Indices Of Emotional Distress Research Articles

Effect of Multimodal Health Education Combined with the Feedback Method in Perioperative Patients with Lung Cancer: A Randomised Controlled Study.

To explore the effect of multimodal health education combined with a feedback method in perioperative patients with lung cancer. A total of 200 lung cancer patients were divided into the observation group and the control group. The observation group adopted the multimodal health education combined with the feedback method, and the control group adopted the conventional health education model. The postoperative extubation time, length of hospital stay, time to first leaving the bed, postoperative exercise compliance, emotional-distress index and patient satisfaction were compared between the two groups. The postoperative extubation time (2.80 ± 1.03 days), the emotional-distress index (8.26 ± 3.01) and the time to first leaving the bed (23.74 ± 11.87 h) were all lower in the observation group than in the control group, with a statistically significant difference (P < 0.05). The postoperative exercise compliance (49.69 ± 3.60) and patient satisfaction (98.32 ± 1.66) values were higher in the observation group than in the control group, with statistically significant differences (P < 0.05). Multimodal health education combined with the feedback method can improve the postoperative exercise compliance of lung cancer patients, reduce their postoperative rehabilitation time and improve their postoperative psychological state and satisfaction, which is in line with the concept of promoting the enhanced recovery of lung cancer patients.

Factors Associated with Word Memory Test Performance in Persons with Medically Documented Traumatic Brain Injury

Objectives: (1) To examine the rate of poor performance validity in a large, multicenter, prospectively accrued cohort of community dwelling persons with medically documented traumatic brain injury (TBI), (2) to identify factors associated with Word Memory Test (WMT) performance in persons with TBI. Method: This was a prospective cohort, observational study of 491 persons with medically documented TBI. Participants were administered a battery of cognitive tests, questionnaires on emotional distress and post-concussive symptoms, and a performance validity test (WMT). Additional data were collected by interview and review of medical records. Results: One hundred and seventeen participants showed poor performance validity using the standard cutoff. Variable cluster analysis was conducted as a data reduction strategy. Findings revealed that the 10 cognitive tests and questionnaires could be summarized as 4 indices of emotional distress, speed of cognitive processing, verbal memory, and verbal fluency. Regression models revealed that verbal memory, emotional distress, age, and injury severity (time to follow commands) made unique contribution to prediction of poor performance validity. Conclusions: Poor performance validity was common in a research sample of persons with medically documented TBI who were not evaluated in conjunction with litigation, compensation claims, or current report of symptoms. Poor performance validity was associated with poor performance on cognitive tests, greater emotional distress, lower injury severity, and greater age. Many participants expected to have residual deficits based on initial injury severity showed poor performance validity.

Fatigue after myocardial infarction: Relationships with indices of emotional distress, and sociodemographic and clinical variables

Fatigue and depressive symptoms are relatively common among patients recovering from myocardial infarction (MI). The symptoms of depression and fatigue overlap. The present study aimed at identifying patient fatigue and at examining the incidence of fatigue, particularly without coexisting depression, after MI. The sample comprised 204 consecutive patients who had completed the questionnaires Hospital Anxiety and Depression Scale and the Multidimensional Fatigue Inventory-20 after MI (1 week and 4 months). The results showed that fatigue had decreased after 4 months compared with the time of MI onset. Compared with the general population, patients reported significantly higher levels of fatigue. Furthermore, fatigue was associated with depression, but 33% of the sample reported fatigue without coexisting depression after 4 months. In order to prevent or treat patients' symptoms of fatigue after MI, the concepts of fatigue and depression should be assessed separately so as to exclude overlapping effects.

Six-month recovery from mild to moderate Traumatic Brain Injury: the role of APOE- 4 allele

The possession of at least one APOE-epsilon4 allele may be linked to poor outcome in patients with predominantly severe traumatic brain injury (TBI). In mild TBI, which accounts for approximately 85% of all cases, the role of the APOE-epsilon4 allele is less clear. Studies completed to date have relied on brief cognitive assessments or coarse measures of global functioning, thereby limiting their conclusions. Our study investigated the influence of the APOE-epsilon4 allele in a prospective sample of 90 adults with mild to moderate TBI in whom neuropsychiatric outcome 6 months after injury was assessed as follows: (i) a detailed neuropsychological battery; (ii) an index of emotional distress (General Health Questionnaire); (iii) a diagnosis of major depression (Structured Clinical Interview for DSM-IV); (iv) a measure of global functioning (Glasgow Outcome Scale); (v) an index of psychosocial outcome (Rivermead Head Injury Follow-up Questionnaire); and (vi) symptoms of persistent post-concussion disorder (Rivermead Post-Concussion Symptoms Questionnaire). No association was found between the presence of the APOE-epsilon4 allele and poor outcome across all measures. Given the homogeneous nature of our sample (mild to moderate injury severity), the uniform follow-up period (6 months) and the comprehensive markers of recovery used, our data suggest that the APOE-epsilon4 allele does not adversely impact outcome in this group of TBI patients.

Psychometric properties of an index of emotional distress in the U.S. National Comorbidity Survey.

The National Comorbidity Survey (NCS; Kessler et al. 1994) was a nationwide household survey of the U.S. population designed to produce data on the prevalence and correlates of psychiatric disorders. The NCS dataset is now in public-use format and continues to be widely used for ongoing research efforts. The NCS dataset included a set of 14 items that have face validity as a measure of current emotional distress (depression and anxiety) and could serve as a potentially useful continuous measure of psychological distress. However, there have been no published studies on its psychometric properties and this measure has not yet been utilized by researchers using the NCS dataset. This paper provides an evaluation of the psychometric properties of the NCS Distress Index. The NCS Part II public-use dataset (N = 5877) was used. Detailed diagnostic information was collected along with 14 items assessing current psychological distress and measures of Neuroticism and Openness to Experience. The NCS Distress Index was found to be internally consistent (Alpha = 0.92) and a series of principal-components analyses demonstrated that the measure is most accurately conceptualized as a single-factor measure of general distress. The construct validity of the Distress Index was supported by its associations with the measures of Neuroticism and Openness to Experience. A series of comparisons between diagnostic groups also supported the construct validity of the measure. For example, those with disorders characterized by depressed mood and worry scored higher on the Distress Index than those with disorders characterized by fear and hyperarousal. The NCS Distress Index is a psychometrically sound measure of current emotional distress. Future studies utilizing the NCS public-use dataset could potentially benefit from the inclusion of this measure in addition to more commonly investigated categorical variables such as diagnosable disorders.

Veterans' reports of pain and associations with ratings of health, health-risk behaviors, affective distress, and use of the healthcare system.

The improved management of pain among veterans seeking care in Veterans Health Administration (VHA) facilities has been established as a priority. This study documents the high prevalence of reports of pain among a convenience sample of 685 veterans seeking care in a VHA primary care setting. Also reported are associations of pain complaints with self-rated health, an index of emotional distress, health-risk behaviors such as tobacco and alcohol use, health-related concerns about diet and weight, and perceptions of the availability of social support. The relationship between the presence of pain and use of outpatient and inpatient medical and mental health services is also examined. Nearly 50% of the sample reported that they experience pain regularly and that they were concerned about this problem at the time of the index visit to their primary care provider. Persons acknowledging the presence of pain, relative to those not reporting pain, were younger, reported worsening health over the past year, had greater emotional distress, used tobacco, had diet and/or weight concerns, and were found to use more outpatient medical, but not inpatient medical or mental health services. Results support the goals of the VHA National Pain Management Strategy designed to reduce unnecessary pain and suffering among veterans receiving care in VHA facilities.

Drawing Conclusions--Or Not-From Drawings

Riethmiller and Handler (this issue) critiqued our article on drawing indices and emotional distress (Joiner, Schmidt, & Barnett, 1996). On several counts, we find their points unconvincing. Specifically, we reject the possibilities that our null results are explained by (a) the distinction between self-attributed and implicit motives, (b) measurement error, and (c) curvilinear relations between variables. Furthermore, we document, using Riethmiller and Handler's own data, that previous research on drawings, construed by Riethmiller and Handler as supportive, actually undermines the validity of drawings as indices of emotional distress.

Emotional distress among males with "syndrome X".

The present study examined traditional risk factors and various indices of emotional distress in males with positive angiograms (N = 122), "syndrome X" males with negative or nominal results on angiogram (N = 53), and age- and socioeconomic status-matched males with no manifest history of otherosclerotic disease (N = 56). Syndrome X patients reported more depression on the Ketterer Stress Symptom Frequency Checklist (KSSFC) than positive angiographic patients. And compared with healthy controls, they were more likely to be perceived by a spouse/friend as depressed and anxious on the KSSFC, scored higher on the Framingham Type A Scale, and reported more unprovoked nocturnal awakening. Syndrome X patients generally appear to be similar to patients with positive angiograms with regard to traditional risk factor history but are more distressed than healthy controls. This becomes most evident when denial is circumvented by discussion with significant others or inquiries are "framed" appropriately.

Obstructive prostatic symptoms: a community survey in Jerusalem.

Benign prostatic hypertrophy has a high prevalence in men aged > or = 50, but there is little information on the correlates of obstructive symptoms. The prevalence and correlates of reported prostatic symptoms in men aged > or = 50 years were studied in a community survey in the Kiryat Hayovel neighbourhood of Jerusalem in 1985-1987. Five prostate-related questions were asked. Two indices of emotional health were used: the Psychiatric Epidemiology Research Interview demoralization scale and a scale based on the Cornell Medical Index. Associations with sociodemographic, behavioural, emotional, biochemical and physical variables and with self-appraised health were examined both controlling for age only and by multivariate logistic regression. The prevalence rates in the 839 respondents were 20.4% for hesitancy, 41.1% for weak stream, and 26.7% for terminal dribbling; the rates tended to increase with age. The associations between the symptoms (controlling for age) were significant, the strongest being between hesitancy and weak stream. All three of the urinary symptoms were associated with indices of emotional distress. In the multivariate analysis, the odds ratios when men in the highest and lowest quartiles of emotional ill health were compared were 3.0 for hesitancy, 2.2 for weak stream, and 3.8 for dribbling. Specific symptoms were associated with blood pressure, social class and educational level. The striking associations with emotional ill health underline the importance of appropriate attention to the emotional health of patients who complain of prostatic symptoms.

Emotional distress among concentration camp survivors--a community study in Jerusalem.

Three hundred and eighty former concentration camp inmates were identified and interviewed in the course of a community health survey in Jerusalem. A set of 8 questions derived from the Cornell Medical Index was used as an index of emotional distress. The concentration camp survivors had a higher prevalence of emotional distress and more symptoms of this type than other European-born members of the community, controlling for age and education. The findings suggested that 16.0% of the emotional distress observed in male camp survivors and 22.9% of that among female camp survivors could be attributed to the camp experience almost three decades after the Holocaust. In this survey, data were elicited in a context unrelated to benefit-seeking such as clinic or compensation claims.

Neuroticism and the number of complaints of ENT outpatients in London and Bangkok

Neuroticism and other indices of emotional distress have been found to be elevated in groups of medical patients. As most patients present with several complaints, this study examined the relationship between number of presenting complaints and N score. The subjects were ENT outpatients in London and Bangkok. Results generally supported the hypothesis that N increases with number of complaints. Three alternative explanations for this finding are offered. All groups of medical patients had elevated L-score means.

Crowding and mental health

An epidemiologic investigation of the mental needs and services of 1645 respondents, aged 17 to 92 years and living in a representative southeastern county in Florida, revealed that 7.8% of the sample lived in crowded conditions. The crowded respondents scored significantly higher than did the uncrowded on both a depression scale and on the Health Opinion Survey. Associations between crowding and high scores on both scales were strongest among: respondents in the childrearing and middle years of life, blacks at all income levels, whites in the intermediate annual family income range of $6000 to $9999, and especially, females rather than males. Consistently, the crowded black population, and particularly, crowded white women, had much higher scores than did the uncrowded women. A multiple regression analysis showed that three variables--being a female, having a lower income, and crowding--accounted for 16.5% of the variance. The discussion emphasizes that the relationship between crowding and higher scores on indices of emotional distress is quite complicated. In crowded situations, depression may be a costly, semi-adaptive reaction to excessive interpersonal stimulation. Women living in crowded situations appear to be at high risk for depressive illness; their plight brings to mind the classic animal experiments which showed that the maternal behavior of females deteriorated in crowded situations.

Corticosteroid Responses to the Psychotherapy of Reactive Depressions

Detailed longitudinal psychiatric and endocrine observations are reported on 6 women receiving psychotherapy for reactive depressions. The authors hypothesized that confrontation of the precipitating loss during psychotherapy would be transiently more painful to the patient than the previous organized depressive equilibrium state. It was therefore predicted that corticosteroid excretion, as an index of emotional distress, would be highest during the period of confrontation of loss. (Psychiatric judgments were made independent of endocrine data.) The hypothesis was supported to the p < 0.005 level for the group of 6 patients. Corticosteroid elevations during periods of confrontation of loss averaged 36% above levels for depressive equilibrium periods. The significance of the findings is discussed in terms of psychoanalytic theories of depressive illness, particularly the concept “primary” or “essential” depressive experience as distinguished from the secondary depressive symptom syndrome. A model for the psychoendocrine “course” of reactive depressions is proposed. Psychosomatic and psychotherapeutic implications are also considered.