Impact Of Psychological Distress Research Articles

How Will I Be Perceived: The Role of Trauma-Related Shame in the Relationship Between Psychological Distress and Expectations of Disclosure Among Survivors of Sexual Victimization.

Sexual assault is a serious physical and psychological concern worldwide. Various negative psychological outcomes are associated with survivor well-being, including depression, posttraumatic stress disorder (PTSD), depressive symptoms, and trauma-related shame. Opportunities for emotional expression and processing have been shown to be beneficial among survivors of trauma; however, survivors of sexual victimization may be reticent to disclose details of their traumatic experience, particularly to formal sources of support. Trauma-related shame (e.g., negative evaluations of self, feelings of worthlessness, and powerlessness) has been shown to negatively impact expectations of disclosure, as some survivors may fear being blamed or judged. Limited research exists on the impact of psychological distress on survivors' expectations of disclosure. The current study investigated whether psychological distress (i.e., depressive and PTSD symptoms) is associated with expectations of disclosure (positive vs. negative) through trauma-related shame among survivors of sexual victimization. Participants, recruited from a primarily Hispanic-serving institution, participated in the present study. Participants (N = 86) completed measures of PTSD and depression symptom severity, trauma-related shame, and expectations of disclosure. Results revealed that psychological distress severity was associated with negative expectations of disclosure through trauma-related shame (b = 0.682, p < .05, 95% confidence interval [CI] [0.197, 1.367]), but not positive expectation (b = -0.068, p = .417, 95% CI [-0.523, 0.155]). Our findings have implications for prognosis and treatment for survivors of sexual victimization, particularly among LatinX populations.

The impact of psychological distress on problematic smartphone use among college students: The mediating role of metacognitions about smartphone use.

A mediation model was constructed to clarify the relationship and mechanisms linking psychological distress to problematic smartphone use (PSU), focusing on the mediating role of metacognitions about smartphone use. A questionnaire method was used to investigate psychological distress, metacognitions about smartphone use, and problematic smartphone use among 664 college students. The results showed that (1) psychological distress had a significant positive predictive effect on problematic smartphone use, and (2) there were differences in the underlying mechanisms linking different types of psychological distress to problematic smartphone use. Specifically, negative metacognition about smartphone use partially mediated the relationship between depression and problematic smartphone use, whereas anxiety could act on problematic smartphone use through the parallel mediation of positive metacognition about smartphone use and negative metacognition about smartphone use, with the latter having a greater positive mediating effect than the former. These findings reveal the mechanism of action linking different types of psychological distress to problematic smartphone use from the perspective of the cognitive-behavioral model of pathological Internet use, which has implications for the prevention and intervention of problematic smartphone use among college students.

The Impact of Psychological Distress Due to COVID-19 on College Student Career Development

The Impact of Psychological Distress Due to COVID-19 on College Student Career Development

Effectiveness of New Maternal Mental Health Service ‘Thrive’ in the Treatment of PTSD Symptoms Arising From Birth Trauma and Perinatal Loss

AimsThe NHS Long-Term Plan includes the perinatal mental health objective: by 2023/24 ‘Maternal Mental Health Services’ will be available across the country to provide psychological therapy for those who experience mental health difficulties directly arising from birth trauma and or/perinatal loss. We achieved early implementer status via application to NHS England and, using transformation funding received, ‘Thrive’ was piloted in East Kent. A gap in service provision was identified: some existing primary care services provide intervention for this cohort, however some people remain in psychological distress but do not meet the criteria for specialist perinatal mental health secondary care services; these secondary care services are not commissioned to support those who have experienced perinatal loss. Thrive is co-delivered by a mental health trust and acute healthcare trust; NICE recommended psychological interventions are provided by Psychological Therapists, Specialist Mental Health Midwives and a Peer Support Worker. The aim of this project was to evaluate the effectiveness of the Thrive pilot in reducing PTSD symptomology whilst also collating feedback from patients, their families and healthcare staff across the maternity system, in order to adapt the service offer for full county rollout.Methods40 people who received care from Thrive from 11th January 2021 to 31st December 2021 were included in this evaluation.Data were collected retrospectively at the end of each period of care via:Clinical outcomes measures (quantitative): •PCL-5: a 20-item self-report measure assessing the 20 DSM-5 symptoms of PTSD.•CORE-34: a universal method of establishing well-being and risk.•HoNOS (Health of the Nation Outcomes Scales): a measure of the health and social functioning of people with severe mental illness.Patient Satisfaction Survey (qualitative).Results•100% of patients improved following Thrive intervention: PCL-5 (significant change = a reduction in score by 10–20 points has been met) / CORE-34 (clinically significant change =score above 10 initially and below 10 after intervention).•Clinical improvement: HoNOS = 100% of patients improved following Thrive intervention.ConclusionEvaluation has evidenced the effectiveness of Thrive in successfully treating those with PTSD symptomology arising from their maternity experience. Post-treatment measures indicate that the level of trauma symptomology and the impact of psychological distress on the functioning of patients who have received intervention from Thrive has reduced to a sub-clinical level in all cases.

ICU bereaved surrogates\u2019 comorbid psychological-distress states and their associations with prolonged grief disorder

Background/objectiveBereaved ICU family surrogates’ psychological distress, e.g., anxiety, depression, and post-traumatic stress disorder (PTSD), is usually examined independently, despite the well-recognized comorbidity of these symptoms. Furthermore, the few studies exploring impact of psychological distress on development of prolonged grief disorder (PGD) did not consider the dynamic impact of symptom evolution. We identified surrogates’ distinct patterns/states of comorbid psychological distress and their evolution over the first 3 months of bereavement and evaluated their associations with PGD at 6-month postloss.MethodsA longitudinal observational study was conducted on 319 bereaved surrogates. Symptoms of anxiety, depression, PTSD, and PGD were measured by the anxiety and depression subscales of the Hospital Anxiety and Depression Scale, Impact of Event Scale-Revised scale, and the PGD-13, respectively. Distinct psychological-distress states and their evolution were examined by latent transition analysis. Association between psychological-distress states and PGD symptoms was examined by logistic regression.ResultsThree distinct comorbid psychological-distress states (prevalence) were initially identified: no distress (56.3%), severe-depressive/borderline-anxiety distress (30.5%), and severe-anxiety/depressive/PTSD distress (13.3%). Except for those in the stable no-distress state, surrogates tended to regress to states of less psychological distress at the subsequent assessment. The proportion of participants in each psychological-distress state changed to no distress (76.8%), severe-depressive/borderline-anxiety distress (18.6%), and severe-anxiety/depressive/PTSD distress (4.6%) at 3-month postloss. Surrogates in the severe-depressive/borderline-anxiety distress and severe-anxiety/depressive/PTSD-distress state at 3-month postloss were more likely to develop PGD at 6-month postloss (OR [95%] = 14.58 [1.48, 143.54] and 104.50 [10.45, 1044.66], respectively).ConclusionsA minority of family surrogates of ICU decedents suffered comorbid severe-depressive/borderline-anxiety distress and severe-anxiety/depressive/PTSD symptoms during early bereavement, but they were more likely to progress into PGD at 6-month postloss.

The Impact of Psychological Distress on the Occupational Well-Being of Sexual and Gender Minorities.

Background: Discrimination against sexual and gender minorities in occupational settings has been an important topic of research. However, little is known about this impact in Portuguese-speaking people. Methods: 305 Portuguese and Brazilian participants who identified as lesbian, gay, bisexual, transgender, queer, intersex, asexual, and other sexual and gender identities (LGBTQIA+) completed an online survey comprising sociodemographic questions, a set of scales to assess psychological distress, and a set of scales to assess occupational well-being. Results: Participants had higher levels of burnout, depressive symptoms, and anxiety and lower levels of work-related quality of life, engagement, and self-efficacy at work compared to the defined cut-off points for normative populations, with asexual and bisexual people appearing to be the most affected. Significant correlations were found for all variables, and psychological distress was a significant predictor of lower occupational well-being. Conclusions: These findings are useful for understanding the occupational health of LGBTQIA+ people and suggest efforts to improve the climate in the workplace for this population.

Impact of psychological distress and psychophysical wellbeing on posttraumatic symptoms in parents of preterm infants after NICU discharge

BackgorundParents after Neonatal Intensive Care Unit (NICU) hospitalization of preterm infant may develop psychopathological symptoms.The aim of the study was to determine how parental stress and psychophysical wellbeing affect posttraumatic symptoms (PTTS) in parents during the first year after NICU discharge. Moreover, this study aimed to explore any gender-specific difference in psychological distress among mothers and fathers.MethodsProspective study design from September 2018 to September 2019. 20 pairs of parents of preterm infants admitted to a tertiary-level NICU were enrolled. Primary outcome was evaluation of PTTS in parents of preterm infants at one year after NICU discharge through Impact of Event Scale- Revised. Secondary outcomes were: impact of parental stress, psychophysical wellbeing, anxiety and depression respectively through Parental Stressor Scale: NICU, Short Form Health Survey-36(SF-36), Self-rating Anxiety Scale and Self-rating Depression Scale.ResultsMothers experienced higher rates of PTTS than fathers across the first year after NICU discharge (55% vs 20%). Maternal avoidance symptoms were associated with perception of their own infant look. Emotional aspects linked to maternal role predicted 36,8% of their hyperarousal symptoms. Maternal PTTS severity was predicted by their social functioning. Paternal mental health was associated both with maternal and paternal intrusive symptoms.. Maternal stress was associated with paternal avoidance symptoms. Paternal mental health predicted their hyperarousal symptoms (40%) and PTSD severity (52%).ConclusionsParents who experienced NICU hospitalization of their own infant are at heightened risk to develop psychopathological symptoms. According to our initial hypothesis, investigating parental psychophysical wellbeing, through SF-36, originally provides a valuable support to detect parents at higher risk to develop posttraumatic outcomes across the first year after NICU discharge. In addition, paternal depression deserves to be taken into account since hospitalization as it could impact paternal PTSD development. Finally, these findings provide an initial evidence of gender-related patterns in PTSD development and psychological distress among mothers and fathers across the first year of their infant.

Impact of psychological distress on physical activity during COVID examined

As many individuals continue to grapple with the emotional challenges brought on by COVID‐19, which is entering its third year, it becomes increasingly important to remain active, say researchers of a study examining the correlation of mental health status and physical activity during this pandemic. However, stay‐at‐home orders don't make it any easier, they noted.

Humans First, Professionals Second: Impact of Psychological Distress on Counselling Self-efficacy and Empathy of Trainee Clinical Psychologists

The current study aimed to find the relationship between the Psychological Distress (PD) of trainee clinical psychologists with their Counseling Self-Efficacy (CSE) and how this relationship may impact their empathy. It was hypothesized that (i) There will be a significant relationship between PD with CSE and empathy of trainee clinical psychologists, (ii) There will be a significant impact of the relationship between PD and CSE on the empathy of trainee clinical psychologists. A purposive convenient sampling technique was used to gather a sample of trainee clinical psychologists who have at least 1 month to 36 months of experience in client dealing and who are currently working in the field. A total sample of 103 (M = 25.92, SD = 2.73) was collected, including both males (5.8%) and females (94.2%). Participants of the study were provided an online form consisting of self-reported measures including the Kessler PD Scale (K10), Counselor Activity Self-Efficacy Scales (CASES) (Lent, Hill, &amp; Hoffman, 2003), and Interpersonal Reactivity Index (IRI; Davis, 1980, 1996). Statistical analysis was done using Statistical Package for Social Sciences (SPSS) to interpret and further analyze scores. Pearson product-moment correlation showed a significantly weak positive correlation of PD with CSE (p-value &lt; 0.05) and empathy (p-value &lt; 0.01). Regression Analysis (R²=0.07) represented the variance caused by PD and CSE on empathy. This research is a base to appreciate the efforts of the clinical psychologists under training as well as a means to encourage them to accept their distress and seek help for it.

Predicting Academic Procrastination and Academic Achievement in Private Higher Education With the HEXACO Model of Personality and Psychological Distress

Academic procrastination is one of the main problems in the private higher education sector associated with a high rate of abandonment of higher education and delays in fulfilling student obligations. In an effort to detect some of the personal predictors of this phenomenon, we examined associations between personality traits, psychological distress, academic procrastination, and academic achievement among students in private higher education. A sample of 369 participants (145 men, 224 women, 23 years on average) was taken. Participants self-reported their academic achievement and anonymously completed several questionnaires: The Studying Procrastination Scale, The Depression Anxiety Stress Scales – 21, the HEXACO Personality Inventory-Revised - 60. In line with prediction, the HEXACO dimensions explained an additional 24% of the variance in academic procrastination after controlling for psychological distress. In addition, Conscientiousness and psychological distress predicted academic procrastination, and Conscientiousness uniquely significantly predicted academic performance. Our results suggest that academic procrastination and academic performance are influenced by personality. Also, this study indicated that the impact of psychological distress on academic outcomes depends on the constellation of personality traits. Current findings could help to better understand personal factors associated with negative academic outcomes and prevent negative emotional states associated with student procrastination and poor academic performance.

Impact of Psychological Distress on Treatment Timeliness in Oncology Patients at a Safety-Net Hospital.

Psychological distress is common in patients with cancer. Distress can affect patients' engagement with treatment. We examined the relationship between psychological distress and treatment timeliness in a sample of adult oncology patients at a safety-net hospital. A retrospective review was conducted of all patients screened for distress at a first outpatient oncology visit between March 1, 2014, and December 31, 2015 (n=500). The analytic sample (n=96) included patients with a new cancer diagnosis and a curative-intent treatment plan for lymphoma (stage I-IV), solid tumor malignancy (stage I-III), or head and neck cancer (stage I-IVb). Distress was measured using the Hospital Anxiety and Depression Scale. Using Poisson regression, we determined the effects of depression and anxiety on treatment timeliness. Patient age, sex, race/ethnicity, insurance type, cancer site, and cancer stage were included as covariates. Mean patient age was 54 years. The median treatment initiation interval was 28 days. Clinically significant anxiety was present in 34% of the sample, and clinically significant depression in 15%. Greater symptom severity in both anxiety and depression were associated with a longer treatment initiation interval after controlling for demographics and disease factors. The average days to treatment (DTT) was 4 days longer for patients with elevated anxiety scores and for those with elevated depression scores compared with those without. Overall survival was not associated with anxiety, depression, or DTT. In this safety-net patient sample, greater psychological distress was associated with slower time to treatment. As of writing, this is a new finding in the literature, and as such, replication studies utilizing diverse samples and distress measurement tools are needed.

The Association of Surrogate Decision Makers’ Anxiety and Depression Levels at Baseline with End-of-Life Patient Care Decisions

Rationale: Little is known about how the psychological status of surrogate decision-makers (SDMs) influences their decisions regarding end-of-life patient care. Anecdotal evidence suggests high psychological distress may lead to denial of poor prognosis and continued aggressive treatments. We hypothesized that SDM psychological distress is associated with greater use of life-sustaining treatments and lower hospice use for seriously ill older adults. &#x0D; Objectives: To determine the relationships between surrogate anxiety and depression levels and surrogates’ decisions regarding end-of-life treatments. &#x0D; Methods: This prospective observational study enrolled patient/surrogate dyads from three Midwestern hospitals in one metropolitan area. Eligible patients were 65 years or older and admitted to the medicine or medical intensive care services. Baseline surveys between hospital days 2 and 10 assessed anxiety (GAD-7) and depression (PHQ-9) levels, and SDM preference for do-not-resuscitate (DNR) status. Chart reviews of the electronic medical record and regional health information exchange six months after enrollment identified the use of aggressive life-sustaining treatments and hospice for patients who died. &#x0D; Results: There were 278 patient/surrogate dyads. After adjusting for other demographic and illness factors, anxiety (adjusted odds ratio [aOR] 1.09; 95% CI 1.02, 1.16; P=.007) and depression (aOR 1.08; 95% CI 1.02, 1.15; P=.011) were associated with greater preference for DNR status. Among patients who died (n=115), anxiety (aOR 0.89; 95% CI 0.79, 0.99; P=.039) was associated with less use of aggressive life-saving interventions within the last 30 days, and anxiety (aOR 1.23; 95% CI 1.09, 1.39; P&lt;.001) and depression (aOR 1.14; 95% CI 1.04, 1.25; P=.004) were associated with greater hospice use. &#x0D; Conclusions: Contrary to our hypothesis, heightened SDM psychological comorbidities at baseline are associated with greater DNR preference, as well as less life-sustaining treatment and more hospice use at the end of life. More research is needed to understand the impact of psychological distress on surrogate decision-making.

Hope attenuates the negative impact of general psychological distress on goal progress.

Symptoms of general psychological distress disrupt goal pursuit; however, not everyone is equally impacted by distress when pursuing goals. We tested whether hope, self-efficacy, and/or grit buffered the impact of symptoms of general psychological distress on longitudinal goal progress. Undergraduate students reported on these constructs and, 2 months later, their progress toward five personal goals (N = 117). Although greater levels of baseline psychological distress predicted less goal progress, the impact of psychological distress on goal progress was moderated by hope, β = .20, SE = 0.07, p < .01. More specifically, at higher hope, participants reported similar goal progress regardless of baseline distress symptoms, while at lower hope, baseline distress was negatively associated with goal progress. Hope may function as a buffer against the association between general psychological distress and impaired goal progress.

Impact of Psychological Distress and Sleep Quality on Balance Confidence, Muscle Strength, and Functional Balance in Community-Dwelling Middle-Aged and Older People.

The objective was to evaluate the associations of psychological distress and sleep quality with balance confidence, muscle strength, and functional balance among community-dwelling middle-aged and older people. An analytical cross-sectional study was conducted (n = 304). Balance confidence (Activities-specific Balance Confidence scale, ABC), muscle strength (hand grip dynamometer), and functional balance (Timed Up-and-Go test) were assessed. Psychological distress and sleep quality were evaluated by the Hospital Anxiety and Depression Scale and the Pittsburgh Sleep Quality Index, respectively. Age, sex, physical activity level, nutritional status, and fatigue were included as possible confounders. Multivariate linear and logistic regressions were performed. Higher values of anxiety (OR = 1.10), fatigue (OR = 1.04), and older age (OR = 1.08) were associated with an increased risk of falling (ABC < 67%). Greater muscle strength was associated with male sex and improved nutritional status (adjusted R2 = 0.39). On the other hand, being older and using sleeping medication were linked to poorer functional balance (adjusted R2 = 0.115). In conclusion, greater anxiety levels and the use of sleep medication were linked to a high risk of falling and poorer functional balance, respectively. No associations were found between muscle strength and sleep quality, anxiety, or depression.

Quality of life in Klinefelter patients on testosterone replacement therapy compared to healthy controls: an observational study on the impact of psychological distress, personality traits, and coping strategies

PurposeWe aimed to verify if 1 year-testosterone-replacement therapy could produce a psychopathological recovery and a satisfactory quality of life in Klinefelter syndrome (KS) patients compared to matched healthy controls. Further, we analyzed personality traits and coping strategies, an issue not yet examined in androgen-treated KS patients. We also enquired whether any of the sociodemographic and psychological variables might predict a patient’s general and sexual life satisfaction.MethodsThe Quality of Life Enjoyment and Satisfaction Questionnaire and the Temperament and Character Inventory-Revised were administered to both 23 KS patients and matched healthy subjects. Psychopathology was investigated by the Symptom Checklist-90-Revised (SCL-90-R) and the Mini-mental State Examination. The COPE Inventory was used to identify cognitive and behavioral strategies to manage disease-related distress.ResultsIn testosterone-treated KS patients, when compared with controls, SCL-90-R subscales analysis evidenced high psychological distress, mainly presented as obsessive thoughts, hanger-hostility, phobias, and psychoticism. Self-directedness and self-transcendence, along with the prevalent use of emotion-focused coping strategies, outlined the personality of our KS patients. Depression and somatization proved to be predictors of general life dissatisfaction. Depression, anger-hostility, and paranoid ideation, instead, emerged as predictors of sexual life dissatisfaction.ConclusionEndocrinologists should cooperate with mental health providers to foster a better outcome of the disease in KS patients.

Patients with Head-and-Neck Cancer: Dysphagia and Affective Symptoms

Objective: Affective symptoms are common in patients with head-and-neck cancer. This study determined the association between the presence of aspiration and symptoms of anxiety and depression, as well as patient characteristics in patients with head-and-neck cancer and dysphagia. Methods: Eighty-four patients with head-and-neck cancer and dysphagia completed the Hospital Anxiety and Depression Scale and underwent a standardized fiberoptic endoscopic evaluation of swallowing. Linear regression analysis was performed to explore the associations. Results:Fifty-two (61.9%) patients presented clinically relevant symptoms of anxiety or depression. Forty-eight (57.1%) patients presented with aspiration during fiberoptic endoscopic evaluation of swallowing. A significant negative association was found between the presence of aspiration and affective (anxiety and depression) symptoms (p = 0.04). Male patients presented significantly lower symptom scores of anxiety compared to females (p = 0.04). Conclusions: Clinically relevant affective symptoms were present in more than half of all patients with head-and-neck cancer and dysphagia. Surprisingly, a significant negative association was found between the presence of aspiration and these affective symptoms. Gender was also significantly associated with affective symptoms. These results suggest that there is a need for further investigation into the impact of psychological distress on patients with head-and-neck cancer and dysphagia.

Enacted support matters in the relationship between psychological distress and health-related quality of life among type 2 diabetes patients in Nigeria

ABSTRACT We examined whether the association between psychological distress (depression, anxiety and stress) and diabetes-related quality of life (DRQoL) among type 2 diabetes Mellitus (T2DM) patients in Nigeria was moderated by enacted support (ES). Participants were 279 T2DMpatients (Mage = 59.65, SD: 11.57) conveniently sampled from three tertiary health-care institutions in Enugu State, Nigeria. Participants completed measures of diabetes-related Quality of Life, depression, anxiety, and stress. Results showed that ES moderated the relationship between anxiety and DRQoL. Moderation graph revealed that for participants with low and moderate ES, anxiety was positively associated with DRQoL. ES also moderated the association between stress and DRQoL. The moderation graph showed that for participants with low and moderate ES, stress was negatively associated with DRQoL. ES did not, however, moderate the association between depression and DRQoL. Our findings suggest the levels of supports for diabetes management behaviours that may be helpful toT2DM patients. This could guide health managers in developing strategies that might prevent or ameliorate the impact of psychological distress.

Health State Values of Deaf British Sign Language (BSL) Users in the UK: An Application of the BSL Version of the EQ-5D-5L.

Deaf people experience health inequalities compared to hearing populations. The EQ-5D, a widely used, standardised, generic measure of health status, which is available in over 100 languages, was recently translated into British Sign Language (BSL) and initial validation conducted. Using data from this previous study of the EQ-5D-5L BSL we aimed to assess (1) whether responses to the EQ-5D differed between a sample of Deaf BSL users and the general population (2) whether socio-demographic characteristics and clinical measures were associated with EQ-5D index scores in Deaf BSL users and (3) the impact of psychological distress and depression on health status in Deaf BSL users. Published population tariffs were applied to the EQ-5D-5L BSL, using the crosswalk methodology, to estimate health state values. Descriptive statistics (mean, SD, 95% CIs) compared Deaf BSL signer participants' (n = 92) responses to data from the general population. Descriptive statistics and linear regression analyses were used to identify associations between Deaf participants' EQ-5D index scores, socio-demographic characteristics, physical health and depression. Descriptive statistics compared the BSL index scores for people with psychological distress/depression to those from two cross-sectional, population-based surveys. Using the EQ-5D, Deaf participants had lower mean health-state values (0.78; 95% CI 0.72-0.83; n = 89) than people participating in the 2017 Health Survey for England (0.84; 95% CI 0.83-0.84; n = 7169). Unlike larger studies, such as the Health Survey for England sample, there was insufficient evidence to assess whether Deaf participants' EQ-5D health state values were associated with their demographic characteristics. Nevertheless, analysis of the BSL study data indicated long-standing physical illness was associated with lower health-state values (ordinary least squares coefficient = -0.354; 95% CI -0.484, -0.224; p < 0.01; n = 82). Forty-three percent of our Deaf participants had depression. Participants with depression had reduced health status (0.67; 95% CI 0.58-0.77; n = 36) compared to those with no psychological distress or depression (0.87; 95% CI 0.61-0.67; n = 36). The study highlights reduced health in the Deaf signing population, compared to the general population. Public health initiatives focused on BSL users, aiming to increase physical and mental health, are needed to address this gap.

Psychological Distress in Workers' Compensation Claimants: Prevalence, Predictors and Mental Health Service Use.

Purpose To determine the prevalence and predictors of psychological distress among injured and ill workers and their mental health service use. Methods Cross-sectional national survey of adults with work-related musculoskeletal or mental health conditions, accepted workers' compensation claims and at least 1 day off work. Psychological distress was measured using the Kessler-6 scale. Mental health service use was measured using self-report. Results A total of 3755 workers were included in the study (Musculoskeletal disorder = 3160; Mental health condition = 595). Of these, 1034 (27.5%) and 525 (14.0%) recorded moderate and severe psychological distress, respectively. Multivariate ordinal logistic regression revealed that being off work, poor general health, low work ability, financial stress, stressful interactions with healthcare providers and having diagnosed mental health conditions had the strongest associations with presence of psychological distress. Of the subgroup with musculoskeletal disorders and psychological distress (N = 1197), 325 (27.2%) reported accessing mental health services in the past four weeks. Severe psychological distress, being off work, worse general health and requiring support during claim were most strongly associated with greater odds of service use. Conclusions The prevalence of psychological distress among workers' compensation claimants is high. Most workers with musculoskeletal disorders and psychological distress do not access mental health services. Screening, early intervention and referral programs may reduce the prevalence and impact of psychological distress.

The efficacy of functional-analytic psychotherapy and acceptance and commitment therapy (FACT) for public employees.

The literature is replete with evidence regarding the impact of psychological distress in the workplace. Traditionally, worksite interventions to enhance mental health have been carried out in groups. This study aimed to implement a brief individual program in the workplace through the combination of Functional Analytic Psychotherapy (FAP) and Acceptance and Commitment Therapy (ACT) for Public Administration employees. One hundred and six public employees from a Spanish city council completed pretest measures and forty-three met the inclusion criteria. The participants´ scores on distress, burnout, psychological flexibility, depression, anxiety and stress were examined in a pretest-posttest design with a waiting list control group and random assignment. Thirty-eight employees completed the intervention (FACT group= 19; Waiting list control group= 19). The intervention lasted three individual sessions using a protocol with the processes of FAP and ACT, resulting in a protocol named FACT. The FACT group showed statistically significant improvements in distress, burnout, psychological flexibility and anxiety compared with the waiting list control group. These results provide a breakthrough and initial support for the inclusion of FAP in the workplace along with the integration with brief ACT in individual sessions to improve employees&rsquo; mental health.