Risk For Psychosocial Distress Research Articles

Adolescent victimization and psychosocial well-being in a Finnish population-based sample

ABSTRACT Potentially traumatizing events are common in adolescence, and these experiences have an impact on psychopathology. Furthermore, these events cumulate for certain individuals. More knowledge about the relationship between well-being and victimization experiences’ amount, type, and timing in adolescents is needed to understand the phenomenon of adolescent victimization. In this cross-sectional study, we investigated in a population-based sample of Finnish adolescents, whether victimization experiences associate with psychosocial well-being. The study sample comprised 5743 adolescents aged 15–16 years who filled in a questionnaire about 12 victimization experiences and psychosocial well-being. General Linear Model regression analyses were used for statistical analysis. A greater number of victimization experiences and recent timing, as well as type of victimization such as cyberbullying, were linked to problems related to psychosocial well-being. It is important to recognize current forms of youth victimization to identify the adolescents at risk for psychosocial distress and investigate on specific types of victimization.

Validity and reliability of the Brazilian Portuguese version of the Florida Patient Acceptance Survey for patients with implantable cardioverter defibrillators

Device acceptance is a crucial factor in identifying implantable cardioverter defibrillator (ICD) patients at risk for psychosocial distress and unfavorable quality of life outcomes. The purpose of this study was to examine the evidence of the validity of internal structure (construct) and reliability of the Florida Patient Acceptance Survey (FPAS) in a sample of ICD patients, comparing the psychometric indicators of the complete (FPAS-18 item) and abbreviated (FPAS-12 item) versions. The sample included 151 participants (97 males, mean age of 55.7 ± 14.1 years) who completed the cross-culturally adapted version of the FPAS instrument for the Brazilian context. The psychometric properties of both versions of the FPAS instrument were evaluated by two distinct approaches:•Exploratory and confirmatory factor analysis: used to test the internal structure of the instrument•Cronbach's Alpha and McDonald's Omega: used to determine the reliability of the instrumentThe two versions of the FPAS-Br instrument showed consistent evidence of internal structure validity and reliability. However, the FPAS-Br 12-item showed a better psychometric adjustment, confirmed by the analysis of the quality indicators of the models.

Documentation of Psychosocial Distress and/or Risk for Psychosocial Distress in Children with Complex Chronic Conditions and Their Families (GP707)

Documentation of Psychosocial Distress and/or Risk for Psychosocial Distress in Children with Complex Chronic Conditions and Their Families (GP707)

The distinct longitudinal impact of pain catastrophizing on pain interference among youth living with sickle cell disease and chronic pain.

Youth living with chronic sickle cell disease (SCD) pain are at risk for psychosocial distress and high levels of pain catastrophizing that contribute to functional impairment. This study aimed to identify the unique long-term impact of pain catastrophizing on pain impairment among youth with SCD. Youth with chronic SCD pain (N = 63, 10-18years old, 58.3% female, 95.1% Black or African American) were recruited within comprehensive SCD clinics and completed a battery of measures at baseline and 4-months follow-up. A linear hierarchical regression examined baseline demographic and clinical characteristics (child SCD genotype, age, and average pain intensity), psychosocial functioning (anxiety, depression), and pain catastrophizing as predictors of pain interference at 4-months follow-up. Pain catastrophizing was the only unique predictor of pain interference at 4-months follow-up. Among youth with chronic SCD pain, pain catastrophizing warrants greater consideration as an important predictor that influences pain management and overall functioning.

Tolerance of Violence against Women and the Risk of Psychosocial Distress in Humanitarian Settings in Northern Uganda.

Background: Violence against women (VAW) remains a public health concern, which can sometimes lead to mental or psychological stress among other negative consequences. Data and methods: we fitted a binary logistic regression model on 657 respondents from host and refugee settings in three humanitarian districts (Adjumani, Obongi, and Lamwo) to examine the determinants of psychosocial stress. Results: experience of psychosocial distress is higher among refugees than host populations. Results indicate a higher proportion of respondents who ever experienced psychosocial stress in the 6 months preceding the survey among those who believed that a woman should tolerate violence (59% vs. 53%). Respondents who believed that a woman should tolerate violence had higher odds of experiencing psychosocial stress than their counterparts who believed a woman should not tolerate violence (OR = 6.86; 95%CI = 1.23–38.22). The likelihood to experience psychosocial stress was higher among females (OR = 6.94; 95%CI = 1.76–27.32), those with primary education (OR = 4.73; 95%CI = 1.24–18.00), and respondents with less than USD 2.7 as personal income one month before the survey (OR = 3.37; 95%CI = 1.32–8.62). Respondents who said that women should engage in income generation activities had higher odds to experience psychosocial stress (OR = 0.39; 95%CI = 0.17–0.89). Conclusion: results suggest that income and positive attitudes toward female-led income generating activities act as protective measures against psychosocial distress. Given the associations between VAW and psychosocial distress, efforts aimed at prevention and response to VAW in humanitarian settings should integrate mental health and psychosocial support interventions.

Protocol for mapping psychosocial screening to resources in pediatric oncology: a pilot randomized controlled trial

BackgroundA pediatric cancer diagnosis and its treatment can have a detrimental effect on the mental health of children and their families. Screening to identify psychosocial risk in families has been recognized as a standard of care in pediatric oncology, but there has been limited clinical application of this standard thus far. A significant impediment to the implementation of psychosocial screening is the dearth of information on how to translate psychosocial screening to clinical practice, and specifically, how to follow-up from screening results. This manuscript aims to describe a protocol of a new intervention examining the feasibility and acceptability of mapping via a Psychosocial Navigator (PSN) psychosocial screening results to specific recommendations of resources for families based on measured risk for psychosocial distress and mental health symptoms.MethodsThe pilot randomized control trial (RCT) consists of dyads of youth (10–17 years) newly diagnosed with cancer and their primary caregiver. This RCT includes two arms (intervention and control group), with each group completing measurements near diagnosis and 1 year later. After the initial assessment, dyads in the intervention group receive monthly screening results and recommendations from the study PSN that are tailored to these results. The patient’s primary healthcare team (nurse, social worker, oncologist) also receive the risk, distress, and mental health results as well as the recommendations from the PSN.DiscussionThis study addresses a significant barrier to the implementation of psychosocial screening in pediatric oncology: specifically, the limited knowledge of how to follow-up from screening results. Findings from this pilot will inform a future definitive RCT to test the effectiveness of the intervention on patient and family mental health outcomes. This project has implications for enhancing clinical care in pediatric oncology, as well as other pediatric populations.Strengths and limitations of this studyThis is the first study of screening and follow-up using a psychosocial navigator.This study involves both patient and caregiver report.The small sample size necessitates a future larger study to investigate the effects of intervention.Trial registrationNCT04132856, Registered 10 October 2019—retrospectively registered.

Abstract 4349: Comparison of Psychosocial Wellbeing among African American and Caucasian Metastatic Cancer Survivors

Abstract Introduction: Approximately 5 million Americans are living with metastatic cancer and are at an increased risk for psychosocial distress (e.g., hopelessness). Hope is vital to life and is essential for effectively coping with illness. Among early-stage cancer survivors, previous studies indicate that African Americans (AA) experience greater cancer burden than Caucasians (CAU). The aim of this study was to compare psychosocial wellbeing between AA and CAU MCS residing in the Deep South. Methods: MCS were identified via UAB Cancer Registry and I2B2.Using a modified Dilman's method, eligible MCS (>21 years and physician permission to contact) were mailed a survey. Psychosocial wellbeing (i.e. physical and mental wellbeing, anxiety, depression, social isolation, emotional support, and hopefulness) of MCS were assessed via PROMIS® measures. Returned surveys were double-key entered into REDCap®. Data were analyzed using Excel. Descriptive statistics were used to characterize the study sample and instrument scores. Between group difference, between AA and CAU MCS, was examined via independent-samples t-test. Results: To date, 100 surveys have been returned (AA=18; CAU=82; Mage=67 years; Msurvivorship=3 years) with a broad representation of primary cancer sites (breast=23%; prostate=10%; gynecological=16%; colorectal=13%; lung=10%; kidney=11%; other=17%). Mean instrument scores were similar between AA and CAU MCS for physical wellbeing (44.57 vs 44.81), mental wellbeing (48.1 vs 48.46), anxiety (45.76 vs 48.45), depression (44.85 vs 46.77), social isolation (39.96 vs 40.89), and emotional support (39.96 vs 40.89). However, AA MCS reported significantly better feelings of hopefulness than CAU MCS (61.34 vs 55.39, p>0.01, d=0.73). Discussion: Findings suggest that AA MCS may be more hopeful than CAU MCS. These preliminary findings warrant further analysis after data collection is complete (an additional 300 returned surveys are anticipated). Citation Format: Jayla M. Caffey, Jennifer Bail. Comparison of Psychosocial Wellbeing among African American and Caucasian Metastatic Cancer Survivors [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 4349.

Abstract OI: Breast Cancer in Young Women: Understanding Differences to Improve Outcomes

Abstract Breast cancer is the leading cause of cancer related deaths in women age 40 years and younger in the United States, and a major cause of morbidity and mortality worldwide. Young women are more likely to develop more aggressive subtypes of breast cancer. Emerging data suggest the effect of age on breast cancer recurrence and death varies by tumor subtype, with young age particularly prognostic in women with ER-positive disease. Greater understanding of the biologic and genetic underpinnings of cancers that arise in younger women, potential differences in tumor and host responses including disease presenting in very premenopausal women or recently pregnant women, is critical to develop novel treatments to improve outcomes. There is also mounting evidence that access to care and behavioral differences leading to suboptimal treatment contribute to disparities in young women, including relatively poor adherence to adjuvant hormonal therapy. Prevention, detection and management of non-adherence, with attention to unique issues facing young women including desire for future fertility and pregnancy, has been the subject of recent research for this vulnerable population who, unsurprisingly, are at increased risk of psychosocial distress compared with older breast cancer survivors. Decision-support tools, and innovative, acceptable, scalable interventions to address anxiety and distress are under investigation. Finally, given that most young women will live for many decades after a diagnosis of breast cancer, it is imperative that we follow this population, in particular, over time and study their long-term, late effects in survivorship. Citation Format: Partridge A. Breast Cancer in Young Women: Understanding Differences to Improve Outcomes [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr OI.

The impact of psychosocial distress on survival in patients diagnosed with gastrointestinal (GI) malignancies.

654 Background: A cancer diagnosis can cause psychological distress that adversely affects patients’ emotional, social, spiritual and physical capabilities. The aim of this study is to identify factors associated with increased risk for psychosocial distress and to evaluate the influence of anxiety and depression on survival of GI cancer patients. Methods: All patients with GI cancer referred to BC Cancer from 2011-2015 who completed a prospective Psychosocial Screen for Cancer – Revised within 6 months of cancer diagnosis were included in the study. Baseline characteristics were collected from the BC Cancer registry. Patient groups were compared using the Chi-squared Fisher’s exact test. OS was calculated using the Kaplan Meier method, compared using the log rank test and Cox proportional hazards model. Results: 8722 patients were included in the analysis. Baseline characteristic: median age 67, male 60% , metastatic disease 29%. Colorectal/anal cancers (60%) were the most common followed by pancreatic cancer (11%). Patients with anxiety and depression were more likely to be younger (aged 64 and less), female and have metastatic disease. Patients with anxiety were more likely to get chemotherapy. Depression was associated with less chemotherapy use. Anxiety and depression were associated with increased psychosocial needs including emotional, informational, physical, spiritual, social/family concerns (p < 0.001). Psychological distress was not influenced by the patient’s geographic location or socioeconomic status. Median OS for patients with anxiety was 20 m vs no symptoms 27 m (p < 0.001) and depression 17 m vs no symptoms 27m (p < 0.001). The impact on OS remained significant for anxiety and depression in a multivariate model that included age, sex, metastatic status and chemotherapy use. Conclusions: Patients with GI malignancies who are female, younger than 64 and have metastatic disease are at risk for psychological distress. Anxiety and depression were associated with poorer survival outcomes even when controlling for age, sex, metastatic status and chemotherapy. Mobilizing resources to meet patients’ needs is important and should be implemented as part of patients’ comprehensive care.

Psychosocial distress and the preferred method of delivery of mind-body interventions among patients with head-and-neck cancer.

ObjectiveTo describe the psychosocial distress of head-and-neck cancer patients at the completion of therapy and the interest in and the preferred method of delivery of mind–body interventions (MBIs) among head-and-neck cancer patients.Materials and methodsA descriptive, cross-sectional design was used to measure sleep disturbance, depression, anxiety, and the interest in and the preference for MBIs using anonymous, self-report questionnaires among a convenience sample of 30 males at their 3-month follow-up. Questionnaires included the Pittsburgh Sleep Quality Index, Hospital Anxiety and Depression Scale, and the self-created Survey for Preferred Methods of MBI. Frequency distributions and descriptive statistics were used to describe the sample demographic and clinical characteristics.ResultsThe mean age of the sample was 59 years. Oral cancer (63%) was the most common type of cancer. Nineteen participants (63%, 90% CI 47%–78%) had some interest in MBIs. Of interested participants, 8 (42%) preferred participating in MBIs alone, 10 (53%) preferred participating in MBIs at homes, 10 (53%) preferred participating in MBIs using a computer or mobile device, and 8 (42%) preferred participating in MBIs after the diagnosis, but before treatment started. Mean depression, anxiety, and sleep disturbance scores were 8.25 (SD 2.93), 5.41 (SD 3.52), and 6.3 (SD 3.86), respectively. Results from the independent-samples t-test and Mann–Whitney U tests revealed no significant differences in anxiety, depression, and sleep disturbance by MBI interest.ConclusionAsking about depression, anxiety, and sleep disturbances may help to identify head-and-neck cancer patients at risk for psychosocial distress. These findings suggest an interest in MBIs, but further research is warranted.

Flying Blind: Sources of Distress for Family Caregivers of Palliative Cancer Patients Managing Pain at Home

Pain requiring treatment is experienced by many cancer patients at the end of life. Family caregivers are often directly implicated in pain management. This article highlights areas of psychosocial concern for family caregivers managing a family member's cancer pain at home as they engage in pain management processes. This article is based on the secondary analysis, guided by interpretive description, of data collected for a grounded theory study that explored the processes used by family caregivers to manage cancer patients’ pain in the home. Interviews and field notes from 24 family caregiver interviews were examined to identify areas of family caregiver psychosocial distress. The analysis revealed that family caregivers experienced distress at different phases of the pain management process. Sources of distress for caregivers included feeling as though they were “in a prison” (overwhelmingly responsible), “lambs to slaughter” (unsupported), and “flying blind” (unprepared). In addition, family caregivers expressed distress when witnessing their loved one in pain and when pain crises invoked thoughts of death. In sum, family caregivers managing a loved one's cancer pain at home are at risk for psychosocial distress. This study identified four key sources of distress that can help health care professionals better understand the experiences of these family caregivers and tailor supportive interventions to meet their needs. Knowledge about sources of distress can help healthcare professionals understand the experiences of these family caregivers and tailor supportive interventions to meet their needs.

Self-reported social and emotional impact of urinary incontinence.

Incontinence-specific and generic measures of well-being were regressed on potential predictors to identify incontinent respondents at risk for psychosocial distress and to understand the relationship between urinary incontinence (UI) and other determinants of social and emotional status. Survey data were collected May 1994 through April 1996. Telephone interviews as a supplement to a nationally representative monthly consumer survey. Analyses were based on 1,116 continent and 206 incontinent respondents age 40 and older. Incontinent respondents self-reported the extent to which urine loss restricted social activities or affected their feelings about themselves. All respondents were asked whether they felt depressed, lonely, or sad. Covariates included sex, age, race, education, social desirability, health status, frequency of urine loss, quantity of loss, and urgency. The majority of incontinent respondents reported that urine loss did not restrict activities or diminish self-esteem. Incontinent respondents who were younger, male, less educated, lower in social desirability, in poorer health, or losing greater quantities of urine were more likely to report psychosocial distress, although these correlates were not consistently significant. Compared with continent respondents, significantly higher percentages of incontinent respondents reported feeling depressed, lonely, or sad. In the multivariate models, incontinence retained an independent association with loneliness, but not with sadness or depression. Even though the direct psychosocial impact of urine loss may be minor in many cases, UI is associated with a constellation of physical and behavioral factors that can impose a social and emotional burden. This suggests that UI cannot be adequately evaluated or treated without consideration of the patient's overall quality of life.

The Relationship Between Agentic and Communal Personality Traits and Psychosocial Adjustment to Breast Cancer

Agency, communion, unmitigated agency (UA), and unmitigated communion (UC) are related to psychosocial health outcomes in nonclinical and medical populations. This study examined the relationship between these personality traits and emotional and interpersonal well-being, as up to 50% of women experience difficulties in psychosocial adjustment after being diagnosed with breast cancer. Seventy-four women newly diagnosed with breast cancer completed baseline assessment measures within 2 weeks prior to their first chemotherapy treatment or at the beginning of their hormonal therapy. Findings indicate that (1) agency and UA are important correlates of emotional and interpersonal adjustment and should be considered when attempting to identify women at high risk for psychosocial distress, and (2) UC deserves increased attention in behavioral medicine research, given its strong relationship with emotional distress in a breast cancer population. Thus, evidence continues to accumulate regarding the important relationship of these personality traits to psychosocial outcomes in medical populations.

Coping and adjustment to illness in the acute myocardial infarction patient

This study examined the coping strategies of acute myocardial infarction (MI) patients one month following discharge from the hospital. Problem- and emotion-focused coping strategies were identified in 30 acute MI patients and correlated with psychologic, social, and physiologic adjustment variables. Individuals who used more problem-focused coping than emotion-focused coping were found to have better social (p less than .005) and psychologic adjustment (p less than .05). Individuals who had more physiologic symptoms were found to have poorer psychologic adjustment. Early identification of those patients at risk for psychosocial distress is paramount to maximize the patient's coping process and prepare the patient psychologically prior to hospital discharge.