Risk Of Psychological Distress Research Articles

A Qualitative Description of HIV-Infected African American Women's Experiences of Psychological Distress and Their Coping Strategies

HIV-infected individuals are at risk for psychological distress, including depression, sadness, and suicidality. The purpose of this qualitative descriptive study was to examine 22 HIV-infected African American women's experiences of psychological distress and use of coping strategies. Data were collected through in-person one-on-one interviews until conceptual saturation was reached. Data were analyzed using inductive content analysis. Four themes were found: (a) psychoemotional suffering, (b) contextual factors negatively influence the everydayness of living with HIV infection, (c) HIV-related stigma perpetuates isolation and loneliness, and (d) creating a safe haven. Implications for nurses and other health care providers include (a) holistic assessment to include evaluation of emotional and mental state, and (b) coping strategies. Integration of spiritual practices into plan of care is also important. Development and evaluation of individualized coping interventions that address stigma and psychological distress through holistic modalities is warranted.

What types of social interactions reduce the risk of psychological distress? Fixed effects longitudinal analysis of a cohort of 30,271 middle-to-older aged Australians

BackgroundResearch on the impact of social interactions on psychological distress tends to be limited to particular forms of support, cross-sectional designs and by the spectre of omitted variables bias. MethodA baseline sample with 3.4±0.95 years follow-up time was extracted from the 45 and Up Study. Change in the risk of psychological distress (Kessler Psychological Distress Scale) was assessed using fixed effects logistic regressions in relation to the number of times in the past week a participant: i) spent time with friends or family they did not live with; ii) talked to friends, relatives or others on the telephone; iii) attended meetings at social clubs or religious groups; and the count of people outside their home, but within one hour travel-time, participants felt close to. Separate models were fitted for men and women, adjusting for age, income, economic and couple status. ResultsAn increase in the number of social interactions was associated with a reduction in the risk of psychological distress, with some gender differences. Interactions with friends or family were important for women (adjusted OR 0.85, 95%CI 0.74, 0.98, p=0.024), whereas telephone calls were effective among men (adjusted OR 0.83, 95%CI 0.72, 0.96, p=0.011). Strong effects for the number of people that can be relied on were observed for men and women, but attendance at clubs and groups was not. No age-specific effects were observed. LimitationsNo indicator of positive mental health. ConclusionsPolicies targeting greater social interactions in middle-to-older age may help protect mental health.

Three-year trend survey of psychological distress, post-traumatic stress, and problem drinking among residents in the evacuation zone after the Fukushima Daiichi Nuclear Power Plant accident [The Fukushima Health Management Survey

Prolonged periods of instability in terms of living environment can lead to a serious increase in mental health issues among disaster-affected individuals. The aim of this study was to assess long-term trends in mental health among adult residents in a nuclear-disaster-affected area. Mail-based, self-administered questionnaire surveys were conducted three times (T1-T3), targeting all residents registered with the municipalities in the evacuation zone in Fukushima prefecture at the time of the disaster. Age-adjusted prevalences of the following were analyzed by sex: risk of psychological distress by the Kessler 6-item Scale, post-traumatic stress by the Post-traumatic Stress Disorder Checklist, and problem drinking by CAGE. The numbers of respondents and response rates were: 73 568, 40.7% (T1); 55 076, 29.9% (T2); and 46 386, 25.0% (T3). Compared with normal Japanese levels in non-disaster settings (4.7%), the prevalence of general psychological distress by Kessler 6-item Scale ≥ 13 was still high 3 years after the event in both men (11.4%) and women (15.8%). Although the age-adjusted prevalence of psychological distress and post-traumatic stress (Post-traumatic Stress Disorder Checklist ≥ 44) had decreased over time (from 19.0% [T1] to 17.8% [T3] for men, and from 25.3% [T1] to 23.3% [T3] for women), the age-adjusted prevalence of problem drinking (CAGE ≥ 2) remained steady in both men (20.7% [T2] and 20.4% [T3]; P = 0.18) and women (10.5% [T2] and 10.5% [T3]; P = 0.91). Our results suggest that long-term interventions focused on post-traumatic stress as well as other mental health problems are strongly needed for disaster-affected individuals.

Does socioeconomic status moderate the relationships between school connectedness with psychological distress, suicidal ideation and attempts in adolescents?

ObjectiveResearch has indicated that school connectedness acts as a buffer against depressive symptoms and suicidality. However, little is known about the role of socioeconomic status (SES) on these links. The present study examined the moderating role of subjective SES and parental education on the relationships between school connectedness and psychological distress, suicidal ideation and suicide attempts. MethodsData were gathered from 4955 participants within the 2013 cycle of the Ontario Students Drug Use and Health Survey, a province-wide repeated school-based survey of students in grade 7 to 12 across Ontario, Canada. ResultsResults indicated that higher subjective SES is associated with high levels of school connectedness. Subjective SES is also a significant moderator of the association between school connectedness and psychological distress, but not between school connectedness and suicidal ideation or attempts. At low subjective SES, there was no difference in risk of psychological distress between students with high and low levels of school connectedness. However, at higher subjective SES, students with high levels of school connectedness have lower odds of psychological distress than those with low levels of school connectedness. The associations between school connectedness and each of the mental health outcomes did not significantly vary with parental education. ConclusionsThese findings suggest that the beneficial effects of school connectedness on mental health problems may be more strongly related to adolescents' status beliefs rather than parental education. Future research is needed to better understand the mechanism through which subjective SES and school connectedness influence psychological distress.

Serum n-3 polyunsaturated fatty acids and psychological distress in early pregnancy: Adjunct Study of Japan Environment and Children's Study.

N-3 polyunsaturated fatty acids (PUFAs), especially long-chain types such as docosahexaenoic acid, are important nutrients in pregnancy, but the relationship between n-3 PUFA levels and perinatal and postnatal depression remains controversial. This study examined the possible relationship between serum n-3 PUFA levels and psychological distress among expectant mothers in early pregnancy. Data and specimen samples were obtained in a birth cohort study started at Toyama Regional Center in July 2012 as an adjunct study of the Japan Environment and Children's Study. Blood samples were collected at 9–14 weeks' gestation (75% of samples) or after 15 weeks (25%). Subjects with a Kessler Psychological Distress Scale score (K6) ⩾9 were assigned to the psychological distress group (n=283). The control group (n=283) was matched for age, educational level and family income. Fatty acid composition was determined from serum samples by gas chromatography. Associations between fatty acid levels and incident psychological distress were evaluated by logistic regression. After adjusting for possible confounders, eicosapentaenoic acid showed an inverse association with risk of psychological distress, with an odds ratio of 0.47 (95% confidence interval: 0.30, 0.73) for the highest tertile. This inverse association remained even after applying a higher cutoff score (K6 ⩾13) indicating severe psychological distress (74 pairs). We believe this is the first study to reveal the associations between serum n-3 PUFAs and risk of psychological distress in early pregnancy. Further research is required to verify the causality of these associations.

Marital satisfaction among spouses of patients with severe mental illness attending psychiatry OPD in AIMS, Kochi

A quantitative approach descriptive study was conducted to assess marital satisfaction among 60 spouses of patients diagnosed with severe mental illness. The objectives of the study were to; assess the marital satisfaction among spouses of patients with severe mental illness, find the association between marital satisfaction of spouses and their selected demographic variables and find the association between marital satisfaction of spouses and selected patient variables. The data was collected using socio demographic sheet of both spouses and patients, Couples Satisfaction Index (structured interview). The major findings of the study were, the marital satisfaction among spouses of 60 patients with severe mental illness was assessed. Satisfaction in marital relationship was found in 41(68.3%) of the spouses and 19(31.7%) were unsatisfied in their marital relationship. It was found that among the 60 subjects, 48(80%) were unhappy with their relationships and only 12(20%) of the subjects were happy in their marital relationship. Also it was found that, only 5% of the subjects feels the relationship as interesting, 1.7% as good, 3.3% as full, 3.3% as full and friendly, 8.3% as sturdy and 5% as hopeful and enjoyable. These findings reveals that the spouses of mentally ill clients are themselves at risk for psychological distress due to the burdens associated with caring for someone with mental illness; burdens such as the feelings of helplessness, hopelessness, fear, uncertainty, the possibility of re-occurrence of disease, the emotional strain on the spouse, and the individual's lack of energy.

Risk of psychological distress in parents of preterm children in the first year: evidence from the UK Millennium Cohort Study

ObjectiveTo assess whether the parents of babies born preterm (PT; <37 weeks completed gestation) are at excess risk of psychological distress (PD) at 9 months postpartum, and to explore the...

Depressive symptoms among children whose parents have serious mental illness: Association with children’s threat-related beliefs about mental illness

Background. Sixty-eight per cent of women and 57% of men with mental illness are parents. There is increasing evidence of adverse psychosocial impact of parental mental illness on their children. However, among children whose parents have mental illness, the potential contribution of the children’s beliefs about mental illness to their own emotional distress is still poorly understood. Aim. To explore among children whose parents have serious mental illness, the relationship between the children’s beliefs about mental illness and their own depressive symptoms. Methodology. We conducted an interview-administered questionnaire survey of 67 Nigerian children whose parents were psychiatric inpatients. The children’s beliefs about mental illness were explored with five questions – two of which embedded threat-related beliefs. Their depressive symptoms were assessed with the Short Mood and Feelings Questionnaire (SMFQ) (Cronbach alpha 0.91). Based on stigma theory, we hypothesised that among this cohort, the children who hold threat-related beliefs about people with mental illness would report statistically significantly more depressive symptoms than those without similar beliefs. Results. The mean age (standard deviation (SD)) of the children was 13.3 (2.8) years, and 38% were males. Twenty-four per cent of the children believed mental illness is infectious. In line with our hypothesis, those holding this belief had statistically significantly more depressive symptoms compared with those without similar beliefs ( p =0.001). Fifty-seven per cent of the children believed that people with mental illness are dangerous. However, contrary to our hypothesis, this belief was not associated with increased depressive symptoms ( p =0.2). Multiple regression showed that statistically significant predictors of increased emotional symptoms were ‘belief that mental illness is infectious’ and younger age. The model explained 39.8% of the variance in SMFQ. Conclusion. In this and similar settings, psycho-education for children whose parents have serious mental illness should explore whether the children believe that mental illness is infectious. Providing reassurance to children holding such beliefs could reduce their risk of psychological distress.

Psychological distress and coping strategies in parents of children with cancer in Lebanon.

To determine the prevalence of psychological distress (PD) among parents of Lebanese children with cancer and to investigate the associated stressors and coping strategies. A cross-sectional study conducted at the American University of Beirut Medical Center-Children Cancer Center of Lebanon in 2012. Parents of all children with cancer admitted for treatment were eligible participants. The General Health Questionnaire (GHQ-12) was used to estimate the prevalence of PD. Coping strategies were measured via the Coping Health Inventory for Parents (CHIP). Bivariate and multiple regression analyses were conducted to evaluate the relationship between GHQ-12 (scores 0-36), stressors, family/social support, and coping strategies. One hundred fourteen parents (68.2%) completed the anonymous questionnaire. Based on GHQ-12, significant PD was considered among 56.0% of the parents. It was found to be significantly positively associated with the degree of family financial problems and significantly negatively associated with the child's disease duration. A significant negative relationship was also found between PD and Coping (CHIP) scale, coping pattern I (Maintaining Family Integration and an Optimistic Outlook for the Situation), pattern II (Seeking Social Support), yet not with pattern III (Seeking Information). PD is prevalent among parents of Lebanese children hospitalized because of cancer. Screening for PD in the latter population is feasible, would identify those who are at risk for disruptive PD, and facilitate the provision of support towards better adjustment and coping. Alleviating parental PD may facilitate the realization of optimal health outcomes.

Concerns about implantable cardioverter-defibrillator shocks mediate the relationship between actual shocks and psychological distress.

Although most implantable cardioverter-defibrillator (ICD) patients cope well, fears about receiving ICD shocks have been identified as a major determinant of psychological distress. The relationships among ICD-related concerns, receipt of defibrillating shocks, and symptoms of anxiety and depression have not yet been investigated. Our objective was to examine whether the relationship between receipt of defibrillating shocks and psychological distress was mediated by patients' concerns related to their ICD. All Swedish ICD-recipients were invited to this cross-sectional correlational study; 3067 completing the survey (55% response rate). Their mean age was 66 ± 11 years, and 80% were male. One-third (35%) had received defibrillating shocks, and 26% had high ICD-related concerns. Regression analyses demonstrated that having received at least one shock significantly predicted symptoms of anxiety and depression [odds ratio (OR) 1.58 and OR 3.04, respectively]. The association between receipt of shocks and psychologically distress was mediated by high ICD-related concerns which explained 68% of the relationship between shocks and symptoms of anxiety, and 54% of the relationship between shocks and symptoms of depression. Implantable cardioverter-defibrillator-related concerns have a bigger impact on psychological distress than receipt of an actual shock. Assessing ICD-related concerns in clinical practice can identify patients at risk for psychological distress. Further research on assessment of, and interventions targeting, ICD-related concerns is warranted.

Depressive symptoms among children whose parents have serious mental illness: Association with children’s threat-related beliefs about mental illness

&lt;p&gt;&lt;strong&gt;Background. &lt;/strong&gt;Sixty-eight per cent of women and 57% of men with mental illness are parents. There is increasing evidence of adverse psychosocial impact of parental mental illness on their children. However, among children whose parents have mental illness, the potential contribution of the children’s beliefs about mental illness to their own emotional distress is still poorly understood.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim. &lt;/strong&gt;To explore among children whose parents have serious mental illness, the relationship between the children’s beliefs about mental illness and their own depressive symptoms.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methodology. &lt;/strong&gt;We conducted an interview-administered questionnaire survey of 67 Nigerian children whose parents were psychiatric inpatients. The children’s beliefs about mental illness were explored with five questions – two of which embedded threat-related beliefs. Their depressive symptoms were assessed with the Short Mood and Feelings Questionnaire (SMFQ) (Cronbach alpha 0.91). Based on stigma theory, we hypothesised that among this cohort, the children who hold threat-related beliefs about people with mental illness would report statistically significantly more depressive symptoms than those without similar beliefs. &lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results. &lt;/strong&gt;The mean age (standard deviation (SD)) of the children was 13.3 (2.8) years, and 38% were males. Twenty-four per cent of the children believed mental illness is infectious. In line with our hypothesis, those holding this belief had statistically significantly more depressive symptoms compared with those without similar beliefs (&lt;em&gt;p&lt;/em&gt;=0.001). Fifty-seven per cent of the children believed that people with mental illness are dangerous. However, contrary to our hypothesis, this belief was not associated with increased depressive symptoms (&lt;em&gt;p&lt;/em&gt;=0.2). Multiple regression showed that statistically significant predictors of increased emotional symptoms were ‘belief that mental illness is infectious’ and younger age. The model explained 39.8% of the variance in SMFQ.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion. &lt;/strong&gt;In this and similar settings, psycho-education for children whose parents have serious mental illness should explore whether the children believe that mental illness is infectious. Providing reassurance to children holding such beliefs could reduce their risk of psychological distress.&lt;/p&gt;

The Relationship Between Violence and Psychological Distress Among Men and Women: Do Sense of Mastery and Social Support Matter?

The aims of this study were to examine associations between reported exposure to psychological and physical violence and psychological distress (PD) among men and women, and to explore the possible mediating or moderating roles of sense of mastery and social support. We used data from the nationally representative Norwegian Health and Level of Living Survey in 2005 and 2012 (Weighted N = 19,386). PD was measured with the Hopkins Symptom Checklist-25, using the subscales for anxiety and depression separately and in combination. Analyses were conducted using hierarchical logistic regression with complex sample adjustment. Altogether, 3.8% of men and 5.4% of women reported psychological violence during the last 12 months, while 2.3% and 1.6% reported physical violence, respectively. Both forms of violence were associated with excess risk of comorbid anxiety and depressive symptoms above clinical cut-point (CAD) in men and women alike, and CAD occurred more frequently than anxiety or depressive problems separately. Sense of mastery, but not social support, partly mediated the association between both forms of violence and CAD in men, whereas both partly mediated the association between psychological violence and CAD in women. No moderator role was indicated. Overall, the results provide evidence for excess risk of PD, particularly CAD, in men and women reporting exposure to violence. Sense of mastery and to a lesser degree social support were shown to constitute significant mediators, underscoring the importance of systems for strengthening coping strategies and social support among violence victims, such as psychological and practical support by the health services.

282 A preventative psychosocial care approach (PPCA) for promoting psychological wellbeing for people with CF (PWCF) and their caregivers

Objectives People with chronic health conditions are at risk for psychological distress. Recent publication of TIDES studies has led to welcome debate about how to ensure psychological needs of PWCF & families are identified, and proposals to develop international guidance for screening & treatment of mental health problems in CF. However, preventative psychosocial care is cost-effective and responsive to the psychological issues occurring in those with chronic physical health issues. Methods The UKPPCF has developed a PPCA, refined over 2 decades, based on well-defined standards of care. Results Guidance has been produced by UKPPCF and will be described in detail. PPCA includes surveillance for a wide range of CF related emotional health difficulties & co-ordination of psychological care from within the CF team. The approach is preventative & promotes psychosocial wellbeing in contrast to more reactive models that screen for indicators of psychopathology. PPCA can be adapted in a stepped care approach for services that do not have a psychologist as part of the core CF team. Conclusion Models of psychological care for people with chronic health conditions indicate that the most cost-effective way of providing care is to intervene at the preventative tier rather than wait for clinical referral. Despite differences in international health funding systems, prevention is better than cure. The UK model & especially the annual surveillance & screening of PWCF & families is a key opportunity to offer a preventative assessment & deliver appropriate specialised interventions in a way that is integrated fully with CF medical care.

Psychological distress and coping amongst higher education students: a mixed method enquiry.

BackgroundPsychological distress among higher education students is of global concern. Students on programmes with practicum components such as nursing and teacher education are exposed to additional stressors which may further increase their risk for psychological distress. The ways in which these students cope with distress has potential consequences for their health and academic performance. An in-depth understanding of how nursing/midwifery and teacher education students experience psychological distress and coping is necessary to enable higher education providers to adequately support these students.MethodsThis mixed method study was employed to establish self-reported psychological distress (General Health Questionnaire), coping processes (Ways of Coping Questionnaire) and lifestyle behaviour (Lifestyle Behaviour Questionnaire) of a total sample (n = 1557) of undergraduate nursing/midwifery and teacher education students in one university in Ireland. Individual interviews (n = 59) provided an in-depth understanding of students experiences of psychological distress and coping.ResultsA significant percentage (41.9%) of respondents was psychologically distressed. The factors which contributed to their distress, included study, financial, living and social pressures. Students used varied coping strategies including seeking social support, problem solving and escape avoidance. The positive relationship between elevated psychological distress and escape avoidance behaviours including substance use (alcohol, tobacco and cannabis) and unhealthy diet is of particular concern. Statistically significant relationships were identified between “escape-avoidance” and gender, age, marital status, place of residence, programme/year of study and lifestyle behaviours such as diet, substance use and physical inactivity.ConclusionThe paper adds to existing research by illuminating the psychological distress experienced by undergraduate nursing/midwifery and teacher education students. It also identifies their distress, maladaptive coping and the relationship to their lifestyle behaviours. The findings can inform strategies to minimise student distress and maladaptive coping during college and in future professional years.

Psychological Distress Among College Youth as a Function of Family SES: The Mediating Effect of Sense of Poverty and the Mitigating Role of Family Resources

Although college provides an opportunity for socioeconomic advancement, poor college youth confront material scarcity and financial problems and are at risk for psychological distress. Yet, distress is a product not only of poverty per se but of a sense of poverty, or a subjective evaluation of one's socioeconomic conditions vis-à-vis life circumstances. Both sense of poverty and psychological distress, however, can be mitigated by collective problem-solving in the family and by the family's social resources. Analysis of data from Filipino college youth ( n = 831) shows that the family's inability to meet financial obligations is not directly associated with distress, but indirectly through sense of poverty. Lack of family assets is not a predictor of psychological distress, given that the positive indirect effect through sense of poverty is counteracted by a negative direct effect. Results also show that family problem-solving lessens psychological distress and that adequate access to social resources lessens the negative effect of sense of poverty on distress.

The influence of childhood trauma on fatigue and depression in breast cancer patients during and after radiotherapy.

e20567 Background: Women with a history of childhood abuse and/or neglect are at increased risk for psychological distress when confronted with new traumatic experiences including a diagnosis and t...

Routinely sleeping away from home and the association with child asthma readmission.

The increased prevalence of transitions between households may have implications for child asthma morbidity. We, therefore, sought to enumerate the prevalence of regularly spending nights sleeping away from home among children admitted to the hospital for asthma and to examine the relationship of nights away to asthma-related readmission. This was a population-based, prospective cohort of 774 children, aged 1-16years, who were admitted with asthma or bronchodilator-responsive wheezing and enrolled in the Greater Cincinnati Asthma Risks Study. The study took place at Cincinnati Children's Hospital Medical Center, an urban, academic children's hospital in the Midwest. The primary exposure was regularly spending nights away from home. Selected covariates included caregiver marital status, shift work, child's race, income, psychological distress, and running out of/not having medications on hand. The primary outcome was asthma-related readmission within 12months. A total of 19% were readmitted within 12months. The 33% of children that spent ≥1 night away from home per week were significantly more likely to be readmitted than those who spent no nights away (25% vs. 16%, p=0.002). Spending nights away from home [adjusted relative risk (aRR) 1.5, 95% confidence interval (CI) 1.2-2.0] and lower income (aRR 2.6, 95% CI 1.1-6.4) were the strongest independent predictors of readmission after adjusting for child age, gender, and race, and caregiver marital status, shift work, risk of psychological distress, and running out of meds. Increased awareness of the multiple settings in which children with asthma live may help shape more comprehensive approaches to asthma care.

Family caregivers' distress levels related to quality of life, burden, and preparedness.

Family caregivers (FCGs) caring for loved ones with lung cancer are at risk for psychological distress and impaired quality of life (QOL). This study explores the relationship between FCGs' distress, per the distress thermometer (DT) and FCGs' QOL, burden, and preparedness. The purpose is to identify types of problems unique to FCGs in cancer care. Family caregivers of patients diagnosed with non-small cell lung cancer were recruited from an adult outpatient setting at a comprehensive cancer center. Questionnaires included demographic information, City of Hope QOL Scale-Family Version, Caregiver Burden Scale, FCG preparedness, and DT. Baseline data were utilized for this analysis. Of the FCGs (N = 163), 68% were spouses, 64% female, and 34% worked full-time. FCG age ranged from 21 to 88 years with a mean of 57 years. FCGs cared for patients with non-small cell lung cancer stage I-III (44%) and stage IV (56%). Psychological distress (DT mean = 4.40) was moderate. DT scores were highly correlated with seven of the eight explanatory variables. Secondary principal components analysis of the explanatory variables combined correlated variables into three constructs identified as self-care component, FCG role component, and FCG stress component. Simultaneous multiple regression of distress onto the three components showed they accounted for 49% of the variance in distress. This exploration of FCGs' concerns associated with elevated distress scores, as measured by the DT, helped identify three component problem areas. These areas warrant further psychosocial assessment and intervention to support FCGs as they care for the patient with cancer.

Does investment in home visitors lead to better psychological health for HIV-affected families? Results from a quasi-experimental evaluation in South Africa

Children and families affected by HIV are at considerable risk for psychological distress. Community-based home visiting is a common mechanism for providing basic counseling and other services to HIV-affected families. While programs emphasize home visitor training and compensation as means to promote high-quality service delivery, whether these efforts result in measurable gains in beneficiaries' well-being remains largely unanswered. This study employs a longitudinal quasi-experimental design to explore whether these kinds of investments yield concomitant gains in psychological outcomes among beneficiaries. Baseline and follow-up data were collected over a two-year period from children aged 10–17 at the time of program enrollment and their caregivers, with 80% retention. In this sample of 1487 children and 918 caregivers, the psychological health outcomes of those enrolled in programs with home visitors who receive intensive training, organizational support, and regular compensation (termed “paraprofessional”) were compared to those enrolled in programs offering limited home visiting services from lay volunteers. Applying multilevel logistic regression, no measurable improvements were found among paraprofessional enrollees, and three outcomes were significantly worse at follow-up regardless of program model. Children's behavior problems became more prevalent even after adjusting for other factors, increasing from 29% to 35% in girls and from 28% to 43% in boys. Nearly one-quarter of girl and boys reported high levels of depression at follow-up, and this was a significant rise over time for boys. Rates of poor family functioning also significantly worsened over time, rising from 30% to 59%. About one-third of caregivers reported high levels of negative feelings at follow-up, with no improvements observed in the paraprofessional group. Results highlight that children's and caregivers' psychological outcomes may be relatively impervious to change even in paraprofessional home visiting models. Findings underscore the need for programs serving HIV-affected families to add focused evidence-based psychological interventions to supplement traditional home visiting.

Sense of coherence as a protective factor for psychological distress among gay men: a prospective cohort study

Gay men face a greater risk of psychological distress than heterosexual men, yet research on protective factors among gay men has been limited. This prospective cohort study investigated whether a sense of coherence (SOC), as a form of coping, helps to protect against psychological distress among middle-aged and older gay men. A nationwide online survey was conducted among a baseline sample of 1135 Australian gay-identified men aged 40 years and older, with a follow-up survey 12 months later. SOC was measured using the 13-item SOC Scale. Psychological distress was measured using the K10 Psychological Distress Scale. Hierarchical regressions were conducted, with analyses controlling for several potential risk factors for distress. Over half of participants had moderate or high psychological distress. However, baseline distress was significantly lower among those with stronger baseline SOC. In addition, baseline SOC significantly predicted distress 12 months later. This predictive effect of SOC was independent of baseline distress levels and occurred despite a strong correlation between baseline and follow-up distress. With SOC appearing to be a protective factor, strategies among middle-aged and older gay men that strengthen SOC may assist in the prevention and treatment of anxiety and other psychological distress in this vulnerable population.