General Psychiatric Distress Research Articles

Examining Factor Structure of a Widely Used Measure of Psychiatric Symptoms in Collegiate Athletes

The Symptom Checklist 90 – Revised (SCL-90-R; Derogatis, 1994) is one of the most widely utilized measures of general psychiatric distress. However, its factor structure varies across populations, and psychometric properties of this scale have yet to be investigated in athletes. In this study several frequently reported factor structures of the SCL-90-R were examined in 311 collegiate athletes. None of the tested models were a good fit based on Confirmatory Factor Analysis (CFI) criteria, although the bi-factor model was reasonable using RMSEA (.06) and AIC (55951) criteria. Explained common variance of the global factor was 73%, reflecting a stronger general factor relative to specific construct factors. Indeed, several items did not significantly load on previously identified factors. Results suggest the SCL-90-R is a good tool to determine general symptom severity of mental health disorders in collegiate athletes.

Finding the precise distance: Self-differentiation, marital relationship and trauma among ex-combatants’ spouses

BackgroundSpouses of ex-combatants often experience psychological distress due to sharing their lives with a partner who endured traumatic experiences, a phenomenon known as “secondary traumatization”. Self-differentiation is the emotional distance one takes, while keeping an amount of togetherness with significant others. The couple's relationship and self-differentiation can impact the manner and expanse of secondary traumatization experienced by the spouse. ObjectiveThis study aimed to examine the role of marital adjustment and self-differentiation (an enmeshed vs detached differentiation style), in secondary traumatization among spouses of ex-combatants. MethodsThis study is part of a longitudinal study examining psychological implications of war among Israeli ex-combatants and their spouses. Overall, 267 spouses have been assessed three times (2003;2011;2016). Participants completed self-report questionnaires evaluating secondary PTSD (SPS), general psychiatric distress (GPD), self-differentiation and dyadic adjustment (DAS). Cross-path models were used to assess associations between the variables longitudinally. ResultsAssociations were found between both self-differentiation and dyadic adjustment and SPS and GPD. Path models showed that fusion\\cutoff differentiation predicted more SPS\\GPD over time and vice-versa. Furthermore, dyadic adjustment mediated the association between fusion\\cutoff differentiation and SPS\\GPD. In other words, fusion\\cutoff differentiation in time 1 predicted dyadic adjustment in time 2, which in turn predicted SPS\\GPD in time 3. ConclusionsOur results can be interpreted in conjunction with original theories about secondary traumatization, emphasizing the importance of keeping a balanced emotional distance in the marital relationship as a way of reducing distress and PTSD symptoms following traumatic events.

Virtual Reality Combined with Artificial Intelligence (VR-AI) Reduces Hot Flashes and Improves Psychological Well-Being in Women with Breast and Ovarian Cancer: A Pilot Study

Breast and ovarian cancers affect the lives of many women worldwide. Female cancer survivors often experience hot flashes, a subjective sensation of heat associated with objective signs of cutaneous vasodilatation and a subsequent drop in core temperature. Breast and Ovarian cancer patients also suffer from sleep difficulties and mental health issues. The present study aimed to assess the effectiveness of Bubble, a novel artificial intelligence-virtual reality (AI-VR) intervention for the treatment of hot flashes in female breast or ovarian cancer patients. Forty-two women with breast and/or ovarian cancer participated in the study. The mean age was 47 years (range: 25-60 years). Patients suffered from hot flashes at different frequencies. They used Bubble, a virtual reality (VR) mobile psychological intervention based on elements from both cognitive behavioral therapy and mindfulness-based stress reduction. The intervention took place in a VR environment, in a winter wonderland setting called Frosty. Patients were instructed to use Bubble at home twice a day (morning and evening) and when experiencing a hot flash. Participants were asked to use the application for 24 consecutive days. Before and after this 24-day period, patients completed self-report questionnaires assessing hot flashes, general psychiatric distress, perceived stress, illness perception, sleep quality, and quality of life. Between pre- and post-intervention, participants reported a significant reduction in the daily frequency of hot flashes, stress, general psychiatric distress, several domains of QOL, and sleep difficulties, as well as an improvement in illness perception. In addition, they reported very high satisfaction with Bubble. Importantly, both age and baseline levels of psychopathology moderated the effect of Bubble on sleep difficulties. This study showed preliminary evidence for the potential of VR interventions in alleviating hot flashes and accompanying mental distress among those coping with breast and ovarian cancer. VR is a powerful therapeutic tool, able to address mind-body aspects in a direct, vivid way. More studies are needed in order to fully understand the potential of this unique intervention.

Grief and functional impairment following COVID-19 loss in a treatment-seeking sample: the mediating role of meaning

ABSTRACT The COVID-19 pandemic has brought unprecedented levels of grief and psychological distress in community samples. We examined unique pandemic grief risk factors, dysfunctional grief, Post-traumatic Stress Disorder (PTSD) symptoms, general psychiatric distress, disrupted meaning, and functional impairment in a treatment-seeking sample of people bereaved from COVID-19 in the United Kingdom. A sample of 183 participants (91.80% female; M = 47.40 years) completed an online survey as part of an intake assessment for a grief support and referral service. Most reported clinically elevated PTSD symptoms (83.1%), psychiatric distress (64.0%), and functional impairment (56.8%). A smaller, but still concerning percentage (39.3%) reported clinically significant symptoms of dysfunctional grief. Disrupted meaning substantially mediated the relationship between risk factors and all four outcomes. Counsellors should address the breadth of psychological distress in those bereaved by COVID-19 and hone their skills in promoting meaning making in the wake of the trauma and loss generated by the pandemic.

Informing the study of suicidal thoughts and behaviors in distressed young adults: The use of a machine learning approach to identify neuroimaging, psychiatric, behavioral, and demographic correlates

Young adults are at high risk for suicide, yet there is limited ability to predict suicidal thoughts and behaviors. Machine learning approaches are better able to examine a large number of variables simultaneously to identify combinations of factors associated with suicidal thoughts and behaviors. The current study used LASSO regression to investigate extent to which a number of demographic, psychiatric, behavioral, and functional neuroimaging variables are associated with suicidal thoughts and behaviors during young adulthood. 78 treatment seeking young adults (ages 18–25) completed demographic, psychiatric, behavioral, and suicidality measures. Participants also completed an implicit emotion regulation functional neuroimaging paradigm. Report of recent suicidal thoughts and behaviors served as the dependent variable. Five variables were identified by the LASSO regression: Two were demographic variables (age and level of education), two were psychiatric variables (depression and general psychiatric distress), and one was a neuroimaging variable (left amygdala activity during sad faces). Amygdala function was significantly associated with suicidal thoughts and behaviors above and beyond the other factors. Findings inform the study of suicidal thoughts and behaviors among treatment seeking young adults, and also highlight the importance of investigating neurobiological markers.

Primary care and suicidality among psychiatric outpatients: The patient-doctor relationship matters.

The purpose of the current study is to examine the relationship between the quality of the Patient-Doctor Relationship and suicidality among patients seeking mental health care; specifically, whether patients who perceive having a more positive relationship with primary care physician will have lower levels of suicidality. Cross-sectional population-based study in Greater Vancouver, Canada. One-hundred ninety-seven participants were recruited from three Mental Health Clinics who reported having a primary care physician. Participants completed a survey containing questions regarding items assessing quality of Patient-Doctor Relationship, general psychiatric distress (K10), borderline personality disorder, and suicidality (Suicidal Behaviours Questionnaire-Revised-SBQ-R). Zero-order correlations were computed to evaluate relationships between study variables. Hierarchical regression analysis was used to control for confounding variables. The quality of the patient doctor relationship was significantly negatively associated with suicidality. The association between the quality of the patient-doctor relationship and suicidality remained significant even after controlling for the effects of psychiatric symptom distress and borderline personality disorder features. The degree to which patients' perceive their primary care physician as understanding, reliable, and dedicated, is associated with a reduction in suicidal behaviors. Further research is needed to better explicate the mechanisms of this relationship over time.

Compassion focused therapy in a university counseling and psychological services center: A feasibility trial of a new standardized group manual

ABSTRACT Objectives: The feasibility and acceptability of a new Compassion Focused Therapy (CFT) group protocol were assessed in a university counseling and psychological services (CAPS) center. Outcome measures included mechanisms of change, compassion, and general psychiatric distress. Method: Eight transdiagnostic CFT groups composed of 75 clients met for 12 weekly sessions. Clients completed measures of fears of compassion, flows of compassion, self-reassurance, self-criticism, shame, and psychiatric distress at pre, mid, and post time points. Self-report feasibility and acceptability data were collected from therapists and clients, respectively. Significant and reliable change was assessed along with exploratory analysis of CFT mechanisms of change using correlational analysis. Results: Significant and reliable change was found for fears of self-compassion, fears of compassion from others, fears of compassion to others, self-compassion, compassion from others, self-reassurance, self-criticism, shame, and psychological distress. Improvements in fears and flows of compassion predicted improvements in self-reassurance, self-criticism, shame, and psychiatric distress. Conclusion: The new CFT group protocol appears to be feasible, acceptable, and effective in a transdiagnostic CAPS population. The identified mechanisms of change support the theory of CFT that transdiagnostic pathological constructs of self-criticism and shame can improve by decreasing fears and increasing flows of compassion.

Far away, so close: The role of self-differentiation in psychopathology among spouses of ex-POWs and comparable combatants.

War captivity entails severe posttraumatic implications for ex-prisoners of war (POWs) and their partners. This study examines the role of self-differentiation in secondary traumatization and dyadic adjustment among ex-POWs' spouses. A total of 106 spouses of Israeli ex-POWs and 56 matched spouses of ex-combatants completed self-report questionnaires assessing secondary posttraumatic stress disorder symptoms (SPS), self-differentiation (fusion, cut-off, balanced), general psychiatric distress (GPD), and dyadic adjustment. Ex-POWs' spouses reported lower dyadic adjustment and higher levels of SPS, GPD, and fusion and cut-off differentiation, compared to ex-combatants' spouses. A "mixed" differentiation style characterized by high levels of both fusion and cut-off was associated with particularly high distress levels. Fusion differentiation moderated the association between SPS/GPD and dyadic adjustment. Self-differentiation plays an important role in posttraumatic spousal relationships. Women showing unstable differentiation may be particularly vulnerable when living with a veteran. Treatments for posttraumatic couples should target dysregulated interpersonal distance and promote adaptive differentiation.

The efficacy of app-supported smartphone interventions for mental health problems: a meta-analysis of randomized controlled trials.

Although impressive progress has been made toward developing empirically-supported psychological treatments, the reality remains that asignificant proportion of people with mental health problems do not receive these treatments. Finding ways to reduce this treatment gap is crucial. Since app-supported smartphone interventions are touted as a possible solution, access to up-to-date guidance around the evidence base and clinical utility of these interventions is needed. We conducted a meta-analysis of 66 randomized controlled trials of app-supported smartphone interventions for mental health problems. Smartphone interventions significantly outperformed control conditions in improving depressive (g=0.28, n=54) and generalized anxiety (g=0.30, n=39) symptoms, stress levels (g=0.35, n=27), quality of life (g=0.35, n=43), general psychiatric distress (g=0.40, n=12), social anxiety symptoms (g=0.58, n=6), and positive affect (g=0.44, n=6), with most effects being robust even after adjusting for various possible biasing factors (type of control condition, risk of bias rating). Smartphone interventions conferred no significant benefit over control conditions on panic symptoms (g=-0.05, n=3), post-traumatic stress symptoms (g=0.18, n=4), and negative affect (g=-0.08, n=5). Studies that delivered a cognitive behavior therapy (CBT)-based app and offered professional guidance and reminders to engage produced larger effects on multiple outcomes. Smartphone interventions did not differ significantly from active interventions (face-to-face, computerized treatment), although the number of studies was low (n≤13). The efficacy of app-supported smartphone interventions for common mental health problems was thus confirmed. Although mental health apps are not intended to replace professional clinical services, the present findings highlight the potential of apps to serve as a cost-effective, easily accessible, and low intensity intervention for those who cannot receive standardpsychological treatment.

Interpersonal problems associated with narcissism among psychiatric outpatients: A replication study .

Aim of the studyBackground: Narcissistic personality disorder is the subject of increasing attention in the literature. However, there remains a relative absence of empirical work that has examined narcissism in clinical samples, especially efforts to replicate previous findings. Findings from a previous large-scale study [1] suggest that narcissism is associated with considerable interpersonal impairment. Aims: The objective of the present study was to replicate the findings of Ogrodniczuk and colleagues in an independent sample of psychiatric outpatients.Subject or material and methodsMethod: Consecutively admitted patients (N=53) to a day treatment program completed measures of narcissism, interpersonal problems, and general psychiatric distress. The association between narcissism and interpersonal impairment at baseline and post-therapy was examined. The relation of narcissism to treatment discharge status was also investigated. Partial correlation analyses were used.ResultsResults: At baseline, higher levels of narcissism were significantly associated with more interpersonal impairment, particularly characterized by domineering, vindictive, and overly nurturing behaviour. Baseline narcissism was also significantly related to interpersonal impairment at post-therapy. Change in interpersonal difficulties following treatment was not significantly associated with baseline narcissism. Treatment discharge status also was unrelated to narcissism.DiscussionImplications for further treatment and clinical considerations are discussed.ConclusionsConclusions: The findings largely replicate those of Ogrodniczuk and colleagues’ earlier study, underscoring prominent interpersonal impairment associated with narcissism and supporting the notion of narcissistic personality disorder as a valid clinical construct.

Beyond "Facebook Addiction": The Role of Cognitive-Related Factors and Psychiatric Distress in Social Networking Site Addiction.

The use of social networking sites (SNSs) is rapidly increasing as billions of individuals use SNS platforms regularly to communicate with other users, follow the news, and play browser games. Given the widespread use of SNS platforms, investigating the potential predictors of addictive SNS use beyond Facebook use has become paramount given that most studies so far focused on "Facebook addiction." In this study, a total of 511 English-speaking SNS users (58.1% young adults aged 20-35 years; 64.6% female) were recruited online and asked to complete a battery of standardized psychometric tools assessing participants' sociodemographic characteristics, SNS preferences and patterns of use, SNS addiction, preference for online social interaction, maladaptive cognitions, fear of missing out (FoMo), dysfunctional emotion regulation, and general psychiatric distress. Overall, about 4.9% (n = 25) of all participants could be classed as having a high SNS addiction risk profile. Moreover, the results further indicated that FoMo (β = 0.38), maladaptive cognitions (β = 0.25), and psychiatric distress (β = 0.12) significantly predicted SNS addiction (i.e., p < 0.0001) and accounted for about 61% of the total variance in SNS addiction, with FoMo providing the strongest predictive contribution over and above the effects of sociodemographic variables and patterns of SNS use. The implications of the present findings were discussed in light of extant literature on behavioral addictions and Facebook addiction and further considerations were provided regarding the potential clinical implications for cognitive-based psychological treatment approaches to SNS addiction.

Pathological grooming: Evidence for a single factor behind trichotillomania, skin picking and nail biting.

Although trichotillomania (TTM), skin picking (SP), and nail biting (NB) have been receiving growing scientific attention, the question as to whether these disorders can be regarded as separate entities or they are different manifestations of the same underlying tendency is unclear. Data were collected online in a community survey, yielding a sample of 2705 participants (66% women, mean age: 29.1, SD: 8.6). Hierarchical factor analysis was used to identify a common latent factor and the multiple indicators and multiple causes (MIMIC) modelling was applied to test the predictive effect of borderline personality disorder symptoms, impulsivity, distress and self-esteem on pathological grooming. Pearson correlation coefficients between TTM, SP and NB were between 0.13 and 0.29 (p < 0.01). The model yielded an excellent fit to the data (CFI = 0.992, TLI = 0.991, χ2 = 696.65, p < 0.001, df = 222, RMSEA = 0.030, Cfit of RMSEA = 1.000), supporting the existence of a latent factor. The MIMIC model indicated an adequate fit (CFI = 0.993, TLI = 0.992, χ2 = 655.8, p < 0.001, df = 307, RMSEA = 0.25, CI: 0.022–0.028, pclose = 1.000). TTM, SP and NB each were loaded significantly on the latent factor, indicating the presence of a general grooming factor. Impulsivity, psychiatric distress and contingent self-esteem had significant predictive effects, whereas borderline personality disorder had a nonsignificant predictive effect on the latent factor. We found evidence that the category of pathological grooming is meaningful and encompasses three symptom manifestations: trichotillomania, skin picking and nail biting. This latent underlying factor is not better explained by indicators of psychopathology, which supports the notion that the urge to self-groom, rather than general psychiatric distress, impulsivity, self-esteem or borderline symptomatology, is what drives individual grooming behaviours.

Do gaming motives mediate between psychiatric symptoms and problematic gaming? An empirical survey study

Previous research has suggested that motives play an important role in several potentially addictive activities including online gaming. The aims of the present study were to (i) examine the mediation effect of different online gaming motives between psychiatric distress and problematic online gaming, and (ii) validate Italian versions of the Problematic Online Gaming Questionnaire, and the Motives for Online Gaming Questionnaire. Data collection took place online and targeted Italian-speaking online gamers active on popular Italian gaming forums, and/or Italian groups related to online games on social networking sites. The final sample size comprised 327 participants (mean age 23.1 years [SD = 7.0], 83.7% male). The two instruments showed good psychometric properties in the Italian sample. General psychiatric distress had both a significant direct effect on problematic online gaming and a significant indirect effect via two motives: escape and fantasy. Psychiatric symptoms are both directly and indirectly associated with problematic online gaming. Playing online games to escape and to avoid everyday problems appears to be a motivation associated with psychiatric distress and in predicting problematic gaming.

Validity and utility of the DSM-5 severity specifier for binge-eating disorder.

To test both the concurrent and predictive significance of the new DSM-5 severity specifier for binge-eating disorder (BED) in adult outpatients. Existing data from 195 adults with DSM-5 BED who received evidence-based treatment (manual-based cognitive-behavioral therapy) in an outpatient setting were re-analysed to examine whether these patients sub-grouped according to the DSM-5 severity levels, defined by the frequency of binge-eating (BE) episodes, would show meaningful differences in a range of variables of clinical interest assessed at pre-treatment and end-of treatment abstinence from BE. Participants categorized with mild (33.3% of the sample), moderate (35.4%), severe (15.9%), and extreme (15.4%) severity of BED, based on their pre-treatment clinician-rated frequency of BE episodes, differed significantly from each other in physical characteristics (body mass index) and another sixteen variables of clinical interest assessed at pre-treatment regarding eating disorder psychopathology and putative maintenance factors, lifetime and current psychiatric disorder comorbidity, general psychiatric distress, and psychosocial impairment. The four DSM-5 severity groups were statistically indistinguishable in demographics or age-of-BED onset. However, significant between-group differences were observed in the treatment outcome, i.e., abstinence from BE, achieved by 98.5%, 66.7%, 38.7% and 6.7% of participants categorized with mild, moderate, severe, and extreme severity respectively. The outcome analyses repeated in the completer sample (n = 187) yielded the same pattern of the aforementioned intent-to-treat (N = 195) results. The findings provide support for the severity specifier for BED introduced in the DSM-5 as a means of addressing within-group variability in severity.

Long-term effects of the Family Bereavement Program on spousally bereaved parents: Grief, mental health problems, alcohol problems, and coping efficacy.

This study reports on the findings from a 6-year follow-up of a randomized trial of the Family Bereavement Program (FBP) on the outcomes for spousally bereaved parents. Spousally bereaved parents (N = 131) participated in the trial in which they were randomly assigned to receive the FBP (N = 72) or literature control (N = 59). Parents were assessed at four time points: pretest, posttest, and 11-month and 6-year follow-up. They reported on mental health problems, grief, and parenting at all four time periods. At the 6-year follow-up, parents reported on additional measures of persistent complex bereavement disorder, alcohol abuse problems, and coping efficacy. Bereaved parents in the FBP as compared to those in the literature control had lower levels of symptoms of depression, general psychiatric distress, prolonged grief, and alcohol problems, and higher coping efficacy (for mothers) at the 6-year follow-up. Multiple characteristics of the parent (e.g., gender, age, and baseline mental health problems) and of the spousal death (e.g., cause of death) were tested as moderators of program effects on each outcome, but only 3 of 45 tests of moderation were significant. Latent growth modeling found that the effects of the FBP on depression, psychiatric distress, and grief occurred immediately following program participation and were maintained over 6 years. Mediation analysis found that improvement in positive parenting partially mediated program effects to reduce depression and psychiatric distress, but had an indirect effect to higher levels of grief at the 6-year follow-up. Mediation analysis also found that improved parenting at the 6-year follow-up was partially mediated by program effects to reduce depression and that program effects to increase coping efficacy at the 6-year follow-up was partially mediated through reduced depression and grief and improved parenting. FBP reduced mental health problems, prolonged grief, and alcohol abuse, and increased coping efficacy of spousally bereaved parents 6 years later. Mediation pathways for program effects differed across outcomes at the 6-year follow-up.

Hospital Anxiety and Depression Scale: Factor Structure, Internal Consistency and Convergent Validity in Patients with Dizziness

Psychiatric comorbidities, particularly anxiety-related pathologies, are often observed in dizzy patients. The Hospital Anxiety and Depression Scale (HADS) is a widely used self-report instrument used to screen for anxiety and depression in medical outpatient settings. The purpose of this study was to assess the factor structure, internal consistency and convergent validity of the HADS in an unselected group of patients with dizziness. The HADS and the Dizziness Handicap Inventory (DHI) were administered to 205 dizzy patients. An exploratory factor analysis was conducted and indicated a 3-factor structure, inconsistent with the 2-subscale structure (i.e. anxiety and depression) of the HADS. The total scale was found to be internally consistent, and convergent validity, as assessed using the DHI, was acceptable. Overall findings suggest that the HADS should not be used as a tool for psychiatric differential diagnosis, but rather as a helpful screener for general psychiatric distress in the two domains of psychiatric illness most germane in dizzy patients.

Client attachment and therapist feelings in the treatment of bulimia nervosa.

The relationship between client attachment and therapist postsession feelings was investigated in a randomized clinical trial of psychoanalytic psychotherapy (PPT) and cognitive behavior therapy (CBT) for bulimia nervosa. Therapists completed feeling word checklists after each session, and client attachment was assessed with the Adult Attachment Interview. A factor analysis identified 3 feeling factors, Happy/Enthusiastic, Overwhelmed/Moved, and Indifferent/Bored. Positive feelings were predominant, but PPT therapists reported more negative and fewer positive feelings than CBT therapists did. Client improvement in terms of frequency of bulimic episodes and general psychiatric distress was related to an increase in Happy/Enthusiastic feelings. Multilevel analyses indicated significant interactions between therapy type and client dismissing versus preoccupied attachment in predicting therapist negative emotional reactions. PPT therapist felt more Indifferent/Bored the more dismissing clients were, whereas CBT therapists felt more Overwhelmed/Moved the more preoccupied clients were.

The mediating effect of gaming motivation between psychiatric symptoms and problematic online gaming: an online survey.

BackgroundThe rapid expansion of online video gaming as a leisure time activity has led to the appearance of problematic online gaming (POG). According to the literature, POG is associated with different psychiatric symptoms (eg, depression, anxiety) and with specific gaming motives (ie, escape, achievement). Based on studies of alcohol use that suggest a mediator role of drinking motives between distal influences (eg, trauma symptoms) and drinking problems, this study examined the assumption that there is an indirect link between psychiatric distress and POG via the mediation of gaming motives. Furthermore, it was also assumed that there was a moderator effect of gender and game type preference based on the important role gender plays in POG and the structural differences between different game types.ObjectiveThis study had two aims. The first aim was to test the mediating role of online gaming motives between psychiatric symptoms and problematic use of online games. The second aim was to test the moderator effect of gender and game type preference in this mediation model.MethodsAn online survey was conducted on a sample of online gamers (N=3186; age: mean 21.1, SD 5.9 years; male: 2859/3186, 89.74%). The Brief Symptom Inventory (BSI), the Motives for Online Gaming Questionnaire (MOGQ), and the Problematic Online Gaming Questionnaire (POGQ) were administered to assess general psychiatric distress, online gaming motives, and problematic online game use, respectively. Structural regression analyses within structural equation modeling were used to test the proposed mediation models and multigroup analyses were used to test gender and game type differences to determine possible moderating effects.ResultsThe mediation models fitted the data adequately. The Global Severity Index (GSI) of the BSI indicated that the level of psychiatric distress had a significant positive direct effect (standardized effect=.35, P<.001) and a significant indirect (mediating) effect on POG (standardized effect=.194, P<.001) via 2 gaming motives: escape (standardized effect=.139, P<.001) and competition (standardized effect=.046, P<.001). The comparison of the 2 main gamer types showed no significant differences in the model. However, when comparing male and female players it was found that women had (1) slightly higher escape scores (on a 5-point Likert scale: mean 2.28, SD 1.14) than men (mean 1.87, SD 0.97) and (2) a stronger association between the escape motive and problematic online gaming (standardized effect size=.64, P<.001) than men (standardized effect size=.20, P=.001).ConclusionsThe results suggest that psychiatric distress is both directly and indirectly (via escape and competition motives) negatively associated with POG. Therefore, the exploration of psychiatric symptoms and gaming motives of POG can be helpful in the preparation of prevention and treatment programs.

New challenges for clinical health psychology in diagnosis and therapy of tinnitus

&lt;b&gt;Background&lt;/b&gt;&lt;br /&gt; Tinnitus is becoming a social issue as the number of individuals suffering from this condition is still increasing. The aim of this study was to analyze the characteristics of tinnitus and related distress, as well as general psychiatric distress of affected individuals.&lt;br /&gt; &lt;br /&gt; &lt;b&gt;Participants and procedure&lt;/b&gt;&lt;br /&gt; The study included 169 tinnitus patients aged between 22 and 88 years (mean 53.52). The duration of tinnitus ranged between 5 months and 30 years (mean 5.29 years). The participants presented either with normal hearing or with hearing loss. The study was based on a standardized interview and examination with two psychometric instruments: the General Health Questionnaire (GHQ-28) and the Tinnitus Handicap Inventory (THI).&lt;br /&gt; &lt;br /&gt; &lt;b&gt;Results&lt;/b&gt;&lt;br /&gt; Duration of tinnitus, its subjective severity, experiencing negative emotions and lack of social support turned out to be a composite measure determining the level of tinnitus-related distress. In turn, the level of psychiatric distress was determined by sex of the participants, presence of difficulties in life, subjective severity of tinnitus and lack of social support.&lt;br /&gt; &lt;br /&gt; &lt;b&gt;Conclusions&lt;/b&gt;&lt;br /&gt; Characteristics of tinnitus and its psychological consequences affect various functional aspects and health of the affected patients. The diagnostic instruments used in the study (THI and GHQ-28) proved to be appropriate and identified a subset of tinnitus patients who required appropriate psychotherapeutic intervention. The complex situation of patients experiencing subjective signs of tinnitus points to a necessity of cooperation between specialists in laryngology and psychologists, as a vital component of multidisciplinary evaluation and the therapeutic process.

A school based study of psychological disturbance in children following the Omagh bomb

ObjectiveTo assess the extent and nature of psychiatric morbidity among children (aged 8 to 13 years) 15 months after a car bomb explosion in the town of Omagh, Northern Ireland.MethodA survey was conducted of 1945 school children attending 13 schools in the Omagh district. Questionnaires included demographic details, measures of exposure, the Horowitz Impact of Events Scale, the Birleson Self-Rating Depression Scale, and the Spence Children’s Anxiety Scale.ResultsChildren directly exposed to the bomb reported higher levels of probable PTSD (70%), and psychological distress than those not exposed. Direct exposure was more closely associated with an increase in PTSD symptoms than in general psychiatric distress. Significant predictors of increased IES scores included being male, witnessing people injured and reporting a perceived life threat but when co-morbid anxiety and depression are included as potential predictors anxiety remains the only significant predictor of PTSD scores.ConclusionsSchool-based studies are a potentially valuable means of screening and assessing for PTSD in children after large-scale tragedies. Assessment should consider type of exposure, perceived life threat and other co-morbid anxiety as risk factors for PTSD.