Self-reported Distress Research Articles

Mental Health among Spanish Adults with Diabetes: Findings from a Population-Based Case–Controlled Study

Background: The purpose of this study was to assess and compare the prevalence of self-reported mental disorders, psychological distress, and psychotropic drug consumption among people with diabetes mellitus (DM) and matched non-DM controls. Methods: A case–controlled study using data from the Spanish National Health Interview Survey was conducted in 2017. We identified 2116 DM adults (aged ≥35 years). Non-DM controls were matched 1:1 by age, sex, and province of residence. Results: Prevalence of mental disorders (25.0% vs. 19.2%; p < 0.001), psychological distress (29% vs. 19.5%; p < 0.001), and consumption of psychiatric medications (29.7% vs. 23.5%; p < 0.001) among DM cases were higher than those among matched non-DM controls. The DM patient variables associated with experiencing a mental disorder, psychological distress, and consumption of psychiatric medications were: being a woman, worse self-rated health, and a visit to a psychologist within the last year. Older age (≥80 years) was associated with a lower probability of reporting mental disorders and psychological distress among DM cases. Not practicing physical exercise was significantly associated with experiencing psychological distress. Conclusions: Adults with DM included in our investigation have a significantly higher prevalence of mental disorders, psychological distress, and consumption of psychiatric medications than non-DM controls. It is necessary to implement screening strategies and psychological interventions to improve the mental health of DM patients in Spain, focusing especially on women and those aged 35 to 59 years.

The Mental Health and Wellbeing of University Students: Acceptability, Effectiveness, and Mechanisms of a Mindfulness-Based Course.

Mental health problems are relatively common during university and adversely affect academic outcomes. Evidence suggests that mindfulness can support the mental health and wellbeing of university students. We explored the acceptability and effectiveness of an 8-week instructor-led mindfulness-based course (“Mindfulness: Finding Peace in a Frantic World”; Williams and Penman, 2011) on improving wellbeing and mental health (self-reported distress), orientation and motivation towards academic goals, and the mechanisms driving these changes. Eighty-six undergraduate and post-graduate students (>18 years) participated. Students engaged well with the course, with 36 (48.0%) completing the whole programme, 52 (69.3%) attending 7 out of 8 sessions, and 71 (94.7%) completing at least half. Significant improvements in wellbeing and mental health were found post-intervention and at 6-week follow-up. Improvements in wellbeing were mediated by mindfulness, self-compassion, and resilience. Improvements in mental health were mediated by improvements in mindfulness and resilience but not self-compassion. Significant improvements in students’ orientation to their academic goal, measured by “commitment” to, “likelihood” of achieving, and feeling more equipped with the “skills and resources” needed, were found at post-intervention and at 6-week follow-up. Whilst exploratory, the results suggest that this mindfulness intervention is acceptable and effective for university students and can support academic study.

Reliability and validity of a temporal distancing emotion regulation task in adolescence.

Adopting a temporally distant perspective on stressors, also known as using a temporal distancing emotion regulation strategy, can alleviate distress. Young adults’ ability to adopt a temporal distancing strategy has previously been measured using an experimental temporal distancing task (Ahmed, Somerville, & Sebastian, 2018). In the current study, we evaluate the psychometric properties of this task in younger (N = 345, aged 10–11) and older (N = 99, aged 18–21) adolescents and explore developmental differences in the ability to use temporal distancing to alleviate distress. Participants listened to scenarios and rated negative affect when adopting a distant-future perspective, a near-future perspective, or when reacting naturally. We evaluated the test–retest reliability of the measure in older adolescents and its construct validity in both younger and older adolescents by assessing correlations with self-report measures of emotion regulation strategy use. Our findings broadly replicated those of Ahmed et al. (2018): Adopting distant- and near-future perspectives produced significantly lower self-reported distress relative to reacting naturally, with the distant-future strategy producing the least distress. Older adolescents alleviated their distress more effectively than younger adolescents and reported projecting further into the future. Regulation success scores on the temporal distancing task showed adequate test–retest reliability. However, these scores did not correlate with self-reported habitual use of temporal distancing or reappraisal strategies generally. These findings suggest that the ability to use a temporal distancing strategy for emotion regulation improves during adolescence, but that ability may not be related to habitual use of this strategy.

CortiLove: A pilot study on hair steroids in the context of being in love and separation

While romantic infatuation and separation influence psychological and physiological functioning, the hypothalamic-pituitary-adrenal axis with its biomarkers cortisol, dehydroepiandrosterone (DHEA), and progesterone central for coping and distress has been scarcely researched in this context. In particular, endocrine hair analyses assumed to be more valid than saliva or blood assessments for studying long-term processes have not yet been conducted in the context of romantic love. Thus, 101 female subjects in phases of infatuation (n = 16), separation (n = 14), long-term relationships (n = 40), and singlehood (n = 31) reported psychological distress and provided 1 cm hair samples for the assessment of long-term integrated cortisol, DHEA, and progesterone over the last month. Separated, infatuated, and single women exhibited higher cortisol levels than those in a long-term relationship (all ps ≤ .031), while self-reported distress was only evident in separated individuals. Further, no group differences for progesterone (p = .602), but higher DHEA levels in the separation (p = .009) and single group (p = .016) compared to the long-term relationship group were detected. This is the first study showing that compared to women in long-term relationships, infatuation, separation, and single groups exhibit higher levels of physiological, but not necessarily self-reported indicators of distress. These findings, albeit on a very small and preliminary sample, are discussed in the context of the stress-buffering effect of relationships, and provide important starting points for bigger, more balanced studies combining multimodal self-report and biological markers in psychological research of romantic love.

The impact of the COVID-19 pandemic on the mental health of young people: A comparison between China and the United Kingdom

sPurposeAs COVID-19 spreads globally and affects people's health, there are concerns that the pandemic and control policies may have psychological effects on young people (age from 17 to 35 years). This psychological impact might vary in different countries, and thus we compared the prevalence of self-reported psychological distress, loneliness and posttraumatic stress symptoms (PTSS) among young people in the United Kingdom (UK) and China at the beginning of the COVID-19 pandemic.MethodsData of this study came from two sources. One source was the first wave of COVID-19 study in Understanding Society, a special wave of the UK household longitudinal study, which provided the high-quality, national-wide representative panel data. The sample comprised 1054 young people. The other source was an online survey on the mental health of 1003 young people from Shanghai, a highly developed area in China. The questionnaire included questions on the prevalence of common mental disorders (cut-off score ≥ 4), loneliness and potential PTSS (cut-off ≥ 33). Univariable analyses were conducted to test the differences in the self-reported prevalence of psychological distress and loneliness between the two groups. Multivariable logistic regression analyses were run to explore the predictors of psychological distress and loneliness among all the young people from England and Shanghai.ResultsAmong the samples with self-reported psychological distress, the UK sample accounted for 34.4% (n=1054) and the Chinese sample accounted for 14.1% (n=1003). The difference between the two groups was statistically significant (p < 0.001). Additionally, 57.1% of people in the UK and 46.7% in China reported that they sometimes or often felt lonely, of which the difference is statistically significant (p < 0.001). Regression analysis of the entire samples showed that nationality, gender, psychotherapy and loneliness were significant predictors of 12-item General Health Questionnaire scores, while the variables of age and living alone were not. Significant predictors of self-reported loneliness were the nationality, gender, age, living alone and psychotherapy. In China, 123 (12.3%) young people, 49 men (11.3%) and 74 women (13.0%), met the criteria of PTSS symptoms (cut-off scores ≥ 33). These scores were only collected in China.ConclusionThis evidence suggests that mental health and loneliness reported by young people were lower in China than that in the UK during the studied period. More research is needed to understand these differences. If the differential negative psychological impacts are confirmed, country-specific measures of prevention and intervention should be adopted to improve the mental health of young people under the ongoing impact of the pandemic.

Supporting the mental well-being of healthcare professionals during a pandemic.

11037 Background: Burnout amongst healthcare professionals has been well-documented as a phenomenon that compromises the quality and viability of patient-centered care, particularly in oncology. Due to the extraordinary demands of the pandemic, burnout has emerged as a public health crisis that warrants immediate attention to preserve the wellbeing of healthcare staff. At the onset of the pandemic, The Sidney Kimmel Cancer Center (SKCC) at Jefferson, an urban NCI-designated cancer center, translated its support offerings to virtual events. Initially, healthcare providers (HP) sought support by attending patient programs. In response, SKCC initiated virtual programming to support the well-being and needs of the HP team. Methods: Within weeks of the state shutdown due to the pandemic, programs were initiated to address HP self-reported distress: Coping Effectively and Mindfulness Moments Each 30-minute session was facilitated by a licensed psychologist and social worker. Coping Effectively offers strategies from evidence based treatment including Dialectical Behavior Therapy, Acceptance and Commitment Therapy, and Cognitive Behavioral Therapy, to cope with distress and burnout. Mindful Moments draws from Mindfulness Based Stress Reduction practices including observing breath and guided meditations. These programs have been offered consistently throughout the pandemic. Schwartz Rounds, geared towards supporting the human side of healthcare, provided “hot” topic moderated discussions, four of which focused on the pandemic These discussions allow for HP to come together to discuss difficult topics and emotions impacting a variety of professionals. All programming was evaluated with a single question to measure the impact of the session on reducing distress. Each program began and ended with a poll asking, “How distressed do you currently feel?” Attendees respond on a Likert scale from 0 to 10, in which10 indicated the highest level of distress. Results: Since March 31st, 340 staff have attended Mindful Moments and 236 staff have attended Coping Effectively. From March 2020-February 2021, 382 attendees measured their distress before and after attending a staff program. Schwartz Rounds hosted 471 HP from a variety of disciplines. Participants were asked to complete an evaluation following rounds. 31% of program participants’ completed an evaluation form and 89% rated the program exceptional/very good. Conclusions: Despite the challenges of COVID-19, the pivot to virtually create programs to support staff during the pandemic was swift and thoughtful. The increased attendance and the feedback from evaluations are promising indicators of decreasing burnout amongst HP. How Distressed do you Currently Feel? (Average Score scale 1-10)[Table: see text]

Psychosocial impacts of COVID-19 upon a diverse Australian oncology workforce: From doctors to ancillary staff.

e23016 Background: Potential moral hazards from COVID-19 for patient-facing oncology staff include rationalizing treatment, but prior research into staff distress has not included ancillary/administrative staff or compared geographic settings. We sought to document measures of distress and perceived preparedness from diverse oncology staff during the COVID-19 pandemic response, and correlate these with unfolding events. Methods: We utilised a mixed-methods approach comprising weekly diarising of executive communications and events-by investigators, and prospective self-administered online surveys-by staff. Survey domains included perceived institutional preparedness, personal wellbeing, and perceived stress using a distress thermometer (0-10, no-extreme distress). Responses were Likert-scaled or free-text. Quantitative responses were aggregated by role/site and analysed using R. These were correlated with emergent qualitative themes using the Framework Method. The study was conducted at a metropolitan and a regional hospital in Queensland, Australia. Results: 12 surveys across 18 weeks commencing April 3, 2020 (encompassing 1st lockdown, lockdown easing, and 2nd lockdown) had 993 individual responses. 40% respondents were located regionally. Role categories included: nursing (50%), allied health (18%), medical (16%), administrative (15%), ancillary (e.g. cleaner, food service) (1%). Emergent themes were: S trategies for protection- at work and home. Up to 27% respondents reported being able to attend to critical personal needs only sometimes or less, although patients were perceived to be well supported most/all of the time (&gt;90% responses). Navigating rules and keeping up-high levels of perceived institutional preparedness in &gt;75% responders coexisted alongside fluctuating levels of self-reported distress, from median 5 (IQR 3-7) at 1st lockdown outset to 1 (IQR 1-4) after lockdown restriction easing. Tempered optimism-pride in one’s place was reported both as reflecting healthcare worker identity and as Australians in the context of low local infection rates. No significant differences in distress or preparedness perceptions were evident comparing geographic sites. Framing the new normal-although respondents longitudinally reported increasing familiarity with pandemic directives, distress levels increased concurrently with the announcement of 2nd lockdown. Conclusions: In the context of low local COVID-19 infection rates, oncology staff regardless of role and geographic setting reported high perceptions of institutional preparedness. Distress levels increased concurrently with lockdown phases and reports of distress and psychosocial workload fatigue were made by various workers including administrative and ancillary. These should be considered frontline staff for the purpose of workplace psychosocial support in pandemic responses.

POS1161 A CITIZEN SCIENCE APPROACH TO CAPTURE POOR MENTAL HEALTH RELATED TO COVID-19 IN RHEUMATIC PATIENTS AFTER CONFINEMENT DURING PANDEMIC IN ITALY

Background:A considerable psychosocial burden is one of the relevant consequences of the COVID-19 pandemic. In particular, quarantine measures have been related to negative psychological effects, including symptoms of post-traumatic stress disorder, stress, anxiety, and depression (1). This rise in mental health disorders might be even worse among people more vulnerable to psychological stress such as patients suffering from chronic rheumatic diseases (RDs).Objectives:The present Italian nationwide survey engages patients with rheumatic conditions through eleven associations of RD patients. It is conducted to establish the COVID-19 related self-reported poor mental health symptoms and to identify potential factors associated with these concerns among RDs who experienced the COVID-19 quarantine in Italy.Methods:We collected data from May to September 2020 from RD patients living in Italy during the COVID-19 quarantine by an ad-hoc online survey. By using their mailing list and the related webpage and social network, eleven patients’ associations sent a call to RD patients asking them to complete an anonymous online survey which included the Perceived Stress Scale (PSS), and the Impact Event Scale-Revised (IES-R). χ2 tests were performed to detect statistically significant differences in both rating scale scores between groups defined by qualitative variables. Correlation analyses were realized with quantitative variables and rating scale scores. Variables significant in univariate analyses were then inserted in multivariate regression models.Results:In total, 507 RD patients completed to the survey. 375 (73.9%) patients had inflammatory arthritis (243 rheumatoid arthritis, 76 psoriatic arthritis, 49 ankylosing spondylitis, and 7 Still’s disease), and 96 (18.9%) with connective tissue diseases or systemic vasculitis. 31 (6.1%) patients had primary fibromyalgia and 5 osteoarthritis or crystal arthropathies. Self-reported major sources of anxiety are reported in the Figure 1 below.The mean (SD) scores of the PSS-10 and the IES-R were 18.1 ± 8.1 and 29.7 ± 17.5, respectively. With regard to the IES-R subscale scores, the total sample did not show a prominence of one of the three main domains (intrusion, avoidance and hyperarousal). Higher PSS scores were significantly associated with younger age (p&lt;0.01), female gender (p&lt;0.01), living outside Lombardy (p=0.03), presence of overweight/obesity (p=0.01), ongoing psychopharmacotherapy (p&lt;0.01), and anxiety for loss of incomes (p&lt;0.01). Female gender (p&lt;0.01) and living outside Lombardy (p=0.02) were associated also with higher IES-R scores, together with the presence of intestinal diseases (p=0.03), anxiety disorders (p&lt;0.01), and worries about health (p&lt;0.01).Conclusion:This nationwide study revealed a high impact of self-reported distress, anxiety, and perceived stress among rheumatic patients after confinement during COVID-19 pandemic in Italy. Different factors were found to be predictive of poor mental health such as having female gender, younger age, living outside Lombardy, having overweight/obesity, or intestinal diseases, having a history of psychiatric symptoms (e.g. anxiety). Moreover, the lockdown experience worsened psychiatric symptoms and increased the assumption of psychopharmacotherapy in this vulnerable population. Prevention strategies focused on specific variables should be implemented to ameliorate psychological well-being of fragile patients during pandemics.

Self-Reported Vision Impairment and Psychological Distress in U.S. Adults

ABSTRACT Purpose Examine the relationship between vision impairment and psychological distress in adults ≥18 years. Methods Using the 2016–2017 cross-sectional, U.S. National Health Interview Survey, we analyzed self-reported data (n = 57,644) on: Kessler psychological distress scores; general vision impairment (GVI), defined as difficulty seeing even when wearing glasses or contacts; and visual function impairment (VFI), measured using six visual function questions. Multinomial logistic regression was used to estimate adjusted odds ratios (aOR) for mild/moderate and serious psychological distress, by GVI and VFI status, and identify predictors of psychological distress among those with GVI or VFI. Results Among adults, 10.6% (95% CI: 10.2, 11.0) had GVI; 11.6% (CI: 11.1, 12.0) had VFI. One in four adults with GVI had psychological distress (14.9% [CI: 13.8, 16.0] reported mild/moderate and 11.2% [CI: 10.2, 12.3] reported serious). Individuals with GVI, versus those without, had higher odds of mild/moderate (aOR = 2.24; CI: 2.00, 2.52) and serious (aOR = 3.41; CI: 2.96, 3.93) psychological distress; VFI had similar findings. Among adults with GVI, odds of serious psychological distress were higher for those aged 18–39 (aOR = 4.46; CI: 2.89, 6.90) or 40–64 (aOR = 6.09; CI: 4.33, 8.57) versus ≥65 years; smokers (aOR = 2.45; CI: 1.88, 3.18) versus non-smokers; physically inactive (aOR = 1.61; CI: 1.22, 2.11) versus active; and with arthritis (aOR = 2.18; CI: 1.66, 2.87) or chronic obstructive pulmonary disease (aOR = 1.65; CI: 1.15, 2.37) versus without. Conclusion Adults with self-reported vision impairment had higher odds of psychological distress. These findings may inform screening interventions to address psychological distress, particularly among younger working-age adults vision impairment.

Psychological Distress Reported by Primary Care Physicians in China During the COVID-19 Pandemic.

Primary care physicians (PCPs) play a key role in responding to the COVID-19 epidemic. The objective of this study was to explore the influencing factors associated with self-reported psychological distress among a sample of PCPs in China in relation to COVID-19. An online survey was distributed to a sample of PCPs in Chengdu city between February 10 and February 13, 2020. The survey consisted of three sections: demographic characteristics, COVID-19-related questions, and the General Health Questionnaire-12 (GHQ-12). After 5 months, a follow-up survey investigating the change of the GHQ-12 was conducted. A total of 712 PCPs completed the baseline survey (11.8% of those invited), 55.6% were female and 74.4% were aged between 30 and 49 years. High levels of psychological distress (GHQ-12 ≥3) were observed in 29.2% and were associated with low preparedness, high work impact, working with infected residents, personal life impact, and concerns, as well as older age and being married (p values < .05). Logistic regression analysis showed that psychological distress was associated with low preparedness (odds ratio [OR] = 0.91, 95% confidence interval [CI] = 0.87-0.96), high work impact (OR = 1.11, 95% CI = 1.03-1.20), personal life impact (OR = 1.12, 95% CI = 1.07-1.17), and safety-related concerns (OR = 1.09, 95% CI = 1.02-1.16). At the 5-month assessment point, high psychological distress was less frequent (21.8%). COVID-19 has resulted in high levels of distress in approximately 30% of PCPs in China. Factors associated with high psychological distress levels include low preparedness and high levels of work impact, personal life impact, and concerns. These findings highlight the importance of enhancing psychological health throughout the course of infectious pandemics.

Feasibility of Present-Centered Therapy for Prolonged Grief Disorder: Results of a Pilot Study.

Present-centered therapy (PCT) was originally developed as a strong comparator for the non-specific effects of psychotherapy in the treatment of posttraumatic stress disorder. PCT qualifies as a not strictly supportive treatment as it is structured and homework is assigned between sessions. It does not focus on cognitive restructuring or exposure. A growing body of literature supports its beneficial effects. For example, it demonstrated only slightly inferior effect sizes and lower dropout rates compared to that of trauma-focused cognitive behavioral therapy in several trials with patients suffering from posttraumatic stress disorder. The current study is the first to evaluate the feasibility and the treatment effects of PCT in adults with prolonged grief disorder (PGD). Meta-analyses on psychotherapy for PGD have yielded moderate effect sizes. N = 20 individuals suffering from PGD were treated with PCT by novice therapists as part of a preparation phase for an upcoming RCT in an outpatient setting. Treatment consisted of 20–24 sessions á 50 min. All outcomes were assessed before treatment, at post-treatment, and at the 3-month follow-up. The primary outcome, PGD symptom severity, was assessed using the Interview for Prolonged Grief-13. Secondary outcomes were self-reported PGD severity, depression, general psychological distress, and somatic symptom severity. Furthermore, therapists evaluated their experiences with their first PCT patient and the treatment manual. In intent-to-treat analyses of all patients we found a significant decrease in interview-based PGD symptom severity at post-treatment (d = 1.26). Decreases were maintained up to the 3-month follow-up assessment (d = 1.25). There were also significant decreases in self-reported PGD symptoms, depression, and general psychological distress. No changes were observed for somatic symptoms. The completion rate was 85%. Therapists deemed PCT to be a learnable treatment program that can be adapted to the patient's individual needs. The preliminary results of PCT as a treatment for PGD demonstrate large effects and indicate good feasibility in outpatient settings. The treatment effects were larger than those reported in meta-analyses. Thus, PCT is a promising treatment for PGD. Possible future research directions are discussed.

Ten weeks in: COVID-19-related distress in adults with autism spectrum disorder.

This study used data collected from 275 adults in the United States with autism spectrum disorder both before the pandemic and then 10 weeks into the pandemic to assess COVID-19-related distress and its impact. Two-thirds of those surveyed reported some type of distress related to the pandemic (i.e. difficulty coping or negative impact on emotional and mental health). While there were no changes in depressive and anxiety symptoms from prior to COVID-19 to 10 week later in the group as a whole, self-reported distress predicted increases in both anxiety and depression across the two timepoints. Furthermore, adults with higher levels of anxiety prior to the pandemic were more likely to report distress, and women were more likely to report a negative impact of the pandemic on their emotional and mental health. Findings highlight the importance of monitoring with adults with autism spectrum disorder to assess their need for mental health support, and providing ongoing support to those who already experience anxiety even before the pandemic.

Association between distress and displacement settings: a cross-sectional survey among displaced Yazidis in northern Iraq

BackgroundGlobally 70.8 million people have been forcibly displaced from their homes and are at disproportionally high risk for trauma. At the time of this study, there was an estimated 1.6 million internally displaced persons (IDP) in Iraq, more than two-thirds of whom reside in private, urban settings. This study aims to understand the impact of post-displacement accommodation on mental well-being of the Yazidi minority group displaced in Iraq.MethodsMulti-stage stratified sampling was used to randomly select IDPs in camp and out of camp settlements in northern Iraq. Standardized questionnaires evaluated factors including exposure to violence and self-reported distress symptoms (measured by Impact of Event Scale-Revised). A multi-variate linear model assessed the relationship between settlement setting and distress symptoms.ResultsOne thousand two hundred fifty-six displaced Yazidi participants were included in the study: 63% in camps and 37% out of camps. After controlling for exposure to violence, social cohesion, unemployment, and access to basic services, IDPs in camps were predicted to have a 19% higher mean distress symptom score compared to those out of camps.ConclusionsThis study provides a framework to investigate post-displacement accommodation as a potential intervention to improve well-being for displaced populations. With a shift towards new models of emergency and long-term housing, it is important to understand the potential and limitations of more decentralized models, and identify effective methods to maintain access to basic services while improving living conditions for both displaced populations and their host communities.

Oral Health in Adult Patients Receiving Palliative Care: A Mixed Method Study.

Oral disease is highly prevalent in persons receiving palliative care (PRPC). Yet, little is known about how PRPC perceive their oral health status and related treatment needs. This mixed-method study included 49 English-speaking PRPC (age≥18) recruited from the University of Iowa Palliative Care Clinic. Participants first completed a structured review of oral symptoms, followed by an oral exam. A nested sample of 11 participants also completed a semi-structured, in-depth interview querying their perceived oral health concerns and related treatment needs. Quantitative and qualitative data was analyzed and integrated for interpretation. Participants averaged 58.4 years. Nearly 70% had terminal cancer and 25% had advanced organ failure. Eighty-six percent of participants reported at least one oral symptom, including dry mouth (83.7%), a pain-related symptom (40.8%), or oral function difficulties (51.0%). Among the 31 dentate participants, 52% had untreated decayed/broken teeth and 33.3% had oral soft tissue lesions. Ill-fitting dentures and denture sores were common among denture users. About 40% of participants reported compromised health and/or quality of life due to oral conditions; however, the perceived impacts were modest. With the exception of painful conditions, oral treatment was not a priority for most of the participants. Oral disease was highly prevalent in PRPC, yet its overall impact was modest. In the absence of painful symptoms, most participants reported limited desire to seek treatment for oral health conditions. However, given the serious impacts of untreated oral diseases, oral healthcare decision should not be based solely on self-reported symptoms or distress.

Evaluating cognitive control training on symptoms of depression over time: Three potential mechanisms

Abstract Background Cognitive Control Training (CCT) may reduce symptoms of depression. The mechanisms behind CCT are unclear, however. This study examined the adaptive Paced Auditory Serial Addition Task's (aPASAT) effect on depressive symptoms, while examining potential mechanisms by which changes may occur. Methods Seventy-two participants were randomly assigned to 1 of 3 conditions: the aPASAT, an active control condition, and a no training control. Participants in the aPASAT and active control conditions each practiced a cognitive task over a 2-week period. The aPASAT is paced and time-pressured, whereas the active control was self-paced and developed to be less stressful. Results Linear trend analysis revealed that, when accounting for age, CCT decreased depressive symptoms as the stress involved in the training task increased, as predicted. Against prediction, self-reported distress tolerance was unrelated to this pattern. Limitations This study did not include data to evaluate performance on the training tasks. Additionally, though the task in the active control condition was developed to be less stressful, participant stress was not directly measured. Conclusions Findings suggest that cognitive control training may reduce depressive symptoms and that the stressful component of the aPASAT may be important in that reduction.

Assessing distress tolerance using a modified version of the Emotional Image Tolerance task

The Emotional Image Tolerance (EIT) task assesses tolerance of negative emotion induced by negatively valenced images. We made several minor modifications to the task (Study 1) and adapted the task to include positive and neutral images in order to assess whether individuals respond to the valence or the intensity of the image content (Study 2). In both studies, we assessed subjective distress, gender differences in task responses, and associations between behavioral and self-reported distress tolerance, and related constructs. Across both studies, the EIT successfully induced distress and gender differences were observed, with females generally indicating more distress than males. In Study 2, responses on the adapted EIT task were correlated with self-reported distress tolerance, rumination, and emotion reactivity. The EIT successfully induces distress and the correlations in Study 2 provide promising evidence of validity.

Socio-economic consequences of mental distress: quantifying the impact of self-reported mental distress on the days of incapacity to work and medical costs in a two-year period: a longitudinal study in Germany

BackgroundMental disorders are related to high individual suffering and significant socio-economic burdens. However, it remains unclear to what extent self-reported mental distress is related to individuals’ days of incapacity to work and their medical costs. This study aims to investigate the impact of self-reported mental distress for specific and non-specific days of incapacity to work and specific and non-specific medical costs over a two-year span.MethodWithin a longitudinal research design, 2287 study participants’ mental distress was assessed using the Hospital Anxiety and Depression Scale (HADS). HADS scores were included as predictors in generalized linear models with a Tweedie distribution with log link function to predict participants’ days of incapacity to work and medical costs retrieved from their health insurance routine data during the following two-year period.ResultsCurrent mental distress was found to be significantly related to the number of specific days absent from work and medical costs. Compared to participants classified as no cases by the HADS (2.6 days), severe case participants showed 27.3-times as many specific days of incapacity to work in the first year (72 days) and 10.3-times as many days in the second year (44 days), and resulted in 11.4-times more medical costs in the first year (2272 EUR) and 6.2-times more in the second year (1319 EUR). The relationship of mental distress to non-specific days of incapacity to work and non-specific medical costs was also significant, but mainly driven from specific absent days and specific medical costs. Our results also indicate that the prevalence of presenteeism is considerably high: 42% of individuals continued to go to work despite severe mental distress.ConclusionsOur results show that self-reported mental distress, assessed by the HADS, is highly related to the days of incapacity to work and medical costs in the two-year period. Reducing mental distress by improving preventive structures for at-risk populations and increasing access to evidence-based treatments for individuals with mental disorders might, therefore, pay for itself and could help to reduce public costs.

Non-Pharmacological Management of Burn-related Pain and Distress in Children: A Systematic Review and Meta-Analysis Study

Introduction: Pain and distress during burn-related painful procedures are common. Various non-pharmacological interventions are used to control pain and distress during burn-related painful procedures. Hereby, this study aimed to systematically review the recent literature regarding the efficacy of the non-pharmacological interventions to control pain perception and distress in children undergoing painful burn management procedures. Methods: the data sources were Cochrane Central Register of Controlled Trials, CINAHL, MEDLINE, and Science Direct databases were searched through 1989-2020. Data extraction was performed by two independent researchers. Selection criteria: Participants included children from birth to nineteen years. Only randomized controlled trials (RCTs) or RCT crossovers that had a no-treatment control comparison were eligible for inclusion in the analyses. Data analysis: The risk of bias was assessed using the Cochrane risk-of-bias tool for randomized trials. Review Manager 5.4 software was used to calculate standardized mean differences (SMDs) with 95% confidence intervals (CIs). Results: Out of 244 studies found, 15 trials met the inclusion criteria for further review with non-pharmacological interventions that included distraction (n=8), VR (n=5), hypnosis (n=1), and massage therapy (n=1). However, 13 trials out of 15 were included in the meta-analysis with 685 participants. Meta-analysis showed large effects of distraction intervention on self-reported pain (SMD -1.64, 95% CI -3.16, -0.12), observer-reported pain (SMD -3.02, 95% CI -5.85, -0.19), and behavioral distress (SMD -2.82, 95% CI -5.50, -0.14). Besides, distraction intervention showed moderate effects on self-reported distress (SMD -0.33, 95% CI -0.58, -0.08), and no effect on behavioral pain (SMD -1.06, 95% CI -2.44, 0.31). On the other hand, VR reported a large effect on self-reported pain (SMD 1.41, 95% CI -2.52, -0.30), a moderate effect on observer-reported pain (SMD -0.56, 95% CI -0.90, -0.22), and no effect on the behavioral pain (SMD -0.48, 95% CI -1.04, 0.08). Overall, the quality of derived evidence was downgraded due to study limitations, inconsistency, and imprecision. Conclusion: Distraction and VR are effective non-pharmacological interventions in reducing the pain perception and distress in children during painful burn management procedures.

Cross-sectional trend analysis of the NCHA II survey data on Canadian post-secondary student mental health and wellbeing from 2013 to 2019

BackgroundCanadian post-secondary students are considered to be at risk for chronic stress and languishing mental health, but there has been no longitudinal analysis of the available population-level data. The purpose of this study was to examine trends in the overall and sex-specific prevalence of self-reported stress, distress, mental illness, and help seeking behaviours among Canadian post-secondary students over the past several years.MethodsUsing the 2013, 2016, and 2019 iterations of the National College Health Assessment II Canadian Reference data, we conducted a trend analysis for each variable of interest, stratified by sex. The significance and magnitude of the changes were modelled using cumulative linked ordinal regression models and log binomial regression models.ResultsWith few exceptions, we observed significant increases over time in the proportion of students reporting symptoms of psychological distress, mental illness diagnoses, and help seeking for mental health related challenges. Female students reported a higher level of stress than male students, with a statistically significant increase in the stress level reported by female students observed over time. In all cases, larger proportions of female students were observed compared to male students, with the proportion of female students who self-reported mental illness diagnoses nearly doubling that of males.ConclusionsOur analysis indicated that the proportion of students self-reporting mental health related challenges, including stress, psychological distress, and diagnosed mental illnesses increased between the 2013, 2016 and 2019 iterations of the NCHA II conducted among Canadian post-secondary students.

Measurement invariance of the distress tolerance scale among university students with and without a history of non-suicidal self-injury.

Non-suicidal self-injury (NSSI) is the intentional damage to one’s body tissue in the absence of suicidal intent. NSSI primarily serves an emotion regulation function, with individuals engaging in self-injury to escape intense or unwanted emotion. Low distress tolerance has been identified as a mechanism that underlies self-injury, and is commonly assessed using the self-report Distress Tolerance Scale. There are mixed findings regarding the factor structure of the Distress Tolerance Scale, with some researchers utilising a higher-order distress tolerance score (derived from the scores on the four lower-order subscales) and other researchers using the four subscales as unique predictors of psychological outcomes. Neither of these factor structures have been assessed among individuals with a history of self-injury. Of note, an inability to tolerate distress (thought to underlie NSSI) may limit an individual’s capacity to accurately observe and report specific thoughts and emotions experienced in a state of heightened distress, which may impact the validity of scores on the Distress Tolerance Scale. Therefore, measurement invariance should be established before attributing NSSI-related differences on the scale to true differences in distress tolerance. We compared the Distress Tolerance Scale higher-order model with the lower-order four factor model among university students with and without a history of NSSI. Our results indicated that the lower-order four factor model was a significantly better fit to the data than the higher-order model. We then tested the measurement invariance of this lower-order factor model among individuals with and without a history of NSSI, and established configural and full metric invariance, followed by partial scalar and full residual error invariance. These results suggest the four subscales of the Distress Tolerance Scale can be used to confidently discern NSSI-related differences in distress tolerance.