Symptoms Of Emotional Distress Research Articles

The Relationships between Metacognitive Beliefs and Personality Dysfunction: A Test Controlling for Personality Traits, Emotional Distress Symptoms and General Functioning

The Relationships between Metacognitive Beliefs and Personality Dysfunction: A Test Controlling for Personality Traits, Emotional Distress Symptoms and General Functioning

PSYCHOSOCIAL RISK AND DISTRESS IN CAREGIVERS OF CHILDREN WITH CANCER

Family members experience challenging situations in the diagnosis/treatment of childhood cancer. The illness can affect the family adjustment and adherence to the child/adolescent's care, reflecting on routines and relationships (family, marital, work and social). Cancer can reach high levels of distress in caregivers. The aim of this research was to investigate the relationships between indicators of psychosocial risk and distress in caregivers of children/adolescents with cancer. Fourteen caregivers answered the instruments on: socioeconomic characteristics (Brazil Economic Classification Criterion [CCEB]); psychosocial risk assessment (Psychosocial Assessment Tool [PAT 2.0]); and distress (Distress Thermometer). The data were submitted to descriptive and inferential statistical analysis. It was found that most families presented a "target" classification of psychosocial risk and distress (e.g., worry, nervousness and pain). Inferential analyses did not confirm the hypothesis of a correlation between the level of distress and the total PAT score. However, positive correlations were observed between the domains of the scales, such as: positive correlation between the level of distress and problems with patients; and between partner distress and sibling problems, caregivers' problems, and caregivers' stress reactions. Negative correlations between physical and emotional distress symptoms and PAT domains were also observed. Caregiver distress may represent limitations to treatment, as it impacts emotional well-being and psychosocial functioning, especially in vulnerable families. Further studies are suggested to consider clinical and sociodemographic characteristics in order to understand the relationships between psychosocial variables involved. The need for systematic psychosocial assessment for pediatric oncology care is reinforced.

Do Patient's Interpersonal Problems Improve Following Metacognitive Therapy? A Systematic Review and Meta-Analysis.

Metacognitive therapy (MCT) aims to modify dysfunctional metacognitions that are thought to be universal determinants of emotional distress and psychological dysfunction more generally. MCT is an effective treatment for emotional distress symptoms, but less is known about its effect for other types of psychological problems. Interpersonal problems are common in psychological disorders and should be improved following psychotherapy. Therefore, we conducted a systematic review and meta-analysis of trials on the effects associated with MCT for interpersonal problems among adults with mental health disorders published until 15 November 2023 using PubMed, Cochrane Library and PsycNet. Trials with a minimum of 10 participants were included. A total of six studies based on five trials reported on the effectiveness of MCT for interpersonal problems and met our inclusion criteria. Two trials evaluated MCT for patients with major depressive disorders, two for patients with anxiety disorders and one for borderline personality disorder. Three of the trials were randomized controlled trials. Four of the trials reported follow-up data but varied in their time-points. The within-group effect size estimate from pretreatment to posttreatment across five trials was large (g = 0.865, 95% CI [0.512-1.218]). Our results indicate that MCT is an effective treatment for improving interpersonal problems in individuals with common mental disorders, even though the treatment is short and primarily concern improving mental regulation through modifying metacognitions. While this finding is in line with metacognitive theory, more trials evaluating personality and interpersonal functioning are needed to draw firm conclusions.

Clinical effects of traditional Chinese herbal medicine management in patients with COVID-19 sequelae: A hospital-based retrospective cohort study in Taiwan.

Introduction: An estimated 43% of COVID-19 patients showed sequelae, including fatigue, neurocognitive impairment, respiratory symptoms, and smell or taste disorders. These sequelae significantly affect an individual's health, work capacity, healthcare systems, and socioeconomic aspects. Traditional Chinese herbal medicine (TCHM) management showed clinical benefits in treating patients with COVID-19 sequelae. This study aimed to analyze the effects of personalized TCHM management in patients with COVID-19 sequelae. Methods: After the COVID-19 outbreak in Taiwan, we recorded Chronic Obstructive Pulmonary Disease Assessment Tool (CAT), Chalder Fatigue Questionnaire (CFQ-11), and Brief Symptom Rating Scale (BSRS-5) to assess post-COVID respiratory, fatigue, and emotional distress symptoms, respectively. In this study, we retrospectively reviewed the medical records between July 2022 and March 2023. We analyzed the effects of TCHM administration after 14- and 28-days of treatment. Results: 47 patients were included in this study. The results demonstrated that personalized TCHM treatment significantly improved the CAT, CFQ-11, and BSRS-5 scores after 14 and 28 days. TCHM alleviated physical and psychological fatigue. In logistic regression analysis, there was no statistically significant differences in the severity of the baseline symptoms and TCHM administration effects concerning the duration since the initial confirmation of COVID-19, sex, age, or dietary preference (non-vegetarian or vegetarian). Conclusions: Our study suggested that personalized TCHM treatment notably reduced fatigue, respiratory and emotional distress symptoms after 14- and 28-days of treatment in patients with COVID-19 sequelae. We propose that TCHM should be considered as an effective intervention for patients with COVID-19 sequelae.

Prevalence of experiencing public humiliation and its effects on victims’ mental health: A systematic review and meta-analysis

Public humiliation is a negative self-conscious emotion that results from experiencing public humiliation; that is, being humiliated in public in front of witnesses. In the current study, experiencing public humiliation refers to the humiliation that is caused by a perpetrator or perpetrators with negative intent at a location that is accessible or visible to the public and in the presence of a witness(es). To investigate the settings where public humiliation occurs, its prevalence, and its impact on victims’ mental health, a systematic review and meta-analysis approach were employed. A total of 33 studies with a sample size of 40,468 were included in the current study. The findings demonstrate the behaviour of public humiliation occurred in a variety of settings (e.g., medical training, healthcare provision, schools) and population groups. The pooled prevalence of experiencing public humiliation was 34.9% (95%CI [0.266, 0.442]). The pooled effect size of experiencing public humiliation on victims’ mental health outcomes was OR = 1.878, 95%CI [1.550, 2.276]. Public humiliation appears to have a substantial impact on victims’ mental health (including symptoms of emotional distress, anxiety, depression; increased stress; posttraumatic stress disorder; suicidal ideation/attempt; Stockholm syndrome, burnout, and being traumatised). A potential mental health pathway model depicting the mechanism underlying the relationship between experiencing public humiliation and mental health is proposed. Recommendations are provided for future research to isolate public humiliation to understand its specific effect on mental health and for developing interventions.

Implementing an integrated care pathway for Somatic Symptoms and Related Disorders (SSRDs) in paediatric population

Introduction: Somatic symptom and related disorders (SSRDs) are commonly encountered in pediatric hospital settings. These children and youth, who present with physical symptoms (e.g., headache, abdominal pain, dizziness) of emotional distress (e.g., anxiety, stress) are diagnostically and psychosocially complex, posing significant challenges for medical and behavioral health care providers. Children and adolescents with SSRDs have high health system utilization and costs and present in multiple clinical settings, have high school absenteeism, and are at elevated risk of iatrogenic harm and missed diagnoses. Patients and their caregivers present with variable readiness to engage in mental health assessment and treatment, with only 40% receiving physician-based mental health care within a year of diagnosis. There is a lack of standardization of care across and within institutions for youth with these disorders. As part of the hospital’s broader strategic direction to integrate physical and mental health care, a SSRD pathway, was developed to address care needs of one of the highest resource intensive populations at a tertiary care hospital. 
 Methods: In 2021, a survey was conducted by our hospital’s implementation team to understand hospital stakeholder priorities when considering the many areas where new integrated care project could be launched. Stakeholders engaged in the survey included physician and operational leaders, clinical staff across the spectrum of disciplines, and a youth and family advisory panel. Focus groups (n = 57) were also conducted to solicit input and feedback. The results highlighted the need to develop a specialized care pathway for children and youth with SSRD focused on integrating physical and mental health care and support with system navigation. Using a logic model with iterative presentations to key stakeholders, the design phase included an interdisciplinary team approach with project management and operational resources to support project implementation and evaluation. Care pathways were developed based on a patient’s readiness to engage in mental health treatment and where they we along their diagnostic odyssey and care journey and intensity of resources required to support their care needs.
 Integrated Care Pathway: As part of the pilot pathway, a patient’s care journey will be planned in accordance with their level of readiness to accept both a somatization diagnosis and a need for mental health treatment. Patients who are partially or non-receptive to mental health supports will have access to a care manager with both physical and mental health expertise. The care manager will engage with families in shifting their focus and understanding about the mind-body connection and provide extended support with care navigation. Patients who are receptive to mental health treatments, will be referred to a group treatment program led by psychiatry and psychology with a focus on psychoeducation relating to the mind-body connection. Patients in this pathway will also have access to occupational therapy and physiotherapy resources to support with restoring function and improving school attendance, when needed. Pilot evaluation will include process and outcome measures such as number of children engaged in this pathway, time to return to functioning, completion of various mental health measures, and health resource utilization."

Cross-cultural adaptation and validation for central sensitization inventory: based on Chinese patients undergoing total knee arthroplasty for knee osteoarthritis

BackgroundThis study was conducted to develop a simplified Chinese version of the central sensitization inventory (CSI-CV) and to evaluate its reliability and validity.MethodsThe CSI-CV was developed through a process involving the translation and back translation of the original CSI. Subsequently, experts reviewed and revised the content of the items to ensure their appropriateness. A total of 325 patients with knee osteoarthritis (KOA), who were scheduled to undergo total knee arthroplasty (TKA), completed the CSI-CV at a prominent orthopedic center in Xi'an, China. Afterward, a random selection of 100 participants was chosen for retesting after one week. The reliability and validity of the inventory were evaluated through exploratory factor analysis, correlation coefficient calculation and other methods.ResultsThe CSI-CV consists of 25 items in five dimensions (emotional distress, headache and jaw symptoms, physical symptoms, urological symptoms, and fatigue and sleep problems). The cumulative variance contribution rate was 75.3%, the Cronbach's α coefficient was 0.83, the Guttman split-half reliability coefficient was 0.88 and the intraclass correlation coefficient was 0.965. The CSI-CV scores correlated moderately with the total scores of the brief pain inventory (r = 0.506), Western Ontario and McMaster Universities Osteoarthritis Index (r = 0.466) and EuroQoL Group's five-dimension questionnaire (r = 0.576).ConclusionsThe findings demonstrate that the CSI was successfully trans-culturally adapted into a simplified Chinese version (CSI-CV) that was reliable and valid for Chinese-speaking patients who awaiting TKA for KOA.

Fear of cancer recurrence and mental health: A comprehensive meta-analysis.

This study aimed to examine the relationship between fear of cancer recurrence (FCR) and symptoms of anxiety, depression, and emotional distress in cancer survivors. Additionally, potential effect modifiers of this link were investigated. A systematic search was conducted in PsychInfo, PubMed/Medline, Web of Science, and the Cochrane Central Register of Controlled Trials until June 2022. Studies reporting the association between FCR and mental health indices in adolescent and young adult survivors (15-39years) and adult survivors (>18years) were included. Study quality was assessed using the Joanna Briggs Institute checklist for cross-sectional studies. A total of 72 primary studies with 31,740 participants were identified, with the majority having a low risk of bias. The results revealed a significant association between FCR and depression, anxiety, and emotional distress. This association was observed whether FCR was examined in relation to each factor individually or collectively. The effect sizes fell within the medium range. Notably, the relationship between FCR and mental health strengthened over the years of publication. Additionally, lengthier FCR assessment instruments yielded larger effect sizes compared to shorter and single-item instruments, underscoring the significance of instrument selection. This meta-analysis provides further evidence that FCR is linked to a range of common mental health problems. The medium effect sizes observed indicate the need to consider FCR when evaluating the mental health of cancer survivors, and vice versa. Further research is required to elucidate the underlying mechanisms of the FCR-mental health link.

Relationship between eating patterns and emotional distress, and perceived quality of life in women with polycystic ovarian syndrome.

Polycystic Ovary Syndrome (PCOS) is a prevalent endocrine disorder with numerous hormonal, metabolic, and reproductive manifestations. Because of the variety of adverse consequences associated with the condition, women with PCOS suffer emotional distress, resulting in reduced health-related quality of life. Similar to other chronic conditions, eating patterns have been shown effective in impacting the quality of life of PCOS patients. Therefore, lifestyle modifications are recommended as a first-line therapy for PCOS, before prescribing any pharmaceutical management of the PCOS. The aim of the study was to investigate the relationship between dietary patterns, emotional distress, and perceived quality of life in women with diagnosed PCOS. The cross-sectional study included 130 women with PCOS aged 18 - 60 years from the Polish population. The respondents were asked to complete a self-administered questionnaire developed for the purpose of the study, inspired by the Food Frequency Questionnaire (FFQ), Polycystic Ovary Syndrome Health-Related Quality of Life Questionnaire (PCOSQ), Three-Factor Eating Questionnaire (TFEQ-R18), and the Eating attitude questionnaire (Eat-26). Respondents were found to experience emotional distress regardless of how healthy their diet. Nonetheless, the results showed that women who followed a healthier eating pattern had lower occurrence of experiencing mood swings, and less often felt triggered in the social context. The group did not show a tendency to over-eat, gain weight, or binge eating. Healthier eating habits, besides providing advantages in weight management, may mitigate symptoms of emotional distress and improve the quality of life in women with PCOS.

Targeting positive valence systems function in children of mothers with depressive symptoms: A pilot randomized trial of an RDoC-Informed preventive intervention

Reduced activation of the Research Domain Criteria (RDoC) positive valence systems (PVS) is observed in high-risk (HR) children of depressed mothers and predictive of future psychopathologies. We developed a dyadic, neuroscience-informed preventive intervention, Family Promoting Positive Emotions (FPPE), designed to prevent psychopathology in HR children by targeting PVS processes. We evaluated the initial efficacy of FPPE compared to written information (WI) psychoeducation in engaging PVS-related targets and reducing perceived stress and emotional distress symptoms in HR youth. Participants included 74 children ages 8–12 years and their biological mothers reporting elevated depressive symptoms. Following random assignment, 55 dyads completed FPPE (n = 29) or WI (n = 26) and pre-post assessments of child clinical symptoms. Youth completed a reinforcement learning task and 10 days of positive affect ratings to assess PVS-related targets. Results revealed a small within-subjects increase in child daily positive affect in FPPE, but not WI. Further, FPPE resulted in reductions in mother-reported child perceived stress and symptoms of anger, anxiety, and depression with medium-to-large within-subjects effects. Intervention effects on reinforcement learning and child-rated clinical symptoms were not observed. This study suggests FPPE shows promise in enhancing positive affect and reducing the emergence of clinical symptoms in HR children. Clinicaltrials.gov identifierNCT05223842.

Психологическая помощь родственникам суицидента

<p style="text-align: justify;"><strong>Relevance. </strong>After suiced family go through a psychological crisis, relatives are at risk of developing symptoms of emotional distress. At the same time, stigmatization can interfere seeking informal help, which makes it important to provide psychological help to this group of clients. <strong>Purpose of the study</strong>. Examine various approaches to providing psychological help to relatives of suicides and highlight the targets of such interventions. <strong>Materials and methods.</strong> The article presents a literature review of foreign studies of the effectiveness of various formats of psychological help for the family of a suicide. <strong>Results</strong>. There are different forms of psychological help for relatives of suicides: individual, group and family psychotherapy. After a suicide attempt, more research are focus on family therapy, and after a completed suicide on group psychotherapy for relatives of a suicide. For family therapy of suicidal behavior, two approaches are the most developt – cognitive–behavioral and attachment–based psychotherapy. The goals of working with the family are to reduce conflict and criticism, increase cohesion, develop communication skills and stabilization of the emotional state of family members. Inclusion of the family in the therapy of patient after suicide attempt increases the effectiveness of treatment. Support groups have become the most popular format for helping relatives after a completed suicide. Among the goals of working with the grieving are opportunity to share difficult feelings, return control over life, reconstruction of the meaning of what happened, and stoping ruminations. Research shows the effectiveness of these interventions for coping with grief, reducing emotional lability and improving social adaptation. <strong>Conclusions. </strong>Relatives of suicidal people need opportune psychological help. The most common approach for psychological help is cognitive–behavioral psychotherapy, which has programs with proven effectiveness for both relatives after a suicide attempt and after a completed suicide.</p>

Relationships between mastery, forgiveness, optimism, and resilience, and PTSD and anxiety during the COVID-19 pandemic

ABSTRACT The COVID-19 pandemic has had devastating emotional consequences. The present study aimed to examine the relationships between personal resources and emotional distress while accounting for COVID-19–related variables. Seven hundred and seventy-seven (N = 777) participants completed demographic, mastery, forgiveness, optimism, resilience, PTSD, and anxiety questionnaires. A stepped hierarchical multiple regression revealed that mastery, forgiveness, cultural group, age, acquaintance with a person who died of COVID-19, and having been infected with COVID-19 contributed significantly to the explained variance in PTSD symptoms. Mastery, forgiveness, optimism, age, and acquaintance with a person who died of COVID-19 contributed significantly to the explained variance in anxiety. However, resilience was not found to significantly contribute to the explained variance in PTSD symptoms or anxiety. This study demonstrates the importance of being aware of both PTSD symptoms and anxiety associated with COVID-19. Thus, it is suggested that therapy programs should pay special attention to mastery and forgiveness as coping resources. In addition, among medical and mental-health personnel awareness should be given to individuals who have been in close acquaintance with those who died of COVID-19, those with COVID-19 risk factors, and those who have been infected. Special attention should also be paid to minority groups as they might tend to experience more emotional distress and trauma symptoms.

Longitudinal Associations Among Symptoms of Family Intensive Care Unit Syndrome.

Family intensive care unit (ICU) syndrome, a comorbid response to another person's stay in the ICU, is characterized by emotional distress, poor sleep health, and decision fatigue. This pilot study examined associations among symptoms of emotional distress (anxiety and depression), poor sleep health (sleep disturbance), and decision fatigue in a sample of family members of patients in the ICU. The study used a repeated-measures, correlational design. Participants were 32 surrogate decision makers of cognitively impaired adults who had at least 72 consecutive hours of mechanical ventilation within the neurological, cardiothoracic, and medical ICUs at an academic medical center in northeast Ohio. Surrogate decision makers with a diagnosis of hypersomnia, insomnia, central sleep apnea, obstructive sleep apnea, or narcolepsy were excluded. Severity of symptoms of family ICU syndrome was measured at 3 time points in 1 week. Zero-order Spearman correlations of the study variables were interpreted at baseline and partial Spearman correlations of study variables were interpreted 3 days and 7 days after baseline. The study variables showed moderate to large associations at baseline. Baseline anxiety and depression were associated with each other and with decision fatigue at day 3. Baseline sleep disturbance was associated with anxiety, depression, and decision fatigue at day 7. Understanding the temporal dynamics and mechanisms of the symptoms of family ICU syndrome can inform clinical, research, and policy initiatives that enhance the provision of family-centered critical care.

The Impact of a School-Based Academic Support Program on Students’ Psychosocial Impairment

The skills conveyed in high school are essential for success, and evidence suggests that psychosocial well-being is critical to that process. Advancement via Individual Determination (AVID) is an in-school, academic support program that targets underserved students. The current study explored the impact of an intervention program targeting academic achievement on student perceptions of social support and psychosocial impairment. The study was conducted in an under-resourced, majority Latinx high school and the sample included 75 AVID students and 140 demographically matched controls. Hierarchical linear regression analyses were performed to identify the impact of participation in the AVID program on symptoms of emotional and behavioral distress. After controlling for demographics factors and academic achievement, student perceptions of emotional and teacher support explained 7.2% of the variance in psychosocial distress; participation in the AVID intervention was found to have significantly improved the variance accounted for (ΔR2=.02, 5.13, p=.025; R2=.11, F(9,204)=2.90, p=.003). The results of this study indicate that perceived teacher social support and AVID participation were, independently, significantly associated with reduced student psychosocial distress. These findings suggest that interventions targeting the complex mechanisms of school achievement may also have a positive impact on psychosocial impairment beyond student perceptions of social support.

The network structure of dysfunctional metacognitions, CAS strategies, and symptoms

In the metacognitive model of psychological disorders, metacognitive strategies and corresponding underlying metacognitive beliefs intensify and maintain emotional distress symptoms. In the current study, our three objectives were to evaluate and replicate the network structure of dysfunctional metacognitions as assessed with the MCQ-30, to examine its stability when adding relevant covariates in the form of metacognitive strategies (worry and rumination) and symptoms (anxiety and depression), and to evaluate how different sets of dysfunctional metacognitions are more or less strongly linked differently to metacognitive strategies and symptoms. A cross-sectional university sample with a mean age of 26 years (N = 440; Males = 156, Females = 283) completed the Metacognitions Questionnaire–30, Penn State Worry Questionnaire, Ruminative Response Scale, and Hopkins Symptom Checklist. Data were analysed using psychological network analysis in R-studio statistical software. The network structure of dysfunctional metacognitions replicated well with item clusters that correspond to clinically meaningful substructures in the metacognitive model. Negative metacognitive beliefs and beliefs about uncontrollability might have more functional significance in the mutual connections between dysfunctional meta-domains as well as the connections with metacognitive strategies and symptoms. For worry and anxiety, negative beliefs about uncontrollability and corresponding danger of worry were more prominently connected in the network structure. For rumination, cognitive self-consciousness was more prominent, whereas for depression, need for control was more prominently connected. Support was found for mutual interdependence between different sets of dysfunctional metacognitive beliefs, that metacognitive beliefs are linked to but separate from metacognitive strategies, and that these may function together in affecting emotional distress symptoms

Caring for Each Other: A Resident-Led Peer Debriefing Skills Workshop.

Inadequate time and space to process critical incidents contribute to burnout. Residents do not regularly participate in emotional debriefs. An institutional needs assessment revealed only 11% of surveyed pediatrics and combined medicine-pediatrics residents had participated in a debrief. The primary objective was to increase resident comfort in participation in peer debriefs after critical incidents from 30% to 50% with implementation of a resident-led peer debriefing skills workshop. Secondary objectives included increasing resident likelihood of leading debriefs and comfort in identifying symptoms of emotional distress. Internal medicine, pediatrics, and medicine-pediatrics residents were surveyed for baseline participation in debriefs and comfort in leading peer debriefs. Two senior residents became trained debrief facilitators and led a 50-minute peer debriefing skills workshop for co-residents. Pre- and post-workshop surveys assessed participant comfort in and likelihood of leading peer debriefs. Surveys distributed 6 months post-workshop assessed resident debrief participation. We implemented the Model for Improvement from 2019 to 2022. Forty-six (77%) and 44 (73%) of the 60 participants completed the pre- and post-workshop surveys. Post-workshop, residents' reported comfort in leading debriefs increased from 30% to 91%. The likelihood of leading a debrief increased from 51% to 91%. Ninety-five percent (42 of 44) agreed that formal training in debriefing is beneficial. Almost 50% (24 of 52) of surveyed residents preferred to debrief with a peer. Six months post-workshop, 22% (15 of 68) of surveyed residents had led a peer debrief. Many residents prefer to debrief with a peer after critical incidents that cause emotional distress. Resident-led workshops can improve resident comfort in peer debriefing.

Heterogeneity of emotional distress in pregnancy during COVID-19 pandemic: a latent profile analysis

ABSTRACT Background Emotional distress, including depressive and anxiety symptoms, is a common concern among pregnant individuals and has negative impacts on maternal and offspring’s health. Previous studies indicated the heterogeneity of perinatal emotional distress. Moreover, during the pandemic of COVID-19, expectant mothers are faced with more tough challenges, which could exacerbate their emotional distress. Objective The aim of present study is to examine potential subgroups with distinct profiles on emotional distress and relationship resources during the pandemic. Methods A total of 187 pregnant people in China were recruited from April 22 to May 16 in 2020. Latent profile analysis was applied based on prenatal depressive and anxiety symptoms, COVID-19-related negative emotions, prenatal attachment, marital satisfaction and family sense of coherence. Results Four subgroups were identified. Group 1 and Group 2 shared with low levels of emotional distress and COVID-19-related negative emotions, among which Group 1 had plenty of relationship resources, while Group 2 had insufficient support. Group 3 had moderate levels of emotional distress but above-average prenatal attachment. Group 4 was a highly distressed subtype with severe emotional distress and poor states across all domains. Conclusion Our findings support that emotion distress among expecting mothers is heterogeneous, highlighting the need for tailed interventions to address the specific needs of subgroups during pregnancy.

Coping styles with stress and its relations to psychiatric and clinical symptoms in patients with sarcoidosis: A latent profile analysis

ObjectiveAlthough stress and styles of coping with it can have a major impact on one's health and can determine the course and management of chronic diseases, no previous studies have evaluated coping strategies and their relation to emotional distress and clinical symptoms in sarcoidosis. MethodsIn two consecutive studies, we investigated differences in coping styles of sarcoidosis patients in comparison to healthy control subjects and the association of identified profiles to an objective measurement of disease (Forced Vital Capacity) and symptoms such as dyspnoea, pain, anxiety and depressive symptoms in 36 patients with sarcoidosis (study 1) and 93 patients with sarcoidosis (study 2). ResultsAcross two studies we found that patients with sarcoidosis used emotion-focused and avoidant coping significantly less often than healthy individuals, and that in both groups the profile with dominant problem (task)-focus style was the most beneficial in terms of mental health. Further, the profile of sarcoidosis patients characterized by the lowest intensity of all coping strategies was found to be superior in terms of physical health status (dyspnoe, pain and FVC level). ConclusionThese findings suggest that successful management of sarcoidosis should include coping styles assessment and call for a multidisciplinary approach in diagnosis and treatment of sarcoidosis patients.

Associations among psychosis, mood, anxiety, and posttraumatic stress symptoms: A network analysis.

The associations among psychotic experiences (i.e., hallucinations and delusions), trauma exposure, and posttraumatic stress symptoms are complex and multidirectional. Using network analysis to understand how psychotic experiences and symptoms of posttraumatic stress disorder (PTSD) relate to one another may identify new interventional targets to treat comorbidity and its underlying pathological processes. This study aimed to use network analysis to examine the associations among psychotic experiences; negative symptoms of psychosis; and symptoms of PTSD, anxiety, and depression. In this population-based cohort study, 4,472 participants (36.7% male) were assessed for psychotic experiences, negative symptoms of psychosis, PTSD, anxiety, and depression at age 23 (M = 23.86 years, SD = 0.520) or 24 years (M = 24.03, SD = 0.848). Associations among symptoms were assessed via network analysis. Exploratory graph analysis identified three clusters of densely connected symptoms within the overall network: psychotic experiences; PTSD symptoms; and depressive and anxiety symptoms and negative symptoms of psychosis. Psychotic experiences had the strongest associations with other symptoms in the network, and symptoms of anxiety played a key role in bridging psychotic experiences, symptoms of PTSD, and depressive symptoms. Consistent with the stress reactivity and affective models for psychotic experiences, the results suggest that symptoms of anxiety and emotional distress (e.g., hyperarousal, panic) may have a key role in the development and maintenance of psychotic experiences and symptoms of PTSD. Targeting these symptoms may ameliorate symptom burden transdiagnostically.

Stressors in health care and their association to symptoms experienced by gender diverse people

ObjectivesMany individuals whose gender does not align with the sex they were assigned at birth (gender diverse [GD] people) report stressful health care encounters. We examined the relationship of these stressors to symptoms of emotional distress and impaired physical functioning among GD people. Study designThis study was conducted using a cross-sectional design with data from the 2015 United States Transgender Survey. MethodsComposite metrics of health care stressors and physical impairments were developed, and the Kessler Psychological Distress Scale (K-6) provided a measure of emotional distress. Linear and logistic regression were used to analyze the aims. ResultsA total of 22,705 participants from diverse gender identity subgroups were included. Participants who experienced at least one stressor in health care during the past 12 months had more symptoms of emotional distress (β = 0.14, P < .001) and 85% greater odds of having a physical impairment (odds ratio = 1.85, P < .001). Transgender men exposed to stressors were more likely than transgender women to experience emotional distress and have a physical impairment, with other gender identity subgroups reporting less distress. Black participants exposed to stressful encounters reported more symptoms of emotional distress than White participants. ConclusionsThe results suggest that stressful encounters in health care are associated with symptoms of emotional distress and greater odds of physical impairment for GD people, with transgender men and Black individuals being at greatest risk of emotional distress. The findings indicate the need for assessment of factors that contribute to discriminatory or biased health care for GD people, education of health care workers, and support for GD people to reduce their risk of stressor-related symptoms.