Psychological Distress Outcomes Research Articles

The feasibility of a psychological first aid intervention as a supportive tactic for feelings of psychological distress and mental health recovery outcomes among earthquake survivors in Northern Syria.

This study aimed to investigate the feasibility of implementing a psychological first aid intervention for psychological distress, resilience capacity, quality and meaning of life among survivors affected by earthquake adversity in Northern Syria. A quasi-experimental, pre-posttest, two-group research design was utilized. A convenience sample of 95 survivors (46 in the study group and 49 in the control group) was recruited for the psychological First Aid intervention at a 1:1 ratio. The psychological first aid intervention was delivered in 10 sessions, twice weekly, followed by 3-month follow-up. A statistically significant improvement in the mean scores of resilience capacity, quality and meaning of life among survivors, along with a significant reduction in psychological distress, was registered among the study group compared with the control group. Our work verified the suitability of implementing psychological first aid following the catastrophic temblors which struck Northern Syria. Given that the psychological first aid intervention is grounded in psychological safety, cognitive reframing, mobilization of social support and installation of hope, the feasibility of its path following public health emergency, traumatic events or even a personal crisis can be favourable.

Effectiveness of mindfulness-based interventions on the well-being of healthcare workers: a systematic review and meta-analysis

BackgroundGrowing evidence attests to the efficacy of mindfulness-based interventions (MBIs), but their effectiveness for healthcare workers remains uncertain.AimsTo evaluate the evidence for MBIs in improving healthcare workers’ psychological well-being.MethodsA systematic...

Parents’ Psychological Distress During COVID-19: Correlates and Relations with Parents’ Engagement in Early Education

ABSTRACT The COVID-19 pandemic has caused a wide range of psychological problems among parents and posed significant challenges to their mental health. However, there is a lack of research exploring the antecedents and consequences of parents’ psychological distress during the pandemic. This study investigated the familial and individual antecedents and childrearing outcomes of psychological distress (depression, anxiety, worry, and loneliness) among 504 parents of preschool children in Zhengzhou, China. Research Findings: The results showed that both familial (family socioeconomic status, changes in family income during the pandemic, family physical health, and household chaos) and individual (resilience) factors were related to parents’ symptoms of psychological distress. Loneliness was negatively related to parents’ involvement in children’s education, and feelings of worry were positively associated with increases in the parents’ time spent engaging with children indoors (e.g. helping children with homework and disciplining children). Practice or Policy: The findings underscore the significance of identifying the risk factors of parents’ psychological distress during the pandemic. They also have important implications for the design of parent- and family-based interventions to alleviate the adverse effects of the pandemic on parents’ psychological distress and childrearing practices.

Mental health outcomes of family carers after admission to aged care: A cross-sectional survey study.

This study investigated the predictors of poor mental health outcomes among family carers of residents after transitioning into residential aged care. Using a cross-sectional design, five groups of variables were evaluated as predictors: caregiver demographics; caregiving load; resident-related variables; loneliness and visiting frequency; and the impact of the COVID-19 context. A total of 309 primary family contacts of all residents of two residential aged care organisations in the state of Victoria (Australia) participated in the study (response rate 19%). The K-10 and the Burden Scale for Family Caregivers were used to measure the primary outcomes. We compared psychological distress and burden outcomes between carers whose relative was admitted within the last 12 months, or longer than 12 months ago. Time since admission (<12 months or >12 months) did not affect the level of psychological distress (t (238) = -.08, p = .94) or subjective burden (t (245) = -.89, p = .38). Being a woman, a spouse, speaking a language other than English at home, being less satisfied with the support offered by the facility, not feeling supported in the decision to admit their relative, being lonely and providing higher levels of care preadmission were predictors of poor mental health outcomes. Older women with low-English proficiency who were primary carers and are socially isolated, are more likely to experience poor mental health outcomes and need additional support. These findings may inform the development of screening tools and tailored interventions to support this population during and after the transition process.

Divine struggles and whole person functioning: a 9-year longitudinal study of middle-aged U.S. adults

Objective This longitudinal study examined the associations of divine struggles with 25 psychological distress, psychological well-being, social well-being, prosociality, physical health, and health behavior outcomes assessed approximately nine years later. Methods We used three waves of data from the National Survey of Midlife Development in the United States (N = 4041): M1 (1995–1996), M2 (2004–2006), and M3 (2013–2014). Following the analytic template for outcome-wide longitudinal designs, our primary analysis employed a series of regression models to estimate the associations between a continuous measure of divine struggles assessed at M2 with each outcome assessed at M3. All models adjusted for a rich set of covariates, including prior values of all outcomes. Results There was modest evidence suggesting that divine struggles were associated with worse subsequent functioning on one or more outcomes for each domain except health behaviors (effect sizes were generally very small). Conclusions Divine struggles have the potential to degrade long-term functioning across multiple domains of life. Practitioners should attend to and address divine struggles in their clinical work.

Development and Validation of a Simple Tool for Predicting Pandemic-Related Psychological Distress Among Health Care Workers

AbstractWe aimed to develop a simple predictive model that enables health care workers (HCWs) to self-assess pandemic-related psychological distress in order to assist them to find psychological support to avert adverse distress-related outcomes. In a pilot study, we recruited and followed longitudinally 220 HCWs at the Hospital of the Ludwig Maximilian University Munich (H-LMU) during the first wave of the COVID-19 pandemic (March–July 2020). In this sample, we evaluated whether a machine-learning model with sociodemographic, epidemiological, and psychological data could predict levels of pandemic-related psychological distress. To maximise clinical utility, we derived a brief, 10-variable model to monitor distress risk and inform about the use of individualised preventive interventions. The validity of the model was assessed in a subsequent cross-sectional study cohort (May–August 2020) consisting of 7554 HCWs at the H-LMU who were assessed for depressiveness after the first wave of the pandemic.The model predicted psychological distress at 12 weeks with a balanced accuracy (BAC) of 75.0% (sensitivity, 73.2%; specificity, 76.8%) and an increase in prognostic certainty of 41%. In the derivation cohort, the brief model maintained a BAC of 75.6% and predicted depressiveness (P &lt; .001), resilience (p.001), and coping (p &lt; .001). Furthermore, it accurately stratified HCWs’ psychological trajectories of global and affective burden as well as behavioural adaptation over the 12-week follow-up period. Our clinically scalable, 10-variable model predicts individual COVID-19 pandemic-related psychological distress outcomes. HCWs may use our associated predictive tool to monitor personal and team-based risk and learn about risk preventive interventions based on an intuitive risk stratification.

Cognitive behavioural therapy including habit reversal training for treating dermatillomania in the context of anxiety and low mood

Abstract Dermatillomania is characterised by repetitive skin picking, resulting in tissue damage and significant distress and/or functional impairment. Cognitive behavioural therapy (CBT) is the recommended psychological intervention for dermatillomania in clinical guidelines, with the evidence base also supporting habit reversal training (HRT) as part of CBT. However, research evaluating CBT and HRT for dermatillomania remains scarce. This case study describes a young woman with dermatillomania, in the context of co-morbid anxiety and low mood, treated with 20 sessions of CBT including HRT in a community setting. Guided by her formulation, additional techniques such as those fostering self-compassion were also integrated, and sociocultural factors were adapted for. Improvements were reported in client-centred goals and outcomes of global psychological distress, functioning, anxiety and symptoms and psychosocial impacts of skin picking. The intervention was well received by the client. Limitations as well as clinical practice implications and research recommendations for dermatillomania are discussed. Key learning aims (1) To understand using CBT, including HRT, to treat a case of dermatillomania in the context of anxiety and depression. (2) To use a formulation-driven approach to guide the intervention. (3) To consider adapting interventions for sociocultural factors.

Psychological Distress and Treatment Outcome in Patients With Early-Stage Mycosis Fungoides.

Skin diseases have been shown to worsen psychological distress, which, in turn, may be detrimental to treatment outcomes. Both the impact of psychological distress on response to treatment in mycosis fungoides (MF) and the effect of treatments on psychological well-being are unclear. To evaluate (1) the association between pretreatment psychological morbidity and treatment outcome in early-stage MF and (2) the impact of response to treatment on psychological well-being. This was a prospective cohort study of patients with early-stage MF who started a new stage-directed treatment for their disease. The response was determined using the modified severity-weighted assessment tool, and psychological distress was assessed using the 12-item General Health Questionnaire (GHQ-12) and Penn State Worry Questionnaire (PSWQ). Participants were followed for 1 year. In all, 24 consecutive patients were recruited. Objective response rate was 71% (17/24), consistent with existing literature. Prior to treatment, 9 patients (38%) had clinically significant psychological distress on the GHQ-12, while 8 (33%) demonstrated high-level worry on the PSWQ. Of these patients, 6 had pathologic scores on both instruments. Patients with significantly less baseline anxiety/depression on the GHQ-12 responded better to treatment than patients with higher levels (P = .004). In addition, responders' mean GHQ-12 scores decreased by 39% and their PSWQ scores by 17%, whereas nonresponders' GHQ-12 scores increased by 93% (P = .042) and their PSWQ scores by 11% (P = .019). These findings suggest that (1) baseline psychological distress is associated with worse outcomes in patients with early-stage MF and that (2) effective treatment improves psychological morbidity.

Investigating the linkages between food insecurity, psychological distress, and poor sleep outcomes among U.S. college students.

Research overwhelmingly demonstrates that sleep is key to human health and wellbeing. Several factors likely contribute to sleep quality, including factors, such as food security and low income. In addition, exposure to structural inequalities early in life likely have downstream effects upon multiple dimensions of health. The objective of this study is to fill gaps in literature by specifically examining the associations between childhood food insecurity, current food insecurity, psychological distress, and sleep among college students. QR codes were randomly distributed to students, linking them to an online quantitative survey. The survey measured sociodemographic variables, food security (current and childhood), diet, mental distress, and sleep quality. A total of n = 134 completed the entire survey. Data were analyzed using binary and multiple linear regressions, as well as cross-tabulations. The findings revealed that psychological distress was the primary factor influencing sleep health (𝛽 = 1.51, p < .01). Students reporting higher childhood food insecurity were more likely to experience extreme psychological distress (OR = 4.61), food insecurity in college (OR = 8.41), and lack of stable housing (OR = 5.86). This study demonstrates that potential linkages exist between childhood food insecurity, poor sleep, and greater psychological distress. While acknowledging the contribution of other factors, the study highlights the importance of addressing food insecurity in relation to sleep health, considering the significant impact of sleep to overall health and wellbeing.

Central Sensitization: The Missing Link Between Psychological Distress and Poor Outcome Following Primary Total Knee Arthroplasty

BackgroundWhile preoperative psychological distress is known to predict risk for worse total knee arthroplasty (TKA) outcomes, distress may be too broad and nonspecific a predictor in isolation. We tested whether there are distinct preoperative TKA patient types based jointly on psychological status and measures of altered pain processing that predict adverse clinical outcomes. MethodsIn 112 TKA patients, we preoperatively assessed psychological status (depression, anxiety, and catastrophizing) and altered pain processing via a simple quantitative sensory testing protocol capturing peripheral and central pain sensitization. Outcomes (pain, function, opioid use) were prospectively evaluated at 6 weeks and 6 months after TKA. Cluster analyses were used to empirically identify TKA patient subgroups. ResultsThere were 3 distinct preoperative TKA patient subgroups identified from the cluster analysis. A low-risk (LR) group was characterized by low psychological distress and low peripheral and central sensitization. In addition, 2 subgroups with similarly elevated preoperative psychological distress were identified, differing by pain processing alterations observed: high-risk centralized pain and high-risk peripheral pain. Relative to LR patients, high-risk centralized pain patients displayed significantly worse function and greater opioid use at 6 months after TKA (P values <.05). The LR and high-risk peripheral pain patient subgroups had similar 6-month outcomes (P values >.05). ConclusionsAmong patients who have psychological comorbidity, only patients who have central sensitization were at elevated risk for poor functional outcomes and increased opioid use. Central sensitization may be the missing link between psychological comorbidity and poor TKA clinical outcomes. Preoperative testing for central sensitization may have clinical utility for improving risk stratification in TKA patients who have psychosocial risk factors.

Helping and Volunteering During COVID-19: Associations With Well-Being and Psychological Distress

IntroductionSalutogenic effects of volunteering and helping activities have been well recognized in the pre-COVID-19 era. This study examines associations between helping others as well as additional volunteer activities during the first wave of the COVID-19 pandemic and six psychological distress and well-being outcomes one year later. MethodsLongitudinal data collected between 2019 and 2021 were used. Analyses were based on data from 42,005 middle-aged and older adults from 27 European countries who participated in the Survey of Health, Ageing, and Retirement in Europe (SHARE) and two SHARE Corona Surveys. Prospective associations were examined using generalized estimating equations. A series of secondary analyses and the sensitivity of the associations to unmeasured confounding provided evidence for the robustness of results. All analyses were conducted in December 2022. ResultsHelping others outside one's home in the first wave of COVID-19 was associated with subsequent increased risks of depression and anxiety. It was concurrently associated with an increased probability of an uplifting, hope, and happiness-inducing experience. Engagement in volunteer activities conducted in addition to helping was found to be prospectively associated with higher probability of an uplifting experience, but not with depression and anxiety. These associations were independent of demographic and socio-economic characteristics, personality traits, prior quality of life and health history as well as pre-COVID-19 engagement in altruistic activities. ConclusionsHelping and volunteering during the COVID-19 pandemic likely led to positive experiences. However, a negative impact on psychological distress of the same activities was also noted.

Emotional behavioral outcomes of children with unilateral and mild hearing loss.

Deaf and hard-of hearing (DHH) children often experience emotional/behavioral difficulties. The impact of unilateral/mild hearing loss (HL) on children's emotion and behavior are unclear. We aimed to describe emotional/behavioral, health related quality-of-life (HRQoL) and parent psychological distress outcomes of school-age children with unilateral/mild HL, compared to children with moderate to profound HL, and in relation to population norms; and identify predictive factors of emotional/behavioral difficulties. Data of 339 DHH children, 5-12 years, enrolled in the Victorian Childhood Hearing Longitudinal Databank (VicCHILD), which include demographics, early development, medical/audiological characteristics and parent rated questionnaires of emotion/behavior, HRQoL and parental psychological distress collected at various stages of child's life were analyzed. We used Cohen's d to investigate the outcomes by measuring the mean score differences of both groups with published norms and logistic regression to analyze the factors predictive of emotional/behavioral difficulties. The proportion of children with unilateral/mild HL and moderate to profound HL who experienced emotional/behavioral difficulties was similar (18.3% vs. 20.6%), with hyperactivity and poor prosocial behavior reported as the predominant symptoms in both groups. Mean emotional/behavioral scores of both groups were comparable and substantially higher than normative population scores. This was also the case for HRQoL and levels of parent distress. Among children with unilateral/mild HL, additional health needs were the strongest predictive factor, demonstrating an approximately 1.7-fold increase in odds of emotional/behavioral difficulties (OR = 1.67; 95% CI 1.29-2.17, p < 0.001) with every additional health need. Early developmental concerns, other than communication milestone and attending mainstream schoolshowed weaker evidence of association. Children with unilateral/mild HL were just as likely as those with moderate to profound HL to experience more emotional/behavioral difficulties, poorer HRQoL and higher parental distress scores compared to population norms. Our findings justify the provision of early intervention, support and medical services for all DHH children to identify those at risk of poorer outcomes.

Intersectional microaggressions, mental health outcomes, and the role of social support among Black LGB adults.

The present study explored the relationship between intersectional microaggressions (racism and heterosexism) and psychological distress outcomes among a sample of 370 Black lesbian, gay, and bisexual (LGB) adults. Additionally, social support from family, friends, and significant others was examined as potential moderators. Results showed that intersectional microaggressions were associated with greater depression, anxiety, and stress. Also, a significant moderating effect for family social support was found, suggesting that Black LGB adults with higher family social support reported greater levels of depression and stress as their microaggression experiences increased compared to those with less family social support. These results highlight the deleterious effects of intersectional microaggressions on the health of Black LGB adults and important clinical considerations pertaining to the role of social support. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The Effectiveness of a Yoga Program on Psychological and Cardiovascular Outcomes of Undergraduate Nursing Students.

Psychological problems among nursing students are well documented. Unfortunately, only a minority of these populations seek help related to their psychological distress. Yoga exercises improve individuals' psychological distress and cardiovascular outcomes. Therefore, we conducted this study to test the feasibility and preliminary efficacy of our health promotion theme-based yoga program to reduce the participants' stress levels and anxiety symptoms and improve their blood pressure and heart rate. This study has a pre/posttest quasi-experimental design. A convenience sampling method was used to recruit the participants who were 18 years or older and could speak and read English. Individuals with any contraindication to participate in yoga or receiving any medications for their mental health or cardiovascular health were excluded from the study. The Perceived Stress Scale and the Depression Anxiety Stress Scale-21 were used to measure the participants' stress levels and anxiety symptoms, respectively. Their blood pressure and heart rate were measured by using a standard blood pressure measuring machine. Participants received 50 minutes of weekly yoga sessions in groups and also performed individual yoga sessions 3 times a week for 8 weeks. Descriptive statistics were used to answer our research questions. Our recruitment rate of 47% (n = 19) was lower than our anticipated rate of 80%; however, we had a retention rate of 90%. There was a reduction in participants' stress levels and anxiety symptoms from the preintervention phase to the postintervention phase. A larger study and a randomized controlled trial are warranted to draw conclusions.

Associations Between Psychological Stress and Hand Pain Among Rural and Urban Adults: Findings From the KoGES Community Cohort Study

Despite known health disparities in chronic pain conditions between rural and urban adults, few studies have examined whether longitudinal associations between psychological stress and hand pain differ. Utilizing community-based cohort data, this study examined whether rural and urban adults differed in the extent to which psychological distress was associated with hand osteoarthritis (OA) symptoms and later functional limitations related to hand pain. Community-dwelling adults (mean age = 51.97, 52.3% women) in a rural (n = 2,971) and urban area (n = 2,782) provided demographic data at baseline and, at a 4-year follow-up, responded to questionnaires about psychological distress and clinical symptoms of hand OA. Levels of functional limitations in hands were assessed at an 8-year follow-up. Ordinal logistic and linear regression were conducted to examine the effects of psychological distress on hand OA symptoms and functional limitations, and whether associations between psychological distress and these pain outcomes were moderated by residential area. The results showed that psychological distress was associated with a higher risk for hand OA symptoms and functional limitations, even after adjusting for demographic and health covariates. There was significant moderation by residential area, such that the association between psychological distress and hand OA was significant only among rural adults and the association with functional limitations was stronger in rural adults than urban adults. Findings suggest greater vulnerability to hand arthritis and hand-related functional limitations among rural adults and the potential for tailored intervention programs to help resolve health disparities among rural communities. PerspectiveThis study compares the association between psychological distress and hand pain outcomes between rural and urban adults using community-based cohort data and suggests that rural adults are more vulnerable to experiencing negative effects of psychological distress on concurrent hand OA symptoms and longitudinal functional limitations in hands.

A Narrative Thematic Analysis of the perceived psychological distress and health outcomes in Indian adults during the early phase of the COVID-19 pandemic

COVID-19 represents a severe, novel, and harmful disease that posed worldwide new challenges to the well-being of people and culminated in negative life outcomes. The current study explored the perceived psychological distress and consequent health outcomes caused by COVID-19. The Narrative Thematic Analysis design was employed. Eighteen participants comprising 12 males and 6 females responded about their experiences of the recent outbreak of COVID-19. The data were collected through a telephonic semi-structured interview which was analyzed through the Thematic Analysis Method. Four themes were generated: maladaptive psychological outcomes of COVID-19, perceived poor social support, increased religious practices, and the development of physical health symptoms. Extreme anxiety, panic experiences, insecurity, helplessness, hyper-vigilance, and negative attributions represented the psychological distress, while decreased social interactions and imposed social distancing characterized the perceived social support. Increased reliance on myths, divine interpretations, and faith in God showed religious practices. Decreased hunger, insomnia, headache, breathing problems, and palpitation were some ill-health outcomes. The pandemic shaped the nature and extent of perceived psychological distress, social support, and religious practices. The first two may have caused negative health and well-being outcomes while the religious practicesmaintained equilibrium among the rest three. Immediate trans-disciplinary efforts for the effective prevention, treatment, and promotion of the affected people are recommended. Positive health practices embedded in different socio-cultural systems may also be explored to help people facing the negative consequences of the recent and future pandemics. The implications and limitations of the study have been discussed.

Sixteen years of innovation in youth mental healthcare: Outcomes for young people attending Australia's headspace centre services.

Australia's headspace initiative is world-leading in nation-wide youth mental healthcare reform for young people aged 12 to 25 years, now with 16 years of implementation. This paper examines changes in the key outcomes of psychological distress, psychosocial functioning, and quality of life for young people accessing headspace centres across Australia for mental health problems. Routinely collected data from headspace clients commencing an episode of care within the data collection period, 1 April 2019 to 30 March 2020, and at 90-day follow-up were analysed. Participants came from the 108 fully-established headspace centres across Australia, and comprised 58,233 young people aged 12-25 years first accessing headspace centres for mental health problems during the data collection period. Main outcome measures were self-reported psychological distress and quality of life, and clinician-reported social and occupational functioning. Most headspace mental health clients presented with depression and anxiety issues (75.21%). There were 35.27% with a diagnosis: overall, 21.74% diagnosed with anxiety, 18.51% with depression, and 8.60% were sub-syndromal. Younger males were more likely to present for anger issues. Cognitive behavioural therapy was the most common treatment. There were significant improvements in all outcome scores over time (P<0.001). From presentation to last service rating, over one-third had significant improvements in psychological distress and a similar proportion in psychosocial functioning; just under half improved in self-reported quality of life. Significant improvement on any of the three outcomes was shown for 70.96% of headspace mental health clients. After 16 years of headspace implementation, positive outcomes are being achieved, particularly when multi-dimensional outcomes are considered. A suite of outcomes that capture meaningful change for young people's quality of life, distress and functioning, is critical for early intervention, primary care settings with diverse client presentations, such as the headspace youth mental healthcare initiative.

Ethnic identity and resilience: a moderated mediation analysis of protective factors for self-blame and racial microaggressions.

People of Color (PoC) in the United States encounter everyday racial microaggressions, and these commonplace experiences can wear and exhaust PoC's resources. Racial microaggressions have shown detrimental effects on physical and psychological well-being. Consequently, researchers have examined and tested different ways in which PoC cope and protect themselves from these everyday exchanges. Past findings have indicated that PoC might blame themselves for racism-related occurrences to cope with these commonplace discriminatory experiences. Ethnic identity and resilience have emerged in research as protective factors that can moderate and buffer the impact of racism on PoC's well-being. We used a combination of mediation, moderation, and conditional analyses to unpack the relationships between racial microaggression (predictor), psychological distress (outcome), self-blame (mediator), resilience (moderator), and ethnic identity (moderator). This study used a cross-sectional design and sampled 696 PoC regarding their experiences and responses to racial microaggressions. We tested the association between psychological distress and racial microaggressions and further examined whether self-blame mediated the relationship. We also tested ethnic identity and resilience as moderators and used a conditional analysis to determine whether these protective factors moderated the mediation model. Findings from the mediation, moderation, and conditional analyses supported our four hypotheses: (H1) self-blame mediated the relation between racial microaggressions and psychological distress (mediation), (H2) ethnic identity moderated the association between racial microaggressions and self-blame but only at low and average levels (moderation), (H3) resilience moderated the relation between self-blame and psychological distress but only at low and average levels (moderation), and (H4) evidence of moderated mediation were found for all five variables (conditional). While statistically significant, most moderation effects were minimal to small. PoC may engage in self-blame when experiencing racial microaggressions, which explains why these everyday, commonplace occurrences might lead to psychological distress. There was evidence that ethnic identity and resilience can protect PoC from the negative effects of racial microaggressions. These buffering effects, however, only emerged for PoC endorsing high levels of ethnic identity and resilience, and it should be noted that for most participants, the link between racial microaggressions and psychological distress was still significant. Future studies might need to explore additional individual and interpersonal alongside institutional factors that can protect PoC from racism-related harms.

Feasibility of delivering a virtual 1-day acceptance and commitment therapy workshop to rural veterans through community partnerships

BackgroundThis single-arm, open pilot study examined the feasibility and initial efficacy of a 1-day virtual Acceptance and Commitment Therapy (ACT) group workshop for distressed veterans. MethodsWe collaborated with veteran-serving community-based organizations to enhance outreach to veterans, especially those in rural areas. Veterans completed a baseline assessment and two follow-up assessments (1 month, 3 months) after workshop participation. Feasibility outcomes included reach (workshop recruitment and completion rates; veteran characteristics) and acceptability (open-ended survey question about satisfaction). Clinical outcomes included psychological distress (Outcome Questionnaire-45), stressor-related distress (PTSD Checklist-5), community reintegration (Military to Civilian Questionnaire), and meaning and purpose (PROMIS Short Form). Psychological flexibility (Action and Acceptance Questionnaire-II) – the proposed change mechanism underlying ACT – was also measured. ResultsSixty-four veterans (50% rural, 39% self-identified as female) participated in a virtual workshop (97.1% completion rate). Overall, veterans liked the format and interactive nature of workshops. Convenience was noted as a benefit, while connectivity issues were highlighted as a drawback. Veterans showed improvements in psychological distress (F(2,109) = 3.30; p = 0.041), stressor-related distress (F(2,110) = 9.50; p = 0.0002), community reintegration (F(2,108) = 4.34; p = 0.015), and meaning and purpose (F(2,100) = 4.06; p = 0.020) over time. No between-group differences were detected, based on rurality or gender. ConclusionPilot findings were promising and warrant a larger randomized trial to assess the efficacy of the 1-day virtual ACT workshop. Integrating community-engaged and participatory-research designs can enhance the external validity of these future studies and promote greater health equity.

Predictors of individual mental health and psychological resilience after Australia's 2019-2020 bushfires.

We assessed the mental health effects of Australia's 2019-2020 bushfires 12-18 months later, predicting psychological distress and positive psychological outcomes from bushfire exposure and a range of demographic variables, and seeking insights to enhance disaster preparedness and resilience planning for different profiles of people. We surveyed 3083 bushfire-affected and non-affected Australian residents about their experiences of bushfire, COVID-19, psychological distress (depression, anxiety, stress, post-traumatic stress disorder) and positive psychological outcomes (resilient coping, wellbeing). We found high rates of distress across all participants, exacerbated by severity of bushfire exposure. For people who were bushfire-affected, being older, having less financial stress, and having no or fewer pre-existing mental disorders predicted both lower distress and higher positive outcomes. Being male or having less income loss also predicted positive outcomes. Severity of exposure, higher education and higher COVID-19-related stressors predicted both higher distress and higher positive outcomes. Pre-existing physical health diagnosis and previous bushfire experience did not significantly predict distress or positive outcomes. To promote disaster resilience, we recommend investment in mental health, particularly for younger adults and for those in rural and remote areas. We also recommend investment in mechanisms to protect against financial distress and the development of a broader definition of bushfire-related impacts than is currently used to capture brushfires' far-reaching effects.