Risk Factors For Psychological Distress Research Articles

Lack of marital support and poor psychological responses in male cancer patients.

A total of 272 men and 252 women with cancer participated in a study of the impact of being married and the presence of spousal support on psychological distress and coping with cancer. All participants underwent a structured interview and completed the Profile of Mood States and the Mental Adjustment to Cancer scale. Multivariate analysis controlling for potentially confounding biomedical and psychosocial variables revealed that unmarried men had significantly higher levels of psychological distress and lower levels of fighting spirit than married men, and that men with spousal support showed higher levels of fighting spirit than men without spousal support. However, no such difference was observed between unmarried and married women or between women with and without spousal support. These findings suggest that being married may play an important role in reducing psychological distress and enhancing fighting spirit of men with cancer, and that being unmarried may be a risk factor for psychological distress and lower fighting spirit for men with cancer.

Routine occupational stress and psychological distress in police

The relationship between routine work stress and psychological distress was investigated among 733 police officers in three US cities, during 1998‐1999. The Work Environment Inventory (WEI) was developed to assess exposure to routine work stressors, while excluding duty‐related traumatic stressors (critical incidents). The WEI and its general properties are presented. The relationship between routine work stress exposure and psychological distress is then explored. Exposure to routine work stressors predicted general psychological distress (r = 0.46), as well as post‐traumatic stress symptoms following officers’ most traumatic career incident (rs = 0.26 to 0.39). Multivariate analyses found that these effects were independent of, and larger than, the effects of cumulative critical incident exposure. (Time since the most traumatic event, social support, and social desirability effects were also controlled statistically.) Routine occupational stress exposure appears to be a significant risk factor for psychological distress among police officers, and a surprisingly strong predictor of post‐traumatic stress symptoms.

Gender differences in psychosocial risk factors for psychological distress among immigrants.

The reasons for a greater prevalence of psychological distress among women than men remain unknown. We sought to test two hypotheses that gender operates either as (1) a moderator or (2) a mediator between psychosocial risk factors and experienced distress. A cross-sectional community survey of 1,062 adult Russian-born Jewish immigrants to Israel was conducted. The Demographic Psychosocial Inventory (DPSI) and the Talbieh Brief Distress Inventory (TBDI) were used to measure the parameters of interest. Univariate and multivariate analyses were used to test the moderation versus mediational hypotheses of gender in the stress-distress relationship. The aggregate levels of psychological distress and depression, anxiety, and obsessive symptoms were significantly higher for women than for men. Five sources of distress were more likely to be reported by women: family problems, inappropriate climatic conditions, anxiety about the future, poor health status, and uncertainty in the present life situation. Men scored higher on three stress-protective factors: the number of reasons for immigration, commitment to the host country, and job adequacy. Results of multiple regression and multivariate analysis of variance (MANOVA) supported the mediation hypothesis that gender differences in psychological distress stem from women's greater exposure to specific psychosocial stressors. Our findings demonstrate the validity of gender as an important mediating mechanism underlying the differential perception of risk factors for the development of psychological distress.

Generational differences in psychosocial adaptation and predictors of psychological distress in a population of recent Vietnamese immigrants.

While first-wave Vietnamese immigrants adapted well to life in the United States, subsequent immigrants have had greater adjustment difficulties, including more evidence of psychological distress. This study aimed to analyze psychosocial adaptation differences among three generations of recent Vietnamese immigrants, as well as to examine predictors of mental distress in the sample as a whole. A community sample of 184 recent Vietnamese immigrants, categorized as either elderly, middle-aged, or young adults, was assessed for levels of psychological distress, including depression, anxiety, and PTSD, as well as family conflict, dissatisfaction with life in the U.S., acculturation and biculturalism, social support, coping, and premigratory stressors. Young Vietnamese adults were most acculturated, most bicultural, and reported themselves as healthiest and least depressed. They were most often working, least often on welfare, and had the highest family income. However, they also reported most dissatisfaction with their current lives in the U.S. and most family conflict. Regression analysis explaining approximately one-quarter of the variance in mental distress implicated current dissatisfaction with and lack of adjustment of life in the United States, as well as greater acculturation and increased family conflict. Although young adults scored significantly higher than other generations on most of the risk factors for psychological distress, they appeared to be buffered against poorer mental health outcomes by factors of generation and perceived positive overall well-being. In terms of testing a predictive model of psychological distress, this study found current adjustment factors significantly more important in determining mental health outcomes than premigratory stressors such as war-related traumas.

Types of social support as predictors of psychiatric morbidity in a cohort of British Civil Servants (Whitehall II Study).

Few studies have examined prospectively both the direct and buffering effects of types of social support and social networks on mental health. This paper reports longitudinal associations between types of social support and psychiatric morbidity from the Whitehall II study. Social support was measured by the Close Persons Questionnaire and psychiatric morbidity by the General Health Questionnaire at baseline (1985-1988) and at first follow-up (1989) in 7697 male and female London-based civil servants aged 35-55 years at baseline. The cohort was followed up and baseline measures were used to predict psychiatric disorder measured by the General Health Questionnaire at second follow-up (1991-1993). Longitudinal analyses showed that low confiding/emotional support in men and high negative aspects of close relationships in men and women were associated with greater risk of psychiatric morbidity even after adjustment for baseline General Health Questionnaire score. There was no evidence of a buffering effect among men or women who experienced life events or chronic stressors. Controlling for a personality measure of hostility did not affect the observed relations. The present findings illustrate that different types of support are risk factors for psychological distress and that they operate in different ways for men and women. Direct effects of emotional support are predictive of good mental health in men and negative aspects of close relations predict poor mental health in both men and women. Emotional support is predictive of good mental health in women whereas, confiding alone is not.

Replication and extension of a risk profile for Amerasian youth

AbstractThe relationship between number of risk factors and symptoms of anxiety and depression was examined in a cohort of Vietnamese Amerasians, replicating a study done with a previous cohort. One hundred forty seven subjects awaiting U.S. placement completed the Hopkins Symptom Checklist, the Vietnamese Depression Scale, and a questionnaire which included items found to be risk factors for psychological distress among Amerasians. Number of risk factors was linearly related to symptoms of both depression and anxiety. Results are consistent with previous findings of the relationship between risk factors and symptoms of psychological distress. The profile may be helpful in anticipating which refugees may be at risk for future psychological distress, and thus be useful in preventively allocating scarce treatment resources.

Replication and extension of a risk profile for Amerasian youth.

The relationship between number of risk factors and symptoms of anxiety and depression was examined in a cohort of Vietnamese Amerasians, replicating a study done with a previous cohort. One hundred forty seven subjects awaiting U.S. placement completed the Hopkins Symptom Checklist, the Vietnamese Depression Scale, and a questionnaire which included items found to be risk factors for psychological distress among Amerasians. Number of risk factors was linearly related to symptoms of both depression and anxiety. Results are consistent with previous findings of the relationship between risk factors and symptoms of psychological distress. The profile may be helpful in anticipating which refugees may be at risk for future psychological distress, and thus be useful in preventively allocating scarce treatment resources.

Predictors of psychological adjustment to genetic testing for Huntington's disease.

In the present study the authors assessed predictors of adjustment to genetic testing for Huntington's disease. Fifty-two genetically positive and 108 genetically negative persons were studied for 1 year following testing. Adjustment, defined by hopelessness and depressive symptoms, was measured at 3, 6, 9, and 12 months after disclosure and was within normal limits for both groups. Those less well adjusted had tested positive, were married, had no children, or were closer to their estimated ages of onset. The study delineated risk factors for psychological distress that should be considered by people contemplating testing for Huntington's disease.

The influence of exile and repatriation on mental and physical health. A population-based study.

This study tested the association between psychosocial stressors extracted from a previous qualitative study, and psychological distress, long-term illness and self-rated ill-health among Latin American refugees in Lund, Sweden, and among repatriated Latin Americans. The study was designed as a population-based cross-sectional study. A structured questionnaire from the Swedish Annual Level-of-Living Surveys 1989: 2 was translated into Spanish. Latin American refugees in Lund (n = 338) and those who had lived in Lund and were repatriated to Santiago de Chile (n = 51) and Montevideo, Uruguay (n = 9), were interviewed in their homes in Sweden and in Latin America. The data were analysed unmatched with logistic regression in main effect models. Torture was an independent risk indicator for psychological distress, with an estimated odds ratio of 2.71 (1.45-4.85). There was a significant association between discrimination, not feeling secure in everyday life and psychological distress, with estimated odds ratios of 1.93 (1.02-3.56) and 3.23 (1.62-6.16), respectively. Torture and not feeling secure in everyday life were independent risk factors for long-term illness. Torture, discrimination and not feeling secure in everyday life were significant strong risk factors for ill-health. Repatriated refugees had significantly higher shares of not feeling secure compared with Latin Americans in Sweden. As risk factors of psychological distress and illness, torture, discrimination and not feeling secure proved to be as important as traditional risk factors such as material factors and lifestyle.

Unaccompanied status as a risk factor in Vietnamese Amerasians.

This study prospectively evaluates the relationship between unaccompanied status and levels of psychological distress in a group of Vietnamese Amerasians both prior to, and during, migration. Its objective was to determine whether unaccompanied migrant status functions as an independent post-departure risk factor for psychological distress, or if unaccompanied migrants are already at increased risk for, and have higher levels of, psychological distress prior to departure and the acquisition of unaccompanied status. Seventy-five Vietnamese Amerasian youth were evaluated at two points during their migration utilizing Felsman's Personal Information Form, the Hopkins Symptom Checklist-25, and the Youth Self-Report. The first assessment was conducted prior to migration at the Amerasian Transit Center in Vietnam, and the second during migration at the Philippine Refugee Processing Center. Unaccompanied Amerasians were found to have significantly higher risk levels for, and significantly more symptoms of, psychological distress prior to migration than accompanied Amerasians. During migration the difference in levels of psychological distress between accompanied and unaccompanied Amerasians increased beyond that attributable to predeparture risk levels alone. This significant differential increase in levels of psychological distress among unaccompanied Amerasians is attributable to unaccompanied status. Unaccompanied migrant status thus appears to function both as an independent postdeparture risk factor for psychological distress and also as a marker for increased levels of risk and psychological distress prior to migration.

Past Personal History of Dysphoria, Social Support, and Psychological Distress Following Conjugal Bereavement

This study describe the course and risk factors of psychological distress following bereavement, controlling for factors often omitted from studies of grief: psychiatric history, social support, and coping choices of the bereaved. Spouses of patients hospitalized for serious illness or elective surgery were systematically screened and followed longitudinally through the recovery or death of the hospitalized patient. Of 440 respondents, 154 were bereaved within 2 months. Spouses were interviewed in their homes by trained interviewers at intake and 2, 6, 13, and 25 months postintake. Dependent variables were measured with the CES-D (depressive symptoms) and the PERI (general anxiety and hopelessness/helplessness) scales. Independent variables were measured with the SADS-L (past personal history of dysphoria) and the Lazarus' Ways of Coping scale as well as sociodemographic measures. Lifetime prevalence of a brief period of dysphoric mood among spouses before the patient's illness was 22%; past personal history of dysphoric mood was related to female sex, smaller networks, and more depression and anxiety during the hospitalization of their spouses. Newly widowed persons with a past history of dysphoria perceived their networks to be relatively nonsupportive, but devoted similar amounts of coping effort to seeking social support and reported similar amounts of social interaction compared with persons with no history of dysphoria. Persons with a past history of dysphoria reported elevated levels of depressive symptoms, general anxiety, and hopelessness/helplessness through 25 months postbereavement, yet their recovery trajectory was similar to those without a past history of dysphoria. It was concluded that a past history of subsyndromal symptomatology in conjunction with a stressful life event such as bereavement increases one's vulnerability to excess psychological distress.

Refugees, labour migrants and psychological distress

This paper shows the strength and influence of ethnicity on mental health in comparison with material factors and lifestyle, which are well-known risk factors for psychological distress. The focus was on health differences between Latin-American refugees and labour migrants from Finland and the south of Europe. The study was designed as a population-based cross-sectional study, with 338 Latin-American refugees aged 16-74 years (response rate = 81.8%) in Lund, a random sample of 396 Finnish and 161 South European labour migrants, and 996 age-, sex- and education-matched Swedish controls from the Swedish Annual Level-of-living Surveys. The data were analysed unmatched with logistic regression in main effect models. The strongest independent risk indicator for self-reported psychological distress was being a non-European refugee, i.e. a Latin-American refugee, with an estimated odds ratio of 4.39 (2.49-7.31). There was a non-significant association in logistic regression between South European labour migrants and psychological distress, but a crude odds ratio of 2.29 (1.09-4.81). There was no association between Finnish labour migrants and psychological distress. Not feeling secure in daily life was a strong risk indicator for psychological distress, with an estimated odds ratio of 3.29 (1.90-5.45).

Premigratory risk factors in Vietnamese Amerasians.

The study's goal was to determine the ability of risk factors determined before migration to predict future levels of anxiety and depression in a group of Vietnamese Amerasian immigrants. In a cohort of 161 randomly selected Vietnamese Amerasian youth in Vietnam awaiting placement, risk factors for psychological distress were identified with Felsman's 35-item Personal Information Form and the Hopkins Symptom Checklist-25 (HSCL-25). Ninety-five members of the original cohort were subsequently reevaluated, again with the HSCL-25, at a Philippine refugee center during their 6-month stay there awaiting placement in the United States. A statistically significant relationship was found between greater numbers of risk factors identified in Vietnam and higher total symptom levels in the Philippines. The strongest relationship was between greater numbers of risk factors and higher levels of depression. The relationship between number of risk factors and levels of anxiety was not significant. This study demonstrates the ability of risk factors determined prior to departure in Vietnam to predict future levels of psychological distress in a group of Vietnamese Amerasian immigrants.