022-7 Section 160.022-7 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Floating Orange Smoke Distress Signals (5 Minutes) § 160.022-7...

46 CFR 160.023-5 - Labeling and marking.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 6 2011-10-01 2011-10-01 false Labeling and marking. 160.023-5 Section 160.023-5 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Hand Combination Flare and Smoke Distress Signals § 160.023-5...

46 CFR 160.023-5 - Labeling and marking.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 6 2014-10-01 2014-10-01 false Labeling and marking. 160.023-5 Section 160.023-5 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Hand Combination Flare and Smoke Distress Signals § 160.023-5...

46 CFR 160.022-7 - Procedure for approval.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 6 2011-10-01 2011-10-01 false Procedure for approval. 160.022-7 Section 160.022-7 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Floating Orange Smoke Distress Signals (5 Minutes) § 160.022-7...

46 CFR 160.057-4 - Approval and production tests.

Code of Federal Regulations, 2013 CFR

2013-10-01

... MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Floating Orange Smoke Distress Signals (15... period of 24 hours. (ii) Smoke emitting time. Ignite specimen according to the directions printed on the signal and place signal in tub or barrel of water. The smoke emitting time of a specimen shall be...

46 CFR 160.022-4 - Approval and production tests.

Code of Federal Regulations, 2014 CFR

2014-10-01

... MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Floating Orange Smoke Distress Signals (5... period of 24 hours. (ii) Smoke emitting time. Ignite specimen according to the directions printed on the signal and place signal in tub or barrel of water. The smoke emitting time of a specimen shall be...

46 CFR 160.023-7 - Procedure for approval.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 6 2011-10-01 2011-10-01 false Procedure for approval. 160.023-7 Section 160.023-7 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Hand Combination Flare and Smoke Distress Signals § 160.023-7...

46 CFR 160.037-7 - Procedure for approval.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 6 2013-10-01 2013-10-01 false Procedure for approval. 160.037-7 Section 160.037-7 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Hand Orange Smoke Distress Signals § 160.037-7 Procedure for...

46 CFR 160.023-5 - Labeling and marking.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 6 2013-10-01 2013-10-01 false Labeling and marking. 160.023-5 Section 160.023-5 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Hand Combination Flare and Smoke Distress Signals § 160.023-5...

46 CFR 160.022-7 - Procedure for approval.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 6 2014-10-01 2014-10-01 false Procedure for approval. 160.022-7 Section 160.022-7 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Floating Orange Smoke Distress Signals (5 Minutes) § 160.022-7...

46 CFR 160.022-4 - Approval and production tests.

Code of Federal Regulations, 2012 CFR

2012-10-01

... MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Floating Orange Smoke Distress Signals (5... period of 24 hours. (ii) Smoke emitting time. Ignite specimen according to the directions printed on the signal and place signal in tub or barrel of water. The smoke emitting time of a specimen shall be...

46 CFR 160.057-7 - Procedure for approval.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 6 2013-10-01 2013-10-01 false Procedure for approval. 160.057-7 Section 160.057-7 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Floating Orange Smoke Distress Signals (15 Minutes) § 160.057-7...

46 CFR 160.022-7 - Procedure for approval.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 6 2013-10-01 2013-10-01 false Procedure for approval. 160.022-7 Section 160.022-7 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Floating Orange Smoke Distress Signals (5 Minutes) § 160.022-7...

46 CFR 160.057-7 - Procedure for approval.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 6 2012-10-01 2012-10-01 false Procedure for approval. 160.057-7 Section 160.057-7 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Floating Orange Smoke Distress Signals (15 Minutes) § 160.057-7...

46 CFR 160.022-4 - Approval and production tests.

Code of Federal Regulations, 2013 CFR

2013-10-01

... MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Floating Orange Smoke Distress Signals (5... period of 24 hours. (ii) Smoke emitting time. Ignite specimen according to the directions printed on the signal and place signal in tub or barrel of water. The smoke emitting time of a specimen shall be...

46 CFR 160.037-7 - Procedure for approval.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 6 2012-10-01 2012-10-01 false Procedure for approval. 160.037-7 Section 160.037-7 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Hand Orange Smoke Distress Signals § 160.037-7 Procedure for...

46 CFR 160.057-7 - Procedure for approval.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 6 2011-10-01 2011-10-01 false Procedure for approval. 160.057-7 Section 160.057-7 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Floating Orange Smoke Distress Signals (15 Minutes) § 160.057-7...

46 CFR 160.023-7 - Procedure for approval.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 6 2013-10-01 2013-10-01 false Procedure for approval. 160.023-7 Section 160.023-7 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Hand Combination Flare and Smoke Distress Signals § 160.023-7...

46 CFR 160.022-7 - Procedure for approval.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 6 2010-10-01 2010-10-01 false Procedure for approval. 160.022-7 Section 160.022-7 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Floating Orange Smoke Distress Signals (5 Minutes) § 160.022-7...

46 CFR 160.057-4 - Approval and production tests.

Code of Federal Regulations, 2014 CFR

2014-10-01

... MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Floating Orange Smoke Distress Signals (15... period of 24 hours. (ii) Smoke emitting time. Ignite specimen according to the directions printed on the signal and place signal in tub or barrel of water. The smoke emitting time of a specimen shall be...

46 CFR 160.023-7 - Procedure for approval.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 6 2012-10-01 2012-10-01 false Procedure for approval. 160.023-7 Section 160.023-7 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Hand Combination Flare and Smoke Distress Signals § 160.023-7...

46 CFR 160.023-7 - Procedure for approval.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 6 2010-10-01 2010-10-01 false Procedure for approval. 160.023-7 Section 160.023-7 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Hand Combination Flare and Smoke Distress Signals § 160.023-7...

46 CFR 160.037-7 - Procedure for approval.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 6 2014-10-01 2014-10-01 false Procedure for approval. 160.037-7 Section 160.037-7 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Hand Orange Smoke Distress Signals § 160.037-7 Procedure for...

46 CFR 160.023-7 - Procedure for approval.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 6 2014-10-01 2014-10-01 false Procedure for approval. 160.023-7 Section 160.023-7 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Hand Combination Flare and Smoke Distress Signals § 160.023-7...

46 CFR 160.023-5 - Labeling and marking.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 6 2012-10-01 2012-10-01 false Labeling and marking. 160.023-5 Section 160.023-5 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Hand Combination Flare and Smoke Distress Signals § 160.023-5...

46 CFR 160.057-4 - Approval and production tests.

Code of Federal Regulations, 2012 CFR

2012-10-01

... MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Floating Orange Smoke Distress Signals (15... period of 24 hours. (ii) Smoke emitting time. Ignite specimen according to the directions printed on the signal and place signal in tub or barrel of water. The smoke emitting time of a specimen shall be...

Primary Care Interventions for Dementia Caregivers: 2-Year Outcomes from the REACH Study

ERIC Educational Resources Information Center

Burns, Robert; Nichols, Linda O.; Martindale-Adams, Jennifer; Graney, Marshall J.; Lummus, Allan

2003-01-01

Purpose: This study developed and tested two 24-month primary care interventions to alleviate the psychological distress suffered by the caregivers of those with Alzheimer's disease. The interventions, using targeted educational materials, were patient behavior management only, and patient behavior management plus caregiver stress-coping…

Psychosocial factors and distress: a comparison between ethnic Norwegians and ethnic Pakistanis in Oslo, Norway

PubMed Central

Syed, Hammad Raza; Dalgard, Odd Steffen; Dalen, Ingvild; Claussen, Bjørgulf; Hussain, Akthar; Selmer, Randi; Ahlberg, Nora

2006-01-01

Background In the Norwegian context, higher mental distress has been reported for the non-Western immigrants compared to the ethnic Norwegians and Western immigrants. This high level of distress is often related to different socio-economic conditions in this group. No efforts have been made earlier to observe the impact of changed psychosocial conditions on the state of mental distress of these immigrant communities due to the migration process. Therefore, the objective of the study was to investigate the association between psychological distress and psychosocial factors among Pakistani immigrants and ethnic Norwegians in Oslo, and to investigate to what extent differences in mental health could be explained by psychosocial and socioeconomic conditions. Method Data was collected from questionnaires as a part of the Oslo Health Study 2000–2001. 13581 Norwegian born (attendance rate 46%) and 339 ethnic Pakistanis (attendance rate 38%) in the selected age groups participated. A 10-item version of Hopkins Symptom Checklist (HSCL) was used as a measure of psychological distress. Results Pakistanis reported less education and lower employment rate than Norwegians (p < 0.005). The Pakistani immigrants also reported higher distress, mean HSCL score 1.53(1.48–1.59), compared to the ethnic Norwegians, HSCL score 1.30(1.29–1.30). The groups differed significantly (p < 0.005) with respect to social support and feeling of powerlessness, the Pakistanis reporting less support and more powerlessness. The expected difference in mean distress was reduced from 0.23 (0.19–0.29) to 0.07 (0.01–0.12) and 0.12 (0.07–0.18) when adjusted for socioeconomic and social support variables respectively. Adjusting for all these variables simultaneously, the difference in the distress level between the two groups was eliminated Conclusion Poor social support and economic conditions are important mediators of mental health among immigrants. The public health recommendations/interventions should deal with both the economic conditions and social support system of immigrant communities simultaneously. PMID:16831229

The mediating role of demand and control in the relationship between leadership behaviour and employee distress: a cross-sectional study.

PubMed

Lornudd, Caroline; Tafvelin, Susanne; von Thiele Schwarz, Ulrica; Bergman, David

2015-02-01

The relationship between leadership and employee distress is well established, however, the processes involved in this relationship remain largely unclear. For a stretched nursing workforce, understanding in what ways leadership may influence employee distress is particularly important. To examine possible mediating effects of the work environment factors demand and control in the relationship between leadership behaviour in change, production, and employee orientation and employee distress. Cross-sectional study design. The study was conducted at a large county council in Sweden providing both institutional and non-institutional care. A random sample of 1249 employees (primarily nurses, but also a wide range of other healthcare professionals and administrative staff), who had a healthcare manager that was about to enter a leadership development programme (n=171), responded to a web-based questionnaire. The response rate was 62%. The employees rated their healthcare managers' behaviour in change, production, and employee orientation, as well as their own perceptions of level of demand, control (subdivided into decision authority and skill discretion), and five distress outcomes. Multilevel analysis was performed. The mediators demand, decision authority, and skill discretion were significant predictors of all five distress outcomes for all three leadership orientations. In eight of 15 regressions, the mediators fully explained the relationships between leadership orientations and outcomes. Four of five relationships with distress outcomes were fully mediated for change-oriented leadership, whereas two of five outcomes were fully mediated for production- and employee-oriented leadership. In all three leadership orientations, the relationship between the mediator skill discretion and the distress measure disengagement were particularly strong, with B-coefficients (-.44, p<.001) twice as high as for any of the other relationships. It seems that the way that employees perceive healthcare managers' change-oriented behaviour, and how that aspect is related to employee distress, is primarily explained by perception of demand and control. Furthermore, regardless of leadership behaviour orientation, how employees perceive their opportunity to use specific job skills plays an important role in the interplay between perception of healthcare managers' behaviour and disengagement. Copyright © 2014 Elsevier Ltd. All rights reserved.

Empathy as a driver of prosocial behaviour: highly conserved neurobehavioural mechanisms across species

PubMed Central

Decety, Jean; Bartal, Inbal Ben-Ami; Uzefovsky, Florina; Knafo-Noam, Ariel

2016-01-01

Empathy reflects the natural ability to perceive and be sensitive to the emotional states of others, coupled with a motivation to care for their well-being. It has evolved in the context of parental care for offspring, as well as within kinship bonds, to help facilitate group living. In this paper, we integrate the perspectives of evolution, animal behaviour, developmental psychology, and social and clinical neuroscience to elucidate our understanding of the proximate mechanisms underlying empathy. We focus, in particular, on processing of signals of distress and need, and their relation to prosocial behaviour. The ability to empathize, both in animals and humans, mediates prosocial behaviour when sensitivity to others' distress is paired with a drive towards their welfare. Disruption or atypical development of the neural circuits that process distress cues and integrate them with decision value leads to callous disregard for others, as is the case in psychopathy. The realization that basic forms of empathy exist in non-human animals is crucial for gaining new insights into the underlying neurobiological and genetic mechanisms of empathy, enabling translation towards therapeutic and pharmacological interventions. PMID:26644596

Does virtual reality increase emotional engagement during exposure for PTSD? Subjective distress during prolonged and virtual reality exposure therapy.

PubMed

Reger, Greg M; Smolenski, Derek; Norr, Aaron; Katz, Andrea; Buck, Benjamin; Rothbaum, Barbara O

2018-06-08

Prolonged exposure (PE) is a treatment for posttraumatic stress disorder (PTSD) based on emotional processing theory. According to this theory, emotional engagement during imaginal exposure is critical to clinical outcome. One rationale for virtual reality exposure therapy (VRE) is the ability of trauma-relevant, multi-sensory stimuli to increase emotional engagement. This study compared the subjective distress of active duty soldiers (N = 108) during exposure via PE or VRE. Soldiers with higher mean or peak distress during the first imaginal exposure had higher baseline PTSD symptom severity. There was no difference between groups on average or peak distress during imaginal exposure at the first or final exposure session. There were no significant differences in between-session habituation observed between VRE and PE groups. However, each ten-point decrease in SUDS scores, either mean or peak, from the initiation of imaginal exposure to the end of treatment, was associated with a greater decrease in CAPS-W scores for both groups. There were no group differences in these trajectories or the magnitude of the association between distress/habituation, and PTSD symptoms. Future research on VRE should measure patient ratings of engagement during exposure to better understand which patients are aided by this innovative approach to treatment. Published by Elsevier Ltd.

"My Heart Die in Me": Idioms of Distress and the Development of a Screening Tool for Mental Suffering in Southeast Liberia.

PubMed

Fabian, Katrin; Fannoh, Josiah; Washington, George G; Geninyan, Wilfred B; Nyachienga, Bethuel; Cyrus, Garmai; Hallowanger, Joyce N; Beste, Jason; Rao, Deepa; Wagenaar, Bradley H

2018-05-04

The integration of culturally salient idioms of distress into mental healthcare delivery is essential for effective screening, diagnosis, and treatment. This study systematically explored idioms, explanatory models, and conceptualizations in Maryland County, Liberia to develop a culturally-resonant screening tool for mental distress. We employed a sequential mixed-methods process of: (1) free-lists and semi-structured interviews (n = 20); patient chart reviews (n = 315); (2) pile-sort exercises, (n = 31); and (3) confirmatory focus group discussions (FGDs); (n = 3) from June to December 2017. Free-lists identified 64 idioms of distress, 36 of which were eliminated because they were poorly understood, stigmatizing, irrelevant, or redundant. The remaining 28 terms were used in pile-sort exercises to visualize the interrelatedness of idioms. Confirmatory FDGs occurred before and after the pile-sort exercise to explain findings. Four categories of idioms resulted, the most substantial of which included terms related to the heart and to the brain/mind. The final screening tool took into account 11 idioms and 6 physical symptoms extracted from patient chart reviews. This study provides the framework for culturally resonant mental healthcare by cataloguing language around mental distress and designing an emic screening tool for validation in a clinical setting.

Psychological health of military children: Longitudinal evaluation of a family-centered prevention program to enhance family resilience

PubMed Central

Lester, Patricia; Stein, Judith A.; Saltzman, William; Woodward, Kirsten; MacDermid, Shelley W.; Milburn, Norweeta; Mogil, Catherine; Beardslee, William

2014-01-01

Family-centered preventive interventions have been proposed as relevant to mitigating psychological health risk and promoting resilience in military families facing wartime deployment and reintegration. This study evaluates the impact of a family-centered prevention program, Families OverComing Under Stress Family Resilience Training (FOCUS), on the psychological adjustment of military children. Two primary goals include: 1) Understanding the relationships of distress among family members using a longitudinal path model to assess relations at the child and family level, and 2) Determining pathways of program impact on child adjustment. Multilevel data analysis using structural equation modeling was conducted with de-identified service delivery data from 280 families (505 children ages 3-17) in two follow-up assessments. Standardized measures included Service Member and Civilian parental distress (Brief Symptom Inventory, PTSD Checklist – Military), child adjustment (Strengths and Difficulties Questionnaire), and family functioning (McMaster Family Assessment Device). Distress was significantly related among the service member parent, civilian parent and children. FOCUS improved family functioning, which in turn significantly reduced child distress at follow-up. Salient components of improved family functioning in reducing child distress mirrored resilience processes targeted by FOCUS. These findings underscore the public health potential of family-centered prevention for military families, and suggest areas for future research. PMID:23929043

Parental divorce and adult psychological distress: evidence from a national birth cohort: a research note.

PubMed

Rodgers, B; Power, C; Hope, S

1997-10-01

An association was found between childhood parental divorce and adult psychological distress in a British national birth cohort at ages 23 and 33. No moderating effects were found for gender, age at separation, or remarriage of the custodial parent. Participants who were young adults when their parents divorced also showed increased levels of symptomatology, whereas those who experienced parental death in childhood showed no increased risk. An interaction between parental divorce and own divorce in women, giving particularly high symptom levels, arose from a selection process in those from divorced families of origin only, with high 23-year scores predicting subsequent divorce. Own divorce was associated with an increase in distress between age 23 and 33, but this was irrespective of family of origin.

Discrimination, acculturation, acculturative stress, and Latino psychological distress: a moderated mediational model.

PubMed

Torres, Lucas; Driscoll, Mark W; Voell, Maria

2012-01-01

Prior research has found that perceived discrimination is associated with adverse mental health outcomes among Latinos. However, the process by which this relationship occurs remains an understudied area. The present study investigated the role of acculturative stress in underlying the relationship between perceived discrimination and Latino psychological distress. Also examined was the ability of acculturation to serve as a moderator between perceived discrimination and acculturative stress. Among a sample of Latino adults (N = 669), moderated mediational analyses revealed that acculturative stress mediated the perceived discrimination-psychological distress relationship, and that the link between perceived discrimination and acculturative stress was moderated by Anglo behavioral orientation but not Latino behavioral orientation. The findings are discussed within a stress and coping perspective that identifies the psychological consequences associated with perceived discrimination and acculturative stress.

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

PubMed

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

2016-09-01

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

Personologic alignment and the treatment of posttraumatic distress.

PubMed

Everly, G

2001-01-01

The therapeutic alliance is generally considered the sine qua non of successful psychotherapy. Yet, establishing the therapeutic alliance with patients suffering from syndromes of posttraumatic distress (including posttraumatic stress disorder) represents an unusual challenge. This paper describes the use of a personality-based approach to the establishment of the therapeutic alliance. This approach is referred to as personologic alignment and consists of alignment with preferential processes, as well as thematic belief systems. It represents an integration of the personology of Theodore Millon and the rhetoric of Aristotle.

The impact of the asylum process on mental health: a longitudinal study of unaccompanied refugee minors in Norway.

PubMed

Jakobsen, Marianne; Meyer DeMott, Melinda Ashley; Wentzel-Larsen, Tore; Heir, Trond

2017-06-21

To examine the mental health of unaccompanied refugee minors prospectively during the asylum-seeking process, with a focus on specific stages in the asylum process, such as age assessment, placement in a supportive or non-supportive facility and final decision on the asylum applications. This was a2½ year follow-up study of unaccompanied minors (UM) seeking asylum in Norway. Data were collected within three weeks (n=138) and at 4 months (n=101), 15 months (n=84) and 26 months (n=69) after arrival. Initially in an observation and orientation centre for unaccompanied asylum-seeking adolescents, and subsequently wherever the UM were located in other refugee facilities in Norway. Male UM from Afghanistan, Somalia, Algeria and Iran. Mental health symptoms assessed by Hopkins Symptom Checklist-25 and Harvard Trauma Questionnaire. At the group level, the young asylum seekers reported high levels of psychological distress on arrival and symptom levels that stayed relatively unchanged over time. According to age-assessment procedures, 56% of the population were not recognised as minors. Subsequent placement in a low-support facility was associated with higher levels of psychological distress in the follow-up period. Those who were placed in a reception centre for adults had higher levels of psychological distress symptoms both after 15 months and 26 months compared with the remaining participants who were placed in reception centres for youth. Refusal of asylum was highly associated with higher levels of psychological distress. Mental health trajectory of young asylum seekers appears to be negatively affected by low support and refusal of asylum. © 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.

In search of salience: phenomenological analysis of moral distress.

PubMed

Manara, Duilio F; Villa, Giulia; Moranda, Dina

2014-07-01

The nurse's moral competences in the management of situations which present ethical implications are less investigated in literature than other ethical problems related to clinical nursing. Phenomenology affirms that emotional warmth is the first fundamental attitude as well as the premise of any ethical reasoning. Nevertheless, it is not clear how and when this could be confirmed in situations where the effect of emotions on the nurse's decisional process is undiscovered. To explore the processes through which situations of moral distress are determined for the nurses involved in nursing situations, a phenomenological-hermeneutic analysis of a nurse's report of an experience lived by her as a moral distress situation has been conducted. Nursing emerges as a relational doctrine that requires the nurse to have different degrees of personal involvement, the integration between logical-formal thinking and narrative thinking, the perception of the salience of the given situation also through the interpretation and management of one's own emotions, and the capacity to undergo a process of co-construction of shared meanings that the others might consider adequate for the resolution of her problem. Moral action requires the nurse to think constantly about the important things that are happening in a nursing situation. Commitment towards practical situations is directed to training in order to promote the nurse's reflective ability towards finding salience in nursing situations, but it is also directed to the management of nursing assistance and human resources for the initial impact that this reflexive ability has on patients' and their families' lives and on their need to be heard and assisted. The only case analysed does not allow generalizations. Further research is needed to investigate how feelings generated by emotional acceptance influence ethical decision making and moral distress in nursing situations. © 2014 John Wiley & Sons Ltd.

The impact of the asylum process on mental health: a longitudinal study of unaccompanied refugee minors in Norway

PubMed Central

Jakobsen, Marianne; Meyer DeMott, Melinda Ashley; Wentzel-Larsen, Tore; Heir, Trond

2017-01-01

Objectives To examine the mental health of unaccompanied refugee minors prospectively during the asylum-seeking process, with a focus on specific stages in the asylum process, such as age assessment, placement in a supportive or non-supportive facility and final decision on the asylum applications. Design This was a2½ year follow-up study of unaccompanied minors (UM) seeking asylum in Norway. Data were collected within three weeks (n=138) and at 4 months (n=101), 15 months (n=84) and 26 months (n=69) after arrival. Setting Initially in an observation and orientation centre for unaccompanied asylum-seeking adolescents, and subsequently wherever the UM were located in other refugee facilities in Norway. Participants Male UM from Afghanistan, Somalia, Algeria and Iran. Main outcome measures Mental health symptoms assessed by Hopkins Symptom Checklist-25 and Harvard Trauma Questionnaire. Results At the group level, the young asylum seekers reported high levels of psychological distress on arrival and symptom levels that stayed relatively unchanged over time. According to age-assessment procedures, 56% of the population were not recognised as minors. Subsequent placement in a low-support facility was associated with higher levels of psychological distress in the follow-up period. Those who were placed in a reception centre for adults had higher levels of psychological distress symptoms both after 15 months and 26 months compared with the remaining participants who were placed in reception centres for youth. Refusal of asylum was highly associated with higher levels of psychological distress. Conclusion Mental health trajectory of young asylum seekers appears to be negatively affected by low support and refusal of asylum. PMID:28637731

Distress Tolerance as a Mediator of the Association Between Borderline Personality Symptoms and Obsessive Relational Intrusion: An Exploratory Analysis.

PubMed

Reilly, Meghan E; Hines, Denise A

2017-06-01

Obsessive relational intrusion (ORI) is the process by which a pursuer makes multiple attempts at establishing an unwanted, intimate relationship with an individual. It encompasses the more widely known behavior, stalking, which is a widespread problem, particularly among college-aged young adults. However, research on the underlying psychological processes involved in ORI and stalking perpetration is still in its infancy. Using relational goal pursuit theory and the emotional cascade model as guides to explore these processes, we investigated whether distress tolerance mediated the association between borderline personality disorder (BPD) symptoms and ORI, among a college student sample. Participants ( N = 224; 62.5% female; M age = 19.6 years) were recruited from an online survey panel and through the psychology research pool at a small, Northeastern university. Consistent with our hypotheses, path modeling showed that distress tolerance was a significant partial mediator between BPD symptoms and frequency of ORI perpetration. These results seem to provide new insight into the established link between BPD symptoms and ORI, and thus may contribute to our understanding of the underlying psychology of people who engage in unwanted pursuit. Future research should look toward replicating the current findings, testing potential gender differences in the model, and exploring other predictors of both the frequency and initiation of ORI behaviors.

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.

Ceramic regenerator systems development program

NASA Technical Reports Server (NTRS)

Cook, J. A.; Fucinari, C. A.; Lingscheit, J. N.; Rahnke, C. J.; Rao, V. D.

1978-01-01

Ceramic regenerator cores are considered that can be used in passenger car gas turbine engines, Stirling engines, and industrial/truck gas turbine engines. Improved materials and design concepts aimed at reducing or eliminating chemical attack were placed on durability tests/in industrial gas turbine engines. A regenerator core made from aluminum silicate shows minimal evidence of chemical attack damage after 7804 hours of engine test at 800 C and another showed little distress after 4983 hours at 982 C. The results obtained in ceramic material screening tests, aerothermodynamic performance tests, stress analysis, cost studies, and material specifications are also included.

Assessment of Brain Derived Neurotrophic Factor in hair to study stress responses: A pilot investigation.

PubMed

Harb, H; González-de-la-Vara, M; Thalheimer, L; Klein, U; Renz, H; Rose, M; Kruse, J; Potaczek, D P; Peters, E M J

2017-12-01

To study pathogenic stress-effects in health and disease, it is paramount to define easy access parameters for non-invasive analysis of biological change in response to stress. Hair samples successfully provide this access for the study of hypothalamus-pituitary-adrenal axis (HPA) changes. In this study, we assess the hair expression and corresponding epigenetic changes of a neurotrophin essential for autonomic nervous system function and mental health: brain derived neurotrophic factor (BDNF). In three independent studies in healthy academic volunteers (study I: German students, N=36; study II, German academic population sample, N=28; study III: Mexican students, N=115), BDNF protein expression or BDNF gene (BDNF) histone acetylation was determined. Simultaneously, mental distress and distress-associated somatic complaints were assessed by self-report. In study I, we found a negative correlation between hair-BDNF protein level and hair-cortisol as well as between hair-BDNF and somatic complaints, while hair-cortisol correlated positively with mental distress. In study II, we found a negative correlation between H4 histone acetylation at the BDNF gene P4-promoter and somatic complaints. Regression analysis confirmed confounder stability of associations in both studies. In study III, we confirmed study I and found lower hair-BDNF protein level in volunteers with high somatic complaints, who also reported higher mental distress during the end of term exams. The results indicate that BDNF protein levels can be detected in clipped hair and are associated with somatic complaints and stress in life. In addition, we concluded that plucked hair can provide material for the study of epigenetic changes in stress-affected tissues. These tools can prove valuable for future studies on distress, both under experimental and field conditions. Copyright © 2017. Published by Elsevier Ltd.

"Zip me up, and cool me down": Molar narratives and molecular intensities in 'helicopter' mental health services.

PubMed

McGrath, Laura; Reavey, Paula

2016-03-01

Experiences of the space-time dimensions of contemporary mental health services are shaped according to what we describe here as a 'helicopter service', where professionals drop down into service users' lives for short, often pre-determined bursts of time. This can create a system where users' experiences are observed and assessed from a more distanced and circumscribed perspective. This paper considers the implications of these systemic changes, using interviews with current UK service users. To help in the exploration of the complexities faced by service users', we use Deleuze and Guatarri's (1987) distinction between molar and molecular forms of organisation. A process oriented thematic analysis discusses: a) Affording narratives of distress: Molarity, monitoring and space in service interactions and b) Narratives in therapy: Compartmentalising the distressed self. Multiple aspects of the relationship between space and distress are explored. An understanding of experiences of distress beyond the boundaries of the molar, which considers its intensive, molecular and transformative nature, may help to open up engagement with the affective and emotional dimensions of mental health. Copyright © 2016 Elsevier Ltd. All rights reserved.

Development and content validation of a questionnaire to assess moral distress among social workers in long-term care facilities.

PubMed

Lev, Sagit; Ayalon, Liat

2018-03-01

Despite the significance of ethical issues faced by social workers, research on moral distress among social workers has been extremely limited. The aim of the current study is to describe the development and content validation of a unique questionnaire to measure moral distress among social workers in long-term care facilities for older adults in Israel. The construction of the questionnaire was based on a secondary analysis of a qualitative study that addressed the moral dilemma of social workers in nursing homes in Israel. A content validation included review and evaluation by two experts, a cognitive interview with a nursing home social worker, and three focus groups of experts and the target population. The initial questionnaire consisted of 25 items. After the content validation process the questionnaire in its final version, consisted of 17 items and included two scales, measuring the frequency of morally loaded events and the intensity of distress that followed them. We believe that the questionnaire can contribute by broadening and deepening ethics discourse and research, with regard to social workers' obligation dilemmas and conflicts.

Bridging the gap between financial distress and available resources for patients with cancer: a qualitative study.

PubMed

Smith, Sophia K; Nicolla, Jonathan; Zafar, S Yousuf

2014-09-01

Cancer treatment-related out-of-pocket costs create substantial financial distress for many patients. However, little work has been done to describe available financial resources and barriers to connecting those resources to patients. This was a single-center, qualitative study that used semistructured interviews and focus groups with social workers and financial care counselors. Interview guides were used to elicit feedback from study participants pertaining to the types of financial problems that their patients were experiencing, the process for addressing these issues, patient assistance resources, and access barriers. Four interviews and two focus group sessions (n = 15) were conducted in which four themes emerged among the social work and financial care counselor samples. Participants cited (1) frustration over the lack of financial resources and increasingly stringent eligibility criteria, (2) barriers to providing assistance such as process inefficiencies, (3) limited resources to identify at- risk patients and refer them for services, and (4) inadequate insurance coverage and availability. To bridge the gap between increasing patient need and limited resources, participants suggested development of interventions designed to aid in patient screening and resource identification. Oncology social workers and financial care counselors reported inadequate financial resources and faced barriers to matching appropriate resources with patients in need. Limited social work resources hindered early screening for financial distress. Interventions that focus on screening for early identification of financial distress and identification of resources are needed. Copyright © 2014 by American Society of Clinical Oncology.

46 CFR 160.023-4 - Approval and production tests.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 6 2010-10-01 2010-10-01 false Approval and production tests. 160.023-4 Section 160.023-4 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Hand Combination Flare and Smoke Distress Signals § 160.023-4 Approval and production tests...

46 CFR 160.022-4 - Approval and production tests.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 6 2011-10-01 2011-10-01 false Approval and production tests. 160.022-4 Section 160.022-4 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Floating Orange Smoke Distress Signals (5 Minutes) § 160.022-4 Approval and production test...

46 CFR 160.023-4 - Approval and production tests.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 6 2011-10-01 2011-10-01 false Approval and production tests. 160.023-4 Section 160.023-4 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Hand Combination Flare and Smoke Distress Signals § 160.023-4 Approval and production tests...

46 CFR 160.028-4 - Approval and production tests.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 6 2010-10-01 2010-10-01 false Approval and production tests. 160.028-4 Section 160.028-4 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Signal Pistols for Red Flare Distress Signals § 160.028-4 Approval and production tests. (a...

46 CFR 160.066-5 - Design, construction, and manufacturing requirements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 6 2011-10-01 2011-10-01 false Design, construction, and manufacturing requirements. 160.066-5 Section 160.066-5 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Distress Signal for Boats, Red Aerial Pyrotechnic Flare § 160.066-5...

46 CFR 160.066-5 - Design, construction, and manufacturing requirements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 6 2014-10-01 2014-10-01 false Design, construction, and manufacturing requirements. 160.066-5 Section 160.066-5 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Distress Signal for Boats, Red Aerial Pyrotechnic Flare § 160.066-5...

46 CFR 160.066-5 - Design, construction, and manufacturing requirements.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 6 2013-10-01 2013-10-01 false Design, construction, and manufacturing requirements. 160.066-5 Section 160.066-5 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Distress Signal for Boats, Red Aerial Pyrotechnic Flare § 160.066-5...

Guidelines for detection, analysis, and treatment of materials-related distress in concrete pavements, volume 3 : case studies using the guidelines.

DOT National Transportation Integrated Search

2002-08-01

The performance of concrete pavements can be adversely affected by the concrete's inability to resist the environment in : which it is placed. This lack of durability can occur even when the structural design of the pavement is adequate. The : distre...

Living through pelvic radiotherapy:A mixed method study of self-care activities and distressful symptoms.

PubMed

Jakobsson, Sofie; Ekman, Tor; Ahlberg, Karin

2015-06-01

To explore patients' experience of their illness when undergoing pelvic radiotherapy by describing the presence and severity of distressful symptoms and to explore initiated self-care activities in response to illness and symptoms. A mixed-method study was performed which included a core qualitative dataset and a supplementary quantitative dataset. Twenty-nine women undergoing five weeks of radiotherapy were prospectively interviewed during five weeks of treatment in order to capture experiences, distressful symptoms and quality of life during treatment. Grounded theory formed collection and analysis of the qualitative dataset and statistics were used to analyze the quantitative dataset. A maintained self-identity was concluded as being central during the trajectory of treatment. Initiated self-care activities served to alleviate physical, emotional, and social suffering; helping the respondents keep their integrity and sense of self. Previous life experiences influenced the process of being able to maintain self-identity. The gastrointestinal symptoms and pain caused most distress. In order to be able to maintain self-identity patients endure treatment by focusing on symptoms, on getting cured and on their self-image. Several distressful symptoms implied social limitations and a sense that the body would not take the strain. The result of this study can help health care professionals to gain a better understanding of the struggle to endure pelvic radiotherapy. Further, health care professionals should be more proactive in alleviating their patients' distressful symptoms. The results imply that previous life experiences should precede initiated interventions because these life experiences affect the patients' self-care activities. Copyright © 2014 Elsevier Ltd. All rights reserved.

Substance Use is a Risk Factor for Neurocognitive Deficits and Neuropsychiatric Distress in Acute and Early HIV Infection

PubMed Central

Weber, Erica; Morgan, Erin E.; Iudicello, Jennifer E.; Blackstone, Kaitlin; Grant, Igor; Ellis, Ronald J.; Letendre, Scott L.; Little, Susan; Morris, Sheldon; Smith, Davey M.; Moore, David J.; Woods, Steven Paul

2012-01-01

The acute and early stages of HIV infection (AEH) are characterized by substantial viral replication, immune activation, and alterations in brain metabolism. However, little is known about the prevalence and predictors of neurocognitive deficits and neuropsychiatric disturbances during this period. The present study examined the impact of demographic, HIV disease, and substance use factors on HIV-associated neurocognitive impairment and self-reported neuropsychiatric distress among 46 antiretroviral-naïve adults with median duration of infection of 75 days, relative to sample a of 21 HIV seronegative (HIV-) adults with comparable demographics and risk factors. Participants were administered a brief neurocognitive battery that was adjusted for demographics and assessed executive functions, memory, psychomotor speed, and verbal fluency, as well as the Profile of Mood States (POMS), a self-report measure of neuropsychiatric distress. Odds ratios revealed that AEH participants were nearly four times more likely than their seronegative counterparts to experience neurocognitive impairment, particularly in the areas of learning and information processing speed. Similarly, AEH was associated with a nearly five-fold increase in the odds of neuropsychiatric distress, most notably in anxiety and depression. Within the AEH sample, HIV-associated neurocognitive impairment was associated with problematic methamphetamine use and higher plasma HIV RNA levels, whereas neuropsychiatric distress was solely associated with high-risk alcohol use. Extending prior neuroimaging findings, results from this study indicate that HIV-associated neurocognitive impairment and neuropsychiatric distress are highly prevalent during AEH and are associated with high-risk substance use. PMID:23250704

Discrimination, Acculturation, Acculturative Stress, and Latino Psychological Distress: A Moderated Mediational Model

PubMed Central

Torres, Lucas; Driscoll, Mark W.; Voell, Maria

2012-01-01

Prior research has found that perceived discrimination is associated with adverse mental health outcomes among Latinos. However, the process by which this relationship occurs remains an understudied area. The present study investigated the role of acculturative stress in underlying the relationship between perceived discrimination and Latino psychological distress. Also examined was the ability of acculturation to serve as a moderator between perceived discrimination and acculturative stress. Among a sample of Latino adults (N=669), moderated mediational analyses revealed that acculturative stress mediated the perceived discrimination-psychological distress relationship, and that the link between perceived discrimination and acculturative stress was moderated by Anglo behavioral orientation but not Latino behavioral orientation. The findings are discussed within a stress and coping perspective that identifies the psychological consequences associated with perceived discrimination and acculturative stress. PMID:22250895

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

Transportation informatics : advanced image processing techniques automated pavement distress evaluation.

DOT National Transportation Integrated Search

2010-01-01

The current project, funded by MIOH-UTC for the period 1/1/2009- 4/30/2010, is concerned : with the development of the framework for a transportation facility inspection system using : advanced image processing techniques. The focus of this study is ...

Rumination, event centrality, and perceived control as predictors of post-traumatic growth and distress: The Cognitive Growth and Stress model.

PubMed

Brooks, Matthew; Graham-Kevan, Nicola; Lowe, Michelle; Robinson, Sarita

2017-09-01

The Cognitive Growth and Stress (CGAS) model draws together cognitive processing factors previously untested into a single model. Intrusive rumination, deliberate rumination, present and future perceptions of control, and event centrality were assessed as predictors of post-traumatic growth (PTG) and post-traumatic stress (PTS). The CGAS model is tested on a sample of survivors (N = 250) of a diverse range of adverse events using structural equation modelling techniques. Overall, the best fitting model was supportive of the theorized relations between cognitive constructs and accounted for 30% of the variance in PTG and 68% of the variance in PTS across the sample. Rumination, centrality, and perceived control factors are significant determinants of positive and negative psychological change across the wide spectrum of adversarial events. In its first phase of development, the CGAS model also provides further evidence of the distinct processes of growth and distress following adversity. Clinical implications People can experience positive change after adversity, regardless of life background or types of events experienced. While growth and distress are possible outcomes after adversity, they occur through distinct processes. Support or intervention should consider rumination, event centrality, and perceived control factors to enhance psychological well-being. Cautions/limitations Longitudinal research would further clarify the findings found in this study. Further extension of the model is recommended to include other viable cognitive processes implicated in the development of positive and negative changes after adversity. © 2017 The British Psychological Society.

Psychological health of military children: longitudinal evaluation of a family-centered prevention program to enhance family resilience.

PubMed

Lester, Patricia; Stein, Judith A; Saltzman, William; Woodward, Kirsten; MacDermid, Shelley W; Milburn, Norweeta; Mogil, Catherine; Beardslee, William

2013-08-01

Family-centered preventive interventions have been proposed as relevant to mitigating psychological health risk and promoting resilience in military families facing wartime deployment and reintegration. This study evaluates the impact of a family-centered prevention program, Families OverComing Under Stress Family Resilience Training (FOCUS), on the psychological adjustment of military children. Two primary goals include (1) understanding the relationships of distress among family members using a longitudinal path model to assess relations at the child and family level and (2) determining pathways of program impact on child adjustment. Multilevel data analysis using structural equation modeling was conducted with deidentified service delivery data from 280 families (505 children aged 3-17) in two follow-up assessments. Standardized measures included service member and civilian parental distress (Brief Symptom Inventory, PTSD Checklist-Military), child adjustment (Strengths and Difficulties Questionnaire), and family functioning (McMaster Family Assessment Device). Distress was significantly related among the service member parent, civilian parent, and children. FOCUS improved family functioning, which in turn significantly reduced child distress at follow-up. Salient components of improved family functioning in reducing child distress mirrored resilience processes targeted by FOCUS. These findings underscore the public health potential of family-centered prevention for military families and suggest areas for future research. Reprint & Copyright © 2013 Association of Military Surgeons of the U.S.

Challenges in treating post-traumatic stress disorder and attachment trauma.

PubMed

Allen, Jon G

2003-06-01

Treating women suffering from trauma poses significant challenges. The diagnostic prototype of post-traumatic stress disorder (PTSD) is based on single-event trauma, such as sexual assault in adulthood. Several effective cognitive- behavioral treatments for such traumas have been developed, although many treated patients continue to experience residual symptoms. Even more problematic is the complex developmental psychopathology stemming from a lifetime history of multiple traumas, often beginning with maltreatment in early attachment relationships. A history of attachment trauma undermines the development of capacities to regulate emotional distress and thereby complicates the treatment of acute trauma in adulthood. Such complex trauma requires a multifaceted treatment approach that must balance processing of traumatic memories with strategies to contain the intense emotions this processing evokes. Moreover, conducting such treatment places therapists at risk for secondary trauma such that trauma therapists also must process this stressful experience and implement strategies to regulate their own distress.

Examining psychological inflexibility as a transdiagnostic process across psychological disorders

PubMed Central

Levin, Michael E.; MacLane, Chelsea; Daflos, Susan; Seeley, John; Hayes, Steven C.; Biglan, Anthony; Pistorello, Jacqueline

2017-01-01

The current cross-sectional study examined psychological inflexibility, a process in which behavior is rigidly guided by psychological reactions rather than direct contingencies or personal values, as a transdiagnostic process relevant to a range of depressive, anxiety, substance use and eating disorders. A sample of 972 first-year college students between 17 and 20 years of age completed self-report measures of psychological inflexibility and psychological distress as well as a structured diagnostic interview. Psychological inflexibility was significantly higher across a range of current and lifetime depressive and anxiety disorders as well as lifetime history of eating disorders, relative to students with no disorder, even after controlling for general psychological distress. Findings were mixed for substance use disorders, with a more consistent pattern for lifetime history than for current disorders. Psychological inflexibility was also related to having comorbid depressive, anxiety, and substance use disorders relative to only having one of these diagnoses. Results are discussed in relation to research on psychological inflexibility as a transdiagnostic pathological process and target for interventions. PMID:29057212

Psychological outcomes in midadulthood associated with mother's child-rearing attitudes in early childhood--evidence from the 1970 British birth cohort.

PubMed

Flouri, Eirini

2004-02-01

This study used longitudinal data from the 1970 British Cohort Study (BCS70) to examine the role of mother's child-rearing attitudes assessed when cohort members were aged 5 in children's psychological well-being (psychological functioning, psychological distress, life satisfaction and self-efficacy) at age 30. Although at the multivariate level mother's childrearing attitudes were not related to sons' psychological well-being in adult life, in daughters self-efficacy and life satisfaction at age 30 were related to mother's anti-child autonomy attitudes and mother's non-authoritarian child-rearing attitudes, respectively. In addition, mother's non-authoritarian childrearing attitudes had a protective effect against later psychological distress and low self-efficacy in daughters who had experienced significant material disadvantage in early childhood.

Fuzzy Based Decision Support System for Condition Assessment and Rating of Bridges

NASA Astrophysics Data System (ADS)

Srinivas, Voggu; Sasmal, Saptarshi; Karusala, Ramanjaneyulu

2016-09-01

In this work, a knowledge based decision support system has been developed to efficiently handle the issues such as distress diagnosis, assessment of damages and condition rating of existing bridges towards developing an exclusive and robust Bridge Management System (BMS) for sustainable bridges. The Knowledge Based Expert System (KBES) diagnoses the distresses and finds the cause of distress in the bridge by processing the data which are heuristic and combined with site inspection results, laboratory test results etc. The coupling of symbolic and numeric type of data has been successfully implemented in the expert system to strengthen its decision making process. Finally, the condition rating of the bridge is carried out using the assessment results obtained from the KBES and the information received from the bridge inspector. A systematic procedure has been developed using fuzzy mathematics for condition rating of bridges by combining the fuzzy weighted average and resolution identity technique. The proposed methodologies and the decision support system will facilitate in developing a robust and exclusive BMS for a network of bridges across the country and allow the bridge engineers and decision makers to carry out maintenance of bridges in a rational and systematic way.

Empathy as a driver of prosocial behaviour: highly conserved neurobehavioural mechanisms across species.

PubMed

Decety, Jean; Bartal, Inbal Ben-Ami; Uzefovsky, Florina; Knafo-Noam, Ariel

2016-01-19

Empathy reflects the natural ability to perceive and be sensitive to the emotional states of others, coupled with a motivation to care for their well-being. It has evolved in the context of parental care for offspring, as well as within kinship bonds, to help facilitate group living. In this paper, we integrate the perspectives of evolution, animal behaviour, developmental psychology, and social and clinical neuroscience to elucidate our understanding of the proximate mechanisms underlying empathy. We focus, in particular, on processing of signals of distress and need, and their relation to prosocial behaviour. The ability to empathize, both in animals and humans, mediates prosocial behaviour when sensitivity to others' distress is paired with a drive towards their welfare. Disruption or atypical development of the neural circuits that process distress cues and integrate them with decision value leads to callous disregard for others, as is the case in psychopathy. The realization that basic forms of empathy exist in non-human animals is crucial for gaining new insights into the underlying neurobiological and genetic mechanisms of empathy, enabling translation towards therapeutic and pharmacological interventions. © 2015 The Author(s).

When seeking influences believing and promotes posttraumatic adaptation.

PubMed

Smith, Andrew J; Donlon, Katharine; Anderson, Scott R; Hughes, Michael; Jones, Russell T

2015-01-01

Theory and evidence link social support processes and self-efficacy appraisals in the promotion of adaptation following traumatic events. Dynamic causal processes, however, have not been examined longitudinally or in the context of mass-violence. This study tested whether quantity of social support seeking indirectly reduced distress severity among student survivors of mass university shootings. Hypotheses specified that the indirect effects of social support seeking on distress severity would occur through positively influencing perceived social support and self-efficacy, and that these effects would emerge and become stronger as posttraumatic stress symptom severity increased. Path analysis via Mplus 7.2 was used to test the hypothesized moderated-serial-mediation model (conditional indirect effects). The sample (N=1191) consisted of students enrolled at Virginia Tech during the 16 April 2007 shootings. Data were collected via online surveys at two time points, 3-4 months and 1-year post-shootings. Hypotheses were supported, showing that the indirect effects of social support seeking on distress reduction occurred through perceived social support, which in turn influenced self-efficacy. These effects emerged and grew in strength as PTS severity increased. Clinical implications, including the need to consider contextual determinants of posttraumatic recovery, are discussed.

UTILITY OF PSYCHOLOGICAL SCREENING OF YOUNG ADULTS WITH TYPE 1 DIABETES TRANSITIONING TO ADULT PROVIDERS.

PubMed

Quinn, Sheila M; Ambrosino, Jodie M; Doyle, Elizabeth A; Weyman, K; Tamborlane, William V; Jastreboff, Ania M

2016-09-01

Screening for depression, diabetes distress, and disordered eating in youth with type 1 diabetes (T1D) is recommended, as these comorbidities contribute to poor glycemic control. No consensus exists on which measures are optimal, and most previous studies have used nondisease-specific measures. We examined the utility of screening for these disorders using two disease-specific and one general measure at the time of transition from pediatric to adult care. Forty-three young adults from a T1D transition clinic completed the Patient Health Questionnaire, the Diabetes Distress Scale, and the Diabetes Eating Problem Survey-Revised. Chart review determined if clinicians noted similar symptoms during the year prior to transition. Metabolic data were also recorded. Chart review identified 5 patients with depressive symptoms and 8 patients with diabetes distress. Screening identified 2 additional patients with depressive symptoms and 1 additional patient with diabetes distress. Of those noted to have symptomatic depression or diabetes distress on chart review, several subsequently screened negative on transition. Disordered eating was not detected by chart review, but 23.5% screened positive on transition. While depression, diabetes distress, and disordered eating positively correlated with glycated hemoglobin (HbA1c) (r = 0.31, P = .05; r = 0.40, P = .009; r = 0.63, P<.001, respectively), disordered eating accounted for the majority of observed variance (df = 1; F = 18.6; P<.001). Even though HbA1c was higher in patients with versus without disordered eating (P<.001), body mass index did not differ between the 2 groups (P = .51). In young adults with T1D, formal screening provides an opportunity to detect psychological problems, which, when treated, may help optimize metabolic control during the transition process. T1D = type 1 diabetes HbA1C = hemoglobin A1c YCDP = Yale Children's Diabetes Program PHQ-8 = Patient Health Questionnaire-8 DDS = Diabetes Distress Scale DEPS-R = Diabetes Eating Problem Survey-Revised.

Mental health of workers in Toulouse 2 years after the industrial AZF disaster: first results of a longitudinal follow-up of 3,000 people.

PubMed

Cohidon, Christine; Diène, Eloi; Carton, Matthieu; Fatras, Jean-Yves; Goldberg, Marcel; Imbernon, Ellen

2009-09-01

On September 21, 2001, the AZF petrochemical factory near Toulouse (France) exploded. A cross-sectional survey of Toulouse workers took place in 2002 and then, a cohort follow-up began in 2003. The aim of this paper is to study the associations between various factors describing exposure to the disaster, and anxiety and depressive symptoms, assessed at cohort inclusion 2 years afterwards. In 2003, 3,006 people were included in the cohort. Psychological distress was measured by the GHQ28 at inclusion. Factors related to exposure to the disaster, such as personal distance from the site, physical injury, immediate psychological symptoms, and material and social effects, came from the 2002 cross-sectional survey. The links between mental health symptoms and exposure were studied in multivariate analyses by logistic regression. The prevalence of psychological distress was 47% at inclusion in the cohort. It varied according to sex and occupational class: blue-collar workers and self-employed people were most highly affected. Factors such as a history of depression, injury to a close friend or family member, sick-leaves and immediate psychological symptoms were associated with psychological distress 2 years later. These associations differed according to sex. This study shows links between the industrial disaster and psychological distress 2 years afterwards. The results about risk factors differ according to sex, and identify particularly vulnerable populations. It should guide preventive interventions in such situation.

Improving Rutting Resistance of Pavement Structures Using Geosynthetics: An Overview

PubMed Central

Karim, Mohamed Rehan; Khodaii, Ali; Almasi, Mohammad Hadi

2014-01-01

A pavement structure consists of several layers for the primary purpose of transmitting and distributing traffic loads to the subgrade. Rutting is one form of pavement distresses that may influence the performance of road pavements. Geosynthetics is one type of synthetic materials utilized for improving the performance of pavements against rutting. Various studies have been conducted on using different geosynthetic materials in pavement structures by different researchers. One of the practices is a reinforcing material in asphalt pavements. This paper intends to present and discuss the discoveries from some of the studies on utilizing geosynthetics in flexible pavements as reinforcement against permanent deformation (rutting). PMID:24526919

Improving rutting resistance of pavement structures using geosynthetics: an overview.

PubMed

Mirzapour Mounes, Sina; Karim, Mohamed Rehan; Khodaii, Ali; Almasi, Mohammad Hadi

2014-01-01

A pavement structure consists of several layers for the primary purpose of transmitting and distributing traffic loads to the subgrade. Rutting is one form of pavement distresses that may influence the performance of road pavements. Geosynthetics is one type of synthetic materials utilized for improving the performance of pavements against rutting. Various studies have been conducted on using different geosynthetic materials in pavement structures by different researchers. One of the practices is a reinforcing material in asphalt pavements. This paper intends to present and discuss the discoveries from some of the studies on utilizing geosynthetics in flexible pavements as reinforcement against permanent deformation (rutting).

An investigation of concentrated and distributed strain inducing constraints for training shape memory alloys

NASA Astrophysics Data System (ADS)

Parent, Pauline Marie

Borderline personality disorder (BPD) is a severe mental illness characterized by high rates of engagement in distress-induced risk behavior. Unfortunately, extant laboratory-based risk paradigms have failed to account for the role of distress in precipitating risk behavior, so many questions remain about processes mechanisms that underlie this behavior. The current study examined affect as a moderator of the relationship between diagnostic status and risk behavior, as measured by a behavioral risk task, and affective and non-affective neurocognitive functioning as potential mediators of this relationship. Results indicated that individuals with BPD engaged in more risk behavior in the distress condition than in the neutral condition, whereas individuals without BPD showed a decrease in risk behavior across the two conditions. However, corresponding changes in executive functioning were not observed, suggesting the need for continued research to identify alternative mechanisms (e.g., neurocognitive, motivational) to explain this effect.

Neighborhood and housing disorder, parenting, and youth adjustment in low-income urban families.

PubMed

Jocson, Rosanne M; McLoyd, Vonnie C

2015-06-01

Using two waves of data, this study examined relations among neighborhood and housing disorder, parents' psychological distress, parenting behaviors, and subsequent youth adjustment in a low-income, multiethnic sample of families with children aged 6-16. Results supported the hypothesized indirect relation between disorder and youth outcomes via parenting processes. Higher levels of neighborhood and housing disorder were associated with higher levels of parents' psychological distress, which was in turn related to more frequent use of harsh and inconsistent discipline strategies and lower parental warmth. More frequent use of harsh and inconsistent discipline was associated with higher levels of youth internalizing and externalizing behaviors 3 years later. Housing disorder contributed more strongly to parents' psychological distress than neighborhood disorder, whereas neighborhood disorder contributed more strongly to youth externalizing behaviors compared to housing disorder. Multiple-group analyses showed that the patterns of relations were similar for younger and older children, and for girls and boys.

Globalisation and mental disorders. Overview with relation to depression.

PubMed

Bhugra, Dinesh; Mastrogianni, Anastasia

2004-01-01

Globalisation is the process by which traditional boundaries of cultures are changing. Industrialisation, urbanisation and influence of the media are influencing idioms of distress across cultures. To discuss the role of globalisation, using the epidemiology, diagnosis, clinical presentation and treatment of depression across various cultures as an example. Recent studies focusing on transcultural aspects of depression were reviewed and summarised. Cultural, social and religious mores account for variations in the presentation of depression across cultures. Somatic symptoms are common presenting features throughout the world and may serve as cultural idioms of distress, but psychological symptoms can usually be found when probed. Feelings of guilt and suicide rates vary across cultures and depression may be underdiagnosed. Training packages could enhance clinicians'cultural competency in multicultural settings. However, globalisation is likely to influence idioms of distress and pathways to care in ways that are difficult to predict.

Impact of depressive symptoms, self-esteem and neuroticism on trajectories of overgeneral autobiographical memory over repeated trials.

PubMed

Kashdan, Todd B; Roberts, John E; Carlos, Erica L

2006-04-01

The present study examined trajectories of change in the frequency of overgeneral autobiographical memory (OGM) over the course of repeated trials, and tested whether particular dimensions of depressive symptomatology (somatic and cognitive-affective distress), self-esteem, and neuroticism account for individual differences in these trajectories. Given that depression is associated with impairments in effortful processing, we predicted that over repeated trials depression would be associated with increasingly OGM. Generalised Linear Mixed Models with Penalised Quasi-Likelihood demonstrated significant linear and quadratic trends in OGM over repeated trials, and somatic distress and self-esteem moderated these slopes. The form of these interactions suggested that somatic distress and low self-esteem primarily contribute to OGM during the second half of the trial sequence. The present findings demonstrate the value of a novel analytical approach to OGM that estimates individual trajectories of change over repeated trials.

Development of satellite position location system for aircraft and boat distress beacons

NASA Technical Reports Server (NTRS)

Kahle, D. R.

1982-01-01

An international satellite system for the detection and location of distress beacons carried on aircraft and vessels is in its technical checkout phase. User demonstration and evaluation (D&E) will start in early 1983 and continue for two years. The D&E phase and a subsequent transition period will form the basis for improved search and rescue operations for the 1980's and beyond. The system, called COSPAS/SARSAT, has international participation involving the U.S., Canada, and France as SARSAT members and joint participation with the Soviet Union's COSPAS Project. Norway and the U.K. have recently joined as investigators. Average position location error of the satellite aided processing is expected to be from 10-20KM for the existing 121.5/243 MHz distress beacons and from 2-5KM for experimental beacons transmitting in the 406 MHz band.

Psychological distress and lifestyle of students: implications for health promotion.

PubMed

Deasy, Christine; Coughlan, Barry; Pironom, Julie; Jourdan, Didier; Mcnamara, Patricia Mannix

2015-03-01

Poor diet, physical inactivity, tobacco smoking and alcohol consumption are major risk factors for chronic disease and premature mortality. These behaviours are of concern among higher education students and may be linked to psychological distress which is problematic particularly for students on programmes with practicum components such as nursing and teaching. Understanding how risk behaviours aggregate and relate to psychological distress and coping among this population is important for health promotion. This research examined, via a comprehensive survey undergraduate nursing/midwifery and teacher education students' (n = 1557) lifestyle behaviour (Lifestyle Behaviour Questionnaire), self-reported psychological distress (General Health Questionnaire) and coping processes (Ways of Coping Questionnaire). The results showed that health- risk behaviours were common, including alcohol consumption (93.2%), unhealthy diet (26.3%), physical inactivity (26%), tobacco smoking (17%), cannabis use (11.6%) and high levels of stress (41.9%). Students tended to cluster into two groups: those with risk behaviours (n = 733) and those with positive health behaviours (n = 379). The group with risk behaviours had high psychological distress and used mostly passive coping strategies such as escape avoidance. The potential impact on student health and academic achievement is of concern and suggests the need for comprehensive health promotion programmes to tackle multiple behaviours. As these students are the nurses and teachers of the future, their risk behaviours, elevated psychological distress and poor coping also raise concerns regarding their roles as future health educators/promoters. Attention to promotion of health and well-being among this population is essential. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Mindfulness-Based Stress Reduction for lung cancer patients and their partners: Results of a mixed methods pilot study.

PubMed

van den Hurk, Desiree G M; Schellekens, Melanie P J; Molema, Johan; Speckens, Anne E M; van der Drift, Miep A

2015-07-01

Lung cancer patients and partners show high rates of impaired quality of life and heightened distress levels. Mindfulness-Based Stress Reduction has proven to be effective in reducing psychological distress in cancer patients. However, studies barely included lung cancer patients. We examined whether Mindfulness-Based Stress Reduction might be a feasible and effective intervention for patients with lung cancer and partners. Mindfulness-Based Stress Reduction is a training in which mindfulness practices are combined with psycho-education to help participants cope with distress. In this mixed methods pilot study, questionnaires on psychological distress and quality of life were administered before, directly after and 3 months after the Mindfulness-Based Stress Reduction training, in combination with semi-structured interviews. Patients with lung cancer and partners were recruited at one tertiary care academic medical centre. A total of 19 lung cancer patients and 16 partners participated in the Mindfulness-Based Stress Reduction training. Most patients were diagnosed with advanced stage lung cancer. Vast majority completed the training. Those receiving anti-cancer treatment did not miss more sessions than patients who were not currently treated. Patients and partners felt positive about participating in a peer group and with their partner. Among participants no significant changes were found in psychological distress. Caregiver burden in partners decreased significantly after following Mindfulness-Based Stress Reduction. The qualitative analysis showed that the training seemed to instigate a process of change in participants. The Mindfulness-Based Stress Reduction training seemed to be feasible for patients with lung cancer and their partners. A randomized controlled trial is needed to examine the effectiveness of Mindfulness-Based Stress Reduction in reducing psychological distress in lung cancer patients and partners. © The Author(s) 2015.

Longitudinal change in parent and child functioning after internet-delivered cognitive-behavioral therapy for chronic pain.

PubMed

Law, Emily F; Fisher, Emma; Howard, Waylon J; Levy, Rona; Ritterband, Lee; Palermo, Tonya M

2017-10-01

Theoretical models of pediatric chronic pain propose longitudinal associations between children's pain experiences and parent and family factors. A large body of cross-sectional research supports these models, demonstrating that greater parent distress and maladaptive parenting behaviors are associated with greater child disability. Family-based cognitive-behavioral therapy interventions have been developed for youth with chronic pain which aim to improve child disability and reduce maladaptive parenting behaviors. However, little is known about temporal, longitudinal associations between parent and child functioning in this population. In the present study, we conducted a secondary analysis of data from 138 families of youth with chronic pain aged 11 to 17 years old who received family-based cognitive-behavioral therapy delivered through the Internet as part of a randomized controlled trial. Measures of child disability, parent protective behavior, and parent distress were obtained at pretreatment, immediate posttreatment, 6-month follow-up, and 12-month follow-up. Latent growth modeling indicated that child disability, parent protective behavior, and parent distress improved with treatment over the 12-month study period. Latent growth modeling for parallel processes indicated that higher parent distress at pretreatment predicted less improvement in child disability over 12 months. No other predictive paths between parent and child functioning were significant. These findings indicate that parent distress may increase the risk of poor response to psychological pain treatment among youth with chronic pain. At present, parent distress is not routinely targeted in psychological interventions for pediatric chronic pain. Research is needed to determine optimal strategies for targeting parent and family factors in the treatment of pediatric chronic pain.

Understanding the Links Between Self-Report Emotional Intelligence and Suicide Risk: Does Psychological Distress Mediate This Relationship Across Time and Samples?

PubMed Central

Mérida-López, Sergio; Extremera, Natalio; Rey, Lourdes

2018-01-01

Objective: In the last decades, increasing attention has been paid to examining psychological resources that might contribute to our understanding of suicide risk. Although Emotional Intelligence (EI) is one dimension that has been linked with decreased suicidal ideation and behaviors, we detected several gaps in the literature in this area regarding the research designs and samples involved. In this research, we aimed to test a mediator model considering self-report EI, psychological distress and suicide risk across samples adopting both cross-sectional and prospective designs in two independent studies. Method: In Study 1, our purpose was to examine the potential role of psychological distress as a mediator in the relationship between self-report EI and suicide risk in a community sample comprised of 438 adults (270 women; mean age: 33.21 years). In Study 2, we sought to examine the proposed mediator model considering a 2-month prospective design in a sample of college students (n = 330 in T1; n = 311 in T2; 264 women; mean age: 22.22 years). Results: In Study 1, we found that psychological distress partially mediated the effect of self-report EI on suicide risk. More interestingly, findings from Study 2 showed that psychological distress fully mediated the relationship between self-report EI and suicide risk at Time 2. Conclusion: These results point out the role of psychological distress as a mediator in the association between self-report EI and suicide risk. These findings suggest an underlying process by which self-report EI may act as a protective factor against suicidal ideation and behaviors. In line with the limitations of our work, plausible avenues for future research and interventions are discussed. PMID:29867607

MoDOT pavement preservation research program volume VI, pavement treatment trigger tables/decision trees and treatment candidate selection process.

DOT National Transportation Integrated Search

2015-10-01

The objective of Task 5 was the development of pavement treatment trigger tables and the treatment candidate selection process. : The input to the trigger tables entails such factors as an overall condition indicator, smoothness, individual distress ...

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.

Physical Fitness and the Stress Process

ERIC Educational Resources Information Center

Ensel, Walter M.; Lin, Nan

2004-01-01

In the current paper we focus on the role of physical fitness in the life stress process for both psychological and physical well-being. The major research question posed in the current study is: Does physical fitness deter distress in a model containing the major components of the life stress process? That is, do individuals who exercise show…

Dysfunctional remembered parenting in oncology outpatients affects psychological distress symptoms in a gender-specific manner.

PubMed

Kouzoupis, Anastasios V; Lyrakos, Dimitrios; Kokras, Nikolaos; Panagiotarakou, Meropi; Syrigos, Kostas N; Papadimitriou, George N

2012-12-01

Evidence suggests that gender differences appear in a variety of biological and psychological responses to stress and perhaps in coping with acute and chronic illness as well. Dysfunctional parenting is also thought to be involved in the process of coping with stress and illness; hence, the present study aimed to verify whether dysfunctional remembered parenting would influence psychological distress in a gender-specific manner in patients suffering from cancer. Patients attending an outpatient oncology clinic completed the Remembered Relationships with Parents (RRP), Hospital Anxiety and Depression and Spielberger's State-Trait Anxiety Inventory scales and the National Cancer Center Network Distress Thermometer. Although no baseline gender differences were detected, a multivariate analysis confirmed that anxiety and depression symptoms of men and women suffering from cancer are differentially affected by the RRP Control and Alienation scores. Women with remembered parental alienation and overprotection showed significantly more anxiety symptoms than men, whereas men were more vulnerable to remembered alienation than overprotection with regard to the Distress Thermometer scores. These results suggest that remembered dysfunctional parenting is crucially, and in a gender-specific manner, involved in the coping strategy adopted by male and female cancer patients. Copyright © 2012 John Wiley & Sons, Ltd.

Pumps and warmers during amnioinfusion: is either necessary?

PubMed

Glantz, J C; Letteney, D L

1996-01-01

To determine if there is evidence from published reports that the use of infusion pumps or solution warmers during amnioinfusion is beneficial. We identified all English-language amnioinfusion reports published since 1983 through Medline and references. Fourteen prospective papers with at least 40 subjects were identified. For the amnioinfusion and control groups in each study, odds ratios (OR) were calculated for cesarean delivery, fetal distress, meconium below the cords, low 5-minute Apgar score, and endometritis. Cumulative ORs were calculated using the Mantel-Haenszel inverse variance method. This process was repeated after separation into pump-gravity and warmed-unwarmed groups. Multiple regression analyses were performed. Amnioinfusion improved the ability of the fetus to tolerate labor (fetal distress OR 0.40), decreased the incidence of meconium below the cords (OR 0.16), and decreased the rate of cesarean delivery (OR 0.56). There were no demonstrable benefits associated with the use of warmers or pumps. In multiple regression analysis, infusion pumps were associated with a significantly increased risk of fetal distress (P = .01). The use of amnioinfusion is associated with a decreased risk of fetal distress, meconium below the cords, and cesarean delivery. To date, there is no demonstrable benefit using infusion pumps or solution warmers during amnioinfusion.

Transportations of space, time and self: the role of reading groups in managing mental distress in the community.

PubMed

Shipman, Judith; McGrath, Laura

2016-10-01

The practice of reading and discussing literature in groups is long established, stretching back into classical antiquity. Although benefits of therapeutic reading groups have been highlighted, research into participants' perceptions of these groups has been limited. To explore the experiences of those attending therapeutic reading groups, considering the role of both the group, and the literature itself, in participants' ongoing experiences of distress. Eleven participants were recruited from two reading groups in the South-East of England. One focus group was run, and eight individuals self-selected for individual interviews. The data were analysed together using a thematic analysis drawing on dialogical theories. Participants described the group as an anchor, which enabled them to use fiction to facilitate the discussion of difficult emotional topics, without referring directly to personal experience. Two aspects of this process are explored in detail: the use of narratives as transportation, helping to mitigate the intensity of distress; and using fiction to explore possibilities, alternative selves and lives. For those who are interested and able, reading groups offer a relatively de-stigmatised route to exploring and mediating experiences of distress. Implications in the present UK funding environment are discussed.

Exploration of psychological distress experienced by survivors of adolescent cancer reporting a need for psychological support

PubMed Central

Thorsell Cederberg, Jenny; von Essen, Louise; Hovén, Emma

2018-01-01

Objective In this qualitative study, we aimed to provide an in-depth exploration of cancer-related psychological distress experienced by young survivors of cancer during adolescence reporting a need for psychological support. Methods Two individual interviews were held with ten young survivors of cancer diagnosed in adolescence. The interviews were audio-recorded and transcribed verbatim. Analysis followed the guidelines for inductive qualitative manifest content analysis. Results The survivors described distress experienced during and after the end of treatment. Five categories comprising 14 subcategories were generated. The categories included: A tough treatment, Marked and hindered, Not feeling good enough, Struggling with the fragility of life, and finally, An ongoing battle with emotions. Conclusion Young survivors of adolescent cancer reporting a need for psychological support described feeling physically, socially, and mentally marked by the cancer experience. They struggled with powerlessness, insecurity, social disconnection, loneliness, and feelings of being unimportant and a failure, and had difficulties understanding and managing their experiences. These concerns should be addressed in psychological treatments for the population irrespective of which approach or model is used to understand survivors’ difficulties. A trans-diagnostic approach targeting processes that underpin different manifestations of distress may be effective. PMID:29664926

Couples with Intimate Partner Violence Seeking Relationship Help: Associations and Implications for Self-Help and Online Interventions.

PubMed

Roddy, McKenzie K; Georgia, Emily J; Doss, Brian D

2017-04-20

In-person conjoint treatments for relationship distress are effective at increasing relationship satisfaction, and newly developed online programs are showing promising results. However, couples reporting even low levels intimate partner violence (IPV) are traditionally excluded from these interventions. To improve the availability of couple-based treatment for couples with IPV, the present study sought to determine whether associations with IPV found in community samples generalized to couples seeking help for their relationship and whether web-based interventions for relationship distressed worked equally well for couples with IPV. In the first aim, in a sample of 2,797 individuals who were seeking online help for their relationship, the levels and correlates of both low-intensity and clinically significant IPV largely matched what is found in community samples. In the second aim, in a sample of 300 couples who were randomly assigned to a web-based intervention or a waitlist control group, low-impact IPV did not moderate the effects of the intervention for relationship distress. Therefore, web-based interventions may be an effective (and easily accessible) intervention for relationship distress for couples with low-intensity IPV. © 2017 Family Process Institute.

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

PubMed

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

2015-06-01

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

Negotiations of distress between East Timorese and Vietnamese refugees and their family doctors in Melbourne.

PubMed

Kokanovic, Renata; May, Carl; Dowrick, Christopher; Furler, John; Newton, Danielle; Gunn, Jane

2010-05-01

Recent critiques of depression have contested its coherence as a concept and highlighted its performance in medicalising distress. Studies of depression in a cross-cultural context have focused on language and belief systems as technical barriers to practice that need to be overcome in enacting depression work. This paper seeks to locate culture within the broader socio-structural context of depression care in general practice. The paper draws on interviews with five general practitioners (GPs), and 24 patients from Vietnamese and East Timorese backgrounds who predominantly have left their home as refugees. Each had been diagnosed with depression or prescribed antidepressants. These patients gave accounts of distress deeply embedded within, and inseparable from, lives fraught with frightening pre-migration experiences, traumatic escape and profound dislocation and alienation in their new 'home'. Fragmented lives were contrasted with the nourishing social fabric of homes left behind. GP participants were involved in a process of engaging with a profoundly communal and structural account of emotional distress while defending and drawing on an individualised notion of depression in performing their work and accounting for the pain presented to them.

Psychological distress and the role of significant others in a population of gay/bisexual men in the era of HIV.

PubMed

Britton, P J; Zarski, J J; Hobfoll, S E

1993-01-01

This study, based on The Conservation of Resources Theory (COR), explores the relationship between social resources and psychological distress, as reported by gay/bisexual men who are at varying degrees of risk for HIV. This study involves theory-based stress research, and adds to the body of literature that addresses social support and gay men. Specific emphasis was placed on the process of social support by significant others in relationship to the devastating impact HIV has on the gay/bisexual community. The investigators employed an ex-post facto design that was guided by past and present theoretical and empirical data, and by specific research hypotheses. The findings suggest that facets of social support appear to be interactively related to the perceived threat of HIV in predicting distress. In general, this study supports COR theory in that resources were related to the experience of psychological distress, yet it emphasizes that the relationship between support and gay men is complex, and thus generalizations from findings based on research with the majority culture may not apply to a population of gay/bisexual men. Implications for future research are also provided.

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

PubMed Central

Ng, Sin Man; Hou, Wai Kai

2017-01-01

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

Remote Sensing Capabilities to Detect Maritime Vessels in Distress

NASA Technical Reports Server (NTRS)

Larsen, Rudolph K.; Green, John M.; Huxtable, Barton D.; Rais, Houra

2004-01-01

The National Aeronautics and Space Administration (NASA) has the responsibility for conducting research and development for search and rescue as charged under the National Search and Rescue Plan. For over two decades this task has been undertaken by the Search and Rescue Mission Office at the NASA Goddard Space Flight Center (GSFC). The technology used by the highly successful beacon locating satellite system, Cospas-Sarsat, was conceived and developed at GSFC and is managed by the National Oceanographic and Atmospheric Administration (NOAA). Using beacon-less remote sensing to find people and vessels in distress complements the demonstrated life saving capabilities of this satellite system. The Search and Rescue Mission Office has been investigating the use of fully polarimetric synthetic aperture radar to locate crashed aircraft. An overview of this effort and potential maritime applications of Search and Rescue Synthetic Aperture Radar (SAR) will be presented. The Mission Office has also developed a Laser search and rescue system called L-SAR. The prototype instrument was designed and built by SenSyTech Inc. It specifically targets the location of novel retro-reflective material easily applied to rescue equipment and vessels in distress. An overview of this effort will also be presented.

Psychological distress and work stress in correctional officers: a literature review.

PubMed

Bezerra, Cláudia de Magalhães; Assis, Simone Gonçalves de; Constantino, Patricia

2016-06-01

This article presents a review of literature based on a survey of national and international journals on psychological distress and stress in the work of correctional officers between 2000 and 2014. The databases used were the Biblioteca Virtual em Saúde, Web of Science, and Scopus, and the descriptors were psychological distress, stress and correctional officers. We analyzed 40 articles, mainly about stress. The concept of burnout appeared in several works. The United States is the country that most publishes on the subject. There is little interest about the subject in the journals of Public Health. In Latin America we found only four studies, all Brazilian. The number of publications has gradually intensified over the years, and there was methodological improvement in the development and assessment scales, mainly regarding stress and burnout. Work overload, lack of material and human resources, level of contact with the inmates, overcrowding, perceptions of fear or danger, and the paradox of punish / reeducate were some of the risk factors encountered, among others. The protective factors refer to social support within the prison environment, and the coping strategies are related to the improvement of officer training, stimulating social support, and offering psychological care.

Moral distress: levels, coping and preferred interventions in critical care and transitional care nurses.

PubMed

Wilson, Melissa A; Goettemoeller, Diana M; Bevan, Nancy A; McCord, Jennifer M

2013-05-01

To examine the level and frequency of moral distress in staff nurses working in two types of units in an acute care hospital and to gather information for future interventions addressing moral distress. In 2008, the American Association of Critical Care Nurses published a Position Statement on Moral Distress. Nurses working in units where critically ill patients are admitted may encounter distressing situations. Moral distress is the painful feelings and/or psychological disequilibrium that may occur when taking care of patients. An exploratory, descriptive design study was used to identify the type and frequency of moral distress experienced by nurses. The setting was an acute care hospital in which the subjects were sampled from two groups of nurses based on their unit assignment. A descriptive, questionnaire study was used. Nurses completed the 38-item moral distress scale, a coping questionnaire, and indicated their preferred methods for institutional support in managing distressing situations. A convenience sample of staff nurses was approached to complete the moral distress questionnaire. Overall, the nurses reported low levels of moral distress. Situations creating the highest levels of moral distress were those related to futile care. A significance between group differences was found in the physician practice dimension. Specific resources were identified to help guide future interventions to recognise and manage moral distress. Nurses reported lower levels and frequency of moral distress in these units but their open-ended responses appeared to indicate moral distress. Nurses identified specific resources that they would find helpful to alleviate moral distress. There are numerous studies that identify the situations and the impact of moral distress, but not many studies explore treatments and interventions for moral distress. This study attempted to identify nurse preferences for lessening the impact of moral distress. © 2013 Blackwell Publishing Ltd.

47 CFR 80.1115 - Transmission of a distress alert by a station not itself in distress.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Safety System (GMDSS) Operating Procedures for Distress and Safety Communications § 80.1115 Transmission of a distress alert by a station not itself in distress. (a) A station in the mobile or mobile-satellite service which learns that a mobile unit is in distress must initiate and transmit a distress alert...

47 CFR 80.1115 - Transmission of a distress alert by a station not itself in distress.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Safety System (GMDSS) Operating Procedures for Distress and Safety Communications § 80.1115 Transmission of a distress alert by a station not itself in distress. (a) A station in the mobile or mobile-satellite service which learns that a mobile unit is in distress must initiate and transmit a distress alert...

Intensive Evening Outpatient Treatment for Patients With Personality Dysfunction: Early Group Process, Change in Interpersonal Distress, and Longer-Term Social Functioning.

PubMed

Joyce, Anthony S; Ogrodniczuk, John S; Kealy, David

2017-01-01

Entrenched interpersonal difficulties are a defining feature of those with personality dysfunction. Evening treatment-a comprehensive and intensive group-oriented outpatient therapy program-offers a unique approach to delivering mental health services to patients with chronic personality dysfunction. This study assessed change in interpersonal problems as a key outcome, the relevance of such change to future social functioning, and the influence of early group processes on this change. Consecutively admitted patients (N = 75) to a group-oriented evening treatment program were recruited; the majority were diagnosed with personality disorder. Therapy outcome was represented by scores on the Inventory of Interpersonal Problems. Follow-up outcome was represented by the global score of the Social Adjustment Scale. Group climate, group cohesion, and the therapeutic alliance were examined as process variables. Patients experienced substantial reduction in distress associated with interpersonal problems; early process factors that reflected a cohesive and engaged group climate and stronger therapeutic alliance were predictive of this outcome. Improvement in interpersonal distress was predictive of global social functioning six months later. The therapeutic alliance most strongly accounted for change in interpersonal problems at posttreatment and social functioning at follow-up. A comprehensive and integrated outpatient group therapy program, offered in the evening to accommodate patients' real-life demands, can facilitate considerable improvement in interpersonal problems, which in turn influences later social functioning. The intensity and intimacy of peer interactions in the therapy groups, and a strong alliance with the program therapists, are likely interacting factors that are particularly important to facilitate such change.

Urban Families and Adolescent Mental Health.

ERIC Educational Resources Information Center

Stern, Susan B.; Smith, Carolyn A.; Jang, Sung Joon

1999-01-01

This study investigates the effects of social and economic disadvantage on parent distress, family processes, and adolescent mental health in a longitudinal, multiethnic sample of 800 urban adolescents and parents. Findings show that poverty, life stressors, and isolation affect parent mood and disrupt family processes, which, in turn, are linked…

RECOGNIZING INFANTS' EMOTIONAL EXPRESSIONS: ARE ADOLESCENTS LESS SENSITIVE TO INFANTS' CUES?

PubMed

Niessen, Anke; Konrad, Kerstin; Dahmen, Brigitte; Herpertz-Dahlmann, Beate; Firk, Christine

2017-07-01

Previous studies have shown that adolescent mothers interact less sensitively with their infants than do adult mothers. This difference might be due to developmental difficulties in the recognition of infants' emotional states in adolescents. Therefore, the aim of the current study was to explore differences in the recognition of infant signals between nonparous adolescent girls and boys as compared to female and male adults. To this end, we examined 54 childless adolescents and 54 childless adults (50% female). Participants were shown a series of 20 short videos of infants aged 3 to 6 months presenting different emotional states ranging from very distressed to very happy. In addition, participants were asked to report their own parental experiences using the German version, Fragebogen zum erinnerten elterlichen Erziehungsverhalten (J. Schumacher, M. Eisemann, & E. Brähler, ), of the Egna Minnen Befräffande Uppfostran (Own Memories of Parental Rearing Experiences in Childhood; C. Perris, L. Jacobsson, H. Lindstrom, L. von Knorring, & H. Perris, ). Adolescents rated distressed infants as more distressed than did the adults. Furthermore, female participants rated the very distressed infants as more distressed than did male participants. These data suggest that adolescents, in general, are not impaired in recognizing infant emotional states, as compared to adults. Thus, we suggest that more extreme ratings of infant signals of discomfort together with immature sociocognitive regulation processes during adolescence might contribute to reduced sensitivity observed in adolescent mothers. © 2017 Michigan Association for Infant Mental Health.

Pathways through which higher neighborhood crime is longitudinally associated with greater body mass index.

PubMed

Richardson, Andrea S; Troxel, Wendy M; Ghosh-Dastidar, Madhumita; Hunter, Gerald P; Beckman, Robin; Colabianchi, Natalie; Collins, Rebecca L; Dubowitz, Tamara

2017-11-09

Although crime and perceived safety are associated with obesity and body mass index (BMI), the pathways are less clear. Two likely pathways by which crime and perceived safety may impact obesity are through distress and physical activity. We examined data from 2013 to 2014 for 644 predominantly African-American adults (mean age 57 years; 77% female) living in low-income Pittsburgh, PA neighborhoods, including self-reported perceptions of safety and emotional distress, interviewer-measured height/weight, and physical activity measured via accelerometry. We used secondary data on neighborhood crime from 2011 to 2013. We built a structural equation model to examine the longitudinal direct and indirect pathways from crime to BMI through perceived safety, distress and physical activity. Long-term exposure to crime was positively associated with lack of perceived safety (β = 0.11, p = 0.005) and lack of perceived safety was positively associated with BMI (β = 0.08, p = 0.03). The beneficial association between physical activity and BMI (β = -0.15, p < 0.001) was attenuated by a negative association between crime and physical activity (β = -0.09, p = 0.01). Although crime was associated with distress we found no evidence of a path from crime to BMI via distress. Our findings suggest decrements in perceived safety and physical activity are important processes that might explain why neighborhood crime is associated with greater BMI.

'Powerlessness' or 'doing the right thing' - Moral distress among nursing home staff caring for residents at the end of life: An interpretive descriptive study.

PubMed

Young, Amanda; Froggatt, Katherine; Brearley, Sarah G

2017-10-01

Caring for dying people can contribute to moral distress experienced by healthcare professionals. Moral distress can occur when this caring is restricted by organisational processes, resources or the provision of futile care. These factors apply to end of life care in nursing homes but research is lacking. To describe how nursing home staff experience moral distress when caring for residents during and at the end of life. An interpretive descriptive design, using the critical incident technique in semi-structured interviews to collect data from nursing home staff. Data were analysed using a thematic analysis approach. Four nursing homes in one large metropolitan area. A total of 16 staff: 2 nurse managers, 4 nurses and 10 care assistants. Participants described holding 'good dying' values which influenced their practice. The four practice-orientated themes of advocating, caring, communicating and relating with residents were found to influence interactions with residents, relatives, general practitioners, and colleagues. These led staff to be able to 'do the right thing' or to experience 'powerlessness', which could in turn lead to staff perceiving a 'bad death' for residents. When there are incongruent values concerning care between staff and others involved in the care of residents, staff feel powerless to 'do the right thing' and unable to influence care decisions in order to avoid a 'bad death'. This powerlessness is the nature of their moral distress.

Mothers' Vagal Regulation During the Still-Face Paradigm: Normative Reactivity and Impact of Depression Symptoms

PubMed Central

Oppenheimer, Julia E.; Measelle, Jeffrey R.; Laurent, Heidemarie K.; Ablow, Jennifer C.

2013-01-01

This study examined mothers' physiological reactivity in response to infant distress during the Still-Face Paradigm. We aimed to explore normative regulatory profiles and associated physiological and behavioral processes in order to further our understanding of what constitutes regulation in this dyadic context. We examined physiological patterns—vagal tone, indexed by respiratory sinus arrhythmia (RSA)-- while mothers maintained a neutral expression over the course of the still face episode, as well as differential reactivity patterns in mothers with depression symptoms compared to non-depressed mothers. Behavioral and physiological data were collected from mothers of 5-month-old infants during the emotion suppression phase of the Still-Face Paradigm. We used Hierarchical Linear Modeling to examine changes in mothers' RSA during infant distress and explored maternal depression as a predictor of physiological profiles. Mothers were generally able to maintain a neutral expression and simultaneously demonstrated a mean-level increase in RSA during the still face episode compared to baseline, indicating an active regulatory response overall. A more detailed time-course examination of RSA trajectories revealed that an initial RSA increase was typically followed by a decrease in response to peak infant distress, suggesting a physiological mobilization response. However, this was not true of mothers with elevated depressive symptoms, who showed no change in RSA during infant distress. These distinct patterns of infant distress-related physiological activation may help to explain differences in maternal sensitivity and adaptive parenting. PMID:23454427

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

PubMed

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

2015-03-01

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

Ethics and Childbirth Educators: Do Your Values Cause You Ethical Distress?

PubMed Central

Ondeck, Michele

2009-01-01

The Code of Ethics for Lamaze Certified Childbirth Educators outlines the ethical principles and standards that are derived from childbirth education's core values to assure quality and ethical practice. This article presents a summary of the history of ethics and medical ethics that informs a value-oriented decision-making process in childbirth education. The role of evidence in ethics is explored from the childbirth educator's viewpoint, and scenarios are used to reflect on situations that are examples of ethical distress. The conclusion is that the practice of ethics and ethical decision making includes regular reflection. PMID:19436591

Ethics and childbirth educators: do your values cause you ethical distress?

PubMed

Ondeck, Michele

2009-01-01

The Code of Ethics for Lamaze Certified Childbirth Educators outlines the ethical principles and standards that are derived from childbirth education's core values to assure quality and ethical practice. This article presents a summary of the history of ethics and medical ethics that informs a value-oriented decision-making process in childbirth education. The role of evidence in ethics is explored from the childbirth educator's viewpoint, and scenarios are used to reflect on situations that are examples of ethical distress. The conclusion is that the practice of ethics and ethical decision making includes regular reflection.

Sexual Distress and Sexual Problems During Pregnancy: Associations With Sexual and Relationship Satisfaction.

PubMed

Vannier, Sarah A; Rosen, Natalie O

2017-03-01

Sexual problems are common during pregnancy, but the proportion of pregnant women who experience sexual distress is unknown. In non-pregnant samples, sexual distress is associated with lower sexual and relationship satisfaction. To identify the proportion of women experiencing sexual distress during pregnancy and to compare the sexual and relationship satisfaction of women who report sexual distress during pregnancy with that of women without distress. Two-hundred sixty-one pregnant women completed a cross-sectional online survey. Women completed validated measurements of sexual functioning (Female Sexual Function Index; score < 26.55 indicates a sexual problem), sexual distress (Female Sexual Distress Scale; score ≥ 15 indicates clinically significant distress), sexual satisfaction (Global Measure of Sexual Satisfaction), and relationship satisfaction (Couples Satisfaction Index). Overall, 42% of women met the clinical cutoff for sexual distress. Of sexually active women (n = 230), 26% reported concurrent sexual problems and distress and 14% reported sexual distress in the absence of sexual problems. Sexual distress and/or problems in sexual functioning were linked to lower sexual and relationship satisfaction compared with pregnant women with lower sexual distress and fewer sexual problems. Sexual distress is common during pregnancy and associated with lower sexual and relationship satisfaction. Health care providers should ask pregnant women about feelings of sexual distress. Identifying pregnant women who experience sexual distress and referring them to appropriate resources could help minimize sexual and relationship problems during pregnancy. Vannier SA, Rosen NO. Sexual Distress and Sexual Problems During Pregnancy: Associations With Sexual and Relationship Satisfaction. J Sex Med 2017;14:387-395. Copyright © 2017 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Clinical review: Exogenous surfactant therapy for acute lung injury/acute respiratory distress syndrome - where do we go from here?

PubMed Central

2012-01-01

Acute lung injury and acute respiratory distress syndrome (ARDS) are characterised by severe hypoxemic respiratory failure and poor lung compliance. Despite advances in clinical management, morbidity and mortality remains high. Supportive measures including protective lung ventilation confer a survival advantage in patients with ARDS, but management is otherwise limited by the lack of effective pharmacological therapies. Surfactant dysfunction with quantitative and qualitative abnormalities of both phospholipids and proteins are characteristic of patients with ARDS. Exogenous surfactant replacement in animal models of ARDS and neonatal respiratory distress syndrome shows consistent improvements in gas exchange and survival. However, whilst some adult studies have shown improved oxygenation, no survival benefit has been demonstrated to date. This lack of clinical efficacy may be related to disease heterogeneity (where treatment responders may be obscured by nonresponders), limited understanding of surfactant biology in patients or an absence of therapeutic effect in this population. Crucially, the mechanism of lung injury in neonates is different from that in ARDS: surfactant inhibition by plasma constituents is a typical feature of ARDS, whereas the primary pathology in neonates is the deficiency of surfactant material due to reduced synthesis. Absence of phenotypic characterisation of patients, the lack of an ideal natural surfactant material with adequate surfactant proteins, coupled with uncertainty about optimal timing, dosing and delivery method are some of the limitations of published surfactant replacement clinical trials. Recent advances in stable isotope labelling of surfactant phospholipids coupled with analytical methods using electrospray ionisation mass spectrometry enable highly specific molecular assessment of phospholipid subclasses and synthetic rates that can be utilised for phenotypic characterisation and individualisation of exogenous surfactant replacement therapy. Exploring the clinical benefit of such an approach should be a priority for future ARDS research. PMID:23171712

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

Distress Responses in a Routine Vaccination Context: Relationships to Early Childhood Mental Health

PubMed Central

Racine, Nicole M.; Gennis, Hannah G.; Pillai Riddell, Rebecca; Greenberg, Saul; Garfield, Hartley

2018-01-01

Social and emotional competencies, such as distress regulation, are established in early childhood and are critical for the development of children’s mental health and wellbeing. Routine vaccinations in primary care provide a unique opportunity to relate responses to a universal, relatively standardized, distress regulation paradigm (i.e., pain-related distress) to key developmental outcomes. The current study sought to examine distress regulation during routine vaccination in infancy and preschool as predictors of outcomes related to socioemotional competence in preschool. It was hypothesized that children with poorer distress regulation abilities post-vaccination would have lower socioemotional development. Furthermore, it was hypothesized that insensitive parenting would exacerbate this relationship for children with poor distress regulation abilities. As part of an ongoing longitudinal cohort, 172 parent–child dyads were videotaped during vaccinations in infancy and preschool, and subsequently participated in a full-day psychological assessment in a university lab. Videotapes were coded for child pre-needle distress (baseline distress), immediate post-needle pain-related distress reactivity (immediate distress reactivity), and pain-related distress regulation (distress regulation). Parent sensitivity during the preschool vaccination was also coded. Baseline distress prior to vaccination predicted greater externalizing problems and behavioral symptoms. Parent sensitivity did not moderate the association between any child distress behaviors and socioemotional development indicators. Child distress behaviors prior to injection, regardless of parent behavior, during the vaccination context may provide valuable information to health care professionals about child socioemotional functioning in the behavioral and emotional domains. PMID:29466307

The Role of Family Functioning in the Stress Process of Dementia Caregivers: A Structural Family Framework

ERIC Educational Resources Information Center

Mitrani, Victoria B.; Lewis, John E.; Feaster, Daniel J.; Czaja, Sara J.; Eisdorfer, Carl; Schulz, Richard; Szapocznik, Jose

2006-01-01

Purpose: The purpose of the study was to evaluate the role of family functioning in the stress process in a sample of caregivers of dementia patients by using a structural family framework. The stress-process model of caregiver distress included family functioning as an intervening variable in the relationship between objective burden and…

Cultural standards, power and subversion in cross-cultural psychotherapy.

PubMed

Rechtman, Richard

2006-06-01

In a creolizing world, psychotherapy is challenged by the growing influence of cultural standards, systems of meaning and idioms of distress supported by new groups who play a major role in public health policies. While these elements were originally introduced in psychotherapy with ethnic minorities both to improve the patient-doctor relationship and to bring relevant material from patients' cultural background, they also became a way to empower nonwestern patients in western health care systems. When in the 1980s it became possible to readdress the issue of power in psychiatric practice, something had already changed in the social regulation that psychiatry should endorse. In this article, the author focuses on the new legitimated social and cultural values that underpin the therapeutic process. While obviously these new values should be taken into account, the aim for psychotherapy remains to find a path for a 'subversive' practice that could be something more than just following social guidelines.

47 CFR 80.325 - Control of distress traffic.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 5 2010-10-01 2010-10-01 false Control of distress traffic. 80.325 Section 80... Safety Procedures § 80.325 Control of distress traffic. (a) Distress traffic consists of all messages relating to the immediate assistance required by the mobile station in distress. In distress traffic, the...

Mindfulness Moderates the Relationship Between Disordered Eating Cognitions and Disordered Eating Behaviors in a Non-Clinical College Sample

PubMed Central

Masuda, Akihiko; Price, Matthew; Latzman, Robert D.

2012-01-01

Psychological flexibility and mindfulness are two related, but distinct, regulation processes that have been shown to be at the core of psychological wellbeing. The current study investigated whether these two processes independently moderated the association between disordered eating cognitions and psychological distress as well as the relation between disordered eating cognitions and disordered eating behaviors. Non-clinical, ethnically diverse college undergraduates completed a web-based survey. Of 278 participants (nfemale=208; nmale=70) aged 18–24 years old, disordered eating cognitions, mindfulness, and psychological flexibility were related to psychological distress after controlling for gender, ethnicity, and body mass index. Disordered eating cognitions and mindfulness accounted for unique variance in disordered eating behaviors. Finally, mindfulness was found to moderate the association between disordered eating cognitions and disordered eating behaviors. PMID:22888181

Family processes as pathways from income to young children's development.

PubMed

Linver, Miriam R; Brooks-Gunn, Jeanne; Kohen, Dafna E

2002-09-01

A variety of family processes have been hypothesized to mediate associations between income and young children's development. Maternal emotional distress, parental authoritative and authoritarian behavior (videotaped mother-child interactions), and provision of cognitively stimulating activities (Home Observation for Measurement of the Environment [HOME] scales) were examined as possible mediators in a sample of 493 White and African American low-birth-weight premature infants who were followed from birth through age 5. Cognitive ability was assessed by standardized test, and child behavior problems by maternal report, when the children were 3 and 5 years of age. As expected, family income was associated with child outcomes. The provision of stimulating experiences in the home mediated the relation between family income and both children's outcomes; maternal emotional distress and parenting practices mediated the relation between income and children's behavior problems.

Exploring the relationship between posttraumatic growth, cognitive processing, psychological distress, and social constraints in a sample of breast cancer patients.

PubMed

Koutrouli, Natalia; Anagnostopoulos, Fotios; Griva, Fay; Gourounti, Kleanthi; Kolokotroni, Filippa; Efstathiou, Vasia; Mellon, Robert; Papastylianou, Dona; Niakas, Dimitris; Potamianos, Gregory

2016-01-01

Posttraumatic growth (the perception of positive life changes after an encounter with a trauma) often occurs among breast cancer patients and can be influenced by certain demographic, medical, and psychosocial parameters. Social constraints on disclosure (the deprivation of the opportunity to express feelings and thoughts regarding the trauma) and the cognitive processing of the disease seem to be involved in the development of posttraumatic growth. Through the present study the authors aim to: investigate the levels of posttraumatic growth in a sample of 202 women with breast cancer in Greece, explore the relationships between posttraumatic growth and particular demographic, medical, and psychosocial variables according to a proposed model, and test the role of social constraints in the relationship between automatic and deliberate cognitive processing of the trauma. The results showed that posttraumatic growth was evident in the majority of the sample and was associated inversely with age at diagnosis (β = -0.174, p < .05) and psychological distress (β = -0.394, p = .001), directly with time since diagnosis (β = 0.181, p < .05), and indirectly with intrusions and psychological distress, through reflective rumination (β = 0.323, p = .001). Social constraints were found to moderate the relationship between intrusions and reflective rumination. Implications of the results and suggestions for future research and practice are outlined.

Maintenance of a gluten free diet in coeliac disease: The roles of self-regulation, habit, psychological resources, motivation, support, and goal priority.

PubMed

Sainsbury, Kirby; Halmos, Emma P; Knowles, Simon; Mullan, Barbara; Tye-Din, Jason A

2018-06-01

A strict lifelong gluten free diet (GFD) is the only treatment for coeliac disease (CD). Theory-based research has focused predominantly on initiation, rational, and motivational processes in predicting adherence. The aim of this study was to evaluate an expanded collection of theoretical constructs specifically relevant to the maintenance of behaviour change, in the understanding and prediction of GFD adherence. Respondents with CD (N = 5573) completed measures of GFD adherence, psychological distress, intentions, self-efficacy, and the maintenance-relevant constructs of self-regulation, habit, temptation and intentional and unintentional lapses (cognitive and behavioural consequences of lowered or fluctuating psychological resources and self-control), motivation, social and environmental support, and goal priority, conflict, and facilitation. Correlations and multiple regression were used to determine their influence on adherence, over and above intention and self-efficacy, and how relationships changed in the presence of distress. Better adherence was associated with greater self-regulation, habit, self-efficacy, priority, facilitation, and support; and lower psychological distress, conflict, and fewer self-control lapses (e.g., when busy/stressed). Autonomous and wellbeing-based, but not controlled motivations, were related to adherence. In the presence of distress, the influence of self-regulation and intentional lapses on adherence were increased, while temptation and unintentional lapses were decreased. The findings point to the importance of considering intentional, volitional, automatic, and emotional processes in the understanding and prediction of GFD adherence. Behaviour change interventions and psychological support are now needed so that theoretical knowledge can be translated into evidence-based care, including a role for psychologists within the multi-disciplinary treatment team. Copyright © 2018 Elsevier Ltd. All rights reserved.

Workplace bullying, perceived job stressors, and psychological distress: Gender and race differences in the stress process.

PubMed

Attell, Brandon K; Kummerow Brown, Kiersten; Treiber, Linda A

2017-07-01

A large body of empirical research documents the adverse mental health consequences of workplace bullying. However, less is known about gender and race differences in the processes that link workplace bullying and poor mental health. In the current study, we use structural equation modeling of survey data from the 2010 Health and Retirement Study (N = 2292) and draw on stress process theory to examine coworker support as a buffering mechanism against workplace bullying, and gender and race differences in the relationships between bullying and psychological distress. The results of the analysis indicate that coworker support serves as a protective buffer against workplace bullying, although the buffering effect is relatively small. We also find that the effects of workplace bullying more heavily impact women and persons of color. Specifically, women and African American individuals in our sample were less protected from the buffering mechanism of co-worker social support. Copyright © 2017 Elsevier Inc. All rights reserved.

Navigating moral distress using the moral distress map.

PubMed

Dudzinski, Denise Marie

2016-05-01

The plethora of literature on moral distress has substantiated and refined the concept, provided data about clinicians' (especially nurses') experiences, and offered advice for coping. Fewer scholars have explored what makes moral distress moral If we acknowledge that patient care can be distressing in the best of ethical circumstances, then differentiating distress and moral distress may refine the array of actions that are likely to ameliorate it. This article builds upon scholarship exploring the normative and conceptual dimensions of moral distress and introduces a new tool to map moral distress from emotional source to corrective actions. The Moral Distress Map has proven useful in clinical teaching and ethics-related debriefings. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Preparing Youth for College and Career: A Process Evaluation of Urban Alliance

ERIC Educational Resources Information Center

Theodos, Brett; Pergamit, Michael R.; Edelstein, Sara; George, Taz; Freiman, Lesley

2014-01-01

This report presents baseline and process study findings of an evaluation of the Urban Alliance high school internship program, which provides training, mentoring, and work experience to high school seniors from distressed communities in Washington, DC, Baltimore, Northern Virginia, and Chicago. The report, which focuses on the program's…

When Professors Confront Themselves: Towards a Theoretical Conceptualization of Video Self-Confrontation in Higher Education.

ERIC Educational Resources Information Center

Perlberg, Arye

1983-01-01

Two explanations of the underlying process in faculty self-evaluation by videotape recording are outlined and integrated into one conceptualization. One theory is based on affect: self-confrontation, dissonance, stress, distress, and eustress. The second is based on a cognitive and information processing approach and includes feedback,…

Moral Distress, Workplace Health, and Intrinsic Harm.

PubMed

Weber, Elijah

2016-05-01

Moral distress is now being recognized as a frequent experience for many health care providers, and there's good evidence that it has a negative impact on the health care work environment. However, contemporary discussions of moral distress have several problems. First, they tend to rely on inadequate characterizations of moral distress. As a result, subsequent investigations regarding the frequency and consequences of moral distress often proceed without a clear understanding of the phenomenon being discussed, and thereby risk substantially misrepresenting the nature, frequency, and possible consequences of moral distress. These discussions also minimize the intrinsically harmful aspects of moral distress. This is a serious omission. Moral distress doesn't just have a negative impact on the health care work environment; it also directly harms the one who experiences it. In this paper, I claim that these problems can be addressed by first clarifying our understanding of moral distress, and then identifying what makes moral distress intrinsically harmful. I begin by identifying three common mistakes that characterizations of moral distress tend to make, and explaining why these mistakes are problematic. Next, I offer an account of moral distress that avoids these mistakes. Then, I defend the claim that moral distress is intrinsically harmful to the subject who experiences it. I conclude by explaining how acknowledging this aspect of moral distress should reshape our discussions about how best to deal with this phenomenon. © 2015 John Wiley & Sons Ltd.

Development and validation of an instrument for rapidly assessing symptoms: the general symptom distress scale.

PubMed

Badger, Terry A; Segrin, Chris; Meek, Paula

2011-03-01

Symptom assessment has increasingly focused on the evaluation of total symptom distress or burden rather than assessing only individual symptoms. The challenge for clinicians and researchers alike is to assess symptoms, and to determine the symptom distress associated with the symptoms and the patient's ability for symptom management without a lengthy and burdensome assessment process. The objective of this article was to discuss the psychometric evaluation of a brief general symptom distress scale (GSDS) developed to assess specific symptoms and how they rank in relation to each other, the overall symptom distress associated with the symptom schema, and provide an assessment of how well or poorly that symptom schema is managed. Results from a pilot study about the initial development of the GSDS with 76 hospitalized patients are presented, followed by a more complete psychometric evaluation of the GSDS using three samples of cancer patients (n=190) and their social network members, called partners in these studies (n=94). Descriptive statistics were used to describe the GSDS symptoms, symptom distress, and symptom management. Point biserial correlations indexed the associations between dichotomous symptoms and continuous measures, and conditional probabilities were used to illustrate the substantial comorbidities of this sample. Internal consistency was examined using the KR-20 coefficient, and test-retest reliability was examined. Construct validity and predictive validity also were examined. The GSDS demonstrated satisfactory internal consistency and test-retest reliability, and good construct validity and predictive validity. The total score on the GSDS, symptom distress, and symptom management correlated significantly with related constructs of depression, positive and negative affect, and general health. The GSDS was able to demonstrate its ability to distinguish between those with or without chronic illness, and was able to significantly predict scores on criterion measures such as depression. Collectively, these results suggest that the GSDS is a straightforward and useful instrument for rapidly assessing symptoms that can disrupt health-related quality of life. Copyright © 2011 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

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

PubMed

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

2017-01-01

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

Pathways to Hazardous Drinking Among Racially and Socioeconomically Diverse Lesbian Women: Sexual Minority Stress, Rumination, Social Isolation, and Drinking to Cope

PubMed Central

Lewis, Robin J.; Mason, Tyler B.; Winstead, Barbara A.; Gaskins, Melissa; Irons, Lance B.

2016-01-01

Lesbian women engage in more hazardous drinking than heterosexual women yet we know relatively little about what explains this disparity. In the present study, race, socioeconomic status, minority stress, general psychological processes and distress were examined as pathways to hazardous drinking among young (18-35 years) Black and non-Hispanic White lesbian women. We used the psychological mediation framework adaptation of minority stress theory and the reserve capacity model as theoretical underpinnings of the conceptual model in the current study. Self-identified lesbian participants (N= 867) completed a one-time online survey that assessed race, socioeconomic status, perceived sexual minority discrimination, proximal minority stress (concealment, internalized homophobia, lack of connection to lesbian community), rumination, social isolation, psychological distress, drinking to cope, and hazardous drinking. Cross-sectional results demonstrated that being Black was associated with hazardous drinking via sequential mediators of rumination, psychological distress, and drinking to cope. Socioeconomic status was associated with hazardous drinking via sequential mediators of sexual minority discrimination, proximal minority stress, rumination, social isolation, psychological distress, and drinking to cope. Understanding these pathways can aid researchers and clinicians studying and working with lesbians who are at risk for hazardous drinking. PMID:28138208

An examination of nervios among Mexican seasonal farm workers.

PubMed

England, Margaret; Mysyk, Avis; Gallegos, Juan Arturo Avila

2007-09-01

The purpose of this exploratory descriptive study was to examine a process model of the nervios experience of 30 Mexican seasonal farm workers. Focused interviews were conducted in Spanish to determine the workers' perspectives on their experiences of nervios while residing in rural, southwest Ontario. Data for analysis originated from variables created to represent key themes that had emerged from open coding of the interviews. Simultaneous entry, multiple regression analyses revealed that provocation, control salience, and cognitive sensory motor distress directly explained 67.2% of the variation in worker expressions of negative affectivity. The combination fear, feeling trapped, and giving in mediated the relationship of provocation, control salience and cognitive sensory motor distress to expressions of negative affectivity (R(2) = 88.1%). Control salience and its dampening effect on other elements of the nervios experience, however, appeared to be key to whether subjects experienced negative reactions to being provoked or distressed. This evidence points to nervios being a powerful, holistic idiom of distress with at least six variables contributing to its affective negativity. This information is important to our understanding of how nervios unfolds and for accurate specification of a nervios model for clinical practice and research. It also sets the stage for improved therapeutic alliances with nervios sufferers, and social action to reduce factors that provoke nervios.

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

PubMed

Viney, L L

1994-11-01

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

An fMRI investigation of responses to peer rejection in adolescents with autism spectrum disorders.

PubMed

Masten, Carrie L; Colich, Natalie L; Rudie, Jeffrey D; Bookheimer, Susan Y; Eisenberger, Naomi I; Dapretto, Mirella

2011-07-01

Peer rejection is particularly pervasive among adolescents with autism spectrum disorders (ASD). However, how adolescents with ASD differ from typically developing adolescents in their responses to peer rejection is poorly understood. The goal of the current investigation was to examine neural responses to peer exclusion among adolescents with ASD compared to typically developing adolescents. Nineteen adolescents with ASD and 17 typically developing controls underwent fMRI as they were ostensibly excluded by peers during an online game called Cyberball. Afterwards, participants reported their distress about the exclusion. Compared to typically developing adolescents, those with ASD displayed less activity in regions previously linked with the distressing aspect of peer exclusion, including the subgenual anterior cingulate and anterior insula, as well as less activity in regions previously linked with the regulation of distress responses during peer exclusion, including the ventrolateral prefrontal cortex and ventral striatum. Interestingly, however, both groups self-reported equivalent levels of distress. This suggests that adolescents with ASD may engage in differential processing of social experiences at the neural level, but be equally aware of, and concerned about, peer rejection. Overall, these findings contribute new insights about how this population may differentially experience negative social events in their daily lives.

Catechol-O-methyltransferase (COMT) genotype biases neural correlates of empathy and perceived personal distress in schizophrenia.

PubMed

Poletti, Sara; Radaelli, Daniele; Cavallaro, Roberto; Bosia, Marta; Lorenzi, Cristina; Pirovano, Adele; Smeraldi, Enrico; Benedetti, Francesco

2013-02-01

The catechol-O-methyltransferase (COMT) Val(108/158)Met polymorphism (rs4680) influences enzyme activity with valine (Val) allele associated with higher enzymatic activity. Several studies suggest that factors influencing dopaminergic transmission could control response to stressful situations. Empathy is an essential element of human behavior, requires the ability to adopt another person's perspective, and has been found to be dysfunctional in schizophrenia. Twenty-eight schizophrenic patients underwent functional magnetic resonance imaging performing an empathy task. Perceived empathy has been evaluated with the Interpersonal Reactivity Index. An effect of COMT on perceived distress subscale has been shown, with methionine (Met)/Met subjects reporting lower rates of stress compared with Val/Val. Moreover, imaging results showed an effect of genotype on empathy processing in the anterior cingulate with Val/Val subjects showing the lowest activation. This is the first study of the effect of rs4680 on interpersonal distress and neural correlates of empathy in schizophrenia. We found a decrease in neural responses in areas that ensure a cognitive control of emotion that is paralleled by perceived distress in interpersonal situation; this functional pattern seems to be influenced by rs4680 COMT polymorphism. Copyright © 2013 Elsevier Inc. All rights reserved.

Associations Between Economic Pressure and Diabetes Efficacy in Couples With Type 2 Diabetes

PubMed Central

Novak, Joshua R.; Anderson, Jared R.; Johnson, Matthew D.; Walker, Ann; Wilcox, Allison; Lewis, Virginia L.; Robbins, David C.

2017-01-01

Objective The purpose of this study was to explore dyadic associations between economic pressure and diabetes self-efficacy via emotional distress in patients with type 2 diabetes and their partners. Background Understanding how economic pressure is associated with successful diabetes management is an important area for research, as couples with type 2 diabetes can incur heavy economic pressures that could likely influence diabetes outcomes. Method Data from 117 married couples were used to test actor–partner associations using moderated mediation analyses in a structural equation modeling framework. Problem-solving communication was tested as a possible moderator of the economic pressure–emotional distress pathway. Results Results revealed that greater patient economic pressure was associated with lower patient and spouse confidence in the patient’s diabetes management ability through higher levels of patient emotional distress. The deleterious association between economic pressure and emotional distress was less pronounced when spouses reported more effective problem-solving communication. Conclusion These results provide evidence that the economic pressure couples with type 2 diabetes face may reduce the patient and spouse’s confidence in the patient’s diabetes management ability. Implications This study demonstrates the importance of couple’s relationship processes in buffering the impact of economic pressure on diabetes management, providing a clear target for intervention and education efforts. PMID:29151662

Subjective Responses to Emotional Stimuli During Labeling, Reappraisal, and Distraction

PubMed Central

Lieberman, Matthew D.; Inagaki, Tristen K.; Tabibnia, Golnaz; Crockett, Molly J.

2011-01-01

Although multiple neuroimaging studies suggest that affect labeling (i.e., putting feelings into words) can dampen affect-related responses in the amygdala, the consequences of affect labeling have not been examined in other channels of emotional responding. We conducted four studies examining the effect of affect labeling on self-reported emotional experience. In study one, self-reported distress was lower during affect labeling, compared to passive watching, of negative emotional pictures. Studies two and three added reappraisal and distraction conditions, respectively. Affect labeling showed similar effects on self-reported distress as both of these intentional emotion regulation strategies. In each of the first three studies, however, participant predictions about the effects of affect labeling suggest that unlike reappraisal and distraction, people do not believe affect labeling to be an effective emotion regulation strategy. Even after having the experience of affect labels leading to lower distress, participants still predicted that affect labeling would increase distress in the future. Thus, affect labeling is best described as an incidental emotion regulation process. Finally, study four employed positive emotional pictures and here, affect labeling was associated with diminished self-reported pleasure, relative to passive watching. This suggests that affect labeling tends to dampen affective responses in general, rather than specifically alleviating negative affect. PMID:21534661

An fMRI investigation of responses to peer rejection in adolescents with autism spectrum disorders

PubMed Central

Masten, Carrie L.; Colich, Natalie L.; Rudie, Jeffrey D.; Bookheimer, Susan Y.; Eisenberger, Naomi I.; Dapretto, Mirella

2011-01-01

Peer rejection is particularly pervasive among adolescents with autism spectrum disorders (ASD). However, how adolescents with ASD differ from typically developing adolescents in their responses to peer rejection is poorly understood. The goal of the current investigation was to examine neural responses to peer exclusion among adolescents with ASD compared to typically developing adolescents. Nineteen adolescents with ASD and 17 typically developing controls underwent fMRI as they were ostensibly excluded by peers during an online game called Cyberball. Afterwards, participants reported their distress about the exclusion. Compared to typically developing adolescents, those with ASD displayed less activity in regions previously linked with the distressing aspect of peer exclusion, including the subgenual anterior cingulate and anterior insula, as well as less activity in regions previously linked with the regulation of distress responses during peer exclusion, including the ventrolateral prefrontal cortex and ventral striatum. Interestingly, however, both groups self-reported equivalent levels of distress. This suggests that adolescents with ASD may engage in differential processing of social experiences at the neural level, but be equally aware of, and concerned about, peer rejection. Overall, these findings contribute new insights about how this population may differentially experience negative social events in their daily lives. PMID:22318914

Estimating Cumulative Traffic Loads, Final Report for Phase 1

DOT National Transportation Integrated Search

2000-07-01

The knowledge of traffic loads is a prerequisite for the pavement analysis process, especially for the development of load-related distress prediction models. Furthermore, the emerging mechanistically based pavement performance models and pavement de...

It could have been me: vicarious victims and disaster-focused distress.

PubMed

Wayment, Heidi A

2004-04-01

College students who had experienced no personal bereavement in the September 11 terrorist attacks completed questionnaires between 3 and 5 weeks after the attacks and 5 months later. Cross-sectional and longitudinal structural equation model (SEM) analyses revealed that general distress and disaster-focused distress are discernable reactions following a collective loss. Both types of distress were higher among women and by those reporting social strain. General distress was associated with previous stressful events and mental health issues. Perceived similarity to the victims predicted disaster-focused distress and mediated the relationship between attending to media accounts of victims and disaster-focused distress. Only the disaster-focused distress reactions of survivor guilt and grief were associated with collective helping behaviors after the attacks and, for women, these behaviors were associated with greater reductions in these distress reactions over time. Discussion focuses on the importance of examining disaster-focused distress reactions following collective loss.

Diabetes Distress and Depression in South Asian Canadians with Type 2 Diabetes.

PubMed

Sidhu, Rawel; Tang, Tricia S

2017-02-01

South Asians are disproportionately affected by diabetes compared to some other ethnic groups in Canada. Although depression and diabetes distress are psychological issues well studied in the general population of those with diabetes, they have not been investigated in South Asian Canadians with type 2 diabetes. We sought to identify the rates of depression and diabetes distress in South Asian adults with type 2 diabetes and to explore the relationship among glycemic control, depression and diabetes distress. We recruited 41 South Asian adults with type 2 diabetes for this study. Glycated hemoglobin (A1C) levels were collected via venous puncture. We utilized the Diabetes Distress Scale to assess total diabetes distress and its subscales (emotional distress, interpersonal distress, regimen-related distress and physician distress) and the Personal Health Questionnaire-9 to assess depressive symptoms. The rate of depression was 15%, and the rate of total diabetes distress was 52.5%. Although neither measure was found to be correlated with A1C levels, depression had a moderate positive correlation with total diabetes distress (r=0.696; p<0.001); subscales of regimen distress and emotional burden emerged as the strongest correlates. This is the first study to report that diabetes distress is a serious concern for South Asian Canadians with type 2 diabetes. Given that depression and diabetes distress are linked, studies recruiting a larger and more diverse sample of South Asian Canadians should be conducted to better understand the psychological issues that may impact diabetes self-management in this community. Copyright © 2016 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

Glutamatergic modulation of separation distress: profound emotional effects of excitatory amino acids in chicks.

PubMed

Normansell, Larry; Panksepp, Jaak

2011-10-01

Pre-clinical models of brain affective circuits provide relevant evidence for understanding the brain systems that figure heavily in psychiatric disorders. Social isolation and the resulting separation distress contribute to the onset of depression. In this work, the effects of excitatory amino acids (EAA) on isolation-induced distress vocalization (DV) were assessed in young domestic chicks. Both glutamate and quisqualate (QA) produced dose-dependent reductions in DVs, while N-methyl-d-aspartate (NMDA) and kainate (KA) increased DVs. Such a differential pattern of responsiveness may indicate the presence of reciprocal or interacting EAA systems in the brain control of separation distress. Administration of either the NMDA receptor antagonist 2-amino-5-phosphonovalerate (APV) or the broad-spectrum antagonist gamma-d-glutamylglycine (DGG) greatly reduced DVs, as did the antagonist 2-amino-4-phosphonobutyrate (APB). APV did not attenuate the increase in vocalizations seen after NMDA or KA administration. DGG, however, was able to block the increase in calling produced by either of these agonists, suggesting a KA receptor mechanism. KA treatment inhibited the ability of other chicks, or auditory and somatosensory information, to suppress DVs. KA-treated animals exhibited a hyperemotional behavior pattern during which a variety of motivated behaviors were disrupted including reactions to novel objects, approaching the flock, and foraging. They could not sustain a coherent flock-like social cohesion, but exhibited strong fixed-action patterns of flight interspersed with hiding and crouching behaviors. The evident behavioral changes suggest that glutamatergic synapses directly influence sensory, motor and emotional processes in the brain and may be especially important in the integration of environmental stimuli with emotional central state processes of animals. Considering that unresolved social loss and grief have been deemed to be among the main precipitating causes of depression, and glutamate plays a large role in the production of negative effect related to separation distress, these results are consistent with the emerging work targeting glutamate blockade as a way to produce rapid anti-depressant effects. Copyright © 2011 Elsevier Ltd. All rights reserved.

Moral distress and moral conflict in clinical ethics.

PubMed

Fourie, Carina

2015-02-01

Much research is currently being conducted on health care practitioners' experiences of moral distress, especially the experience of nurses. What moral distress is, however, is not always clearly delineated and there is some debate as to how it should be defined. This article aims to help to clarify moral distress. My methodology consists primarily of a conceptual analysis, with especial focus on Andrew Jameton's influential description of moral distress. I will identify and aim to resolve two sources of confusion about moral distress: (1) the compound nature of a narrow definition of distress which stipulates a particular cause, i.e. moral constraint, and (2) the distinction drawn between moral dilemma (or, more accurately, moral conflict) and moral distress, which implies that the two are mutually exclusive. In light of these concerns, I argue that the definition of moral distress should be revised so that moral constraint should not be a necessary condition of moral distress, and that moral conflict should be included as a potential cause of distress. Ultimately, I claim that moral distress should be understood as a specific psychological response to morally challenging situations such as those of moral constraint or moral conflict, or both. © 2013 John Wiley & Sons Ltd.

Decision-making Processes among Prostate Cancer Survivors with Rising PSA Levels: Results from a Qualitative Analysis.

PubMed

Shen, Megan Johnson; Nelson, Christian J; Peters, Ellen; Slovin, Susan F; Hall, Simon J; Hall, Matt; Herrera, Phapichaya Chaoprang; Leventhal, Elaine A; Leventhal, Howard; Diefenbach, Michael A

2015-05-01

Prostate cancer survivors with a rising prostate-specific antigen (PSA) level have few treatment options, experience a heightened state of uncertainty about their disease trajectory that might include the possibility of cancer metastasis and death, and often experience elevated levels of distress as they have to deal with a disease they thought they had conquered. Guided by self-regulation theory, the present study examined the cognitive and affective processes involved in shared decision making between physicians and patients who experience a rising PSA after definitive treatment for prostate cancer. In-depth interviews were conducted with 34 prostate cancer survivors who had been diagnosed with a rising PSA (i.e., biochemical failure) within the past 12 months. Survivors were asked about their experiences and affective responses after being diagnosed with a rising PSA and while weighing potential treatment options. In addition, patients were asked about their decision-making process for the initial prostate cancer treatment. Compared with the initial diagnosis, survivors with a rising PSA reported increased negative affect following their diagnosis, concern about the treatability of their disease, increased planning and health behavior change, heightened levels of worry preceding doctor appointments (especially prior to the discussion of PSA testing results), and a strong reliance on physicians' treatment recommendations. Prostate cancer survivors' decision-making processes for the treatment of a rising PSA are markedly different from those of the initial diagnosis of prostate cancer. Because patients experience heightened distress and rely more heavily on their physicians' recommendations with a rising PSA, interactions with the health care provider provide an excellent opportunity to address and assist patients with managing the uncertainty and distress inherent with rising PSA levels. © The Author(s) 2014.

Self-reported interpersonal problems and impact messages as perceived by significant others are differentially associated with the process and outcome of depression therapy.

PubMed

Altenstein-Yamanaka, David; Zimmermann, Johannes; Krieger, Tobias; Dörig, Nadja; Grosse Holtforth, Martin

2017-07-01

Interpersonal factors play a major role in causing and maintaining depression. This study sought to investigate how patients' self-perceived interpersonal problems and impact messages as perceived by significant others are interrelated, change over therapy, and differentially predict process and outcome in psychotherapy of depression. For the present study, we used data from 144 outpatients suffering from major depression that were treated within a psychotherapy study. Interpersonal variables were assessed pre- and posttherapy with the self-report Inventory of Interpersonal Problems-Circumplex Scale (IIP-32; Thomas, Brähler, & Strauss, 2011) and with the informant-based Impact Message Inventory (Caspar, Berger, Fingerle, & Werner, 2016). Patients' levels on the dimensions of Agency and Communion were calculated from both measures; their levels on Interpersonal Distress were measured with the IIP. Depressive and general symptomatology was assessed at pre-, post-, and at 3-month follow-up; patient-reported process measures were assessed during therapy. The Agency scores of IIP and IMI correlated moderately, but the Communion scores did not. IIP Communion was positively associated with the quality of the early therapeutic alliance and with the average level of cognitive-emotional processing during therapy. Whereas IIP Communion and IMI Agency increased over therapy, IIP Distress decreased. A pre-post-decrease in IIP Distress was positively associated with pre-postsymptomatic change over and above the other interpersonal variables, but pre-post-increase in IMI Agency was positively associated with symptomatic improvement from post- to 3-month follow-up. These findings suggest that significant others seem to provide important additional information about the patients' interpersonal style. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Stepping back to move forward: Expressive writing promotes self-distancing.

PubMed

Park, Jiyoung; Ayduk, Özlem; Kross, Ethan

2016-04-01

Prior research indicates that expressive writing enhances well-being by leading people to construct meaningful narratives that explain distressing life experiences. But how does expressive writing facilitate meaning-making? We addressed this issue in 2 longitudinal studies by examining whether and how expressive writing promotes self-distancing, a process that facilitates meaning-making. At baseline in both studies, participants reflected on a distressing life experience. In Study 1 participants were then randomly assigned to write about their distressing experience or a non-emotional topic for 15 min on 3 consecutive days; in Study 2 participants were randomly assigned to write or think about their distressing experience or write about a non-emotional topic for the same amount of time. One day following the intervention, expressive writing participants in both studies self-distanced more when they reflected over their distressing experience compared with participants in the other conditions, which in turn led them to experience less emotional reactivity 1 month (Studies 1 and 2) and 6 months (Study 2) after the intervention. Analyses using data from both studies indicated that expressive writing reduced physical symptoms indirectly through its effects on self-distancing and emotional reactivity [that is, expressive writing group (vs. comparison groups) → greater self-distancing → less emotional reactivity → fewer physical symptoms]. Finally, linguistic analyses using essays from both studies indicated that increased use of causation words and decreased use of negative emotion words and first-person singular pronouns predicted increases in self-distancing over time. These findings demonstrate that expressive writing promotes self-distancing and illustrate how it does so. (c) 2016 APA, all rights reserved).

Positive changes following cancer: posttraumatic growth in the context of other factors in patients with cancer.

PubMed

Baník, Gabriel; Gajdošová, Beáta

2014-08-01

The incidence of posttraumatic growth (PTG) has mostly been researched after typical traumatic events such as war, violence, bereavement, vehicle accidents, and so forth. This research has shown that PTG also occurs after cancer. This article presents the results of research which focused on PTG and what was related to its incidence, such as the specific reaction to trauma, among patients with hematological cancer (N = 72). The differences in the levels of PTG were analyzed from the perspective of demographic characteristics, characteristics of the disease, and treatment. PTG was measured using the Posttraumatic Growth Inventory-Czech version (PTGI-CZ). The associated variables were measured using instruments in measuring benefit findings [Benefit Finding Scale for Children-Czech version (BFSC-CZ)], distress tolerance [Distress Tolerance Scale (DTS)], hope [Adult Hope Trait Scale (AHTS)], and optimism [Revised Life Orientation Test (LOT-R)]. Regression analysis found that a higher perception of benefits of the disease (benefit findings) and a greater effort to regulate feelings of distress (distress regulation) explained 67.1% of the variance of PTG. There were no significant differences in the level of PTG in terms of demographic indicators, type of cancer, current state of disease, or type of treatment. It was found that it was important for patients to perceive that their disease had been beneficial in a certain way. It was also important that patients made a great effort to regulate distress, which can occur when coping with the negative consequences of a disease, and at the same time, it is important for the process of PTG.

Individual differences in action co-representation: not personal distress or subclinical psychotic experiences but sex composition modulates joint action performance.

PubMed

van der Weiden, Anouk; Aarts, Henk; Prikken, Merel; van Haren, Neeltje E M

2016-02-01

Successful social interaction requires the ability to integrate as well as distinguish own and others' actions. Normally, the integration and distinction of self and other are a well-balanced process, occurring without much effort or conscious attention. However, not everyone is blessed with the ability to balance self-other distinction and integration, resulting in personal distress in reaction to other people's emotions or even a loss of self [e.g., in (subclinical) psychosis]. Previous research has demonstrated that the integration and distinction of others' actions cause interference with one's own action performance (commonly assessed with a social Simon task). The present study had two goals. First, as previous studies on the social Simon effect employed relatively small samples (N < 50 per test), we aimed for a sample size that allowed us to test the robustness of the action interference effect. Second, we tested to what extent action interference reflects individual differences in traits related to self-other distinction (i.e., personal distress in reaction to other people's emotions and subclinical psychotic symptoms). Based on a questionnaire study among a large sample (N = 745), we selected a subsample (N = 130) of participants scoring low, average, or high on subclinical psychotic symptoms, or on personal distress. The selected participants performed a social Simon task. Results showed a robust social Simon effect, regardless of individual differences in personal distress or subclinical psychotic symptoms. However, exploratory analyses revealed that the sex composition of interaction pairs modulated social Simon effects. Possible explanations for these findings are discussed.

Virtual milgram: empathic concern or personal distress? Evidence from functional MRI and dispositional measures.

PubMed

Cheetham, Marcus; Pedroni, Andreas F; Antley, Angus; Slater, Mel; Jäncke, Lutz

2009-01-01

One motive for behaving as the agent of another's aggression appears to be anchored in as yet unelucidated mechanisms of obedience to authority. In a recent partial replication of Milgram's obedience paradigm within an immersive virtual environment, participants administered pain to a female virtual human and observed her suffering. Whether the participants' response to the latter was more akin to other-oriented empathic concern for her well-being or to a self-oriented aversive state of personal distress in response to her distress is unclear. Using the stimuli from that study, this event-related fMRI-based study analysed brain activity during observation of the victim in pain versus not in pain. This contrast revealed activation in pre-defined brain areas known to be involved in affective processing but not in those commonly associated with affect sharing (e.g., ACC and insula). We then examined whether different dimensions of dispositional empathy predict activity within the same pre-defined brain regions: While personal distress and fantasy (i.e., tendency to transpose oneself into fictional situations and characters) predicted brain activity, empathic concern and perspective taking predicted no change in neuronal response associated with pain observation. These exploratory findings suggest that there is a distinct pattern of brain activity associated with observing the pain-related behaviour of the victim within the context of this social dilemma, that this observation evoked a self-oriented aversive state of personal distress, and that the objective "reality" of pain is of secondary importance for this response. These findings provide a starting point for experimentally more rigorous investigation of obedience.

Meditation-induced neuroplastic changes in amygdala activity during negative affective processing.

PubMed

Leung, Mei-Kei; Lau, Way K W; Chan, Chetwyn C H; Wong, Samuel S Y; Fung, Annis L C; Lee, Tatia M C

2018-06-01

Recent evidence suggests that the effects of meditation practice on affective processing and resilience have the potential to induce neuroplastic changes within the amygdala. Notably, literature speculates that meditation training may reduce amygdala activity during negative affective processing. Nonetheless, studies have thus far not verified this speculation. In this longitudinal study, participants (N = 21, 9 men) were trained in awareness-based compassion meditation (ABCM) or matched relaxation training. The effects of meditation training on amygdala activity were examined during passive viewing of affective and neutral stimuli in a non-meditative state. We found that the ABCM group exhibited significantly reduced anxiety and right amygdala activity during negative emotion processing than the relaxation group. Furthermore, ABCM participants who performed more compassion practice had stronger right amygdala activity reduction during negative emotion processing. The lower right amygdala activity after ABCM training may be associated with a general reduction in reactivity and distress. As all participants performed the emotion processing task in a non-meditative state, it appears likely that the changes in right amygdala activity are carried over from the meditation practice into the non-meditative state. These findings suggest that the distress-reducing effects of meditation practice on affective processing may transfer to ordinary states, which have important implications on stress management.

Empathic concern drives costly altruism

PubMed Central

FeldmanHall, Oriel; Dalgleish, Tim; Evans, Davy; Mobbs, Dean

2015-01-01

Why do we self-sacrifice to help others in distress? Two competing theories have emerged, one suggesting that prosocial behavior is primarily motivated by feelings of empathic other-oriented concern, the other that we help mainly because we are egoistically focused on reducing our own discomfort. Here we explore the relationship between costly altruism and these two sub-processes of empathy, specifically drawing on the caregiving model to test the theory that trait empathic concern (e.g. general tendency to have sympathy for another) and trait personal distress (e.g. predisposition to experiencing aversive arousal states) may differentially drive altruistic behavior. We find that trait empathic concern – and not trait personal distress – motivates costly altruism, and this relationship is supported by activity in the ventral tegmental area, caudate and subgenual anterior cingulate, key regions for promoting social attachment and caregiving. Together, this data helps identify the behavioral and neural mechanisms motivating costly altruism, while demonstrating that individual differences in empathic concern-related brain responses can predict real prosocial choice. PMID:25462694

Families in the context of macroeconomic crises: A systematic review.

PubMed

Fonseca, Gabriela; Cunha, Diana; Crespo, Carla; Relvas, Ana Paula

2016-09-01

The present study is a systematic review of empirical literature from the last 35 years on families' responses to economic distress in the context of macroeconomic crises. Thirty-nine studies published between 1983 and 2015 in 12 countries were identified, resulting in 3 main findings. First, economic distress was associated with negative changes in family dynamics, specifically couple relationships and parenting. Second, protective factors were found to buffer the adverse effects of economic distress on family and individual outcomes. Third, the results suggest that individual responses to macroeconomic crises may be moderated by sex. Implications for future research encompass using validated assessment instruments, including participants beyond 2-parent families with adolescent children and conducting both longitudinal and qualitative studies that focus on the processes and meanings of adaptation within this risk context. Conclusions highlighted the need to assist families dealing with macroeconomic crises' demands, encouraging the development and validation of macrosystemic intervention programs. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Distress or no distress, that's the question: A cutoff point for distress in a working population

PubMed Central

van Rhenen, Willem; van Dijk, Frank JH; Schaufeli, Wilmar B; Blonk, Roland WB

2008-01-01

Background The objective of the present study is to establish an optimal cutoff point for distress measured with the corresponding scale of the 4DSQ, using the prediction of sickness absence as a criterion. The cutoff point should result in a measure that can be used as a credible selection instrument for sickness absence in occupational health practice and in future studies on distress and mental disorders. Methods Distress is measured using the Four Dimensional Symptom Questionnaire (4DSQ), a 50-item self-report questionnaire, in a working population with and without sickness absence due to distress. Sensitivity and specificity were compared for various potential cutoff points, and a receiver operating characteristics analysis was conducted. Results and conclusion A distress cutoff point of ≥11 was defined. The choice was based on a challenging specificity and negative predictive value and indicates a distress level at which an employee is presumably at risk for subsequent sick leave on psychological grounds. The defined distress cutoff point is appropriate for use in occupational health practice and in studies of distress in working populations. PMID:18205912

Distress or no distress, that's the question: A cutoff point for distress in a working population.

PubMed

van Rhenen, Willem; van Dijk, Frank Jh; Schaufeli, Wilmar B; Blonk, Roland Wb

2008-01-18

The objective of the present study is to establish an optimal cutoff point for distress measured with the corresponding scale of the 4DSQ, using the prediction of sickness absence as a criterion. The cutoff point should result in a measure that can be used as a credible selection instrument for sickness absence in occupational health practice and in future studies on distress and mental disorders. Distress is measured using the Four Dimensional Symptom Questionnaire (4DSQ), a 50-item self-report questionnaire, in a working population with and without sickness absence due to distress. Sensitivity and specificity were compared for various potential cutoff points, and a receiver operating characteristics analysis was conducted. A distress cutoff point of >/=11 was defined. The choice was based on a challenging specificity and negative predictive value and indicates a distress level at which an employee is presumably at risk for subsequent sick leave on psychological grounds. The defined distress cutoff point is appropriate for use in occupational health practice and in studies of distress in working populations.

A mindfulness intervention to reduce maternal distress in neonatal intensive care: a mixed methods pilot study.

PubMed

Mendelson, Tamar; McAfee, Ciara; Damian, April Joy; Brar, Amitoj; Donohue, Pamela; Sibinga, Erica

2018-06-05

Mothers with an infant in the neonatal intensive care unit (NICU) are at risk for depression, anxiety, and trauma symptoms, with negative implications for maternal-infant bonding, maternal well-being, and infant development. Few interventions to promote NICU mothers' mental health, however, have been developed or tested. This pre-post pilot study assessed feasibility, acceptability, and preliminary outcomes of a mindfulness intervention for NICU mothers. Twenty-seven mothers were recruited from a university NICU and offered a mindfulness intervention via introductory video and audio-recorded practices. Participants completed a baseline self-report survey. After 2 weeks of engaging with intervention materials, participants completed a second survey and in-depth interview. Quantitative data were analyzed using paired t tests; qualitative data were analyzed using thematic coding. Twenty-four women (89%) completed the study. Quantitative data indicated significant improvements in depressive, anxiety, and trauma symptoms, negative coping, NICU-related stress, and sleep (p < 0.05). Qualitative data identified themes of perceived improvements in psychological distress and stress symptoms, self-care, and relationships. Findings support the mindfulness intervention's feasibility, acceptability, and potential promise for reducing maternal distress and promoting well-being. Use of video and audio modalities may facilitate program sustainability and scale up. Further research on the program is merited.

Ironic effects of emotion suppression when recounting distressing memories.

PubMed

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

2009-10-01

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

Parent-reported distress in children under 3 years old during preventive medical and dental care.

PubMed

Nelson, T M; Huebner, C E; Kim, A; Scott, J M; Pickrell, J E

2015-06-01

This study examined factors related to young children's distress during preventive oral health visits. Additionally, associations between parent-reported child behaviour during the dental visit and during previous medical visits were tested. One hundred twenty-two children under 3 years of age enrolled in a government insurance programme for low-income children were seen for examination, prophylaxis, and fluoride application at a university-based dental clinic. Child distress was rated by parents on a numerical rating scale. The average age of children enrolled was 23.5 ± 7.3 months. The majority (55.7 %) were judged to have little or no distress pre-examination. Mild or no distress during the examination was reported for 42.6 % of the children and severe distress was reported for 39.4 %. Intensity of distress during the examination was not associated with the child's age, gender, dental health, or previous experience with dental care. Distress was also unrelated to the caregiver's education level or own dental health. Intensity of distress was associated with the child's pre-dental examination distress and distress during prior medical examinations and injections. Dental professionals can better anticipate child distress by assessing children before a dental examination and enquiring about previous medical experiences. Strategies to prepare parents and alleviate distress may help children cope with the preventive dental visit.

47 CFR 80.1111 - Distress alerting.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE... Safety Communications § 80.1111 Distress alerting. (a) The transmission of a distress alert indicates... distress message format, which is relayed through space stations. (b) The distress alert must be sent...

47 CFR 80.1111 - Distress alerting.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE... Safety Communications § 80.1111 Distress alerting. (a) The transmission of a distress alert indicates... distress message format, which is relayed through space stations. (b) The distress alert must be sent...

47 CFR 80.1111 - Distress alerting.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE... Safety Communications § 80.1111 Distress alerting. (a) The transmission of a distress alert indicates... distress message format, which is relayed through space stations. (b) The distress alert must be sent...

47 CFR 80.1111 - Distress alerting.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE... Safety Communications § 80.1111 Distress alerting. (a) The transmission of a distress alert indicates... distress message format, which is relayed through space stations. (b) The distress alert must be sent...

47 CFR 80.1111 - Distress alerting.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE... Safety Communications § 80.1111 Distress alerting. (a) The transmission of a distress alert indicates... distress message format, which is relayed through space stations. (b) The distress alert must be sent...

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.

Psychological distress, health and treatment-related factors among individuals initiating ART in Oromia, Ethiopia.

PubMed

Parcesepe, Angela M; Tymejczyk, Olga; Remien, Robert; Gadisa, Tsigereda; Kulkarni, Sarah Gorrell; Hoffman, Susie; Melaku, Zenebe; Elul, Batya; Nash, Denis

2018-03-01

HIV diagnosis may be a source of psychological distress. Late initiation of antiretroviral therapy (ART) and treatment-related beliefs may intensify psychological distress among those recently diagnosed. This analysis describes the prevalence of psychological distress among people living with HIV (PLWH) and examines the association of recent HIV diagnosis, late ART initiation and treatment-related beliefs with psychological distress. The sample includes 1175 PLWH aged 18 or older initiating ART at six HIV clinics in Ethiopia. Psychological distress was assessed with Kessler Psychological Distress Scale. Scores ≥ 29 were categorized as severe psychological distress. Individuals who received their first HIV diagnosis in the past 90 days were categorized as recently diagnosed. Multivariable logistic regression modeled the association of recent diagnosis, late ART initiation and treatment-related beliefs on severe psychological distress, controlling for age, sex, education, area of residence, relationship status, and health facility. Among respondents, 29.5% reported severe psychological distress, 46.6% were recently diagnosed and 31.0% initiated ART late. In multivariable models, relative to those who did not initiate ART late and had longer time since diagnosis, odds of severe psychological distress was significantly greater among those with recent diagnosis and late ART initiation (adjusted OR [aOR]: 1.9 [95% CI 1.4, 2.8]). Treatment-related beliefs were not associated with severe psychological distress in multivariable models. Severe psychological distress was highly prevalent, particularly among those who were recently diagnosed and initiated ART late. Greater understanding of the relationship between psychological distress, recent diagnosis, and late ART initiation can inform interventions to reduce psychological distress among this population. Mental health screening and interventions should be incorporated into routine HIV clinical care from diagnosis through treatment.

Physical and Psychological Distress Are Related to Dying Peacefully in Residents With Dementia in Long-Term Care Facilities.

PubMed

De Roo, Maaike L; Albers, Gwenda; Deliens, Luc; de Vet, Henrica C W; Francke, Anneke L; Van Den Noortgate, Nele; Van den Block, Lieve

2015-07-01

Although dying peacefully is considered an important outcome of high-quality palliative care, large-scale quantitative research on dying peacefully and the factors associated with a peaceful death is lacking. To gain insight into how many residents with dementia in long-term care facilities die peacefully, according to their relatives, and whether that assessment is correlated with observed physical and psychological distress. This was a retrospective cross-sectional study of deceased nursing home residents in a representative sample of long-term care facilities in Flanders, Belgium (2010). Structured post-mortem questionnaires were completed by relatives of the resident, who were asked to what extent they agreed that the resident "appeared to be at peace" during the dying process. Spearman correlation coefficients gave the correlations between physical and psychological distress (as measured using the Symptom Management at the End of Life with Dementia and Comfort Assessment in Dying at the End of Life with Dementia scales) and dying peacefully (as measured using the Quality of Dying in Long Term Care instrument). The sample comprised 92 relatives of deceased residents with dementia. In 54% of cases, relatives indicated that the resident died peacefully. Weak-to-moderate correlations (0.2-0.57) were found between dying peacefully and physical distress in the last week of life. Regarding psychological distress, weak-to-moderate correlations were found for both the last week (0.33-0.44) and last month of life (0.28-0.47). Only half of the residents with dementia died peacefully as perceived by their relatives. Relatives' assessment of whether death was peaceful is related to both physical and psychological distress. Further qualitative research is recommended to gain more in-depth insights into the aspects on which relatives base their judgment of dying peacefully. Copyright © 2015 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Psychological distress screening in cancer patients: psychometric properties of tools available in Italy.

PubMed

Muzzatti, Barbara; Annunziata, Maria Antonietta

2012-01-01

The main national and international organisms recommend continuous monitoring of psychological distress in cancer patients throughout the disease trajectory. The reasons for this concern are the high prevalence of psychological distress in cancer patients and its association with a worse quality of life, poor adherence to treatment, and stronger assistance needs. Most screening tools for psychological distress were developed in English-speaking countries. To be fit for use in different cultural contexts (like the Italian), they need to undergo accurate translation and specific validation. In the present work we summarized the validation studies for psychological distress screening tools available in Italian that are most widely employed internationally, with the aim of helping clinicians choose the adequate instrument. With knowledge of the properties of the corresponding Italian versions, researchers would be better able to identify the instruments that deserve further investigation. We carried out a systematic review of the literature. Results. Twenty-nine studies of eight different instruments (five relating to psychological distress, three to its depressive component) were identified. Ten of these studies involved cancer patients and 19 referred to the general population or to non-cancer, non-psychiatric subjects. For seven of the eight tools, data on concurrent and discriminant validity were available. For five instruments data on criterion validity were available, for four there were data on construct validity, and for one tool divergent and cross-cultural validity data were provided. For six of the eight tools the literature provided data on reliability (mostly about internal consistency). Since none of the eight instruments for which we found validation studies relative to the Italian context had undergone a complete and organic validation process, their use in the clinical context must be cautious. Italian researchers should be proactive and make a valid and reliable screening tool for Italian patients available.

Public involvement in suicide prevention: understanding and strengthening lay responses to distress.

PubMed

Owens, Christabel; Owen, Gareth; Lambert, Helen; Donovan, Jenny; Belam, Judith; Rapport, Frances; Lloyd, Keith

2009-08-23

The slogan "Suicide prevention is everyone's business" has been used in a number of campaigns worldwide in recent years, but most research into suicide prevention has focused on the role of medical professionals in identifying and managing risk. Little consideration has been given to the role that lay people can play in suicide prevention, or to the resources they need in order to do so.The majority of people who take their own lives are not under the care of specialist mental health services, and around half have not had recent contact with their general practitioner. These individuals are not known to be 'at risk' and there is little or no opportunity for clinical intervention. Family members and friends may be the only ones to know that a person is troubled or distressed, and their capacity to recognise, assess and respond to that distress is therefore vitally important. This study aims to discover what the suicidal process looks like from the point of view of relatives and friends and to gain insight into the complex and difficult judgements that people have to make when trying to support a distressed individual. The study uses qualitative methods to build up a detailed picture of 15-20 completed suicides, aged 18-34. Data are gathered by means of in-depth interviews with relatives, friends and others who knew the deceased well. In each case, as many informants as possible are sought using a purposive snowballing technique. Interviews focus on the family and social network of the deceased, the ways in which relatives and friends interpreted and responded to his/her distress, the potential for intervention that may have existed within the lay network and the knowledge, skills and other resources that would have helped members to support the distressed individual more effectively. The study will inform interventions to promote public mental health awareness and will provide a basis on which to develop community-focussed suicide prevention strategies.

U.S. Coast Guard SARSAT Final Evaluation Report. Volume II. Appendices.

DOT National Transportation Integrated Search

1987-03-01

Contents: Controlled Tests; Controlled Test Error Analysis, Processing of Westwind Data; Exercises and Homing Tests; Further Analysis of Controlled Tests; Sar Case Analysis Tables; Narratives of Real Distress Cases; RCC Response Scenarios; Workload A...

Persistent Distress after Water Contamination.

PubMed

Schade, Charles P; Gupta, Rahul; Jha, Ayan; Wright, Nasandra

2016-01-01

A chemical spill contaminated the public water supply of Charleston, West Virginia in January 2014 for at least a week. Psychological distress is common after disasters. We surveyed the exposed population to assess psychological distress during and three months after the incident. We inquired about stressors that might predict distress, adequacy of communication from public officials, and use of the water supply and perceptions of its safety three months after the incident. Twenty six percent of interviewees had persistent symptoms of distress. Female sex, negative household experiences during the episode (especially having someone sick), and poor perception of communication increased odds of persistent distress. Households of respondents without persistent distress were significantly more likely to report drinking tap water (RR=1.95) than those with persistent distress. Distress in Charleston area residents persisted and may have resulted in continuing mistrust of the water supply.

Noncoherent Tracking of a Source of a Data-Modulated Signal

NASA Technical Reports Server (NTRS)

Arndt, G. Dickey; Ngo, Phong; Chen, Henry; Phan, Chau T.; Hill, Brent; Bourgeois, Brian; Dusl, John

2003-01-01

A proposed tracking receiver system containing three suitably positioned antenna elements and special signal-processing equipment would determine the direction of incidence of a microwave signal containing spread-spectrum digital data modulation. If the system were to contain two sets of antenna elements separated by a known baseline, it could determine the location of the transmitter as the intersection of the lines of incidence on the two antennas. Such systems could be used for diverse purposes in outer space and on Earth, including tracking astronauts and small robotic spacecraft working outside a spacecraft or space station, and locating cellular telephones from which distress calls have been made. The principle of operation does not require the transmission of a special identifying or distress signal by the cellular telephone or other transmitter to be tracked; instead, the system could utilize the data signal routinely sent by the transmitter, provided that the signal had the characteristics needed for processing.

Dancing around death: hospitalist-patient communication about serious illness.

PubMed

Anderson, Wendy G; Kools, Susan; Lyndon, Audrey

2013-01-01

Hospital physicians care for most seriously ill patients in the United States. We employed dimensional analysis to describe communication about death and dying in audio-recorded admission encounters between seriously ill patients and hospitalists. Acknowledging or not acknowledging the possibility of dying emerged as a key process. Acknowledgment was rare, and depended on synergistic communication behaviors between patient and physician. Facilitators included patients cuing for information and disclosing emotional distress, and physicians exploring the patient's understanding of his or her illness and emotional distress. When hospitalists focused on acute issues, stated that they were awaiting test results, and deferred to other physicians, discussion moved away from acknowledgment. Meaningful discussion of end-of-life issues, including goals and values, fears about death and dying, prognosis, and options for palliative care followed open acknowledgment. This acknowledgment process can serve as a guide for providers to sensitively and honestly discuss essential end-of-life issues.

Patient Outcomes in Association With Significant Other Responses to Chronic Fatigue Syndrome: A Systematic Review of the Literature

PubMed Central

Band, Rebecca; Wearden, Alison; Barrowclough, Christine

2015-01-01

Social processes have been suggested as important in the maintenance of chronic fatigue syndrome (also known as myalgic encephalomyelitis; CFS/ME), but the specific role of close interpersonal relationships remains unclear. We reviewed 14 articles investigating significant other responses to close others with CFS/ME and the relationships between these responses and patient outcomes. Significant other beliefs attributing patient responsibility for the onset and ongoing symptoms of CFS/ME were associated with increased patient distress. Increased symptom severity, disability, and distress were also associated with both solicitous and negative significant other responses. Specific aspects of dyadic relationship quality, including high Expressed Emotion, were identified as important. We propose extending current theoretical models of CFS/ME to include two potential perpetuating interpersonal processes; the evidence reviewed suggests that the development of significant other–focused interventions may also be beneficial. PMID:26617440

Dancing Around Death: Hospitalist-Patient Communication About Serious Illness

PubMed Central

Anderson, Wendy G.; Kools, Susan; Lyndon, Audrey

2012-01-01

Hospital physicians care for most seriously ill patients in the United States. We employed dimensional analysis to describe communication about death and dying in audio-recorded admission encounters between seriously ill patients and hospitalists. Acknowledging or not acknowledging the possibility of dying emerged as a key process. Acknowledgment was rare, and depended on synergistic communication behaviors between patient and physician. Facilitators included patients cuing for information and disclosing emotional distress, and physicians exploring the patient’s understanding of his or her illness and emotional distress. When hospitalists focused on acute issues, stated that they were awaiting test results, and deferred to other physicians, discussion moved away from acknowledgment. Meaningful discussion of end-of-life issues, including goals and values, fears about death and dying, prognosis, and options for palliative care followed open acknowledgment. This acknowledgment process can serve as a guide for providers to sensitively and honestly discuss essential end-of-life issues. PMID:23034778

Cultural differences in emotion regulation during self-reflection on negative personal experiences.

PubMed

Tsai, William; Lau, Anna S

2013-01-01

Reflecting on negative personal experiences has implications for mood that may vary as a function of specific domains (e.g., achievement vs. interpersonal) and cultural orientation (e.g., interdependence vs. independence). This study investigated cultural differences in the social-cognitive and affective processes undertaken as Easterners and Westerners reflected on negative interpersonal and performance experiences. One hundred Asian Americans and 92 European-American college students were randomly assigned to one of three conditions: interpersonal rejection, achievement failure, or a control condition. Results revealed that Asian Americans experienced greater distress than European Americans after self-reflecting over a failed interpersonal experience, suggesting cultural sensitivity in the relational domain. Consistent with theoretical predictions, analysis of the social cognitive and affective processes that participants engaged in during self-reflection provided some evidence that self-enhancement may buffer distress for European Americans, while emotion suppression may be adaptive for Asian Americans.

Cancer-Related Psychological Distress: A Concept Analysis.

PubMed

Gundelach, Amy; Henry, Barb

2016-12-01

Cancer-related psychological distress, as a concept, has limited research literature substantiation. Several studies report that patients with cancer suffer from significant psychological distress; however, the description of the concept of cancer-related psychological distress has not been clearly described. Theoretical work based on the concept is also unclear. This article is a report on the concept of cancer-related psychological distress to clarify the concept as separate from non-cancer-related psychological distress and promote the use of the term in nursing practice and research across the cancer trajectory. This article used a content analysis to examine the literature. The literature review for this article used CINAHL®, PsycINFO®, and PubMed to search publications from 1999-2016. Content analysis of the literature revealed that the term psychological distress was used often with regard to distress in patients with cancer, but the concept of cancer-related psychological distress was not clearly defined. Four attributes encompass the concept of cancer-related psychological distress.

Who Is Experiencing What Kind of Moral Distress? Distinctions for Moving from a Narrow to a Broad Definition of Moral Distress.

PubMed

Fourie, Carina

2017-06-01

Moral distress, according to Andrew Jameton's highly influential definition, occurs when a nurse knows the morally correct action to take but is constrained in some way from taking this action. The definition of moral distress has been broadened, first, to include morally challenging situations that give rise to distress but which are not necessarily linked to nurses feeling constrained, such as those associated with moral uncertainty. Second, moral distress has been broadened so that it is not confined to the experiences of nurses. However, such a broadening of the concept does not mean that the kind of moral distress being experienced, or the role of the person experiencing it, is morally irrelevant. I argue that differentiating between categories of distress-e.g., constraint and uncertainty-and between groups of health professionals who might experience moral distress is potentially morally relevant and should influence the analysis, measurement, and amelioration of moral distress in the clinic. © 2017 American Medical Association. All Rights Reserved.

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.

The cultural expression of spiritual distress in Israel.

PubMed

Schultz, Michael; Meged-Book, Tehilah; Mashiach, Tanya; Bar-Sela, Gil

2018-03-30

Although spiritual distress is present across cultures, the ways in which patients experience it vary between cultures. Our goal was to examine the cultural expression and key indicators of spiritual distress in Israel. We conducted a structured interview of 202 oncology outpatients in a cross-sectional study. Self-diagnosis of spiritual distress, which is a demonstrated gold standard for identifying its presence, was compared with the Facit-Sp-12 and a number of other items (from the Spiritual Injury Scale and newly developed Israeli items) hypothesized as Israeli cultural expressions of spiritual distress, demographic and medical data, and patient desire to receive spiritual care. Significant variation was found between Israeli cultural expression of spiritual distress and that found in studies from other countries. Key expressions of spiritual distress in this study included lack of inner peace, grief, and an inability to accept what is happening. Items related to faith were not significant, and loss of meaning showed mixed results. Patients requesting spiritual care were more likely to be in spiritual distress. No demographic or medical data correlated with spiritual distress. Specially designed interventions to reduce spiritual distress should address the expressions of the distress specific to that culture. Studies of the efficacy of spiritual care can examine the extent of spiritual distress in general or of its specific cultural expressions.

Understanding Children's Emotional Processes and Behavioral Strategies in the Context of Marital Conflict

ERIC Educational Resources Information Center

Koss, Kalsea J.; George, Melissa R. W.; Bergman, Kathleen N.; Cummings, E. M.; Davies, Patrick T.; Cicchetti, Dante

2011-01-01

Marital conflict is a distressing context in which children must regulate their emotion and behavior; however, the associations between the multidimensionality of conflict and children's regulatory processes need to be examined. The current study examined differences in children's (N=207, mean age=8.02 years) emotions (mad, sad, scared, and happy)…

Effects of Mindfulness-Based versus Interpersonal Process Group Intervention on Psychological Well-Being with a Clinical University Population

ERIC Educational Resources Information Center

Byrne, Ciara; Bond, Lynne A.; London, Miv

2013-01-01

This quasi-experimental study compared a group mindfulness-based intervention (MI) with an interpersonal process (IP) group intervention and a no-treatment (NT) control condition in reducing psychological distress among 112 students at 2 universities. At postintervention, IP and MI group participants exhibited significant reductions in anxiety,…

Distress in the Transition Process: The Role of Loss, Community, and Coping

ERIC Educational Resources Information Center

Budge, Stephanie L.

2011-01-01

Given the extensiveness of rejection and discrimination that transgender individuals experience (Lombardi, Wilchins, Priesing, & Malouf, 2001), the purpose of the current study was to examine the process of coping and how this relates to well-being at different stages of the gender transition. A total of 357 transsexual individuals (n = 226…

Adopting a family approach to theory and practice: measuring distress in cancer patient-partner dyads with the distress thermometer.

PubMed

Zwahlen, Diana; Hagenbuch, Niels; Jenewein, Josef; Carley, Margaret I; Buchi, Stefan

2011-04-01

Significant others are central to patients' experience and management of their cancer illness. Building on our validation of the Distress Thermometer (DT) for family members, this investigation examines individual and collective distress in a sample of cancer patients and their matched partners, accounting for the aspects of gender and role. Questionnaires including the DT were completed by a heterogeneous sample of 224 couples taking part in a multisite study. Our investigation showed that male patients (34.2%), female patients (31.9%), and male partners (29.1%) exhibited very similar levels of distress, while female partners (50.5%) exhibited much higher levels of distress according to the DT. At the dyad level just over half the total sample contained at least one individual reporting significant levels of distress. Among dyads with at least one distressed person, the proportion of dyads where both individuals reported distress was greatest (23.6%). Gender and role analyses revealed that males and females were not equally distributed among the four categories of dyads (i.e. dyads with no distress; dyads where solely the patient or dyads where solely the partner is distressed; dyads where both are distressed). A remarkable number of dyads reported distress in one or both partners. Diverse patterns of distress within dyads suggest varying risks of psychosocial strain. Screening patients' partners in addition to patients themselves may enable earlier identification of risk settings. The support offered to either member of such dyads should account for their role- and gender-specific needs. Copyright © 2010 John Wiley & Sons, Ltd.

Mental Disorder, Psychological Distress, and Functional Status in Canadian Military Personnel.

PubMed

Sampasa-Kanyinga, Hugues; Zamorski, Mark A; Colman, Ian

2018-01-01

We examined the overlap between mood and anxiety disorders and psychological distress and their associations with functional status in Canadian Armed Forces (CAF) personnel. Data on Regular Forces personnel ( N = 6700) were derived from the 2013 Canadian Forces Mental Health Survey, a nationally representative survey of the CAF personnel. Current psychological distress was assessed using the Kessler K10 scale. Past-month mood and anxiety disorders were assessed using the World Health Organization World Mental Health Composite Diagnostic Interview. The prevalence of psychological distress was the same as that of any past-month mood or anxiety disorder (7.1% for each). A total of 3.8% had both distress and past-month mood or anxiety disorder, 3.3% had past-month disorder without psychological distress, while another 3.3% had psychological distress in the absence of a past-month mood or anxiety disorder. After adjusting for age, sex, marital, education, income, language, element, rank, and alcohol use disorder, individuals with both psychological distress and past-month mood and anxiety disorders exhibited the highest levels of disability, days out of role, and work absenteeism relative to those with neither mental disorders nor psychological distress. Relative to individuals with both disorder and distress, those who endured distress in the absence of mental disorder exhibited lower, but meaningful, levels of disability compared with those with neither disorder nor distress. Disability is most severe among CAF personnel with both distress and past-month mood and anxiety disorders. Nevertheless, distress in the absence of disorder is prevalent and is associated with meaningful levels of disability.

The experience and impact of traumatic perinatal event experiences in midwives: A qualitative investigation.

PubMed

Sheen, Kayleigh; Spiby, Helen; Slade, Pauline

2016-01-01

Through their work midwives may experience distressing events that fulfil criteria for trauma. However, there is a paucity of research examining the impact of these events, or what is perceived to be helpful/unhelpful by midwives afterwards. To investigate midwives' experiences of traumatic perinatal events and to provide insights into experiences and responses reported by midwives with and without subsequent posttraumatic stress symptoms. Semi-structured telephone interviews were conducted with a purposive sample of midwives following participation in a previous postal survey. 35 midwives who had all experienced a traumatic perinatal event defined using the Diagnostic and Statistical Manual of Mental Disorders (version IV) Criterion A for posttraumatic stress disorder were interviewed. Two groups of midwives with high or low distress (as reported during the postal survey) were purposefully recruited. High distress was defined as the presence of clinical levels of PTSD symptomatology and high perceived impairment in terms of impacts on daily life. Low distress was defined as any symptoms of PTSD present were below clinical threshold and low perceived life impairment. Interviews were analysed using template analysis, an iterative process of organising and coding qualitative data chosen for this study for its flexibility. An initial template of four a priori codes was used to structure the analysis: event characteristics, perceived responses and impacts, supportive and helpful strategies and reflection of change over time codes were amended, integrated and collapsed as appropriate through the process of analysis. A final template of themes from each group is presented together with differences outlined where applicable. Event characteristics were similar between groups, and involved severe, unexpected episodes contributing to feeling 'out of a comfort zone.' Emotional upset, self-blame and feelings of vulnerability to investigative procedures were reported. High distress midwives were more likely to report being personally upset by events and to perceive all aspects of personal and professional lives to be affected. Both groups valued talking about the event with peers, but perceived support from senior colleagues and supervisors to be either absent or inappropriate following their experience; however, those with high distress were more likely to endorse this view and report a perceived need to seek external input. Findings indicate a need to consider effective ways of promoting and facilitating access to support, at both a personal and organisational level, for midwives following the experience of a traumatic perinatal event. Copyright © 2015 Elsevier Ltd. All rights reserved.

Moral Distress in PICU and Neonatal ICU Practitioners: A Cross-Sectional Evaluation.

PubMed

Larson, Charles Philip; Dryden-Palmer, Karen D; Gibbons, Cathy; Parshuram, Christopher S

2017-08-01

To measure the level of moral distress in PICU and neonatal ICU health practitioners, and to describe the relationship of moral distress with demographic factors, burnout, and uncertainty. Cross-sectional survey. A large pediatric tertiary care center. Neonatal ICU and PICU health practitioners with at least 3 months of ICU experience. A 41-item questionnaire examining moral distress, burnout, and uncertainty. The main outcome was moral distress measured with the Revised Moral Distress Scale. Secondary outcomes were frequency and intensity Revised Moral Distress Scale subscores, burnout measured with the Maslach Burnout Inventory depersonalization subscale, and uncertainty measured with questions adapted from Mishel's Parent Perception of Uncertainty Scale. Linear regression models were used to examine associations between participant characteristics and the measures of moral distress, burnout, and uncertainty. Two-hundred six analyzable surveys were returned. The median Revised Moral Distress Scale score was 96.5 (interquartile range, 69-133), and 58% of respondents reported significant work-related moral distress. Revised Moral Distress Scale items involving end-of-life care and communication scored highest. Moral distress was positively associated with burnout (r = 0.27; p < 0.001) and uncertainty (r = 0.04; p = 0.008) and inversely associated with perceived hospital supportiveness (r = 0.18; p < 0.001). Nurses reported higher moral distress intensity than physicians (Revised Moral Distress Scale intensity subscores: 57.3 vs 44.7; p = 0.002). In nurses only, moral distress was positively associated with increasing years of ICU experience (p = 0.02) and uncertainty about whether their care was of benefit (r = 0.11; p < 0.001) and inversely associated with uncertainty about a child's prognosis (r = 0.03; p = 0.03). In this single-center, cross-sectional study, we found that moral distress is present in PICU and neonatal ICU health practitioners and is correlated with burnout, uncertainty, and feeling unsupported.

Distress in patients with cancer: definition, assessment, and suggested interventions.

PubMed

Vitek, Leesa; Rosenzweig, Margaret Quinn; Stollings, Susan

2007-06-01

Distress in patients with cancer impacts their quality of life. The National Comprehensive Cancer Network (NCCN) created a distress thermometer and a problem checklist to aid in recognizing distress. The thermometer measures distress on a 0-10 scale, and the problem checklist identifies more specific etiologies of distress, such as practical, spiritual, physical, emotional, and family problems. Oncology nurses play a key role in the success of the distress-screening tool because they have the most patient contact. The NCCN guidelines suggest that patients complete the screening tools at each visit and clinicians review the outcome. NCCN has provided clinical pathways for treating the etiologies of distress using a multidisciplinary approach, including members from social work, pastoral services, mental health, and oncology.

Psychosocial distress in patients with thyroid cancer.

PubMed

Buchmann, Luke; Ashby, Shaelene; Cannon, Richard B; Hunt, Jason P

2015-04-01

The purpose of this study is to evaluate levels of psychosocial distress in thyroid cancer patients. An analysis of factors contributing to levels of distress is included. Individual retrospective cohort study. Head and neck cancer clinic at the Huntsman Cancer Institute. A total of 118 newly diagnosed thyroid cancer patients were included in the study. Univariate and multivariate analyses evaluated levels of and factors contributing to distress. Almost half (43.3%) of patients had significant distress. Those with self-reported psychiatric history, use of antidepressant medication, and history of radiation treatment had higher levels of distress. On multivariate analysis, patient endorsement of emotional issues predicted a higher distress level. Thyroid cancer patients have high distress levels. Identification of thyroid cancer patients with high distress levels is important to offer additional support during cancer therapy. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

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

PubMed

Lin, Hung-Chu; McFatter, Robert

2012-12-01

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

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

Moral distress among nurses in medical, surgical and intensive-care units.

PubMed

Lusignani, Maura; Giannì, Maria Lorella; Re, Luca Giuseppe; Buffon, Maria Luisa

2017-09-01

To assess the frequency, intensity and level of moral distress perceived by nurses working in medical, surgical and intensive care units. Moral distress among nurses compromises their ability to provide optimal patient care and may cause them to leave their job. A cross-sectional questionnaire survey of 283 registered nurses was conducted to evaluate the frequency, intensity and levels of moral distress. A revised version of the Moral Distress Scale (MDS-R) was used. The highest level of moral distress was associated with the provision of treatments and aggressive care that were not expected to benefit the patients and the competency of the health-care providers. Multivariate regression showed that nurses working in medical settings, nurses with lower levels of experience working in medical, surgical or intensive care settings, and nurses who intend to leave their job experienced the highest levels of moral distress. The present study indicates that nurses experience an overall moderate level of moral distress. Gaining further insight into the issue of moral distress among nurses and the clinical situations that most frequently cause this distress will enable development of strategies to reduce moral distress and to improve nurse satisfaction and, consequently, patient care. © 2016 John Wiley & Sons Ltd.

Variation in psychosocial influences according to the dimensions and content of children's unusual experiences: potential routes for the development of targeted interventions.

PubMed

Ruffell, Tamatha; Azis, Matilda; Hassanali, Nedah; Ames, Catherine; Browning, Sophie; Bracegirdle, Karen; Corrigall, Richard; Laurens, Kristin R; Hirsch, Colette; Kuipers, Elizabeth; Maddox, Lucy; Jolley, Suzanne

2016-03-01

The psychosocial processes implicated in the development and maintenance of psychosis differ according to both the dimensional attributes (conviction, frequency, associated distress, adverse life impact) and the content or type (e.g. grandiosity, hallucinations, paranoia) of the psychotic symptoms experienced. This has informed the development of 'targeted' cognitive behavioural therapy for psychosis (CBTp): interventions focusing on specific psychological processes in the context of particular symptom presentations. In adults, larger effect sizes for change in primary outcomes are typically reported in trials of targeted interventions, compared to those for trials of generic CBTp approaches with multiple therapeutic foci. We set out to test the theoretical basis for developing targeted CBTp interventions for young people with distressing psychotic-like, or unusual, experiences (UEs). We investigated variations in the psychosocial processes previously associated with self-reported UE severity (reasoning, negative life events, emotional problems) according to UE dimensional attributes and content/type (using an established five-factor model) in a clinically referred sample of 72 young people aged 8-14 years. Regression analyses revealed associations of conviction and grandiosity with reasoning; of frequency, and hallucinations and paranoia, with negative life events; and of distress/adverse life impact, and paranoia and hallucinations, with emotional problems. We conclude that psychological targets for intervention differ according to particular characteristics of childhood UEs in much the same way as for psychotic symptoms in adults. The development of targeted interventions is therefore indicated, and tailoring therapy according to presentation should further improve clinical outcomes for these young people.

Witnessing images of extreme violence: a psychological study of journalists in the newsroom.

PubMed

Feinstein, Anthony; Audet, Blair; Waknine, Elizabeth

2014-08-01

User Generated Content - photos and videos submitted to newsrooms by the public - has become a prominent source of information for news organisations. Journalists working with uncensored material can frequently witness disturbing images for prolonged periods. How this might affect their psychological health is not known and it is the focus of this study. Descriptive, exploratory. The newsrooms of three international news organisations. One hundred and sixteen journalists working with User Generated Content material. Psychometric data included the re-experiencing, avoidance and autonomic arousal indices of posttraumatic stress disorder (Impact of Event Scale-revised), depression (Beck Depression Inventory-II; BDI-II), a measure of psychological distress (GHQ-28), the latter comprising four subscales measuring somatisation, anxiety, social dysfunction and depression, and mean weekly alcohol consumption divided according to gender. Regression analyses revealed that frequent (i.e. daily) exposure to violent images independently predicted higher scores on all indices of the Impact of Event Scale-revised, the BDI-II and the somatic and anxiety subscales of the GHQ-28. Exposure per shift only predicted scores on the intrusion subscale of the Impact of Event Scale-revised. The present study, the first of its kind, suggests that frequency rather than duration of exposure to images of graphic violence is more emotionally distressing to journalists working with User Generated Content material. Given that good journalism depends on healthy journalists, news organisations will need to look anew at what can be done to offset the risks inherent in viewing User Generated Content material. Our findings, in need of replication, suggest that reducing the frequency of exposure may be one way to go.

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

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

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

2008-01-01

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

Socioeconomic variation in back and joint pain in Finland.

PubMed

Leino-Arjas, P; Hänninen, K; Puska, P

1998-01-01

Differences in the prevalence of back and joint pain by occupational class and education were studied in surveys representative of adult Finns. The effects of lifestyle factors and mental distress on these differences were also analysed. The material comprised 3915 women and 3629 men, all occupationally active. Occupational class and level of education were associated with back and joint pain; the associations were more obvious in men than in women. Among men, the age-adjusted odds ratio of joint pain in farmers was 3.2 (95% CI: 2.1-5.0), in manual workers 2.6 (1.9-3.6), in entrepreneurs 2.4 (1.5-3.7) and in lower white-collar workers 1.7 (1.1-2.4) as compared with upper white-collar employees. Similar odds ratios of back pain were 2.1 (1.6-2.9) in farmers, 1.8 (1.5-2.3) in manual workers, 1.7 (1.2-2.4) in entrepreneurs and 1.4 (1.1-1.7) in lower white-collar workers. Most of the associations persisted in multivariate analyses, in which height, marital status, lifestyle (smoking, leisure-time physical activity and body mass index (BMI)) and mental distress were considered; in these models, mental distress was consistently associated with pain. Back pain was associated with smoking in men and with BMI in women; BMI was also associated with joint pain in both sexes. In women, height showed an association with back pain for which a doctor had been consulted. Marital status, alcohol consumption, leisure-time physical activity and the urbanization level of the community were not important as determinants of pain. Obvious differences occurred in back and joint pain by indicators of social class that were not due to socioeconomic differences in lifestyle, height or mental distress.

Prospective Study of Psychosocial Distress Among Patients Undergoing Radiotherapy for Head and Neck Cancer

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

Chen, Allen M.; Jennelle, Richard; Grady, Victoria

Purpose: To determine the prevalence of psychosocial distress among patients undergoing radiotherapy (RT) for head and neck cancer and to examine the association between depression and anxiety and demographic and medical variables. Methods and Materials: A total of 40 patients (25 men and 15 women) with nonmetastatic head and neck cancer were enrolled in this prospective study and underwent RT administered with definitive (24 patients) or postoperative (16 patients) intent. Twenty patients (50%) received concurrent chemotherapy. All patients completed the Hospital Anxiety and Depression Scale and Beck Depression Inventory-II instrument before RT, on the last day of RT, and atmore » the first follow-up visit. The effect of patient-, tumor-, and treatment-related factors on psychosocial distress was analyzed. Results: The prevalence of mild to severe pre-RT depression was 58% and 45% using the Hospital Anxiety and Depression Scale-D and Beck Depression Inventory-II scale, respectively. The prevalence of severe pre-RT anxiety was 7%. The depression levels, as determined by the Hospital Anxiety and Depression Scale and Beck Depression Inventory-II instrument increased significantly during RT and remained elevated at the first follow-up visit (p < 0.001 for both). The variables that were significantly associated with post-RT depression included a greater pre-RT depression level, employment status (working at enrollment), younger age (<55 years), single marital status, and living alone (p < 0.05, for all). Conclusion: The results of our study have shown that an alarming number of patients undergoing RT for head and neck cancer have symptoms suggestive of psychosocial distress even before beginning treatment. This proportion increases significantly during RT. Studies investigating the role of antidepressants and/or psychiatric counseling might be warranted in the future.« less

AHTD cracking protocol application with automated distress survey for design and management.

DOT National Transportation Integrated Search

2011-03-09

Manual surveys of pavement cracking have problems associated with variability, repeatability, processing : speed, and cost. If conducted in the field, safety and related liability of manual survey present challenges : to highway agencies. Therefore a...

Revised Condition Rating Survey Models to Reflect All Distresses : Volume 1

DOT National Transportation Integrated Search

2018-04-01

Pavement condition assessment plays a key role in infrastructure programming and planning processes. Similar to other state agencies, the Illinois Department of Transportation (IDOT) has been using a system to evaluate the condition of pavements sinc...

Evaluation of lignin as an antioxidant in asphalt binders and bituminous mixtures : technical summary.

DOT National Transportation Integrated Search

2017-01-01

The chemical process of oxidative age-hardening in asphalt pavements is one of the major distresses leading to hot mix asphalt (HMA) pavement failure as evidenced by fatigue and thermal (low temperature) cracking.

Testing guide for implementing concrete paving quality control procedures.

DOT National Transportation Integrated Search

2008-03-01

Construction of portland cement concrete pavements is a complex process. A small fraction of the concrete pavements constructed in the : United States over the last few decades have either failed prematurely or exhibited moderate to severe distress. ...

Relationships among moral distress, level of practice independence, and intent to leave of nurse practitioners in emergency departments: results from a national survey.

PubMed

Trautmann, Jennifer; Epstein, Elizabeth; Rovnyak, Virginia; Snyder, Audrey

2015-01-01

The aims of this research study were to investigate moral distress among emergency department (ED) nurse practitioners (NPs) and examine relationships between moral distress and level of practice independence as well as intent to leave a position. Moral distress has been studied regarding registered nurses and physicians (MDs) but less so in NPs. It is important to explore moral distress in NPs because they tread a unique path between nursing and physician roles. Moral distress may play a significant role in staff nurses' intention to leave practice, and level of practice independence is found to have a relationship with NPs' intention to leave. A convenience sample of ED NPs was obtained from a mailing list of a national nursing specialty organization, the Emergency Nurses Association. Using a correlational design, survey methods assessed moral distress with the Moral Distress Scale-Revised (MDS-R), level of practice independence with the Dempster Practice Behavior Scale, and intent to leave with self-report. Correlational and regression analyses of data were conducted to characterize moral distress among ED NPs and associations between moral distress, level of practice independence, and intent to leave. Results found ED NPs do experience moral distress with poor patient care results from inadequate staff communication and working with incompetent coworkers in their practice. The MDS-R was a significant predictor of intention to leave among respondents. This study is the first of its kind to explore moral distress in ED NPs. Results suggest moral distress influences ED NPs' intent to leave their position. Further studies are needed to explore the findings from this research and to formulate interventions to alleviate moral distress in ED NPs and improve retention in the clinical setting.

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.

Using the patients concerns inventory for distress screening in post-treatment head and neck cancer survivors.

PubMed

Ghazali, Naseem; Roe, Brenda; Lowe, Derek; Tandon, Sank; Jones, Terry; Shaw, Richard; Risk, Janet; Rogers, Simon N

2017-10-01

Cancer patients can experience significant distress during their cancer trajectory, which impacts upon clinical outcomes and quality of life. Screening for distress using holistic assessments can help identify and address unmet concerns/needs. The purpose of this study was to evaluate the relationship between concerns and distress, and the impact of distress on clinic outcomes in post-treatment head and neck cancer patients. 170 patients attending routine follow-up clinics were prospectively recruited. All patients completed the Patient Concerns Inventory (PCI) and the Distress thermometer (DT) at preconsultation. The rate of significant distress (i.e. DT cut-off score ≥4) was 36% (62/170). Significantly distressed patients selected more items overall than patients without distress (mean, median (QR) of 5.40, 5 (2-8) vs 2.61, 2 (0-4), p < 0.001). Significant distress was most strongly associated with Physical and Functional well-being (p < 0.001) and Psychological and Emotional well-being domains (p = 0.001). On balance, very little difference was noted between cut-off points of either ≥4 or ≥5 PCI items of concern selected. Both cut-off points demonstrated an acceptable level of sensitivity, specificity and predictive values for significant distress. Consultations were longer with increasing numbers of concerns. Just over one-third of patients are significantly distressed. They were more likely to express a higher number of concerns. A cutoff score ≥4 or ≥5 PCI items selected can identify those at risk of significant distress. Concerns causing significant distress were related to emotional/psychological issues and physical function. Copyright © 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. 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

Comparing the meanings of living with advanced breast cancer between women resilient to distress and women with persistent distress: a qualitative study.

PubMed

Lam, W W T; Yoon, S W; Sze, W K; Ng, A W Y; Soong, I; Kwong, A; Suen, D; Tsang, J; Yeo, W; Wong, K Y; Fielding, R

2017-02-01

Most women with advanced breast cancer (ABC) show little distress, but about one in ten show persistent distress over time. It remains unclear if meanings ascribed by patients to ABC differentiate these distress trajectories. This qualitative study (a) compared illness meanings of ABC between women with persistent psychological distress and those with low/transient distress, and (b) examined how illness meanings might influence coping strategies. The sample was drawn from a prior quantitative study exploring psychological distress trajectories following ABC diagnosis. Overall, 42 Cantonese- or Mandarin-speaking Chinese women diagnosed with locally advanced or metastatic ABC were recruited based on their distress trajectory status (low-stable, transient, or persistent distress). Interviews were recorded, transcribed, and analyzed following grounded theory approach using simultaneous analysis. Women with persistent distress viewed their diagnosis as another blow in life, the illness was global, permeating every aspect of their life. Maladaptive rumination and thought suppression were common responses to illness demands. These women had poor social support. A sense of demoralization stood out in their narratives. In contrast, women with transient/low-stable distress encapsulated the illness, with minimum impacts of their life. They did not evidence dysfunctional repetitive thoughts. Living in a supportive environment, they were able to accept and/or live in the present-moment. Rumination, thought suppression, social constraints, and pre-existing exposure to life stress may be potential risks for chronic distress in response to advanced breast cancer. Persistent and transient distress responses to cancer may have different underpinnings. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Psychological distress associated with cancer screening: A systematic review.

PubMed

Chad-Friedman, Emma; Coleman, Sarah; Traeger, Lara N; Pirl, William F; Goldman, Roberta; Atlas, Steven J; Park, Elyse R

2017-10-15

Current national cancer screening recommendations include the potential risk of psychological harm related to screening. However, data on the relation of psychological distress to cancer screening is limited. The authors conducted a systematic review to assess psychological distress associated with cancer screening procedures. Studies that administered measures of psychological distress between 2 weeks before and 1 month after the screening procedure were included. In total, 22 eligible studies met criteria for review, including 13 observational trials and 9 randomized controlled trials. Eligible studies used a broad range of validated and unvalidated measures. Anxiety was the most commonly assessed construct and was measured using the State Trait Anxiety Inventory. Studies included breast, colorectal, prostate, lung, and cervical screening procedures. Distress was low across procedures, with the exception of colorectal screening. Distress did not vary according to the time at which distress was measured. None of the studies were conducted exclusively with the intention of assessing distress at the time of screening. Evidence of low distress during the time of cancer screening suggests that distress might not be a widespread barrier to screening among adults who undergo screening. However, more studies are needed using validated measures of distress to further understand the extent to which screening may elicit psychological distress and impede adherence to national screening recommendations. Cancer 2017;123:3882-94. © 2017 American Cancer Society. © 2017 American Cancer Society.

47 CFR 80.1115 - Transmission of a distress alert by a station not itself in distress.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 5 2012-10-01 2012-10-01 false Transmission of a distress alert by a station not itself in distress. 80.1115 Section 80.1115 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE MARITIME SERVICES Global Maritime Distress and...

47 CFR 80.1115 - Transmission of a distress alert by a station not itself in distress.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 5 2014-10-01 2014-10-01 false Transmission of a distress alert by a station not itself in distress. 80.1115 Section 80.1115 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE MARITIME SERVICES Global Maritime Distress and...

46 CFR 28.145 - Distress signals.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 1 2011-10-01 2011-10-01 false Distress signals. 28.145 Section 28.145 Shipping COAST... VESSELS Requirements for All Vessels § 28.145 Distress signals. Except as provided by 28.305, each vessel must be equipped with the distress signals specified in table 28.145. Table 28.145—Distress Signals...

46 CFR 28.145 - Distress signals.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 1 2012-10-01 2012-10-01 false Distress signals. 28.145 Section 28.145 Shipping COAST... VESSELS Requirements for All Vessels § 28.145 Distress signals. Except as provided by 28.305, each vessel must be equipped with the distress signals specified in table 28.145. Table 28.145—Distress Signals...

46 CFR 28.145 - Distress signals.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 1 2013-10-01 2013-10-01 false Distress signals. 28.145 Section 28.145 Shipping COAST... VESSELS Requirements for All Vessels § 28.145 Distress signals. Except as provided by 28.305, each vessel must be equipped with the distress signals specified in table 28.145. Table 28.145—Distress Signals...

46 CFR 28.145 - Distress signals.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 1 2014-10-01 2014-10-01 false Distress signals. 28.145 Section 28.145 Shipping COAST... VESSELS Requirements for All Vessels § 28.145 Distress signals. Except as provided by 28.305, each vessel must be equipped with the distress signals specified in table 28.145. Table 28.145—Distress Signals...

Psychological distress, gender, and health lifestyles in Belarus, Kazakhstan, Russia, and Ukraine.

PubMed

Cockerham, William C; Hinote, Brian P; Abbott, Pamela

2006-11-01

This paper examines the relationship between psychological distress, gender, and health lifestyles in Belarus, Kazakhstan, Russia, and Ukraine. These countries have been subjected to highly stressful and extensive social change associated with the transition out of communism. Data were collected by face-to-face interviews (n = 10,406) in November 2001. Distress was measured by 12 psychological distress symptoms. Health lifestyles focused on measures of alcohol consumption, smoking and diet. We found that females carried a much heavier burden of psychological distress than males, but this distress did not translate into greater alcohol consumption and smoking for these women or for men. The greatest influence of distress on health lifestyle practices was on daily diets in that both less distressed females and males consumed a more balanced diet than more distressed persons. Our findings suggest that it is the normative demands of a particular lifestyle, rather than distress, that principally shapes the pattern of heavy male drinking. This is an important finding as some sources indicate heavy drinking is largely responsible for the health crisis in the former socialist states.

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

PubMed

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

2006-09-01

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

Psychometric validation of the Growth and Empowerment Measure (GEM) applied with Indigenous Australians.

PubMed

Haswell, Melissa R; Kavanagh, David; Tsey, Komla; Reilly, Lyndon; Cadet-James, Yvonne; Laliberte, Arlene; Wilson, Andrew; Doran, Chris

2010-09-01

Empowerment is a complex process of psychological, social, organizational and structural change. It allows individuals and groups to achieve positive growth and effectively address the social and psychological impacts of historical oppression, marginalization and disadvantage. The Growth and Empowerment Measure (GEM) was developed to measure change in dimensions of empowerment as defined and described by Aboriginal Australians who participated in the Family Well Being programme. The GEM has two components: a 14-item Emotional Empowerment Scale (EES14) and 12 Scenarios (12S). It is accompanied by the Kessler 6 Psychological Distress Scale (K6), supplemented by two questions assessing frequency of happy and angry feelings. For validation, the measure was applied with 184 Indigenous Australian participants involved in personal and/or organizational social health activities. Psychometric analyses of the new instruments support their validity and reliability and indicate two-component structures for both the EES (Self-capacity; Inner peace) and the 12S (Healing and enabling growth, Connection and purpose). Strong correlations were observed across the scales and subscales. Participants who scored higher on the newly developed scales showed lower distress on the K6, particularly when the two additional questions were included. However, exploratory factor analyses demonstrated that GEM subscales are separable from the Kessler distress measure. The GEM shows promise in enabling measurement and enhancing understanding of both process and outcome of psychological and social empowerment within an Australian Indigenous context.

An Innovative Cooling Jacket to Combat Heat Intolerance in Children with Anhidrosis.

PubMed

Inamadar, Arun C; Palit, Aparna; Khurana, Neha

2017-07-01

Hyperthermia and heat intolerance are distressing symptoms in patients with anhidrosis. Body cooling devices are an integral part of management of these patients. A cooling jacket made from easily available materials has been invented for a girl with congenital insensitivity to pain and anhidrosis with severe heat intolerance. This innovative cooling jacket may be helpful for anhidrotic children in resource-poor situations. © 2017 Wiley Periodicals, Inc.

Neonatal respiratory distress syndrome

MedlinePlus

Hyaline membrane disease (HMD); Infant respiratory distress syndrome; Respiratory distress syndrome in infants; RDS - infants ... improves slowly after that. Some infants with severe respiratory distress syndrome will die. This most often occurs ...

Distinguishing Between Spiritual Distress, General Distress, Spiritual Well-Being, and Spiritual Pain Among Cancer Patients During Oncology Treatment.

PubMed

Schultz, Michael; Meged-Book, Tehilah; Mashiach, Tanya; Bar-Sela, Gil

2017-07-01

Spiritual distress is present in approximately 25% of oncology patients. We examined the extent to which this measure is identical to a variety of other measures, such as spiritual well-being, spiritual injury, spiritual pain, and general distress. Structured interview of oncology outpatients over 12 months, approached nonselectively. The presence or absence of spiritual distress was compared against spiritual pain and two spiritual well-being tools: Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being 12-Item Scale (FACIT-Sp-12) and the Spiritual Injury Scale (SIS). We also examined whether a general distress visual analogue scale sufficed to identify spiritual distress. Other questions concerned demographic and clinical data. Of 416 patients approached, 202 completed the interview, of whom 23% reported spiritual distress. All measures showed significant correlation (receiver operating characteristic, area under the curve: SIS 0.79; distress thermometer [DT] 0.68; FACIT-Sp-12 0.67), yet none were identical with spiritual distress (sensitivity/specificity: SIS 64%/79%; spiritual pain 72%/76%; DT 41%/76%; FACIT-Sp-12 57%/72%). Of the FACIT-Sp-12 subscales, only peace correlated with spiritual distress. A significant predictor of spiritual distress was patients' self-evaluation of grave clinical condition (odds ratio 3.3; 95% CI 1.1-9.5). Multivariable analysis of individual measure items suggests an alternative three-parameter model for spiritual distress: not feeling peaceful, feeling unable to accept that this is happening, and perceived severity of one's illness. The DT is not sufficient to identify spiritual distress. The peace subscale of FACIT-Sp-12 is a better match than the measure as a whole. The SIS is the best match for spiritual distress, although an imperfect one. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

The impact of parental bonding on sexual distress in women with type 1 diabetes mellitus.

PubMed

Bargiota, Alexandra; Dimitropoulos, Konstantinos; Mouzas, Odysseas; Melekos, Michael; Tzortzis, Vassilios; Koukoulis, Georgios

2013-02-01

Psychosomatic and social issues have been found to be determinants of sexual distress in diabetic and non-diabetic populations. However, the role of parental bonding as a determinant for sexual distress has not been studied in women with type 1 diabetes mellitus (DM-1). To study the role of parental care and overprotection, in the pathogenesis of sexual distress in women with DM-1. Seventy-seven women with uncomplicated DM-1 and 77 healthy controls were enrolled in the study. The Female Sexual Distress Scale (FSDS), the General Health Questionnaire-28, and the Parental Bonding Instrument were used to evaluate sexual distress, general health and bonding with parents, respectively. To assess the role of parental bonding as risk factor for sexual distress, in women with DM-1. Women with DM-1 had significantly higher FSDS scores compared with controls. Furthermore, women with DM-1 had significantly higher maternal and paternal care, and lower maternal overprotection in comparison with the healthy ones. Paternal overprotection and general health were similar in both groups (P > 0.05). Sexual distress was more frequent in women with DM-1 (31.43% vs. 8.57% of controls, P < 0.05). Diabetic women with sexual distress had lower maternal care, higher maternal overprotection and lower paternal overprotection compared to diabetics without sexual distress (P < 0.05). No difference was found in the paternal care between the two groups (P > 0.05). Moreover, sexually distressed DM-1 women had worse general health parameters in comparison with the non-sexually distressed diabetics (P < 0.05). In the DM-1 group, low maternal care and low paternal overprotection were significant risk factors for sexual distress (P < 0.05). Parental care and overprotection can lead to sexual distress and, therefore, to Female Sexual Dysfunction in DM-1 women. Evaluation of parental bonding is necessary in DM-1 women with distressing sexual problems. © 2012 International Society for Sexual Medicine.

Ceramic regenerator systems development program. [for automobile gas turbine engines

NASA Technical Reports Server (NTRS)

Cook, J. A.; Fucinari, C. A.; Lingscheit, J. N.; Rahnke, C. J.

1977-01-01

Ceramic regenerator cores are considered that can be used in passenger car gas turbine engines, Stirling engines, and industrial/truck gas turbine engines. Improved materials and design concepts aimed at reducing or eliminating chemical attack were placed on durability test in Ford 707 industrial gas turbine engines. The results of 19,600 hours of turbine engine durability testing are described. Two materials, aluminum silicate and magnesium aluminum silicate, continue to show promise toward achieving the durability objectives of this program. A regenerator core made from aluminum silicate showed minimal evidence of chemical attack damage after 6935 hours of engine test at 800 C and another showed little distress after 3510 hours at 982 C. Results obtained in ceramic material screening tests, aerothermodynamic performance tests, stress analysis, cost studies, and material specifications are also included.

A pavement Moisture Accelerated Distress (MAD) identification system, volume 2

NASA Astrophysics Data System (ADS)

Carpenter, S. H.; Darter, M. I.; Dempsey, B. J.

1981-09-01

A users manual is designed which provides the engineer with a rational method of examining a pavement and determining rehabilitation needs that are related to the causes of the existing distress, particularly moisture related distress. The key elements in this procedure are the MAD Index developed in Volume 1, the Pavement Condition Index (PCI) and the Moisture Distress Index (MDI). Step by step procedures are presented for calculating each parameter. Complete distress identification manuals are included for asphalt surfaced highways and jointed reinforced concrete highways with pictures and descriptions of all major distress types. Descriptions of the role moisture plays in the development of each distress type are included.

Idioms of Distress.

PubMed

Desai, Geetha; Chaturvedi, Santosh K

2017-08-01

The presentations of psychosocial distress and cultural conflicts are often bodily symptoms, especially in traditional societies and village backgrounds. These might not meet the criteria of the current psychiatric diagnostic systems. Sociocultural milieu contributes to the unique presentations of the stress in the form of idioms of distress. The latter are alternative modes of expressing distress and indicate manifestations of distress in relation to personal and cultural meaning. Health professionals often consider these as hysterical, functional or having functional overlays, and abnormal illness behaviors. Management of idioms of distress would need cultural competence and sensitivity. This article highlights the common idioms of distress in India with specific focus on bodily symptoms.

Idioms of Distress

PubMed Central

Desai, Geetha; Chaturvedi, Santosh K.

2017-01-01

The presentations of psychosocial distress and cultural conflicts are often bodily symptoms, especially in traditional societies and village backgrounds. These might not meet the criteria of the current psychiatric diagnostic systems. Sociocultural milieu contributes to the unique presentations of the stress in the form of idioms of distress. The latter are alternative modes of expressing distress and indicate manifestations of distress in relation to personal and cultural meaning. Health professionals often consider these as hysterical, functional or having functional overlays, and abnormal illness behaviors. Management of idioms of distress would need cultural competence and sensitivity. This article highlights the common idioms of distress in India with specific focus on bodily symptoms. PMID:28936079

Medical students' experiences of moral distress: development of a web-based survey.

PubMed

Wiggleton, Catherine; Petrusa, Emil; Loomis, Kim; Tarpley, John; Tarpley, Margaret; O'Gorman, Mary Lou; Miller, Bonnie

2010-01-01

To develop an instrument for measuring moral distress in medical students, measuring the prevalence of moral distress in a cohort of students, and identifying the situations most likely to cause it. Moral distress, defined as the negative feelings that arise when one knows the morally correct thing to do but cannot act because of constraints or hierarchies, has been documented in nurses but has not been measured in medical students. The authors constructed a survey consisting of 55 items describing potentially distressing situations. Responders rated the frequency of these situations and the intensity of distress that they caused. The survey was administered to 106 fourth-year medical students during a three-week period in 2007; the response rate was 60%. Each of the situations was experienced by at least some of the 64 respondents, and each created some degree of moral distress. On average, students witnessed almost one-half of the situations at least once, and more than one-third of the situations caused mild-to-moderate distress. The survey measured individual distress (Cronbach alpha = 0.95), which varied among the students. Whereas women witnessed potentially distressing situations significantly more frequently than did men (P = .04), men tended to become more distressed by each event witnessed (P = .057). Medical students frequently experience moral distress. Our survey can be used to measure aspects of the learning environment as well as individual responses to the environment. The variation found among student responses warrants further investigation to determine whether students at either extreme of moral distress are at risk of burnout or erosion of professionalism.

Determinants of moral distress in daily nursing practice: a cross sectional correlational questionnaire survey.

PubMed

de Veer, Anke J E; Francke, Anneke L; Struijs, Alies; Willems, Dick L

2013-01-01

Moral distress is associated with job dissatisfaction, turnover and early retirement. Because of these negative consequences moral distress should be reduced. Little research has been done on what job factors contribute to whether or not a situation causes moral distress. To identify individual and job characteristics associated with moral distress in nursing staff. This is a cross sectional correlational study. Nursing staff members completed two survey questionnaires with a time-interval of 3 months. In the first survey questions were asked about job characteristics and job satisfaction. Three months afterwards the respondents answered questions on moral distress. 365 nursing staff members employed in nursing homes, homes for the elderly, home care and acute care hospitals completed both questionnaires. High moral distress levels were related to lower job satisfaction. Moral distress is higher when nurses perceive less time available to give care to patients. If satisfaction with the consultation possibilities within the team is low and when an instrumental leadership style exists, nursing staff members are also more likely to experience moral distress. Nursing staff members working 30-40h per week experience less moral distress than colleagues working fewer hours per week. Multivariate analyses showed no relations with other individual characteristics measured. Job characteristics that contribute to moral distress should be an issue for managers because it is related to job satisfaction. Interventions to reduce moral distress should target at organisational issues. The way a team is supported can raise or decrease moral distress levels. Copyright © 2012 Elsevier Ltd. All rights reserved.

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

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.

Cancer-Related Distress in Young Adults Compared to Middle-Aged and Senior Adults.

PubMed

Burgoyne, Mary Jo; Bingen, Kristin; Leuck, Julianne; Dasgupta, Mahua; Ryan, Polly; Hoffmann, Raymond G

2015-06-01

Little is known about cancer-related distress during young adulthood. Results from the few studies that have directly assessed this age group have indicated that young adults (YAs) may be at greater risk of developing psychosocial difficulties due to their unique challenges of coping with cancer. This study's objective was to investigate cancer-related distress in YAs compared to older adults. This retrospective cross-sectional study compared the distress level of YAs (18-39 years old) with that of middle-aged (40-64 years old) and senior adults (65-90 years old) using the Distress Thermometer (DT) and associated Problem List (PL). Factors that may be associated with distress by age group were examined, including demographics, cancer type, and PL items endorsed. YAs had higher cancer-related distress than senior adults but similar distress levels to middle-aged adults. Findings from distress comparisons across demographics, cancer types, and PL items endorsed suggest that YAs and middle-aged adults had similar distress patterns when compared to senior adults, who had the lowest DT scores. Multivariable analyses indicated age-related risk factors for high distress, including gynecologic cancers for YAs; divorced, single, or unemployed statuses for middle-aged adults; and being of Hispanic ethnicity for senior adults. Female gender and practical, emotional, and physical problems were associated with distress for all age groups. There is a differential impact of cancer by age. It is important to screen for cancer-related distress, paying attention to risk factors by age to determine age-appropriate supportive care needs.

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

PubMed

O'Connor, Daryl B; Ashley, Laura

2008-09-01

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

Assault-related shame mediates the association between negative social reactions to disclosure of sexual assault and psychological distress.

PubMed

DeCou, Christopher R; Cole, Trevor T; Lynch, Shannon M; Wong, Maria M; Matthews, Kathleen C

2017-03-01

Several studies have identified associations between social reactions to disclosure of sexual assault and psychological distress; however, no studies have evaluated shame as a mediator of this association. This study evaluated assault-related shame as a mediator of the associations between negative social reactions to disclosure of sexual assault and symptoms of posttraumatic stress disorder (PTSD), depression, and global distress and hypothesized that there would be an indirect effect of social reactions to disclosure upon symptoms of psychopathology via assault-related shame. Participants were 207 female psychology undergraduates who reported past history of completed or attempted sexual assault and had disclosed the assault to at least 1 other person. Participants completed self-report measures of social reactions to sexual assault disclosure, assault-related shame, and symptoms of psychopathology. Participants reported significant histories of attempted or completed sexual assault and indicated clinically significant symptoms of depression and subthreshold symptoms of PTSD and global distress, on average. Evaluation of structural models confirmed the hypothesized indirect effect of negative social reactions to sexual assault disclosure upon symptoms of PTSD (z = 5.85, p < .001), depression (z = 4.56, p < .001), and global distress (z = 4.82, p < .001) via assault-related shame. These findings offer new insight concerning the intervening role of assault-related shame and highlight the importance of shame as a target for therapeutic intervention. This study suggests the need for future research concerning the role of shame in the etiology of PTSD and process of disclosure among survivors of attempted or completed sexual assault. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Virtual Milgram: Empathic Concern or Personal Distress? Evidence from Functional MRI and Dispositional Measures

PubMed Central

Cheetham, Marcus; Pedroni, Andreas F.; Antley, Angus; Slater, Mel; Jäncke, Lutz

2009-01-01

One motive for behaving as the agent of another's aggression appears to be anchored in as yet unelucidated mechanisms of obedience to authority. In a recent partial replication of Milgram's obedience paradigm within an immersive virtual environment, participants administered pain to a female virtual human and observed her suffering. Whether the participants’ response to the latter was more akin to other-oriented empathic concern for her well-being or to a self-oriented aversive state of personal distress in response to her distress is unclear. Using the stimuli from that study, this event-related fMRI-based study analysed brain activity during observation of the victim in pain versus not in pain. This contrast revealed activation in pre-defined brain areas known to be involved in affective processing but not in those commonly associated with affect sharing (e.g., ACC and insula). We then examined whether different dimensions of dispositional empathy predict activity within the same pre-defined brain regions: While personal distress and fantasy (i.e., tendency to transpose oneself into fictional situations and characters) predicted brain activity, empathic concern and perspective taking predicted no change in neuronal response associated with pain observation. These exploratory findings suggest that there is a distinct pattern of brain activity associated with observing the pain-related behaviour of the victim within the context of this social dilemma, that this observation evoked a self-oriented aversive state of personal distress, and that the objective “reality” of pain is of secondary importance for this response. These findings provide a starting point for experimentally more rigorous investigation of obedience. PMID:19876407

Eudaimonic Well-Being and Tumor Norepinephrine in Epithelial Ovarian Cancer Patients

PubMed Central

Davis, Lauren Z.; Slavich, George M.; Thaker, Premal H.; Goodheart, Michael J.; Bender, David; Dahmoush, Laila; Farley, Donna; Markon, Kristian; Penedo, Frank J.; Lubaroff, David M.; Cole, Steve W.; Sood, Anil K.; Lutgendorf, Susan K.

2015-01-01

Background The impact of psychological well-being on physiologic processes involved in cancer progression remains unclear. Prior research has implicated adrenergic signaling in tumor growth and metastasis. Given that adrenergic signaling is influenced by both positive and negative factors, we examined how two different aspects of well-being (eudaimonic and positive affect) and psychological distress were associated with tumor norepinephrine (NE) in ovarian cancer patients. Methods Women with suspected ovarian cancer (N=365) completed psychosocial assessments pre-surgery and clinical information was obtained from medical records. Study inclusion was confirmed following histological diagnosis. Tumor NE was measured in frozen tissue samples using HPLC with electrochemical detection. We employed confirmatory factor analysis to model eudaimonic well-being, positive affect, and psychological distress, and structural equation modeling (SEM) to examine associations between these factors and tumor NE. Results Eudaimonic well-being, positive affect, and psychological distress, modeled as distinct but correlated constructs, best fit the data (i.e., compared to unitary or 2-factor models) (RMSEA=.048, CFI=.982, SRMR=.035). SEM analyses that included physical well-being, stage, histology, psychological treatment history, beta-blocker use, and caffeine use as covariates had good model fit (RMSEA=.052, CFI=.955, SRMR=.036) and showed that eudaimonic well-being was related to lower tumor NE (β=−.24, p=.045). In contrast, we found no effects for positive affect or psychological distress. Conclusion Eudaimonic well-being is associated with lower tumor NE, independent of positive affect and psychological distress. Because adrenergic signaling is implicated in tumor progression, increasing eudaimonic well-being may improve both psychological and physiologic resilience in ovarian cancer patients. PMID:26096769

Social cognitions, distress, and leadership self-efficacy: associations with aggression for high-risk minority youth.

PubMed

Leff, Stephen S; Baker, Courtney N; Waasdorp, Tracy E; Vaughn, Nicole A; Bevans, Katherine B; Thomas, Nicole A; Guerra, Terry; Hausman, Alice J; Monopoli, W John

2014-08-01

Urban ethnic minority youth are often exposed to high levels of aggression and violence. As such, many aggression intervention programs that have been designed with suburban nonethnic minority youth have been used or slightly adapted in order to try and meet the needs of high-risk urban youth. The current study contributes to the literature base by examining how well a range of social-cognitive, emotional distress and victimization, and prosocial factors are related to youth aggression in a sample of urban youth. This study utilized data gathered from 109 9- to 15-year-old youth (36.7% male; 84.4% African American) and their parents or caregivers. A series of hierarchical multiple regressions were fit predicting youth aggression from social-cognitive variables, victimization and distress, and prosocial variables, controlling for youth gender and age. Each set of variables explained a significant and unique amount of the variance in youth aggressive behavior. The full model including all predictors accounted for 41% of the variance in aggression. Models suggest that youth with stronger beliefs supportive of violence, youth who experience more overt victimization, and youth who experience greater distress in overtly aggressive situations are likely to be more aggressive. In contrast, youth with higher self-esteem and youth who endorse greater leadership efficacy are likely to be less aggressive. Contrary to hypotheses, hostile attributional bias and knowledge of social information processing, experience of relational victimization, distress in relationally aggressive situations, and community engagement were not associated with aggression. Our study is one of the first to address these important questions for low-income, predominately ethnic minority urban youth, and it has clear implications for adapting aggression prevention programs to be culturally sensitive for urban African American youth.

Testing Cross-Sectional and Prospective Mediators of Internalized Heterosexism on Heavy Drinking, Alcohol Problems, and Psychological Distress Among Heavy Drinking Men Who Have Sex With Men.

PubMed

Kuerbis, Alexis; Mereish, Ethan H; Hayes, Marie; Davis, Christine M; Shao, Sijing; Morgenstern, Jon

2017-01-01

Minority stress theory is one of the primary theories used to understand substance use among lesbian, gay, and bisexual populations. This study tested whether drinking to cope with stress (DTC), loneliness, and gay community participation (GCP) mediated the relationship between one type of minority stress (i.e., internalized heterosexism) and behavioral health outcomes. Using secondary data analysis and the PROCESS procedure, relationships between internalized heterosexism, the mediators (DTC, loneliness, and GCP), and outcomes (heavy drinking, alcohol problems, and psychological distress) were explored, both cross-sectionally and in a lagged manner, among both treatment-seeking and non-treatment-seeking problem drinking men who have sex with men. Problem drinkers (N = 187) were assessed, provided brief normative feedback about their drinking, given the choice to receive brief alcohol use disorder treatment or change on their own, and then followed for 9 months. Cross-sectional findings revealed that internalized heterosexism was significantly associated with heavy drinking, alcohol problems, and psychological distress. DTC emerged as a significant mediator of internalized heterosexism for all the health outcomes. Loneliness and GCP were significant mediators of internalized heterosexism for alcohol problems and psychological distress. Multiple mediation models reveal that all three mediators significantly contribute to internalized heterosexism's effect on health outcomes. Lagged analyses did not yield any significant indirect effects. DTC, loneliness, and GCP all play an integral, mediational role in the relationship between internalized heterosexism and alcohol problems and psychological distress. Findings underscore the necessity of addressing internalized heterosexism in psychosocial interventions along with coping skills training, emphasizing culturally relevant social support and loneliness.

Assessment of work intensification by managers and psychological distressed and non-distressed employees: a multilevel comparison.

PubMed

Bamberger, Simon Grandjean; Larsen, Anelia; Vinding, Anker Lund; Nielsen, Peter; Fonager, Kirsten; Nielsen, René Nesgaard; Ryom, Pia; Omland, Øyvind

2015-01-01

Work intensification is a popular management strategy to increase productivity, but at the possible expense of employee mental stress. This study examines associations between ratings of work intensification and psychological distress, and the level of agreement between compared employee-rated and manager-rated work intensification. Multi-source survey data were collected from 3,064 employees and 573 company managers from the private sector in 2010. Multilevel regression models were used to compare different work intensification ratings across psychological distress strata. Distressed employees rated higher degree of total work intensification compared to non-distressed employees, and on three out of five sub ratings there were an increased prevalence of work intensification in the case group. In general, there was poor agreement between employee and company work intensification rating. Neither manager-rated work intensification nor employee/manager discrepancy in work intensification ratings was associated with psychological distress. Distressed employees had a higher total score of employee/manager agreed work intensification, and a higher prevalence of increased demands of labour productivity. This study demonstrates higher ratings of employee/manager agreed work intensification in distressed employees compared to non-distressed employees, challenging previous findings of reporting bias in distressed employees' assessment of work environment.

Assessment of work intensification by managers and psychological distressed and non-distressed employees: a multilevel comparison

PubMed Central

BAMBERGER, Simon Grandjean; LARSEN, Anelia; VINDING, Anker Lund; NIELSEN, Peter; FONAGER, Kirsten; NIELSEN, René Nesgaard; RYOM, Pia; OMLAND, Øyvind

2015-01-01

Work intensification is a popular management strategy to increase productivity, but at the possible expense of employee mental stress. This study examines associations between ratings of work intensification and psychological distress, and the level of agreement between compared employee-rated and manager-rated work intensification. Multi-source survey data were collected from 3,064 employees and 573 company managers from the private sector in 2010. Multilevel regression models were used to compare different work intensification ratings across psychological distress strata. Distressed employees rated higher degree of total work intensification compared to non-distressed employees, and on three out of five sub ratings there were an increased prevalence of work intensification in the case group. In general, there was poor agreement between employee and company work intensification rating. Neither manager-rated work intensification nor employee/manager discrepancy in work intensification ratings was associated with psychological distress. Distressed employees had a higher total score of employee/manager agreed work intensification, and a higher prevalence of increased demands of labour productivity. This study demonstrates higher ratings of employee/manager agreed work intensification in distressed employees compared to non-distressed employees, challenging previous findings of reporting bias in distressed employees’ assessment of work environment. PMID:25752252

Relationship between negative mental adjustment to cancer and distress in thyroid cancer patients.

PubMed

Seok, Jeong-Ho; Choi, Won-Jung; Lee, Yong Sang; Park, Cheong Soo; Oh, Young-Ja; Kim, Jong-Sun; Chang, Hang-Seok

2013-05-01

Previous studies have reported that over a third of cancer patients experience significant psychological distress with diagnosis and treatment of cancer. Mental adjustment to cancer as well as other biologic and demographic factors may be associated with their distress. We investigated the relationship between mental adjustment and distress in patients with thyroid cancer prior to thyroidectomy. One hundred and fifty-two thyroid cancer patients were included in the final analysis. After global distress levels were screened with a distress thermometer, patients were evaluated concerning mental adjustment to cancer, as well as demographic and cancer-related characteristics. A thyroid function test was also performed. Regression analysis was performed to discern significant factors associated with distress in thyroid cancer patients. Our regression model was significant and explained 38.5% of the total variance in distress of this patient group. Anxious-preoccupation and helpless-hopeless factors on the mental adjustment to cancer scale were significantly associated with distress in thyroid cancer patients. Negative emotional response to cancer diagnosis may be associated with distress in thyroid cancer patients awaiting thyroidectomy. Screening of mental coping strategies at the beginning of cancer treatment may predict psychological distress in cancer patients. Further studies on the efficacy of psychiatric intervention during cancer treatment may be needed for patients showing maladaptive psychological responses to cancer.

Review of a Parent's Influence on Pediatric Procedural Distress and Recovery.

PubMed

Brown, Erin A; De Young, Alexandra; Kimble, Roy; Kenardy, Justin

2018-06-01

Understanding how parents influence their child's medical procedures can inform future work to reduce pediatric procedural distress and improve recovery outcomes. Following a pediatric injury or illness diagnosis, the associated medical procedures can be potentially traumatic events that are often painful and distressing and can lead to the child experiencing long-term physical and psychological problems. Children under 6 years old are particularly at risk of illness or injury, yet their pain-related distress during medical procedures is often difficult to manage because of their young developmental level. Parents can also experience ongoing psychological distress following a child's injury or illness diagnosis. The parent and parenting behavior is one of many risk factors for increased pediatric procedural distress. The impact of parents on pediatric procedural distress is an important yet not well-understood phenomenon. There is some evidence to indicate parents influence their child through their own psychological distress and through parenting behavior. This paper has three purposes: (1) review current empirical research on parent-related risk factors for distressing pediatric medical procedures, and longer-term recovery outcomes; (2) consider and develop existing theories to present a new model for understanding the parent-child distress relationship during medical procedures; and (3) review and make recommendations regarding current assessment tools and developing parenting behavior interventions for reducing pediatric procedural distress.

Moral distress and intention to leave: A comparison of adult and paediatric nurses by hospital setting.

PubMed

Dyo, Melissa; Kalowes, Peggy; Devries, Jessica

2016-10-01

To assess moral distress intensity and frequency in adult/paediatric nurses in critical care and non-critical care units; and explore relationships of nurse characteristics and moral distress with intention to leave. A descriptive, correlational design was used to administer an online survey using the Moral Distress Scale to nurses across multiple settings. Intensity and frequency of moral distress and intention to leave current position. The survey response rate was 43% (n=426/1000). Critical care nurses had the highest levels of moral distress intensity and frequency, compared to non-critical care specialties (M=2.5±0.19, p=0.005 for intensity and M=1.6±0.11, p<0.001 for frequency). Moral distress frequency showed a positive relationship with intention to leave a position of employment. Each unit increase in moral distress frequency doubled the odds of intention to leave when adjusting for age, gender, ethnicity and specialty area (p=0.003). Hispanic nurses had significantly higher levels of moral distress intensity (p=0.01). Moral distress is a complex phenomenon requiring further study, particularly with regard to the role of ethnic and cultural differences on perceptions of moral distress. Copyright © 2016 Elsevier Ltd. All rights reserved.

Framing the issues: moral distress in health care.

PubMed

Pauly, Bernadette M; Varcoe, Colleen; Storch, Jan

2012-03-01

Moral distress in health care has been identified as a growing concern and a focus of research in nursing and health care for almost three decades. Researchers and theorists have argued that moral distress has both short and long-term consequences. Moral distress has implications for satisfaction, recruitment and retention of health care providers and implications for the delivery of safe and competent quality patient care. In over a decade of research on ethical practice, registered nurses and other health care practitioners have repeatedly identified moral distress as a concern and called for action. However, research and action on moral distress has been constrained by lack of conceptual clarity and theoretical confusion as to the meaning and underpinnings of moral distress. To further examine these issues and foster action on moral distress, three members of the University of Victoria/University of British Columbia (UVIC/UVIC) nursing ethics research team initiated the development and delivery of a multi-faceted and interdisciplinary symposium on Moral Distress with international experts, researchers, and practitioners. The goal of the symposium was to develop an agenda for action on moral distress in health care. We sought to develop a plan of action that would encompass recommendations for education, practice, research and policy. The papers in this special issue of HEC Forum arose from that symposium. In this first paper, we provide an introduction to moral distress; make explicit some of the challenges associated with theoretical and conceptual constructions of moral distress; and discuss the barriers to the development of research, education, and policy that could, if addressed, foster action on moral distress in health care practice. The following three papers were written by key international experts on moral distress, who explore in-depth the issues in three arenas: education, practice, research. In the fifth and last paper in the series, we highlight key insights from the symposium and the papers in the series, propose to redefine moral distress, and outline directions for an agenda for action on moral distress in health care.

Pediatric acute respiratory distress syndrome: definition, incidence, and epidemiology: proceedings from the Pediatric Acute Lung Injury Consensus Conference.

PubMed

Khemani, Robinder G; Smith, Lincoln S; Zimmerman, Jerry J; Erickson, Simon

2015-06-01

Although there are similarities in the pathophysiology of acute respiratory distress syndrome in adults and children, pediatric-specific practice patterns, comorbidities, and differences in outcome necessitate a pediatric-specific definition. We sought to create such a definition. A subgroup of pediatric acute respiratory distress syndrome investigators who drafted a pediatric-specific definition of acute respiratory distress syndrome based on consensus opinion and supported by detailed literature review tested elements of the definition with patient data from previously published investigations. International PICUs. Children enrolled in published investigations of pediatric acute respiratory distress syndrome. None. Several aspects of the proposed pediatric acute respiratory distress syndrome definition align with the Berlin Definition of acute respiratory distress syndrome in adults: timing of acute respiratory distress syndrome after a known risk factor, the potential for acute respiratory distress syndrome to coexist with left ventricular dysfunction, and the importance of identifying a group of patients at risk to develop acute respiratory distress syndrome. There are insufficient data to support any specific age for "adult" acute respiratory distress syndrome compared with "pediatric" acute respiratory distress syndrome. However, children with perinatal-related respiratory failure should be excluded from the definition of pediatric acute respiratory distress syndrome. Larger departures from the Berlin Definition surround 1) simplification of chest imaging criteria to eliminate bilateral infiltrates; 2) use of pulse oximetry-based criteria when PaO2 is unavailable; 3) inclusion of oxygenation index and oxygen saturation index instead of PaO2/FIO2 ratio with a minimum positive end-expiratory pressure level for invasively ventilated patients; 4) and specific inclusion of children with preexisting chronic lung disease or cyanotic congenital heart disease. This pediatric-specific definition for acute respiratory distress syndrome builds on the adult-based Berlin Definition, but has been modified to account for differences between adults and children with acute respiratory distress syndrome. We propose using this definition for future investigations and clinical care of children with pediatric acute respiratory distress syndrome and encourage external validation with the hope for continued iterative refinement of the definition.

Young Children Sympathize Less in Response to Unjustified Emotional Distress

ERIC Educational Resources Information Center

Hepach, Robert; Vaish, Amrisha; Tomasello, Michael

2013-01-01

Three-year-old children saw an adult displaying the exact same distress in 3 different conditions: (a) the adult's distress was appropriate to a genuine harm, (b) the adult's distress was an overreaction to a minor inconvenience, and (c) there was no apparent cause for the adult's distress. Children who witnessed the adult being appropriately…

Young men in 'crisis': attending to the language of teenage boys' distress.

PubMed

McQueen, Carolyn; Henwood, Karen

2002-11-01

The last two decades have seen a changing profile of young male mental health in Britain, including increased suicidal and parasuicidal behaviours. For mental health professionals to respond effectively and appropriately to meet these changing needs there needs to be further theorising and development of knowledge of young men's psychological processes and, in particular, how they make sense of their experiences within the cultural context of their lives. By drawing upon contemporary theories of subjectivities, this paper attempts to begin to address some of these issues. It looks in detail at two young men's accounts of their experiences of mental health problems. By using narrative, thematic and discourse analyses, the authors consider the cultural concepts the young men draw upon, and the language they use to voice their distress. The paper focuses on how gender and traditional masculinities constrain and influence the young men's narratives within the context of their individual life-histories and how these may become problematic for their mental health. The analyses provide a contemporary language-sensitive and culturally-sensitive reading of the young men's accounts of mental distress. It highlights how young men may talk about their distress in ways that are not immediately recognisable and extends the knowledge of the contemporary discourses used by young men in British society today. The implications for male subjectivities and mental health and therapeutic engagement are discussed.

Love flows downstream: mothers' and children's neural representation similarity in perceiving distress of self and family.

PubMed

Lee, Tae-Ho; Qu, Yang; Telzer, Eva H

2017-12-01

The current study aimed to capture empathy processing in an interpersonal context. Mother-adolescent dyads (N = 22) each completed an empathy task during fMRI, in which they imagined the target person in distressing scenes as either themselves or their family (i.e. child for the mother, mother for the child). Using multi-voxel pattern approach, we compared neural pattern similarity for the self and family conditions and found that mothers showed greater perceptual similarity between self and child in the fusiform face area (FFA), representing high self-child overlap, whereas adolescents showed significantly less self-mother overlap. Adolescents' pattern similarity was dependent upon family relationship quality, such that they showed greater self-mother overlap with higher relationship quality, whereas mothers' pattern similarity was independent of relationship quality. Furthermore, adolescents' perceptual similarity in the FFA was associated with increased social brain activation (e.g. temporal parietal junction). Mediation analyses indicated that high relationship quality was associated with greater social brain activation, which was mediated by greater self-mother overlap in the FFA. Our findings suggest that adolescents show more distinct neural patterns in perceiving their own vs their mother's distress, and such distinction is sensitive to mother-child relationship quality. In contrast, mothers' perception for their own and child's distress is highly similar and unconditional. © The Author (2017). Published by Oxford University Press.

Masculine norms, disclosure, and childhood adversities predict long-term mental distress among men with histories of child sexual abuse.

PubMed

Easton, Scott D

2014-02-01

Child sexual abuse (CSA) can have a profound effect on the long-term mental health of boys/men. However, not all men with histories of CSA experience psychopathology. To improve prevention and intervention services, more research is needed to understand why some male survivors experience mental health problems and others do not. The purpose of this study was to examine factors related to mental distress among a large, non-clinical sample of men with histories of CSA (N=487). Using a cross-sectional design with purposive sampling from three national survivor organizations, data were collected through an anonymous Internet-based survey. Multivariate analyses found that only one of the four CSA severity variables-use of physical force by the abuser-was related to mental distress. Additional factors that were related to mental distress included the number of other childhood adversities, years until disclosure, overall response to disclosure, and conformity to masculine norms. Overall, the final model predicted 36% of the variance in the number of mental health symptoms. Mental health practitioners should include masculine norms, disclosure history, and childhood adversities in assessments and intervention planning with male survivors. To more fully explicate risk factors for psychopathology in this population, future studies with probability samples of men that focus on mediational processes and use longitudinal designs are needed. Copyright © 2013 Elsevier Ltd. All rights reserved.

Love flows downstream: mothers’ and children’s neural representation similarity in perceiving distress of self and family

PubMed Central

Qu, Yang

2017-01-01

Abstract The current study aimed to capture empathy processing in an interpersonal context. Mother–adolescent dyads (N = 22) each completed an empathy task during fMRI, in which they imagined the target person in distressing scenes as either themselves or their family (i.e. child for the mother, mother for the child). Using multi-voxel pattern approach, we compared neural pattern similarity for the self and family conditions and found that mothers showed greater perceptual similarity between self and child in the fusiform face area (FFA), representing high self–child overlap, whereas adolescents showed significantly less self–mother overlap. Adolescents’ pattern similarity was dependent upon family relationship quality, such that they showed greater self–mother overlap with higher relationship quality, whereas mothers’ pattern similarity was independent of relationship quality. Furthermore, adolescents’ perceptual similarity in the FFA was associated with increased social brain activation (e.g. temporal parietal junction). Mediation analyses indicated that high relationship quality was associated with greater social brain activation, which was mediated by greater self–mother overlap in the FFA. Our findings suggest that adolescents show more distinct neural patterns in perceiving their own vs their mother’s distress, and such distinction is sensitive to mother–child relationship quality. In contrast, mothers’ perception for their own and child’s distress is highly similar and unconditional. PMID:29069521

Idioms of distress: alternatives in the expression of psychosocial distress: a case study from South India.

PubMed

Nichter, M

1981-12-01

This paper focuses attention on alternative modes of expressing distress and the need to analyze particular manifestations of distress in relation to personal and cultural meaning complexes as well as the availability and social implications of coexisting idioms of expression. To illustrate this point the case of South Kanarese Havik Brahmin women is presented. These women are described as having a weak social support network and limited opportunities to ventilate feelings and seek counsel outside the household. Alternative means of expressing psychosocial distress resorted to by Havik women are discussed in relation to associated Brahminic values, norms and stereotypes. Somatization is focused upon as an important idiom through which distress is communicated. Idioms of distress more peripheral to the personal or cultural behavioral repertoire of Havik women are considered as adaptive responses in circumstances where other modes of expression fail to communicate distress adequately or provide appropriate coping strategies. The importance of an 'idioms of distress' approach to psychiatric evaluation is noted.

Systematic Review: Predisposing, Precipitating, Perpetuating, and Present Factors Predicting Anticipatory Distress to Painful Medical Procedures in Children

PubMed Central

Pillai Riddell, Rebecca R.; Khan, Maria; Calic, Masa; Taddio, Anna; Tablon, Paula

2016-01-01

Objective To conduct a systematic review of the factors predicting anticipatory distress to painful medical procedures in children. Methods A systematic search was conducted to identify studies with factors related to anticipatory distress to painful medical procedures in children aged 0–18 years. The search retrieved 7,088 articles to review against inclusion criteria. A total of 77 studies were included in the review. Results 31 factors were found to predict anticipatory distress to painful medical procedures in children. A narrative synthesis of the evidence was conducted, and a summary figure is presented. Conclusions Many factors were elucidated that contribute to the occurrence of anticipatory distress to painful medical procedures. The factors that appear to increase anticipatory distress are child psychopathology, difficult child temperament, parent distress promoting behaviors, parent situational distress, previous pain events, parent anticipation of distress, and parent anxious predisposition. Longitudinal and experimental research is needed to further elucidate these factors. PMID:26338981

Post-Event Processing in Children with Social Phobia

ERIC Educational Resources Information Center

Schmitz, Julian; Kramer, Martina; Blechert, Jens; Tuschen-Caffier, Brunna

2010-01-01

In the aftermath of a distressing social event, adults with social phobia (SP) engage in a review of this event with a focus on its negative aspects. To date, little is known about this post-event processing (PEP) and its relationship with perceived performance in SP children. We measured PEP in SP children (n = 24) and healthy controls (HC; n =…

Private College Mergers and State Policy: A Case Study of New York. State Policy and Private College Distress.

ERIC Educational Resources Information Center

Chambers, Gail S.

The regulation of the college merger process in New York, including its effects on a recent merger between private institutions, is examined. New York's higher education policy formation process and the laws and policies that make college mergers possible are considered. The merger of Eisenhower College and Rochester Institute of Technology…

Impact of “Sick” and “Recovery” Roles on Brain Injury Rehabilitation Outcomes

PubMed Central

Barclay, David A.

2012-01-01

This study utilizes a multivariate, correlational, expost facto research design to examine Parsons' “sick role” as a dynamic, time-sensitive process of “sick role” and “recovery role” and the impact of this process on goal attainment (H1) and psychosocial distress (H2) of adult survivors of acquired brain injury. Measures used include the Brief Symptom Inventory-18, a Goal Attainment Scale, and an original instrument to measure sick role process. 60 survivors of ABI enrolled in community reentry rehabilitation participated. Stepwise regression analyses did not fully support the multivariate hypotheses. Two models emerged from the stepwise analyses. Goal attainment, gender, and postrehab responsibilities accounted for 40% of the shared variance of psychosocial distress. Anxiety and depression accounted for 22% of the shared variance of goal attainment with anxiety contributing to the majority of the explained variance. Bivariate analysis found sick role variables, anxiety, somatization, depression, gender, and goal attainment as significant. The study has implications for ABI rehabilitation in placing greater emphasis on sick role processes, anxiety, gender, and goal attainment in guiding program planning and future research with survivors of ABI. PMID:23119164

Effects of Guided Written Disclosure Protocol on mood states and psychological symptoms among parents of off-therapy acute lymphoblastic leukemia children.

PubMed

Martino, Maria Luisa; Freda, Maria Francesca; Camera, Flavia

2013-06-01

This study assesses the effects of Guided Written Disclosure Protocol on psychological distress in mothers and fathers of off-therapy acute lymphoblastic leukemia children. An experimental group participated in the writing intervention with a control group subject only to test-taking standards. The Symptom Questionnaire and Profile of Mood States were administered at baseline, post-intervention, and follow-up. Guided Written Disclosure Protocol had significant effects on the progressive reduction of anxiety, depression, somatic symptoms, hostility, tension-anxiety, and fatigue-inertia within the experimental group. However, the control group distress levels tended to worsen over time. The mediating role of emotional processing was highlighted.

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).

Gender, age and surgery as a treatment modality leads to higher distress in patients with cancer.

PubMed

Thomas, Bejoy C; NandaMohan, V; Nair, Madhvan K; Pandey, Manoj

2010-02-01

Distress has been defined as a multidimensional construct that extends along a continuum, ranging from common normal feelings of vulnerability, sadness and fears to problems that can become disabling, such as depression, anxiety, panic, social isolation and existential and spiritual crisis. Several studies have pointed out the need to screen for distress in the cancer. Emotional distress has been found as a core indicator of a patient's health and well-being and has installed it as the sixth vital sign. The aim of the present study was to identify the predictors of distress in cancer patients. For the present study, a total of 760 patients with cancer in a tertiary cancer centre were assessed using the Distress Inventory for Cancer Version 2 (DIC V2). A multivariate logistic regression was carried out to identify the predictors of distress and six subscales. Female patients under the age of 44 years scheduled to undergo surgery or those who had undergone surgery predicted significantly higher levels of overall distress. Composite disease stage other than stage IV metastatic disease and being a daily wage employee predicted significantly lower levels of overall distress. Higher distress among women undergoing surgery could imply distress associated with significant cosmetic disfigurement and feeling of loss of womanhood especially in those with breast or cervix cancer. The study once again demonstrate gender and age differences in distress and also highlights the importance of knowing that cancer is confined to one organ and has not spread.

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.

Parent and child distress after war exposure.

PubMed

Lai, Betty S; Hadi, Fawzyiah; Llabre, Maria M

2014-09-01

The purpose of this study was to examine multiple distress symptoms (i.e., post-traumatic stress [PTS], anxiety, depression) among parents and children exposed to the Gulf Crisis in 1990-1991. Profiles of parent distress were identified, and the relationship between parent distress and specific child distress symptoms was examined. Parents and children were assessed at one time point. Participants included 151 children (Mage = 10.62 years; 51% female) and 140 parents (Mage = 40 years; 81% female). Utilizing latent profile analysis, three parallel profiles of parent distress were identified: low distress, moderate distress, and high distress. Parent distress was a risk factor for child depression, but it was not a risk factor for child PTS or anxiety. Findings support the importance of broadening the scope of research conducted after exposure to traumatic events to include the assessment of anxiety and depression, as well as PTS, among both parents and children. Additional implications for research and clinical work are discussed. Findings support the importance of screening for multiple distress symptoms among both children and parents after war exposure. Based on our findings, clinicians may want to consider including parents in therapy for children reporting psychological distress, especially depression symptoms, after exposure to traumatic events. This study was cross-sectional. Thus, we are not able to infer direction or causality. The generalizability of our study should be interpreted with caution, as findings will need to be replicated across other populations and other cultures. © 2014 The British Psychological Society.

Evaluation of lignin as an antioxidant in asphalt binders and bituminous mixtures.

DOT National Transportation Integrated Search

2017-01-01

The chemical process of oxidative age-hardening in asphalt pavements is one of the major distresses : leading to hot mix asphalt (HMA) pavement failure as evidenced by fatigue and thermal (low temperature) : cracking. : Research investigations at the...

Abortion in Adolescence.

ERIC Educational Resources Information Center

Campbell, Nancy B.; And Others

1988-01-01

Explored differences between 35 women who had abortions as teenagers and 36 women who had abortions as adults. Respondents reported on their premorbid psychiatric histories, the decision-making process itself, and postabortion distress symptoms. Antisocial and paranoid personality disorders, drug abuse, and psychotic delusions were significantly…

Kansas Department of Transportation 2014 chip seal manual : [technical summary].

DOT National Transportation Integrated Search

2014-03-01

A chip seal is a very effective thin surface treatment process used by maintenance managers to preserve existing asphalt pavements. Two of the major asphalt pavement distresses, cracking and loss of friction are effectively addressed with the use of ...

Automated management for pavement inspection system (AMPIS)

NASA Astrophysics Data System (ADS)

Chung, Hung Chi; Girardello, Roberto; Soeller, Tony; Shinozuka, Masanobu

2003-08-01

An automated in-situ road surface distress surveying and management system, AMPIS, has been developed on the basis of video images within the framework of GIS software. Video image processing techniques are introduced to acquire, process and analyze the road surface images obtained from a moving vehicle. ArcGIS platform is used to integrate the routines of image processing and spatial analysis in handling the full-scale metropolitan highway surface distress detection and data fusion/management. This makes it possible to present user-friendly interfaces in GIS and to provide efficient visualizations of surveyed results not only for the use of transportation engineers to manage road surveying documentations, data acquisition, analysis and management, but also for financial officials to plan maintenance and repair programs and further evaluate the socio-economic impacts of highway degradation and deterioration. A review performed in this study on fundamental principle of Pavement Management System (PMS) and its implementation indicates that the proposed approach of using GIS concept and its tools for PMS application will reshape PMS into a new information technology-based system providing a convenient and efficient pavement inspection and management.

GIS-based automated management of highway surface crack inspection system

NASA Astrophysics Data System (ADS)

Chung, Hung-Chi; Shinozuka, Masanobu; Soeller, Tony; Girardello, Roberto

2004-07-01

An automated in-situ road surface distress surveying and management system, AMPIS, has been developed on the basis of video images within the framework of GIS software. Video image processing techniques are introduced to acquire, process and analyze the road surface images obtained from a moving vehicle. ArcGIS platform is used to integrate the routines of image processing and spatial analysis in handling the full-scale metropolitan highway surface distress detection and data fusion/management. This makes it possible to present user-friendly interfaces in GIS and to provide efficient visualizations of surveyed results not only for the use of transportation engineers to manage road surveying documentations, data acquisition, analysis and management, but also for financial officials to plan maintenance and repair programs and further evaluate the socio-economic impacts of highway degradation and deterioration. A review performed in this study on fundamental principle of Pavement Management System (PMS) and its implementation indicates that the proposed approach of using GIS concept and its tools for PMS application will reshape PMS into a new information technology-based system that can provide convenient and efficient pavement inspection and management.

Using the trauma film paradigm to explore interpersonal processes after trauma exposure.

PubMed

Woodward, Matthew J; Beck, J Gayle

2017-07-01

The present study sought to examine ways in which social support might influence trauma symptoms using a variation of the trauma film paradigm. Sixty-seven undergraduate female students in romantic relationships were randomized to watch a stressful film clip depicting a sexual assault, either in the presence (PP) or absence (PA) of their romantic partner. Analyses showed that the PP condition experienced more intrusive memories of the film than the PA condition. In addition, participants in the PP condition whose romantic partner reported low relationship trust had higher film-related distress than participants in the PP condition whose romantic partner reported high relationship trust. Observational coding of partner behaviors after viewing the film clip found that greater expression of negative emotion from partners predicted participants' negative affect and intrusive memories over time. Positive emotional support did not have any effect upon participants' distress. Findings identify possible ways in which interpersonal processes influence trauma adjustment and suggest that the trauma film paradigm can be adapted to examine the role of interpersonal processes in post-trauma adjustment. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

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

PubMed Central

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

2013-01-01

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