Emotional Distress Variables Research Articles

P42: Experiential avoidance and gratitude impact in emotional distress among old people post COVID-19 crisis

Some studies have shown that older people experience less experiential avoidance and more gratitude when they were compared with younger people (López, 2020). These variables might be important to improve the mental health of older people, especially in crisis situations.Objective:Investigate the relationship between experiential avoidance (EA), gratitude and distress in old people post crisis COVID-19.Methods:A cross-sectional study was carried out. Data from 361 people older than 60 years. The mean age was 68,44 (SD= 5.31), 62.9% were woman. The sample included in the cross-sectional analysis consisted of who provided data on the Acceptance and Action Questionnaire - II (AAQ–II; Bond et al., 2011), Gratitude subscale of the Values in Action Inventory of Strengths-Short Form (Littman-Ovadia, 2015) and Hospital Anxiety and Depression Scale (Zigmond & Snaith, 1983). Pearson´s correlations were used to explore the relationships among study variables including EA, gratitude, and emotional distress. Lineal regression analyses were used to investigate the incremental explained variance in emotional distress according to the main hypotheses. Standardized regression coefficients β were used to determine the relative contribution of these variables.Results:EA and gratitude were negatively correlated (r=-.27; p= <.000). Gratitude and emotional distress were negatively correlated (r=-.30; p= <.000). EA and emotional distress were positive correlated (r=.61; p= <.000). Regression analyses indicated that AAQ-II and gratitude were significant predictors of emotional distress among old people. AAQ-II and gratitude were added. AAQ-II and gratitude were significant predictor of emotional distress R2adj=62.7 % explain the model.Conclusion:EA and gratitude are powerful factors to predict emotional distress in a crisis among older people. EA is an important construct in the understanding of emotional distress. This is an initial step to deep in the process of internal experiences and promoting gratitude can be very beneficial to generate programs to promote mental health in old people.

The Effect of Daily Meditative Practices Based on Mindfulness and Self-Compassion on Emotional Distress under Stressful Conditions: A Randomized Controlled Trial

Intervention programs based on self-compassion have demonstrated their efficacy both in reducing psychological distress and increasing well-being. The goal of this study was to test the efficacy of an online intervention to increase mindfulness and self-compassion levels in a non-clinical sample in a highly stressful context: the ten weeks of lockdown imposed in the early stages of the COVID-19 pandemic. The intervention sessions consisted of thirty-minute guided meditations followed by thirty minutes of inquiry. Sixty-one participants completed two thirds of the sessions or more, and 65 individuals participated in a waiting-list (WL) control group. Self-compassion, anxiety, depression and stress levels were assessed. The analysis of pre-post results suggests that the interventions increased self-compassion levels and decreased anxiety, depression and stress levels, whereas the WL group did not show any significant changes. The emotional changes in the intervention group were associated with the increase in self-compassion. However, at follow-up, the scores of emotional distress variables returned to the initial pre-intervention scores. These data can be interpreted in line with previous results that have shown the efficacy of self-compassion-based intervention programs. Given that this efficacy was not maintained at follow-up, data are discussed according to the pervasive role of a highly stressful context and-as described in other studies-the need for regular practice to maintain the benefits obtained.

Investigating the Impact of Self-Criticism and Self-Reassurance on the Experience of Distress People with Traumatic Brain Injuries

Objective: To examine whether psychological processes involved in self-appraisal and responses to aversive internal experiences are significant factors in understanding the levels of distress experienced by people following Traumatic Brain Injury (TBI). Participants: One hundred and fifteen people with TBI completed a set of questionnaires. Design: A cross-sectional/observational design employing a multiple hierarchical regression analysis. Main Measures: Emotional distress as measured by Depression Anxiety and Stress Scale – 21 item (DASS-21); self-criticism and self-reassurance as measured by Forms of Self-Criticism/Attacking and Self-Reassurance Scale (FSCRS); psychological inflexibility as measured by Flexibility of Responses to Self-Critical Thoughts (FoReST). Result: Self-criticism, self-reassurance and psychological inflexibility explained an additional 30% of variance in emotional distress beyond demographic, clinical and injury-related factors, with only self-criticism making a significant independent contribution. Exploratory moderation analysis revealed that there was no significant effect on emotional distress when considering the interaction between self-criticism with self-reassurance and psychological inflexibility. Conclusion: While emotional distress is common following TBI, there remains no demographic, clinical or injury-related factors that have demonstrated consistent associations with the level of emotional distress experienced. The present study demonstrates that psychological factors, relating to personal evaluations, explains considerable variance in emotional distress beyond demographic and injury-related factors. These processes may help identify those at risk of poorer emotional outcomes following TBI, and targeting these processes via psychological interventions may improve emotional wellbeing in these people.

Relationships between Coping Styles, Emotional Distress, and Fear of COVID-19 among Workers in the Oil and Gas Industry in Malaysia during the COVID-19 Pandemic

The COVID-19 pandemic has had serious impacts on psychological health globally. However, very little is currently known regarding the link between fear of COVID-19 with psychological health and various coping styles, especially among oil and gas workers. This study aims to assess the prevalence of depression and anxiety among oil and gas workers, and subsequently examine the role of sociodemographic and occupational variables, various coping styles, and emotional distress in contributing to fear of COVID-19. A total of 299 oil and gas workers participated in this study. The DASS-21, Brief COPE, and Fear of COVID-19 (FCV-19) were used to assess the research variables. The descriptive analyses of DASS-21 indicated a prevalence of 26.8%, 33.5%, and 17.1% for depression, anxiety, and stress, respectively, among oil and gas workers. The results also indicated that all types of coping styles (problem-oriented, emotion-oriented, and dysfunctional-oriented) were significant predictors of fear of COVID-19. Sociodemographic and occupational variables and emotional distress variables were not significant predictors of fear of COVID-19. The study suggests how crucial it is for occupational mental health surveillance and prompt intervention for oil and gas workers.

Machine Learning-Based Predictive Modeling of Anxiety and Depressive Symptoms During 8 Months of the COVID-19 Global Pandemic: Repeated Cross-sectional Survey Study.

BackgroundThe COVID-19 global pandemic has increased the burden of mental illness on Canadian adults. However, the complex combination of demographic, economic, and lifestyle factors and perceived health risks contributing to patterns of anxiety and depression has not been explored.ObjectiveThe aim of this study is to harness flexible machine learning methods to identify constellations of factors related to symptoms of mental illness and to understand their changes over time during the COVID-19 pandemic.MethodsCross-sectional samples of Canadian adults (aged ≥18 years) completed web-based surveys in 6 waves from May to December 2020 (N=6021), and quota sampling strategies were used to match the English-speaking Canadian population in age, gender, and region. The surveys measured anxiety and depression symptoms, sociodemographic characteristics, substance use, and perceived COVID-19 risks and worries. First, principal component analysis was used to condense highly comorbid anxiety and depression symptoms into a single data-driven measure of emotional distress. Second, eXtreme Gradient Boosting (XGBoost), a machine learning algorithm that can model nonlinear and interactive relationships, was used to regress this measure on all included explanatory variables. Variable importance and effects across time were explored using SHapley Additive exPlanations (SHAP).ResultsPrincipal component analysis of responses to 9 anxiety and depression questions on an ordinal scale revealed a primary latent factor, termed “emotional distress,” that explained 76% of the variation in all 9 measures. Our XGBoost model explained a substantial proportion of variance in emotional distress (r2=0.39). The 3 most important items predicting elevated emotional distress were increased worries about finances (SHAP=0.17), worries about getting COVID-19 (SHAP=0.17), and younger age (SHAP=0.13). Hopefulness was associated with emotional distress and moderated the impacts of several other factors. Predicted emotional distress exhibited a nonlinear pattern over time, with the highest predicted symptoms in May and November and the lowest in June.ConclusionsOur results highlight factors that may exacerbate emotional distress during the current pandemic and possible future pandemics, including a role of hopefulness in moderating distressing effects of other factors. The pandemic disproportionately affected emotional distress among younger adults and those economically impacted.

Maternal emotional distress and infant sleep: A longitudinal study from pregnancy through 18 months.

This longitudinal study examined whether changes in maternal emotional distress (depressive, anxiety, and parenting-stress symptoms) predict changes over time in subjective and objective infant sleep. We recruited 226 Israeli expectant mothers (M age 28.8 ± 3.3), most representing the middle-upper socioeconomic class. Maternal depressive and anxiety symptoms were assessed in the third trimester of pregnancy. After delivery (3, 6, 12, and 18 months), infant sleep quality and duration were assessed for 5 nights using actigraphy and the Brief Infant Sleep Questionnaire. Maternal depressive and anxiety symptoms were reassessed, and maternal parenting-stress was measured at all postpartum assessments. The findings demonstrated significant correlations between maternal emotional distress and mothers' subjective ratings of infant sleep problems (rs >.16 and < .46). Latent trajectory analyses indicated no significant effects of changes in maternal emotional distress variables on changes in infant subjective or objective sleep. Post hoc power analyses demonstrated that we had enough statistical power to reject the null hypothesis. The results suggest that mothers with higher emotional distress symptoms-and especially those with parenting-stress symptoms-are more likely to experience their infant's sleep as problematic. However, our results challenge the assumption that maternal emotional distress symptoms contribute to infant sleep disturbances over time. The findings are relevant to mothers with mild to moderate emotional distress symptoms and must not be generalized to mothers who experience major clinical depression. Future studies should evaluate whether maternal emotional distress interacts with other risk factors, such as infant temperament, to predict infant sleep disturbances. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The Association Between Maladaptive Metacognitive Beliefs and Emotional Distress in People Living With Amyotrophic Lateral Sclerosis.

ObjectiveApproximately half of all people living with amyotrophic lateral sclerosis (ALS) experience persistent or recurrent emotional distress, yet little is known about the psychological processes that maintain emotional distress in this population. The self-regulatory executive functioning (S-REF) model specifies that maladaptive metacognitive beliefs and processes are central to the development and maintenance of emotional distress. This study explored whether maladaptive metacognitive beliefs are associated with emotional distress after controlling for demographic factors, time since diagnosis, and current level of physical functioning.DesignIn a cross-sectional design, 75 adults with a diagnosis of ALS completed self-report questionnaires. Participants had a mean age of 60.40 years, mean duration of symptoms 63.92 months, and male:female gender ratio of 14:11.Main Outcome MeasuresQuestionnaires assessed emotional distress (HADS, adapted for ALS), physical functioning (ALSFRS-R), repetitive negative thinking (RTQ-10), metacognitive beliefs (MCQ-30), and demographic factors.ResultsMaladaptive metacognitive beliefs explained additional variance in emotional distress after controlling for age, gender, time since diagnosis, physical functioning, and repetitive negative thinking. Repetitive negative thinking partially mediated the relationships between positive and negative metacognitive beliefs and emotional distress.ConclusionsThese data support the utility of the metacognitive model in understanding emotional distress in people with ALS. Examination of the temporal relationship between maladaptive metacognitive beliefs and emotional distress in people living with ALS may help to guide the development of therapeutic approaches.

The impact of the COVID-19 pandemic on individuals with eating disorders: the role of emotion regulation and exploration of online treatment experiences

ObjectiveThe Covid-19 pandemic has wrought disruption to everyday life and services, and emerging evidence suggests that those with eating disorders (EDs) are likely to experience marked distress and exacerbation of their symptoms. However, little is known around the most relevant factors to symptom change; whether certain emotion regulation and coping strategies are linked to better outcomes; and how people with EDs are adjusting to psychological interventions moving online.MethodIn a mixed-method design, we collected qualitative and quantitative data from 207 (76 males) self-selected UK residents with self-reported ED, who described and ranked impacts of the pandemic on their symptoms. Regression analysis examined whether emotion regulation strategies were associated with self-reported symptom change, ED symptomatology, and negative emotional states. Thematic analysis explored participants’ experiences of the pandemic, particularly factors affecting their ED, coping strategies used, and experiences of psychological intervention.ResultsMost participants (83.1%) reported worsening of ED symptomatology, though factors affecting symptom change differed between specific EDs. Emotion regulation, such as having fewer strategies, poorer emotional clarity, and non-acceptance of emotions, explained nearly half of the variance in emotional distress during the pandemic. Qualitative findings indicated that difficult emotions (such as fear and uncertainty), changes to routine, and unhelpful social messages were triggering for participants during the pandemic. While some participants described employing positive coping strategies (such as limiting social media exposure), many reported using ED behaviours (among other maladaptive strategies, like alcohol use) to cope with the pandemic. Finally, loss of treatment support, feeling underserving of support and experiencing a ‘detached connection’ online were further exacerbating factors for these participants.DiscussionWhile our sample was self-selected and may not represent all people with EDs, our results suggest that people with EDs have been strongly affected by the pandemic. Some aspects of online treatment were found to be beneficial but our findings suggest it also needs some improvement. Our paper discusses implications for online treatment such as taking into account personal circumstances and, in a time where people have limited control over the antecedents of negative emotion, the need to develop skills to manage emotions when they arise.

1102 Relationship Between Emotional Distress And Sleep Duration Among Hispanics Using The 2018 National Health Interview Survey Dataset

Abstract Introduction Although Hispanics experience a high level of shorter sleep duration (&amp;lt; 7 hrs./24 period), a clear mechanism or cause is lacking. Previous research indicate that emotional distress may explain the burden of shorter sleep among blacks. Applying these findings to Hispanics, we investigated whether emotional distress explains the burden of short sleep duration (&amp;lt; 7 hrs.) among Hispanics and if this relationship varies by sex Methods We used data from the 2018 National Health Interview Survey (NHIS) dataset, a nationally representative sample, in which only Hispanic ethnicity participants (N=3,091) were analyzed. Average sleep duration was self-reported and measured in hours. Emotional distress was measured using Kessler 6, which measures how an individual felt over the past 30 days: nervous, hopeless, restless/fidgety, depressed, effortful and worthless. To assess the association between short sleep duration and emotional distress, we performed Pearson correlation, hierarchical regression analyses, and stratified this relationship by sex to determine if this relationship differed between males and females, adjusting for covariates. Results Of the total sample of 3,091 Hispanics, 1,762 were female, and 1,329 were male. Sleep duration and emotional distress were negatively correlated among females (r = -.27, p &amp;lt;.001) and males (r=-.18, p &amp;lt;.001). Among Hispanic females, sleep duration significantly predicted emotional distress, β = -.27, t = -11.60, p &amp;lt;.001, and explained a significant portion of variance in emotional distress, R2 = .07, F= 134.63, p &amp;lt;.001. While, among Hispanic males, sleep significantly predicted emotional distress (β = -.18, t =-6.5, p &amp;lt;.001) and explained a significant portion of the variance in emotional distress (R2 = .03, F= 42.37, p &amp;lt;.001). Conclusion Our findings indicate that a negative sleep-ED relationship, suggesting that shorter sleep was predictive of higher levels of emotional distress among Hispanics and that this relationship is greater among Hispanic females, compared males. Support K01HL135452, R01MD007716, R01HL142066, and K07AG052685

Quality and Quantity of Social Support Show Differential Associations With Stress and Depression in African Americans

Social support (SS) is typically associated with lower emotional distress (e.g., stress and depression) in individuals. However, SS is a multifaceted construct that can vary by quality, quantity (amount), and type (i.e., it can be emotional or instrumental in nature). ObjectiveThe current study examined the relationships between characteristics of SS, stress, and depression in aging African Americans. ParticipantsAnalyses focused on data from 705 participants aged 22–92 years from the Carolina African American Twin Study of Aging. MeasurementsMeasures included the quality and quantity of emotional and instrumental support received, as well as stress and depression. DesignA series of univariate and increasingly complex multivariate regression models were conducted in MPlus (using the cluster option to control for family structure) to examine the relationships between SS and emotional distress variables. ResultsOverall, better quality of emotional SS predicted fewer depression symptoms and less perceived stress, after controlling for age, gender, socioeconomic status variables, and the other subtypes of SS. However, more instances of emotional SS were associated with higher levels of perceived stress, depression symptoms, and more stressful life events within the past year. Likewise, more instrumental SS predicted more perceived stress, while holding the other variables constant. ConclusionAfrican Americans who experience more emotional distress report more SS, but the quality of emotional support appears to play an important role in the association between reduced levels of stress and depression. These findings suggest that interventions should include approaches to reduce emotional distress as well as enhance the quality SS.

The importance of emotional distress, cognitive behavioural factors and pain for life impact at baseline and for outcomes after rehabilitation - a SQRP study of more than 20,000 chronic pain patients.

Although literature concerning chronic pain patients indicates that cognitive behavioural variables, specifically acceptance and fear of movement/(re)injury, are related to life impact, the relative roles of these factors in relation to pain characteristics (e.g. intensity and spreading) and emotional distress are unclear. Moreover, how these variables affect rehabilitation outcomes in different subgroups is insufficiently understood. This study has two aims: (1) to investigate how pain, cognitive behavioural, and emotional distress variables intercorrelate and whether these variables can regress aspects of life impact and (2) to analyse whether these variables can be used to identify clinically meaningful subgroups at baseline and which subgroups benefit most from multimodal rehabilitation programs (MMRP) immediately after and at 12-month follow-up. Pain aspects, background variables, psychological distress, cognitive behavioural variables, and two life impact variables were obtained from the Swedish Quality Registry for Pain Rehabilitation (SQRP) for chronic pain patients. These data were analysed mainly using advanced multivariate methods. The study includes 22,406 chronic pain patients. Many variables, including acceptance variables, showed important contributions to the variation in clinical presentations and in life impacts. Based on the statistically important variables considering the clinical presentation, three clusters/subgroups of patients were identified at baseline; from the worst clinical situation to the relatively good situation. These clusters showed significant differences in outcomes after participating in MMRP; the subgroup with the worst situation at baseline showed the most significant improvements. Pain intensity/severity, emotional distress, acceptance, and life impacts were important for the clinical presentation and were used to identify three clusters with marked differences at baseline (i.e. before MMRP). Life impacts showed complex relationships with acceptance, pain intensity/severity, and emotional distress. The most significant improvements after MMRP were seen in the subgroup with the lowest level of functioning before treatment, indicating that patients with complex problems should be offered MMRP. This study emphasizes the need to adopt a biopsychosocial perspective when assessing patients with chronic pain. Patients with chronic pain referred to specialist clinics are not homogenous in their clinical presentation. Instead we identified three distinct subgroups of patients. The outcomes of MMRP appears to be related to the clinical presentation. Thus, patients with the most severe clinical presentation show the most prominent improvements. However, even though this group of patients improve they still after MMRP show a complex situation and there is thus a need for optimizing the content of MMRP for these patients. The subgroup of patients with a relatively good situation with respect to pain, psychological distress, coping and life impact only showed minor improvements after MMRP. Hence, there is a need to develop other complex interventions for them.

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

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

The moderating effects of perceived emotional benefits on inhalant initiation among American Indian and white youth.

Inhalant use co-occurs with emotional distress. Inhalant use may be a means of self-medicating distress, but more recent study focuses on the cognitive appraisal of personal benefits of using substances. Objectives were to determine whether emotional distress variables predict early versus later initiation of inhalant use, whether such relationships differ between American Indian and white youth, and whether perceived emotional benefits of inhalant use moderates the relationship between emotional distress and stage of inhalant initiation. Data were from a study of 7-12th grade American Indian youth who live on or near reservations. A total of 856 students from 32 schools surveyed from 2009 to 2012, who reported having used inhalants (American Indian = 683; white = 173), were surveyed about age first use of inhalants, levels of emotional distress, and perceived benefits of inhalant use. SEM models were used to assess study objectives. Depression and anger did not discriminate between early and later initiation. Lower self-esteem related to earlier initiation, but only among American Indian students. Perceived emotional benefits of inhalant use did not moderate the relationship between self-esteem and stage of initiation. Among middle school and high school American Indian and white youth living on or near American Indian reservations, emotional distress is not strongly related to stage of inhalant initiation. These findings raise questions about the timing and strength of relationship between emotional distress and early inhalant initiation. Prospective studies are need to assess this relationship more fully.

Psychological, demographic, illness and treatment risk factors for emotional distress amongst paediatric oncology patients prior to reaching 5-year survivorship status.

Studies assessing emotional distress severity of paediatric oncology patients prior to reaching 5-year survivorship status have produced inconsistent findings. This cross-sectional multi-centre study aimed to determine psychological, demographic, illness and treatment risk factors for emotional distress in this population. Paediatric oncology patients (n = 74), aged 12-18 years, completed the Paediatric Index of Emotional Distress, Self-Description Questionnaire and Paediatric Quality of Life Inventory. Seventy-two parents provided background information regarding demographics, diagnoses and treatment protocols in addition to appropriate proxy ratings. Hierarchical multiple regression analyses demonstrated that demographic, illness and treatment factors explained little variance in emotional distress. Global self-concept, global-generic and cancer-specific health-related quality of life (HRQOL) were significant predictors. Provisional multiple regression analyses indicated that pain/hurt, illness-related worries, communication difficulties and negative self-views in relation to math abilities, parent relations and opposite-sex peer relations were risk factors for emotional distress in this sample. Paired-sample t-tests and Pearson's moment-correlation coefficients showed patient and parent reports of patients' self-concepts and HRQOL were highly consistent. This study empirically identified modifiable psychological risk factors for emotional distress prior to 5-year survivorship status and provided guidance for future interventions. Furthermore, findings suggest that parent reports can provide reliable estimates of patients' self-concepts and HRQOL. Generalizability of the findings was enhanced by the diversity of the sample studied, in terms of diagnosis and treatment exposure, and the multi-centre recruitment strategy employed. Nevertheless, the findings should be corroborated by larger, longitudinal studies.

Factors affecting the quality of life of middle‐aged women suffering Hwa‐Byung

To test a staged theoretical model designed to explain causal relationships affecting the quality of life (QOL) of middle-aged Korean women suffering from Hwa-Byung (HB). The model contains three stages comprised of antecedents (stage 1), perception (stage 2) and outcome variable (stage 3). Stage 1 contains individual characteristic and emotional distress variables. In stage 2, the perception variable is depression (DEP). In stage 3, the outcome factor is QOL. Design. A cross-sectional, descriptive design was used. A convenience sample of 135 community dwelling middle-aged women was recruited over a five-month period in the neuropsychology outpatient clinic at an Oriental hospital in Korea. The instruments were the Korean version of WHO Quality of Life-BREF (WHOQOL-BREF), Korean version of State-Trait Anger Expression Inventory (STAXI-K), The Korean version of State-Trait Anxiety Inventory (STAI-K) and Korean version of Beck Depression Inventory (K-BDI). Forty-five per cent of the variance in the QOL of women with HB was explained by the direct effect of depression (β = -0·356, p = 0·000) and trait anxiety (β = -0·324, p = 0·001). State anger (β = 0·429, p = 0·000) and spouse (β = -0·180, p = 0·021) explained 45·0% of the variance in (of) depression. The findings showed that depression mediates the relationship between the emotional distress and QOL as a negative outcome. These relationships can guide researchers and psychiatric mental health nurses to understand depression as a mediating factor and to develop nursing interventions to improve QOL of HB women.

The relationship between clinical indicators, coping styles, perceived support and diabetes‐related distress among adults with type 2 diabetes

This article is a report of a cross-sectional study examining the degree to which clinical indicators, coping styles and perceived support from healthcare professionals and family are related to diabetes-related distress. Many people with type 2 diabetes experience high levels of distress stemming from concerns and worries associated with their disease. Diabetes-related distress has predominantly been studied in relation to diabetes management and metabolic control, and to some extent in relation to coping styles and perceived social support. To date, little is known about the relative contribution of clinical indicators, coping styles and perceptions of social support to perceived distress among people with type 2 diabetes. A sample comprising 425 Norwegian adults, aged 30-70, with type 2 diabetes, completed questionnaires assessing coping styles, perceived social support from health professionals and family and diabetes-related distress assessed by the Problem Areas in Diabetes Scale. Demographical and clinical data were collected by self-report. Data were collected in October 2008. Results from the regression analyses showed a greater variance in emotional distress accounted for by coping styles (21·3%) and perceived support (19·7%) than by clinical indicators (5·8%). FINDINGS may indicate that healthcare providers should pay more attention to non-clinical factors such as coping styles and social support, when addressing diabetes-related distress. They should also be aware that interventions based on psychosocial approaches may primarily influence distress, and not necessarily metabolic control.

Avoidance behaviors and negative psychological responses in the general population in the initial stage of the H1N1 pandemic in Hong Kong

BackgroundDuring the SARS pandemic in Hong Kong, panic and worry were prevalent in the community and the general public avoided staying in public areas. Such avoidance behaviors could greatly impact daily routines of the community and the local economy. This study examined the prevalence of the avoidance behaviors (i.e. avoiding going out, visiting crowded places and visiting hospitals) and negative psychological responses of the general population in Hong Kong at the initial stage of the H1N1 epidemic.MethodsA sample of 999 respondents was recruited in a population-based survey. Using random telephone numbers, respondents completed a structured questionnaire by telephone interviews at the 'pre-community spread phase' of the H1N1 epidemic in Hong Kong.ResultsThis study found that 76.5% of the respondents currently avoided going out or visiting crowded places or hospitals, whilst 15% felt much worried about contracting H1N1 and 6% showed signs of emotional distress. Females, older respondents, those having unconfirmed beliefs about modes of transmissions, and those feeling worried and emotionally distressed due to H1N1 outbreak were more likely than others to adopt some avoidance behaviors. Those who perceived high severity and susceptibility of getting H1N1 and doubted the adequacy of governmental preparedness were more likely than others to feel emotionally distressed.ConclusionsThe prevalence of avoidance behaviors was very high. Cognitions, including unconfirmed beliefs about modes of transmission, perceived severity and susceptibility were associated with some of the avoidance behaviors and emotional distress variables. Public health education should therefore provide clear messages to rectify relevant perceptions.

Relationships with Parents, Spousal Reciprocity, and Psychological Distress in Middle-Age Adults

Data from 301 middle-age couples were employed to investigate links between their recalled parents’ parenting styles and perceptions of reciprocity with their parents, as well as their current perceptions of spousal reciprocity, on their psychological distress. The research extends Baumrind’s theory of childhood parenting styles and Youniss’ theory of late adolescents’ perceived reciprocity to a developmental model for middle-age psychological distress. Differential effects were found according to the gender of both the offspring and the parent. There were significant positive findings only if the opposite-sex parent was perceived as authoritative, and significant negative findings if the same-sex parent was perceived as authoritarian. Regression models indicated mediated, integrated relationships (through maternal and spousal reciprocity) for females, but no mediations were found for males. Significantly more variance in emotional distress was explained by spousal reciprocity than by the parent related variables, and for the men than for the women.

The Patients’ Illness Perceptions and the Use of Primary Health Care

To investigate if primary care patients' perceptions of a current health problem were associated with use of health care. One thousand seven hundred eighty-five patients presenting a new health problem to 1 of 38 physicians from 28 general practices in Aarhus County, Denmark. Patients completed a questionnaire on their illness perceptions and emotional distress before the consultation. The physicians completed a questionnaire for each patient on diagnostics and prognostics. Register data on primary health care utilization 3 years before and 2 years after baseline were obtained. Odds ratios were estimated to examine associations between previous health care use and illness perceptions. Linear regression analysis was performed to examine if illness perceptions predicted later health care use. Previous use: Higher use was associated with psychosocial, stress, and lifestyle attributions. Accident/chance attributions were associated with higher use for patients with a chronic disorder but with lower use for patients without a chronic disorder. A strong illness identity (number of self-reported symptoms), illness worry, a long timeline perspective, a belief that the symptoms would have serious consequences, and all emotional distress variables were associated with higher use. Use during follow-up: Infection/lowered immunity attributions were associated with higher use for patients with a chronic disorder, whereas psychosocial and lifestyle attributions were associated with higher use for all patients. Illness worry and all emotional distress variables predicted higher health care use. A strong illness identity, a long timeline perspective, a belief in serious consequences, and stress and accident/chance attributions were among the strongest predictors of health care use in a multivariate model including all variables. Patients' perceptions of a current health problem are associated with health care use and may offer an obvious starting point for a biopsychosocial approach in primary care.

Tactile analogue scale instrument for investigation of low vision patient psychological characteristics

PurposeExamination information gained from a simple tactile analogue scale technique (10 cc syringe) of measuring psychological aspects of coping in a low vision patient population. MethodsIn routine low vision rehabilitation evaluations, patients were asked to estimate the impact of their vision loss on emotional factors. A 10 cc syringe was used by the patient with closed (0 cc level) indicating no problem and totally open (10 cc level) indicating greatest difficulty. ResultsThe sample included 25 male and 29 female low vision patients. Mean scores (x/10) for emotional distress variables were frustration 7.4, anxiety 5.5, depression 4.8, fear 4.1, and anger 4.1. Mean scores (x/10) for cognitive appraisal variables were: interference 7.8 and intolerance 4.4. Younger age was associated with greater anger (r=−0.45, p<0.01). No other significant correlations between age or gender and emotional reactions were found. The two cognitive appraisals were better predictors of emotional distress than visual acuity or demographic information. DiscussionThis technique demonstrated patients to have a noteworthy amount of distress which is important clinical information in low vision rehabilitation programs. Visual acuity and demographic factors did not predict the distress. This 10 cc syringe technique is inexpensive and easy to administer. It opens a helpful dialogue that may not occur otherwise. SupportHelen Keller Foundation for Research and Education