Current Psychological Distress Research Articles

Concussion history associated with adolescent psychological distress but not hazardous gambling: a cross-sectional study

BackgroundSustaining multiple concussions over one’s lifetime may be associated with behavioral and mood changes beyond the acute phase of injury. The present cross-sectional study examined the relationship between concussion history, the incidence of current moderate-severe psychological distress, and lifetime adolescent hazardous gambling in high school students.MethodsFour-hundred fifty-nine high school students from southern Sweden (age: 16.81 ± 0.83, 58.2% male) completed a survey assessing concussion history (0,1,2…>8), psychological distress using the Kessler-6 scale, and lifetime hazardous gambling using the NODS-CLiP scale.ResultsParticipants who self-reported three or more concussions were more likely to endorse moderate-severe symptoms of psychological distress than those with no concussion history while controlling for covariates, OR = 2.71, 95% CI [1.19, 6.18]. In contrast, concussion history was not associated with hazardous gambling after controlling for confounding variables.ConclusionsSelf-reporting three or more concussions was associated with increased current psychological distress beyond the acute phase of injury among high school students. Adolescents who have sustained multiple concussions should undergo mental health evaluations beyond the acute phase of injury to identify and treat psychological distress, but probing for hazardous gambling may not be clinically relevant in this previously concussed adolescent population.

Exploring Retrospective Parenting Styles and Parent-Child Relationship Quality as Correlates of Chinese Adults’ Current Psychological Distress: Influence of Family-of-Origin?

Exploring Retrospective Parenting Styles and Parent-Child Relationship Quality as Correlates of Chinese Adults’ Current Psychological Distress: Influence of Family-of-Origin?

Loneliness, Social Isolation, and Obsession with COVID-19 among Older Adults.

During the COVID-19 pandemic, older people were socially isolated for their protection against the virus impacting their mental health. Aiming to explore the role of loneliness and social isolation in the obsession with COVID-19 among older adults, we conducted an anonymous online survey with 300 older adults aged 65-80 years in South Korea between January and February 2023. The survey collected demographic information, past psychiatric history, medical disease, current psychological distress, and experiences related to COVID-19. Rating scales were the Obsession with COVID-19 Scale (OCS), Coronavirus Reassurance-seeking Behaviors Scale(CRBS), Stress and Anxiety to Viral Epidemics-6 items (SAVE-6), and Loneliness and Social Isolation Scale (LSIS). The regression analysis revealed that CRBS (β = 0.55, p < 0.001) and SAVE-6 (β = 0.34, p < 0.001) were significant predictors of obsession with COVID-19 (adjusted R2 = 0.63, F = 126.9, p < 0.001). Mediation analysis showed that loneliness and social isolation had a positive total effect on obsession with COVID-19, mediated by reassurance-seeking behavior and viral anxiety (Standardized Estimator = 0.21, standard error = 0.05, p < 0.001, 95% confidence interval 0.20-0.41). Loneliness and social isolation were found to be indirectly linked to obsession with COVID-19 through reassurance-seeking behavior and viral anxiety. The findings highlight the importance of addressing loneliness and social isolation among older adults during the COVID-19 pandemic to prevent obsession with COVID-19.

Paths from adverse and benevolent childhood experiences to personal growth after childbirth: The role of psychological distress, social support, and self-compassion.

Dealing with the difficulties and demands of the postpartum period may be distressing for the mother, but it is also an opportunity for her to experience personal growth. One factor that may contribute to this growth is the mother's childhood experiences. Using a prospective study design, and based on Belsky's parenting model and personal growth theory, we examined the direct and indirect contribution of mothers' adverse and benevolent childhood experiences and their current psychological distress, self-compassion, and social support to their personal growth following childbirth and motherhood. A convenience sample of 392 women was recruited through social media and participated in the study about 16 weeks after childbirth (Phase 1) and again 6-10 months postpartum (Phase 2). The direct effects of adverse and benevolent childhood experiences on personal growth were not significant. However, multiple significant paths of indirect associations were found through psychological distress, self-compassion, and social support. To understand the roots of the mother's personal growth, researchers and clinicians alike should not only explore her personal resources, but also the primary processes that contribute to the creation of those resources, that is, childhood experiences. Addressing the mother's childhood experiences may help her to better understand the connections between the past and the present, and to identify the implications of her "ghosts and angels" for her mental state, personal resources, and experience of personal growth. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Intergenerational effects of child maltreatment on adolescents’ anxiety and depression in Ethiopia: the important mediating and moderating roles of current psychological distress

BackgroundChild abuse is widespread around the world, and one continent with particularly high rates is Africa. Research in high- and middle-income countries shows the cascading effect of parental history of child abuse and neglect on adolescents’ maltreatment and, in turn, on mental health problems. This cascade has been reported in young children but has rarely been studied in parent-adolescent dyads or in low-income countries (LICs). The goal of this study was to test intergenerational associations of child abuse and neglect and to examine how these experiences are in turn associated with youth anxiety and depression in an LIC.MethodsA total of 231 adolescents (age: 13–21 years) and 185 of their parents (n = 90 fathers and n = 95 mothers) were recruited from secondary schools in Addis Abeba, Ethiopia. Using a cross-sectional design, participants completed a set of questionnaires assessing child maltreatment (in adolescence and own past history in parents), parental psychological distress, youth depression and anxiety, and sociodemographic factors.ResultsThe frequencies of child maltreatment exposure were 68% for adolescents and 65% for their parents (when they were a child). Fifty-one percent and 42% of adolescents had borderline to clinical levels of anxiety and depression symptoms, respectively. Adolescents of parents with a history of child abuse and neglect also reported higher exposure to maltreatment themselves (p < 0.001). Current paternal, but not maternal, psychological distress mediated this intergenerational association of maltreatment experiences (95% CI [1.164, 9.467]). We further found parents’ psychological distress to be a significant moderator of the indirect pathways of the intergenerational effect of child maltreatment on adolescents’ anxiety and depression (95% CI [− 0.770, − 0.012]).ConclusionsWe found child maltreatment to be intergenerationally associated, and this effect subsequently affected adolescents’ anxiety and depression through different pathways supporting the cascading effects across generations. Intervention plans may be effective through an array of possible indirect pathways and encourage the implementation of multiple access points to facilitate change in the lives of affected youth in Africa.

Childhood Bullying as a Predictor of Suicidality in Young Adults in a Nationwide Population-Based Health Examination Study

Objective Having been bullied at school in childhood links to suicidality. We aimed at verifying earlier findings and delivering diverse data from a representative population-based sample of young adults to characterize the impacts beyond childhood. Method A random sample of adults, aged 18–28 years and representative of the general population living in Finland, participated in a nationwide health examination study. Adverse childhood experiences before the age of 16 years were analyzed for 779 participants in relation to lifetime suicidality (suicidal ideation, suicide attempts), current suicidal thoughts (HSCL-25), mental disorders (self-reports for lifetime, M-CIDI for DSM-IV during the past 12 months), current usage of mental health services, current usage of prescription medicines (ATC codes), current psychological distress (GHQ-12), and current work capacity and work ability. Results Having been bullied in childhood contributed to greater suicidality (p < 0.001), more frequent current usage of antipsychotics (p < 0.001) as well as antidepressants (p < 0.001), greater current psychological distress (p < 0.001), and poorer current work capacity (p < 0.001) as well as work ability (p < 0.001). Of the self-reported mental disorders on lifetime basis, psychosis had the strongest association (p = 0.03) with having been bullied, whereas the interview-based diagnosis of mental disorders during the past 12 months had no significant association. Conclusions Having been bullied at school before the age of 16 years was independently associated not only with suicidality, but also with the self-report of psychosis as well as a range of indicators of poorer mental health at the age of 18–28 years.

The prevalence of child sexual abuse with online sexual abuse added

Background and objectiveResearch efforts are measuring various forms of online sexual abuse. There is a need to incorporate such measures of online sexual abuse into the calculation of overall prevalence rates for child sexual abuse. ParticipantsA sample of 2639 respondents aged 18-to-28 was recruited from a nationally representative online panel. MethodsUsing an online questionnaire, respondents were assessed via self-report about 9 types of online sexual abuse in childhood and were also assessed with 2 questions that have been used to assess generic child sexual abuse prevalence in previous surveys. ResultsThe addition of the online abuse to the generic questions about child sexual abuse raised the overall prevalence rate from 13.5 % to 21.7 %. The rate for females increased from 19.8 % to 31.6 % and for males from 6.2 % to 10.8 %. The largest independent contribution to the overall combined increase were the offenses involving non-consensual image sharing and voluntary online sexual interactions with an impermissibly older adult partner. The inclusion of the online sexual abuse exposures also increased the ability to identify the survivors with the highest levels of current psychological distress. ConclusionThe study highlights the importance of counting and including online sexual abuse in efforts to estimate the overall prevalence of childhood sexual abuse. The paper proposes 2 or 3 questions that could be added to sexual abuse questionnaires to assess these online offenses efficiently.

Test anxiety and its determinants among health sciences students at Mattu University: a cross-sectional study.

Test anxiety is a particular type of anxiety that is marked by physical, cognitive, and behavioural symptoms when taking and performing tests. It is defined as "severe stress" before, during, and after exams and other assessments. Test anxiety could cause poor academic performance and increase dropout rates. This study aimed to determine the levels of test anxiety and its determinants among health sciences students at Mattu University. An institution-based cross-sectional study was conducted among 421 selected students from June 1 to June 30, 2021. The study utilized the Westside Test Anxiety, the Oslo Social Support Scale, the Rosenberg Self-esteem Scale, and the Kessler Scale to assess test anxiety, social support, self-esteem, and psychological distress, respectively. The collected data were entered into EpiData version 3.1 and then exported to STATA version 14.0 for analysis. A linear regression model was used to determine factors associated with test anxiety. The multiple regression assumptions were checked for each variable. Statistically significant effects were assumed for a p-value of less than 0.05 at a 95% confidence interval in the multiple linear regression analysis. A total of 416 (99%) participants were completed out of the 420 questionnaires administered. The mean score of test anxiety among participants was 25.3 (SD: ±5.51). Tobacco use (β: 1.028; 95% CI: 0.709-1.347), khat chewing (β: 0.115; 95% CI: 0.038-0.192), self-esteem (β: -0.049; 95% CI: -0.062-(-0.036)), psychological distress (β: 0.022; 95% CI: 0.017-0.027), and physical activity (β: -0.162; 95% CI: -0.224-(-0.099)) were shown to have a significant association with test anxiety. Test anxiety was common in the study area. Current substance use (tobacco use and khat chewing) and psychological distress were discovered to be factors that exacerbated test anxiety, whereas self-esteem and physical activity were discovered to be factors that alleviated test anxiety. Therefore, students and stakeholders need to work to discourage those factors that increase test anxiety while promoting factors that alleviate it.

Investigating the linkages between food insecurity, psychological distress, and poor sleep outcomes among U.S. college students.

Research overwhelmingly demonstrates that sleep is key to human health and wellbeing. Several factors likely contribute to sleep quality, including factors, such as food security and low income. In addition, exposure to structural inequalities early in life likely have downstream effects upon multiple dimensions of health. The objective of this study is to fill gaps in literature by specifically examining the associations between childhood food insecurity, current food insecurity, psychological distress, and sleep among college students. QR codes were randomly distributed to students, linking them to an online quantitative survey. The survey measured sociodemographic variables, food security (current and childhood), diet, mental distress, and sleep quality. A total of n = 134 completed the entire survey. Data were analyzed using binary and multiple linear regressions, as well as cross-tabulations. The findings revealed that psychological distress was the primary factor influencing sleep health (𝛽 = 1.51, p < .01). Students reporting higher childhood food insecurity were more likely to experience extreme psychological distress (OR = 4.61), food insecurity in college (OR = 8.41), and lack of stable housing (OR = 5.86). This study demonstrates that potential linkages exist between childhood food insecurity, poor sleep, and greater psychological distress. While acknowledging the contribution of other factors, the study highlights the importance of addressing food insecurity in relation to sleep health, considering the significant impact of sleep to overall health and wellbeing.

Severe or chronic disease in childhood predicts suicidality and links to anxiety in young adulthood

Purpose Suicide prevention needs measures, and further understanding of the role of adverse childhood experiences may elucidate the suicide process and ease the identification of suicide risk. Materials and methods A random sample of adults, aged 18–28 years and representative of the general population living in Finland, participated in a nationwide health examination survey. Of them (n = 793) we analyzed whether severe or chronic disease in childhood before the age of 16 years contributed to suicidality (suicidal ideation and/or suicide attempts), and whether severe or chronic disease in childhood was associated with mental disorders, current psychological distress, current usage of prescription medicines, or current work capacity. Results Having severe or chronic disease in childhood contributed independently to suicidality, with the odds ratio of 5.41 (95% confidence interval of 2.98–9.82, p < .001), but the significance of this association was lost after controlling for mental disorders. Having severe or chronic disease during childhood, as compared not having such condition, was associated with having more frequently anxiety (p < .001), greater psychological distress (p < .001), more frequently usage of psychotropic medicines (p < .001), and poorer work capacity (p < .001). Conclusion Having severe or chronic disease in childhood not only increased the odds for suicidality, but also associated with anxiety, current psychological distress, current usage of psychotropic medication, and current work capacity in young adulthood.

Untreated depression and anxiety in patients with common skin diseases: a cross-sectional study in China.

The study aimed to analyze the current status and reasons for the neglect of the psychological need of patients with common skin diseases. This cross-sectional study was conducted in China using an online self-assessment questionnaire distributed via social media. Demographic, clinical and psychological data were collected, and the main outcomes, i.e., depression (evaluated using the 9-item Patient Health Questionnaire, PHQ-9) and anxiety (evaluated using Generalized Anxiety Disorder-7, GAD-7). Multivariate regression analysis was used for the prediction of variates of mental health service seeking behaviors. A total of 1,010 patients participated in the survey, and 273 (27.0%) patients met the "with need" criteria, i.e., having the need for mental health intervention but not being treated. In the multivariate regression model, income (OR = 0.80, 95%CI: 0.65-0.99), duration of disease (OR = 0.68, 95%CI: 0.49-0.95) and suicide ideation (OR = 2.10, 95%CI: 1.14-3.87) were significant factors. For patients who did not receive mental health care, the lack of knowledge about the availability of mental health services, lack of knowledge of where to seek help, concerns about the side effects of treatment, failure to seek treatment for severe skin diseases, and absence of current psychological distress were associated with their need for psychological intervention. This study examined the current status of the need for psychological intervention and the reasons why the need was unmet in patients with skin diseases. Due to the confusion and a lack of knowledge about their mental health issues, mental health services are often underutilized.

Comparison of Self-Reported Childhood Maltreatment Between East and West Germany

The socioecological model emphasize the relevance of political, cultural and economic socialization effects for the prevalence of childhood maltreatment, which are analyzed by comparing child maltreatment between East and West German subjects who came of age before the fall of the Berlin Wall. Using an online survey, a representative general population sample with respect to age, gender distribution and income was assessed regarding child maltreatment and current psychological distress using standardized self-report instruments. Of 507 study participants, 22,5% reported being born and socialized in East Germany. They reported significantly less emotional abuse than the 77,5% who grew up in the FRG. The East and West German subjects did not differ in any other form of abuse. Our findings underline the importance of socialization and enculturation effects on memory, which should be considered when interpreting the results.

Psychological recovery and well-being of spouses of patients with prostate cancer 5 years after primary treatment in Finland: a follow-up survey

Objective and settingTo study longitudinally cancer-related experiences of spouses of patients with prostate cancer and the predictors of their psychological recovery and quality of life (QOL) by following the participants...

The health needs of people leaving prison with a history of methamphetamine and/or opioid use.

Methamphetamine use is more common than opioid use among prison entrants in some countries, including Australia, yet most research and policy focuses on opioid use. This suggests that traditional opioid-focused interventions are no longer appropriate for the majority of this group in countries such as Australia. To inform policy and practice, we compared socio-demographic characteristics and health needs of people leaving prison with a history of methamphetamine use and/or opioid use. A cross-sectional survey of incarcerated adults administered the World Health Organization Alcohol, Smoking and Substance Involvement Screening Test was used to identify moderate-/high-risk methamphetamine use (n=909), opioid use (n=115) or combined methamphetamine/opioid use (n=356) before incarceration. We compared groups using modified log-linked Poisson regression with robust error variance. Compared to the opioid-only group, the methamphetamine-only group were: significantly more often aged <25 years; significantly more likely to identify as Indigenous; significantly less likely to have a history of prior incarceration, drug injection or overdose. A significantly lower proportion of methamphetamine-only and methamphetamine-and-opioid participants self-reported current hepatitis C infection compared to opioid-only participants. A majority of participants in all groups screened positive for current psychological distress according to the K10. People leaving prison with a history of methamphetamine use differ from opioid users with respect to demographics, patterns of substance use and related health concerns. Treatment and harm reduction efforts for people who experience incarceration must respond to patterns of drug use in this population, and invest at scale in coordinated, continuous services for co-occurring substance use and mental health problems.

The Role of Pre-Pandemic Mental Health Status and Personality Traits on Psychological Distress during the COVID-19 Lockdown among Italian Young Adults.

The COVID-19 pandemic imposed changes on day-to-day activities and had a detrimental psychological effect on the population, especially among vulnerable individuals, such as adolescents and young adults. The current study aimed to explore variables associated with anxiety, depressive and somatic symptoms in a sample of 608 Italian young adults aged 18 to 25. Data were collected using an online questionnaire administered two months into the COVID-19 lockdown, which explored several areas including sociodemographic information, pre-pandemic and current psychological distress, pre-pandemic and current levels of loneliness, and the traits of intolerance of uncertainty and boredom susceptibility. Results highlighted that having pre-existing mental health issues, being female, and the personality traits of intolerance to uncertainty and boredom susceptibility all played a role in the psychological distress experienced during the pandemic. COVID-19 contributed to negative impacts on young adults' mental health, highlighting the necessity to develop protective psychological intervention tailored for this vulnerable population.

Awareness and utilization of mental health services through primary care centers during COVID-19: A cross-sectional study among adult individuals in rural Mangaluru, India

Abstract Introduction: Mental health issues were neglected in India. However, coronavirus disease 2019 (COVID-19) had raised the importance of mental health. Hence, this study aimed to determine the prevalence of awareness and utilization of the mental health services provided by primary care centers during the COVID-19 pandemic. Methods: This community-based cross-sectional study was conducted among individuals aged 18 years and above in selected primary health center (PHC) service areas, Karnataka, South India. The sample size was 388. A semi-structured questionnaire was used to collect the information. Results: The mean (standard deviation [SD]) age of the participants was 42.7 (±15.37) years and 76% were female. The prevalence of awareness was 47% (95% confidence interval [CI] 41.8%–52.0%), and only 1% (95% CI 0.8%–2.6%) had utilized the mental health services through PHCs during COVID-19. About 82% (95% CI 78.0%–85.8%) were willing to avail the mental health services through PHCs. No formal education (adjusted prevalence ratios [APR] = 7.33, 95% CI 1.81–29.60, P = 0.005) and current psychological distress (APR = 2.99, 95% CI 2.08–4.30, P = 0.00) were significantly associated with unwillingness to avail care from PHCs. Conclusion: The awareness and utilization of mental health services through primary care centers were poor in the community. Strategic measures must be implemented through the mental health program to improve the utilization of the services.

Mental health and substance use risks and resiliencies in a U.S. sample of transgender and gender diverse adults.

Victimization contributes to mental and behavioral health inequities among transgender and gender diverse (TGD) people, but few studies have simultaneously examined health-promoting resiliencies. We sought to identify classes of risk and resilience among TGD adults, assess characteristics associated with these classes, and examine their relationship with mental health and substance use outcomes. Cross-sectional data were from the 2015 US Transgender Survey, a non-probability study including 26,957 TGD adults. Using latent class analysis, we classified patterns of vulnerability and resilience based on risk (past-year denial of equal treatment, verbal harassment, physical attack, bathroom-related discrimination; lifetime sexual assault, intimate partner violence) and protective (activism; family, work, classmate support) factors. Regression models were fit to (1) determine the association between sociodemographic and gender affirmation characteristics and latent classes; (2) model associations between latent classes and mental health (current serious psychological distress, past-year and lifetime suicidal thoughts and attempts, and lifetime gender identity/transition-related counseling) and substance use (current binge alcohol use, smoking, illicit drug use; past-year drug/alcohol treatment) outcomes. Three latent classes were identified: high risks, with activism involvement ("risk-activism," 35%); low risks, with not being out about one's TGD identity ("not-out," 25%); and low risks, with high family support ("family-support," 40%). Gender affirmation and sociodemographic characteristics, such as race/ethnicity and sexual orientation, were associated with latent classes. Risk-activism class membership was associated with higher odds of negative mental health and substance use outcomes, while the family-support class had lower odds of these outcomes. Interventions leveraging family support, and policy protections from discrimination and victimization, may promote TGD mental and behavioral health.

Learning based PTSD symptoms in persons with specific learning disabilities

Specific learning disorders (SLD) persist into adulthood. Persons with SLD frequently experience emotional and social difficulties. Following qualitative descriptions of individuals with SLD who experienced learning, as traumatic, we hypothesized that individuals reporting SLD would report higher levels of learning-based post-traumatic-stress-disorder (PTSD) symptoms. In Study 1 (N = 216), participants responded to questionnaires concerning SLD and learning-based PTSD. A separate sample (N = 43) was queried about adjustment disorder symptoms. Study 2 (N = 176) examined if current psychological distress was predicted by levels of learning-based PTSD at each developmental stage (elementary/high-school/post-high-school) and whether SLD links to current psychological distress. Finally, we assessed if SLD-psychological distress associations are mediated by cumulative levels of learning-based PTSD across these school periods. In Study 1 individuals reporting SLD displayed higher learning-based PTSD levels than those without SLD. SLD-PTSD associations held beyond adjustment disorder symptom levels. In Study 2, SLD was linked with psychological distress, mediated by accumulated learning-based PTSD symptom levels across school periods. These results suggest that in individuals with SLD, learning experiences may be associated with learning-based PTSD symptoms. Further, persons with SLD may be scarred by their traumatic learning experiences linking with current psychological distress, a link mediated by cumulative difficulties experienced over school years.

Self-harm and suicide attempts among incarcerated lesbian, gay and bisexual people in Australia.

Guided by minority stress theory, we explored the association between sexual identity, justice system involvement, self-harm and suicide attempts, among a cohort of incarcerated adults in Australia. A sample of 2698 adults incarcerated in Queensland and Western Australia were surveyed between 1 August 2008 and 12 August 2016 about their current psychological distress, mental health diagnoses, contact with mental health services, and lifetime and recent self-harm and suicide attempts. We used multivariable logistic regression to explore the relationship between sexual orientation, prior criminal justice system involvement, mental health and demographic factors. Five percent of the sample identified as gay, lesbian or bisexual, with 37% of lesbian, gay, bisexual and other same-sex attracted individuals reporting that they had self-harmed (vs 14% of heterosexual peers; χ2 = 52.4; p < 0.001) and 49% reporting a history of at least one suicide attempt (vs 23%; χ2 = 49.2; p < 0.001). Lesbian, gay, bisexual and other same-sex attracted people were 2.1 times (95% confidence interval: [1.4, 3.3]) and 1.8 times (95% confidence interval: [1.2, 2.8]) more likely to report a history of self-harm and suicide attempt, respectively, than non-lesbian, gay, bisexual and other same-sex attracted respondents. Intersectionality theory suggests that people who are navigating two or more marginalised identities often experience a compounding of internal and external stressors. Consistent with that theory, lesbian, gay, bisexual and other same-sex attracted people who experience incarceration may be at particularly high risk of self-harm and suicidal behaviour. Custodial settings should both improve cultural competency for frontline staff working with lesbian, gay, bisexual and other same-sex attracted individuals and improve access to mental health services during incarceration.

Inconsistent Reporting of Adverse Life Events Is Predicted by Current Internalizing Distress Among Military Service Members.

Accurate measurement of adverse life events is critical for understanding the effects of stressors on health outcomes. However, much of this research uses cross-sectional designs and self-report years after the events take place. The reliability of this retrospective reporting and the individual difference factors associated with inconsistent recall over time are not frequently addressed, especially among military service members. A longitudinal cohort of National Guard service members (n = 801) completed the Deployment Risk and Resilience Inventory-2 Prior Stressors scale and several measures of general well-being, including anxious depressive symptomatology, personal functioning, perceived social support, and overall health at two time points (before and after completion of basic combat training; median 11-month interval). Consistency in reporting the life event items ranged from 69.5% to 99.7%, with an overall Cohen's kappa coefficient of 0.215 for the scale, indicating minimal agreement. Lower well-being scores at Time 1 independently predicted yes-to-no changes in responding, whereas lower well-being scores at Time 2 independently predicted no-to-yes changes in responding. Follow-up mediations were conducted using study measures available only at Time 2. For all study measures, Time 2 well-being independently predicted changes from no-to-yes responding by way of indirect effects through self-reported non-specific internalizing distress and arousal. These findings highlight the confounding effects of fluctuations in current emotional distress on past stressor recall. There is a need for additional caution regarding the use of retrospective self-report of adverse life events in research and clinical practice and greater consideration of current psychological distress at the time of measurement completion.