Effects Of Psychological Distress Research Articles

Objectively Measured Social Integration Is Associated With an Immune Risk Phenotype Following Marital Separation

Close relationships play an integral role in human development, and robust evidence links marital separation and divorce to poor health outcomes. Social integration may play a key role in this association. In many ways, the study of marital separation and divorce provides an ideal model system for a more complete understanding of the association between life stress and physical health. The current study investigated associations among objectively measured social integration, psychological distress, and biomarkers of immune health in recently separated adults (N = 49). We collected four measures of immune functioning-interleukin-6, C-reactive protein, and antibody titers to latent cytomegalovirus and Epstein-Barr virus-that were combined to yield a viral-Immune Risk Profile. To assess how variability in social integration is associated with immunological correlates following the end of a marriage, we incorporated observational ecological momentary assessment data using a novel methodology (the Electronically Activated Recorder). We found that objectively measured social behaviors are associated with concurrent viral-Immune Risk Profile scores over and above the effects of psychological distress and that psychological distress may be linked to biomarkers of immune health through social integration. This research expands current knowledge of biomarkers of immune health after divorce and separation and includes a new methodology for objective measures of social engagement.

Gender Differences in Suicidal Behaviors: Mediation Role of Psychological Distress Between Alcohol Abuse/Dependence and Suicidal Behaviors

Suicide is the second leading cause of death among emerging adults ages 18 to 25. Aims: To examine gender differences on the mediation effect of psychological distress between alcohol abuse or dependence (AAD) and suicidal behaviors (ideation, plan, and attempt). Method: The current study used the 2014 NSDUH public use data. Young adults aged 18 to 25 years (M = 21.02) old were selected as study participants. The three outcome variables were suicide ideation, plan, and attempt. AAD was an independent variable. As a mediation variable, psychological distress was used to test the research questions. The mediation effect was tested by using bootstrapping methods with the SPSS version of the macro (PROCESS version 2.16) developed by Preacher and Hayes. Results: Six separate mediation analyses (three for a male and three for a female group) were conducted for different types of suicidal behaviors including ideation, plan, and attempt. Overall, psychological distress mediated the association between AAD and suicidal behaviors, except the relationship between AAD and suicide attempts among the male young adults group. Conclusions: The findings of the current study provide specific directions for practitioners to reduce suicide rates among young adults who are at risk for suicidal behavior.

Predictors of well-being in the lives of student service members and veterans

ABSTRACTObjective: The current study examined predictors of well-being, including quality of life and academic engagement, in a sample of student service members and veteran college students. Methods: Eighty-seven student service members/veterans (SSM/V) completed an online survey containing questions about post-deployment social support, emotion regulation skills, psychological distress, academic engagement, quality of life, and demographics. Participants were recruited from September 2012 through May 2014. Results: Results provided partial support for the proposed bi-directional mediational relations between post-deployment social support and emotion regulation predicting to quality of life and academic engagement. Path models indicated that both post-deployment social support and emotion regulation skills partially mediated the relation with quality of life while accounting for the effect of psychological distress, and that emotion regulation skills fully mediated the relation between social support and academic engagement. Conclusions: These findings suggest that both social support and emotion regulation skills may be useful targets for health promotion and intervention efforts for this population. Limitations and clinical implications for the development of on-campus SSM/V focused health promotion services are discussed.

Sex differences in effects of trait impulsivity on vulnerability to substance dependence

Aims: Trait level impulsivity is a core feature of addictive processes. Research with non-clinical populations suggests that different components of impulsivity are most prominent among men (sensation seeking: SS) and women (negative urgency: NU). This study investigated potential sex differences in the relationship between sensation seeking, negative urgency and substance use among 271 participants with substance use disorders (SUDs). Methods: 139 men and 132 women completed the UPPS-P Impulsive Behavior Scale as part of a larger study of sex differences in neurocognition and drug dependence. DSM-IV TR diagnoses wereobtainedusing theSCID-SubstanceAbuseModule.All subjects were verified abstinent by toxicology screening. Results: As predicted, men scored significantly higher on the SS (p= .02) (Cohen’sd=0.50)whileNUscoreswere significantlyhigher for women (p< .001) (Cohen’s d=0.3). Among women, higher NU scores were significantly associated with past alcohol dependence, p= .01. By contrast, higher SS scores were significantly associated with cocaine dependence among men, p= .004. These results were unchanged when controlling for depression. Conclusions: NU is an index of behavioral dyscontrol triggered by negative affect and SS is the tendency and openness to try new and exciting activities that vary in danger level. NU had a significant positive relationship with past alcohol dependence only for women and this effect could not be attributed to nonspecific effects of psychological distress,while SSwas significantly associatedwith cocaine dependence, but only among men. These findings suggest that specific components of impulsivity interact with vulnerability to substance use disorders differently amongmen and women and that effective prevention and treatment strategies for alcohol and cocaine dependence may benefit from sex and substance specific tailoring. Financial support: Supported by the National Institute on Drug Abuse R01 DA12828.

Effect of psychological distress on weight concern and weight control behaviors.

Obesity is associated with chronic disorders like coronary artery diseases, metabolic syndrome, cancers, and psychiatric disorders. Stress may contribute to weight gain by disrupting weight concern, and lead to uncontrolled eating behavior. This study aimed to investigate the effects of stress on weight concern and control behaviors in normal weight and obese adults. A total of 9544 subjects were selected by multi-stage random sampling from three provinces in central Iran. Information related to weight concern and control behavior was registered in normal weight and obese participants. Psychological distress was measured by a 12-item General Health Questionnaire (GHQ-12) and subjects were divided into high and low stress groups. Logistic regression was used for analysis. The mean age of participants was 38.7 ± 15.5 years and 50% (4772) of them were males. The adjusted odds ratio (OR) for age, sex and education of high stress to low stress level for weight concern, weight control behavior and acceptable physical activity behavior was more than 1; but the OR was less than 1 for waist circumference, obesity and healthy diet behavior. Among obese participants, higher levels of stress were associated with lower weight concern with OR, 95%CI: 0.821, (0.682 - 0.988), lower acceptable physical activity with OR = 0.833, 95%CI: (0.624 - 0.912), but higher rates of healthy diet behavior with OR = 1.360, 95% CI: (1.040 - 1.780). Individuals with high stress level have lower weight concern and lower physical activity; therefore, they are prone to weight gain and obesity. It could be concluded that stress management should be considered as a crucial component of obesity prevention and control programs.

Sa1220 The Effect of Psychological Distress and Perceived Stress on Change in Symptom Activity and Inflammation Over Time in Crohn's Disease

Sa1220 The Effect of Psychological Distress and Perceived Stress on Change in Symptom Activity and Inflammation Over Time in Crohn's Disease

Effects of psychological distress and perceptions of illness on recovery from total knee replacement

This cohort study investigated the influence of psychological factors, including perception of illness, anxiety and depression on recovery and functional outcome after total knee replacement surgery. A total of 100 patients (55 male; 45 female) with a mean age of 71 (42 to 92) who underwent a primary total knee replacement for osteoarthritis were recruited into this study. In all 97 participants completed the six week and 87 the one year follow-up questionnaires. Pre-operatively patients completed the revised Illness Perception Questionnaire, Hospital Anxiety and Depression Scale and Recovery Locus of Control Scale. Function was assessed pre-operatively, at six weeks and one year using Oxford Knee Score (OKS) and the goniometer-measured range of movement (ROM). The results showed that pre-operative function had the biggest impact on post-operative outcome for ROM and OKS. In addition questionnaire variables and depression had an impact on the OKS at six weeks. Depression and anxiety were also associated with a higher (worse) knee score at one year but did not influence the ROM at either six weeks or one year. Recovery from total knee replacement can be difficult to predict. This study has identified psychological factors that play an important role in recovery from surgery and functional outcome. These should be taken into account when considering patients for total knee replacement.

Gender moderates the influence of psychosocial factors and drug use on HAART adherence in the context of HIV and childhood sexual abuse

This study aimed to examine gender moderation within a stress and coping model of HIV medication adherence in adults with a history of childhood sexual abuse (CSA). Sequelae of CSA, including negative coping, psychological distress, and drug use, interfere with adherence to highly active antiretroviral treatment (HAART). These obstacles to adherence are likely moderated by gender. Gender may particularly influence the mediational effect of drug use on adherence. Participants included 206 adults living with HIV/AIDS and CSA. Categorical/continuous variable methodology in a structural equation modeling framework was used to test a multigroup model with women and men. Gender significantly moderated several effects in the model. For women, the effect of psychological distress on HAART adherence was mediated by drug use and the effect of drug use on viral load was mediated by HAART adherence. Among men, drug use did not significantly impact adherence. Since gender appears to moderate the effect of drug use on medication adherence, it is particularly important to address drug use within the context of HIV disease management in women with a history of CSA. Further, interventions to increase HAART adherence should take trauma history, gender, and drug abuse into account when assessing efficacy.

1079 – Effects of psychological distress and social support on mental fitness among patients of mental health services

Introduction Life events and accompanying psychological and behavioral reactions frequently have an impact upon people's daily lives and are believed to predispose them to disease. Psychological stressors impact many physiological and pathological disease outcomes, including mental illness. Positive social interactions have in turn been shown to exert powerful beneficial effects on health outcomes and longevity. Objectives The Objective of this study was to analyze the relationships of Psychological Distress, Social Support, and Mental Fitness among patients of mental health services. Aims This article aims to discuss the evidence supporting the mediating effect of social support between psychological stress and mental health. Methods This study was performed on patients who visited the mental health services in Daejeon from October to December 2011. In total, 395 patients were evaluated with Mental Fitness Scale, Kessler Psychological Distress Scale(KPDS), and Multidimensional Scale of Perceived Social Support(MSPSS). Results Correlations among variables of psychological distress and social support on subordinate variable of mental fitness of patients were significant. The result of the regression analysis, psychological distress and social support have a positively significant influence on mental fitness of patients. social support showed mediating effects between psychological distress and mental fitness. Conclusion These results suggest that health care providers ought to seek social support for patients, in order to provide positive mental fitness of patients.

Age-Related Differences in the Effect of Psychological Distress on Mortality: Type D Personality in Younger versus Older Patients with Cardiac Arrhythmias

Background. Mixed findings in biobehavioral research on heart disease may partly be attributed to age-related differences in the prognostic value of psychological distress. This study sought to test the hypothesis that Type D (distressed) personality contributes to an increased mortality risk following implantable cardioverter defibrillator (ICD) treatment in younger patients but not in older patients. Methods. The Type D Scale (DS14) was used to assess general psychological distress in 455 younger (≤70 y, m = 59.1) and 134 older (>70 y, m = 74.3) ICD patients. End points were all-cause mortality and cardiac death after a median follow-up of 3.2 years. Results. Older patients had more advanced heart failure and a higher mortality rate (n = 34/25%) than younger patients (n = 60/13%), P = 0.001. Cardiac resynchronization therapy (CRT), but not Type D personality, was associated with increased mortality in older patients. Among younger patients, however, Type D personality was associated with an adjusted hazard ratio = 1.91 (95% CI 1.09–3.34) and 2.26 (95% CI 1.16–4.41) for all-cause and cardiac mortality; other predictors were increasing age, CRT, appropriate shocks, ACE-inhibitors, and smoking. Conclusion. Type D personality was independently associated with all-cause and cardiac mortality in younger ICD patients but not in older patients. Cardiovascular research needs to further explore age-related differences in psychosocial risk.

The Effects of Psychological Distress, Work, and Family Stressors on Child Behavior Problems

Family stressors help identify behavioral outcomes in children. Yet, there may be subsequent factors associated with child behavior problems. An expansion of the current literature on child behavior problems will allow for further interpretation of these subsequent factors. The purpose of this study is to examine the influence of psychological distress and work and family strcssors on child behavior problems for parents (N=85 l) from the 1995 Detroit Area Study. Findings suggest that respondents who were younger, experienced psychological distress, lived in large households, felt bothered as a parent, and had difficulty balancing work and family were more likely to experience child behavior problems than their peers. Implications for this study underscore the application of an intcrscctional approach when working with children and families so that various aspects of parental and child well-being are addressed by researchers and service professionals.

Review of Psychiatry and heart disease: The mind, brain and heart.

Psychiatry and Heart Disease: The Mind, Brain and Heart, by Michelle Riba, Lawson Wulsin, and Melvyn Rubenfire (Eds.), Divy Ravindranadi (Associate Ed.). Wiley, 2012, 257 pages (ISBN: 978-0-470-68580) Reviewed by PAUL GREENMAN DOI: 10.1037/a0027763 As psychologists become increasingly involved in the provision of interdisciplinary, frontline healdi care services in Canada, resources to guide them in their assessment and treatment of medical patients are more important than ever. To ensure that their patients receive the highest quality care possible, psychologists who work with people suffering from chronic physical illnesses such as heart disease, diabetes, inflammatory bowel disease, and cancer must not only have a solid understanding of the psychological and interpersonal consequences of these illnesses, but also of the biological bases of their aetiology and treatment. The new book Psychiatry and Heart Disease responds well to this growing need for clear, concise materials to help psychologists learn from and contribute to interdisciplinary healtii care teams. Any psychologist who works with patients recovering from heart disease is confronted on a daily basis with side effects of heart medications that affect mood and behaviour, or the discovery of a new psychosocial element to their heart patient's condition. Requests for help and direction from colleagues in different healdi professions who are treating the same patient are also common. The chapters in this volume provide an excellent bridge between the biological and psychological aspects of heart disease. They include overviews of the psychological consequences of heart disease and its treatment, discussions of the potential biological causes of psychological problems related to heart disease, side effects of medications typically prescribed for cardiac patients, and summaries of empirically supported pharmacological and psychological treatment options for patients with psychological difficulties in the wake of heart disease. A particular strengtii of this volume is the attention paid to the unique psychological consequences of specific cardiac ailments and cardiac treatments (e.g., atherosclerosis, heart attack, heart transplants, installation of implantable cardioverter-defibrillators, arterial hypertension). The book also contains chapters on noncardiac chest pain, sleep disorders related to heart disease, and the behavioural components involved in the development and treatment of cardiac illness. The preface and the first three chapters focus on the welldocumented link between depression and heart disease, the effects of psychological distress on cardiac outcomes, and the underlying biological processes diat contribute to the onset of psychological distress and the exacerbation of cardiac disease. Although the authors of Chapter 3 mention anxiety and anger in their discussion, the emphasis in this part of the book is on the relation between depression and cardiac illness, most likely because of the extensive scientific literature on the subject. The next three chapters (Chapters 4-6) present empirical findings and theoretical models of the psychiatric implications of cardiac surgery, cardiac transplantation, and the implantation of electronic devices such as left ventricular assist devices and implantable cardioverter-defibrillators. These chapters, along with a number of others in the book, give much needed attention to the lesser known but equally important psychosocial consequences of the treatment of cardiac illnesses, rather than the attention often paid to the psychosocial consequences of the diseases themselves. …

Abstract 3696: Psychological stress inhibits, while GABA potentiates, the prevention of pancreatic cancer progression in xenografts by celecoxib

Abstract Pancreatic cancer has a poor prognosis and is associated with high levels of psychological distress. We have earlier shown that beta-adrenergic receptors, which are activated by stress neurotransmitters, regulate pancreatic cancer cells via cAMP-dependent signaling in vitro and that psychological distress promotes pancreatic cancer growth in vivo. The observation that psychological distress acts as an ancillary factor in growth promotion of pancreatic cancer have implications for cancer prevention strategies where stress initiated growth stimulus may retard the efficacy of cancer preventive regimens. Therefore this study tested the hypothesis that psychological stress inhibits the cancer preventive effects of celecoxib on pancreatic cancer progression whereas α-aminobutyric acid (GABA) which neutralizes the stress neurotransmitter stimulated cAMP signaling may potentiate the chemopreventive outcome of anti-cancer drugs. The effects of psychological distress in the absence and presence of treatment (with COX-2 inhibitor celecoxib alone / celecoxib with GABA co-adminstration) was tested in mice carrying xenograft from human pancreatic cancer cell line BxPC-3. Neuroendocrine responses (noradrenaline, adrenaline, cortisol &amp; GABA), cancer stimulating factors (VEGF &amp; prostaglandin PGE2) and levels of cAMP were measured by immunoassays in serum and xenograft tissue. Phosphorylation of nicotinic receptors (≥4 and α7), beta-adrenergic receptors, celecoxib targets (COX-2 &amp; 5-lipoxygenase) and signaling proteins downstream of α-ARs were determined by semi-quantitative Western blots. The results show a significant inhibition of cancer preventive effects of celecoxib by psychological stress. By contrast, GABA significantly potentiated the preventive effects of celecoxib in this tumor model. The effector molecules of stress signaling via the cAMP pathway were downregulated by GABA and celecoxib additionally inhibited COX-2 and 5-lipoxygenase lead to significant inhibition of tumor growth in our xenografts model. Our findings identify the interruption of stress-induced c-AMP-dependent neuroendocrine stimulation as central regulator of pancreatic cancer that negatively impacts cancer prevention. In addition, our data identify the anti-stress GABA signaling as an effective adjuvant to standard interventions which in turn shows induce in the COX-2 phosphorylation and increase PGE2 level in the social stress groups which are inhibited by GABA or celecoxib or combination treatment. Better understanding in the above areas may help to develop new therapeutic for pancreatic cancer development. Grant Support: RC1CA144640 and R01CA042829 with the National Cancer Institute. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 3696. doi:1538-7445.AM2012-3696

Abstract 329: Effect of Psychological Distress on Cardiovascular Event Rates One Year Following Cardiac Rehabilitation

Rationale: Psychological (psych) distress is a putative risk factor for coronary artery disease (CAD) and may affect compliance with lifestyle &amp; treatment. We sought to determine the impact of psych distress in cardiac rehab (CR) patients (pts) on cardiovascular event rates (CVE) including PCI/CABG, coronary angiogram, acute coronary syndrome (ACS). Methods: Psych profile of 440 CAD pts was assessed on entry to CR using Symptom Check List-90 (SCL-90). Questionnaire screened for depression (dep), anxiety (anx), hostility, and a global severity index (GSI). Mean SCL-90 T-score for each parameter in the adult population is 50 with a standard deviation of 10. SCL-90 score ≥60 = 84th percentile, SCL≥63 = 90th percentile, SCL score ≥70 is the 98th percentile. Complete data on repeat admissions and subsequent non-elective and elective CV procedures performed in the one-year following enrollment to CR was available on 410 pts. Results: Of the 440 pts 28.4% were female, 75.7% married and 89% Caucasian; 25.5% were hypertensive, 20.5% diabetic and 47% had a BMI&gt;30. Mean age was 61.5+10.7. Clinical indication for CR: 56.4% PCI/CABG, 8.4% stable angina (SA) and 35.2% ACS. There was a high prevalence of dep, anx, and overall psych distress as measured by the GSI (Table1.) SA pts had significantly higher prevalence of anx (p=0.018) and hostility (p=0.009) compared to PCI/CABG and ACS. There was no difference in SCL-90 scores by gender, age, education, body mass index (BMI) or diabetes. 89 CVE required hospital admission; 62 (15.1%) pts once and 27(6.5%) two or more times. Reasons for the 89 readmissions included myocardial infarction (7.9%), SA (11.2%), unstable angina (50.6%) and other non-cardiac (30.3%). 62 procedures were performed, which included 6(10%) CABG, 21(34%) PCI, 20(32%) heart catheterizations, and 15(24%) other procedures. Forty percent of procedures performed were elective. Odds of readmission at one year was 3.14 greater in pts with dep score ≥70 (p=0.003) and 2.95 times greater in pts with Anx score ≥70 (p=0.037). Pts with dep score ≥70 were 3.4 times more likely to get a non-elective procedure (p&lt;0.001), while the likelihood of a non-elective procedure in a patient with anx score ≥70 was not statistically significant (p=0.59) (Table 2.) 32 (7.8%) of pts had both dep and anx scores ≥ 63 and these pts were significantly more likely to be re-admitted OR 3.14, (p=0.003) and more likely to have multiple admissions OR 3.9 (p=0.007). Conclusions: Psych distress in CR pts has a significant impact on outcomes. Consideration should be given to routine psych profiling at entry to CR and appropriate treatment for these pts.

Resources as a Protective Factor for Negative Outcomes of Frailty in Elderly People

Background: Although frailty is often conceptualized in terms of deficits, the level of frailty can be perceived as a complex interplay between deficits and resources. Objective: We studied whether resources such as educational level, financial situation, and living-alone status moderate the negative effects of deficits on two potentially adverse consequences of frailty: self-perceived health and receiving professional care. Methods: Logistic regression analysis was performed with data from a cross-sectional survey, designed by the public health service in the south of the Netherlands. The questionnaire was completed by a representative sample of people aged 70 and over (n = 5,559). Interaction effects between deficits (multimorbidity, difficulty performing ADLs, psychological distress, loneliness) and resources (educational level, financial situation, living-alone status) were studied in relation to self-perceived health and receiving professional care. Results: We found that in males the effect of difficulty in performing ADLs on self-perceived health was modified by educational level (p < 0.05, indicating that difficulty in performing ADLs is more strongly related to moderate/bad self-perceived health for those with higher education). In females, the effect of psychological distress on self-perceived health was modified by educational level (p < 0.05, indicating that suffering from psychological distress is more strongly related to moderate/bad self-perceived health for those with higher education) and the effect of difficulty in performing ADLs on receiving professional care was modified by living-alone status (p < 0.05, indicating that difficulty in performing ADLs was more strongly related to receiving professional care for those women who lived alone). Conclusions: Resources moderate the impact of personal deficits on self-perceived health and receiving professional care. Some frail people seem to be more vulnerable as they lack resources such as a high level of education. This should be taken into account in deciding when elderly people are at risk of negative outcomes of frailty and is therefore important for health professionals and policy-makers.

Effects of Psychological Distress on Academic Achievement in Brunei Student Teachers: Identification Challenges and Counseling Implications

Students with psychological and mental health problems are often accorded a low status and priority compared to peers with other disabilities. Recent research indicated that a female Brunei student teacher prematurely left her training program due to unaddressed mental health problems. The present study used a mixed methods approach. The random sample consisted of 85 trainee teachers (59 females) out of whom 6 at-risk and vulnerable students (2 males and 4 females) with extreme scores on the psychometric assessments and depressed scores on the academic evaluations were included in the case study. Anxiety was found operating in combination with either extroversion or introversion. While mild extroversion, introversion, and anxiety were not necessarily harmful, excessive amounts of each of these traits could undermine a student’s educational and social functioning. Recommendations included encouraging students to undergo voluntary testing, self-referred counseling, and mounting an active mental health promotion campaign and pastoral care program.

Effect of Psychological Distress on Continuation of Anti-Tumor Necrosis Factor Therapy in Patients with Rheumatoid Arthritis

To investigate the relationship of psychological distress and associated factors with continuation of tumor necrosis factor (TNF) antagonist therapy in patients with rheumatoid arthritis (RA). Patients about to start therapy with TNF antagonists (n = 166) were assessed for psychological distress using the Hospital Anxiety and Depression Scale (HADS). A core set of demographic and clinical variables, including comorbidities from medical records and cigarette smoking history by questionnaire, were recorded at baseline and regular intervals thereafter. Cox proportional hazards regression analysis was used to assess the likelihood of patients discontinuing therapy over a 36-month followup period. The number of years smoked was associated with anxiety (HADS-A; p for trend = 0.008) and general psychological distress (HADS-Total; p for trend = 0.03). In univariate analyses, earlier discontinuation was associated with these variables at baseline: anxiety (HADS-A), depression (HADS-D), abnormal mood (HADS-Total), smoking history (> 30 pack-yrs), years smoked (> 30 yrs), current smoking, high Disease Activity Score 28-joint count (DAS28), poor patient global assessment, and evidence of cardio/cerebrovascular disease (CVD). In multivariate analyses, the strongest predictors of discontinuation were HADS-Total, smoking history (> 30 pack-yrs), DAS28, and evidence of CVD at baseline. Discontinuation of therapy with TNF antagonists is independently associated with psychological distress, heavy smoking, and CVD at baseline.

The Effect of Psychological Distress on Medication Adherence in Persons With HIV Infection in Nigeria

A high level of adherence to prescribed antiretroviral (ARV) regimens is required to achieve and maintain suppression of human immunodeficiency virus (HIV) replication and prevent drug resistance. This study aimed to determine the possible relationship between psychopathology and ARV medication adherence in Nigeria. Persons with HIV infection (N = 182) completed various questionnaires on sociodemographic and clinical details, general psychopathology, self-esteem, and medication adherence. Low medication adherence was reported in 26.9% of the participants; significant correlates included presence of psychopathology and perceived poor social support. The success of any intervention policy for HIV-infected persons in sub-Saharan Africa must consider both low level of medication adherence and its associated factors.

The Effect of Psychological Distress on Medication Adherence in Persons With HIV Infection in Nigeria

A high level of adherence to prescribed antiretroviral (ARV) regimens is required to achieve and maintain suppression of human immunodeficiency virus (HIV) replication and prevent drug resistance. This study aimed to determine the possible relationship between psychopathology and ARV medication adherence in Nigeria. Persons with HIV infection (N=182) completed various questionnaires on sociodemographic and clinical details, general psychopathology, self-esteem, and medication adherence. Low medication adherence was reported in 26.9% of the participants; significant correlates included presence of psychopathology and perceived poor social support. The success of any intervention policy for HIV-infected persons in sub-Saharan Africa must consider both low level of medication adherence and its associated factors.

Neuropsychological Function 5 Years after Cardiac Surgery and the Effect of Psychological Distress

Research has shown conflicting results with regard to the influence of depression and anxiety on neuropsychological performance following coronary artery bypass graft (CABG) surgery. Notably, the independent effects of depression and anxiety have not been examined among CABG candidates in the longer term where it is has been suggested that these patients show marked cognitive deterioration. A neuropsychological test battery and measures of psychological distress were completed by 86 CABG patients and 50 nonsurgical control participants at baseline and 6 months, whereas 75 patients and 36 controls, respectively, completed a 5-year follow-up. In CABG patients, cognitive and affective depressive symptoms were independently associated with lower and worse performance on the Boston Naming Test, Purdue Peg Board, and Digit Symbol Coding 6 months after surgery, whereas at 5-year follow-up an effect for Digit Symbol persisted, and an association was also observed for the Trail Making Test (TMT). On average, CABG patients performed worse on TMT and Digit Symbol at 6 months, whereas at 5-year follow-up their performance was worse on short-term delayed verbal recall. The results among the CABG patients did not show a consistent pattern of association between psychological distress and those neuropsychological domains that were on average significantly lower than a nonsurgical control group. The results here also support the use of nonbiased statistical methodology to document dysfunction among heterogeneous cognitive domains after CABG surgery.