Psychological Distress In Individuals Research Articles

Examining Psychological Distress and Learned Helplessness in Iranians Chronic Pain Patients with Differing Post-traumatic Stress Disorder Intensity: A Comparative Study

Background: Chronic pain (CP) is defined as persistent, severe pain lasting for more than three months and is often associated with psychological distress (PD) and learned helplessness (LH). Objectives: This study aims to explore the relationship between post-traumatic stress disorder (PTSD), PD, and LH in individuals with CP. Methods: The research employed a descriptive, causal-comparative methodology. The study population consisted of patients referred to pain and physiotherapy clinics in Tehran between 2022 and 2023. From a pool of 300 CP patients, 150 with high-grade PTSD severity and 150 with low-grade PTSD severity were purposively selected. Participants completed PTSD (Blevins et al., 2015), PD (Lovibond & Lovibond, 1995), and LH (Quinnells & Nelson, 1988) questionnaires. Data analysis was conducted using SPSS-24 software, with multivariate analysis of variance used for data analysis (P < 0.005). Results: Among the 300 patients, 52.6% were married, 44.0% held a bachelor’s degree, and 37.4% had musculoskeletal disorders. The findings revealed significant differences in PD and LH levels between the two groups (P < 0.001). Chronic pain patients with high-grade PTSD exhibited greater levels of depression (F = 211.09), anxiety (F = 231.06), stress (F = 374.85), and LH (F = 457.79) compared to those with low-grade PTSD (P < 0.001). Conclusions: This research highlights the significant impact of PTSD severity on PD and LH in individuals with CP. These results emphasize the need to consider psychological factors in the treatment and management of CP.

Respiratory Symptoms and Psychological Distress in Farmers Living With Chronic Obstructive Pulmonary Disease.

Farmers with chronic obstructive pulmonary disease (COPD) often face both respiratory issues and psychological distress, which can exacerbate their condition. However, no prior research has examined how the frequency of respiratory symptoms is associated to psychological distress in these individuals. Therefore, this study aimed to explore this relationship among U.S. farmers living with COPD. A cross-sectional study involved 101 participants, a mix of on-site and online recruits, assessing respiratory symptoms and psychological distress in farmers with COPD. The study employed standard self-reported measures and utilized both simple and multiple linear regression to analyze the association between respiratory symptoms and psychological distress. Participants reported notably higher levels of respiratory symptoms (61.6 [SD = 13.3]) compared to the reference score of 12, along with elevated psychological distress (25.9 [SD = 10.6]). Factors like COPD duration, income, smoking, and emergency department (ED) visits correlated with respiratory symptoms, while age, COPD duration, income, smoking, pesticide exposure, and farm type were associated to psychological distress. Notably, even after accounting for age, smoking, and pesticide exposure, a significant association remained between respiratory symptoms and psychological distress (β = 0.46, p < .001). Respiratory symptoms were significantly associated to psychological distress, even when considering other factors. While this aligns with existing research, a future longitudinal study is crucial to establish the cause-effect relationship between these variables. Understanding this relationship could inform the development of targeted interventions to alleviate psychological distress in individuals with respiratory symptoms. The correlation between COPD symptoms and psychological distress in farmers emphasizes the need for integrated nursing care. Occupational health nurses should prioritize combined respiratory and mental health assessments.

Effect of Emotional Regulation Strategies on Psychological Distress in Obsessive-Compulsive Tendency

Background: This study examined the effects of emotion regulation strategies on psychological distress in individuals with obsessive-compulsive tendencies.Methods: A total of 339 adults completed online and offline surveys administered to determine the level of obsessive-compulsive symptoms. Among them, 56 were categorized into the obsessive-compulsive tendency group and randomly assigned to the reappraisal, acceptance, and suppression groups, where each participated in emotion regulation strategy training. Their psychological distress was assessed before and after the training.Results: The results of the repeated-measures analysis of variance (ANOVA) showed that the main effects of neither group nor time were significant, but the interaction between group and time was significant. The acceptance group showed a significant decrease in psychological distress post-training, whereas the suppression group showed a significant increase. The reappraisal group showed no significant changes in psychological distress before and after the training.Conclusions: This study demonstrated that the acceptance strategy was especially effective and adaptive in reducing psychological distress. These findings expand our understanding of emotion regulation strategies and have therapeutic implications. Finally, the implications and limitations of this study are discussed, presenting directions for future research.

Assessment of Emotional Distress among Hepatitis C Patients Undergoing Antiviral Therapy at Jinnah Hospital Lahore

Hepatitis C is a significant worldwide health issue, causing mental and psychological distress in individuals, resulting in heightened stress and depression. Objective: To assess the emotional distress and assess the relationship between emotional distress and demographic variables of hepatitis c patients undergoing antiviral therapy at Jinnah Hospital Lahore. Methods: A quantitative cross sectional study design was used for this study. The study was carried out in Jinnah Hospital Lahore. Sample size of 108 patients is calculated with 95% confidence interval and 5% margin of error. Data were collected by using self-developed through convenient sampling technique. Both Male and female conscious patient, have a confirmed diagnosis of Hepatitis C and on antiviral therapy for 12 weeks were included in the study. Patients with Liver Cirrhosis and emotional trauma were excluded from study. An adopted Emotional Distress scale, consists of 14 questions was used to collect data from patients Emotional Distress Scale was used to collect data. Data were analyzed using SPSS 25.0. Chi square test applied to assess association between emotional distress and demographic variables of Hepatitis C patients. Results: The result showed that among 108, the most of the participants are the age group of 18-40 years and 58.3% are female. Emotional distress among hepatitis C patients undergoing antiviral therapy revealed varying degrees of emotional experiences and majority 45.4% of participants had severe distress. Conclusions: It was concluded that majority experienced severe emotional distress during antiviral therapy, offering valuable insights for interventions.

Sociocultural determinants of psychological distress and coping among South Asian individuals with chronic illness

Sociocultural determinants affect the physical and mental well-being and coping of individuals with chronic illnesses. However, no studies have examined the relationship of sociocultural determinants with psychological distress and coping. The purpose of this study was to determine the levels of psychological distress and coping among individuals with chronic illness and identify sociocultural determinants affecting distress and coping. A cross-sectional design was used. Data were collected from a convenience sample of 384 individuals admitted to inpatient settings and attending outpatient clinics at two tertiary care hospitals. The validated Urdu-translated version of the Hospital Anxiety and Depression Scale, and the Brief COPE scales were used for data collection. The mean HADS-Depression score was (11.38 ± 2.53), and the HADS-Anxiety score was 13.42 ± 2.34), indicating high levels of depression and anxiety. The most commonly used coping strategies were problem-focused coping (15.95 ± 4.95), followed by emotion-focused coping (15.01 ± 2.33), and avoidance coping (13.89 ± 4.77). Higher levels of psychological distress in individuals with chronic illnesses underscore the importance of implementing community-based support approaches. Varied use of coping strategies was influenced by the type of chronic illness, living conditions, educational level, years of living with a chronic illness, family dynamics, and available support systems.

Long-term impact of resilience and extraversion on psychological distress during the COVID-19 pandemic: a longitudinal investigation among individuals with and without mental health disorders.

Over the past years, the COVID-19 pandemic has caused significant disruptions in daily routines. Although the pandemic has affected almost everyone, it has been particularly challenging for people with pre-existing mental health conditions. Therefore, this study investigated the long-term impact of resilience and extraversion on psychological distress in individuals diagnosed with mental health disorders (MHD) compared to the general population. In addition, possible gender-specific differences were investigated. 123 patients with pre-existing MHD and 343 control subjects from Austria and Italy participated in three online surveys that had been conducted after the initial wave of the COVID-19 pandemic (t0), during the second lockdown in both countries (t1), and one year thereafter (t2). Participants completed standardized questionnaires on psychological distress (Brief-Symptom-Checklist), resilience (Resilience Scale), and extraversion (Big Five Inventory). A mediation model was employed to test the primary hypothesis. Possible gender-specific differences were analyzed using a moderated mediation model. The prevalence of psychological distress was consistently higher in patients compared to controls (t0: 37.3% vs. 13.2%, t1: 38.2% vs 11.7%, t2: 37.4% vs. 13.1%). This between-group difference in psychological distress at the first follow-up was fully mediated by baseline resilience scores (65.4% of the total effect). During the second-follow up, extraversion accounted for 18% of the total effect, whereas resilience slightly decreased to 56% of the total effect. Gender was not a significant moderator in the model. Next to showing that people with MHD were particularly affected by the pandemic, these findings indicate that higher degrees of resilience and extraversion are related to less long-term psychological distress. Our findings stress the relevance of strengthening resilience and extraversion and to provide mental health support in times of crises, both to patients with MHD and the general population.

Tobacco, Alcohol, Illegal Drug and Substance Use, Sociodemographic Variables and Psychological Distress Symptoms in Individuals Aged 50-65

Aim: The aim of the study is to evaluate the relationship between tobacco, alcohol, illegal drug and substance use, demographic variables and symptoms of psychological distress in individuals aged 50-65 living in the city center of XXXXXXX, and to create a risk profile based on these variables. Materials and Methods: The data of the study were collected through survey forms. Participants filled out the sociodemographic-clinical data form, Fagerström Nicotine Dependency Test (FNDT), Symptom Checklist 90-Revised (SCL90-R). Results: Three hundred twelve participants, 154 women and 158 men, were included in the study. 43.3% of the participants were smoking, 10.3% were using alcohol, and 3.8% were using illegal drugs and substances. The SCL90-R subscale scores and overall symptom severity were significantly higher in smokers and alcohol users compared to non-users, except for somatization. Moderate significant positive correlations were found between the FNDT scale score and the SCL90-R scale scores. It was found that male gender increased tobacco use by approximately 10.7 times (OR:10.7, 95% CI [5,721, 20,113]), a one-unit increase in paranoia increased it by 3.4 times (OR:3.4, 95% CI [2,373, 4,963]), while a one-unit increase in age decreased it by 0.9 times (OR:0.9, 95% CI [0,900, 0,976]). Conclusion: It has been observed that tobacco and alcohol use in early old age is closely related to symptoms of psychological distress.It can be said that preventive interventions for the psychological health of the community may be important in combating tobacco and alcohol use.

Smart-Spend: Excess Shopping Provoker Trolly with an Alert System

Abstract: Impulsive and excessive shopping behavior has become a prevalent issue in modern society, leading to financial strain and psychological distress for individuals. This research addresses the pervasive issue of overspending by introducing SmartSpend —a technological solution designed to proactively curb impulsive purchases and promote budget-conscious shopping behavior. The trolley incorporates a personalized budget-setting feature, allowing users to establish spending limits prior to shopping. As items are added, the trolley dynamically calculates the total cost and issues alerts as the set limit approaches. These notifications serve as immediate reminders, encouraging shoppers to evaluate their choices and make informed decisions. Furthermore, the trolley incorporates human following capabilities to enhance user experience and ensure seamless navigation in retail environments. By merging technology and psychology, the Excess Shopping Provoker Trolley addresses the root causes of excessive shopping behavior. It empowers individuals to regain control over their spending patterns and cultivates responsible consumption habits. This innovative solution presents a tangible means of countering the negative consequences of impulsive shopping, fostering financial stability and emotional well-being in today's consumer-oriented landscape.

Posttraumatic Growth, Maladaptive Cognitive Schemas and Psychological Distress in Individuals Involved in Road Traffic Accidents-A Conservation of Resources Theory Perspective.

Road traffic accidents can have profound psychological impacts on the individuals involved, encompassing both negative distress and positive growth. This study, guided by the conservation of resources (COR) theory, investigates the intricate relationship between posttraumatic growth (PTG), maladaptive cognitive schemas, and psychological distress in individuals involved in road traffic accidents. PTG reflects an individual's ability to derive positive changes from adversity, while maladaptive schemas represent negative cognitive patterns. Using a 122 sample of individuals involved in road traffic accidents, we examined direct and indirect effects within this complex network. Our findings reveal significant direct effects of PTG on psychological distress (β = 0.101, p = 0.02). Particularly noteworthy are the indirect effects mediated by cognitive schemas, emphasizing the role of impaired autonomy and perceived performance deficiencies (β = 0.102, p = 0.05). This suggests that individuals involved in road traffic accidents experiencing higher PTG levels may indirectly experience greater psychological distress through these maladaptive cognitive schemas. This study not only advances our understanding of the psychological consequences of road traffic accidents but also aligns with self-determination theory, emphasizing autonomy and competence as fundamental needs. Individuals involved in road traffic accidents may undergo profound shifts in perspective following the trauma, which our results support. Recognizing the nuanced relationship between PTG, maladaptive cognitive schemas, and psychological distress is crucial for tailoring interventions and support systems for individuals involved in traffic accidents. As PTG can coexist with distress, interventions should foster adaptive growth while addressing maladaptive schemas to promote resilience in the face of traumatic events.

Wheel and talk: A Progressive Supranuclear Palsy case summary

BackgroundThe negative psychological effects of neurogenerative disorders (NDDs) are well known. However, there is limited research identifying ways to ameliorate psychological distress in individuals with progressive supranuclear palsy (PSP).CaseAn 84-year-old gentleman was referred to the Older Adult (OA) Community Mental Health Team (CMHT) due to low mood following a PSP diagnosis. After assessment and formulation, elements of a cognitive-behaviour therapy (CBT) framework which adapted ‘Walk and Talk’ therapy to Wheel and Talk, was used to support a move towards a sense of acceptance following the associated losses of a PSP diagnosis.ConsentVerbal consent was sought and gained from the client. Details have been amended to protect their identity. A pseudonym, Robert, was utilised for this client.ResultsThrough ongoing assessment and reformulation, adapting sessions to have an outdoor focus enabled Robert to move towards a sense of connectedness to his values and identity.ConclusionThis case summary reveals the importance of empowering services to adapt to the needs of the client through simple modifications and modelling.

The Dynamics of Psychological Distress in the Trajectory of At-Risk and Problem Gambling: Results from a Prospective Population-Based Longitudinal Study in Australia

AbstractThis study employed parallel growth curve modelling to examine the changes in both psychological distress and at-risk and problem gambling as a development process. We used a prospective longitudinal population-based study to provide further insights beyond treatment samples and cross-sectional studies. A secondary data analysis was conducted by extracting a sample of 3460 Victorian adults from the Victorian Gambling Study 2008–2011. Findings suggested that psychological distress was a consistent risk factor for at-risk and problem gambling, as measured by the problem gambling severity index (PGSI), after controlling for other risk factors such as sex, age, histories of at-risk and problem gambling, and the experience of trauma. A more rapid increase in psychological distress over time was related to a more rapid increase in the PGSI trajectory. It is concluded that this study supports a positive association in the development trends of problem gambling severity and psychological distress in individuals who engaged in gambling. The association persists after adjusting for histories of gambling problem risk and the experience of trauma in life. The implications of the study suggest addressing the comorbidity of problem gambling risk and psychological distress in treatment and prevention, and the development of dual-diagnosis treatment programs.

Age-related differences in the severity of sexual dysfunction symptoms and psychological distress in individuals with multiple sclerosis

BackgroundSexual dysfunction (SD) is a common symptom for many with multiple sclerosis (MS). However, SD research in general appears to often overlook young adults within their samples, which can be a major issue for better understanding and treatment for the MS population. Few studies have compared age-related differences in distress in response to physical disability. Research has also found that many people diagnosed with MS do not discuss any SD struggles with their providers. The present study hopes to see whether age-related differences exist in the reporting of the levels of primary, secondary, and tertiary SD, as defined by subscale scores of the Multiple Sclerosis Intimacy and Sexuality Questionnaire-19 (MSISQ-19), and amount of distress, as defined by the 12-Item Short Form Health Survey (SF-12)’s Mental Component Summary (MCS-12). Additionally, we hope to determine if there are any age-related or sex-related differences in help-seeking behaviors for SD. MethodsStudy participants were recruited from the North American Research Committee on Multiple Sclerosis (NARCOMS) Registry. Participants completed the MSISQ-19, SF-12, and Patient Determined Disease Steps (PDDS), provided demographic information, and responded if they received medical or psychological treatment for SD. Study participants were 5815 respondents (Mage = 51 years, SD = 9.63, 75 % female, 30 % having attained a high school diploma, 35 % scoring “advanced disability” on the PDDS). Young adult (19–39 years), middle adult (40–64 years), and mature adult (65-older) were compared on SD. ResultsLinear mixed effects modeling revealed that the MSISQ-19 subscale scores were significantly predicted by secondary SD (t = 2.48, p < .13). Young adult participants had the lowest primary SD (M = 13.87, 95 % CI [13.13, 14.61]) when compared to mature adult (M = 14.12, 95 % CI [13.27, 14.97]) and middle adult participants (M = 14.44, 95 % CI [14.21, 14.66]), though none were statistically significant. Mature adults had the lowest secondary SD (M = 16.50, 95 % CI [15.65, 17.35]), a statistically significant difference from the middle adults (M = 18.20, 95 % CI [17.97, 18.42]) and young adults (M = 18.91, 95 % CI [18.17, 19.65]). Mature adults had the lowest tertiary symptoms (M = 10.12, 95 % CI [9.27, 10.96]), followed by young adults (M = 12.23, 95 % CI [11.48, 12.97]), and middle adults (M = 11.65, 95 % CI [11.43, 11.88]), though none were statistically significant. Hierarchical multiple regressions found that age had the most significant impact on SD. When SF-12 MCS-12 was added, linear mixed effects did not reveal any statistically significant results between the age groups and SD levels. In contrast, hierarchical multiple regressions found that SF-12 MCS-12 scores had the most significant impact on SD. There were significant age-related and sex-related differences in help-seeking behaviors in those who sought psychological counseling as opposed to medical treatment for SD. ConclusionOur study has highlighted the importance of clinicians assessing for SD and psychological distress within their patients and to consider potential differences in symptom presentations of age groups to better address their unique needs.

Quarter-life crisis: Personal growth initiative as a moderator of uncertainty intolerance in psychological distress

Quarter-life crisis is a psychosocial crisis in which individuals are vulnerable to experiencing psychological distress. One contributor to such distress is uncertainty intolerance, while personal growth initiative is a factor that can reduce it. This study examines Personal Growth Initiative (PGI) in determining the effect of uncertainty intolerance on psychological distress in individuals experiencing a quarter-life crisis. A total of 309 participants were selected through a screening process using the Quarter-life Crisis Questionnaire. The participants completed the Intolerance of Uncertainty Scale, General Health Questionnaire-12, and Personal Growth Initiative Scale. Moderation regression analysis was performed using the Hayes PROCESS Macro. The results indicate that personal growth initiative buffers the effect of uncertainty intolerance on psychological distress in individuals experiencing a quarter-life crisis (B = -0.193, p = .003, R2 = .117), but with differences shown based on age and gender categories. Based on the findings, it is necessary to build personal growth initiative skills, which will assist individuals in achieving and maximizing their potential and adapting well when faced with conditions of uncertainty.

Investigating the Role of Upward Comparisons and Self-compassion on Stigma in People With Acne: Cross-sectional Study.

The use of image-laden social media is hypothesized as being implicated in psychological distress in individuals with conditions affecting their appearance. However, relatively little is known about the mechanisms involved in this relationship. This cross-sectional study examined the relationship between photo-orientated social media use and feelings of stigmatization in adults with acne, and tested whether upward skin comparisons mediate and self-compassion moderates this relationship. Adults (N=650) with acne symptoms completed web-based measures of social media use (daily Facebook or Instagram use, Facebook function use), self-compassion, skin appearance comparisons, and internalized stigmatization. Moderated-mediation and mediation analyses indicated that there was a significant indirect effect of Facebook photo use on stigmatization, mediated by upward appearance comparisons (estimation of indirect effect 11.03, SE 5.11, 95% CI 1.19-21.12). There was no significant relationship between Instagram use and feelings of stigmatization (estimation of indirect effect 0.0002, SE 0.005, 95% CI -0.011 to 0.009), yet upward appearance comparisons predicted feelings of stigmatization (B=0.99, P<.001). Self-compassion did not moderate the indirect or direct relationships between photo-orientated social media use and stigma. However, self-compassion was negatively correlated with upward appearance comparisons and feelings of stigmatization in both Facebook and Instagram users. The way that individuals engage with social media, and in particular make appearance comparisons, should be considered when working with individuals with skin-related distress. Interventions aimed at boosting self-compassion and reducing appearance comparisons may provide avenues for protecting against feelings of stigma.

Using the emotional functioning in clinical practice to detect psychological distress in patients with advanced thoracic and colorectal cancer

PurposePatients with advanced cancer suffer significant decline of their psychological state. A rapid and reliable evaluation of this state is essential to detect and treat it and improve quality of life. The aim was to probe the usefulness of the emotional function (EF) subscale of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EF-EORTC-QLQ-C30) to assess psychological distress in cancer patients.MethodsThis is a multicenter, prospective, observational study involving 15 Spanish hospitals. Patients diagnosed with unresectable advanced thoracic or colorectal cancer were included. Participants completed the Brief Symptom Inventory 18 (BSI-18), the current the gold standard, and the EF-EORTC-QLQ-C30 to assess their psychological distress prior to initiating systemic antineoplastic treatment. Accuracy, sensitivity, positive predictive value (PPV), specificity, and negative predictive value (NPV) were calculated.ResultsThe sample comprised 639 patients: 283 with advanced thoracic cancer and 356 with advanced colorectal cancer. According to the BSI scale, 74% and 66% displayed psychological distress with an EF-EORTC-QLQ-C30 accuracy of 79% and 76% in detecting psychological distress in individuals with advanced thoracic and colorectal cancer, respectively. Sensitivity was 79 and 75% and specificity was 79 and 77% with a PPV of 92 and 86% and a NPV of 56 and 61% (scale cut-off point, 75) for patients with advanced thoracic and colorectal cancer, respectively. The mean AUC for thoracic cancer was 0.84 and, for colorectal cancer, it was 0.85.ConclusionThis study reveals that the EF-EORTC-QLQ-C30 subscale is a simple and effective tool for detecting psychological distress in people with advanced cancer.

Social cognition in cervical dystonia

BackgroundWhilst traditionally considered a movement disorder, it is now generally accepted that cervical dystonia (CD) presents with additional non-motor symptoms which significantly impact quality of life. Our study primarily aimed to explore social cognition and levels of psychological distress in individuals with CD, in comparison to age- and sex-matched healthy controls. Methods20 participants with CD attending a specialist movement disorders clinic were recruited. 20 age and sex matched neurologically healthy controls were recruited in parallel. Participants completed the Hospital Anxiety and Depression Scale, and two novel social cognition tasks: The Cambridge Mindreading Face-Voice Battery (CAFMB) and the Edinburgh Social Cognition Test (ESCoT). ResultsParticipants with CD exhibited poorer complex emotion recognition abilities for visual and auditory stimuli, compared to controls on the CAFMB task. Participants with CD did not differ significantly from controls on performance on cognitive or affective Theory of Mind tasks, or interpersonal or intrapersonal understanding of social norms, as measured by the ESCoT. The proportion of depressive symptoms was significantly higher for participants with CD than controls. 40% of participants with CD reported clinically elevated depressive symptoms, and 60% reported clinically elevated anxiety. Poorer understanding of emotional facial expressions was associated with higher levels of depression in the CD group. ConclusionsSignificant between-group differences between participants with CD and controls suggests socio-cognitive dysfunction is an important aspect of the non-motor syndrome of CD. Findings highlight the need for assessment of and intervention for both social cognitive difficulties and psychological distress in individuals with CD.

Alexithymia and psychological distress in fibromyalgia and chronic migraine: A cross-sectional study

Objective: Several studies have shown a strong association between alexithymia and psychological distress in both healthy and clinical populations. The aim of this study was to investigate the prevalence and association between alexithymia and psychological distress in individuals with fibromyalgia (FM) and chronic migraine (CM) compared with healthy controls (HC).Methods: A cross-sectional study was conducted. Two hundred fifty women with FM (age: 51.2 ± 10.5) and 250 women with CM (age: 46.1 ± 11.5) were assessed with the Toronto Alexithymia Scale (TAS-20) and the Hospital Anxiety and Depression Scale (HADS) and compared with HCs (n = 280; age: 51.8 ± 9.0) by one-way analyses of variance. A moderation analysis was performed to examine the moderation effect of groups on the relationship between alexithymia and psychological distress.Results: Differences between groups showed significantly higher scores for TAS-20 [F(2,755) = 11.7, p < .001] and HADS [F(2,763) = 31.7, p < .001] in FM, compared with CM and HCs. The moderation analysis showed that both clinical groups and TAS-20 (β = 0.20, p < .001) were significant predictors, as well as the interaction terms. The slope of the correlation curve was more pronounced in the patient groups, indicating that the degree of alexithymia had a significantly higher influence on the HADS total score in the patient groups.Conclusion: The results suggest a common psychological dysregulation in FM and CM, with a slight but greater prevalence of alexithymia and psychological distress in FM. These data suggest that although there is a similar psychological substrate, it is expressed in a different expression of somatic symptoms.

The indirect impact of heart rate variability on cold pressor pain tolerance and intensity through psychological distress in individuals with chronic pain: the Tromsø Study.

Chronic pain (CP) patients often display lower heart rate variability (HRV) and baroreceptor sensitivity (BRS), which are associated with increased evoked pain intensity and decreased pain tolerance. The purpose of this study was to test whether the association between low levels of HRV and BRS and increased evoked pain responsiveness in individuals with CP is mediated by psychological distress and whether this mediation is sex dependent. The sample consisted of 877 participants in Wave 6 of the Tromsø population study who reported clinically meaningful CP. Resting HRV and BRS parameters were derived from continuous beat-to-beat blood pressure recordings. Psychological distress was assessed using the Hopkins Symptom Checklist-10. After cardiovascular assessment, participants completed a 106-second cold pressor task (3°C bath), which assessed cold pressor pain intensity (CPI) and cold pressor pain tolerance (CPT). In the full CP sample, mediation analyses showed significant indirect effects, without direct effects, of HRV and BRS on both CPT and CPI via psychological distress. When stratified by sex, significant indirect effects via psychological distress were only found in males for the impact of rMSSD on CPT, the impact of SDNN on CPT, and the impact of BRS on CPT via psychological distress. Moderated mediation analyses revealed that there were no significant sex differences in the indirect effects of HRV and BRS on both CPT and CPI via psychological distress. The hypoalgesic impact of cardiovascular regulatory systems on evoked pain responses is conveyed via the indirect effects of psychological distress.

The Pandemic's Toll on Young Adolescents: Prevention and Intervention Targets to Preserve Their Mental Health

PurposeAdolescence is characterized by dramatic physical, social, and emotional changes, making teens particularly vulnerable to the mental health effects of the COVID-19 pandemic. This longitudinal study identifies young adolescents who are most vulnerable to the psychological toll of the pandemic and provides insights to inform strategies to help adolescents cope better in times of crisis. MethodsA data-driven approach was applied to a longitudinal, demographically diverse cohort of more than 3,000 young adolescents (11–14 years) participating in the ongoing Adolescent Brain Cognitive Development Study in the United States, including multiple prepandemic visits and three assessments during the COVID-19 pandemic (May–August 2020). We fitted machine learning models and provided a comprehensive list of predictors of psychological distress in individuals. ResultsPositive affect, stress, anxiety, and depressive symptoms were accurately detected with our classifiers. Female sex and prepandemic internalizing symptoms and sleep problems were strong predictors of psychological distress. Parent- and youth-reported pandemic-related psychosocial factors, including poorer quality and functioning of family relationships, more screen time, and witnessing discrimination in relation to the pandemic further predicted youth distress. However, better social support, regular physical activities, coping strategies, and healthy behaviors predicted better emotional well-being. DiscussionFindings highlight the importance of social connectedness and healthy behaviors, such as sleep and physical activity, as buffering factors against the deleterious effects of the pandemic on adolescents' mental health. They also point to the need for greater attention toward coping strategies that help the most vulnerable adolescents, particularly girls and those with prepandemic psychological problems.

Evaluation of a physical activity promotion intervention for adults with whiplash associated disorders: a single-case experimental design study

Purpose There is considerable variation in the physical and psychological presentations of people with whiplash-associated disorder (WAD). Optimal treatment continues to be a challenge. This research evaluated the efficacy of a community-located, theory-based intervention designed to promote physically active behaviour in people with persistent WAD, and thereby improve perceptions of pain interference and confidence completing activities in the presence of neck pain. Materials and methods A multiple-baseline, single-case experimental design was used to evaluate the 16-week intervention across six participants. Results Weighted Tau-U showed significantly increased accelerometer-measured physical activity in three participants with large effect sizes (>0.5), with increased confidence in one participant (ES > 0.5), and reduced pain interference in another participant (ES > 0.7). Changes in other behaviours included clinically important improvements in quality of life for five participants and, in those participants with baseline symptom levels outside threshold levels, improvements in pain catastrophizing and pain self-efficacy. Conclusions Participation in a theory-based intervention resulted in significant improvements in physical and psychological health for five of six participants. Providing this type of community-located physical activity promotion strategy, to individuals with persistent WAD, may help address physical impairments and psychological distress commonly experienced in WAD. Trial registration: The trial was registered with the Australia and New Zealand Clinical Trials Registry (ACTRN: ACTRN12617001261303p) and ClinicalTrials.gov (Protocol Number: 2018000349/2017/743). Implications for rehabilitation Rehabilitation professionals should consider recommending theory-based physical activity promotion strategies to reduce physical impairments and psychological distress in individuals with persistent WAD. Individually tailored physical activity promotion strategies may help individuals with persistent WAD become more physically active thereby reducing their risk of diseases associated with inactivity which may compound the effects of WAD Improvements in physical and psychological health may occur independently of increasing habitual physical activity. Rehabilitation professionals may find that other community-located strategies which aim to promote physically active behaviour confer similar benefits for individuals with persistent WAD.