General Psychological Symptoms Research Articles

Psychological Symptoms as Long-Term Consequences of War Experiences

Background/Aims: War experiences can affect mental health, but large-scale studies on the long-term impact are rare. We aimed to assess long-term mental health consequences of war in both people who stayed in the conflict area and refugees. Method: On average 8 years after the war in former Yugoslavia, participants were recruited by probabilistic sampling in 5 Balkan countries and by registers and networking in 3 Western European countries. General psychological symptoms were assessed on the Brief Symptom Inventory and posttraumatic stress symptoms on the Impact of Event Scale-Revised. Results: We assessed 3,313 interviewees in the Balkans and 854 refugees. Paranoid ideation and anxiety were the severest psychological symptoms in both samples. In multivariable regressions, older age, various specific war experiences and more traumatic experiences after the war were all associated with higher levels of both general psychological and posttraumatic stress symptoms in both samples. Additionally, a greater number of migration stressors and having only temporary legal status in the host country were associated with greater severity of symptoms in refugees. Conclusions: Psychological symptoms remain high in war-affected populations many years after the war, and this is particularly evident for refugees. Traumatic war experiences still predict higher symptom levels even when the findings have been adjusted for the influence of other factors.

Noise Pollution, Psychiatric Symptoms and Quality of Life: Noise Problem in the East Region of Turkey

Aim: As to clinical examinations, predisposition to aggression and aggressive behavior among drivers are very high in Turkey. For this reason, direct correlation between the noise pollution and general psychological symptoms with quality of life in public transport drivers were investigated in this survey. Material and Methods: Bus drivers of varying bus brands (F, O and P which has different noise levels) were subjected in this study. SCL-90-R and SF-36 questionnaire were used to assess the presence and severity of psychiatric symptoms and quality of life. Sound level meter (Smart Sensor AR844) was used for noise pollution measurements (dB(A)) within the buses and city main streets. Results: According to the measurements; F, O and P brand buses average 65.16 dB(A), 70.86 dB(A) and 75.33 dB(A) noise produces respectively. Especially, P brand mini-bus drivers were found to have worked under continuously high noise (75.33 dB(A), average 11.22±3.86 hours daily). According to psychiatric SCL-90-R and SF-36 assessments, observed psychiatric symptoms were more pronounced between the high noise exposed group than other groups (P<0.001). Discussion: In this survey, we observed that Psychologies and quality of life of bus drivers were affected by the noise pollution and noise pollution had cause to serious psychological symptoms on drivers such as anxiety, depression, hostility, etc., and noise had negative effects over the quality of life, particularly, when drivers were exposed for longer working periods and above certain values Key Words: Noise Pollution; Work Place Safety; Psychological Symptoms; Quality of Life; Drivers.

P-436 - Noise pollution, psychiatric symptoms and quality of life: noise problem in the east region of Turkey

Introduction Noise is defined as unwanted sounds and can cause psychological symptoms such as anxiety, restlessness, irritability, sleep disturbances and difficulty concentrating. Transportation noise represents a large majority of external noise that affects people in large cities. Professional drivers are the highest risk group. Aim The aim of this study is to investigate the correlation between noise pollution and, general psychological symptoms, quality of life in public transport drivers. Material and methods Bus drivers of varying bus brands (F, O and P) were subjected in this study. SCL-90-R and SF-36 questionnaire were used to assess the presence and severity of psychiatric symptoms and quality of life. Sound level meter (Smart Sensor AR844) was used for noise pollution measurements (dB(A)) within the buses and city main streets. Results F, O and P brand buses average 65.16 dB(A), 70.86 dB(A) and 75.33 dB(A) noise produces respectively. Especially, P brand mini-bus drivers were found to have worked under continuously high noise (75.33 dB(A), average 11.22 ± 3.86 hours daily). According to psychiatric SCL-90-R and SF-36 assessments, observed psychiatric symptoms were more pronounced between the high noise exposed group than other groups (P Conclusion Psychologies and quality of life of bus drivers were affected by the noise pollution and noise pollution had cause to serious psychological symptoms on drivers such as anxiety, depression, hostility, etc., and noise had negative effects over the quality of life in the east region of Turkey, particularly, when drivers were exposed for longer working periods and above certain values.

Age Differences and Similarities in Identity Distress Following the Katrina Disaster: Theoretical and Applied Implications of Erikson’s Theory

This study examined predictions from Erik- son's lifespan developmental theory in the context of severe disaster exposure. Relationships among traumatic stress exposure, age, identity distress, and posttraumatic stress (PTS) symptoms were explored among 401 indi- viduals (age 18-86, mean = 32.83, SD = 14.1 years) exposed to Hurricane Katrina. Traumatic exposure expe- riences were related to identity distress ratings, but results suggested that the association was a function of PTS symptoms. Identity distress was negatively correlated with age, but the association between identity distress and age was moderated by the level of PTS symptoms. Identity distress was associated with PTS symptoms even while controlling for general psychological symptoms. The utility of the identity distress construct and theoretical implica- tions for identity research in the wake of disaster are discussed.

General psychological distress symptoms and help-avoidance in young Australians

Epidemiological studies suggest that young people might have a tendency to avoid help when they experience symptoms of psychological distress. There is growing evidence that many young people prefer no help from anyone for their mental health problems. The current study examined the association between symptoms of general psychological distress and intentions to seek help from friends, family and professional mental health sources in a sample of 109 trade (TAFE) students from regional and rural Australia. Participants were 67% male and aged from 15–25 years. Higher levels of general psychological distress symptoms were associated with stronger intentions to not seek help from anyone and weaker intentions to seek help from friends and family for mental health problems. The variable ‘negative beliefs about treatment’ was also associated with a stronger intentions to not seek help and weaker intentions to seek help from mental health professionals. Help-avoidance in relation to symptoms of general psychological distress and beliefs about mental health treatment is discussed, together with suggestions for encouraging appropriate and effective help-seeking in young people.

Psychological resilience and long-term distress in Swedish and Icelandic parents’ adjustment to childhood cancer

Aim. Studies of parental reactions to a child's cancer have traditionally been carried out within the framework of psychiatry and psychopathology. We studied the significance of individual resource factors strengthening parents’ resilience to long-term cancer-related distress, a focus that has rarely been used. Participants and methods. The two-nation Nordic sample included 398 parents; 190 of whom had experienced a child's cancer, and 208 reference parents. We studied the sense of coherence (SOC) using the SOC-13 questionnaire. For assessing distress reactions we used a primarily illness-specific 11-dimensional Parental Psychosocial Distress in Cancer (PPD-C) self-report questionnaire developed for use with parents of childhood cancer patients, and the General Health Questionnaire (GHQ). Resilience was defined as absence of/less severe distress. Results. Low SOC was significantly associated with more severe distress in all dimensions of the PPD-C and GHQ. The protective effect of SOC was indicated by it being most negatively related to general psychiatric symptoms, physical and psychological stress symptoms, anxiety and depression. The influence of SOC varied with parents’ gender, showing a stronger modifying influence among mothers. Mothers and fathers also differed in their utilisation of professional psychosocial support when confronted with the child's cancer. Conclusion. Parental resilience to cancer-related distress varies with identifiable strength factors. A strengths-oriented approach helps in understanding parental adjustment to childhood cancer. In order to counteract psychological vulnerability, addressing resilience instead of pathology helps to identify parents at risk and in need of professional support when faced with a child's cancer.

Development and initial psychometric properties of the University of Texas at San Antonio Future Disposition Inventory

We describe the development and initial psychometric properties of a 24-item self-report measure, the University of Texas at San Antonio Future Disposition Inventory (UTSA FDI). This instrument is designed to evaluate future related thoughts and feelings that are associated with suicide-related risk behaviors: positive focus, suicide orientation, and negative focus. The items were generated by clinical and nonclinical samples. The structure of the instrument was defined in a sample of 350 university undergraduate students (Study 1). Using CFA, we confirmed the fit of the 3-factor solution in an independent sample of college age students (n=452; Study 2). Scale reliability estimates were good (all rho's>or=.80) in both studies. Known-groups validation analyses showed that scores on each scale were useful in differentiating the responses of the study groups. Correlates for the scales were identified when scores on measures of suicide-related risk and general psychological symptoms were included as validation self-report instruments.

A Therapist‐Assisted Internet‐Based CBT Intervention for Posttraumatic Stress Disorder: Preliminary Results

Posttraumatic stress disorder (PTSD) is a debilitating mental health condition frequently associated with psychiatric comorbidity and diminished quality of life, and it typically follows a chronic, often lifelong, course. Previous research has shown that trauma‐related psychopathology (but not necessarily clinical PTSD) can be effectively treated via the Internet. This study is the first of its kind to report on the online treatment of patients with a Diagnostic and Statistical Manual of Mental Disorders (fourth edition) clinical diagnosis of PTSD with therapist support by e‐mail only. Preliminary findings are presented of an open trial involving a 10‐week Internet‐based therapist‐assisted cognitive behavioural treatment for PTSD (PTSD Online). Pre and posttreatment measures of PTSD and related symptomatology were compared for 16 participants with a variety of trauma experiences. Participants showed clinically significant reductions in PTSD severity and symptomatology, moderate tolerance of the program content, and high therapeutic alliance ratings. No significant change was found on measures of more general psychological symptoms. The results suggest that PTSD Online appears to be an effective and accessible clinical treatment for people with a confirmed PTSD diagnosis.

Person-centred counselling to ameliorate symptoms of psychological distress among South African patients living with hypertension and diabetes: Results of an intervention study

Background: Previous research, internationally and in South Africa, suggests that symptoms of depression and anxiety are prevalent among patients living with a chronic illness. Very few behavioural interventions have shown to be effective in ameliorating such symptoms among patients attending public health clinics in South Africa. In this study, a five-session counselling programme was tested to ameliorate symptoms of depression and anxiety in clinic patients living with diabetes and hypertension in the Western Cape, South Africa. Method: A convenience sample of patients (n = 37) was recruited from two public clinics. The sample was non-randomly assigned to a treatment group (n = 20) and a control group (n = 17), and assessed before and after the intervention was presented. A battery of instruments consisting of the Hopkins Symptom Checklist, the Beck Depression Inventory, and the Beck Anxiety Inventory was administered before and after the intervention. Results: The results indicate that person-centred counselling was effective in ameliorating general psychological distress and symptoms of depression, but not symptoms of anxiety, as measured by the above instruments. The results suggest that psychological counselling may be helpful to medical patients. Conclusions: While counselling interventions may be well placed in public health settings from the perspective of treatment efficacy, it is necessary to temper this recommendation with an understanding of the barriers to implementing such services and the resulting impact on therapeutic effectiveness.

Individual Symptoms and Coping Resources Reported by Trauma Survivors and Their Partners: A Qualitative Research Study with Clinical Couples

ABSTRACT Trauma-focused research has traditionally addressed symptom development in individuals who directly experienced traumatic events, overlooking the systemic impact of trauma on family members of trauma survivors. In recent years, researchers and clinicians have begun to understand the systemic effects of trauma by examining how individual exposure to traumatic events affects partners, children, parents, and other members of victims' social systems. The purpose of the current study was to further examine the systemic impact of trauma by exploring the individual symptoms of partners in dual- and single-trauma couples. The study examined qualitative interview data from 17 individuals, analyzed using a retroductive methodology to identify how each individual partner in an intimate partner relationship is affected when one or both partners have a history of trauma exposure. The following primary themes were identified: general psychological symptoms, self-esteem issues, emotional responses, cognitive symptoms, and coping resources. The strong emphasis on coping resources and the limited psychological symptoms reported by both trauma survivors and their partners provides important information to the study of traumatic stress in couples. Areas for future research and clinical implications also are identified.

Longitudinal Psychological Effects of the Garuda Indonesia Air Disaster in Japan

We examined the general health and psychological symptoms among survivors of the 1996 Garuda Indonesia air disaster in Japan. We conducted a prospective study 6 months and 1 year (Study 1) after the disaster. A retrospective follow-up study was performed ten years after the disaster (Study 2). The mean score on the 28-Item General Health Questionnaire was 6.5 (SD=6.9) 1 year after the disaster. Those who witnessed the death of an acquaintance in the disaster were classified into the high risk group. In Study 2, more than one-third of respondents complained of a flying phobia. These findings indicate that the psychological burdens of air disasters may last as long as 10 years.

Beliefs and attitudes among Swedish workers regarding the risk of hearing loss

The aim of this study was to develop an abridged version of the Tinnitus Questionnaire (TQ) to be used as a quick tool for the assessment of tinnitus-related psychological distress. Data from 351 inpatients and 122 outpatients with chronic tinnitus were used to analyse item statistics and psychometric properties. Twelve items with an optimal combination of high item–total correlations, reliability and sensitivity in assessing changes were selected for the Mini-TQ. Correlation with the full TQ was >0.90, and test–retest reliability was 0.89. Validity was confirmed by associations with general psychological symptom patterns. Treatment effects indicated by the Mini-TQ were slightly greater than those indicated by the full TQ. The Mini-TQ is recommended as a psychometrically approved and solid tool for rapid and economical assessment of subjective tinnitus distress.

Cancer survivorship and psychological distress in later life.

Recent research in psychosocial oncology has pointed to the traumatic nature of the stress experienced by cancer survivors. Most of this research has focused on children, young adults survivors and their families. This investigation proposes a conceptual model for understanding general psychological distress (anxiety, hostility and depression) and symptoms of posttraumatic stress (hyper-arousal, avoidance and intrusiveness) that may be associated with cancer survivorship among older adults. Findings from a survey of 180 older adult, long-term cancer survivors are used to illustrate the key features of this model. Results of multivariate analysis show that most older adult long-term cancer survivors do not demonstrate clinical levels of posttraumatic stress disorder (PTSD), although over 25% evidence clinical levels of depression. However, many survivors display important symptoms of psychological distress that are related to the continuing effects of cancer and its treatment. Current cancer-related symptoms are the strongest predictors of depression (beta=0.27, p=0.046) and the PTSD sub-dimension of hyper-arousal (beta=0.377, p=0.004). These effects persist even when the effects of other stressors and non-cancer illness symptoms are statistically controlled. Additionally, it appears in this sample that symptoms of PTSD are significantly correlated with traditional measures of psychological distress.

Physiological and psychological reactivity in women with asthma: the effects of anxiety and menstrual cycle phase

The relation between menstrual cycle timing, panic attacks, and diagnosis of asthma was explored in this study. Women with or without asthma and with or without a history of panic attacks engaged in a psychophysiological task during either the intermenstrual or premenstrual cycle phase and completed self-report measures of menstrual symptoms and attitudes, general psychological symptoms, and attitudes toward illness. No significant differences were identified for psychological or psychophysiological measures with menstrual cycle phase as a factor. However, women with both asthma and a history of panic attacks reported more general psychological distress than women in the other groups, and more state anxiety than controls. Women in the asthma, asthma and panic, and panic groups reported higher anxiety sensitivity than the control group. After listening to asthma-related scenes, women with asthma exhibited a decrease in peak expiratory air flow, and women with asthma and panic exhibited increased skin conductance response magnitude. Implications for the role of anxiety in lung function are discussed, as well as directions for future research with asthma and anxiety populations.

Vasomotor and Other Menopausal Symptoms Influenced by Menopausal Stage and Psychosocial Factors in Japanese Middle‐Aged Women

Vasomotor and Other Menopausal Symptoms Influenced by Menopausal Stage and Psychosocial Factors in Japanese Middle‐Aged Women: Kuninori Shiwaku, et al. Department of Environmental Medicine, Shimane Medical University—The relationship among menopausal symptoms, the menopausal stage and psychosocial factors in climacteric of Japanese women was investigated. Information on menopausal symptoms, the menstrual cycle and psychosocial factors were collected by means of a self‐reported questionnaire in six rural communities. A general population sample of 2,886 women (recovery rate of 75%) aged 40 to 69 yr completed a report on seventeen self‐reported health symptoms over the preceding 12 months. The most bothersome complaints were aching/painful joints, weakness and headache that were reported by approximately half the population aged 40 to 69 yr, but less than 4% of the women were affected severely. One‐third of the women were bothered by night sweats, cold hands and feet, nervousness and anxiety. Approximately one in five of the women complained of hot flushes, numbness, early waking, and sleeplessness. Four factors emerged from a factor analysis: general somatic symptoms, psychological symptoms, vasomotor symptoms and aging symptoms. Hot flushes, night sweats, numbness, early waking and sleeplessness were significantly higher in the perimenopausal and postmenopausal periods than in the premenopausal period of women aged 45 to 54 yr. The menopausal stages were significantly related to the vasomotor symptoms, but had little relationship to the other menopausal symptoms, in a logistic regression model. Japanese women characteristically have a lower incidence of vasomotor and other menopausal symptoms, and a lower utilization of medical treatment for menopausal symptoms. Vasomotor symptoms were clearly associated with menopause, but other menopausal symptoms in Japanese middle‐aged women related to self‐rated health, social support and occupation.

The connection between disgust and obsessions and compulsions in a non-clinical sample

Abstract Although obsessive-compulsive patients (OCD) frequently report thoughts and compulsions about dirt and contamination, there is scarce evidence for a relationship between disgust and OCD. This study investigates whether there is a specific relationship between obsessive symptoms and disgust, independently of general psychological distress symptoms. We tested 278 non-clinical volunteers, through the Disgust Scale [ Haidt, J., McCauley, C., & Rozin, P. (1994). Individual differences in sensitivity to disgust: a scale sampling seven domains of disgust elicitors. Personality Individual Differences . 16, 701–713 ], the Padua Inventory — Revised [PI-R; van Oppen, P., Hoekstra, R. J., & Emmelkamp, M. G. (1985). The structure of obsessive-compulsive symptoms. Behaviour Research and Therapy , 33, 15–23 ], the State-Trait Anxiety Inventory [ Spielberger, C. D., Gorsuch, R. L., Lushene, R., Vagg, P. R., & Jacobs, G. A. (1983). Manual for the State-Trait Anxiety Inventory (Form Y) . Palo Alto, CA: Consulting Psychologists Press ], and the Beck Depression Inventory [ Beck, A. T., & Steer, R. (1987). Beck depression inventory scoring manual. The psychological corporation. New York: Harcourt Brace Janovich ]. A multiple regression analysis showed a significant positive relationship between disgust and obsessive symptoms, after controlling for gender, age, anxiety, and depression. Washing and checking behaviors were best predicted by disgust, while impulses and rumination were best predicted by anxiety and/or depression. These findings are in line with the hypothesis of a specific relationship between disgust and at least some kinds of obsessive symptoms.

Appraisals of Blame in Adjustment in Conjugal Bereavement

Bereaved individuals who had lost a spouse through death (on average 7.2 months previously) engaged in an “empty-chair” monolog task in which they imagined that they had one last opportunity to speak to their deceased spouse. The verbal content of their monolog speech was rated by judges on the appraisal categories deceased as blameworthy and self as blameworthy. As predicted, deceased as blameworthy was associated with greater anger toward the deceased, whereas self as blameworthy was related to greater guilt on a repeated measure assessing affective experience when thinking about the deceased in daily life. In addition, these appraisal categories were positively correlated with measures of symptomatic distress; specifically, deceased as blameworthy was related to general psychological symptoms, whereas self as blameworthy correlated with grief-specific symptoms. Furthermore, deceased as blameworthy was predictive of 14 months post-loss general psychological distress symptoms when statistically controlling for these symptoms at the time of the monolog in a hierarchical regression analysis, thus providing support for its mediating role in later adjustment. The implications of the findings for the assessment of grief outcome and directions for future research are discussed.

General Health and Psychological Symptom Status in Pregnancy and the Puerperium

General Health and Psychological Symptom Status in Pregnancy and the Puerperium

General health and psychological symptom status in pregnancy and the puerperium: what is normal?

Objective: To identify normative changes in psychological and physiologic health status associated with pregnancy and the puerperium. Methods: Self-administered surveys containing Ware’s Short Form-36 and Derogatis’s Brief Symptom Inventory were completed by 393 pregnant women during their third trimester. Of those, 253 completed the same survey during the puerperium. Results were compared between periods and with those of samples of women from standardized community samples. Results: On the Short Form-36, pregnant women in the third trimester had significantly poorer levels of functioning ( P < .01) than community controls with regard to bodily pain (51.86 versus 79.61), physical functioning (62.91 versus 89.12), social functioning (74.0 versus 84.06), vitality (47.24 versus 58.04), and functional limitations resulting from physical health problems (45.0 versus 86.73) subscales. Those differences persisted into the puerperium. Compared with pregnancy, scores on social functioning and functional limitations caused by emotional problems decreased during the puerperium. Women reported improved perceptions of their general health in the puerperium compared with community controls (80.22 versus 74.80). On the Brief Symptom Inventory, pregnant women reported significantly higher levels of emotional distress on the three global measures and on the somatization (0.75 versus 0.35), obsessive-compulsive (0.70 versus 0.48), and hostility (0.59 versus 0.36) subscales than controls; those changes normalized in the puerperium. Conclusion: Pregnancy and the puerperium are associated with significant changes in psychological and physiologic health status. Documentation of those changes is important if the Short Form-36 and Brief Symptom Inventory are to be used in health outcomes research with this population.

Do participants' reports of symptom prevalence or severity vary by interviewer gender?

Although interviews are commonly used to gather research data, the integrity of interview data can be threatened by discrepancies between interviewers and respondents on such characteristics as race, gender, or age. To determine if participants' reports of the prevalence and severity of 30 symptoms varied as a function of interviewer gender. Symptoms that were assessed included general physical symptoms (diarrhea, headaches), psychological symptoms (feel blue and depressed, worry about nervous breakdown), and menopausal symptoms (hot flashes, vaginal dryness). Structured telephone interviews were completed by 137 women who were a mean of 56.5 years old (SD = 11.1, range 36-83) and a mean of 38.8 months (SD = 23.6) postdiagnosis of breast cancer. Interviewers included two women and two men. Symptom prevalence and severity did not vary as a function of interviewer gender. Findings suggest that both male and female interviewers can be used successfully to assess participants' reports of physical, psychological, or menopausal symptoms.