High Levels Of Emotional Distress Research Articles

EMOTIONAL DISTRESS AND SELF-EFFICACY AMONG HEPATITIS C PATIENTS

Hepatitis C is a major public health concern in Pakistan, significantly affecting patients' psychological and behavioral well-being. Emotional distress and low self-efficacy among hepatitis C patients can negatively influence disease management and overall quality of life. This study aimed to evaluate emotional distress and self-efficacy levels among hepatitis C patients in a tertiary care hospital. Methods: A descriptive cross-sectional study was conducted with 117 patients diagnosed with hepatitis C. Participants were selected through convenience sampling, and data were collected using a structured questionnaire assessing demographic characteristics, emotional distress, and self-efficacy. Statistical analysis was performed using SPSS version 26, with a p-value of <0.05 considered significant. Results: The findings revealed high levels of emotional distress, with 47% of participants frequently feeling tense and 49.6% occasionally experiencing fear. Self-efficacy scores were low, as 46.2% of participants were "not at all confident" in discussing their illness with their doctor. Younger patients exhibited better self-efficacy, while female participants reported higher emotional distress. Significant gaps in patient education and communication with healthcare providers were identified. Conclusion: Emotional distress and low self-efficacy are prevalent among hepatitis C patients in Pakistan, emphasizing the need for integrated psychological support and educational interventions in routine care. Strengthening patient-provider communication and implementing scalable mental health programs can enhance treatment adherence and patient outcomes.

Gender-Specific Insights into Depression in Patients with Ischemic Heart Disease: Findings from a Pilot Study Using a Self-Developed Questionnaire.

Ischemic heart disease (IHD) significantly affects mental health, with gender-specific differences being observed in psychological responses. This pilot study aimed to explore these differences in the demographic, clinical, psychological, psychiatric, and social profile of patients diagnosed with IHD. A descriptive, cross-sectional design was used, recruiting 183 adult patients diagnosed with coronary artery disease and depression at the Psychiatry Department of Arad County Emergency Hospital, Romania, between May 2021 and May 2024. Data were collected using a self-developed tool, named the Depression Assessment in Ischemic Heart Disease Questionnaire (DA-IHDQ), alongside standardized assessments. Statistical analysis was performed using JASP statistical software (Version 0.19.1, University of Amsterdam, Amsterdam, Netherlands), employing binomial and multinomial tests for categorical data, and Cronbach's alpha was used to assess internal consistency. This study found significant demographic differences, with female patients exhibiting higher levels of emotional distress and severe depression compared with the male subjects. Women reported greater social isolation and a stronger desire to seek for psychological or psychiatric support. Furthermore, a positive correlation between depression severity and physical symptoms was observed in both genders. These findings highlight the importance of recognizing gender-specific responses to IHD, emphasizing the need for tailored interventions in mental healthcare and cardiac rehabilitation. Future research should further explore these differences to enhance the understanding of the psychosocial/psychiatric aspects of IHD and improve patient outcomes.

Distress reactions and susceptibility to misinformation for an analogue trauma event

Accuracy of memory is critical in legal and clinical contexts. These contexts are often linked with high levels of emotional distress and social sources that can provide potentially distorting information about stressful events. This study investigated how distress was associated with susceptibility to misinformation about a trauma analogue event. We employed an experimental design whereby in Phase 1, participants (N = 243, aged 20–72, 122 females, 117 males, 4 gender diverse) watched a trauma film (car crash) and heard an audio summary that contained misinformation (misled items), true reminders (consistent items), and no reminders (control items) about the film. Participants rated their total distress, and symptoms of avoidance, intrusions, and hyperarousal, in response to the film. They then completed cued recall, recognition, and source memory tasks. One week later in Phase 2, participants (N = 199) completed the same measures again. Generalised linear mixed models were used. A significant misinformation effect was found, and importantly, participants with higher distress levels showed a smaller misinformation effect, owing to especially poor memory for consistent items compared to their less distressed counterparts. Distress was also associated with improved source memory for misled items. Avoidance of the film’s reminders was associated with a smaller misinformation effect during immediate retrieval and a larger misinformation effect during delayed retrieval. Findings suggest that distress is associated with decreased susceptibility to misinformation in some cases, but also associated with poorer memory accuracy in general. Limitations are discussed, and the need for further research is highlighted.

Emotional well-being among community mental health professionals during COVID-19: an exploratory study

ABSTRACT This paper presents a study related to burnout and well-being deriving from professional practice in community mental health services. The sample consisted in 133 workers from the public mental health system of Barcelona (Spain). An ad-hoc questionnaire was used, and data was analyzed from a descriptive approach. The results reveal a high level of emotional distress and exhaustion related to professional practice that prevents from job satisfaction and affects work quality. Furthermore, the pandemic led to an increase in distress related to work in that field. Finally, the limitations of the study and directions for future research are raised.

Minimizing Ambulatory Setting Pediatric Healthcare-Induced Anxiety: A Case Review

It is no longer a rare phenomenon for pediatric patients to experience moderate to high levels of emotional distress, including anxiety, during preventive care office visits with healthcare providers. This distress can be attributed to multiple factors, including being in an unfamiliar setting with unknown people, and unclear expectations. Further compounding the anguish, children are often aware of the potential for, or likelihood of, physical discomfort, or pain during the office visit. These combined variables often result in unwelcome behavioral demonstrations of protest to healthcare workers and the child’s caregivers. Some children may scream, cry, pinch, bite, hit, or even refuse to engage in the examination or procedure. When these behavioral protests impede necessary care, expedient interventions must be considered. The following case review aims to demonstrate that attuning to a child’s emotional needs and providing developmentally appropriate power and control during an outpatient office visit in a healthcare setting, can aid in offering emotional safety and reduce the potential for long-term psychological harm

Group eye movement desensitization and reprocessing (EMDR) in chronic pain patients.

The prevalence of chronic pain is increasing, and conventional pain therapies often have limited efficacy in individuals with high levels of psychological distress and a history of trauma. In this context, the use of Eye Movement Desensitization and Reprocessing (EMDR), an evidence-based psychotherapy approach for the treatment of posttraumatic stress disorder, is becoming increasingly important. EMDR shows promising results, particularly for patients with pain and high levels of emotional distress. Although group therapy is becoming increasingly popular in pain management, EMDR has mainly been studied as an individual treatment. However, a systematic review suggests that group therapy can be an effective tool for improving mental health outcomes, especially when trauma is addressed together. Based on these findings, an outpatient EMDR group program was developed for patients with chronic pain. The program consists of a total of four treatment days with 5-5.5 h therapy sessions each day and provides patients with a supportive environment in which they can learn effective pain management strategies and interact with other patients with similar experiences. Initial pilot evaluations indicate high efficacy and adequate safety for patients with chronic pain.

The association among executive functions, academic motivation, anxiety and depression: a comparison between students with specific learning disabilities and undiagnosed peers

ABSTRACT Since COVID-19 pandemic started, schools had to face environmental changes, one was shifting from a face-to-face educational approach to online learning. It represented an unfavourable learning environment, especially for children with Specific Learning Disabilities (SpLD). Following the Self Determination Theory (SDT) framework, the current study investigated the differences in cognitive, emotional, and motivational domains between students with SpLD and undiagnosed peers, and the relations between executive functioning, emotional distress, and academic motivation. Participants included 97 Italian students, 47 with SpLD (average age of 10.9 years, SD = 1.35), and 50 undiagnosed peers (average age of 10.7 years, SD = 1.58) attending OL lectures during COVID-19. Results displayed lower executive functions (EFs), higher levels of emotional distress in students with SpLD. Furthermore, students with SpLD showed lower levels of identified and intrinsic motivation but higher levels of introjected motivation.

Predicting Emotional Distress, Based on Acquisition, Extinction, Avoidance, and Generalization Learning

This prospective study aimed to investigate whether fear conditioning parameters measured at baseline could predict the development of emotional distress over a 6‐month period among 655 first‐year university students. Verbal and behavioral measures of acquisition, extinction, avoidance, and generalization were obtained through an online task at the start of the academic year. Emotional distress was evaluated 4 to 6 months later, with questionnaires assessing anxiety, stress, depression, and coping trajectories. Initial analyses explored the interplay of conditioning parameters at baseline, hypothesizing that the corresponding learning processes may mutually reinforce each other, contributing to distinct vulnerabilities for emotional distress. Although no distinct profiles based on conditioning processes were identified, the analyses did uncover correlations between increased acquisition and avoidance of conditioned threat stimuli and reduced extinction, avoidance of safe stimuli, and generalization. Subsequent main analyses related the processes and their interactions to the development of emotional distress. Findings suggest that acquiring fear toward conditioned safety and threat stimuli, as well as avoiding conditioned threat stimuli, may be predictive of higher levels of emotional distress. Analyses relating extinction and generalization to emotional distress revealed mostly nonsignificant findings, emphasizing the need for methodological scrutiny in identifying anxiety‐related learning indices. This research contributes to understanding individual differences in the development of emotional distress and informs future investigations into learning processes and their implications for mental health.

Predictors of response after single session interventions for emotional distress: using enhanced psychoeducation in crisis situations.

Single-session interventions are an effective strategy for reducing emotional distress. Enhanced psychoeducation, which includes empathic listening, risk stratification, symptom monitoring, and habit modification is particularly suitable for single-session interventions. We investigated predictors of response to an online enhanced psychoeducation intervention among essential service professionals during the COVID-19 pandemic in Brazil. The TelePSI Project, financed by the Brazilian Ministry of Health, was a nationwide initiative that served more than 3,300 individuals in various psychotherapeutic modalities. Data were collected from April 2020 to December 2021. We included all participants with high levels of emotional distress who received single-session interventions. The final sample included 460 individuals (89.1% women, 81.1% health professionals). After 1 month, 300 participants were reassessed. Overuse of social media, use of social networks to contact family and friends, playing video games, smoking, drinking alcohol, and spending time with pets were associated with less improvement in symptoms, whereas playing an instrument and previous psychological treatment were associated with greater symptom improvement. This highlights the impact of lifestyle factors on the efficacy of single-session interventions. These results underscore the importance of considering individual lifestyle factors when implementing single-session interventions and contribute to a growing body of evidence that supports tailored application of psychoeducational strategies in mental health interventions, particularly in high-stress environments.

Teachers’ perceptions of the psycho-social effects of COVID-19 on learners’ well-being in South African schools

The lockdown the South African government implemented in 2020 to contain the COVID-19 pandemic resulted in school closures. During this time, and also when learners were allowed to attend school again, the focus was on the physical health and safety of the learners. However, in the process, schools might have neglected the psycho-social and mental well-being of learners, which is a state in which learners are able to manage stress and function optimally. This paper reports on a study that investigated teachers’ views on how learners’ psycho-social and mental well-being was affected by the COVID-19 pandemic. This qualitative study used semi-structured interviews to gather data from 17 teachers from five schools in two districts of the North-West Province in South Africa. The school mental health theoretical framework was used for the study because of its focus on the psycho-social mental health of learners and the role of institutions in supporting mental health. The findings indicate that learners experienced a higher level of emotional distress during the lockdown. This was caused by an increase in fear, stress, anxiety, uncertainty, frustration, anger and aggression during the pandemic. Although learners from all the schools were negatively affected by COVID-19, learners from low-income schools that had limited access to resources were affected more due to the limited professional psycho-social support they received. This highlights the need for Education Departments to build the capacity of all South African schools to address the emotional and psycho-social well-being of their learners. It is vital that schools commit themselves to enabling learners to develop a high level of resilience and antifragility at all times, not just during major crises such as the COVID-19 pandemic.

Identify the Level of Emotional Stress Factors for Workload, Lack of Resources, Administrative Management, Time Constraints and Negative Student Behavior and Disciplinary Problems Among Teachers at Sekolah Menengah Kebangsaan Pangkal Meleret, Machang, Kelantan

A very challenging form of social services is the teaching profession. A teacher’s profession has a high level of emotional distress. The problem of emotional stress among teachers is of concern to the public both inside and outside the educational organization. This study was done to find out the extent of the emotional stress that teachers experienced at Sekolah Menengah Kebangsaan Pangkal Meleret. The study aims are to see the extent of the level of the emotional stress of the teacher's workload, lack of resources, administrative management, time constraints, and negative student behavior and disciplinary problems. To achieve the purpose of the research, quantitative methods have been used. This study was conducted at Sekolah Menengah Kebangsaan Pangkal Meleret, Machang, Kelantan. A total of 44 teachers were selected as sample size to represent 54 respondents. Frequency and descriptive statistical tests covering frequency, percentage, mean and standard deviation have been used to describe demographic profiles and descriptive analysis. Cronbach's Alpha reliability value is 0.806 also good for pilot study. The findings showed that the highest levels of teacher emotional stress were teacher’s workload (M=4.37, SP=.459), followed by lack of resources (M=4.07, SP=.524), and administrative management (M=4.05, SP=.599), while time constraints were at moderate levels (M=3.54, SP=.862), followed by negative student behavior and disciplinary problems (M=3.21, SP=.855). The results of this study prove that these five factors influence the level of the emotional stress of the teacher. The results of this study contribute as reference material and guidance to the school to overcome the problem of emotional stress among teachers to improve the quality of teacher services.

Emotional Distress in Portuguese Cancer Patients: The Use of the Emotion Thermometers (ET) Screening Tool.

Cancer patients may experience significant distress. The "Emotion Thermometers" (ETs) are a short visual analogue scale used to screen patients for psychosocial risk. This study aimed to assess emotional distress in a large sample of cancer patients attending psychological services at an non-governmental organization (NGO), and to explore factors that may contribute to it. The ETs were answered by 899 cancer patients. They were, on average, 59.9 years old, the majority were female, had breast cancer, were under treatment or were disease-free survivors, and reported high levels of emotional distress, above the cut-off (≥5). A Generalized Linear Model was used to measure the association between the level of distress, age, gender, disease phase and 33 items of the problem list. Four items-sadness, depression, sleep and breathing-were found to be significantly related to a higher level of distress. Additionally, women and patients who were in the palliative phase also had significantly higher levels of distress. The results confirm the need for early emotional screening in cancer patients, as well as attending to the characteristics of each patient. Additionally, they highlight the utility of the ETs for the clinical practice, allowing to optimize the referral to specialized psychosocial services.

The Interconnection Between Social Support and Emotional Distress Among Individuals with Chronic Pain: A Narrative Review.

Chronic pain is a public health concern affecting over 100 million U.S. adults. Because chronic pain is multifactorial, it requires a biopsychosocial approach to understand how biological, psychological, and social factors contribute to both the development and maintenance of pain. On average, individuals with chronic pain report higher levels of emotional distress compared to pain-free individuals. Research has demonstrated that social support is associated with better pain outcomes and less emotional distress. It has been proposed that social support may improve pain outcomes by reducing the influence of stressors. However, the majority of research exploring the relationships between social support and pain-related outcomes has focused on the direct relationship between these variables, largely overlooking the process by which social support has a positive influence on pain. This narrative review synthesizes research on how chronic pain, emotional distress, and social support are highly interconnected, yet research investigating chronic pain and emotional distress within a social context is limited. We then highlight disparities in chronic pain, such that the burden of chronic pain is unequal between demographic groups. Next, we discuss existing evidence for the use of group-based interventions to address pain-related outcomes. Lastly, we summarize limitations of prior research studies and highlight gaps in the current literature. Overall, longitudinal research comprehensively investigating the distinct nuances in the measurement of social support and how these nuances relate to emotional distress and pain outcomes is needed and may provide insight into the unique needs of individuals or subgroups. Further, demographically diverse randomized controlled trials are needed to identify the process by which group-based interventions improve pain outcomes and whether these interventions are more effective for particular groups in order to personalize treatment approaches and address inequities in pain care.

The Longitudinal Mediating Effect of Distress Tolerance in a Mindfulness-Based Intervention: A Randomized Controlled Trial

"Objective: The present study aimed to investigate the intermediary role of distress tolerance in Mindfulness-Based Intervention (MBI) with respect to self-perceived stress reduction. Method: One hundred and twenty-nine adults with a high level of emotional distress were randomized into MBI groups or a waiting-list group. Levels of mindfulness skills, self-perceived stress, and distress tolerance (tolerance, appraisal, absorption, and regulation) were measured four times: pre-test, week 3, week 6, and post-test. Results: The developmental trajectories modeled by the univariate latent growth curve showed that the factor intervention significantly predicted the slope of observing, non-reactivity, overall mindfulness, and distress appraisal during first six weeks. Bivariate latent growth curve models demonstrated a significant association between increases in the growth rate of distress appraisal and non-reactivity in participants receiving mindfulness training. Such an association was not observed among those who did not receive an MBI. Longitudinal mediation analyses further revealed that the effect of MBI on non-reactivity and self-perceived stress at week 6 was fully mediated by distress appraisal at week 3, respectively."

Contents and Characteristics of Mental Imagery and their Association with Emotional Intensity in Adolescents: A Pilot Study

The contents and characteristics of mental imagery (MI) have been investigated with respect to a few mental disorders, but not yet in healthy samples. In adults, it was found that characteristics like the vividness and perspective of MI might be associated with emotions and emotional distress, a matter which needs to be examined in youths. A sample of 80 adolescents (14–20 years; 75.3% female) completed a web-based quasi-experimental design about the contents, and characteristics (frequency, vividness, perspective, controllability) of spontaneous positive and negative MI and emotional distress and emotions, as well as the Beck Depression Inventory and the Social Phobia Inventory. Adolescents described mental images primarily about social themes and those participants experiencing images about social conflicts reported higher levels of emotional distress. Participants reported perceiving images in a combination of field- and observer perspective also stated a higher score of anxiety. A higher frequency, vividness and less control over negative images were significantly linked to a higher intensity of emotional distress and anxiety. A higher frequency, vividness and a higher level of control over positive images were significantly linked to a higher intensity of joy. Small sample size and high social status of participants limits generalizability. Findings indicate that encouraging young people to create vivid positive images and to use a training to increase control over MI might be useful to increase mental health. The results do not permit causal conclusions to be drawn, but raise questions about previous studies comparing each imagery perspective individually.

A test of the dyadic associations between ineffective arguing, emotional distress, and violence perpetration and victimization among couples seeking therapy.

Researchers have tested associations between ineffective arguing and emotional distress among couples without relationship violence. Moreover, studies have demonstrated associations between physical violence perpetration and victimization in the aftermath of emotional distress. However, there is a paucity of research examining linkages between ineffective arguing, emotional distress, and physical violence perpetration or victimization. Dyadic data from 231 married, heterosexual couples seeking therapy were used to test a model examining pathways between ineffective arguing and physical violence perpetration and victimization through emotional distress. The hypothesized model was compared to two plausible alternative models. Results revealed higher levels of men's ineffective arguing were positively associated with men's physical violence perpetration, both directly and indirectly, through higher levels of emotional distress. Higher levels of men's ineffective arguing were associated with lower men's physical violence perpetration through higher levels of women's emotional distress. Results can inform the clinical treatment of interpersonal violence by targeting ineffective arguing and emotional distress.

Effect of a digital biopsychometric risk profile of patients with cancer on the delivery of risk-stratified personalised prehabilitation.

e13636 Background: Cancer symptoms and treatment consequences such as fatigue, nausea, distress and breathlessness contribute to inactivity, malnutrition, sarcopenia and ultimately poor clinical outcomes. Multimodal prehabilitation, with a focus on physical activity, nutrition and emotional well-being, is associated with improved treatment outcomes. However, prehabilitation needs to be personalised to maximise adherence and impact. Digital solutions offer an opportunity to collect and consolidate health data to facilitate the personalisation of prehabilitation programmes. Methods: Patients were referred from the NHS to an independent digital prehabilitation provider, Onkohealth Ltd. Baseline health metrics were collected via validated survey tools and wearable technology to develop a biopsychometric profile including the following modifiable factors. Multi-morbidity risk (MMR) was represented as a score from 0-14. Frailty estimation was based on walking speed. Diet quality was based on the World Cancer Research Fund diet score with higher score for better quality food items (range 0-3). Psychological wellbeing was measured via an emotional distress scale (range 0-10) and self-efficacy (range 0-40). Exercise metrics included 1 minute heart rate recovery (1m HRR) and 30 second Sit to Stand test (30sSTS). Risk-stratification was undertaken using the validated thresholds for each of these 9 modifiable risk metrics, including BMI. EuroQoL EQ5D5L was used to report quality of life as health utility (EQ-HU). Results: 303 patients with a range of cancer diagnosis [gastrointestinal (41%), biliopancreatic (10%) gynaecological (16%) and breast (20%) were included. 72% of patients had at least one high-risk metric and 30% had >3 high risk metrics. 42% of patients were obese, 34% had a high MMR and 25% had a slow walking speed. There were strong correlations between age and MMR (rho=0.53; p<0.001) and walking speed (rho=0.33; p=0.004). 16% had a low HRR and 17% had a low STS. STS had significant correlation with walking speed [rho=0.47; p<0.001) and BMI (rho=0.34; p<0.001). 42% of patients reported a low quality diet. High levels of anxiety were recorded in 21% of patients and high levels of depression in 26% of patients. Higher levels of anxiety (rho-0.24; p=0.002) and distress (rho=0.29; p<0.001) and lower levels of self-efficacy (rho= 0.25, p<0.001) were associated with lower EQ HU. Conclusions: This study demonstrated that 7 in 10 cancer patients have at least one risk factor and 1 in 4 patients have more than 3 predictors of poor treatment outcomes. Bio-psychometric profiling highlights modifiable risk factors and provides a focus for prehabilitation to be personalised. The findings also highlighted the importance of psychological wellbeing as high levels of emotional distress were associated with lower reported quality of life.

0150 Increased Prevalence of Clinical Depression in Late Teens with Sleep Complaints

Abstract Introduction Adolescent mental health is becoming clinical attention since suicide is one of the leading causes of death in late teens. Depression and sleep are interconnected, since depression affects sleep, vice versa. Clinical depression with symptoms of sleep disturbance were interviewed by a board certified psychiatrist following depression inventory. Age, sex matched adolescents were also accessed by depression inventory scales. Methods 71 adolescence aged from 16-18 ( M:F=1:1) who visited sleep disorders clinic for their complaints of daytime sleepiness, sleep initiation problems, snoring, frequent midnight awakenings. 29% of them diagnosed with narcolepsy, 21% delayed sleep phase syndrome, 19% obstructive sleep apnea syndrome, 15% of them had chronic insomnia. Some of them have multiple sleep disorders associated diagnosis like OSA + narcolepsy, OSA + insomnia, or DSPS + OSA. 21 aged, sex matched high school students were evaluated for their anxiety and depression symptoms. Results Patients with sleep complaints had higher level of emotional distress compared with healthy adolescents without sleep complaints. Among sleep disorders, patients with narcolepsy had higher level of depression. These explains why children or adolescents with narcolepsy are initially misdiagnosed with depression in clinical setting. Comorbid depression and narcolepsy should be differentiated in clinical field. Conclusion In adolescents, patients with sleep disorders especially with narcolepsy have higher level of depression. Misdiagnosis of narcolepsy as depression may delay narcolepsy diagnosis. Support (if any)

Exploring experiences of moral injury and distress among health care workers during the Covid-19 pandemic.

Health care workers have been exposed to a variety of practical and emotional challenges because of the Covid-19 pandemic, leaving them vulnerable to experiencing moral injury and distress. However, there is currently sparse research which directly explores such experiences. This study aimed to explore and characterise the experiences and impacts of moral injury and distress among health care workers during the pandemic. Twenty semi-structured interviews were conducted with health care workers employed across both mental and physical health care services. Interviews were analysed from a critical realist perspective using thematic analysis. Three key themes were identified: attitudes towards moral injury, experiences of moral injury and consequences of moral injury. Participants appeared to identify with the idea of acting against their morals to varying extents based on their job roles. Participants experienced a range of potentially morally injurious and distressing events throughout the pandemic and many ultimately felt that they provided sub-standard levels of care due to extreme pressures on services. Detrimental impacts upon wellbeing were commonly reported, including high levels of emotional distress and feelings of guilt and shame. Some reported a loss of enthusiasm for their job and a desire to leave the profession entirely. Moral injury and distress presents a real concern for staff wellbeing and retention within the profession. During and beyond the Covid-19 pandemic, there is an urgent need for health care providers to implement wider strategies to target moral injury and distress, and support staff within health care settings.

Effects of risk exposure on emotional distress among Chinese adults during the COVID-19 pandemic: The moderating role of disruption of life and perceived controllability.

COVID-19 affects not only the physical health of individuals but also their mental health and different types of risk exposures are believed to have different effects on individual emotional distress. This study explores the relationships between risk exposure, disruption of life, perceived controllability, and emotional distress among Chinese adults during the COVID-19 outbreak. This study is based on an online survey conducted during the COVID-19 pandemic, from 1 to 10 February 2020, with a total of 2,993 Chinese respondents recruited through convenience and snowball sampling. Multiple linear regression analysis were used to examine the relationships among risk exposure, disruption of life, perceived controllability, and emotional distress. This study found that all types of risk exposures were significantly associated with emotional distress. Individuals with neighborhood infection, family member infection/close contact, and self-infection/close contact had higher levels of emotional distress (B = 0.551, 95% CI: -0.019, 1.121; B = 2.161, 95% CI: 1.067, 3.255; B = 3.240, 95% CI: 2.351, 4.129) than those without exposure. The highest levels of emotional distress occurred among individuals experiencing self-infection/close contact, while the lowest levels of emotional distress occurred among individuals experiencing neighborhood infection and the moderate levels of emotional distress occurred among individuals experiencing family member infection (Beta = 0.137; Beta = 0.073; Beta = 0.036). Notably, the disruption of life aggravated the effect of self-infection/close contact on emotional distress and family member infection/close contact on emotional distress (B = 0.217, 95% CI: 0.036, 0.398; B = 0.205, 95% CI: 0.017, 0.393). More importantly, perceived controllability lowered the strength of the association between self-infection/close contact and emotional distress, as well as family member infection/close contact and emotional distress (B = -0.180, 95% CI: -0.362, 0.002; B = -0.187, 95% CI: -0.404, 0.030). These findings shed light on mental health interventions for people exposed to or infected with COVID-19 near the beginning of the pandemic, particularly those who themselves had COVID or had family members with COVID-19 risk exposure, including being infected/having close contact with an infected person. We call for appropriate measures to screen out individuals or families whose lives were, or remain, more severely affected by COVID-19. We advocate providing individuals with material support and online mindfulness-based interventions to help them cope with the after-effects of COVID-19. It is also essential to enhance the public's perception of controllability with the help of online psychological intervention strategies, such as mindfulness-based stress reduction programs and mindfulness-oriented meditation training programs.