Forms Of Psychological Distress Research Articles

A prospective study of phobic anxiety, risk of ovarian cancer, and survival among patients.

In ovarian cancer patients and mouse models, psychosocial stress is associated with higher circulating markers of angiogenesis and cell migration, impaired immune response, and increasing tumor burden and aggressiveness. In the Nurses' Health Studies (NHS/NHSII), we assessed whether phobic anxiety, a marker of chronic distress, was associated with risk of incident ovarian cancer as well as survival among ovarian cancer patients. We used Cox proportional hazards regression to model the relative risks (RRs) and 95 % confidence intervals (CI) of ovarian cancer incidence and survival by categories of the Crown-Crisp phobic anxiety index (CCI). We identified 779 cases of ovarian cancer during 2,497,892 person-years of follow-up. For baseline CCI (NHS: 1988; NHSII: 1993), we observed a statistically nonsignificant increased risk of epithelial ovarian cancer (RR for CCI ≥ 4 vs. 0 or 1: 1.14; 95 % CI 0.96-1.36). However, when we updated CCI (NHS: 2004; NHSII: 2005), the associations were attenuated. Pre-diagnosis CCI was not associated with ovarian cancer survival (RR for ≥4 vs. 0 or 1: 1.00; 95 % CI 0.77-1.31); results were similar for post-diagnosis CCI. Distress, as measured by phobic anxiety symptoms, was not associated with ovarian cancer risk, although we cannot rule out a modest association. Future research should explore the role of phobic anxiety and other forms of psychological distress and ovarian cancer risk and survival.

Depression, Social Support, and Mental Health: A Longitudinal Mediation Analysis in African American Custodial Grandmothers.

Custodial grandparents raising grandchildren experience intense levels of stress that can lead to depression and other forms of psychological distress. Drawing on a coping model of family stress, adjustment, and adaptation, we explored the relationship between depression and mental health quality of life mediated by social support and moderated by grandparent's age. The sample consisted of 667 African American custodial grandmothers, dichotomized into two age groupings, ≤55 (n = 306) and 55 + (n = 361). All grandmothers participated in a 12-month support intervention. The prospective analysis revealed social support was a mediator in the association between depressive symptoms and mental health quality of life for older African American grandmothers; however, this same relationship did not hold for their younger counterparts. Study limitations and future research directions are discussed.

Patients With Chronic Pain Need Better Psychiatric Care

Patients With Chronic Pain Need Better Psychiatric Care

Sibling Death and Adult Maladjustment Indices: A Brief Report

ABSTRACTWhile symptoms of grief pose the most immediate psychological concern in the aftermath of sibling death, emerging research suggests that distal correlates may include strained interpersonal relations and externalized forms of psychological distress. College students with a history of Sibling Loss (n = 36), Parental Loss (n = 32), or No Loss (n = 367) were compared on the Minnesota Multiphasic Personality Inventory (MMPI-2). Sibling Loss was associated with higher Psychopathic Deviate (Pd; d = .62) and Hypomania (d = .42) scores. The relative risk (RR = 2.96) of a Pd elevation (T > 65) was higher after sibling death.

Group Psychotherapy in Italy

This article describes the history and the prevailing orientations of group psychotherapy in Italy (psychoanalytically oriented, psychodrama, CBT groups) and particularly group analysis. Provided free of charge by the Italian health system, group psychotherapy is growing, but its expansion is patchy. The main pathways of Italian training in the different group psychotherapy orientations are also presented. Clinical-theoretical elaboration on self development, psychopathology related to group experiences, and the methodological attention paid to objectives and methods in different clinical groups are issues related to group therapy in Italy. Difficulties in the relationship between research and clinical practice are discussed, as well as the empirical research network that tries to bridge the gap between research and clinical work in group psychotherapy. The economic crisis in Italy has led to massive cuts in health care and to an increasing demand for some forms of psychological treatment. For these reasons, and because of its positive cost-benefit ratio, group psychotherapy is now considered an important tool in the national health care system to expand the clinical response to different forms of psychological distress.

Culture Shock, Social Support and Mental Health Problems in Foreign Medical Students in Romania

Introduction Studying abroad is a growing trend in higher education. Culture shock is a form of psychological distress associated with migration. Social support has been identified as significantly related to the onset and outcome of psychological disorders. There are studies investigating the processes of acculturation of the students as temporary migrants, with particular attention to medical studies. In Romania there is virtually no research addressing processes of acculturation of temporary immigrants. Aims The aim of this study was to examine the relationship between culture shock, social support, personality factor and psychological adaptation in foreign medical students studying at University of Medicine “Iuliu Hatieganu” Cluj-Napoca, Romania Methods A total of 167 first year foreign students from English Section, completed 5 self-administered questionnaires: Culture Shock Questionnaire, Social Support Questionnaire, STAI, NEO-FFI and a questionnaire about alcohol, smoking and illicit drug use. Results Gender and the quality of support received were found to be strongly associated with culture shock. Furthermore, culture shock was significantly positively related to the level of state anxiety. There are personality characteristics like extraversion and openness that influence the drug taking and drinking habits of students. Conclusion Social support is an important factor associated with the degree of culture shock and should be taken into consideration in order to protect against or help to overcome this kind of psychological distress experienced by foreign students. Adequate counseling should be provided by educational institutions, taking into consideration the way social factors and personality are associated with migrant students’ mental health.

Hazardous alcohol use among doctors in a Tertiary Health Center.

Background:Doctors have been identified as one of the key agents in the prevention of alcohol-related harm, however, their level of use and attitudes toward alcohol will affect such role.Aim:This study is aimed at describing the pattern of alcohol use and the predictors of hazardous drinking among hospital doctors.Setting:Study was conducted at the Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria.Design:A cross-sectional survey involving all the doctors in the teaching hospital.Materials and Methods:All the consenting clinicians completed a sociodemographic questionnaire and alcohol use was measured using the 10-item alcohol use disorder identification test (AUDIT) and psychological well-being was measured by the 12-item General Health Questionnaire (GHQ-12).Statistical Analysis Used:Statistical analyses were done using the Statistical Package for Social Sciences version 16. Chi-square tests with Yates correction were used to describe the relationship between respondent's characteristics and AUDIT scores as appropriate.Results:There were a total of 122 participants. Eighty-five (69.7%) of them were abstainers, 28 (23%) were moderate drinkers, and 9 (7.3%) hazardous drinkers. With the exception of age, there was no significant relationship between sociodemographic status, years of practice, specialty of practice, and hazardous alcohol use. Experiencing stress or GHQ score above average is significantly associated with hazardous drinking.Conclusion:Hazardous drinking among hospital doctors appears to be essentially a problem of the male gender, especially among those older than 40 years. Stress and other form of psychological distress seem to play a significant role in predicting hazardous drinking among doctors.

Female residents experiencing medical errors in general internal medicine: a qualitative study.

BackgroundDoctors, especially doctors-in-training such as residents, make errors. They have to face the consequences even though today’s approach to errors emphasizes systemic factors. Doctors’ individual characteristics play a role in how medical errors are experienced and dealt with. The role of gender has previously been examined in a few quantitative studies that have yielded conflicting results. In the present study, we sought to qualitatively explore the experience of female residents with respect to medical errors. In particular, we explored the coping mechanisms displayed after an error. This study took place in the internal medicine department of a Swiss university hospital.MethodsWithin a phenomenological framework, semi-structured interviews were conducted with eight female residents in general internal medicine. All interviews were audiotaped, fully transcribed, and thereafter analyzed.ResultsSeven main themes emerged from the interviews: (1) A perception that there is an insufficient culture of safety and error; (2) The perceived main causes of errors, which included fatigue, work overload, inadequate level of competences in relation to assigned tasks, and dysfunctional communication; (3) Negative feelings in response to errors, which included different forms of psychological distress; (4) Variable attitudes of the hierarchy toward residents involved in an error; (5) Talking about the error, as the core coping mechanism; (6) Defensive and constructive attitudes toward one’s own errors; and (7) Gender-specific experiences in relation to errors. Such experiences consisted in (a) perceptions that male residents were more confident and therefore less affected by errors than their female counterparts and (b) perceptions that sexist attitudes among male supervisors can occur and worsen an already painful experience.ConclusionsThis study offers an in-depth account of how female residents specifically experience and cope with medical errors. Our interviews with female residents convey the sense that gender possibly influences the experience with errors, including the kind of coping mechanisms displayed. However, we acknowledge that the lack of a direct comparison between female and male participants represents a limitation while aiming to explore the role of gender.

The mediating effect of psychological distress on functional dependence in stroke patients.

To explore varied forms of psychological distress and to determine the mediating influence of psychological distress on functional outcomes in stroke patients. Previous studies attest to the influence of depression on poststroke functional recovery. While there is evidence for neuropathological deficits that occur after stroke to be associated with psychological distress, few studies have explored the effect of various types of psychological distress on functional recovery. A cross-sectional study was used. Data were collected from 178 first-time stroke patients. Study variables included demographic and disease characteristics (stroke location and stroke syndrome classification), psychological distress (the Chinese language version of the Emotional and Social Dysfunction Questionnaire) and functional outcome (Barthel index). Regression and mediation models were used to evaluate the effect of psychological distress on functional outcome. Results revealed that stroke patients experience various forms of mild psychological distress, including anger, helplessness, emotional dyscontrol, indifference, inertia and euphoria, after stroke. Regression and mediation analyses further confirmed that various forms of psychological distress significantly mediated the effect of severe stroke syndromes on functional dependence. The various forms of psychological distress after stroke might play a mediating role in functional recovery and explain how stroke severity affects functional dependence. By understanding the nature of various forms of psychological distress, healthcare professionals should adopt appropriate assessment instruments and design effective interventions to help improve mental and physical function of stroke patients.

Victimization, psychological distress, and help-seeking: Disentangling the relationship for Latina victims.

OBJECTIVE: The aim of this analysis was to evaluate the role of help-seeking on the victimization-psychological distress link. Specifically, we aim to determine whether help-seeking is associated with various forms of psychological distress among victims of interpersonal violence. METHOD: This study used data from the Sexual Assault Among Latinas (SALAS) Study, which surveyed 2,000 Latino women using random digit dial methodology, and queried participants about lifetime victimization, help-seeking behaviors associated with victimization, and psychological distress. Using linear regression with a subsample of the women who experienced victimization in adulthood (N = 242), we evaluated the association of victimization, cultural variables, formal help-seeking, and informal help-seeking on psychological distress. Subsequently, we also evaluated the relationship of each specific form of help-seeking on current psychological distress. RESULTS: Results suggest that formal help-seeking but not informal help-seeking was associated with lower psychological distress among Latino women. Specifically, formal help-seeking was associated with decreased levels of current depression, anger, dissociation, and anxiety. When looking at specific forms of formal help-seeking, reporting to police was the main form of help-seeking associated with decreased levels of current psychological distress. Interaction effects also showed the victimization--anger relationship was stronger for those with higher Latino orientation that were neither of Mexican nor Cuban descent. CONCLUSION: The results support the importance of promoting formal help-seeking behaviors, particularly police reporting, as a way of decreasing the negative psychological impact of victimization. Among Latinas, cultural factors and ethnicity need to be taken into consideration to better understand help-seeking behaviors and emotional functioning.

Distress, demoralization and psychopathology: Diagnostic boundaries

Background and Objectives: The objectives of the manuscript are: (a) to review the understanding of demoralization and its assessment; (b) to describe its clinical progression; (c) to explain the differences between demoralization and other form of psychological distress; (d) to propose a set of criteria for future research on demoralization. Methods: A MEDLINE search using the keywords distress, subjective incompetence, depression, demoralization, helplessness, hopelessness and psychopathology was conducted. This was supplemented by a manual search of the literature. Results: Demoralization can be distinguished from passing or transient distress, nonspecific distress, sub-threshold depression or anxiety, and certain mental disorders. Demoralization can be a risk factor for the manifestation of psychopathology, the prodromal phase of a mental disorder, or a trigger for exacerbation or recurrence of psychiatric distress symptoms. The domains of distress and demoralization are described and research diagnostic criteria for demoralization are presented. Conclusions: The scales discussed in this article differ in their time frames and have not yet been applied to the same population at the same time. The role of demoralization as a risk factor for mental disorders is just beginning to be understood. The domains and the diagnostic criteria for demoralization presented in this article need to be confirmed by epidemiological and empirical studies. Future research should continue to clarify its role in the pathogenesis of both mental disorders and physical illnesses and identify appropriate interventions for its arrest or prevention.

Anger: a common form of psychological distress among patients at the end of life

Psychological distress is common in palliative care patients and their families, and anger is a complex component of distress experienced by many patients at the end of life. Anger can be a form of tension release, as well as a coping mechanism for the patient and a way to disguise fear and anxiety. The interdisciplinary team are responsible for recognising psychological distress in patients, assessing their needs, and providing adequate psychological support. Although a certain level of psychological distress such as anger is expected in terminally ill patients owing to their situation, such responses may also be dysfunctional. This paper aims to highlight the challenges and complexities of adequately assessing and supporting palliative care patients who are presenting with psychological distress in the form of anger, in order to relieve their suffering and assist them in resolving their issues and improving their quality of life. Anger can be difficult to treat, and for some patients can be more distressing than some physical symptoms. Hence this paper also aims to offer anger management guidance to palliative care practitioners.

Correlation between Poverty and Mental Health: Towards a Psychiatric Evaluation

A review of epidemiological journals on mental health identifies a link between poverty and chronic health disorders. Explanatory models of persons suffering from mental health disorders have been described in a number of studies, in all of which poverty and socioeconomic problems have been cited as one of the most important factors causing emotional distress (Patel, 1995). Some medical literatures have shown a clear association between indicators of poverty and the risk of mental disorders, the most consistent link being with low levels of education and income (Patel, et, al, 2003). While these indicators remain unclear to me, there are still unfounded beliefs on how poverty triggers chronic mental illnesses. However, recent exploratory studies have strongly supported the link between poverty and mental health. Drawing analysis from exploratory studies, I tend to argue in this study that poverty is a gateway to mental illness. This argument is based on statistical studies that have pointed out that poor mental health conditions have greater potentiality to trigger many forms of psychological distress. Despites poor condition of life, genetic and psychological factors supports the link between poverty and mental illness. Clinicians in the last two decades have identified difficulties while untangling effects of causation, adversity and stress associated with low social statuses from those within selection,” which posits that genetically predisposed persons can drift down or fail to rise in their poverty” (Dohrenwend, Levav, Shrout et al, 1992). This descriptive study makes a case that there is correlation between poverty, psychological distress and mental health. My believe is supported by new study published in the Journal of mental health disorder which strongly argues that childhood poverty, adolescents level of stress and induced mental health disorder in adults are linked together. For Drishya (2012), the way we spend our childhood and the experiences we gain at our tender age stays with us for the rest of our lives. This paper uses evidence-research methodologies from cross sectional regions of the country to demonstrate an association between poverty and homelessness and how both are associated with mental health disorders. It uses empirical studies to support a correlation that exists between depression, suicidal ideation, schizophrenic symptoms and anxiety disorders. Future research is needed to further identify link between poverty, substance dependence, depression, and other mental health problems. Poverty alleviation and prevention efforts should target those with substance use and delinquent behaviors.

Health Risk Behavior and Sexual Assault Among Ethnically Diverse Women

Sexual assault is associated with a number of health risk behaviors in women. It has been hypothesized that these risk behaviors, such as hazardous drinking, may represent women's attempts to cope with psychological distress, such as symptoms of depression and anxiety. However, extant research has failed to evaluate these relationships among ethnic minority samples or identify the mechanisms responsible for this association. The current study examined sexual assault history and two health risk behaviors (hazardous drinking and engaging in sexual behavior to regulate negative affect) in a diverse sample of 1,620 college women. Depression and anxiety were examined as mediators of the relationship between sexual assault and health risk behaviors. There was evidence of moderated mediation, such that for European American women, but not for ethnic minority women, both forms of psychological distress were significant mediators of the sexual assault/hazardous drinking relationship. In contrast, among all ethnic groups, the relationship between sexual assault and both forms of psychological distress was mediated by the use of sexual behavior as an affect regulation strategy. Results support a need to evaluate the assault experiences of ethnically diverse women, as well as the impact of the assault on their postassault experiences including health risk behaviors and psychological adjustment. Additionally, results suggest that practitioners should carefully assess health risk behaviors among victims of sexual assault and be aware that there may be differences in the risk factors and motives for these behaviors among women of various ethnic backgrounds.

Psychological Distress Among Religious Nonbelievers: A Systematic Review

Studies of religious belief and psychological health are on the rise, but most overlook atheists and agnostics. We review 14 articles that examine differences between nonbelievers and believers in levels of psychological distress, and potential sources of distress among nonbelievers. Various forms of psychological distress are experienced by nonbelievers, and greater certainty in one's belief system is associated with greater psychological health. We found one well-documented source of distress for nonbelievers: negative perceptions by others. We provide recommendations for improving research on nonbelievers and suggest a model analogous to Pargament's tripartite spiritual struggle to understand the stresses of nonbelief.

Psychological distress and investment in one’s appearance in patients with pemphigus

Pemphigus vulgaris is a chronic disease not currently curable. Physical involvement and the impact of chronic therapies can lead patients to changes in psychological and relational areas. To provide a measure of psychological distress, dysfunctional investment in one's appearance, and their relationship. Self-administered questionnaires (ASI, HADS) were given to 74 pemphigus inpatients. Strong associations between psychological distress and dysfunctional investment in one's appearance were observed [adjusted odds ratio (OR)=7.36, 95% confidence intervals (CI) 1.20-45.11; OR 5.38, 95% CI 0.81-35.87, respectively, for appearance stereotyping and body-image vulnerability], together with a perceived high disease severity (OR 6.03, 95% CI 1.90-23.46). Our results are compatible with the idea that some forms of psychological distress could be in part due to one's perception of his/her own body image.

Prevalência da síndrome de burnout em trabalhadores de enfermagem de um hospital de grande porte da Região Sul do Brasil

Burnout syndrome is a chronic adaptive disorder that affects workers and is characterized by three forms of psychological distress: emotional exhaustion, depersonalization, and a sense of low personal fulfillment. A cross-sectional quantitative design was used to apply questionnaires including socio-cultural data and the Maslach Burnout Inventory in 151 nurses and nurse technicians, representing 54.1% of this professional category in a large general hospital in Tubarão, Santa Catarina State, Brazil. Mean scores were: emotional exhaustion (17), depersonalization (7.79), and low personal fulfillment (36.6). According to the criterion proposed by Ramirez et al., no cases of burnout were diagnosed. According to the criteria by Grunfeld et al., 35.7% of the interviewees displayed burnout. The standard profile of workers with burnout identified in the study was: nurse technicians, female gender, age 26-35 years, married, with no children, and with five or more years in the profession. Hospital wards or areas with the highest proportion of nursing staff with burnout were the grouped hospital sectors (42.6%), ICU (25.9%), and neonatal ICU (18.5%). There was no statistically significant association between ward or hospital area and burnout.

Depression in advanced physical illness: diagnostic and treatment issues

Assessing and managing depression and other forms of psychological distress in patients with advanced physical illness (such as advanced cancer) can be complex clinical tasks. Assessment of distress is complicated by the contribution of the physical disease and side effects of its treatment to symptoms. Clinical evidence has indentified factors that increase vulnerability to experiencing distress and interventions that can improve wellbeing in patients with serious physical illness, yet there are significant gaps in current practice and challenges for health professionals in addressing the core emotional concerns of patients with advanced physical illness. The 2003 publication Clinical practice guidelines for the psychosocial care of adults with cancer provides evidence-based recommendations for providing psychosocial care. Implementing existing guidelines, including systematic assessment of risk and adapting interventions to reflect the precise needs of patients, requires strategies to help clinicians in the emotional dimensions of this caring role.

The NICE guidelines are misleading, unscientific, and potentially impede good psychological care and help

NICE guidelines have been given the authority to determine what psychological therapies can be provided within the UK National Health Service. This also has implications for private practice. The guidelines are based on a medical model and consider psychotherapy as analogous to a drug. Psychological thinking is discouraged by this approach. A large amount of psychotherapy research evidence is ignored by NICE, particularly the persistent finding that differences in effectiveness between therapies are minimal and elusive. Differences between the skills of therapists are a more significant factor. Practice-based evidence, and learning from the patient's feedback (both conscious and unconscious) may be a better approach. For most forms of psychological distress, none of the main psychological therapies studied in randomized controlled trials can be considered to be clinically effective, even though they facilitate some degree of statistically significant change.

Disability Status, Disease Parameters, Defense Styles, and Ego Strength Associated with Psychiatric Complications of Multiple Sclerosis

The aim of the present study was to identify disease parameters, defensive styles and ego strength measurements associated with various forms of psychiatric complications in patients with multiple sclerosis (MS). Seventy-nine patients with MS participated in the study and 158 healthy subjects matched for age and sex served as controls. A wide range of clinical information was collected and the following self-report instruments were used: General Health Questionnaire, Symptom Distress Check List, Defense Style Questionnaire, MMPI Ego Strength Scale and Hostility and Direction of Hostility Questionnaire. The odds of being assessed with a psychiatric diagnosis upon interview were 6.7 times greater among patients compared to controls and 9.3 times greater among patients with recent-onset MS compared to patients with long-term disease. Psychiatric complications of MS were closely associated with age of the disease onset and the degree of disability due to MS. Additionally, higher rates of introverted hostility, adoption of maladaptive ego defenses and weakened ego strength were also closely associated with several forms of psychological distress, especially depressive symptoms. MS patients experience elevated symptoms of psychological distress, especially depressive symptoms, which are most closely associated with disease parameters. However, the crucial role of various personality traits such as ego defenses and hostility features in the psychiatric symptom formation also appear to contribute to the development of depressive symptoms. Clinicians involved in the clinical management of patients with MS should identify and modify treatment if these specific personality markers that indicate the exhaustion of the patient's resources to cope with the physical and psychological stress of the illness are present.