Psychological Distress In Survivors Research Articles

Effects of cardiac radiation on sleep and psychological distress in adult survivors of pediatric Hodgkin lymphoma without breathing sleep disorders.

10068 Background: Adult survivors of childhood Hodgkin lymphoma (HL) are at higher risk for excessive sleepiness, fatigue, and other morbidities that affect long-term quality of life (QoL). The relationship between radiation dose to the heart delivered during treatment and self-reported sleep quality, fatigue, QoL, and psychological distress in survivors of HL has not been explored. This study examines clusters of cardiac dosimetry and sleep quality and associated symptoms of insomnia, fatigue, QoL, and psychological distress in a subset of adult survivors of pediatric HL without breathing sleep disorders. Methods: Survivors completed standardized surveys of sleep quality (Pittsburg Sleep Quality Index, PSQI), insomnia (Insomnia Severity Index), fatigue (FACIT-F), QoL (SF36 short survey), and psychological distress (BS18). Two consecutive nights of in-home polysomnography were completed with at least 4 hours of recorded sleep in one night. Analyses were conducted on 95 survivors (mean[SD] age=36[7.2] years, 55 female) who demonstrated at least average sleep efficiency (>85%) and demonstrated no evidence of sleep apnea (Apnea-Hypopnea Index <5, or AHI >5 and <15 with no daytime sleepiness as defined by the American Society of Sleep Medicine). Radiation dose to the heart was estimated using dose reconstruction methods for therapeutic radiation exposure developed by the MD Anderson Cancer Center. Radiation/Sleep clusters were found using a silhouette analysis and K-means algorithm. Linear regression associations between clusters and outcomes were adjusted by age and body mass index. Statistical analyses were computed in the statsmodels toolbox for Python3. Results: Sleep and radiation were not correlated (ρ=0.03, p=0.67). Considering good sleep as PSQI<5, three main Radiation/Sleep clusters were found indicating a low-radiation/middling-sleep group (22%; RT = 251[250.7] cGy, PSQI = 7[2.7]), a high- radiation/better-sleep group (46%; RT = 2012[406.8] cGy, PSQI = 4[1.5]), and a high- radiation/worst-sleep group (32%; RT = 2072[472.3] cGy, PSQI = 11[2.5]). Survivors in high-radiation/worst-sleep group demonstrated worse fatigue ( β=-12.3, p=0.001) and insomnia ( β=9.52, p<0.001). This group was associated with poor Mental Health ( β=-2.1, p<0.001) but not Physical Health QoL ( β=-0.4, p=0.154). This latter group also indicated more psychological distress (depression β=11.6, p=0.001, somatization β=11.8, p<0.001), but not anxiety ( β=4.6, p=0.241). Conclusions: Our results highlight the burden of symptoms associated with higher radiation dosimetry in the heart including poor sleep quality, insomnia, fatigue, and increased psychological distress. Understanding the mechanisms of sleep quality and fatigue in HL survivors is warranted as some survivors demonstrate poor sleep quality and fatigue due to factors other than clinical sleep disorders.

Abstract B021: Trends in psychological distress among adult survivors of childhood, adolescent and young adult cancers: Analysis of 2008-2018 National Health Interview Survey data

Abstract Background: Cancer survivors diagnosed at childhood, adolescent and young adults age face psychological distress in the form of depression, anxiety, and panic attacks. In addition, psychological distress has been found to have an impact on the medical expenditures of cancer survivors. Previous studies have examined psychological distress in survivors of childhood, and young adult cancers (AYA) and found them to be high, whether this increasing or decreasing over the years is unknown. The aim of our study was to examine trends in psychological distress among survivors of childhood AYA cancers. Methods: We analyzed the 2008-2018 National Health Interview Survey (NHIS) data, a cross-sectional household interview survey of the US civilian, non-institutionalized population that uses a multistage area probability design. We identified individuals (n=6,175) who were diagnosed with cancer between 0 to 39 years of age. Psychological distress was assessed using the validated Kessler 6-item scale. Using a 30-day reference period, respondents’ rate how often they felt nervous, hopeless, restless or fidgety, so sad that nothing could cheer them up, that everything was an effort, and worthless. Response options include ‘never’, ‘a little of the time’, ‘some of the time’, ‘most of the time’, and ‘all of the time’. Responses were scored and added to produce a range of 0–24. We defined mild distress as a score of less <5, moderate distress as a score between 5-13 and severe distress as a score of >13. Joinpoint regression estimated yearly increases/decreases in psychological distress using annual percent changes. Results: Overall, the proportion of childhood and AYA cancer survivors with moderate distress decreased slightly between 2008 and 2014 but increased from 2014-2018 by 5% per year, though not statistically significant. However, the proportion of childhood and AYA cancer survivors with mild and severe distress remained relatively stable throughout the study period. The proportion of females and males with moderate distress increased by an average of 5% and 6% annually from 2014-2018 respectively, however, the increase was not statistically significant. The proportion of childhood and AYA cancer survivors who were married with moderate distress increased by 8% from 2014-2018 whereas survivors who were never married with severe distress decreased by 29% in the same time range. Conclusion: There is an increase in the number of survivors with moderate psychological distress while mild psychological distress has declined from 2014-15 onwards. Severe distress has remained relatively stable in all the years. Citation Format: Pranali G. Patel, Chaitali S Dagli, Nosayaba Osazuwa-Peters, Mrudula Nair, Dina K. Abouelella, Oluwole A. Babatunde, Shreya P. Ramkumar, Eric Adjei Boakye. Trends in psychological distress among adult survivors of childhood, adolescent and young adult cancers: Analysis of 2008-2018 National Health Interview Survey data [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr B021.

Perceived negative consequences of cancer and psychological distress in survivors: the moderating role of social support.

Many cancer survivors experience psychological distress at some point during their care. The degree to which individuals perceive negative consequences of cancer has been associated with psychological distress, including anxiety and depression. Identifying psychosocial factors that buffer the effects of illness perceptions on distress may provide a target for intervention to improve the psychological health of cancer survivors. As such, the present study aimed to examine whether social support moderates the relationship between perceived negative consequences of cancer and psychological distress. The current longitudinal study of 413 cancer survivors (64% female, 58% breast cancer, Mage = 59.68, SD = 11.41) examined social support as a potential moderator of the relationship, hypothesizing that greater overall perceived social support would buffer the relationship between perceived negative consequences of cancer and subsequent symptoms of anxiety and depression. Perceived negative consequences of cancer predicted anxiety and depression over time (p < .05), but social support had a buffering effect on the perceived negative consequences of cancer-anxiety relationship (β = - .20, p < .001) as well as the perceived negative consequences of cancer-depression relationship (β = - .11, p < .05). Results suggest that social support is a protective factor over time against the pathway of illness perceptions leading to psychological distress among cancer survivors. Interventions that improve social support in cancer survivors may attenuate psychological distress and help support these individuals in their survivorship journey.

Psychological distress in survivors of childhood cancer and their parents before and after a follow-up appointment: the need for screening and validation of the emotion thermometer

AbstractBackground:Childhood cancer affects patients and their parents. Childhood cancer survivors are at risk of mental health problems. Regular psychological screening is recommended. The emotion thermometer (ET) is a short, validated tool to detect psychological distress in adult patients with cancer. However, its suitability and acceptability in young cancer populations have not yet been reported. We (1) describe mental health in survivors and their parents before and after a follow-up appointment and (2) investigate the ET's usefulness for screening in young childhood cancer survivors.Methods:Survivors (15 years or older at study, ≥1 year after treatment ended) and their parents completed two electronic surveys to assess mental health (including somatization, depression, anxiety, a Global Severity Index [GSI], fear of cancer recurrence/relapse and post-traumatic stress). The first questionnaire was completed in the weeks leading up to the follow-up appointment and the second one after. We assessed survivors' opinion on acceptability of the ET.Results:Forty-five survivors (age at study: 22 years, 54% female) and 46 parents (age: 54 years, 63% female) participated. Scores forsomatization,depression, and theGSIwere lower after the appointment (p&lt;.05 for all). For parents, there was no change. A subset of survivors reported clinically relevant post-traumatic stress (Nbefore= 3 [8%], Nafter= 4 [10%]). Fear of cancer recurrence/relapse remained stable. The ET identified moderate-to-severe distress in 13 survivors (29%), showing good specificity (0.91) and sensitivity (0.91) in relation to the gold standard Symptom Checklist-90-R. Survivors found the ET to be easy to use and understand.Conclusions:Psychological distress in survivors attending follow-up care is common, and screening is imperative. The ET may be helpful for initial psychological screening.

Psychological distress in survivors of childhood cancer and their parents before and after a follow-up appointment: the need for screening and validation of the emotion thermometer

Psychological distress in survivors of childhood cancer and their parents before and after a follow-up appointment: the need for screening and validation of the emotion thermometer

Course and predictors of psychological distress among colorectal cancer survivors with ostomies: A longitudinal study.

To examined the course and predictors of psychological distress among colorectal cancer survivors with ostomies. 131 survivors were considered in this longitudinal study. Participants were measured at first month (T1), third month (T2), and sixth month (T3) post-operation. Psychological distress, peristomal skin complications and stomal complications were measured. All participants' sociodemographic data were collected one day before discharge. ANOVA with repeated measures was used to compare the course of psychological distress. Generalized Estimating Equations were used to determine the predictors. The prevalence of mild to severe psychological distress in colorectal cancer survivors undergoing colostomy at T1, T2 and T3 was 96.94%, 88.55%, and 29.77%，respectively. The difference of psychological distress in survivors with ostomies at T1, T2 and T3 was statistically significant (F=603.310, P<0.001). Higher level psychological distress was generally differentiated by no religious belief, spouse caregiver, first and third month after ostomy, permanent enterostomy, peristomal skin complications and stomal complications. Survivors generally experience psychological distress, especially at first and third month after surgery. A multidisciplinary collaborative group comprised of Wound, Ostomy, and Continence/Enterostomal Therapy nurses and doctors, as well as psychological counselors, peer educators, and other participants, should be formed to conduct continuous assessments and management of psychological distress. Permanent enterostomies at first and third month after surgery, with spouse caregiver and no religious belief, with peristomal skin complications and stomal complications were being a priority for targeted attention.

Psychological distress in survivors of farmers' suicides in drought prone Aurangabad and Jalna Districts of Marathwada region in Maharashtra, India

Background: Survivors of suicide experience psychological distress for years after suicide. In India, farmers' suicide survivors are special group, with unique set of stressors. There are very few studies examining this group in India. The objective was to assess psychological distress and its correlates in survivors of farmers' suicides. Methods: This was a cross-sectional study from two districts of Marathwada region of Maharashtra. A predesigned and pretested semi-structured questionnaire to assess sociodemographic variables was used. Self-reporting questionnaire-20 was administered to evaluate psychological distress in 93 survivors of farmers' suicides. Standard descriptive statistics (percentages, means, and Chi-square test) were used. Results: Female-to-male ratio was 2.8:1. Majority (76%) survivors were young adults and 97.8% were from rural area. Most survivors assessed in study were spouse (68.8%) followed by parents (9.6%), siblings (2.2%), progeny, and others (19.35%) of suicide victims. Of all survivors, 75% were doing farming, while rest had other sources of income in addition to farming. Out of 93 survivors, 81.7% of survivors were experiencing significant psychological distress. Twenty-eight percent survivors themselves had thought of ending their life during 1 month prior to assessment. Most commonly, distress was expressed through somatic symptoms and depressed mood. There was no significant correlation of psychological distress with age, sex, occupation, and place of residence of survivors. There was no significant correlation between psychological distress and relationship of survivor with suicide victim. Conclusions: Survivors of farmers' suicides are suffering from significant psychological distress. Suicide ideation was present in significant number of them. The current situation needs urgent psychological intervention to alleviate their suffering.

Musculoskeletal Pain is Associated With New-Onset Psychological Distress in Survivors of the Great East Japan Earthquake.

Psychological distress is a common symptom after natural disasters. Although musculoskeletal pain also increases after natural disasters, its relation to psychological distress is not known. This study aimed to examine the association of musculoskeletal pain with new-onset psychological distress among survivors of the Great East Japan Earthquake. A panel study was conducted with survivors at 2 and 3 years after the Great East Japan Earthquake. New-onset psychological distress was defined as psychological distress absent at 2 years and present at 3 years after the disaster. The number of musculoskeletal pain sites at 2 years after the disaster was divided into 3 categories (0, 1, and ≥2). Multivariate logistic regression models were used to calculate the odds ratio and 95% confidence interval for new-onset psychological distress according to the number of musculoskeletal pain sites. The rate of new-onset psychological distress was 6.7%. Musculoskeletal pain was associated with new-onset psychological distress. Using "0" as a reference, the adjusted odds ratios (95% confidence interval) were 1.65 (0.92-2.95) in "1" and 2.12 (1.24-3.64) in "≥2" (P for trend=.02). Musculoskeletal pain is associated with new-onset psychological distress among survivors of the Great East Japan Earthquake. (Disaster Med Public Health Preparedness. 2019;13:295-300).

Long-term Sequelae of Pediatric Neurocritical Care: The Parent Perspective.

Critical neurologic disease and injury affect thousands of children annually with survivors suffering high rates of chronic morbidities related directly to the illness and to critical care hospitalization. Postintensive care syndrome (PICS) in patients and families encompasses a variety of morbidities including physical, cognitive, emotional, and psychological impairments following critical care. We conducted a focus group study with parents of children surviving pediatric neurocritical care (PNCC) for traumatic brain injury, stroke, meningitis, or encephalitis to determine outcomes important to patients and families, identify barriers to care, and identify potential interventions to improve outcomes. Sixteen parents participated in four groups across Oregon. Three global themes were identified: (1) PNCC is an intense emotional experience for the whole family; (2) PNCC survivorship is a chronic illness; and (3) PNCC has a significant psychological and social impact. Survivors and their families suffer physical, emotional, psychological, cognitive, and social impairments for many years after discharge. Parents in this study highlighted the emotional and psychological distress in survivors and families after PNCC, in contrast to most PNCC research focusing on physical outcomes. Several barriers to care were identified with potential implications on survivor outcomes, including limited pediatric resources in rural settings, perceived lack of awareness of PICS among medical providers, and the substantial financial burden on families. Parents desire improved education surrounding PICS morbidities for families and medical providers, improved communication with primary care providers after discharge, access to educational materials for patients and families, direction to mental health providers, and family support groups to assist them in dealing with morbidities and accessing appropriate resources. Clinicians and researchers should consider the parent perspectives reported here when caring for and evaluating outcomes for children requiring PNCC.

Health-related quality of life and psychological distress in young adult survivors of childhood cancer and their association with treatment, education, and demographic factors

PurposeThis study investigated health-related quality of life (HRQOL) and psychological distress among young adult (YA) survivors of childhood cancer and the association of these measures with treatment, education, and demographic factors ≥ 5 years post diagnosis.MethodsParticipants included cancer survivors (n = 91) recruited through the Cancer Registry of Norway (CRN) and healthy controls (n = 223) recruited from a student population. All participants completed self-report questionnaires, and the Pediatric Quality of Life Inventory (PedsQL™) 4.0 and the Hopkins Symptom Checklist-10 (HSCL-10) as a measure of HRQOL and distress, respectively.ResultsSurvivors reported HRQOL at the same level as controls, except for poorer physical functioning. Survivors in general, and female survivors specifically, had higher odds than controls of reporting symptoms of distress above cut-off, but survivors did not have higher mean levels of distress compared to controls. Survivors reporting distress levels above the cut-off had significantly poorer HRQOL regarding physical functioning and lower total PedsQL scores than controls scoring above the cut-off. Age (for HRQOL only), female gender, low educational level, and perceived low economic status significantly predicted HRQOL and distress. Education interacted with the effect of cranial radiation in predicting HRQOL.ConclusionsSurvivors reported similar mean levels of HRQOL and distress as controls, except for physical functioning. For cancer survivors, demographic variables predicted HRQOL and distress. Some groups of survivors require closer follow-up, and more attention should be paid to factors associated with poor HRQOL and psychological distress in survivors, including female gender, lower education level, and lower income. Survivors treated with cranial radiation may be particular vulnerable in combination with low education regarding HRQOL.

Moderators of the effects of meaning-centered group psychotherapy in cancer survivors on personal meaning, psychological well-being, and distress

PurposeThere is evidence to support that meaning-centered group psychotherapy for cancer survivors (MCGP-CS) is an effective intervention for improving personal meaning and psychological well-being, as well as reducing psychological distress. In order to investigate which subpopulations MCGP-CS specifically benefits, this explorative study aims to analyze potential sociodemographic, clinical, and psychosocial factors that may moderate the effects.MethodsCancer survivors (N = 114) were randomly assigned to MCGP-CS, or care as usual (CAU). Potential moderators included age, sex, relationship, education, employment, religion, cancer type, tumor stage, cancer treatment, time since treatment, anxiety, depression, other negative life events, and previous psychological treatment. Outcome measures were the Personal Meaning Profile (PMP), Scales of Psychological Well-Being (SPWB), and the Hospital Anxiety and Depression Scale (HADS). Assessment took place at baseline, post-intervention (short-term), and 3- and 6-month follow-ups (long-term). For each moderator, separate short-term and long-term linear mixed models were built.ResultsShort-term effect of MCGP-CS was moderated by (male) sex (on HADS-D; F(1,98) = 6.1, p = .015) and (a high level of) depressive symptoms at baseline (on SPWB; F(1,93) = 5.7, p = .019). Long-term effect of MCGP-CS was moderated by (not having received) previous psychological treatment (on HADS-total; F(3253) = 3.4, p = .017).ConclusionsMost sociodemographic and clinical characteristics do not appear to moderate the positive effect of MCGP-CS on personal meaning. However, MCGP-CS appears to reduce depressive symptoms, particularly in males, and to improve purpose in life of survivors with depressive symptoms. In the long-term, MCGP-CS appears to reduce psychological distress in survivors who had not received psychological treatment in the past year.Trial registration: NTR3571

Examining the relationship between multiple primary cancers and psychological distress: A review of current literature.

The incidence of multiple primary cancers (MPCs) is increasing, but little is known about psychological distress in this population. The purpose of this study is to review and synthesize the literature regarding what is known about psychological distress in adults who have experienced MPC diagnoses. All potentially eligible studies identified in PubMed and CINAHL were reviewed by 2 independent evaluators, and each relevant article was assessed for methodological quality. Data were extracted, organized, and recorded using a coding log, PRISMA flow diagram, and a standardized table of evidence. Effect size (ES) values were calculated using Cohen's d. Five of the 562 potentially relevant articles were selected for final analysis. MPC survivors, when compared with single cancer survivors, had lower global quality of life (d=0.32-0.37), poorer emotional role function and stress (d=0.08-0.20), greater and more frequent distress (d=0.11-0.37), and greater subclinical anxiety (d=0.15). Depressive symptoms were variable (d=0.01-0.22), and no differences between MPC and single cancer groups were identified for sleep and suicidal ideation. There is a substantial lack of evidence focused on psychological distress among the growing MPC survivor population. ES noted in the 5 studies reflect small but potentially significant increases in psychological distress in survivors of MPC compared with survivors of a single cancer. Clinicians should be aware of this at-risk population when screening for distress in cancer survivors. Suggestions for future research are provided.

Knowledge About and Perceptions of Advance Care Planning and Communication of Chinese-American Older Adults.

Although advance care planning (ACP) is associated with better care at the end of life, better quality of death, and less psychological distress in survivors, ethnic disparities in ACP completion rates have been documented and may be attributable to lack of knowledge about ACP or differences in cultural values and preferences. Despite rapid increases in the size of the Asian-American population, little is known about ACP preferences of Chinese Americans. The purpose of this study is to explore the knowledge, attitudes, and preferences of older Chinese Americans toward ACP. Focus groups with Chinese older adults (n = 34) were conducted in Mandarin, Cantonese, and English, and transcripts were analyzed using a grounded theory approach. Identified themes included knowledge and experience with ACP and end-of-life care options, health as a factor in timing of ACP and communication, and communication of end-of-life care preferences. Knowledge of and experience with ACP and end-of-life decision-making varied according to focus group, although few participants had an advance directive. Findings suggest that Chinese older adults prefer to use indirect communication strategies, such as commenting on the circumstances of others rather than directly stating their wishes, and informal contexts, such as during a family dinner rather than formal meeting, to convey their care preferences to loved ones and may employ similar tactics when communicating with clinicians. This is particularly important given the recent decision by the Centers for Medicare and Medicaid Services to provide reimbursement to physicians for engaging in advance care planning conversations.

Examining the relationship between multiple primary cancers and psychological distress: A systematic literature review.

214 Background: The incidence of multiple primary cancers (MPC) in cancer survivors is increasing. However, little is known about the psychological effects of MPCs on cancer survivors. The purpose of this systematic review was to synthesize the evidence regarding the impact of MPC on psychological distress in cancer survivors. Methods: Relevant studies were identified in PubMed database (up to June 2015). Non-English articles were excluded. Two independent evaluators reviewed articles for relevancy and data extraction. Data was organized and recorded using a coding log with exclusionary rationale, a PRISMA flow diagram, and a standardized table of evidence. Effect sizes (ES) were calculated using Cohen’s d to measure relationship magnitude and direction. Results: Of the 543 potentially relevant articles identified, four articles met criteria and were retained for analysis. Different quality of life (QOL) measures were used to assess psychological distress across studies, so ES were calculated for individual studies. There were consistently small but significant ES found for the impact of MPC on distress. When compared to survivors of a single cancer: one study found lower global QOL and higher total stress (ES, 0.1430 and 0.3653); one study reported that those with MPC were more likely to experience frequent mental distress and sleep problems (ES, 0.1404 and 0.2235); and one study found that those with MPC had lower global QOL and emotional function and greater anxiety and depressive symptoms (ES range, 0.1026 - 0.3215). Finally, the one study that evaluated suicidal ideation in survivors of childhood cancers did not find a higher incidence among those with MPC. Conclusions: The ES noted in the four studies suggest a small but significant increase in psychological distress in survivors of MPC compared to survivors of a single cancer. Clinicians should be aware of this at-risk population when screening for distress in cancer survivors. Additional studies that control for care transition points known to increase distress are warranted to explore the impact of MPC on psychological distress over time. Additionally, as the science in this area grows, it will be necessary to reevaluate the literature.

A case-control study of psychological distress in survivors of farmers' suicides in Wardha District in central India.

Context:Lack of literature on psychological aspects of survivors of farmers' suicides is hurdle in devising effective helping strategies for rising number of survivors across the country.Aims and Objectives:To assess the psychological distress and its correlates in survivors of farmers' suicides.Settings and Design:Case–control study design was used in Wardha District of Vidarbha region in the central India.Materials and Methods:A predesigned and pretested semistructured questionnaire was used to assess sociodemographic variables. Self-Reporting Questionnaire-20 was used to evaluate psychological distress in 98 survivors of farmers' suicides and 98 age, sex, and occupation-matched controls.Statistical Analysis:Significance of differences between case and control groups were assessed using Chi-square test or Fisher's two-tailed exact test for class variables. For continuous variables, Student's t-test was used P < 0.05 was considered significant.Results:Significantly higher proportion of survivors had psychological distress than controls. Female survivors, spouse and parents of suicide victims had a high risk of distress. Psychological distress was commonly expressed by depressive and somatic symptoms.Conclusions:Survivors of farmers' suicides are suffering from significant psychological distress.

The Effectiveness of EMDR in Reducing Psychological Distress in Survivors of Natural Disasters: A Review

Natural disasters affect whole communities both at an individual level as well as economically and socially. However, the impact of natural disasters on an individual’s mental health is substantial; yet, the response to one’s mental health needs after a disaster is underdeveloped. Nevertheless, the Humanitarian Assistance Programme has attempted to address these needs by providing eye movement desensitization and reprocessing (EMDR) to natural disaster survivors. This systematic review provides evidence for the effectiveness and efficacy of EMDR in the treatment of psychological distress in survivors of natural disasters. Of the 8 studies reviewed, 4 were controlled trials and 1 study part-controlled. All the studies demonstrated statistical and clinical significance in reducing posttraumatic stress disorder (PTSD) symptoms, anxiety, depression, and other distress experienced by survivors of natural disasters. In addition, 4 of the 8 studies demonstrated clinical significance after just 1 session, presenting EMDR as resource-, time-, and cost-efficient intervention. Theoretical framework, adaptation in intervention, methodological issues, and quality assessment of studies are discussed. Implications for future research and clinical practice are also discussed.

The prevalence and risk factors for psychological distress in older men and women affected by the Wenchuan, China earthquake

The aim of this study was to examine the prevalence of psychological distress in survivors aged 60 years old and older by sex and analyse risk factors for psychological distress in male and female older survivors 2 years after the Wenchuan earthquake. This was a cross-sectional study. Two hundred and fifty-seven older people were involved and a multistage random sampling method was utilised. Logistic regression analysis was used to determine risk factors for psychological distress among older men and women. A higher prevalence of psychological distress was observed in older women than in older men. Loss of family members and displacement from pre-earthquake residence were significant risk factors for psychological distress in older men. Significant risk factors for psychological distress in older women were low educational level, chronic diseases, loss of family members, and displacement from original residence. Health-care providers should develop gender-based strategies to improve mental health among older survivors in a long-term post-disaster recovery programme.

Cancer rehabilitation may improve function in survivors and decrease the economic burden of cancer to individuals and society

Cancer and its treatment may cause physical impairments and psychological distress in survivors. Rehabilitation is a critical component of quality cancer care, returning survivors to their highest functional potential. This overview focuses on the benefits of multidisciplinary cancer rehabilitation - including improving physical function, reducing psychological distress, promoting return to work and, therefore, decreasing the economic burden of cancer and its treatment on individuals and society in general. Relevant literature was identified through a search of the PubMed database and reviewed for its relevance to cancer rehabilitation and the topic of this article. Search terms included, but were not limited to, cancer rehabilitation, cancer prehabilitation, disability, return to work, employment, and unemployment. Cancer survivors are less likely to be employed and take more sick leave than workers without a history of cancer. Pain, musculoskeletal issues, deconditioning, fatigue, balance, psychosocial issues, and lymphedema are most amenable to rehabilitation. Overall health and the need for work accommodations must be addressed in order to improve return to work and subsequent productivity in cancer survivors. Survivors are usually best served by a multidisciplinary care team comprising members who can address the myriad impairments affecting survivor function.

The Roles of Cognitive Flexibility and Experiential Avoidance in Explaining Psychological Distress in Survivors of Interpersonal Victimization

The long-term negative psychological consequences associated with interpersonal victimization are significant; however a history of interpersonal victimization alone does not necessarily lead to greater long-term psychological distress. The current study examined the relationship between cognitive flexibility, experiential avoidance, and psychological distress among 92 women who reported a history of interpersonal victimization. The findings indicate that both cognitive flexibility and experiential avoidance are significantly related to posttraumatic stress symptomology and depression in this sample. Preliminary evidence is also presented suggesting experiential avoidance maybe a potential mediator between cognitive flexibility and psychological distress in this sample. The current findings suggest that treatments targeting greater emotional acceptance and mindfulness might be useful approaches in working with survivors of interpersonal victimization.

Predictors of psychological distress in survivors of the 1999 earthquakes in Turkey: effects of relocation after the disaster

Relocations after disasters are known to cause added distress in survivors. This study examined the effects of migration and other factors on psychological status of survivors 4 years after the two severe earthquakes in Turkey. Five hundred and twenty-six adult survivors of the 1999 earthquakes currently living in Ankara were given self-report measures assessing traumatic stress, depression, earthquake experience and social support. The rates of current post-traumatic stress disorder (PTSD) and depression were 25% and 11%, respectively. Although both traumatic stress and depression factors were predicted by some demographic and trauma severity variables, relocation status predicted depression but not traumatic stress. The rates of psychological distress were higher than expected in a city considered to be safe in terms of earthquake risk. Relocation after the disaster may increase psychological distress by disrupting the social network.