Indicators Of Psychological Distress Research Articles

Wartime psychological stressors: proliferation and effects among the Ukrainian population

The article examines the impact of various wartime stressors on the mental health of the Ukrainian population. The psychological state of the population is assessed through indicators of psychological distress. A review of wartime stressors identified in previous research is presented, forming the basis for the authors’ proposed list of stressors (28 in total) encountered by the Ukrainian population. Through the empirical evaluation of these stressors, 12 general groups of stressors were identified: 1) experiences of being in dangerous situations; 2) lack of essential services (broadly defined); 3) challenges related to relocation to new permanent residences; 4) material hardships; 5) prolonged absence from home and separation from family; 6) discrimination, lack of family support, and moral dilemmas; 7) conflicts with family and others, exacerbated by the war; 8) health issues, both personal and familial; 9) the threat to one’s own life or the lives of family members as a probability; 10) large-scale negative effects (such as distressing news and issues with basic utilities); 11) traumatic memories, particularly of mass panic; 12) the burden of responsibility for others. Using a generalized analytical model (developed through multiple regression: F = 34.8; df = 14; p-value < 0.001; R2 = 14.6%), seven specific stressors were found to have the most significant impact on respondents’ psychological distress: 1) lack of family support when needed; 2) the necessity of engaging in morally condemnable actions due to severe circumstances; 3) discrimination based on social group affiliation; 4) memories of past stressful experiences and corresponding negative emotions; 5) significant financial or material losses; 6) health issues affecting family members; 7) emotional distress caused by exposure to media (radio, TV, internet).

From active escapism to virtual withdrawal: Validation of the Compensatory-Dissociative Online Gaming scales (C-DOGs).

In the Compensatory-Dissociative Online Gaming (C-DOG; Giardina etal., 2024) model, we proposed a continuum from compensatory to dissociative gaming involvement. This continuum represents different degrees of integration between physical and virtual environments with three core processes - Active Escapism, Escape, and Dissociation - and two peripheral processes - Gaming-Related Relaxation and Body-Mind Detachment. Here, we developed and tested a multidimensional measure based on this model. We capitalized on existing items for measuring escapism and dissociation and we generated new items consistent with the hypothesized model dimensions. A total of 54 items were administered to 1,176 online gamers playing different game genres, together with measures of problematic gaming, passion for gaming, and other psychological distress indicators. Exploratory and confirmatory factor analyses yielded a six-factor, 36-item structure, with multiple hierarchical regression analyses highlighting unique associations with other psychological constructs assessed. The following factors were identified: (1) Emotional Displacement - redirection of negative emotion into the game with associated relaxation; (2) Absorption - detachment of the player from time and space while gaming; (3) Active Escapism - simulative use of the game to compensate for lack of self-confidence in reaching physical life objectives; (4) Virtual Withdrawal - maladaptive gaming to balance impaired social functioning, predicted by traumatic experiences and pervasive depression; (5) Dissociative Regulation - dysfunctional level of engagement associated with excessive anxiety; (6) Failure Escape - problematic avoidance via gaming related to fear of future failures. The C-DOG factors identify critical psychological processes associated with problematic gaming, with relevant research and clinical implications.

Is Bedtime Procrastination Related to Multidimensional Sleep Health? Evidence from Samples of Different Educational Stages (Aged 10-25) in China.

Bedtime procrastination has been associated with poorer sleep health, but evidence for this association is not sufficient. This cross-sectional study aimed to investigate the relationship between bedtime procrastination and multidimensional sleep health among students at different educational stages (from elementary school to college) in China, and further examine the moderating role of psychological distress in the procrastination-sleep health link. A total of 3539 students (Mage = 15.6 [2.9] years) completed an online survey between December 17th and 31st, 2023. Sociodemographics, bedtime procrastination, chronotype, psychological distress, and sleep health indicators were assessed. Binary logistic regression was used to estimate the association of bedtime procrastination with sleep health. The moderating effects of psychological distress were examined using the Process macro. The results showed that, from elementary school to college, scores of bedtime procrastination displayed a gradually increasing trend. Greater bedtime procrastination across different educational stages was related to poorer sleep health, including satisfaction, alertness, timing, efficiency, and regularity. However, there was no significant association between bedtime procrastination and sleep duration among elementary, middle, and high school students. Moreover, the moderating effect of psychological distress was observed among middle and high school students. The negative association between bedtime procrastination and total sleep health was attenuated in students with high psychological distress than in students with low psychological distress. The findings underscore the importance of early prevention and intervention strategies targeting bedtime procrastination.

Rumination as a Moderator of the Relation between Childhood Adversity Exposure and College Students’ Psychological Distress

American college students (N = 598) completed self-report questionnaires assessing rumination, psychological distress while attending college (general distress, anhedonic depression, anxious arousal), and exposure to specific types of childhood adversity (i.e., emotional abuse, sexual abuse, physical abuse, emotional neglect, and physical neglect). Latent Moderated Structural Equation Modeling indicated that 1) rumination was associated with all three indicators of psychological distress and 2) rumination moderated associations between childhood adversity exposure and college students’ reports of general distress and anxious arousal such that associations were strongest at higher levels of rumination and weaker at lower levels of rumination. Implications regarding higher education professionals’ efforts to support college student well-being are discussed.

Difference in long-term mortality after takotsubo syndrome. The role of gender, socioeconomic profile, and psychological distress

Abstract Background While Takotsubo Syndrome is less common in men, their mortality rates surpass those of women. The influence of socioeconomic factors and psychological distress, remains unexplored in this context. The aim of the study was: 1) to investigate gender differences in socioeconomic profile, and psychological distress in patients with incident Takotsubo Syndrome. And 2) to investigate gender differences in survival in patients discharged alive after incident takotsubo syndrome when taking into account differences in socioeconomic profile and psychological distress. Method A nationwide cohort study using the Danish national registers was performed. All patients discharged alive from Danish hospitals with an incident Takotsubo Syndrome diagnosis between 2008 and 2018 were eligible. Socioeconomic factors covering marital status, cohabitation status, labour market attachment, highest formal education and family income, and psychological distress was explored, and compared. Multivariable Cox-regression models were performed to assess the mortality risk. Results A total of 662 patients with Takotsubo Syndrome were discharged alive from Danish hospitals. Of those, 79 (11.9%) were men with a median age of 67 years (IQR 62-77). Men with Takotsubo Syndrome were socioeconomically disadvantaged compared to their women counterparts, and this disparity was also reflected in mortality rates. Secondly, mortality within three years after an incident Takotsubo Syndrome diagnose was higher among men than women, HR 2.19, 95%CI 1.04-4.61, most pronounced among men with a low family income, HR 2.08, 95% CI 1.03-4.18, and increase in comorbidity score, HR 1.23, 95% CI 1.06-1.43. Conclusion Results unveiled notable gender differences in the socioeconomic profile of individuals diagnosed with TS. Furthermore, the identified gender disparities in mortality can be attributed to socioeconomic and sociodemographic factors, the use of psychiatric medication as an indicator of psychological distress, and a greater comorbidity burden.Survival according to socioeconomy

Psychological distress and trajectories of sleep duration among Australian adolescents: a prospective cohort study

ObjectivesThis study investigated the association between indicators of psychological distress and well-being and trajectories of sleep duration among a cohort of Australian adolescents.DesignA prospective cohort of adolescents was followed over...

The impact of group cognitive behavioral psychotherapy on disease severity and psychosocial functioning in patients with inflammatory bowel disease: a randomized controlled study.

Patients with inflammatory bowel disease (IBD) often report symptoms of anxiety and depression as well as impaired quality of life (QoL). To date, there are few studies on the effect of psychotherapy on psychological functioning and clinical outcome in patients with IBD. The aim of this prospective, randomized, controlled study was to investigate the effect of a brief psychotherapeutic intervention on psychological distress, QoL, sexual functioning, and inflammation and disease activity indices in patients with IBD. Participants were randomized to receive either group cognitive behavioral therapy or treatment as usual (controls) and were assessed at baseline and after six months using psychometric instruments to assess psychological distress, QoL, and sexual functioning. In addition, laboratory measurements, including levels of C-reactive protein (CRP), cytokines and calprotectin, and calculations of disease activity indices were performed during the two study periods. 80 participants took part in the study. Patients who received psychotherapy reported a significant decrease in anxiety and depression symptoms, a significant improvement in physical functioning, general health, vitality, social functioning and mental health, a decrease in physical pain and a decrease in role limitations caused by emotional problems. CRP levels and the Crohn's disease activity index (CDAI) also decreased significantly at follow-up compared to controls. Group cognitive behavioral therapy is proving to be an important component of holistic care for IBD patients, as it can significantly improve not only patients' psychosocial functioning but also their clinical course by inhibiting inflammation and reducing disease activity.

Psychological distress in registered nurses and the role of the workplace: A cross-sectional study

Objective: To investigate the impact of workplace factors on psychological distress in New Zealand registered nurses. Background: Nurses are often faced with challenging work environments, with long work hours, high patient ratios, and emotionally charged situations that cause stress. Despite the well-established links between the nurse work environment and well-being, there remains a gap in the literature around the role of workplace factors on psychological distress in nurses. Study design and methods: A cross-sectional survey was conducted with registered nurses in New Zealand. Depression, anxiety, and stress were self-reported using the DASS-21, while difficult practice environments and negative workplace acts were self-reported using PES-NWI and NAQ-R. Descriptive and inferential statistics were undertaken using SPSS. STROBE guidelines were used to report the study. Results: 480 RNs completed the survey. On average, depression, anxiety, and stress scores were 6.08 (SD=7.06, Normal), 4.87 (SD=6.05, Normal), and 9.50 (SD=7.30, Normal), respectively. The Average PES-NWI score was 2.70 (SD=0.54), while the average total NAQ-R score was 34.27 (SD=12.67). Depression, anxiety, and stress scores were positively associated with NAQ-R scores, and negatively associated with PES-NWI scores (p-values <0.05). PES-NWI score was negatively associated with NAQ-R score (p<0.05). PES-NWI and NAQ-R explained 28.8%, 15.6%, and 26.1% of the variation in depression, anxiety, and stress, respectively. Depression, anxiety, and stress were significantly associated with intention to leave (p-values <0.05). Depression and anxiety were significantly associated with ethnicity (p-values <0.05). Age was negatively associated with anxiety and stress (p-values <0.05). Years employed as a nurse were also negatively associated with anxiety (p<0.05). Discussion: This study addresses a knowledge gap by demonstrating that workplace factors are associated with psychological distress in nurses. Conclusion: Psychological distress in nurses is significantly associated with the work environment and with intention to leave the profession. Given that most countries are facing nurse shortages and are actively recruiting nurses from diverse countries and ethnic backgrounds, targeted and individualised support needs to be provided to preserve nurses’ mental health and subsequent retention in the workforce. Implications for research, policy, and practice: Healthcare providers must prioritise modifying the work environment to address the factors contributing to nurses’ psychological distress. This includes providing culturally tailored mental health resources and support for nurses with diverse backgrounds and experiences. Future research should examine how organisational-level strategies can reduce psychological distress in nurses. What is already known about the topic? Psychological distress is common in nurses. Indicators of psychological distress include non-specific symptoms of stress, anxiety, and depression. Psychological distress is associated with challenging working conditions. What this paper adds: Vulnerable groups, such as nurses from specific ethnic backgrounds and less experience, report higher levels of psychological distress, such as anxiety and depression. The quality of the practice environment is associated with psychological distress in registered nurses. Negative acts in the workplace (i.e., bullying and harassment) are positively associated with psychological distress in registered nurses.

Development and validation of the Transgender Adolescent Stress Survey-Dysphoria.

Transgender and nonbinary adolescents (TNBA) may experience gender dysphoria arising from incongruities between their body and their gender. Prior dysphoria measures have largely focused on clinical diagnosis with little regard to comparability of forms for people assigned male or female at birth, overall psychometric performance, or applicability to nonbinary populations. This study develops and validates the Transgender Adolescent Stress Survey-Dysphoria (TASS-D), intended to address these gaps. The current study recruited a U.S. national sample of TNBA (N = 444, aged 12-17; 65.5% White, 9.5% Black, 9.5% Latine, 15.5% other ethnicity; 34.7% transmasculine, 17.3% transfeminine, 38.3% nonbinary, 9.5% agender). The item pool was developed from life history calendars, a modified Delphi process, and cognitive interviews with TNBA. Scale development included factor analysis, item response theory modeling, measurement invariance testing, and reliability analyses. Associations were examined between the TASS-D and existing measures of gender dysphoria (convergent validity), gender minority stress (divergent validity), and behavioral health outcomes (criterion validity). TASS-D and its subscales (body distress and gender expression burden) were significantly and strongly associated with gender dysphoria; significantly but weakly associated with gender minority stress; and significantly associated with most indicators of psychological distress including depressive, anxiety, and posttraumatic stress symptoms, suicidal behaviors and nonsuicidal self-injury. The TASS-D is a reliable and valid measure of gender dysphoria for TNBA, offering notable benefits over existing measures: It is psychometrically sound, inclusive of all gender identities, and does not assume that respondents identify binarily or desire medical transition as a terminal goal.

Escape from an unclear self: Escapism mediates the association that self-concept clarity has with psychological distress

We investigated whether the associations that self-concept clarity had with indicators of psychological distress were mediated by the forms of escapism referred to as self-suppression (engaging in activities in an effort to avoid unpleasant mental processes) and self-expansion (engaging in activities in order to experience growth). The indirect associations that self-concept clarity had with psychological distress through self-suppression and self-expansion were examined in college students (Study 1; N = 270), Cosplayers (Study 2; N = 45), and Furries (Study 3; N = 191). Across these three studies, self-concept clarity had very large associations with psychological distress and negative associations with self-suppression that ranged from small to large in magnitude. Further, engaging in activities for the purpose of self-suppression mediated the associations that self-concept clarity had with various indicators of psychological distress with the most consistent associations emerging for depression. In contrast, self-concept clarity did not have consistent associations with the motivation to engage in activities for the purpose of self-expansion nor did self-expansion consistently mediate the associations that self-concept clarity had with the indicators of psychological distress. These findings indicate that engaging in activities for the purpose of self-suppression may play an important role in the link between low self-concept clarity and psychological distress.

Exploring the Mediating Role of Physical Activity in the Relationship between Green Space Exposure and Well-being: Results from the AUGS Survey

Although previous studies have shown that exposure to nature has a positive impact on physical and mental health, the factors that produce such benefits are still not well established, especially in high- and middle-income countries. In the present study, we implemented a mediation approach between green space exposure and psychological distress, body fat percentage and well-being index in Tirana (Albania), through the mediation of physical activity. The significant direct effects of green space on body fat percentage index (BFPI), psychological distress index (PDI) and well-being index, together with the relatively smaller mediating role of physical activity, offer insightful implications for the design and prioritization of urban green spaces. The differential impact on health outcomes suggests a complex association that is not only mediated by physical activity, but also offers clear benefits by reducing psychological distress (as indicated by PDI scores) and significantly improving overall well-being. This dichotomy highlights the multifaceted role of green spaces in public health, requiring a broad lens that goes beyond physical health metrics to include mental health and subjective well-being. Our findings also confirm the intrinsic value of green spaces in improving well-being and reducing psychological distress, independent of the physical activities they may promote.

Positive mental health, depression and burnout in healthcare workers during the second wave of COVID-19 pandemic.

INTRODUCTION: Few studies focused on healthcare workers' positive mental health (i.e. high levels of psychological well-being) and its association with anxiety, depression and burnout in the second wave of the pandemic. To evaluate the protective role of well-being in buffering burnout and psychological distress. We evaluated 173 Italian healthcare workers with indicators of psychological distress (Depression Anxiety Stress Scales [DASS]-21), burnout (Copenhagen Burnout Inventory [CBI]) and positive mental health (Mental Health Continuum) and we cross-classified them according to their levels of mental health (flourishing, languishing and moderate mental health) and their levels of anxiety, depression and burnout. Forty-eight per cent of health workers were classified as flourishing, 10% as languishing and 42% as moderate mental health. Flourishing individuals presented lower scores on DASS and CBI scales, whereas no differences emerged between languishing and moderate mental health groups. More than 80% of health workers with clinically significant symptoms of anxiety, depression and risk of burnout were classified as not flourishing. This investigation documented the presence of flourishing mental health in almost half of the sample of Italian healthcare workers. However, those with moderate or languishing mental health manifested higher levels of anxiety, depression and higher risks of burnout. The study confirms the importance of maintaining and/or promoting the well-being of this population, with a crucial role of mental health nurses who can easily approach other healthcare workers and provide them informational (training, guidelines) and emotional support programmes (psychoeducation, mental health support team, peer support and counselling) when facing adverse working conditions.

Exploring the association between patient-drawn pain diagrams and psychological and physical health variables: A large-scale study of patients with low back pain.

Despite the use of Patient-Drawn Pain Drawings (PDPDs) in clinical settings, their validity as indicators of psychological distress remains debated. We aimed to assess the association between PDPD areas and physical health and psychological variables. This study analysed digitally-drawn PDPDs from 15,345 chronic low back pain (LBP) patients at a Danish outpatient hospital unit. We employed a novel quantitative approach to calculate four log-transformed geometric pain areas for each PDPD. We assessed six psychological constructs and seven physical health variables. Associations were modelled using multivariable linear regression. Increasing leg pain intensity (estimates from 0.12 to 0.25), disability (estimates from 0.3 to 0.14), and pain duration (estimates from 0.10 to 0.33) had the strongest associations with increasing pain areas. Conversely, increasing fear of movement (estimates from -0.02 to -0.05) and catastrophizing (estimates from -0.02 to -0.03) were associated with slight reductions in pain areas. Anxiety and depression had the weakest and most uncertain relationships to pain area size. Increasing levels of leg pain intensity, pain duration, and pain-related disability were consistently associated with larger geometric pain areas in PDPDs. Conversely, the associations between the psychological constructs and the geometric pain areas exhibited varying directions and were notably weaker. Clinicians are encouraged to focus on the association of PDPDs with physical symptoms rather than psychological conditions during clinical assessments. This large-scale study demonstrates that extensive pain areas in pain drawings drawn by LBP patients do not signify psychological distress. Our findings reveal that these pain representations are more closely linked to increased pain intensity, pain duration, and disability rather than being independently associated with psychological factors. Clinicians are encouraged to focus on the association of extensive pain areas with physical symptoms rather than psychological distress during clinical assessments.

Functional somatic symptoms in Emergency Department frequent presenters

BackgroundPatients with Functional Somatic Symptoms (FSS) are frequently encountered within healthcare settings such as Emergency Departments (ED). There is limited research regarding characterisation and frequency of FSS within frequent presenters to ED and no previous Australian evidence. This study aims to fill this gap.MethodsA retrospective, single-centre study of frequent ED presenters over a 6-month period was undertaken. Patients with > 3 re-presentations/month were reviewed for the presence of FSS using Stephenson and Price’s (Stephenson DT, Price JR. Medically unexplained physical symptoms in emergency medicine. Emerg Med J. 2006;23(8):595.) categorisation of FSS. Patients were divided into three groups – FSS, possible FSS (pos-FSS) and non-FSS. The characteristics of these groups were compared using descriptive statistics (chi-square tests, Welch’s ANOVA). Person-time at risk during the 6-month study period was estimated for patients in each group and incidence of ED presentation for each group was then calculated. Psychological distress indicators for ED presenters with FSS, as noted by the treating clinician, were also analysed.Results11% (71/638) of frequent ED presenters were categorised as having FSS and 72% (458/638) as having possible FSS (Pos-FSS). Mean ED presentations in the FSS group during the study period were significantly higher than in the non-FSS and Pos-FSS groups (p < 0.01). Anxiety was found to be the primary psychological distress indicator associated with ED presentations with FSS.ConclusionWe found that, amongst frequent ED presenters, patients with FSS presented significantly more frequently to ED than those without FSS. We propose revising the model of care for FSS in ED to promote appropriate referral to therapy services as a possible demand reduction strategy to improve patient care and efficiency in ED.

A Preliminary Analysis of Stress Burden and Cognitive Function and Clinically Adjudicated Cognitive Outcomes in Black American Adults.

The combination of exposure to multiple stressors and psychological distress may contribute to the disproportionate burden of dementia risk among Black Americans. This study estimates the effect of an index of stress and psychological distress (ie, "stress burden") on cognitive function and clinically adjudicated cognitive outcomes among older Black American adults, and examines sleep as a mediator. The sample included 204 Black adults (79% female; mean age = 64 years) from Pittsburgh, PA, USA. Stress burden comprised 3 self-reported stress and distress measures assessed in 2016: discrimination, psychological distress, and posttraumatic stress. Potential mediators included actigraphy-assessed sleep duration and efficiency from 2018. Cognitive battery and clinical adjudication in 2019 assessed cognitive function and clinically adjudicated outcomes. Causal mediation analysis estimated the direct effect between stress burden and cognitive outcomes, and indirect effects through sleep, after adjusting for sociodemographics and hypertension. Higher stress burden had a significant direct effect on lower executive functioning and visuospatial performance. However, there were no significant indirect effects (ie, mediation) by sleep disturbances on any domain of cognitive function assessed. Also, there were no significant direct or indirect effects on clinically adjudicated outcomes. Multiple stressors often co-occur and may contribute to racial disparities in cognitive health. Findings suggest that higher stress burden had negative effects on functioning in executive and visuospatial domains in this community-based sample of older Black American adults. However, there was no evidence of mediation by sleep. Findings highlight the importance of continued work to identify modifiable pathways between stress burden and cognitive health disparities.

The reports of specific waking-state oral behaviours, including awake bruxism activities, and psychological distress have a dose-response relationship: A retrospective medical record study

ABSTRACT Objective To investigate if there are dose-response relationships between self-reported waking-state oral behaviours, including awake bruxism, and three indicators of psychological distress (depression, anxiety, stress). Methods The study sample consisted of 1,886 patients with function-dependent TMD pain. Relationships between six non-functional and six functional waking-state oral behaviours, scored on a 5-point ordinal scale, and the psychological factors were investigated using ordinal logistic regression. Results Mean age was 42.4 (±15.3) years, 78.7% being female. The odds of reporting the higher categories of non-functional oral behaviours depended on the severity of depression, anxiety, and stress. Most OR coefficients followed a quadratic dose-response distribution, the others increased linearly as the severity of the psychological scales increased. Almost no such associations were found with normal jaw function behaviours. Conclusion Within the limitations of this study, it may be concluded that non-functional waking-state oral behaviours, including awake bruxism, and psychological distress have a dose-response relationship, with higher levels of distress being associated with higher reports of oral behaviours.

Exploring the Interplay of Sleep Quality, Stress, and Academic Performance in Jordanian Medical Students: A National Perspective

Background: Sleep is a fundamental biological activity crucial for brain function, memory processing, and learning. Medical students are particularly susceptible to sleep problems due to demanding schedules that potentially affect their cognitive performance and academic achievement. This study aimed to explore the relationship between sleep quality, psychological distress, and academic performance among medical students in Jordan. Methods: A self-reported cross-sectional survey was conducted, targeting medical students from six Jordanian universities. Participants completed a questionnaire including demographics, sleep quality using the Pittsburgh Sleep Quality Index (PSQI), psychological distress using the Kessler Psychological Distress Scale (K10), the academic performance of the past year, and other like studying related factors. Statistical analyses used descriptive and Chi-square tests to explore the associations between the studied variables. Results: The study involved 707 participants, predominantly females (62.8%), with the majority (38.5%) aged between 21 and 24 years old. A high prevalence of poor sleep quality was observed (74.4%), with a mean PSQI score of 8.16 ± 3.67. Psychological distress was prevalent (77%), with 36.5% of participants experiencing severe distress. The global score of PSQI did not show a significant association with the stress overall score(P-value = 0.6). However, the K10 distress score was significantly associated with all components of the PSQI scale except for component 6. Moreover, K10 score was significantly associated with Grade Average Points (GPA) and gender. Conclusion: This study highlighted the substantial prevalence of poor sleep quality and psychological distress among medical students in Jordan. It emphasizes the interconnectedness of sleep quality, psychological well-being, and academic performance. Although global PSQI scores did not correlate with psychological distress, various sleep quality components were associated with psychological distress and academic performance indicators. These findings underscore the need for comprehensive strategies to improve sleep quality and manage psychological distress to enhance the academic performance of medical students.

Psychological distress, wellbeing and resilience: modelling adolescent mental health profiles during the COVID-19 pandemic

There has been concern about adolescent mental health during the pandemic. The current study examined adolescent mental health during the initial phase of the COVID-19 pandemic in the UK. Using indicator of psychological distress, wellbeing and resilience, latent profile analysis was used to identify homogeneous mental health groups among young people aged 13–24 (N = 1971). Multinomial logistic regression was then used to examine which sociodemographic and psychosocial variables predicted latent class membership. Four classes were found. The largest class (Class 1, 37.2%) was characterised by moderate symptomology and moderate wellbeing. Class 2 (34.2%) was characterised by low symptomology and high wellbeing, while Class 3 (25.4%) was characterised by moderate symptomology and high wellbeing. Finally, Class 4 was the smallest (3.2%) and was characterised by high symptomology and low wellbeing. Compared to the low symptomology, high wellbeing class, all other classes were associated with less social engagement with friends, poorer family functioning, greater somatic symptoms, and a less positive model of self. A number of unique associations between the classes and predictor variables were identified. Although around two-thirds of adolescents reported moderate-to-high symptomology, most of these individuals also reported concurrent moderate-to-high levels of wellbeing, reflecting resilience. Furthermore, these findings demonstrate how a more comprehensive picture of mental health can be gained through adopting a dual-continua conceptualisation of mental health that incorporates both pathology and well-being. In this way, at-risk youth can be identified and interventions and resources targeted appropriately.

Abstract PO4-10-07: Understanding Psychological distress in patients prior to breast cancer diagnosis:Mixed Methods Study

Abstract Purpose:While the association between diagnosis of breast cancer and post-diagnosis psychological distress has been well documented, data regarding pre-diagnosis psychological distress in the breast cancer population are limited. The purpose of the current study is to measure the distress levels of patients prior to breast cancer diagnosis, to identify the categories of distress they have, and describe the experience of distress of patients before diagnosis. Methods: This study uses a mixed research method of cross-sectional survey and qualitative interviews. In the quantitative part, a cross-sectional survey of 118 patients with completed breast biopsies awaiting pathological diagnosis was conducted using the National Comprehensive Cancer Network’s (NCCN’s) Distress Thermometer(DT) and Problem List (PL), In the qualitative part, 15 patients were invited using convenient and purposive sampling. Data was collected using a semi-structured face-to-face interview and recorded. The transcribed text was analyzed using Colaizzi's phenomenological method. Results: The results reveal that 63.6% of patients reported a higher level of psychological distress (n=75, scoring≥4).Most patients had emotional (98%) or physical (64%) problems. Among these, worry or anxiety (47.5%), fear (33.1%), finances (21.2%), sadness and depression(18.6%), and grief or loss(15.3%) were the most frequently reported problems. Multivariate logistic regression analysis showed that the factors associated with psychological distress before the diagnosis of breast cancer patients were age, education level. The experience of patients before diagnosis emerged five themes: Very high psychological distress index; Strong uncertainty; The demand of information; Guilt for the family; Hoped for psychological support from the health care team. Conclusions: Psychological distress is prevalent prior to breast cancer diagnosis and may merit early intervention. Understanding patients’ distress may help guide future psychosocial needs assessments and interventions to promote patient quality of life. Table 1 Sample characteristics (n=118). Table 2 Univariate analysis of predictors associated with psychological distress Table 3 The binary logistic regression model of psychological distress Citation Format: Yan Gao, Jinnan Gao. Understanding Psychological distress in patients prior to breast cancer diagnosis:Mixed Methods Study [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 PO4-10-07.

Interrelation between subjective assessment of mental state and perception of family relations by relatives caring for patients with addiction

The addictive disorder often becomes a difficult experience for the all family. Studying the factors influencing the level of psychological distress of addicted patients’ relatives is necessary to create an effective system of psychological assistance for them.Purpose: to reveal the interrelations between the subjective assessment of the mental state and the perception of family relationships among relatives of patients with pathological gambling (PG) and relatives of patients with stimulant use disorder (SUD).Materials and methods. In a cross-sectional study 100 and 41 patients’ relatives were included in the PG and SUD groups respectively. The Symptom Checklist-90-Revised (SCL-90-R) and the Family Environment Scale (FES) was used as an assessment tools. Socio-demographic and clinical data were also collected.Results. The analysis of interrelations between the severity of psychopathological symptoms and the perception of family relationships in the studied groups determined both general and specific correlations. In both groups there are multiple negative correlations between the majority of SCL-90-R scales and the “Cohesion” scale (FES). The specific interrelations included, for example, multidirectional correlations between the “Expressiveness” scale (FES) and psychopathological symptoms scales of the SCL-90-R. Increased expressiveness in the PG group was associated with less severity of psychopathological symptoms and level of distress, and, on the contrary, a greater severity of psychological distress in respondents of the SUD group. Analysis of the correlations in PG compared to SUD showed greater predictability of the connections between psychopathological symptoms and perception of family relationships in the PG group. Thus, the indicators of psychopathological symptoms and psychological distress are negatively associated with parameters reflecting the perception of family cohesion, trust in intrafamily relations, social activity and family organization and, at the same time, have positive interrelations with the indicator of conflict in family relationships.Conclusion. The perception of the family cohesion function as the intrapsychic protection that facilitate the relatives’ adaptation in the emerging life situation, regardless of the form of patients’ addiction.