Self-reported Psychological Distress Research Articles

Population Health Implications of Medicaid Prerelease and Transition Services for Incarcerated Populations.

As states expand prerelease and transition services for incarcerated individuals under the Medicaid Reentry Section 1115 Demonstration Opportunity, we sought to systematically inform Medicaid state and plan administrators regarding the population size and burden of disease data available on incarcerated populations in both jails and prisons in the United States. We analyzed data on eligibility criteria for new Medicaid prerelease and transition services based on incarceration length and health conditions across states. We estimated the potentially eligible populations in prisons and jails, considering various incarceration lengths and health status requirements. We also compared disease prevalence in the incarcerated population with that of the existing civilian Medicaid population. We found that rural and smaller states would experience a disproportionately large proportion of their Medicaid populations to be eligible for prerelease and transition services if new Medicaid eligibility rules were broadly applied. Self-reported psychological distress was notably higher among incarcerated individuals compared with those currently on Medicaid. The prevalence rates of previously diagnosed chronic hepatitis C and kidney disease were also much higher in the incarcerated population than the existing civilian Medicaid population. We estimated large volumes of potentially Medicaid-eligible entrants as coverage policy changes take effect over the coming years, particularly impacting smaller and more rural states. Our findings reveal very high disease prevalence rates among the incarcerated population subject to new Medicaid coverage, including specific chronic, infectious, and behavioral health conditions that state Medicaid programs, health plans, and providers may benefit from advanced planning to address.

The changing impacts of social determinants on youth mental health in Australia.

Most lifetime mental health disorders begin by age 25 years, and the prevalence among young people has been increasing over recent years. We sought to understand what impact, if any, social determinants have had on this increase through the analysis of an Australian longitudinal dataset (with data from 2007 to 2021). The analysis focused on five social determinants: loneliness and lack of social support, family relationships, participation in education and employment, receipt of government benefits and relative socio-economic status. We analysed cross-sectional changes in self-reported psychological distress between 2007 and 2021 (using the Kessler-10 item; K10 scores) and examined the effects of these five social determinants on psychological distress using weighted linear regression models. We identified a significant increase in psychological distress among Australians from 2007 to 2021, with the sharpest rise among those aged 15 to 25 years, who saw more than doubling in the percentage of high and very high K10. This period also saw an increase in the prevalence of social determinants such as loneliness and lack of social support, as well as poor family relationships, particularly in 2021 post COVID-19 pandemic. Regression models suggest loneliness and lack of social support had the most pronounced and increasing impact on psychological distress, followed by poor family relationships. The observed significant and steady increases in psychological distress and related social determinant factors, particularly loneliness and lack of social support among young people, highlight the urgent need for comprehensive actions. Coordinated research and community-based initiatives are needed to deliver intrapersonal, interpersonal and socially-focused interventions with a holistic approach to support psychosocial wellbeing. Policymakers must adopt a comprehensive shift in political commitment and a whole-of-government approach to address these challenges.

The Role of Social Determinants of Health in Self-Reported Psychological Distress among United States Adults Post-COVID-19 Pandemic.

Psychological distress, an emotional condition with symptoms of anxiety and depression, leads to impaired function, behavior, and personal traits. The current study examined the association between social determinants of health and the severity of psychological distress among adults in the United States after the COVID-19 pandemic. Using multinomial multivariable logistic regression, we analyzed data from 5106 (n = 5106) participants in the Health Information National Trends Survey (HINTS) 6. Compared to non-Hispanic Whites, African Americans (AOR = 0.62, CI = 0.42-0.93) had lower odds of reporting mild psychological distress rather than no stress. Other variables associated with a higher likelihood of reporting moderate to severe psychological distress, rather than no distress, are being in the 50-64 years age group (AOR = 2.77, CI = 1.45-5.28), divorced (AOR = 2.50, CI = 1.70-3.69), and widowed (AOR = 3.78, CI = 2.15-6.64). Respondents living in an urban area had lower odds of reporting moderate to severe psychological distress (AOR = 0.56, CI = 0.39-0.80) compared to those living in rural areas. Our findings identify several risk factors for psychological distress by sociodemographic characteristics such as age, race, marital status, and urban living, providing empirical evidence for interventions in behavioral health. These findings suggest there is an utmost need for a multi-sectoral approach to address the social determinants of health associated with psychological distress post-COVID-19 pandemic.

Assessment of the Mental and Physical Health Problems of Clients Undergoing Opioid Substitution Therapy: A Hospital-based Cross-sectional Study

Background: Opioid substitution therapy (OST) is one of the most effective treatment options for opioid dependence. However, there are not enough credible studies available on the health-care problems of clients undergoing OST. Materials and Methods: The study recruited 100 patients undergoing OST on an outpatient basis using a consecutive sampling technique. The mental and physical health problems were evaluated using the Patient Health Questionnaire-9, General Anxiety Disorder Scale 7, and a self-reported physical symptom checklist. Results: The estimates of depression and anxiety were 52% and 39%, respectively. The general physical ailments were more often reported by the subjects followed by musculoskeletal problems and neurological problems. A significant correlation was observed between physical health problems with anxiety (r = 0.40, P < 0.01) and depression (r = 0.37, P < 0.01). Conclusion: The clients undergoing OST have a high degree of self-reported health problems and psychological distress in this setting.

Psychological distress among Canadian postsecondary students: a repeated cross-sectional analysis of the Canadian Campus Wellbeing Survey (CCWS) between spring 2020–2023

Objective: To examine trends in self-reported psychological distress among Canadian postsecondary students between 2020 and 2023. Participants and Methods: Using data collected from postsecondary students (n = 103,936) through the Canadian Campus Wellbeing Survey (CCWS), multilevel regression models were fitted to determine how distress levels, as measured by the Kessler Psychological Distress Scale, differed across six-time points of the CCWS. Results: Across the cycles, students reported high levels of distress (mean across cycles = 26.16, SD = 8.61). Considering the impact of time on distress, when compared to pre-COVID-19 pandemic, Fall 2020 (β = 1.4, p < .001), Spring 2021 (β = 1.2, p < .001), Spring 2022 (β = 1.6, p < .001), and Spring 2023 (β = 0.80, p < .017) had significantly higher levels of distress. Distress levels were associated with ancestry, age, gender, and sexual orientation. Conclusion: It is imperative to develop strategies and allocate resources to address the high levels of psychological distress among Canadian postsecondary students.

Self-reported cognitive function and its relationship with self-reported health, psychological distress, and life satisfaction among cardiac arrest survivors - a nationwide register study

Abstract Introduction Cognitive problems in terms of memory, executive function, information retrieval, perception, and attention are common in cardiac arrest (CA) survivors. Studies show that cognitive impairment are associated with important outcomes such as lower quality of life, social function, and ability to work. However, cognitive function is commonly assessed by performance-based or observer-reported outcome measures that do not reflect the person’s own experience. To offer a person-centred CA care, this knowledge is of high importance. Purpose To describe self-reported cognitive function and its relationship with self-reported health, psychological distress, and life satisfaction among CA survivors. Methods This nationwide register study utilized data from the (Country) Register of Cardiopulmonary Resuscitation, encompassing survivors of both in-hospital and out-of-hospital CA. Inclusion criteria comprised survivors with a Cerebral Performance Category (CPC) scale score ≤3 at hospital discharge who underwent a follow-up phone interview with a registered nurse 3-6 months post CA. Health status was measured using the EQ-5D Visual Analogue Scale (EQ VAS), psychological distress with the Hospital Anxiety and Depression Scale (HADS), and life satisfaction with a global question about overall satisfaction from the Life Satisfaction Questionnaire (LiSat-11). Self-reported cognitive function was measured by a single question: ‘How do you experience your memory, concentration, and/or planning abilities today compared to before the cardiac arrest?’ Data was analysed using multiple linear regression and multiple binary logistic regression models. Results The sample consisted of 1,254 CA survivors, 32% females. The mean age was 66 (SD=13.4) years. Most of the CAs occurred in-hospital (74%) and were witnessed (93%). A cardiac aetiology (55%) and a shockable initial rhythm (57%) were most common. In total, 68% reported an unchanged cognitive function while 27% reported worse cognitive function. Better cognitive function was reported by 5%. Experiencing a worse cognitive function in relation to unchanged or better cognitive function was associated with worse self-reported health measured using the EQ VAS (p&amp;lt;0.001), higher levels of symptom of anxiety and depression measured with the HADS (p&amp;lt;0.001 and p&amp;lt;0.001 respectively), and a lower life satisfaction measured by the LiSat-11 (p&amp;lt;0.001). The significant associations remained after the regression models were adjusted for age, sex, place, aetiology, initial rhythm, and witnessed status. Conclusions As CA survivors with worse cognitive function reported poorer health, more psychological distress, and reduced life satisfaction, this study points out the importance to screen for self-reported cognitive function. Using a single question may facilitate the ability to identify survivors with a perceived worse cognitive function in need of support.

Digital cognitive behavioral therapy for insomnia for people with comorbid psychological distress: A large scale randomized controlled trial

Study objectivesTo examine if comorbid anxiety and depression symptoms (psychological distress) moderate intervention effect in participants receiving digital Cognitive Behavioral Therapy for Insomnia (dCBT-I) in a large-scale randomized controlled trial (RCT), compared to a patient education (PE) control condition. Further, we investigate if dCBT-I reduced levels of psychological distress for those with insomnia and comorbid psychological distress. Methods1721 participants with insomnia completed online assessments of sleep, fatigue and psychological distress, at baseline and at nine-week follow-up. Primary outcome was Insomnia Severity Index (ISI), and secondary outcomes included self-reported sleep (diary), cognition, fatigue, and psychological distress. Participants with psychological distress (HADS>16) were separated from participants without psychological distress. Linear mixed models in SPSS were conducted to test the effects of the intervention. ResultsAt nine-week follow-up we found no difference in effect of the intervention between those who had comorbid psychological distress vs. those without psychological distress in terms of insomnia severity (p = 0.552) and fatigue (p = 0.744). Both groups had large effect size improvements on insomnia severity (p < 0.001=), small to medium (Cohen d < 0.08) improvements on fatigue (p < 0.01=) and sleep efficiency (p < 0.001), and small improvement on other sleep diary measures, compared to their respective control group. The psychological distress group showed a small, but statistically significant decrease in psychological distress (d = 0.2, p < 0.05) with dCBT-I compared to PE. ConclusiondCBT-I is a viable treatment for Insomnia also for those who have comorbid psychological distress.

Effects of cardiac radiation on sleep and psychological distress in adult survivors of pediatric Hodgkin lymphoma without breathing sleep disorders.

10068 Background: Adult survivors of childhood Hodgkin lymphoma (HL) are at higher risk for excessive sleepiness, fatigue, and other morbidities that affect long-term quality of life (QoL). The relationship between radiation dose to the heart delivered during treatment and self-reported sleep quality, fatigue, QoL, and psychological distress in survivors of HL has not been explored. This study examines clusters of cardiac dosimetry and sleep quality and associated symptoms of insomnia, fatigue, QoL, and psychological distress in a subset of adult survivors of pediatric HL without breathing sleep disorders. Methods: Survivors completed standardized surveys of sleep quality (Pittsburg Sleep Quality Index, PSQI), insomnia (Insomnia Severity Index), fatigue (FACIT-F), QoL (SF36 short survey), and psychological distress (BS18). Two consecutive nights of in-home polysomnography were completed with at least 4 hours of recorded sleep in one night. Analyses were conducted on 95 survivors (mean[SD] age=36[7.2] years, 55 female) who demonstrated at least average sleep efficiency (&gt;85%) and demonstrated no evidence of sleep apnea (Apnea-Hypopnea Index &lt;5, or AHI &gt;5 and &lt;15 with no daytime sleepiness as defined by the American Society of Sleep Medicine). Radiation dose to the heart was estimated using dose reconstruction methods for therapeutic radiation exposure developed by the MD Anderson Cancer Center. Radiation/Sleep clusters were found using a silhouette analysis and K-means algorithm. Linear regression associations between clusters and outcomes were adjusted by age and body mass index. Statistical analyses were computed in the statsmodels toolbox for Python3. Results: Sleep and radiation were not correlated (ρ=0.03, p=0.67). Considering good sleep as PSQI&lt;5, three main Radiation/Sleep clusters were found indicating a low-radiation/middling-sleep group (22%; RT = 251[250.7] cGy, PSQI = 7[2.7]), a high- radiation/better-sleep group (46%; RT = 2012[406.8] cGy, PSQI = 4[1.5]), and a high- radiation/worst-sleep group (32%; RT = 2072[472.3] cGy, PSQI = 11[2.5]). Survivors in high-radiation/worst-sleep group demonstrated worse fatigue ( β=-12.3, p=0.001) and insomnia ( β=9.52, p&lt;0.001). This group was associated with poor Mental Health ( β=-2.1, p&lt;0.001) but not Physical Health QoL ( β=-0.4, p=0.154). This latter group also indicated more psychological distress (depression β=11.6, p=0.001, somatization β=11.8, p&lt;0.001), but not anxiety ( β=4.6, p=0.241). Conclusions: Our results highlight the burden of symptoms associated with higher radiation dosimetry in the heart including poor sleep quality, insomnia, fatigue, and increased psychological distress. Understanding the mechanisms of sleep quality and fatigue in HL survivors is warranted as some survivors demonstrate poor sleep quality and fatigue due to factors other than clinical sleep disorders.

Chronic Physical and Mental Health Conditions Associated With Employment Status in Veterans

Veterans commonly experience both poor health and employment difficulty. However, the research examining potential relationships between chronic physical and mental health conditions and employment in veterans has important limitations. This study examines those potential relationships using large-scale, nationally representative data. The authors' hypothesis was that veterans experiencing these conditions would be less likely to be employed than veterans without the conditions and, further, that there may be differences in these relationships when comparing male veterans with female veterans. The study team conducted a pooled cross-sectional analysis of nationally representative data from the 2004-2019 administrations of the Medical Expenditures Panel Survey, which had items addressing health conditions, employment, and military experience. The authors assessed the relationship between health conditions and employment using multivariate logistic regression. Control variables included demographics, SES, family size, and survey year. Veterans experiencing diabetes, high blood pressure, stroke, emphysema, arthritis, serious hearing loss, poor self-reported mental health, poor self-reported health, depression, or psychological distress were less likely to be employed than veterans without those conditions, even after adjusting for potential confounding factors. Veterans with diabetes had 25% lesser odds of being employed than veterans without the condition (95% CI=0.65, 0.85). Veterans with increased likelihood of depression had 35% lesser odds of being employed than veterans without depression (95% CI=0.52, 0.81). This study adds evidence to the understanding of the role of chronic health conditions in employment status of veterans. The results support arguments for programs that aid veterans with both their health and their employment.

Adolescents’ Covitality Patterns: Relations with Student Demographic Characteristics and Proximal Academic and Mental Health Outcomes

Identifying and promoting students’ social-emotional strengths is essential in building their mental health. Covitality, representing the co-occurrence of psychological strengths, is a helpful framework for characterizing students’ well-being. This study used latent profile analysis to identify adolescents’ (n = 11,217; 50.3% female, 37.8% male; grades 9 [33.7%], 10 [21.0%], 11 [28.9%], and 12 [16.5%]) covitality patterns across 12 social-emotional health domains. We investigated whether student demographic characteristics (i.e., sex, parent educational attainment, ethnic identification) were related to profile membership. We further examined profiles’ relations to students’ proximal academic and mental health outcomes, including self-reported grades, school connectedness, life satisfaction, and psychological distress. Four covitality profiles were identified—High, Moderate-High, Moderate-Low, and Low. Profile membership was statistically significantly related to students’ sex and socioeconomic circumstances but with small effect sizes. We identified consistent differences across covitality profiles on student self-reported proximal outcomes. Overall, students in profiles with higher covitality levels (High and Moderate-High) reported (a) higher grades, school connectedness, and life satisfaction and (b) less psychological distress, with students in the High profile reporting the most favorable outcomes. Assessing students’ strengths and providing interventions focused on building strengths across domains are recommended.

Development process, clinical utility, and preliminary psychometric evidence of a new tool for screening psychological distress in renal care settings: the Hemodialysis Distress Thermometer (HD-DT)

Objective This study aimed to develop, evaluate the clinical utility, and test the psychometric properties of a new tool – the Hemodialysis Distress Thermometer (HD-DT) – designed to screen self-reported psychological distress and its sources in adults receiving hemodialysis. Methods and Measures Phase 1 focused on the process of developing and evaluating the content validity and clinical utility of the HD-DT using a stepwise mixed-methods approach; in Phase 2, the measurement properties of the European Portuguese version of the HD-DT were tested against reference measures in a cross-sectional study (n = 134 people on hemodialysis); while in Phase 3 the HD-DT was translated and culturally adapted into American English using forward-backward translation and review by a panel of experts. Results Qualitative findings suggested that the HD-DT was perceived by feedback panels as practical and useful for rapidly screening psychological distress in nephrology centers. The European Portuguese version of this new tool showed good test-retest reliability and high diagnostic accuracy using a cutoff point of ≥ 6 for total distress. High convergent validity was found with reference measures that assess psychological health, and symptoms of anxiety and depression. Conclusion This study highlights the potential clinical utility of the HD-DT as an acceptable, reliable, and valid measure that can be used by health psychologists in clinical practice and research in renal care settings. Data collection to validate the American English version of the HD-DT is currently underway.

Birdwatching linked to increased psychological well-being on college campuses: A pilot-scale experimental study

Exposure to nature is known to improve human health, but little is known about how one of the most common forms of nature engagement, birdwatching, impacts psychological well-being - especially among campus populations at great risk for experiencing mental health challenges. This study engaged 112 campus participants in a stepped design experiment evaluating the degree to which five >30 min weekly birdwatching (n = 62) and nature walk (n = 77) exposures impacted self-reported subjective well-being (WHO-5) and psychological distress (STOP-D) levels relative to a control group (n = 81). The directions of all relationships supported hypotheses that nature-based experiences, and birdwatching in particular, would increase well-being and reduce distress. These results build on preliminary evidence of a causal relationship between birdwatching and well-being and highlight the value of considering well-being impacts for specific types of activities in nature, underscoring the need for future research with larger and more diverse samples.

Study on Psychological Stress Perceived among Employees in an Italian University during Mandatory and Voluntary Remote Working during and after the COVID-19 Pandemic.

This cross-sectional study examined the perceived psychological well-being of administrative/technical employees and researchers/lecturers at the University of L'Aquila (Italy) during the COVID-19 pandemic. The study was carried out in two different periods of 2022: April 2022, when remote working was still mandatory, and December 2022, when the pandemic emergency had ended and, in Italy, remote working had become voluntary for two days a week and exclusively for administrative staff. Perceived psychological well-being was investigated using the GHQ-12 (Global Health Questionnaire, short-form with 12 items), a self-administered questionnaire created on Google Forms and sent via email to all the employees of the University of L'Aquila. Statistical analysis was conducted using means, standard deviations, and frequency tables for the descriptive analysis of socio-demographic data, while the t-test or Wilcoxon test and the Χ2 test were used to verify the statistical difference and association between categorical variables. Overall, 365 employees, including 118 administrative/technical and 247 research/teaching staff, participated in the survey in April 2022 when remote working was mandatory. Among them, 219 (52.8%) were female and 196 (47.2%) were male. In December 2022, 266 employees engaged in voluntary remote working, including 184 (69.2%) women and 82 (30.8%) men, took part in the study. The most represented age group was 50-59 years old (36.3% of study participants). During mandatory remote working, 83.4% of lecturers reported a perceived level of psychological distress ranging from moderate to severe versus 69.5% of technicians. The percentage of self-reported psychological distress was higher among the technicians forced to work from home (n. 118-42.9%) vs. the technicians working from home on a voluntary basis (n. 157-57.1%), with GHQ score being >14 in 65.5% of enforced remote workers vs. 62.3% of voluntary remote workers. During mandatory remote working, there was a significant difference in the GHQ-12 score between administrative and research staff, particularly related to items such as loss of self-confidence, emotional pressures, and diminished productivity. Moreover, from the comparison between the group of administrative staff engaged in mandatory remote working and those in voluntary remote working for specific GHQ-12 items, a statistically significant difference emerged concerning the perception of not being able to overcome difficulties; the GHQ-12 score was higher in the first group. Significant differences in the overall GHQ-12 score were evident between male and female lecturers, as the latter reported higher levels of perceived stress during mandatory remote working. The results confirm that remote working could be associated with a better psychological state of administrative university staff, especially in the case of voluntary remote working. During mandatory remote working, a difference was observed between teaching and administrative staff, with higher stress in the first group and among women. Therefore, our sample appears fragmented in the self-assessment of psychological well-being during remote working, possibly due to profound differences in the organization of work activities between lecturers and administrative employees. Additionally, the increased perception of stress by female lecturers compared to males may reflect gender disparities, as women working from home during the pandemic experienced an increased workload including domestic activities. Remote working is a type of working that has both advantages and disadvantages. An advantage is undoubtedly a better work-life balance; however, the risks of technostress, workaholism, increased sedentary behaviour, and social isolation are negative aspects. This study provides an indicative overview of the psychological state related to remote working in a university setting during the SARS-CoV-2 pandemic. The study might therefore serve as a starting point for further research on the impact of remote working on self-reported psychological well-being, especially in the university environment.

Job Flexibility, Job Security, and Mental Health Among US Working Adults

Understanding the association between job characteristics and mental health can inform policies and practices to promote employee well-being. To investigate associations between job characteristics and mental health, work absenteeism, and mental health care use among US adults. This cross-sectional study analyzed data from the 2021 National Health Interview Survey and included adults aged 18 years or older who reported employment during the past 12 months. Data were analyzed from May 2023 to January 2024. Job flexibility was assessed as a summative variable to 3 questions: perceived ease of changing one's work schedule to do things important to oneself or their family, regularity of work schedule changes, and advance notice of work hours. Job security was measured as perceived likelihood of losing one's job. Mental health outcomes included self-reported serious psychological distress and frequency of anxiety. Work absenteeism was assessed using the number of missed workdays due to illness. Mental health care use was examined for both current and past year use. Multivariable logistic and binomial regression analyses were used to examine associations of interest. The analytic sample consisted of 18 144 adults (52.3% [95% CI, 51.5%-53.2%] male; mean age, 42.2 [95% CI, 41.9-42.6] years). Greater job flexibility was associated with decreased odds of serious psychological distress (odds ratio [OR], 0.74 [95% CI, 0.63-0.86]; P < .001) and lower odds of weekly anxiety (OR, 0.89 [95% CI, 0.81-0.97]; P = .008) or daily anxiety (OR, 0.87 [95% CI, 0.79-0.96]; P = .005). Greater job security was associated with decreased odds of serious psychological distress (OR, 0.75 [95% CI, 0.65-0.87]; P < .001) and lower odds of anxiety weekly (OR, 0.79 [95% CI, 0.71-0.88]; P < .001) or daily (OR, 0.73 [95% CI, 0.66-0.81]; P < .001). Greater job flexibility (incidence rate ratio [IRR], 0.84 [95% CI, 0.74-0.96]; P = .008) and job security (IRR, 0.75 [95% CI, 0.65-0.87]; P < .001) were each associated with decreased number of days worked despite feeling ill over the past 3 months. Greater job security was associated with decreased absenteeism in the past year (IRR, 0.89 [95% CI, 0.82-0.98]; P < .014). Organizational policies that enhance job flexibility and security may facilitate a healthier work environment, mitigate work-related stress, and ultimately promote better mental health.

Wellbeing After Stroke (WAterS): Feasibility Testing of a Co-developed Acceptance and Commitment Therapy Intervention to Support Psychological Adjustment After Stroke

Objective Feasibility test a co-developed intervention based on Acceptance and Commitment Therapy to support psychological adjustment post-stroke, delivered by a workforce with community in-reach. Design Observational feasibility study utilising patient, carer, public involvement. Setting Online. UK. Participants Stroke survivors with self-reported psychological distress 4 + months post-stroke. Interventions The co-developed Wellbeing After Stroke (WAterS) intervention includes: 9-weekly, structured, online, group sessions for stroke survivors, delivered via a training programme to upskill staff without Acceptance and Commitment Therapy experience, under Clinical Psychology supervision. Main measures Feasibility of recruitment and retention; data quality from candidate measures; safety. Clinical and demographic information at baseline; patient-reported outcome measures (PROMs) via online surveys (baseline, pre- and post-intervention, 3 and 6 months after intervention end) including Mood (hospital anxiety and depression scale (HADS)), Wellbeing (ONS4), Health-Related Quality of Life (EQ5D5L), Psychological Flexibility (AAQ-ABI) and Values-Based Living (VQ). Results We trained eight staff and recruited 17 stroke survivors with mild-to-moderate cognitive and communication difficulties. 12/17 (71%) joined three intervention groups with 98% attendance and no related adverse events. PROMS data were well-completed. The HADS is a possible future primary outcome (self-reported depression lower on average by 1.3 points: 8.5 pre-group to 7.1 at 3-month follow-up; 95% CI 0.4 to 3.2). Conclusion The WAterS intervention warrants further research evaluation. Staff can be trained and upskilled to deliver. It appears safe and feasible to deliver online to groups, and study recruitment and data collection are feasible. Funding has been secured to further develop the intervention, considering implementation and health equality.

Emotional impacts of racial discrimination on caregiver-child dyads: Can mentalizing-focused parenting groups buffer against racism-related stress?

Black and Latinx caregivers face high risk for parenting stress and racism-related stress due to experiences of racial discrimination (RD). This study aimed to explore the associations between RD, parenting stress, and psychological distress in caregiver-child dyads, as well as the impact of a mentalizing-focused group intervention on caregivers' experiences of RD distress. Ethnoracially minoritized caregivers of children aged 5-17 years old participated in a non-randomized clinical trial (N = 70). They received either a 12-session mentalizing-focused group parenting intervention or treatment-as-usual in outpatient psychiatry. We assessed self-reported frequency and distress related to RD, parenting stress, and psychological distress at baseline (T1) and post-intervention (T2). Caregiver- and self-reported child psychological distress were also measured. The results showed that greater RD frequency and greater RD distress separately predicted higher overall parenting stress and parental role-related distress. Greater RD distress was linked to increased psychological distress in caregivers. Similarly, greater RD frequency and distress among caregivers were associated with higher caregiver-reported, but not self-reported, child psychological distress. No significant changes in RD distress were observed between T1 and T2 for either of the treatment groups. These findings highlight the exacerbating role of RD on parenting stress and psychological distress among ethnoracially minoritized caregivers and their children.

Pain and salivary biomarkers of stress in temperomandibular disorders were affected by maxillary splints.

Longitudinal intervention studies on treatment options in temporomandibular dysfunction (TMD) including self reports and salivary biomarkers of stress are rare and the exact therapeutic function of occlusal splints widely unknown. We examined the therapeutic effects of a Michigan splint with occlusal relevance in patients with TMD using a placebo-controlled, delayed-start design. Two intervention groups received a Michigan splint, while one of them had a placebo palatine splint for the first 3 weeks. We collected pain intensities (at rest and after five occlusal movements), salivary measures associated with stress (cortisol and alpha-amylase) and self-reported psychological distress (stress, anxiety, catastrophizing) at baseline and 3 and 7 weeks after onset of intervention. At baseline, we observed increased pain intensity and psychological distress in TMD patients compared to 11 matched healthy controls. Baseline anxiety was linked to movement pain intensity through stress. Over therapy reductions in pain intensity and morning cortisol were more pronounced in those patients starting immediately with the Michigan splint, while psychological distress decreased similarly in both groups. Our results suggest that perceived stress plays a role for the association between anxiety and TMD pain and underlines the need for an interdisciplinary perspective on the pathogenesis and therapy of TMD in a setting where psychotherapeutic knowledge is still scarce or rarely applied.

The Hemodialysis Distress Thermometer for Caregivers (HD-DT-C): development and testing of the psychometric properties of a new tool for screening psychological distress among family caregivers of adults on hemodialysis

PurposeTo develop and test the measurement properties of the HD-DT-C, a new tool designed to facilitate the screening of psychological distress and its sources in family caregivers of adults on hemodialysis.MethodsThe present investigation was carried out in three phases: Phase 1 focused on the process of developing and exploring the content validity and clinical utility of the HD-DT-C using a mixed-methods approach and feedback panels; Phase 2, where the psychometric properties of this new tool were tested in a cross-sectional study (n = 106 caregivers); and Phase 3, where the European Portuguese version of the HD-DT-C was translated and culturally adapted into American English using a forward–backward translation procedure, followed by an expert panel review.ResultsFindings suggested that the HD-DT-C was perceived by feedback panels as practical, appropriate, and useful for increasing dialysis provider/family caregiver communication in nephrology centers. The European Portuguese version of the HD-DT-C showed good test–retest reliability (ICC = 0.991 for the barometer and κ ≥ 0.80 in 77% of the checklist items), high diagnostic accuracy (AUC = 0.956), and strong convergent validity (all r ≥ 0.50) with reference measures that assess quality of life, caregiver burden, and symptoms of anxiety and depression. Cutoff scores with good clinical utility (CUI + ≥ 0.70) were recommended for screening distress in research (≥ 6) and clinical practice (≥ 5).ConclusionThe HD-DT-C is a brief, reliable, valid, and acceptable measure for identifying self-reported psychological distress and its sources among people caring for a family member or friend on hemodialysis. Future research is needed to explore the measurement properties of the American English version of this new tool.

A short-interval longitudinal study of associations between psychological distress and hippocampal grey matter in early adolescence

This study of Australian adolescents (N = 88, 12-13-years-old) investigated the relationship between hippocampal grey matter volume (GMV) and self-reported psychological distress (K10) at four timepoints, across 12 months. Participants were divided into two groups; those who had K10 scores between 10 and 15 for all four timepoints were categorised as “low distress” (i.e., control group; n = 38), while participants who had K10 scores of 16 or higher at least once over the year were categorised as “moderate-high distress” (n = 50). Associations were tested by GEE fitting of GMV and K10 measures at the same time point, and in the preceding and subsequent timepoints. Analyses revealed smaller preceding left GMV and larger preceding right GMV were associated with higher subsequent K10 scores in the “moderate-high distress” group. This was not observed in the control group. In contrast, the control group showed significant co-occurring associations (i.e., at the same TP) between GMV and K10 scores. The “moderate-high distress” group experienced greater variability in distress. These results suggest that GMV development in early adolescence is differently associated with psychological distress for those who experience “moderate-high distress” at some point over the year, compared to controls. These findings offer a novel way to utilise short-interval, multiple time-point longitudinal data to explore changes in volume and experience of psychological distress in early adolescents. The results suggest hippocampal volume in early adolescence may be linked to fluctuations in psychological distress.

Self-reported psychological distress among patients with sellar processes

Self-reported psychological distress among patients with sellar processes