Domains Of Distress Research Articles

Validation of a Biopsychosocial Distress Screening Tool, SupportScreen, in a Brazilian Cancer Center.

Biopsychosocial distress is a common yet often underestimated complication in cancer care. We sought to translate and evaluate the psychometric properties of SupportScreen distress assessment tool in Brazil. A cancer cohort study was conducted at a public hospital in Brazil. The SupportScreen tool underwent transcultural translation into Portuguese. Eligible patients completed the SupportScreen, Distress Thermometer (DT), Hospital Anxiety and Depression Scale (HADS), and Functional Assessment of Cancer Therapy-General version (FACT-G). Statistical analyses included confirmatory and exploratory factor analyses (CFA and EFA), comparisons with established distress tools, and assessments of associations with patients' characteristics. A total of 302 patients were assessed (M:F 35.4%:64.6%; median age: 55). Most patients were diagnosed with breast (29.1%) and gastrointestinal cancer (20.5%), at advanced disease stage (78.8%). CFA identified optimal models for emotional and physical distress; EFA revealed two factors for the logistics of medical care: practical and medical system distress. The concurrent validity of subscales demonstrated significant correlations between distress domains. Sensitivity analyses indicated good performance of emotional and physical domains in identifying distress compared to gold standard criteria. Female patients were more likely to report high emotional distress, while younger age and late disease stage were associated with higher physical distress. Additionally, late disease stage was linked to higher practical distress. Emotional and physical domains demonstrated validity and reliability, aligning with validated measures. Logistics of medical care distress revealed practical and medical system dimensions, expanding understanding of patient challenges. The SupportScreen tool exhibited concurrent validity and sensitivity in identifying distress.

Composite Functional and Quality of Life Outcomes in Adults Operated for Cloacal Malformation

IntroductionComposite long-term outcomes of cloacal malformations remain unclear. We aimed to evaluate bowel and bladder control, sexual function, reproductive health, and quality of life in adulthood. MethodsA Nordic multi-center cross-sectional observational study evaluating the outcome of adult patients with cloacal malformations was performed. Patient characteristics were retrieved from case records. Established questionnaires were sent to the patients to evaluate bowel- bladder- and sexual function and quality of life. ResultsThirty-four of 48 (70%) eligible patients with median age 28 years (18–45) responded. Eight (24%) patients had a common channel >3 cm. Imaging-confirmed spinal and sacral abnormalities were present in 4 and 17 patients respectively. 85% (n = 29/34, four patients with permanent urinary diversions after bladder neck closure excluded) reported no urinary leakage without physical activity or urge to urinate. Three patients had a permanent enterostomy. 42 % (n = 11/26) reported acceptable bowel function according to Bowel Function Score (with eventual ongoing bowel management). The median Profile of Female Sexual Function Score was below normative values. Quality of life was comparable to the reference population, but thirty percent scored within the distress domains. Eight patients (24%) had been pregnant (15 pregnancies), resulting in seven live births, but the need of assisted reproduction techniques (40%, n = 6/15) and miscarriage (40%, n = 6/15) was common. ConclusionsAdequate spontaneous bowel control was rare, while most patients were dry for urine without additional procedures. Cloacal malformation also have a negative impact on sexual function health related quality of life and reproductive health. Long-term follow-up is crucial, not only regarding bowel and bladder function, but also for sexual and reproductive function, which may be important negative factors for health-related quality of life. Level of EvidenceLevel IV.

Development and validation of the domain-specific climate change distress scale

Climate change is one of, if not the greatest, global challenges of this century, as its consequences can have a wide range of impacts on society, the environment, and the personal lives of many individuals. Consequently, many people experience severe psychological distress in the form of fears, anxieties, or worries, elicited by one, some, or all these different consequences. Thus, climate change distress can be conceptualized as a domain-specific construct. We conducted a literature review and a qualitative lay survey to develop the Domain-Specific Climate Change Distress Scale (DCCDS), with a generic climate change distress domain and six sub-domains (ecology, existence, food supply, future generations, society, and wealth). In the first study, we validated this structure with a bifactor-(S-1) model and refined the scale according to its psychometric properties. In a second study, we showed convergent and discriminant validity with the respective constructs. In a third study, we demonstrated the external validity of the scale by investigating the relation of its sub-domains to fear reactions to real-life news excerpts and willingness to donate to different charity organizations. Each sub-domain showed incremental validity over the generic domain. The scale had adequate psychometric properties and stability over three measurement timepoints in German gender-balanced convenience samples. We thus conclude that the domain-specific conceptualization of climate change distress yields important diagnostic benefits and could provide important insights into the future handling of climate change distress on a political, socio-cultural, and personal level.

Associations between hypopharyngeal defect closure and quality of life in long-term total laryngectomy survivors.

Few studies have examined health-related quality of life (HRQOL) outcomes in long-term total laryngectomy survivors in relation to the type of hypopharyngeal defect. A cross-sectional study was performed in long-term total laryngectomy survivors, treated between 2000 and 2020. The primary outcome was HRQOL, assessed using the FACE-Q Head and Neck Cancer Module, in relation to the type of hypopharyngeal closure (primary closure, partial or circumferential reconstruction). Seventy-nine survivors were included with a median follow-up of 92.1 months (IQR 75.6-140.2 months). Patients requiring partial hypopharyngeal reconstruction (n = 18) scored significantly worse than patients with primary closure (n = 51) on 4 of 13 FACE-Q domains: functional domains of eating (p = 0.03), speech (p = 0.05), and swallowing (p = 0.03), and the psychological domain of speaking-related distress (p = 0.02). No statistically significant differences were found between the circumferential hypopharyngeal defect reconstruction group (n = 10). Stricture occurrence was the only clinical factor associated with worse eating, speaking, swallowing, eating-related distress, and cancer worry in multivariable analyses. Several functional and psychological domains were significantly worse following partial hypopharyngeal reconstruction than in patients who received primary closure. Efforts to reduce stricture rates to enhance reconstructive outcomes following total laryngectomy merit further research.

Patient-reported outcomes in chronic hepatitis delta: An exploratory analysis of the phase III MYR301 trial of bulevirtide

Once-daily treatment of chronic hepatitis delta (CHD) with bulevirtide is well tolerated and associated with significant reductions in HDV RNA in the blood and in biochemical liver disease activity. This study explored the effects of 48-week bulevirtide treatment on health-related quality of life (HRQoL) in patients with CHD. In an open-label, randomised, Phase 3 trial, 150 patients with CHD and compensated liver disease were stratified by liver cirrhosis status and randomised 1:1:1 to no treatment (control), bulevirtide 2 mg/day, or bulevirtide 10 mg/day for 48 weeks. HRQoL was evaluated by the following patient-reported outcome (PRO) instruments at baseline, 24 weeks, and 48 weeks: EQ-5D-3L, Hepatitis Quality of Life Questionnaire (HQLQ), and Fatigue Severity Scale (FSS). Patient characteristics and HRQoL scores were balanced at baseline between the treatment (2 mg, n = 49; 10 mg, n = 50) and control (n = 51) groups. Patients receiving 2-mg bulevirtide reported significant improvements compared with controls on the HQLQ domains of role physical, hepatitis-specific limitations, and hepatitis-specific health distress. Numerically higher scores for general health, hepatitis-specific limitations, and hepatitis-specific health distress domains were reported by patients with cirrhosis who received bulevirtide vs control. FSS scores remained stable across treatment groups throughout. At week 48, patients in the 2-mg group showed greater mean improvement from baseline in health status compared with controls on the EQ-5D-3L visual analogue scale. PROs indicate that 48-week treatment with bulevirtide monotherapy may improve aspects of HRQoL in patients with CHD. Bulevirtide 2 mg is the only approved treatment for patients with chronic hepatitis delta (CHD) in the EU. Patients with CHD have worse quality of life scores than those with chronic hepatitis B. Bulevirtide treatment for 48 weeks reduced HDV RNA and alanine aminotransferase levels and was well tolerated among patients with CHD. For the first time, this study shows that patients who received bulevirtide therapy for 48 weeks reported improvements in physical and hepatitis-related quality of life domains compared to those who did not receive therapy (control group). ClinicalTrials.gov Identifier, NCT03852719.

The utility of coping through emotional approach: A meta-analysis.

A systematic review and meta-analysis was conducted to examine associations between attempts to cope with stressors through the two facets of emotional approach coping (EAC; i.e., processing and expressing stressor-related emotions) and indicators of physical and mental health. EBSCO databases including MEDLINE, PsycINFO, and Cochrane Collections were searched from inception to November 2022. In all, 86 studies were included in a meta-analytic evaluation using a random-effects model and meta-regression analysis. EAC was associated with better overall health (r = .05; p = .04; 95% confidence interval = [.003, .10]). Emotional expression (EE) and emotional processing (EP) also were positively associated with better overall health, although these relationships were not statistically significant. In meta-regressions examining specific health domains, EAC was linked to better health in biological/physiological, physical, and resilience-related psychological adjustment domains, as well as to worse outcomes in the risk-related psychological adjustment and mental/emotional distress domains. Results for EE and EP mirrored this pattern; however, only EP was associated with more engagement in health-promoting behaviors. Coping with stressors through emotional approach appears to be associated with better mental and physical health, with some observed differences for EE and EP. The literature on EAC and health is marked by heterogeneity across study methodologies and measures. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Recommended measurement instruments for menopausal vasomotor symptoms: the COMMA (Core Outcomes in Menopause) consortium.

The aim of the study is to identify suitable definitions and patient-reported outcome measures (PROMs) to assess each of the six core outcomes previously identified through the COMMA (Core Outcomes in Menopause) global consensus process relating to vasomotor symptoms: frequency, severity, distress/bother/interference, impact on sleep, satisfaction with treatment, and side effects. A systematic review was conducted to identify relevant definitions for the outcome of side-effects and PROMs with acceptable measurement properties for the remaining five core outcomes. The consensus process, involving 36 participants from 16 countries, was conducted to review definitions and PROMs and make final recommendations for the measurement of each core outcome. A total of 21,207 publications were screened from which 119 reporting on 40 PROMs were identified. Of these 40 PROMs, 36 either did not adequately map onto the core outcomes or lacked sufficient measurement properties. Therefore, only four PROMs corresponding to two of the six core outcomes were considered for recommendation. We recommend the Hot Flash Related Daily Interference Scale to measure the domain of distress, bother, or interference of vasomotor symptoms and to capture impact on sleep (one item in the Hot Flash Related Daily Interference Scale captures interference with sleep). Six definitions of "side effects" were identified and considered. We recommend that all trials report adverse events, which is a requirement of Good Clinical Practice. We identified suitable definitions and PROMs for only three of the six core outcomes. No suitable PROMs were found for the remaining three outcomes (frequency and severity of vasomotor symptoms and satisfaction with treatment). Future studies should develop and validate PROMs for these outcomes.

Trends in Research Studies on Menstrual Distress and Selfefficacy Among Adolescent Girls: A Bibliometric Analysis

Menstrual hygiene is a complex issue that requires coordinated efforts at various levels, especially for adolescent girls. However, the lack of basic facilities like sanitary products, water supply, and a safe environment for changing pads limits their options for safe menstrual hygiene. To understand more about menstrual distress and self-efficacy among schoolgoing girls, we analyzed 6,681 publications from the Web of Science (WoS) Core Collection and 4,974 records from 2008 to 2022. The study used CiteSpace 6.1.R6 software for a thorough analysis, including Document Co-citation Analysis (DCA) to identify important studies and research clusters, as well as keyword co-occurrence analysis to reveal emerging trends in the literature. Furthermore, temporal analysis was conducted to examine publication trends over time, showing a notable rise in research output, especially in the past five years. The research on menstrual distress and selfefficacy is primarily focused in countries like the United States, England, China, Australia, and Canada, and institutions like the University of California, University of London, Harvard University, Pennsylvania Commonwealth System of Higher Education, and the University of North Carolina. Keywords like distress, life event, psychopathology, memory, and salivary cortisol indicate emerging trends in this field. The Document Co-citation Analysis (DCA) revealed that the studies on young women in middle-income countries are the predominant cluster in the domain of menstrual distress and self-efficacy. This bibliometric analysis helps identify potential contributors for future research on menstrual distress and hygiene among adolescent girls.

Assessing the Impact of Oral Disorders on the Oral Health-Related Quality of Life of Preschool Children and their Families: A Cross-sectional Study

Introduction: Oral disorders such as Traumatic Dental Injury (TDI) and Early Childhood Caries (ECC) can significantly impact the functional, social, and psychological well-being of growing children and their families. The Early Childhood Oral Health Impact Scale (ECOHIS) serves as a proxy assessment of Oral Health-Related Quality of Life (OHRQoL) in children, developed to evaluate the effects on the quality of life of preschool children. Aim: To assess the impact of oral disorders on the OHRQoL of children aged two to six years and their families. Materials and Methods: In this cross-sectional study, a total of 1000 children aged 2 to 6 years from various preschools in South Bangalore were selected. All children underwent examinations for caries, stains, and fractures. A modified questionnaire survey based on ECOHIS, consisting of 26 questions, was completed by the parents of the children. The answered questionnaire was then evaluated to assess the impact of dental conditions on the quality of life of both children and parents. Kruskal-Wallis Test, Dunn’s post-hoc Test, and Mann-Whitney Test were used to compare the mean scores of different domains of the OHRQoL scale based on ECC and dental trauma, respectively. Results: The severity of ECC demonstrated an adverse effect on the symptom domain (p<0.001), function domain (p=0.002), psychology domain (p=0.03), and the entire score of the Child Impact Section (CIS) (p<0.001). In the Family Impact Section (FIS), the mean scores of the family distress domain and the overall FIS were statistically significant (p<0.001). Dental trauma also showed an adverse effect on the symptoms domain (p<0.001) and the entire scores of the CIS (p=0.001). Additionally, the mean scores of the family distress domain and the overall FIS were statistically significant (p<0.001). Conclusion: The presence of ECC and dental trauma is likely to have a negative impact on the physical, psychological, and emotional well-being of preschool-aged children and their families.

50 BSI-18 as a Measure of Psychological Distress Across Different Domains in TMS Patients

Objective:Transcranial magnetic stimulation (TMS) is an effective treatment for individuals with pharmacoresistant major depressive disorder (MDD), yet identifying which patients best respond remains an important area of inquiry. The Brief Symptom Inventory (BSI-18) serves as a screen for psychological distress, providing measures across three separate domains (e.g., somatization, depression, and anxiety) and one composite score (i.e., global severity index). The psychometric properties of the BSI-18 have been validated across multiple studies; however, it has sparsely been used to track changes in patient symptoms in response to intervention. Assessing patient symptom severity across these domains is imperative since these symptoms can negatively influence cognitive functioning. Accordingly, the current study utilized the BSI-18 to measure psychological distress across these different domains in patients receiving TMS treatment. We hypothesized that all domains of the BSI-18 would see a significant decrease after treatment, that elevated scores in specific domains would predict a less favorable response to treatment, and that measurement of depressive symptoms will be consistent across measures of similar scope.Participants and Methods:Veterans (n=94) with MDD and met standard clinical TMS criteria were administered the BSI-18 before and after receiving an adequate dose of treatment (e.g., 30 sessions). Paired Samples T-test were used to compare the pre-treatment and post-treatment scores across domains.Results:The results of paired sample t-tests indicated a statistically significant reduction in measures of global psychological distress (t(93) = 7.99, p < .001, Cohen's d =.82), as well as depressive (t(93) = 8.34, p < .001, d = .86), anxious (t(93) = 7.64, p < .001, d = .79), and somatic symptoms (t(92) = 5.29, p < .001, d = .55) after receiving treatment. Individuals with elevated levels of anxiety (e.g., BSI-A>63) saw a significant reduction in depressive (t(62) = 8.15, p < .001, d = 1.03), anxious (t(62) = 8.34, p < .001, d = 1.05) and somatic (t(61) = 4.94, p < .001, d = .63) symptoms. Lastly, two measures of depressive symptoms, the BSI-D and PHQ-9, had a statistically significant strong, positive relationship before (r=.66) and after (r=.88) treatment (all n=65 and p<.001).Conclusions:The BSI-18 can detect changes in different domains of psychological distress as a function of TMS treatment. Unexpectedly, TMS patients with elevated levels of anxiety responded well to treatment despite comorbid anxiety often being associated with less favorable outcomes in treatment trials. The positive relationship of the BSI-D and PHQ-9 before and after treatment suggests the use of the BSI as a valid, additional measure of depressive symptoms.

Integrating Group Cognitive Behavioural, Art Psychotherapy for women following childhood sexual abuse

ABSTRACT Background Despite the prevalence of childhood sexual abuse, and the number of adults referred to secondary mental services with symptoms of mental distress or disorder who report such a history, there is little in the way of specific recommendations for treatment approaches. Aims We wanted to consider the effectiveness of a combined Cognitive Behavioural Therapy (CBT) and Art Psychotherapy (ApT)* group therapy model (GCB-ApT) for women with experience of childhood sexual abuse. Methods GCB-ApT was delivered to seven groups of female survivors of childhood sexual abuse (n = 41) in community mental health team settings, using a standardised model. There were 32 participants who completed the group, and full data is available for 30 participants. Each group was facilitated by two female therapists – a clinical psychologist and an art psychotherapist. The study was registered with the employing Trust (BSMHFT) as a retrospective evaluation of validated clinical outcome measures routinely administered pre – and post-intervention. Results Results showed significant post-intervention improvement in the domains of global distress, depression and self-esteem. Conclusions Results were promising, although numbers were small. Implications for practice/policy/future research Results suggested that group provision using the GCB-ApT model could be a helpful addition to clinical interventions provided for women who have experienced childhood sexual abuse. Further research is recommended. *Some texts referenced may use ‘art therapy’ rather than ‘art psychotherapy’. The abbreviation ApT is used for either throughout. Plain-language summary We looked at how we could provide specific ways to help those women referred to Psychological Services who had experienced childhood sexual abuse. There weren’t many suggestions from previous research that gave us a confident idea about what specific approach works best. We found evidence that Cognitive Behavioural Therapy and Art Psychotherapy can be useful, and we wanted to combine them in a group setting to see how helpful this was. Cognitive Behavioural Therapy looks at how our thoughts might affect our behaviours and feelings, while Art Psychotherapy uses and explores image-making as a way of helping with distressing experiences and emotions. We organised seven groups with a total of forty-one women. Two therapists (one specialist in each therapy) led each group, held over twenty sessions. There were three parts to the group: firstly we covered coping strategies, then we looked in more detail at each person's account of what they had been through. Finally, we supported women to review what had happened for them in the group and to plan for after it had ended. Each week we began by looking at a topic or theme relevant to this group (e.g. flashbacks) through information giving and discussion. The theme provided a starting point for using the art materials, followed by group members being invited to share the images they had made and how that had felt, and to explore any thoughts and feelings that arose in the group in response. We gave each woman three questionnaires to complete at the beginning and the end of the groups, and compared the results. These showed that there had been improvements in mood, self-esteem and psychological well-being. There are limitations with these results, partly because the numbers are small. However, they suggest that more research would be worthwhile.

Sense of Coherence or resilience as predictors of psychological distress in nursing students during the COVID-19 pandemic.

The COVID-19 pandemic lead to the occurrence of numerous psychological distress among students. This study aimed to determine the level of psychological distress as well as the predictive role of Sense of Coherence (SOC) and resilience in nursing students. A cross-sectional descriptive study was conducted on 310 nursing students in Ahvaz Jundishapur University of Medical Sciences, Iran. The data of the study was collected through the demographic information questionnaire, the General Health Questionnaire (GHQ), the Academic Resilience Inventory (ARI), and the Sense of Coherence Scale (SOC-13). Students' mean scores for the GHQ, ARI, and SOC were 5.81 ± 1.37, 102.88 ± 11.91, and 54.54 ± 6.46, respectively. Regression models showed that two domains of SOC [meaningfulness (β = -0.28, p < 0.001), manageability (β = -0.19, p = 0.001)], female gender (β = 0.12, p = 0.015), and overall ARI (β = -0.12, p = 0.037), were significantly associated with the GH of nursing students. SOC domains [meaningfulness (β = -0.19, p = 0.002), manageability (β = -0.15, p = 0.006)], problem-oriented/positive thinking domain of ARI (β = -0.15, p = 0.011), sex (β = 0.12, p = 0.015), and history of death in first-degree relatives (β = 0.12, p = 0.021) were significantly associated with social dysfunction domain of GH. Three domains of SOC [meaningfulness (β = -0.26, p < 0.001), manageability (β = -0.13, p = 0.032), and comprehensibility (β = -0.13, p = 0.039)], were significantly associated with psychological distress domain of GH. Our results indicated that low SOC and resilience were predictors of psychological distress in nursing students. Accordingly, interventions such as teaching stress management skills, the skills of using positive coping methods in dealing with stressful situations, and self-management skills are necessary to improve the level of resilience and SOC in nursing students.

#5500 THE IMPACT OF CHRONIC KIDNEY DISEASE-ASSOCIATED PRURITUS RELIEF ON SKINDEX-10 DISEASE AND SOCIAL FUNCTIONING DOMAINS

Abstract Background and Aims Chronic kidney disease-associated pruritus (CKD-aP) is a serious condition that greatly impacts patients’ quality of life (QoL). Moderate-severe pruritus affects up to 47% of patients undergoing haemodialysis (HD) [1]. The aim of this analysis was to assess the impact of itch relief on the disease and social functioning domains of the Skindex-10 questionnaire in a post hoc analysis of the difelikefalin (DFK) Phase 3 studies in patients with CKD-aP undergoing HD. Method Patients with moderate-to-severe CKD-aP (mean Worst Itch Numerical Rating Scale [WI-NRS] score ≥4 [KALM-1] or ≥5 [Study 3105 and KALM-2]) undergoing HD were enrolled and randomised 1:1 to receive intravenous DFK 0.5 µg/kg or placebo (KALM-1 and -2) or open-label DFK (Study 3105) 3 times/week for 12 weeks. Data from all patients who completed the studies were included in the present analysis irrespective of study drug exposure; data were pooled for patients receiving DFK and placebo from the KALM studies. The 12-week change from baseline in the Skindex-10 questionnaire subdomains were assessed for disease (Q1–3) and social functioning (Q7–10). Change from baseline in the mood/emotional distress domain has previously been reported (Q4–6) [2]. Results Skindex-10 scores were available for 914 patients (KALM studies: n = 720; Study 3105: n = 194). At Week 12, patients with a clinically relevant (WI-NRS ≥3-point) change (decrease) in itch (KALM: n = 305; 3105: n = 143) reported a relative mean (± standard error) corresponding improvement of 59.7%±2.0 (KALM) and 65.9%±2.6 (3105) from baseline in the disease domain of Skindex-10, compared with 18.4%±2.3 and 30.7%±4.4 of patients with &amp;lt;3-point WI-NRS improvement (KALM: n = 415 [Figure A]; 3105: n = 51 [Figure B]). In addition, a much greater improvement in QoL was reported for the social functioning domain for patients with ≥3-point WI-NRS improvement, compared with patients with &amp;lt;3-point improvement (66.2%±3.5 vs 11%±7.6 in the KALM studies; 75.5%±4.0 vs 49.4%±8.5 in Study 3105). Overall, the patients with ≥3-point WI-NRS change reported relative mean improvement from baseline ranging from 64%±2.3 to 70.2%±2.6 across the total Skindex-10 scale compared with 15.1%±4.8 to 35.4%±5.5 of patients with &amp;lt;3-point improvement at Week 12 across all studies. Conclusion In this post hoc analysis, patients with CKD-aP undergoing HD who reported a clinically meaningful reduction in itch intensity also achieved a substantially greater improvement in both the disease and social functioning domains of Skindex-10, as well as overall itch-related QoL.

Parent psychosocial adjustment to inpatient pediatric rehabilitation, and the role of uncertainty and self-care.

The stressors experienced by parents of children admitted for inpatient rehabilitation likely place parents at high risk for poor psychosocial adjustment; however, no research to date has described parent adjustment during the acute phase of a child's inpatient rehabilitation hospitalization. The present study evaluates parent adjustment processes through the lens of the transactional stress and coping model by assessing a specific cognitive process (i.e., illness uncertainty) and coping methods (i.e., self-care), which may influence parent adjustment during the inpatient rehabilitation. Forty-two parents (47.6% White, 86% female) of children newly admitted to a pediatric inpatient rehabilitation hospital were recruited. Parents completed self-report measures of demographics, illness uncertainty, self-care, and depressive, anxious, and posttraumatic stress symptoms. Sixty-six percent of parents reported clinically significant symptoms in at least one domain of distress. Illness uncertainty accounted for 22.2%-42.4% of the variance in parent distress symptoms, after controlling for parent and child age, parent trauma history, and income. Self-care accounted for 35.1%-51.9% of the variance in parent distress symptoms, when accounting for parent and child age, parent trauma history, and income. More than half of parents endorsed clinical elevations in anxiety, depression, and/or posttraumatic stress. Illness uncertainty and self-care are likely very important clinical topics to discuss with parents. Future research should seek to not only assess how parent distress changes across time, but also how other cognitive processes, as well as environmental and family factors influence the parent adjustment process. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

AFRICAN-AMERICAN ALZHEIMER’S CAREGIVER TRAINING AND SUPPORT PROJECT 2 PILOT STUDY: OUTCOMES ANALYSIS

Abstract The purpose of this study was to conduct an initial evaluation of the quantitative and qualitative outcomes of the African-American Alzheimer’s Caregiver Training and Support Project 2 (ACTS2). Quantitative objectives focused on assessing changes in caregiver depression and health status, as well as the severity of caregiving and self-care problems from pre- to post-intervention. Secondary quantitative analyses examined post-treatment changes in social support and caregiver burden. Qualitative objectives included examining caregivers’ perceptions of the effectiveness of in-session training activities, quality of relationships among participants and their facilitator, and appraisals of spiritual elements of the program. Nine African American family caregivers of older adults with dementia completed the ACTS2 lay pastoral care facilitator-led, telephone cognitive-behavioral intervention. The twelve-week training program included 7 skills-building groups and 5 individual problem-solving sessions. Significant improvements were found on the majority of dependent measures, including caregiver depression, health status, problem severity, and social support. Qualitative analysis highlighted the value caregivers placed on relationships with their co-participants and group facilitators, the role of spirituality within the program, and the importance of goal setting in improving caregiver distress and self-care. Convergence was found between quantitative and qualitative findings, particularly improvements in the domains of caregiver distress, health status, and social support. Overall, the findings of the pilot study were promising. Replication using a randomized controlled design with a larger sample size is needed to test the reliability of the findings. Benefits of tailoring intervention to caregivers’ sociocultural preferences and spiritual values are also addressed.

Gender Impact on Diabetes Distress Focus at Medical Communication Concerns, Life and Interpersonal Stress.

along with the rapidly aging population in many countries around the world, the global prevalence of diabetes and suffering from diabetes-related depression have risen in middle-aged and elderly adults. However, given that psychological stress is deeply influenced by culture, gender inequality in these statistics is often exhibited and increases with age. The aim of this study was to explore the gender difference in diabetes distress among middle-aged and elderly diabetic patients. 395 participants from four hospitals were recruited for a cross-sectional survey. The Taiwan Diabetes Distress Scale (TDDS) was used to measure diabetes distress. Linear regression was conducted to assess the gender difference in different types of diabetes distress. there was significant gender difference in each diabetes distress domain. In particular, men who had received diabetes education in the past six months seemed to be more concerned about diabetes complications and felt pressured to communicate with doctors. In addition, women seemed to be more affected by diabetes distress because of their marital status, especially for married women. diabetes distress seems to have significant gender differences; however, more longitudinal research is needed on the causal relationship between gender and diabetes distress.

Cancer-Related Distress and Risk for Anxiety and Depression Among Lymphoma Survivors

Background: In blood cancer like lymphoma, patients often feel their cancer is invisible to others, and may have less contact with the healthcare team during periods of prolonged remission. Further, lymphoma patients experience significant enough levels of anxiety and depression to impact participation in treatment or hinder treatment decision-making and quality of life. The aim of the present study was to describe how lymphoma patients characterize their cancer-related distress and concerns, including symptoms of anxiety and depression, and to explore associations between key distress domains and anxiety/depression risk and if associations vary by current remission status. Methods: 200 lymphoma patients/survivors enrolled in Cancer Support Community's online Cancer Experience Registry from 2015-2021 and completed CancerSupportSource™(CSS), a 25-item validated distress screening tool in which participants rate their level of concern (0=Not at all, 1=Slightly, 2=Moderately, 3=Seriously, 4=Very seriously) across five domains: (1) emotional well-being (EWB; 8 items, α=.92; including 2-item depression and anxiety risk screening subscales); (2) symptom burden and impact (SYM; 8 items, α=.89); (3) body image and healthy lifestyle (BHL; 4 items, α=.81); (4) healthcare team communication (HCC; 2 items, α=.65); and (5) relationships and intimacy (REL; 2 items, α=.46). The average item rating for each domain was calculated. Logistic regression was used to explore associations between anxiety/depression risk and distress domains (SYM, BHL, HCC, and REL) controlling for demographic/clinical variables associated with anxiety or depression risk. Results: The sample (n=200) was 80% Non-Hispanic White, 66% female, 79% urban/suburban; mean (SD) age was 56 (15) years (range: 21-83). 45% were employed, 29% retired, and 23% unemployed; 25% reported household income<$40K. Median time since diagnosis was 2 years (range: <1-34); 33% reported a general diagnosis of lymphoma, 47% specified non-Hodgkin lymphoma, and 21% Hodgkin lymphoma; 53% were in remission. 90% had received chemotherapy, 32% radiation, 20% immunotherapy, 17% targeted therapies, and 10% stem cell transplantation; 39% were currently receiving treatment. Mean (95% CI) distress subscale score was highest for BHL concerns (1.37; 1.22-1.51), followed by EWB (1.27; 1.13-1.41), SYM (1.22; 1.09-1.35), REL (0.97; 0.83-1.11), and HCC (0.73; 0.60-0.87). Regarding BHL, top concerns (% moderately to very seriously concerned) included eating and nutrition (53%) and exercising and being physically active (47%). With regard to EWB, items of greatest distress were worrying about the future (51%) and worrying about finances (45%). For SYM, over half (49%) were concerned about fatigue, and 46% about sleep problems, and for REL, one-third (36%) were concerned about intimacy, sexual function, or fertility, and 21% about problems in relationship with their spouse or partner. Regarding HCC, 26% reported concern related to making treatment decisions, and 19% about communicating with their doctor. Nearly half (46%) were identified as at risk for clinically significant anxiety, and 37% identified as at risk for clinically significant depression; 33% were at risk for both anxiety and depression. Odds of anxiety risk were predicted by concerns about HCC (OR=5.78, p<.001), SYM (OR=4.67, p=.001), and REL (OR=2.04, p=.022), and odds of depression risk by SYM (OR=8.20, p<.001) and BHL (OR=2.33, p=.025). The associations did not vary significantly by current remission status. Conclusion: In this sample, one-third to one-half of lymphoma survivors experienced substantive symptoms of depression and anxiety. Unaddressed and untreated emotional distress, regardless of cancer remission status, may contribute to increased risk. Concerns about symptom burden and impact had strong associations with both anxiety and depression risk. Interestingly, concern about healthcare team communication, on average, was lower than other distress domains but had the strongest association with anxiety risk. Routine multidimensional distress screening, including risk assessment for both anxiety and depression, can identify cancer-related concerns and triage patients to tailored care for emotional and mental health. Future research should examine barriers to accessing care for emotional and mental health concerns among lymphoma patients and survivors.

Perceived posttraumatic growth after interpersonal trauma and subsequent well-being among young Colombian adults: A longitudinal analysis.

Research has shown that people sometimes report self-perceived growth as a result of dealing with a potentially traumatic event, but relatively few methodologically rigorous studies have examined whether perceived posttraumatic growth is associated with improved subsequent well-being across a wide range of outcomes. In this three-wave longitudinal study of Colombian emerging adults (n = 636), we examined the associations of perceived posttraumatic growth with 17 well-being outcomes across domains of psychological well-being (i.e., self-rated mental health, meaning in life, sense of purpose, happiness, life satisfaction), psychological distress (i.e., anxiety symptoms, depression symptoms, subjective suffering), social well-being (i.e., content with relationships, satisfying relationships, loneliness), physical well-being (i.e., self-rated physical health, sleep quality), and character strengths (i.e., state hope, trait forgivingness, orientation to promote good, delayed gratification). Using an outcome-wide analytic design that adjusted for a range of covariates assessed in Wave 1, we found that overall perceived posttraumatic growth assessed in Wave 2 was robustly associated with improvements in one or more facet of each well-being domain (15/17 outcomes in total) assessed approximately six months later in Wave 3. Our findings suggest that perceived posttraumatic growth may contribute to individual well-being over the longer-term.

Systems training for emotional predictability and problem solving in older adults with personality disorders: a pilot study.

Systems Training for Emotional Predictability and Problem Solving (STEPPS) is a cognitive behavioural therapy-based group treatment programme for patients with borderline personality disorder (BPD). STEPPS has demonstrated its effectiveness for (younger) adults. However, there are no studies into the effects of STEPPS for older adults. The aim was to explore the outcome of STEPPS in older adults with personality disorders. In this naturalistic pre- vs post-treatment study, older patients with a personality disorder, reporting emotion regulation difficulties, were included. The primary outcome was BPD symptoms. Secondary outcomes included psychological distress and maladaptive personality functioning. Twenty-four patients, with a mean age of 63.9 years (SD=4.6), completed the 19-week programme. Nine patients (23.1%) did not complete the treatment. There were no significant differences in age, gender or global severity between completers and patients dropping out. There was a significant pre- vs post-treatment decrease of BPD symptoms, with a large effect size (Cohen's d=1.577). Self-control improved significantly and demonstrated a large effect size (r=.576). Furthermore, identity integration improved significantly, with a medium effect size (Cohen's d=.509). No significant differences were reported for most domains of psychological distress and maladaptive interpersonal personality functioning. The findings in this pilot study suggest STEPPS is a feasible treatment programme for older adults with personality disorders and emotion regulation difficulties. Adaptations to the program, for a better fit for older adults, however, might be needed.

High Distress Portends Worse Patient-Reported Outcomes Among Newly Diagnosed Breast Cancer Patients

INTRODUCTION: New cancer diagnoses may lead to heightened levels of distress, which may affect quality of life (QoL). In this study, we aimed to evaluate the relationship between high distress and patient-reported outcomes (PRO) among newly diagnosed breast cancer patients. METHODS: Patients evaluated for stage 0–III breast cancer at an academic breast center were offered a cancer distress screening survey which measures 4 domains of distress: emotional, health, social, and practical. High distress was defined as a score greater than 5 of 10 in any domain. Immediately after their initial appointment, patients were invited to complete the Breast-Q module, a validated PRO scale evaluating QoL across 4 domains: satisfaction with breasts (SB), psychosocial wellbeing (PsW), physical wellbeing (PhW), and sexual wellbeing (SW). The primary outcomes were scores for each Breast-Q domain. Groups were compared by t-tests, Mann–Whitney U tests, and multiple regression models. RESULTS: A total of 111 patients completed both the distress screen and the PRO survey. Sixty-seven patients (60%) had high distress, whereas 44 patients (40%) did not have high distress. In the univariate analysis (Figure), patients with high distress had lower SB (p < 0.01), PsW (p < 0.01), PhW (p = 0.03), and SW (p < 0.01) scores. In the multiple regression, high distress was an independent predictor of lower score for SB (p = 0.02), PsW (p = 0.02), and SW (p = 0.03). CONCLUSION: Breast cancer patients with high distress at diagnosis report worse QoL compared with their peers. Early intervention should be provided to improve QoL in this patient population.Figure