Psychological Distress In Women Research Articles

Supplemental Material for Perceived Discrimination and Women's Psychological Distress: The Roles of Collective and Personal Self-Esteem

Supplemental Material for Perceived Discrimination and Women's Psychological Distress: The Roles of Collective and Personal Self-Esteem

Interdependent anxiety and psychological distress in women with breast cancer and their partners

The purpose of this study was to determine the extent of interdependence on anxiety within dyads where one person was undergoing treatment for breast cancer. Perceptions of relationship quality were expected to mitigate the anxiety experienced by both members of the dyad. 96 dyads participated in a 3-wave longitudinal study that took place over 10 weeks. Dyads were composed of a woman with stage I-III breast cancer who was currently undergoing treatment, and a partner who she nominated to participate in the study along with her. Results indicated that anxiety felt by women with breast cancer was consistently associated with that of her partner. Structural equation analyses suggest that the within-dyad influence runs mostly from partners' anxiety to the anxiety of women with breast cancer. Partners' anxiety was also associated with other indicators of the women's well being including depression, fatigue, and symptom management. Perceptions of relationship quality from women with breast cancer and their partners were negatively associated with partners' anxiety. However, women's anxiety was only correlated with their partners', but not their own, perceptions of relationship quality. These findings underscore the benefit of having partners who are able to cope with or get help for their own personal distress as women cope with the stress of breast cancer and its treatment.

Are pregnant Australian women well informed about prenatal genetic screening? A systematic investigation using the Multidimensional Measure of Informed Choice

Ethical practice requires that decisions to participate in medical care be well informed. Investigations into prenatal genetic screening for Down syndrome have assessed women's knowledge but have not examined whether being well informed about the potential consequences of screening, such as subsequent diagnostic testing, diagnosis and termination, is associated with psychological distress for women. To assess informed choice to participate in second trimester maternal serum screening (2MSS) in pregnant women using a validated measure and to compare anxiety levels in women who were well informed versus poorly informed. A prospective cohort study where pregnant women completed the Multidimensional Measure of Informed Choice and the Hospital Anxiety and Depression Scale immediately prior to the offer of 2MSS. Follow-up questionnaires assessing psychological symptomatology were completed at 20 and 30 weeks gestation. Only 37% of decisions were informed; those who participated in screening were more likely to have made an informed decision than those who did not (P = 0.01); 31% did not know that miscarriage was a possible consequence of diagnostic testing subsequent to an increased risk screening result and only 62% correctly identified that termination of pregnancy would be offered if Down syndrome were to be diagnosed. Short-term anxiety levels in those who were well informed were not significantly different from those who were poorly informed (P = 0.14). Health promotion strategies, which are readily applicable in clinical settings and address diverse learning needs and attitudes of pregnant women, are needed. The impact of antenatal screening on other dimensions of pregnancy psychology remains to be investigated.

Editorial

Editorial

A randomized clinical trial of an individualized home-based exercise programme for women with fibromyalgia

To determine the efficacy of a 12-week individualized home-based exercise programme on physical functioning, pain severity and psychological distress for women with fibromyalgia (FM). Seventy-nine women with a primary diagnosis of FM were randomized to a 12-week individualized home-based moderate-intensity exercise programme or to a usual care control group. Outcomes were functional capacity (Fibromyalgia Impact Questionnaire), pain severity and psychological distress. Outcomes were measured at study entry, at the end of the 12-week intervention, and at 3 and 9 months following completion of the intervention. On the basis of intention-to-treat analyses, a significant improvement in functional capacity at 3 and 9 months following treatment for participants in the exercise group who were more functionally disabled at study entry was observed. At both 3 and 9 months post-treatment, the mean estimated benefit of the intervention was more than 10 points [-12.3 (95% CI, -21.9 to -2.8); -10.8 (95% CI, -21.5 to -0.2)]. Compared with the control group, statistically significant improvements in upper body pain were evident in the exercise group at post-treatment. These between-group differences in upper body pain were maintained at 3 and 9 months post-treatment. No statistically significant group differences on lower body pain and psychological distress were found. Home-based exercise, a relatively low-cost treatment modality, has the potential to improve important health outcomes in FM.

The Big Five Personality Dimensions, Work-Family Conflict, and Psychological Distress

Abstract. The Big Five personality dimensions were examined as possible risk, resource, vulnerability, or protective factors in the link between work-family conflict and psychological distress. Data were derived for 75 men and 80 women from the Jyväskylä Longitudinal Study of Personality and Social Development (JYLS), in which the NEO Personality Inventory was completed at age 33, and work-family conflict and psychological distress were assessed at age 36. Neuroticism was positively linked to work-to-family conflict (WFC), family-to-work (FWC) conflict, and psychological distress in both genders. Neuroticism was also a moderator strengthening the link between WFC and psychological distress in women. Openness to Experience was positively linked to FWC in men, and Agreeableness was negatively linked to psychological distress in both genders.

Immigrant Women and Counseling: The Invisible Others

The U.S. Census Bureau reports that 10.4% of the U.S. population, or approximately 28 million individuals, are immigrants (Schmidley, 2001). Immigration is undoubtedly the strongest force that has shaped U.S. history, and current global changes account for unprecedented movements of individuals across the world in search of better life opportunities and conditions (Marsella & Ring, 2003). The amount of information on recent immigrants in psychological literature is sparse (Hovey, 2000; Pernice, 1994; Yoshihama & Horrucks, 2002), however, and there is even less information about the impact of immigration on women and their counseling needs and experiences (Hondagneu-Sotelo, 1999). A few researchers have examined immigrant women's psychological distress (Rodriguez & DeWolfe, 1990), post-traumatic stress symptoms and victimization (Yoshihama & Horrucks, 2002), adaptation strategies (McIntyre & Augusto, 1999), and identity changes (Weeks, 2000). Cole, Espin, and Rothblum (1992) devoted a text to the mental health issues of refugee women. Books that address issues specific to Latina and Asian American women highlight difficulties faced by racial and ethnic minority immigrant women (Falicov, 1998; Uba, 1994). This research shows that immigrant women's migration and acculturation experiences may threaten their physical, emotional, and mental health. As a result, counselors in the United States are challenged to learn about the mental health needs of immigrant women to support their successful transition in the U.S. Building on the existent literature, we first provide an overview of issues immigrant women face upon relocation to the U.S. Second, we use Bronfenbrenner's (1979) ecological model to outline mental health concerns and experiences of oppression for immigrant women and to identify counseling strategies for working with this population. Throughout the article, we focus on the experiences of Mexican immigrant women because Mexicans constitute the largest group of new U.S. immigrants and make up 64% of the total U.S. Latino population (Guarnaccia, 1997; Montgomery, 1994). The Legal Aspects of Immigration Immigration constitutes a wide array of relocation circumstances, which have a strong bearing on women's experiences in their host environments. The three broad categories of relocation that are officially recognized in the U.S. are (a) legal immigration, (b) refugee relocation, and (c) or illegal immigration. Legal immigration refers to relocation of noncitizens who are granted legal permanent residence by the U.S. federal government. Legal permanent residence provides the fight to remain in the country indefinitely, to be gainfully employed, and to seek benefits of U.S. citizenship through naturalization (Mulder et al., 2001). This status does not give the fight to vote or receive benefits, such as many federal subsidies reserved for U.S. citizens. A different type of immigration status is granted to individuals who are considered refugees. Refugees are defined by the 1967 United Nations Protocol on Refugees as those people outside their country of nationality who are unable or unwilling to return to that country because of persecution or well-founded fear of persecution (Mulder et al., 2001). The third category of U.S. immigrants represents individuals who seek to relocate to the U.S. in search of employment and better living conditions. Often referred to as the illegal or undocumented population, the unauthorized migrant population consists primarily of two groups: (a) those who enter the U.S. without inspection and (b) those who enter the U.S. with legal temporary visas but stay beyond the time allotment of their visas (Mulder et al., 2001). The U.S. Census Bureau (Mulder et al., 2001) estimates that approximately 5 to 8 million individuals remain in the U.S. without legal documents, with Mexicans constituting 95% of immigrants who are detained in the U. …

Psychological distress in women at risk of hereditary breast/ovarian or HNPCC cancers in the absence of demonstrated mutations

To examine psychological distress in women at risk of familial breast-ovarian cancer (FBOC) or hereditary non-polyposis colorectal cancer (HNPCC) with absence of demonstrated mutations in the family (unknown mutation). Two-hundred and fifty three consecutive women at risk of FBOC and 77 at risk of HNPCC and with no present or past history of cancer. They were aware of their risk and had received genetic counseling. Comparisons were made between these two groups, normal controls, and women who were identified to be BRCA1 mutation carriers. The questionnaires Beck Hopelessness Scale (BHS), General Health Questionnaire (GHQ-28), Hospital Anxiety and Depression Scale (HADS) and Impact of Event Scale (IES) were employed to assess psychological distress. No significant differences concerning psychological distress were observed between women with FBOC and women with HNPCC. Compared to mutation carriers for BRCA1, the level of anxiety and depression was significantly higher in the FBOC group with absence of demonstrated mutation. Compared to normal controls, the level of anxiety was higher, while the level of depression was lower in the groups with unknown mutation. Women in the absence of demonstrated mutations have higher anxiety and depression levels than women with known mutation-carrier status. Access to genetic testing may be of psychologically benefit to women at risk for FBOC or HNPCC.

The impact of having relatives affected with breast cancer on psychological distress in women at increased risk for hereditary breast cancer

Being at hereditary risk of breast cancer (BC) may lead to elevated levels of distress because of the impact of the BC-process in relatives. Determine the association between psychological distress and BC in relatives. We studied: kind of kinship with the affected relative(s), degree of involvement with the relative's BC, time elapsed since the BC diagnosis of the relative, and loss of a relative as a consequence of BC. The study cohort consisted of women at increased risk of developing BC, adhering to regular surveillance and participating in the Dutch MRISC-study. Two months prior to the surveillance appointment, demographics, general and BC specific distress and experience with BC in the family were assessed. 347 out of 351 participants (mean age 40 1/2) had at least one relative affected with BC. The following variables were significantly, positively related to BC specific distress: having at least one affected sister (n = 105; p < 0.04); close involvement in a sister's BC process (n = 94; p < 0.03); and a recent (less than three years ago) BC diagnosis in a sister (n = 30; p < 0.03). General distress did not show any significant associations with the experience of BC in the family. These findings show the impact of a BC diagnosis in a sister, particularly a recent diagnosis, on psychological distress. Women who have experienced BC in their sister may be in need of additional counselling or of more attention during the surveillance process.

Women's Psychological Distress in Midadulthood: The Role of Childhood Parenting Experiences

Abstract. This study explored the role of parental family structure, perceived father figure's involvement, and perceived mother figure's involvement in childhood in women's psychological distress in midadulthood. Six hundred and seventeen 28-59-year-old women with secondary school age children from three areas in South England completed the GHQ-12, scales retrospectively assessing mother's involvement and father's involvement, and items on parental family structure, educational attainment, social class (housing tenure), family size (number of children under age 21 in the household), partner status, employment status, and age. It was found that, even after controlling for current sociodemographic confounding variables, mother's involvement and father's involvement were negatively related to psychological distress. Parental family structure was unrelated to psychological distress. Family structure did not moderate the relationship between parental involvement and daughters' psychological distress, and the effect of father's involvement on a daughter's psychological distress did not vary with the level of mother's involvement.

Correlates of Change in Marital Relationships under Stress: The Case of Childhood Cancer

This study focuses on the factors associated with positive and negative change in the marital relationship among parents of children with cancer. Data were gathered from both parents in 35 couples whose children had been treated for cancer. Measures included perception of the situation and personal, system, and community resources. Change in the marital relationship was primarily associated with mothers' social support and fathers' sense of coherence, as well as with duration of the illness. Additionally, change was associated with psychological distress of the fathers, but not of the mothers. Whereas women's psychological distress is buffered by social support, men achieve their primary support within the marriage and therefore experience less distress when the marital relationship is stronger.

Relational Predictors of Psychological Distress in Women and Men Presenting for University Counseling Center Services

The authors examined psychological distress and relational patterns in college men and women. Peer, mentor, and community relationships; year in school; and family experiences were hypothesized to predict psychological distress, although predictive patterns were expected to differ in women and men. Overall, results supported the hypotheses. Findings are interpreted from the perspective of the relational‐cultural model. Counseling implications focus on interventions congruent with the specific relational needs of women and men.

Menopausal Symptoms and Psychological Distress in Women With and Without Tubal Sterilization

Data from self-administered mailed questionnaires were used to examine the relationship between menopausal and psychological/psychiatric factors in women age 45-50 years with and without tubal sterilization. In multivariate logistic regression analysis, tubal sterilization was associated with current flushing (odds ratio = 8.78, 95% confidence interval [CI] = 1.58-48.67) and current symptoms of psychological distress (odds ratio = 3.37, 95% CI = 1.27-8.95); psychological distress was associated with tubal sterilization (odds ratio = 3.28, 95% CI = 1.28-8.42) and with being perimenopausal (odds ratio = 3.93, 95% CI = 1.08-14.34). Sterilization was marginally associated with a history of physician-diagnosed depression (univariate age-adjusted odds ratio = 2.24, 95% CI = 0.90-5.60). The menopausal and psychological symptoms of women with tubal sterilization should be taken seriously and treated appropriately.

Psychological distress in women at increased risk for breast cancer: the role of risk perception

The magnetic resonance imaging screening (MRISC) study evaluates a surveillance programme for women with a hereditary risk for breast cancer. The psychological burden of surveillance in these women may depend on inaccurate risk perceptions. To examine differences in risk perceptions between three predefined risk categories and associations with psychological distress. BC-specific distress, general distress, and RP (cognitive and affective) were assessed, two months before a surveillance appointment. Cumulative lifetime risk (CLTR) of developing breast cancer was trichotomised into: (1) CLTR of 60–85% (mutation carriers), (2) CLTR of 30–50%, and (3) CLTR of 15–30%. In a total group of 351 women (mean age 40.5 years, range 21–63 years) the three risk categories significantly differed in their accuracy of assessing cognitive risk perceptions. In category 1, 60% had an accurate risk perceptions, in category 2, 43.7% and in category 3, 33.3%. Overestimators reported significantly more breast cancer-specific distress. After adding affective risk perception to the model, this effect disappeared. Affective risk perceptions showed significant associations with breast cancer-specific and general distress. Affective risk perception is a more important determinant for psychological distress than cognitive risk perception. This knowledge should be used during surveillance appointments in order to improve and individualise support for these women.

Changes in Psychological Distress of Women With Breast Cancer in Long-Term Remission and Their Husbands

The purpose of this randomized, prospective study was to identify factors influencing the psychological distress of breast cancer patients and their husbands during remission. Background variables and distress levels of 172 couples in two locations (Graz, Austria, and Jerusalem, Israel) were assessed by using three standardized instruments in two interviews conducted 6-8 months apart. In both geographic-cultural groups, women whose partners refused to participate in the interview reported significantly less perceived family support. The global severity index (measuring total psychological distress) reflected minor changes in psychological distress of both patients and their husbands over time.

An investigation in primary care of the relationship between consultation behaviour, increased vaginal bleeding and mental disorder

Studies have shown an association between consultation for increased vaginal bleeding and the presence of psychological disturbance. However, many of the studies have failed to control the known link between psychological distress and propensity to consult in general. The aim of this case - control study was to determine whether psychological distress in women consulting with increased vaginal bleeding is associated with the illness or with the propensity to consult. Women consulting as cases of 'increased vaginal bleeding' were compared with three sets of control women: two sets of consulting controls ('acute respiratory tract infection' or a physical 'other illness') and one set of community controls. Predictor measures were consultations and prescriptions in the previous 5 years. There was no difference in overall consultation rates (P = 0.19), proportion consulting for a mental disorder (P = 0.39), frequency of consultation for a mental disorder (P = 0.46) or having a prescribed hypnotic or anxiolytic (P = 0.29) between the three consulting groups. However, the consulting groups had higher rates of consulting both overall and specifically for a mental disorder than the community controls. The association between increased vaginal bleeding and mental disorder or use of psychotropic medication appeared to be explained by consultation behaviour.

Childhood and Adolescent Sexual Abuse of Community Women: Mediated Effects on Psychological Distress and Social Relationships.

Possible mediators of sexual abuse severity were tested on the basis of D. Finkelhor and A. Browne's (1985) traumagenic dynamics model with 178 low-income African American, European American, and Mexican American community women interviewed for Project Health Outcomes of Women. This subsample reported contact sexual abuse before the age of 18 years. Severity was level of force, number of perpetrators, relationship to perpetrator, and age at first assault. As expected, structural equation modeling showed powerlessness, and stigmatization largely mediated the effects of sexual abuse severity on women's psychological distress in adulthood. Powerlessness also mediated the effects of severity on maladaptive social relationships. The expected path from betrayal to relationships was nonsignificant. Overall, the results support extension of D. Finkelhor and A. Browne's model. Possible interventions are addressed.

Is the 12-item General Health Questionnaire (GHQ-12) confounded by scoring method during pregnancy and following birth?

The GHQ-12 has been recommended as a reliable screening instrument for psychological distress in all clinical groups. The usefulness of the GHQ-12 was evaluated in pregnant women experiencing pre-labour rupture of membrane (PROM) at term. The GHQ-12 was administered to two groups of pregnant women presenting with term PROM over three observation points (baseline, at labour/prior to induction, 28 days post-delivery). The type of scoring method used had a significant impact on both interpretation of data and the relative prevalence of 'cases' in this study cohort. The use of the GHQ-12 as a screening instrument to determine psychological distress in women with PROM at term cannot be recommended due to confound of case determination by alternative scoring methods. A further study is required to determine the optimal threshold score for the GHQ-12 in this clinical population before the instrument can be seriously considered as a screening tool in pregnancy.

Do Attitude Toward Cancer, Sense of Coherence and Family High Risk Predict More Psychological Distress in Women Referred for a Breast Cancer Examination?

ABSTRACT Objective: The study focuses on the connection between attitude toward cancer, sense of coherence and family history of breast cancer, on the one hand, and psychological distress on the other among women who are referred for breast cancer examination following a medical examination prompted by a complaint of “feeling something in the breast.” Method: A sample of 314 women referred to a breast health clinic in northern Israel completed questionnaires that measured psychological distress (Brief Symptom Inventory), personal resources (the Sense of Coherence Scale), and mindset (Attitude to Cancer Treatment Scale). Results: A weak sense of coherence and a more negative attitude toward cancer (i.e., viewing victims of cancer with pity; viewing the illness as a death sentence; harboring a fear of death from cancer) predict a high level of psychological distress while awaiting an examination. A family history of breast cancer, or a first-time examination, were not found to be predictors of greater psychological distress. Conclusion: Learning cognitive behavioral coping skills, as well as access to information on cancer and treatment in order to change attitude toward cancer, are needed.

The impact of the Russian transition on psychosocial resources and psychological distress

AbstractStudies suggest that the difficult transition of the Russian economy has led to decreased physical health among Russians. However, the impact of economic turmoil on Russians' psychological health has not been examined. We used Hobfoll's (1988; 1998) Conservation of Resources (COR) theory to examine how economic losses deteriorate personal and social resources (e.g., mastery and social support), and how these deteriorated resources, in turn, impact psychological well being. Participants were Russian women working in the retail (n = 99) and medical (n = 99) fields, two poorly paid sectors. Structural equation modeling indicated that economic loss negatively impacted mastery, but not social support. Women with greater mastery and social support resources, in turn, reported less psychological distress. Economic loss had both direct and indirect effects, through mastery, on women's psychological distress. Results supported COR theory and point to the importance of building and sustaining personal and social resources in the face of major economic stress. © 2003 Wiley Periodicals, Inc.