Source Of Psychological Distress Research Articles

Parenting under pressure: a cross-sectional questionnaire study of psychological distress, parenting concerns, self-efficacy, and emotion regulation in parents with cancer.

As many as one in four adults with cancer have children under 18 years. Balancing parenting and cancer is challenging and can be a source of psychological distress. This study aimed to examine psychological distress in parents with cancer and its associations with parenting concerns, self-efficacy, and emotion regulation. This was a cross-sectional questionnaire study of 406 parents (aged 25-60 years) diagnosed with cancer within the last 5 years, with at least one dependent child (≤ 18 years). Parents completed questionnaires on psychological distress (DASS-21), parenting concerns (PCQ), self-efficacy (GSE), emotion regulation (ERQ), mental and physical health, and sociodemographics. Data were analysed using multiple logistic regressions on depression (yes/no), anxiety (yes/no), and stress (yes/no). Higher parenting concerns were associated with greater odds of depression (OR = 2.33, 95% CI: 1.64-3.31), anxiety (OR = 2.30, 95% CI: 1.64-3.20), and stress (OR = 3.21, 95% CI: 2.20-4.69) when adjusting for health and sociodemographic factors. Poorer self-efficacy was associated with increased odds of anxiety (OR = 0.94, 95% CI: 0.89-0.99, p < 0.05), whereas lower use of cognitive reappraisal and higher use of expressive suppression increased the odds of depression (OR = 0.76, 95% CI: 0.59-0.98 | OR = 1.46, 95% CI: 1.18-1.80). The findings highlight the complexity of parental well-being in relation to parenthood and cancer, stressing the need for interventions that address relevant psychological factors to improve overall mental health in this population.

Homelessness and psychosocial resources: the role of stress and psychological capital

Objective: Homelessness is widely recognised as a social problem which has major health consequences for those who experience the condition. The aims of the study were to a) to develop a brief homelessness stress scale based on previous evidence, b) determine whether the experience of being homeless is a source of psychological distress, c) determine whether stress is associated with negative health behaviour and psychological disturbance and d) investigate psychosocial variables that may mediate the experience of stress. Method: A total of 189 individuals (132 males and 57 females) experiencing homelessness, based in one of two UK cities completed face-to face surveys with validated measures focusing on psychological capital, social support, health behaviours, stress, and psychological wellbeing. Results: Participants recorded significantly lower levels of psychological capital and social support and significantly higher levels of psychological distress compared to normative scores. Analysis suggests that low SES, and mental health issues are associated with lower perceived social support, lower psychological capital scores and higher perceived stress levels. Discussion: Findings suggest the potentially utility of psychological capital as a measure of psychological resources contributing to the resilience of vulnerable homeless individuals. What is known: Homelessness is a social problem which affects a wide range of individuals across ethnicity, sex, and age. Homeless individuals are vulnerable to physical and mental health problems. Homeless people are deprived of economic, social, psychological, and political power. What this paper adds: Housing is a public health issue and needs to be addressed as such. Psychological Capital can mediate the impact of homelessness on physical and mental health. Most homeless individuals are fundamentally resilient but need to be empowered.

Exploring the Unmet Supportive Care Needs of Breast Cancer Survivors Experiencing Psychological Distress: Qualitative Study

ObjectivesThis study aimed to explore the unmet supportive care needs of breast cancer survivors who experience psychological distress. Data SourcesA qualitative study design with inductive content analysis was used. Semistructured interviews were conducted with 18 Turkish breast cancer survivors who experienced psychological distress. The Consolidated Criteria for Reporting Qualitative Research checklist was used to report the study. ConclusionThree key themes emerged from data analysis: sources of psychological distress, unmet supportive care needs, and barriers to support. The survivors who experienced psychological distress defined a variety of unmet supportive care needs, in the areas of information support, psychological/emotional support, social support, and individualized health care support. They also described personal and health professional−related factors as barriers. Implications for Nursing PracticeNurses should assess psychosocial well-being and supportive care needs of breast cancer survivors. Survivors should be supported to discuss their experiences of symptoms in the early survival phase, and they should be referred to an appropriate supportive care resource. A multidisciplinary survivorship services model is needed to offer posttreatment psychological support routinely in Turkey. Early, effective psychological care integrated into follow-up services for survivors can be protective against psychological morbidity.

Evaluation of social autonomy of schizophrenic patients

IntroductionSchizophrenia is a debilitating and mutilating mental illness, generally progressing in a Chronic way . It is at the origin of a limitation of social autonomy and source of psychological distress .Objectivesevaluate the effective social autonomy of schizophrenic patients.Methodsit is a cross-sectional study carried out at the EPS psychiatry consultation in Mahdia during a period of 3 months, with schizophrenic patients meeting the DSM 5 criteria, having an age varying from 19 to 65 years and whose duration of evolution was at least of one year. Have been excluded those in a state of decompensation, presenting a severe organic disease or having a major cognitive impairment. Information was collected from patients and fromtheir medical records using a pre-established questionnaire. The scale of social autonomy (EAS) of Legay with 17 items grouped into 5 dimensions was used for the evaluation.ResultsThe general characteristics of the 360 schizophrenic patients who met the inclusion criteria, revealed an average age of 40.2 years, a sex ratio of 2.33, a majority of single (55.8%), a low level of education(66.7%), an absence of professional activity (67.3%) and a deteriorated socioeconomic level (68.6%).Clinical Characteristics noted an average onset age of the disorder of 26 years, an average duration of evolution of 14 years and a preponderance of the residual type and of the episodic evolutionary course with residual symptoms between episodes respectively in 40.6 and 76.4%. The average of EAS scores were 39.08. Three quarters of the population (75.7%) had a score below 59. 24.3% of patients had scores between 60 and 108 signifying impaired social autonomy.ConclusionsThe evaluation of effective social autonomy is essential for any therapeutic project considering psychosocial integration and rehabilitation of schizophrenic patients.Disclosure of InterestNone Declared

Clinical Pearls.

Research has shown that unrestricted visitation is beneficial and contributes to high-quality family-centered care. However, with the onset of the COVID-19 pandemic most hospitals banned visitors. In the ensuing time, despite repeated evidence of the negative effects of restricted visitation on patients, caregivers, and families, many hospitals continue to enforce a restrictive policy.Marmo and colleagues examined current visitation policies of Magnet and Pathway to Excellence facilities that had unrestricted visitation policies in their adult intensive care units before the pandemic. They found that All participating nurse leaders thought that the decision to restrict during the pandemic was made by external systems with no input from nursing.None of the hospitals went back to an open visitation policy, and most study participants thought that open visitation polices would not return.Nurse leaders described restricted visitation causing harm to patients, families, and nurses.Although technology capabilities such as virtual visiting allowed family participation, these methods added further responsibility and strain to the nursing staff. The authors recommend that hospitals use the best evidence available and shared decision-making with all key stakeholders to develop safe visitation policies and practices.See Article, pp 31-41Infants with critical congenital heart disease (CCHD) often require complex medical care at home following surgery. The caregivers of these infants must learn a great deal of medical skills through extensive training, often in a short period. Many caregivers experience stress and feel unprepared for postdischarge parental care.Shackleford and colleagues describe nurses’ perceptions of a 24-hour rooming-in program for caregivers of infants with CCHD. They identified 3 themes: This study was the first to examine rooming-in with caregivers of patients with CCHD. Although areas of improvement were recognized, findings suggest that a rooming-in program for CCHD infant care can effectively support the quality of discharge education.See Article, pp 54-61Psychological distress of family caregivers of critically ill patients can result in post–intensive care syndrome– family after hospitalization. This distress also occurs during hospitalization and may include anxiety, lack of sleep, and decrease in sound decision-making. However, little research has explored the factors that affect caregiver stress during the hospitalization.Blok and colleagues interviewed adult family caregivers (most were adult children and patient spouses) in person in the intensive care unit to explore their sources of psychological distress. They found Overall, findings show that factors influencing family distress are wide-ranging and vary by level of caregiver anxiety. The authors suggest early identification and assessment of family factors to develop strategies for reducing distress.See Article, pp 21-30Delirium during hospitalization in the intensive care unit (ICU) contributes to adverse consequences such as prolonged hospital stay, increased hospitalization cost, and increased mortality risk. As several risk factors contribute to onset of delirium, prediction models have been developed. However, some models are more thoroughly validated than others, and the effect of mechanical ventilation on one of the models’ prognostic accuracy needs further study.Van Nieuw Amerongen and colleagues compared 3 prediction models—the PRE-DELIRIC, E-PRE-DELIRIC, and Lanzhou models—in adult ICU patients receiving and not receiving mechanical ventilation. They found Although there are limitations with any model, the findings support the use of a prognostic tool during the first 24 hours of ICU stay to support decision-making in delirium care.See Article, pp 43-50

Feeling unsafe as a source of psychological distress in early adolescence

RationaleSymptoms of psychological distress at an early age have proved to undermine adolescents' academic achievements, as well as their personal and social well-being. The literature acknowledges a wide range of risk factors that cause psychological distress, while at the same time emphasizing the role of social support as a protective factor. On the other hand, feelings of unsafety as a possible source of psychological distress have been so far largely overlooked in the literature. ObjectiveThe present study explores the consequences of a specific stressor (feeling unsafe) and asks whether social support can act as a moderator in the association between subjective unsafety and psychological distress. MethodsA multi-group structural equation model was run with a sample of 2876 young adolescents aged 10–12 enrolled in educational centers in the city of Barcelona, Spain. ResultsThe results show that direct exposure to sibling violence at home and bullying at school are significant predictors of psychological distress, regardless of biological sex. The hypothesis of a negative correlation of subjective perceptions of unsafety on psychological distress is also supported, although neighborhood-based risk factors emerge as a greater source of distress for females than for males. The involvement of supportive adults is associated with lower levels of perceptions of unsafety and distress in both groups, but girls seem capable of drawing more effectively on alternative sources of support, specifically their peers, to enhance their safety at school and in the neighborhood. ConclusionOverall, gender differences in our model overlap with socio-environmental inequalities (low income, exposure to violence and conflictual public spaces), thus suggesting that an intervention into the root causes of these inequalities could contribute to lowering psychological distress in early adolescence.

Qualitative study on mental health and well-being of Syrian refugees and their coping mechanisms towards integration in the UK

ObjectiveThis study aimed to explore the mental well-being of Syrian refugees and identify their coping mechanisms and pathways towards integration into new communities.DesignQualitative study using in-depth semi-structured interviews.Setting and participantsAdult...

Sources of psychological distress among primary care physicians during the COVID-19 pandemic's first wave in Spain: a cross-sectional study.

The COVID-19 pandemic is affecting people worldwide. In Spain, the first wave was especially severe. This study aimed to identify sources and levels of distress among Spanish primary care physicians (PCPs) during the first wave of the pandemic (April 2020). A cross-sectional study was conducted using a survey that included sociodemographic data, a description of working conditions related to distress [such as gaps in training in protective measures, cleaning, and hygiene procedures in work setting, unavailability of personal protective equipments (PPEs) and COVID-19 RT-PCR test, and lack of staff due to be infected] and a validated scale, the 'Self-applied Acute Stress Scale' (EASE). The survey was answered by a non-probability sampling of PCPs working in family healthcare centres from different regions of Spain. Analysis of variance and multivariate linear regression analysis were performed. In all, out of 518 PCP participants, 123 (23.7%) obtained high psychological distress scores. Only half of them had received information about the appropriate use of PPE. PCP characteristics associated with higher levels of distress include female gender [1.69; 95% confidence interval (CI) 0.54, 2.84]; lack of training in protective measures (1.96; 95% CI 0.94, 2.99); unavailable COVID-19 RT-PCR for health care workers after quarantine or COVID-19 treatment (-0.77 (-1.52, -0.02). Reinforcing disinfection of the work environment (P < 0.05), availability of PPEs (P < 0.05), and no healthcare professional was infected (P < 0.05) were related to the lowest distress score. A better understanding of the sources of distress among PCPs could prevent its effect on future outbreaks.

Psychological Distress, Demoralization, and Illness Fears in Medical Staff Treating Patients with COVID-19

This paper analyzes the outcomes of an exploratory review of the current research on psychological distress, demoralization, and illness fears in medical staff treating patients with COVID-19. The data used for this study was obtained and replicated from previous research conducted by ACHA, APIC, BMA, CMA, CPHA, CVN, GWI, HMN, ICF, IPPR, Potloc, Prescott et al. (2020), Statista, and YouGov. We performed analyses and made estimates regarding levels and sources of psychological distress in healthcare workers treating patients with COVID-19. Data collected from 4,300 respondents are tested against the research model. Descriptive statistics of compiled data from the completed surveys were calculated when appropriate.

The ritual use of ayahuasca during treatment of severe physical illnesses: a qualitative study

ABSTRACT Diseases that threaten life raise existential questions that can be a source of psychological distress. Studies with psychedelics demonstrate therapeutic effects for anxiety and depression associated with life-threatening illnesses. Ayahuasca has been proposed as a possible therapeutic agent in the treatment of psychiatric disorders. Preliminary studies suggest that ayahuasca could promote therapeutic effects for people with physical illnesses. The aim of this study was to explore how the ritual use of ayahuasca during the treatment of severe physical illnesses (SPI) may influence the way people understand and relate to their illness, using qualitative methods to assess the participants’ perspectives. Participants who consumed ayahuasca ritualistically during the period of treatment for SPI were purposely chosen. Data were obtained through semi-structured interviews. A thematic analysis was performed with 14 individuals. The ritual experience with ayahuasca acted on the participants’ illness understanding through multiple psychological mechanisms, including introspection, self-analysis, emotional processing and catharsis, recall of autobiographical memories subjectively related to illness origin, illness resignification, and perspective changes. This study suggests that the experience with ayahuasca may facilitate illness acceptance through an influence on the meanings of the illness, life, and death. These changes may favor a more balanced relationship with illness and treatment.

Monsters and posttraumatic stress: an experiential-processing model of monster imagery in psychological therapy, film and television

Trauma survivors may see images of monsters in nightmares and visions when experiencing posttraumatic stress. However, there has been little commentary on the significance and meaning of this imagery and the wider relationship between monster imagery and posttraumatic stress. Applying an integrated experiential-processing approach to working with trauma in Counselling and Psychotherapy, emphasis is placed on facilitating ‘processing’ or making sense of the trauma, psychologically, emotionally, existentially and culturally. Examining the interplay of these elements, this paper explores monsters as symbol and metaphor for unspoken or unprocessed personal and cultural trauma, vessels for symbolically representing underlying, unacknowledged fears and experience. This paper discusses how encounters with the monster onscreen, in mental imagery or metaphor, may be allegorical to the individual’s internal struggle with post-traumatic stress. The model presented is applied within an analysis of the symbolic representation of the trauma of cancer, cancer treatment and traumatic loss in survival horror movie The Shallows (Collet-Serra (dir) (2016). The Shallows. Columbia Pictures). Jungian ideas are integrated to consider monsters as emergent symbolisation of unspoken ‘shadow’ fears, such as those surrounding cancer. In an experiential-processing account of trauma, incongruence between self-concept (our beliefs about self and world) and our actual experience of traumatic events is viewed as a source of psychological distress, prompting a breakdown and reorganisation of the self-structure. It is proposed that trauma experience confronts us with our mortality and fragility, bringing us into contact with the sense of ‘abject’ horror represented by monster imagery. Creeds (2007. The monstrous feminine: film, feminism, psychoanalysis. Routledge, London and New York) description of the abject as the ‘place where meaning collapses’ is applied to an understanding of psychological trauma, given that encounters with existential threats may render the everyday meaningless, engendering a need for meaning-making. Monster imagery psychologically represents the collapsing border between our ideas about self and world, and the destabilising experience of the shattering of pre-trauma assumptions. In this account monsters are located within a wider, adaptive evolutionary drive towards the reduction of trauma-related psychological distress, through symbolising experience into awareness for processing and meaning making. In this way monsters may play a complex role in a human struggle to come to terms with overwhelming events.

No Country for Middle-Aged Men?

In many high-income countries, the rate of suicide is highest among middle-aged men. Despite this, few studies have explored the factors that underpin psychological distress and support-seeking among this cohort. This qualitative study used an intersectional approach to account for the plurality of middle-age masculinities and to offer deeper insights into middle-age men’s mental health experiences. Focus groups and interviews were conducted with nine demographic groups of middle-aged men considered ‘at risk’ of suicide in Ireland (n=34). Data collection and data analysis were informed by the principles of grounded theory. A master code list and conceptual maps were developed from which four themes emerged. Theme 1 Reconciling Increasing Expectations with Diminishing Capacities to Achieve at Middle-Age captures various tensions that emanated from expectations on men to have acquired mastery of various gendered norms by middle-age that coincided with a reality of different manifestations of middle-aged vulnerability as well as large scale societal change in Ireland. Theme 2 Isolation at Middle-Age broadly describes a sense of loneliness at middle-age as a result of narrowing social circles, a lack of social outlets, relationship breakdown and living alone. For those men who experienced discrimination, prejudice or racism, their isolation tended to be more deep-rooted and multifaceted and was a particular source of psychological distress. The notion of a ‘double burden’ was central to Theme 3 Barriers to Support Seeking, and encapsulated men’s sense of shame in having to ask for help and ‘failing’ to manage their own problems. Theme 4 Catalysts for Change &amp; Strategies for Improved Self-Care highlights what were seen as the foundations of good mental health for middle-aged men, as well as the value of educational programmes and social contact. The use of an intersectional approach in this study fostered a deeper understanding of the blended identities and wide range of mental health experiences of middle-age men which have informed training and resources currently being implemented under the auspices of ‘Connecting for Life’, Ireland’s strategy to reduce suicide.

The Psychological Distress of Food Insecurity: A Qualitative Study of the Experiences of Low-Income Parents and Their Coping Strategies

Abstract Objectives Food insecurity increases the risks of numerous chronic disease and mental health outcomes in low-income adults; however, the mechanisms underlying these associations have not been clearly identified. Chronic, psychological stress may represent an important pathway between food insecurity and health. Using in-depth interviews, the objective of this qualitative study was to obtain a better understanding of psychological distress specific to food insecurity among adults. Methods We conducted one-on-one, semi-structured interviews with 48 parents recruited from the San Francisco Bay Area. Eligibility criteria included any experience of household food insecurity over the past 12 months, having a child in the family, and the ability to speak English fluently. An interview guide was developed by an interdisciplinary research team to specifically delve into the psychological experience of adult food insecurity. Interviews were audio-recorded, transcribed, and analyzed for thematic content using the constant comparative method. Results Parents discussed six themes related to the psychological distress of food insecurity: 1) anxiety about not having enough food to meet the needs of all family members, 2) frustration over the high costs of healthful foods (e.g., fruits and vegetables), 3) embarrassment about using community food assistance, 4) fear of running out of money for food and other necessities, 5) sadness about their cyclical and chronic food situation, and 6) guilt over the inability to adequately provide for their children. Strategies that parents used to cope with food insecurity included seeking help from family and friends, relying on their faith, distracting themselves from their current situation (e.g., sleeping, cleaning, drinking), and becoming increasingly tolerant of their food situation. Conclusions Food insecurity is a source of psychological distress among parents. Psychological distress may represent a pathway by which food insecurity influences physical and mental health outcomes. Funding Sources This study was supported by a grant from the Eunice Kennedy Shriver National Center for Child Health and Human Development.

Coping Mechanisms, Psychological Distress, and Quality of Life Prior to Cancer Genetic Counseling.

Background: Breast Cancer susceptibility genes 1 and 2 are implicated in hereditary breast and ovarian cancer and women can test for the presence of these genes prior to developing cancer. The goal of this study is to examine psychological distress, quality of life, and active coping mechanisms in a sample of women during the pre-test stage of the genetic counseling process, considering that pre-test distress can be an indicator of post-test distress. We also wanted to identify if subgroups of women, defined based on their health status, were more vulnerable to developing distress during the genetic counseling process.Methods: This study included 181 female participants who accessed a Cancer Genetic Counseling Clinic. The participants were subdivided into three groups on the basis of the presence of a cancer diagnosis: Affected patients, Ex-patients, and Unaffected participants. Following a self-report questionnaire, a battery of tests was administered to examine psychological symptomatology, quality of life, and coping mechanisms.Results: The results confirm that the genetic counseling procedure is not a source of psychological distress. Certain participants were identified as being more vulnerable than others; in the pre-test phase, they reported on average higher levels of distress and lower quality of life. These participants were predominantly Ex-patients and Affected patients, who may be at risk of distress during the counseling process.Conclusions: These findings highlight that individuals who take part in the genetic counseling process are not all the same regarding pre-test psychological distress. Attention should be paid particularly to Ex-patients and Affected patients by the multidisciplinary treating team.

Psychological distress among final year medical undergraduates in a Sri Lankan university

Background: Studying medicine is challenging since medical students undergo many stressors during their long course of studying. Moreover, their final year is probably more stressful with more clinical work and stringent assessments. Aim of this study was to assess the prevalence and sources of psychological distress among final year students in University of Sri Jayewardenepura in Sri Lanka with a well validated screening tool. Methods: This is a cross sectional study of 151 medical students evaluating stress through general health questionnaire (GHQ) with 30 items. Comparison was made with another 257 non-medical undergraduates of the same university. Results: More than half of students (59.6%) in our university had psychological distress. When compared medical students (62.9%) are more distressed than non-medical (56.4%) students. Major source of stress for medical students was academic pressure. Conclusions: Final year medical students have significantly high psychological impairment and the main reason reported by students was academic pressure. It warrants implementation of stress management programs and curriculum based interventions to minimize stress.

Psychological distress, health and treatment-related factors among individuals initiating ART in Oromia, Ethiopia

ABSTRACTHIV diagnosis may be a source of psychological distress. Late initiation of antiretroviral therapy (ART) and treatment-related beliefs may intensify psychological distress among those recently diagnosed. This analysis describes the prevalence of psychological distress among people living with HIV (PLWH) and examines the association of recent HIV diagnosis, late ART initiation and treatment-related beliefs with psychological distress. The sample includes 1175 PLWH aged 18 or older initiating ART at six HIV clinics in Ethiopia. Psychological distress was assessed with Kessler Psychological Distress Scale. Scores ≥ 29 were categorized as severe psychological distress. Individuals who received their first HIV diagnosis in the past 90 days were categorized as recently diagnosed. Multivariable logistic regression modeled the association of recent diagnosis, late ART initiation and treatment-related beliefs on severe psychological distress, controlling for age, sex, education, area of residence, relationship status, and health facility. Among respondents, 29.5% reported severe psychological distress, 46.6% were recently diagnosed and 31.0% initiated ART late. In multivariable models, relative to those who did not initiate ART late and had longer time since diagnosis, odds of severe psychological distress was significantly greater among those with recent diagnosis and late ART initiation (adjusted OR [aOR]: 1.9 [95% CI 1.4, 2.8]). Treatment-related beliefs were not associated with severe psychological distress in multivariable models. Severe psychological distress was highly prevalent, particularly among those who were recently diagnosed and initiated ART late. Greater understanding of the relationship between psychological distress, recent diagnosis, and late ART initiation can inform interventions to reduce psychological distress among this population. Mental health screening and interventions should be incorporated into routine HIV clinical care from diagnosis through treatment.

Maternal Psychological Distress and Perceived Impact on Child Feeding Practices in South Kivu, DR Congo.

Maternal mental health problems are associated with poor child growth and suboptimal child feeding practices, yet little qualitative research has been conducted to understand mothers' perceptions about how maternal mental ill health and child nutrition are related. The objective of the study was to understand maternal perceptions on sources of psychological distress, and how distress impacts functioning, especially related to childcare and feeding practices among mothers of young children in South Kivu, DR Congo. Mothers of young children who were participating in a larger study were eligible. Using purposive sampling, participants were selected if they had high or low levels of psychological distress, based on their mean item score on measures of symptoms of depression, anxiety, and post-traumatic stress. Twenty in-depth interviews and 2 focus group discussions were conducted, with a total of 35 mothers. Key informant interviews were conducted with 5 local health workers. Audio recordings were transcribed and coded, and the analysis was guided by Grounded Theory methodology. Major themes to emerge were that women's husbands were a significant source of distress, with husbands' infidelity, abandonment, and lack of financial support mentioned by participants. Psychological distress resulted in appetite and weight loss, and poor nutritional status made it difficult to breastfeed. Participants perceived psychological distress caused milk insufficiency and difficulty breastfeeding. Mothers experiencing psychological distress may need greater support for maternal nutrition and breastfeeding, and engaging fathers through responsible parenting interventions may reduce psychological distress and have a positive impact on child health.

Mad at Tangier: Hygienist discourses, mental disorders, and European competition for hegemony in early twentieth-century Morocco

ABSTRACTThis study focuses on the discourse on mental pathologies affecting Western residents in Tangier that was elaborated from the late 1920s. After gaining prestige as a health resort during the nineteenth century, Tangier experienced mounting foreign intervention, ultimately leading to the establishment of an international regime, which substantially changed the city’s perception. Strong winds and a rough sea climate, coupled with the stress associated with the restless struggle for hegemony between the Western powers, became a suspected source of psychological distress for foreign newcomers. In this context, the French doctor Paul Remlinger, director of the Pasteur Institute, and José Sievert, head of the Spanish Laboratory, defined a mental pathology supposedly specific to the city: the “Tangerian neurosis” or “psychosis.” As we will try to show, their views, which enjoyed a lasting influence that went beyond medicine into literature and popular culture, reflected general anxieties associated to the efforts of France and Spain to colonize Tangier and Morocco at large, and to pathologize their inhabitants and environment.

Preoperative psychological distress, coping and quality of life in Chinese patients with newly diagnosed gastric cancer.

The purpose of this study was to investigate the prevalence of preoperative psychological distress and its relationship with coping style and quality of life in Chinese patients with newly diagnosed gastric cancer. Being newly diagnosed with cancer can be a source of psychological distress. Understanding the preoperative psychological distress may contribute to the development of appropriate interventions. This is a descriptive correlational survey study. The study was conducted in two teaching hospitals in Anhui province, China. A total of 165 patients with gastric cancer completed a battery of self-report questionnaires including the Distress Thermometer, the revised Chinese version of the Quality of Life Questionnaire-Stomach 22 and the Cancer Coping Modes Questionnaire. The prevalence of clinically significant preoperative psychological distress was 76·97% in this group. Statistically significant correlations were identified between the distress score and stomach pain, eating restrictions and anxiety subscale. Positive associations were found between the distress scores and four subdimensions of coping (avoidance and suppression, resignation, fantasy and catharsis), whereas a negative association was found between the distress scores and one subdimension of coping (Confrontation). There were also significant differences in the quality of life and coping style of patients who had different psychological distress statuses. These findings indicate a relatively high prevalence of preoperative psychological distress among Chinese patients with gastric cancer. Patients with clinically psychological distress were more likely to have poor quality of life and to demonstrate negative coping styles. Nursing professionals need to carefully assess the psychological status of patients with gastric cancer. Tailored interventions can be administered to help these patients appropriately cope with the disease and to enhance their quality of life.

Garnering an in-depth understanding of men who have sex with men in Chennai, India: a qualitative analysis of sexual minority status and psychological distress.

Men who have sex with men (MSM) in India are a hidden and largely understudied population, and have an HIV prevalence 17 times higher than that of the general Indian population. Experiences of social marginalization and negative psychosocial conditions occur concurrent to HIV risk among Indian MSM. To better understand the contextual variables driving HIV risk and inform intervention development, five focus groups (n=46) and nine key informant interviews were conducted with 55 MSM in Chennai in 2010. NVivo software was used to code the transcripts, and data were analyzed using qualitative descriptive analysis methodology. Participants described sources of psychological distress and low self-worth related to gender non-conformity and sexual minority status. These included stigma from society, pressure to marry, lack of familial acceptance, childhood sexual abuse, and the imperative to keep sexual minority status a secret. Participants' personal evaluations revealed that self-acceptance may be an important resilience factor that can shield these psychosocial and HIV risk factors. In promoting health-seeking behavioral changes for Indian MSM at an individual level, our findings point to the potential strength of strategies that focus on self-acceptance of one's sexual minority identity to foster better psychosocial and overall health.