Higher Emotional Distress Research Articles

Alterations in Gut Microbiota Composition Are Associated with Changes in Emotional Distress in Children with Obstructive Sleep Apnea

Emerging evidence underscores the pivotal role of the gut microbiota in regulating emotional and behavioral responses via the microbiota–gut–brain axis. This study explores associations between pediatric obstructive sleep apnea (OSA), emotional distress (ED), and gut microbiome alterations before and after OSA treatment. Sixty-six children diagnosed with OSA via polysomnography participated, undergoing adenotonsillectomy alongside routine educational sessions. ED was assessed using the OSA-18 questionnaire, categorizing participants into high ED (scores ≥ 11, 52%) and low ED (scores < 11, 48%) groups. Gut microbiome analysis revealed significant diversity differences, with high ED linked to a reduced Shannon index (p = 0.03) and increased beta diversity (p = 0.01). Three months post-treatment, significant improvements were observed in OSA symptoms, ED scores, and gut microbiome alpha diversity metrics among 55 participants (all p < 0.04). Moreover, changes in the relative abundances of Veillonella, Bifidobacterium, Flavonifractor, and Agathobacter, as well as ultra-low frequency power and low frequency power of sleep heart rate variability, were independently associated with ED score alterations. These findings underscore the gut microbiome’s critical role in the emotional and behavioral symptoms associated with pediatric OSA, suggesting that microbiome-targeted interventions could complement traditional treatments for ED reduction and emphasizing the need for further research.

Non-pharmacological interventions for ICU nurses’ burnout syndrome: A meta-analysis

Burnout syndrome is a critical issue among Intensive Care Unit (ICU) nurses due to high workloads, emotional distress, and constant exposure to life-threatening situations. Characterized by emotional exhaustion, depersonalization, and a reduced sense of personal accomplishment, burnout negatively impacts both the well-being of nurses and the quality of patient care. While pharmacological interventions may offer some relief, non-pharmacological strategies are increasingly recognized as essential for preventing and managing burnout without the risk of medication-related side effects. This meta-analysis aims to evaluate the effectiveness of various non-pharmacological interventions, such as art therapy, guided meditation, mindfulness-based stress reduction, cognitive-behavioral therapy (CBT), and peer support programs, in reducing the symptoms of burnout syndrome among ICU nurses.A systematic literature search was conducted across multiple databases (PubMed, CINAHL, PsycINFO, and Cochrane Library) for randomized controlled trials (RCTs) and quasi-experimental studies evaluating non-pharmacological interventions for burnout in ICU nurses. Studies published between 2010 and 2024 were included. The primary outcome measure was the reduction in burnout symptoms as assessed by validated scales such as the Maslach Burnout Inventory (MBI). Data extraction and quality assessment were performed independently by two reviewers, and statistical analyses were conducted using a random-effects model to calculate pooled effect sizes. A total of 18 studies involving 2,346 ICU nurses were included in the meta-analysis. The pooled effect size indicated that non-pharmacological interventions significantly reduced emotional exhaustion (Hedges’ g = 0.67, 95% CI [0.45, 0.89], p < 0.01) and depersonalization (Hedges’ g = 0.59, 95% CI [0.38, 0.81], p < 0.01) while improving personal accomplishment (Hedges’ g = 0.53, 95% CI [0.30, 0.76], p < 0.01). Among the interventions, mindfulness-based stress reduction and CBT showed the highest efficacy, followed by art therapy and guided meditation. Peer support programs also demonstrated moderate effectiveness but were less studied.The findings suggest that non-pharmacological interventions, particularly mindfulness and cognitive-behavioral therapies, are effective in reducing burnout symptoms among ICU nurses. These interventions offer a sustainable, low-risk alternative to pharmacological approaches, contributing to better mental health outcomes and improved nurse retention in high-stress environments. Future research should focus on larger, multi-center trials and explore the long-term impacts of these interventions.

Decentering as a mediator of the effect of mindfulness on emotional distress: Evidence from cross-sectional and longitudinal designs

Objective To investigate the role of decentering as a mediator of the effect of mindfulness/mindfulness-based intervention (MBI) on emotional distress, we conducted cross-sectional and longitudinal designs. Method In Study 1, a total of 998 participants with high emotional distress were included. Mindfulness, decentering, anxiety, and depression were measured at baseline. In Study 2, 688 participants with high emotional distress were randomized to a Mindfulness Intervention for Emotional Distress (MIED) group (N = 344) and a waitlist control (WL) group (N = 344). The same variables were assessed at pre-intervention, week 3, week 5, and post-intervention. Results In the cross-sectional design, simple mediation analyses pointed to decentering as a significant mediator of the relationship between mindfulness and symptoms of anxiety and depression. In the longitudinal designs, repeated measures ANOVAs showed that decentering, anxiety, and depression significantly improved in the MIED group compared to WL group. Random-intercept cross-lagged panel models found that decentering and emotional distress reciprocally influenced each other. Longitudinal mediation analyses showed that decentering during the intervention significantly mediated the effect of the MIED program on alleviating emotional distress. Conclusion Decentering may potentially act as a pivotal mediator for alleviating emotional distress in MBIs.

Validation of a Biopsychosocial Distress Screening Tool, SupportScreen, in a Brazilian Cancer Center.

Biopsychosocial distress is a common yet often underestimated complication in cancer care. We sought to translate and evaluate the psychometric properties of SupportScreen distress assessment tool in Brazil. A cancer cohort study was conducted at a public hospital in Brazil. The SupportScreen tool underwent transcultural translation into Portuguese. Eligible patients completed the SupportScreen, Distress Thermometer (DT), Hospital Anxiety and Depression Scale (HADS), and Functional Assessment of Cancer Therapy-General version (FACT-G). Statistical analyses included confirmatory and exploratory factor analyses (CFA and EFA), comparisons with established distress tools, and assessments of associations with patients' characteristics. A total of 302 patients were assessed (M:F 35.4%:64.6%; median age: 55). Most patients were diagnosed with breast (29.1%) and gastrointestinal cancer (20.5%), at advanced disease stage (78.8%). CFA identified optimal models for emotional and physical distress; EFA revealed two factors for the logistics of medical care: practical and medical system distress. The concurrent validity of subscales demonstrated significant correlations between distress domains. Sensitivity analyses indicated good performance of emotional and physical domains in identifying distress compared to gold standard criteria. Female patients were more likely to report high emotional distress, while younger age and late disease stage were associated with higher physical distress. Additionally, late disease stage was linked to higher practical distress. Emotional and physical domains demonstrated validity and reliability, aligning with validated measures. Logistics of medical care distress revealed practical and medical system dimensions, expanding understanding of patient challenges. The SupportScreen tool exhibited concurrent validity and sensitivity in identifying distress.

Depression, anxiety, and stress in young adult gamers and their relationship with addictive behaviors: A latent profile analysis

BackgroundThere is limited research examining latent profiles of gamers based on emotional variables, which has implications for prevention efforts. The study sought to identify young adult gamer profiles based on depression, anxiety, and stress, and to examine differences between the latent profiles in other addictive behaviors (i.e., tobacco, alcohol, cannabis, illegal substance use, gaming, and gambling). MethodsA total of 1209 young adults (Mage = 19.37, SD = 1.62; 55.3%males) reported past-year gaming. A latent profile analysis (LPA) was performed to identify distinct profiles, and a set of ANOVA and chi-square analyses characterized the profiles in terms of sociodemographic, addictive behaviors, and emotional variables. ResultsLPA suggested a three-profile solution: profile 1 (n = 660, ‘low emotional distress’), profile 2 (n = 377, ‘moderate emotional distress’), and profile 3 (n = 172, ‘high emotional distress’). Participants with ‘moderate’ and ‘high emotional distress’ were mostly women, showed greater gaming severity, higher prevalence of past-month substance use (i.e., tobacco and illegal drugs), and greater consequences of alcohol use. LimitationsThe cross-sectional nature of the study and sample being university students. ConclusionFindings revealed three distinct profiles of gamers, which differed in emotional, gaming, and substance use severity. Transdiagnostic prevention programs have the potential to provide significant benefits to college students by addressing the core processes (e.g., emotion regulation) that underlie substance use and gaming.

The impact of widowhood on mental health: anxiety, depression, and stress among widowed women in Nepal.

In South Asia, particularly in regions with strong patriarchal norms, widowhood is stigmatized, compounding the negative impact of grief and partner loss. This study measured the prevalence of mental health symptoms among widows in Nepal and its relationship to demographic variables. This cross-sectional study surveyed 588 Nepalese widows from six districts in Nepal (mean age = 52.62, SD = 13.99) who had lost their spouses within the past two years. Participants completed the Anxiety, Depression and Stress Scale (ADSS). Analyses examined prevalence of anxiety, depression, and stress symptoms, using standard ADSS cut-points. Level of anxiety, depression, and stress symptoms measured by the ADSS in the sample were also compared with female psychiatric and nonpsychiatric normative ADSS data, and were compared with one available comparison sample (a sample of older Nepalese women). Measures of association between ADSS scores and demographic variables were computed. Results showed that a high percentage of the Nepalese widows reported moderate to severe symptoms of anxiety, depression, and stress. They also endorsed significantly higher levels of anxiety, depression, and stress symptoms relative to normative data and the comparison sample. Stress scores were significantly negatively correlated with age, Anxiety and Depression scores were associated with income under the poverty line, and Depression scores were associated with homemaker status. These findings confirm the high emotional distress among widowed women in Nepal, and establish the relationship between emotional distress and poverty, homemaker status, and age. These findings can inform public health efforts and mental health care providers regarding the mental health needs of widows in Nepal.

Maternal stress in pregnancy and pubertal timing in girls and boys: a cohort study

To investigate whether maternal stress in pregnancy is associated with pubertal timing in girls and boys and to explore potential mediation by childhood body mass index (BMI) and childhood psychosocial stress. Cohort study. Not applicable. In total, 14,702 girls and boys from the Puberty Cohort, nested within the Danish National Birth Cohort. Maternal stress was obtained from a computer-assisted telephone interview in gestational weeks 30-32 as maternal life stress and emotional distress in pregnancy using questions on the basis of validated screening tools. Maternal life stress and emotional distress in pregnancy were analyzed separately and in an interaction analysis. Pubertal timing was measured half-yearly from age 11 years and throughout pubertal development and assessed as Tanner stages 1-5 (breast and pubic hair development in girls and genital and pubic hair development in boys), menarche in girls, voice break and first ejaculation in boys, and occurrence of acne and axillary hair in both girls and boys. A combined estimate for overall pubertal timing was derived using Huber-White robust variance estimation. Mean differences in age at attaining the pubertal milestones according to prenatal exposure to no (reference), low-, moderate-, or high-maternal stress in pregnancy were estimated using a multivariable censored regression model. Potential mediation by childhood BMI and childhood psychosocial stress was investigated in separate models. After adjustment for potential confounding factors, prenatal exposure to high-maternal life stress (combined estimate: -1.8 months [95% CI, -2.7 to -0.8] and -0.9 months [95% CI, -1.8 to 0.0]), high maternal emotional distress (combined estimate: -1.5 months [95% CI, -2.5 to -0.5] and -1.7 months [95% CI, -2.8 to -0.7]), and both high-maternal life stress and emotional distress (combined estimate: -2.8 months [95% CI, -4.2, to -1.4] and -1.7 months [95% CI, -3.1 to -0.2]) were associated with earlier pubertal timing in girls and boys, respectively. The associations were not mediated by childhood BMI or childhood psychosocial stress. Prenatal exposure to maternal stress in pregnancy was associated with earlier pubertal timing in girls and boys in a dose-dependent manner. The associations were not mediated by childhood BMI or childhood psychosocial stress.

"Infertility Isn't a Choice!": Conversations on Twitter about the Financial Burden of Oncofertility Care.

This study aimed to evaluate how the adolescent and young adult (AYA) cancer community utilized Twitter to discuss the financial challenges of oncofertility care and to advocate for change. Tweets related to oncofertility and finances (n = 166), collected over a 12-week time period encompassing AYA Cancer Awareness Week, were thematically analyzed. Conversations highlighted how the high cost of care contributed to already high emotional and social distress. Proposed actions included providing timely information more equitably, improving access to financial support, and continued advocacy of policy changes to improve access to oncofertility care. Future research can explore the potential impact on policy change and clinical care.

Abstract PO1-11-01: Effectiveness of Susan G. Komen’s national telehealth patient navigation model in reaching underserved populations and reducing cancer-related distress

Abstract Background: Despite its effectiveness in reducing breast cancer inequities, patient navigation (PN) is not accessible to all patients across the United States. To improve access, Susan G. Komen established a telehealth PN model, scaled to deliver PN services equitably across the country. Methods: Patients are referred to Komen patient navigators through Komen’s Helpline. Navigators conduct an initial distress screening and barrier assessment and create an individualized care plan. This information, recommended interventions, and other health data are documented, 62 days. Navigators communicate via the patient’s preferred method: phone, email, text, or video. A patient satisfaction survey is administered 30 days after the start of navigation. Results: From April 1, 2022, to March 31, 2023, 1,092 individuals were navigated. Navigation was provided throughout the continuum of care, including screening and diagnosis through treatment. Of the 3,064 barriers identified by patients, 63% were economic, 20% related to emotional health, 11% indicated lack of access to care and 6% related to care management. Eleven percent of individuals selected Spanish as their preferred language, 84% had a household income at or below 200% of the Federal Poverty Level and 24% were uninsured. Navigated individuals identified as: 46% Black or African American, 37% white or Caucasian, 20% Hispanic or Latino, 2% Asian, and 14% preferred not to answer. The average patient age was 54 years old, ranging from 20 to 101 years old. 588 patients identified as being diagnosed with breast cancer, with 69% diagnosed as early stage (Stage 0-III), 22% as metastatic (Stage IV), and 8% undesignated. Distress screening is administered, within the domains established by the National Comprehensive Cancer Network, at intake, major transitions in care and end of navigation. Average distress across all domains was 6.1 on an 11-point scale at first observation (a score of 10 indicating the highest level of distress). Financial distress was the highest average (7.5) followed by emotional distress (6.6). During navigation enrollment, financial distress decreased 14% and emotional distress decreased 14%. Survey respondents reported: the Komen navigation program helped them: follow their treatment plan (91%), will help them continue their care (92%), feel more prepared to talk with their care team (91%), to be able to get care faster (88%), and improve their quality of life (91%). Conclusion: Distress screening was developed for a clinical setting with in-network medical and mental health providers. This program’s demonstrates distress screening can be adapted for use in a non-clinical, virtual setting. Socioeconomic, survey, and distress data indicate Komen’s model succeeded in reaching people that research shows have numerous barriers to breast health services and cancer care, and overcome the most common barriers, thus improving access to timely, high-quality care. Opportunities for program improvement include: -To improve support for those experiencing high emotional distress, additional training in emotional support is being incorporated into onboarding and Komen’s Navigation Training Program. - Research shows that navigation is most effective when delivered by someone who shares a lived experience, so the diversity of navigators is important. More bilingual navigators have been added to the program to better serve the Spanish-speaking population. - To improve support of those living with metastatic breast cancer seeking navigation support, Komen has launched a research study to identify the unique needs of patients living with MBC, and use this information to enhance navigation services. Citation Format: Julie McMahon, Shelby Lautner, Mandy Spadine, Toni Lee, Janet Okamoto. Effectiveness of Susan G. Komen’s national telehealth patient navigation model in reaching underserved populations and reducing cancer-related distress [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO1-11-01.

The Role of Attentional Control in Mindfulness Intervention for Emotional Distress: A Randomized Controlled Trial With Longitudinal Mediation Analyses.

This study aimed to investigate whether attentional control serves as a mediator for mindfulness-based interventions for emotional distress, utilizing a randomized waitlist (WL)-controlled design. A total of 498 participants with high emotional distress was recruited online and randomly assigned to a 49-day online Mindfulness Intervention for Emotional Distress (MIED) group (N = 249) or a WL control group (N = 249). Levels of attentional control, anxiety and depression were assessed at baseline (T0), Week 3 (T3), Week 5 (T5) and Week 7 (postintervention, T7). Linear mixed models revealed significant Group-by-Time interaction effects for attentional control (p < 0.001), anxiety (p < 0.001) and depression (p < 0.05). Latent growth curve analyses demonstrated a significant increase in attentional control and a decrease in anxiety and depression levels during the MIED programme. These changes becoming evident starting Week 3. Longitudinal mediation analyses revealed that the slope of attentional control significantly mediated the effects of the MIED programme on the slope of anxiety and depression levels. Further, attentional control level at Week 3 significantly mediates the effect of MIED programme on anxiety and depression levels at Weeks 5 and 7. Similarly, attentional control level at Week 5 significantly mediates the MIED programme's effects on anxiety and depression levels at Week 7. The present trial provides evidence suggesting that mindfulness interventions may alleviate emotional distress through the enhancement of attentional control. Chinese Clinical Trial Registry number: ChiCTR2200064140.

The Mediating Role of Anxiety/Depression Between Auditory Verbal Hallucinations and the Level of Insight in Schizophrenia.

Auditory verbal hallucination (AVH) is a prominent symptom of schizophrenia causing profound distress. The influence of AVHs on insight appears to be intricate and contingent on other accompanying symptoms. This study investigated the relationship and possible mediators between AVHs and the degree of insight. One hundred patients with schizophrenia participated in the study. Scales were used to evaluate the hallucinatory experience, the level of insight and other psychopathology. Complex relationships between variables were envisaged as a path model, whose initial structure was constructed via Gaussian Graphical Model. The validity of the final model was verified by Structural Equation Modeling. Separate analyses were performed for self-reported and clinician-rated data to enhance the model's robustness. The greater the severity of the physical aspects of AVHs, the lower the level of insight observed. Conversely, higher emotional distress was associated with increased insight. These relationships were only evident in the self-reported results and were not reflected in the clinician-rated results. The path model suggested that the Positive and Negative Syndrome Scale (PANSS) anxiety/depression factor was an important mediator that linked the found association. Notably, the PANSS negative symptom had the opposite effect on the PANSS anxiety/depression factor and insight, making it difficult to define its overall effect. The findings of this study provided one possible route for the positive influence of AVH experience in gaining insight. The mediating role of anxiety/depression modified by negative symptoms emerged as a valuable concept for clarifying this intricate relationship.

Self-Reported Well-Being of Family Caregivers of Children with Medical Complexity

ObjectiveProvide an in-depth and psychometrically rigorous profile of the emotional well-being and sleep-related health of family caregivers of children with medical complexity (CMC). MethodsCross-sectional survey study of family caregivers of CMC receiving care from a pediatric complex care center between May 2021 and March 2022. Patient Reported Outcomes Measurement Information System Short-Forms (PROMIS-SF) assessed global mental health, emotional distress (anxiety, depression, anger), psychological strengths (self-efficacy, emotional regulation, meaning and purpose), and sleep-related health (fatigue, sleep-related impairment). Student’s t-tests compared the sample’s mean T-scores to US population norms. Pearson’s correlation coefficient (ρ) examined associations between measures of psychological strengths and emotional distress. Unadjusted linear regression analyses explored relationships between well-being outcomes and child and caregiver characteristics. ResultsCompared to US population norms, caregivers of CMC (n = 143) reported significantly lower global mental health and emotional regulation ability as well as elevated symptoms of anxiety, depression, anger, fatigue, and sleep-related impairment (all P < .01). Whereas participants reported a significantly higher sense of meaning and purpose (P < .05), levels of self-efficacy were not significantly different from population norms. We observed moderate-to-strong inverse relationships between psychological strengths and emotional distress (ρ range, −0.39 to −0.69); with the strongest inverse associations found between emotional regulation ability and emotional distress. In exploratory analyses, caregiver race and ethnicity, socioeconomic status, and child health insurance type were significantly associated with caregiver well-being. ConclusionFamily caregivers of CMC report poor well-being, most notably, increased symptoms of anxiety and reduced global mental health and sleep-related health.

Vortioxetine as an effective drug in the treatment of depression in adolescents with long QT index. A case report

IntroductionThis is a 13-year-old female patient admitted to the psychiatric unit active suicidal ideation.Objectivesthe objective is to show through a clinical case how vortioxetine can be safe in adolescents.MethodsCase report and literature reviewResultsShe has a history of daily consumption of at least 2 units of cannabis per day. She presents high emotional distress secondary to academic failure, consuming the substance as a coping strategy. Due to prohibition and control by her parents, the patient stopped taking the substance, presenting severe depressive symptoms, self-injury and suicide ideation. For this reason she is admitted to the inpatient psychiatric unit. The electrocardiogram performed on admission shows a corrected QT index of 524. Exploring physical symptoms, she recognized episodes of syncope and palpitations. Coordination was made with cardiology, who performed an echocardiogram with normal results and began follow-up with them without prescribing medication. It was agreed not to use drugs that could prolong the QT index. Evaluating the clinical situation, it was decided to start treatment with Vortioxetine up to 10 mg. With this treatment there was no worsening of the electrocardiogram and the patient’s mood improved, anxiety and ideas of death were remittedConclusionsThis work aims to show how vortioxetine has been effective and safe at the cardiological level in the case of moderate-severe depression in an adolescent with prolonged QT indexDisclosure of InterestNone Declared

Moderating effect of age on the relationship between physical health loss and emotional distress post-acute care in Japanese older hospitalized patients

BackgroundAt present, there are no consistent findings regarding the association between physical health loss and mental health in older adults. Some studies have shown that physical health loss is a risk factor for worsening of mental health. Other studies revealed that declining physical health does not worsen mental health. This study aimed to clarify whether the relationship between physical health loss and emotional distress varies with age in older inpatients post receiving acute care.MethodsData for this study were collected from 590 hospitalized patients aged ≥ 65 years immediately after their transfer from an acute care ward to a community-based integrated care ward. Emotional distress, post-acute care physical function, and cognitive function were assessed using established questionnaires and observations, whereas preadmission physical function was assessed by the family members of the patients. After conducting a one-way analysis of variance (ANOVA) and correlation analysis by age group for the main variables, a hierarchical multiple regression analysis was conducted with emotional distress as the dependent variable, physical function as the independent variable, age as the moderator variable, and cognitive and preadmission physical function as control variables.ResultsThe mean GDS-15 score was found to be 6.7 ± 3.8. Emotional distress showed a significant negative correlation with physical function in younger age groups (65-79 and 80-84 years); however, no such association was found in older age groups (85-89, and ≥ 90 years). Age moderated the association between physical function and emotional distress. Poor physical function was associated with higher emotional distress in the younger patients; however, no such association was observed in the older patients.ConclusionsAge has a moderating effect on the relationship between physical health loss and increased emotional distress in older inpatients after acute care. It was suggested that even with the same degree of physical health loss, mental damage differed depending on age, with older patients experiencing less damage.

The feasibility of developing an online teacher training program for a neuroscience-informed mental health intervention for Japanese students

Background Neuroscience-informed mental health intervention involves integrating neuroscientific knowledge into mental health interventions, showing potential in effectively enhancing children's mental health. Online platforms are deemed suitable for teaching these strategies to Japanese teachers, especially, under the coronavirus disease (COVID-19) pandemic. However, there is a lack of research investigating the appropriateness, feasibility, learning needs and goals to develop an online teacher training program focuses on teaching neuroscience-informed mental health intervention. Methods Employing a single-group survey design, this study sought to fill the research gap by conducting surveys and interviews to 20 teachers and 245 students in a Japanese primary school. This study adopted a mixed-method approach, incorporating both qualitative and quantitative data collection from students and teachers. Results Quantitative analysis of student surveys revealed that nearly 30% of students had low subjective well-being and high emotional distress. Thematic analysis of teacher interviews revealed the challenges faced by Japanese educators in delivering effective mental health support, partly attributed to a lack of training in mental health intervention. Approximately 80% of teachers expressed strong or moderate interest in learning about neuroscience-informed mental health intervention. These findings supported the appropriateness and feasibility of an online teacher training program in this domain. Thematic analysis of teacher interviews also revealed the importance of practicality, providing teachers with easily deployable intervention resources, and delivering comprehensive instruction in both intervention and prevention strategies. The analysis also suggested that a format consisting of 6-10 concise, self-paced learning modules, complemented by a brief online interactive session, would be suitable for the online teacher training program focused on teaching neuroscience-informed mental health intervention. Conclusions Future research should focus on developing and evaluating an online teacher training program dedicated to delivering neuroscience-informed mental health intervention. Such a program holds promise for enhancing the mental health of children, integrating the findings from this study.

AGE DIFFERENCES IN PSYCHOLOGICAL DISTRESS AFTER MULTIPLE DISASTER EXPOSURES: EFFECT OF NEGATIVE COVID-19 IMPACTS

Abstract This study examined how older adults differed from their younger counterparts in psychological distress following exposures to tornadoes and the COVID-19 pandemic; and how the multidimensional negative COVID-19 impacts contextualized the above age differences. Data used were from a two-wave panel study of tornado victims during the COVID-19 pandemic (N = 554). Latent class analysis was first conducted to explore the underlying patterns of negative COVID-19 impacts at T1 (October 2020-August 2021). Negative binomial regressions were performed to examine the age differences in psychological distress at T2 (May-August 2022), as well as the moderating effect of the identified latent classes, with baseline psychological distress and covariates controlled. Three latent classes were identified: class 1 “low overall impacts” (39.24%), class 2 “moderate overall impacts with high emotional distress” (47.71%), and class 3 “severe overall impacts” (13.05%). Individuals aged 65+ reported lower psychological distress at T1 relative to those aged 18-34, 35-49, and 50-64, and their advantages in mental health over people under 50 can be maintained over time. However, compared to people aged 18-34, 35-49, and 50-64, those aged 65+ reported the greatest increases in T2 psychological distress if they had experienced moderate or severe overall COVID-19 impacts at T1. These findings highlighted the resilience and vulnerability of older adults in post-disaster recovery. As the frequency and intensity of cumulative disasters increase across the globe, there is a pressing need for mental health interventions that are tailored to multi-disaster scenarios and age-related differences in long-term disaster recovery.

Self-Compassion Mediates the Relationships Between University Students’ Mindfulness, Dysfunctional Attitudes, and Various Distress and Well-Being Indicators

Objective. The current study intended to model the relationships between mindfulness, dysfunctional attitudes, and self-compassion in predicting university students’ various indicators of emotional distress and well-being of university students. We aimed to examine the mediative role of self-compassion and the mediative roles of self-coldness and self-warmth in these relationships. Methods. Applying a correlational design, validated instruments were used to measure mindfulness, dysfunctional attitudes, self-compassion (and its two main components: self-warmth and self-coldness), various indicators of emotional distress (i.e., negative affect, depression, anxiety, stress), and well-being (i.e., soothing positive affect, activating positive affect, satisfaction with life). The final sample consisted of N = 176 university students. The proposed models were tested by SEM (structural equation modeling) using SPSS AMOS 20. Results. The main results obtained were consistent with the hypotheses. As expected, higher levels of mindfulness led to higher well-being and lower emotional distress through increased self-compassion, and higher levels of dysfunctional attitudes led to lower well-being and higher emotional distress through decreased self-compassion. However, the results also indicated that self-coldness was more important than self-warmth in all of these relationships. Conclusion. The results of the proposed current study supported the models for the relationships between dysfunctional attitudes, mindfulness, and self-compassion (and its positive and negative components) in predicting the various indicators of emotional distress and well-being of university students. These findings support the use of self-compassion interventions, particularly those aimed at reducing self-coldness, to improve well-being and reduce distress among university students.

Fear of Cancer Recurrence (FCR) in Human Papillomavirus-Associated Oropharyngeal Cancer (HPVOPC) Patients 12 months (12m) after (Chemo)Radiation (RT/CRT)

This study constitutes a planned secondary endpoint analysis from a longitudinal unmet needs study. The aim was to: (1) describe FCR outcomes 12m after RT/CRT; (2) examine associations between FCR severity scores 12m after RT/CRT and patient and disease characteristics and other patient-reported outcomes (PROs); and (3) to evaluate preferred FCR referral pathways. Eligible HPVOPC patients scheduled for curative RT/CRT were approached for enrolment. FCR was assessed with the 42-item Fear of Cancer Recurrence Inventory (FCRI) 12m after RT/CRT, as were patients' preferences for FCR referral pathways, using customized questions. Optimism (LOT-R) and resilience (Connor-Davidson Resilience Scale) were assessed at enrolment. Health-related quality of life (HRQL, EORTC QLQ-C30), disease-specific symptom severity and interference (MDASI-HN) and emotional distress (PROMIS Anxiety 7a, Depression 8a) were assessed 12m after RT/CRT. A total of 100/129 eligible patients were enrolled between October 2020 and November 2021. 85/93 (91%) alive patients without recurrence completed the FCRI; patients were mostly men (n = 73, 86%), with a median age of 60 years (range 44-77). A majority had stage I disease (n = 46, 54%) and received CRT (n = 82, 96%). The mean FCRI total score was 45.4 (SD = 26.3, range 0-102, possible range 0-168). The mean FCRI severity score was 12.1 (SD = 7.4, median = 11.0, range 0-29); 13%, 31% and 56% of respondents scored in the severe (≥22), moderate (>12-22) and low (≤12) range, respectively. Univariable regression analysis indicated that lower resilience, lower HRQL (global health status, all functional domains), higher emotional distress (anxiety, depression), and higher symptom severity and interference were associated with higher FCR severity scores 12m after RT/CRT. Apart from lower levels of education, associations between FCRI severity scores and other patient and disease factors were not statistically significant. If FCR had been a problem (n = 66), 86%, 44%, 14% and 5% of patients indicated they would like to discuss it with their oncologist, primary care physician, a psychologist or nurse, respectively (multiple responses allowed). If specific FCR interventions were available, 70/85 indicated their preferred sources for delivery (ordered by median rank) were oncologist, primary care physician, psychologist or nurse (tied), self-management or group sessions (tied). Almost half of HPVOPC patients reported moderate-to-severe FCR 12m after RT/CRT. Increased FCR severity was associated with education and self-reported resilience at baseline and with other measures of HRQL, toxicity and emotional distress at 12m. While patients view oncologists as central in FCR management, education about the benefits of other FCR-reducing approaches may be necessary.

Yours, mine, or ours? Dyadic sleep hygiene and associations with sleep quality, emotional distress, and conflict frequency in mixed-gender, bed-sharing couples.

Although prior research demonstrates the interdependence of sleep quality within couples (i.e., the sleep of one partner affects the sleep of the other), little is known about the degree to which couples' sleep hygiene behaviours are concordant or discordant, and if one's own sleep hygiene or their report of their partners' sleep hygiene is related to worse relational, psychological, and sleep outcomes. In a sample of 143 mixed-gender, bed-sharing couples, each partner completed an online questionnaire consisting of the Sleep Hygiene Index (for themselves and their partner), PROMIS sleep disturbance scale, conflict frequency, PHQ-4 for anxiety and depressive symptoms, and the Perceived Stress Scale. Paired samples t-tests between partners were conducted using total and individual-item Sleep Hygiene Index scores to examine similarities and differences. Intraclass correlation coefficient (ICC) scores of dyadic reports were conducted to examine the level of agreement between each partner's sleep hygiene. Finally, we examined associations between one's own sleep hygiene and their report of their partner's sleep hygiene with both partner's sleep quality, emotional distress, and conflict frequency in a dyadic structural equation model with important covariates and alternative model tests. The results revealed a significant difference between men's (M = 14.45, SD = 7.41) and women's total score self-report sleep hygiene ([M = 17.67, SD = 8.27]; t(142) = -5.06, p < 0.001) and partners only had similar sleep hygiene for 5 out of the 13 items. Examining dyadic reports of sleep hygiene revealed that partners had moderate agreement on their partners' sleep hygiene (0.69-0.856). The results from the dyadic structural equation model revealed that poorer sleep hygiene was associated with one's own poor sleep quality, higher emotional distress, and more frequent relational conflict. For both men and women a poorer report of a partner's sleep hygiene was associated with one's own report of higher relationship conflict. Finally, men's poorer report of a partner's sleep hygiene was related better to their own sleep quality but was related to poorer sleep quality for their partners. These results have implications for sleep promotion and intervention efforts as well as for couple relationship functioning.

Age differences in experiencing negative impacts of the COVID-19 pandemic: A latent class analysis

This study examined the types of negative COVID-19 impacts across multiple domains, the age differences in identified class membership, and how the impact of COVID-19 on social relationships moderated such age differences. Data used were from a cross-sectional survey conducted by the research team concerning individuals who had experienced tornadoes in Texas, Tennessee, and Alabama, USA. Data collection took place between October 2020 and August 2021, and the respondents were asked about their experience of recent tornadoes and the COVID-19 pandemic via online platform, mail-in-survey, or telephone interview. Latent class analysis and multinomial logistic regression were performed based on a sample of 1080 adults. Three latent classes were identified: class 1 “low overall impacts”, class 2 “moderate overall impacts with high emotional distress”, and class 3 “severe overall impacts”. Compared to those aged 65–74, people aged 18–34, 35–49, and 50–64 had higher odds of being in the “severe overall impacts” class versus “low overall impacts” class. Individuals whose relationship with family had been positively impacted by COVID-19 had lower odds of being in the “severe overall impacts” class over “low overall impacts” class. Positive COVID-19 influence on relationships with friends/colleagues and community were respectively more important for those aged 65 to 74 than for those aged 75+ in lowering the likelihood of being in the “severe overall impacts” class versus “low overall impacts” class. Results highlighted the strengths and heterogeneity of older adults and the importance of social relationships in response to the COVID-19 pandemic and future public health disasters.