Symptom Distress Research Articles

Harnessing the Gut Microbiome: To What Extent Can Pre-/Probiotics Alleviate Immune Activation in Autism Spectrum Disorder?

Children diagnosed with autism spectrum disorder (ASD) are at an increased risk of experiencing gastrointestinal (GI) discomfort, which has been linked to dysfunctions in the microbiome-gut-brain axis. The bidirectional communication between gut and brain plays a crucial role in the overall health of individuals, and alterations in the gut microbiome can contribute to immune activation and gut-brain dysfunction in ASD. Despite the limited and controversial results of pre-/probiotic applications in ASD, this review comprehensively maps the association between ASD clinical symptoms and specific bacterial taxa and evaluates the efficacy of pre-/probiotics in modulating microbiota composition, reducing inflammatory biomarkers, alleviating difficulties in GI distress, sleep problems, core and other ASD-associated symptoms, as well as relieving parental concerns, separately, in individuals with ASD. Beyond simply targeting core ASD symptoms, this review highlights the potential of pre-/probiotic supplementations as a strategy to modulate gut homeostasis and immune response, and to delineate the potential mechanisms by which its direct or mediating effects can alleviate gut-brain dysfunction and poor nutritional status in ASD management. Further well-designed randomized controlled trials are needed to strengthen the existing evidence and establish optimal protocols for the use of pre-/probiotics in the context of ASD.

Management of Acute Pancreatitis and Kidney Injury in a Dog

Concurrent acute pancreatitis and acute kidney injury represent significant pathological conditions in dogs, presenting challenges in diagnosis and management. In human medicine this is interconnected and complex co morbid condition. Renal impairment consequently leads to fluid and electrolyte imbalance, in turn causes metabolic disturbances that may predispose to pancreatitis in dogs. Identification of underlying etiology and predisposing factors prevents further recurrence in affected individuals. The critical interplay between AP and AKI needs comprehensive management procedure. This article poses a case study of an eight-year-old Dalmatian cross dog presenting with severe respiratory distress, jaundice and gastrointestinal symptoms. Laboratory findings revealed elevated markers of pancreas, liver and kidney injury. Prompt intervention with fluid therapy, antibiotics and supportive care led to significant clinical improvement. Subsequent re-evaluation demonstrated resolution of pancreatic inflammation and restoration of renal function. This case underscores the importance of early recognition, aggressive intervention and comprehensive management in achieving successful outcomes in dogs with concurrent pancreatitis and acute kidney injury in dogs.

Impulsivity as a predictor of clinical and psychological outcomes in a naturalistic prospective cohort of subjects at ultra-high risk (UHR) for psychosis from Tunisia

BackgroundImpulsivity is associated with serious detrimental consequences on physical, mental, behavioral and social aspects of health among patients with psychosis. The present prospective 12-month follow-up study aimed to determine the prevalence of highly impulsive individuals among Ultra High Risk (UHR) patients, how impulsivity evolves over the follow-up period, and whether impulsivity impacts clinical, psychological and functional outcomes in this population. MethodUHR patients were invited to complete a battery of measurements at three-time points: at baseline, and at 6 and 12 months of follow-up. Impulsivity was assessed using both behavioral (the Wisconsin Card Sorting Test, WCST) and self-report (the Barratt Impulsiveness Scale, BIS-11) measures. ResultsFindings showed that at 6 months of follow-up, higher 6-month BIS-11 attentional and motor impulsivity were significantly associated with lower quality of life and greater general psychological distress. In addition, higher baseline BIS-11 motor impulsivity significantly predicted more severe positive psychotic symptoms at 12 months of follow-up. However, WCST scores did not show any significant associations with study variables at the different times of follow-up. ConclusionInterventions targeting impulsivity in UHR individuals could help decrease psychological distress and positive psychotic symptoms’ severity, as well as improve quality of life in UHR individuals.

Intimate partner violence and symptoms of psychological distress and depression in adolescents and young adults in Haiti

BackgroundIntimate partner violence (IPV) is prevalent in low and middle-income countries, such as Haiti. However, there is little research on its association with mental health problems such as psychological distress and depression. Although there is evidence that men may experience IPV, few studies have investigated mental health difficulties among Haitian men and women. The present study aims to 1) assess the prevalence of depressive symptoms and psychological distress in this population and 2) examine the association between IPV, psychological distress, and depression while considering potential risk and protective factors. MethodA representative sample of 3,586 adolescents and young adults aged 15 to 24 living in Haiti was recruited. Structural equation modeling was used to examine the association between IPV, depressive symptoms, and psychological distress. ResultsAlmost half of the sample reported depressive symptoms and psychological distress, with high rates among both genders. IPV was found to be an independent predictor of both depressive symptoms and psychological distress after accounting for risk and protective factors. LimitationThis study is the first step in understanding the interplay between IPV victimization, risk and protective factors, and psychological difficulties in this population. However, because of the cross-sectional design, causality should not be inferred. Furthermore, this study did not measure community violence, which could have affected participants' mental health. ConclusionThis study highlights the importance of considering the occurrence of IPV victimization when evaluating depression and psychological distress among adolescents and young adults.

Understanding Post-Traumatic Growth in Adolescent Survivors of Childhood Sexual Abuse

Post-traumatic growth (PTG) involves a positive transformation in the survivor’s cognitive, emotional, and behavioral responses to life. However, little is known about the factors facilitating PTG in adolescent survivors of childhood sexual abuse. This study examined how potential variables (self-concept, dissociation, the severity of the abuse, and distress symptoms) contribute and interact to account for perceived PTG in a sample of 70 Israeli adolescents, all survivors of childhood sexual abuse, along with one of their parents. It also explored how survivors’ self-concept, the tendency for dissociation, and distress symptoms moderated the association between abuse severity and PTG. Regression decision trees and linear regression models addressed the study’s questions. The results of the regression trees indicated that survivors with low global self-concept had lower levels of PTG, whereas survivors with high global self-concept and low tendencies for dissociation displayed higher levels of PTG. The linear regression analysis also pointed to the contribution of abuse severity and survivors’ global self-concept to PTG. A positive association was only found between abuse severity and PTG for survivors with moderate to high global self-concept. The discussion centers on the combined pivotal role of positive global self-concept, low dissociation, and abuse severity in facilitating adolescents’ PTG.

Relationships of Psychosocial Factors to Diabetes Self-efficacy: A Cross-sectional, Correlational Study.

Self-care in people with diabetes is poor, which could be influenced by positive and negative psychosocial factors. Self-efficacy is an important factor affecting self-care, and depressive symptoms and diabetes distress may directly and indirectly affect self-efficacy. The aim of this study was to examine the relationships of depressive symptoms, diabetes distress, age, sex, self-compassion, resilience, self-esteem, and social support to diabetes self-efficacy and the mediating roles of diabetes distress and depressive symptoms in the relationships among people with diabetes. In this cross-sectional, correlational study, data on all the psychosocial and demographic factors were collected (N = 148; 57.6 years old) through Research Electronic Data Capture in 2023. The PROCESS macro for SPSS was used to address the purpose. The mean score of diabetes self-efficacy was 28.6 (range, 8-40). In 1 model, depressive symptoms were directly and indirectly associated with diabetes self-efficacy through diabetes distress (direct effect, -3.524; t = -3.020, P = .003; indirect effect, -2.089; 95% bootstrap confidence interval, -3.494 to -0.911). In another model, diabetes distress was directly and indirectly associated with diabetes self-efficacy through depressive symptoms (direct effect, -3.778; t = -3.638, P < .001; indirect effect, -0.785; 95% bootstrap confidence interval, -1.868 to -0.089). In addition, self-esteem was associated with both depressive symptoms and diabetes distress. Resilience was associated with diabetes self-efficacy in 1 model. Negative psychological factors were directly and indirectly associated with diabetes self-efficacy. Depressive symptoms, diabetes distress, self-esteem, and resilience can be important targets of interventions to improve diabetes self-efficacy.

Immediate Effects of Mindful Awareness in Body-oriented Therapy as an Adjunct to Medication for Opioid Use Disorder.

While effective, medication for opioid use disorder (MOUD) treatment outcomes can be limited by co-occurring polysubstance use, mental health and chronic pain conditions. Interoceptive training may facilitate well-being and support medication treatment for MOUD. This study examined the pre-post effects of the mindfulness-based intervention Mindful Awareness in Body-oriented Therapy (MABT) as an adjunct to MOUD. MABT teaches interoceptive awareness skills to promote self-care and emotion regulation. People stabilized on medication for OUD (N = 303) from 6 community clinics in Northwestern United States were recruited and randomly assigned to MABT plus MOUD or MOUD only. In a mixed-methods study, we used an intent-to-treat approach to examine the proportion of days abstinent from non-prescribed opioids, and other substance use (primary outcomes) at baseline and 3 months post-intervention. Secondary outcomes included symptoms of mental health distress; emotional regulation difficulties; pain and physical symptom indicators; interoceptive awareness and mindfulness skills. Participant experience of MABT was collected through post-intervention surveys. Changes in outcomes were assessed using linear mixed models; content analysis was used to analyze the qualitative data. Levels of overall substance use were low and did not differ between groups. Significant improvements in PTSD symptoms, interoceptive awareness, pain severity, pain activity interference, and physical symptom frequency were found for those who received MABT compared to MOUD only. In this stable MOUD population, substance use outcomes were not improved, however MABT demonstrated significant positive changes across multiple health outcomes critical for improving MOUD treatment. Clinical Trials Registration: NCT04082637 on 9/3/2019.

Testing the feasibility and preliminary efficacy of Meaningful Activity for Managing Behavioral Symptoms of Distress (MAC-4-BSD)intervention for residents with dementia in assisted living: Protocol description.

The purpose of this manuscript is to describe the protocol for an Alzheimer's Association-funded cluster randomized trial that focuses on engaging assisted living residents with dementia in meaningful activity to help address their behavioral symptoms of distress using a theoretically based approach, Meaningful Activity for Managing Behavioral Symptoms of Distress (MAC-4-BSD). The development of MAC-4-BSD was based on the Social Ecological Model and Social Cognitive Theory. The MAC-4-BSD intervention includes the following four steps: (1)Assessment of the assisted living physical environment and policies to facilitate meaningful activity; (2)Education of staff about implementation of meaningful activity; (3)Assessment of resident preferences and goals for meaningful activity; (4)Mentoring and motivating staff and residents to facilitate engagement in meaningful activity. The overall aim of this study will be to determine the feasibility and preliminary efficacy of implementing the MAC-4-BSD intervention and test whether it will improve residents'engagement in meaningful activity, behavioral symptoms of distress, and quality of life as well as the environment and policies to promote meaningful activity in assisted living.

The impact of psychosis symptoms and psychosocial factors on symptoms of depression among individuals in an early phase of psychosis illness

AbstractDepressive symptoms are common among individuals with schizophrenia spectrum disorders, yet few studies have examined how various psychosocial factors and psychosis symptoms relate to depression in an early phase of psychosis illness. A greater understanding regarding the connection between psychosis symptoms and depressive symptoms is needed to inform assessment and intervention efforts in this population. The current study examined the relationships between psychosocial factors (distress, peer rejection, emotional support, perceived hostility), psychosis symptoms (positive, negative, general), and depression among individuals in an early phase of psychosis illness. Data were obtained from the Human Connectome Project for Early Psychosis including 167 individuals between the ages of 16 and 35 at the time of consent who met criteria for having onset of affective or nonaffective psychosis within 5 years. Clinical assessments and questionnaires were administered, and data were analyzed in SPSS and MPlus. Peer rejection (p &lt; 0.05), distress (p &lt; 0.001), perceived hostility (p &lt; 0.05), and general symptoms of psychosis (p &lt; 0.001) significantly related to depression. Bivariate associations existed between all psychosocial factors and psychosis symptoms with the exception of negative symptoms. Understanding symptoms and factors that associate with depression among individuals with psychosis in an early phase of illness can inform tailored intervention approaches of clinicians to focus on distress, peer rejection, perceived hostility, and general psychosis symptoms.

Finding the precise distance: Self-differentiation, marital relationship and trauma among ex-combatants’ spouses

BackgroundSpouses of ex-combatants often experience psychological distress due to sharing their lives with a partner who endured traumatic experiences, a phenomenon known as “secondary traumatization”. Self-differentiation is the emotional distance one takes, while keeping an amount of togetherness with significant others. The couple's relationship and self-differentiation can impact the manner and expanse of secondary traumatization experienced by the spouse. ObjectiveThis study aimed to examine the role of marital adjustment and self-differentiation (an enmeshed vs detached differentiation style), in secondary traumatization among spouses of ex-combatants. MethodsThis study is part of a longitudinal study examining psychological implications of war among Israeli ex-combatants and their spouses. Overall, 267 spouses have been assessed three times (2003;2011;2016). Participants completed self-report questionnaires evaluating secondary PTSD (SPS), general psychiatric distress (GPD), self-differentiation and dyadic adjustment (DAS). Cross-path models were used to assess associations between the variables longitudinally. ResultsAssociations were found between both self-differentiation and dyadic adjustment and SPS and GPD. Path models showed that fusion\\cutoff differentiation predicted more SPS\\GPD over time and vice-versa. Furthermore, dyadic adjustment mediated the association between fusion\\cutoff differentiation and SPS\\GPD. In other words, fusion\\cutoff differentiation in time 1 predicted dyadic adjustment in time 2, which in turn predicted SPS\\GPD in time 3. ConclusionsOur results can be interpreted in conjunction with original theories about secondary traumatization, emphasizing the importance of keeping a balanced emotional distance in the marital relationship as a way of reducing distress and PTSD symptoms following traumatic events.

Prospective, non-blinded, randomized controlled trial on early administration of pulmonary surfactant guided by lung ultrasound scores in very preterm infants: study protocol.

Bedside lung ultrasonography has been widely used in neonatal intensive care units (NICUs). Lung ultrasound scores (LUS) may predict the need for pulmonary surfactant (PS) application. PS replacement therapy is the key intervention for managing moderate to severe neonatal respiratory distress syndrome (NRDS), with early PS administration playing a positive role in improving patient outcomes. Lung ultrasonography aids in the prompt diagnosis of NRDS, while LUS offers a semi-quantitative assessment of lung health. However, the specific methodologies for utilizing LUS in clinical practice remain controversial. This study hypothesizes that, in very preterm infants [<32 weeks gestational age (GA)] exhibiting respiratory distress symptoms, determining PS application through early postnatal LUS combined with clinical indicators, as opposed to relying solely on clinical signs and chest x-rays, can lead to more timely PS administration, reduce mechanical ventilation duration, improve patient outcomes, and lower the occurrence of bronchopulmonary dysplasia (BPD). This is a protocol for a prospective, non-blinded, randomized controlled trial that will be conducted in the NICU of a hospital in China. Eligible participants will include very preterm infants (< 32 weeks GA) exhibiting signs of respiratory distress. Infants will be randomly assigned in a 1:1 ratio to either the ultrasound or control group. In the ultrasonography group, the decision regarding PS administration will be based on a combination of lung ultrasonography and clinical manifestations, whereas in the control group, it will be determined solely by clinical signs and chest x-rays. The primary outcome measure will be the mechanical ventilation duration. Statistical analysis will employ independent sample t-tests with a significance level set at α = 0.05 and a power of 80%. The study requires 30 infants per group (in total 60 infants). This study aims to demonstrate that determining PS application based on a combination of LUS and clinical indicators is superior to traditional approaches. This approach may enhance the accuracy of NRDS diagnosis and facilitate early prediction of PS requirements, thereby reducing the duration of mechanical ventilation. The findings of this research may contribute valuable insights into the use of LUS to guide PS administration.

Psychological Distress at a Regional Australian Law School: Reporting on Law Students’ Experiences of Depression, Anxiety, and Stress

Legal education in Australia is constantly evolving to meet the needs of law students and to prepare many of them for roles in the legal profession. Examples include changes to law degree structures, optional elective units, and subjects aimed at preparing law students to be ‘workplace ready’. Law students face challenging academic requirements and law school culture that can result in greater levels of psychological distress compared to the general population. Promoting law student wellbeing and responding to high student levels of psychological distress is a key area of focus for Australian Law Schools. This article explores existing law student wellbeing studies in Australia and reports findings from an empirical exploratory study investigating the levels of depression, anxiety, and stress (DASS) using the DASS21 survey instrument in law students at a regional Australian university, James Cook University. The results from this study support earlier studies at Australian universities that show law students experience higher levels of psychological distress symptoms compared to the general population, and it is an area of concern that requires ongoing attention. Results include an exploration of the impact of factors including type of degree being studied, campus location, year of study, gender, and time spent at law school.

The Scrotal Displacement of the Catheter After Femoral Venous Cutdown: A Neonatal Case Report from Iran

Introduction: One of the most preferred cutdown access sites in neonates is the femoral vein; however, the medical staff should be aware of the associated complications. In this study, we present a case where the displacement of the catheter tip after femoral vein cutdown resulted in a scrotal hematoma. Case Presentation: A neonate with a gestational age of 39 weeks and a birth weight of 3740 grams was born in an academic hospital in Tehran, Iran, in 2022. The newborn gradually showed symptoms of respiratory distress and was immediately transferred to the neonatal intensive care unit (NICU). Within the first minutes of NICU admission, the newborn developed acute respiratory distress, and a chest X-ray revealed congenital pneumonia. The patient was promptly intubated, and endotracheal surfactant was administered. Simultaneously, peripheral vascular access was established. On day 3, the vascular access failed, and multiple attempts at percutaneous venipuncture were unsuccessful. A consultation with an expert pediatric surgeon led to the decision to perform a surgical venous cutdown. A 22-gauge catheter was inserted into the external iliac vein through the right femoral access to initiate intravenous fluid and antibiotics. Within the next four hours, the neonate developed right scrotal edema, discoloration, localized erythema, and clear fluid leakage from the right scrotum. Intravenous infusion was urgently clamped. The pediatric surgeon recommended catheter removal, suspecting displacement of the catheter. A sonography examination revealed a hypoechoic 11 × 10 × 4 mm region, indicating a hematoma at the inferior pole of the right testis. The neonate was placed under serial follow-up to monitor vital signs and local manifestations. The patient was managed with conservative treatment and discharged in good condition on the 10th day of NICU admission. Conclusions: The presented case demonstrated scrotal damage following femoral cutdown catheterization. This unexpected complication was effectively managed by the immediate removal of the catheter, close monitoring, conservative therapy, and serial follow-ups, which prevented the progression of local signs. NICU staff should be aware of the potential for testicular injuries in such cases.

The Relationships between Metacognitive Beliefs and Personality Dysfunction: A Test Controlling for Personality Traits, Emotional Distress Symptoms and General Functioning

Personality dysfunction operationalized as impairment in self- and interpersonal functioning is a characteristic of personality disorders. The metacognitive model suggests that dysfunctional metacognitive beliefs are a common cause of psychological disorders, but the relevance and importance of metacognitions for personality dysfunction is less explored and was the objective for the current study. In a sample of 1278 individuals, we conducted a multiple hierarchical regression analysis to test the predictive role of metacognitive beliefs for personality dysfunction. We found a unique and independent contribution from negative beliefs about the uncontrollability and danger of worry and lower cognitive confidence to personality dysfunction whilst controlling age, gender, maladaptive personality traits, big-5 personality traits, emotional distress symptoms, and general psychosocial functioning. The results bring further support for the metacognitive model of psychological disorders which may be relevant for formulation and treatment of personality dysfunction and disorder.

Efficacy of a nurse-led sexual rehabilitation intervention for women with gynaecological cancers receiving radiotherapy: results of a randomised trial

BackgroundThe multicentre randomised SPARC trial evaluated the efficacy of a nurse-led sexual rehabilitation intervention on sexual functioning, distress, dilator use, and vaginal symptoms after radiotherapy for gynaecological cancers.MethodsEligible women were randomised to the rehabilitation intervention or care-as-usual. Four intervention sessions were scheduled over 12 months, with concurrent validated questionnaires and clinical assessments. Primary outcome was the Female Sexual Function Index (FSFI). A generalised-mixed-effects model compared groups over time.ResultsIn total, 229 women were included (n = 112 intervention; n = 117 care-as-usual). No differences in FSFI total scores were found between groups at any timepoint (P = 0.37), with 12-month scores of 22.57 (intervention) versus 21.76 (care-as-usual). The intervention did not significantly improve dilator use, reduce sexual distress or vaginal symptoms compared to care-as-usual. At 12 months, both groups had minimal physician-reported vaginal stenosis; 70% of women were sexually active and reported no or mild vaginal symptoms. After radiotherapy and brachytherapy, 85% (intervention) versus 75% (care-as-usual) of participants reported dilation twice weekly.DiscussionSexual rehabilitation for women treated with combined (chemo)radiotherapy and brachytherapy improved before and during the SPARC trial, which likely contributed to comparable study groups. Best practice involves a sexual rehabilitation appointment 1 month post-radiotherapy, including patient information, with dilator guidance, preferably by a trained nurse, and follow-up during the first year after treatment.Clinical trial registrationNCT03611517.

The relationship between acculturative stress and psychological outcomes in international students: a systematic review and meta-analysis.

The current systematic review aimed to examine the relationship between acculturative stress (AS) and psychological outcomes in international students to determine the role AS may play in predicting the mental health of international students. The studies included in the current systematic review and meta-analysis had considered AS and its impact on psychological outcomes among international students studying abroad. After checking the studies found in our primary search through the scientific databases in terms of our eligibility criteria, 29 studies were included, of which 26 were eligible for a meta-analysis (total N = 7,247). Meta-analysis indicated a moderate mean correlation of AS with psychological outcomes like depression, life satisfaction, quality of life, vocational outcome expectations, drinking behaviors, resilience, health promotion behavior, psychological adjustment, psychological distress, negative affect, and mental health symptoms (r = 0.39) and depression (r = 0.41), respectively. The review of studies revealed a robust relationship between AS and increased negative psychological outcomes such as depression, psychological distress, and general stress, as well as decreased positive psychological outcomes such as psychological adjustment, mental health, life satisfaction, and quality of life.

The Brief Symptom Inventory in the Swiss general population: Presentation of norm scores and predictors of psychological distress.

Psychological distress is an important and frequent health problem. The Brief Symptom Inventory (BSI) allows screening for psychological distress in clinical, general and research populations. We aimed to provide normative data for the BSI and the BSI-18 for the Swiss general population: We 1) present psychometric properties, 2) develop a Swiss T-standardization and validate it using a clinical sample, 3) describe psychological distress in the Swiss general population and the clinical sample, and 4) compare the means and T-standardized scores of the Swiss general population to different German norm populations. Using a cross-sectional study design, we invited a representative sample of the Swiss general population aged 18-75 years to the study. A sample of psychotherapy outpatients had competed the BSI before start of their therapy. We calculated scores for the nine scales of the BSI (three of them constitute the BSI-18), the T-standardization and the following BSI indices: Global Severity Index (GSI), Positive Symptom Total (PST), Positive Symptom Distress Index (PSDI), and Caseness (reaching T≥63 on the GSI or T≥63 on at least two of the scales). A total of 1238 general population participants completed the BSI (41.8% male; mean age 48.9 years). The BSI had good psychometric properties. The Swiss T-standardization showed good validity when applied in the clinical sample. Females reached a significantly higher GSI score than males (p<0.001). Older participants (p = 0.026), those with higher education (p <0.001), and those employed or retired (p<0.001) reached lower scores than participants aged 18-25 years, those with compulsory schooling, and unemployed participants, respectively. A total of 18.1% (CI: 16.0-20.5) participants of the general population and 75.2% (CI: 73.7-76.7) of the psychotherapy patients were considered cases with psychological distress. Our study presents detailed normative data for the BSI and the BSI-18 based on a representative sample of the Swiss general population. This information will be helpful for clinical applications and research in the Swiss and international context.

Symptom Distress Before and After Heart Transplantation - A Longitudinal 5-Year Follow-Up.

Symptom distress after heart transplantation (HTx) is a significant problem causing uncertainty, low self-efficacy, and psychological distress. Few studies have addressed self-reported symptoms. The aim was to explore self-reported symptom distress from time on the waiting list to 5years after HTx and its association with self-reported psychological well-being, chronic pain, and fatigue in order to identify possible predictors of psychological or transplant specific well-being. This multicenter, longitudinal cohort study includes 48 heart recipients (HTRs), 12 women, and 36 men, with a median age of 57years followed from pretransplant to 5years post-transplant. Symptom distress was explored by means of four instruments measuring psychological general wellbeing, transplant specific wellbeing, pain, and fatigue. Transplant specific well-being for the whole improved in a stepwise manner during the first 5years compared to pretransplant. Heart transplant recipients with poor psychological wellbeing were significantly more burdened by symptom distress, in particular sleep problems and fatigue, for up to 5years after HTx, and their transplant-specific well-being never improved compared to baseline. The prevalence of pain varied from 40% to 60% and explained a significant proportion of the variance in transplant-specific well-being, while psychological general well-being was mainly predicted by overall symptom distress. The presence of distressing symptoms explains a significant proportion of poor psychological wellbeing both among HTRs reporting chronic pain and those without pain.

Effects of Dialectical Behavior Therapy (DBT) Skills Training on Depression and Anxiety Disorders - A Pilot Study under Routine Care Conditions

Skills training as an integral part of dialectical behavioral therapy (DBT) is highly effective in the treatment of borderline personality disorder. Research interest is increasingly focused on the transdiagnostic effects of the skills training on depression and anxiety disorders. The present study examined the extent to which the findings of high-quality randomized controlled studies can be transferred to everyday treatment under routine care conditions. N=26 patients without personality disorders were treated in a day clinic over a period of eight weeks. In the control group, 11 patients received routine care treatment and in the experimental group 15 patients additionally received weekly skills training. Symptom distress, as well as emotion regulation and mindfulness were assessed longitudinally at three time points. Multilevel analyzes were used to examine whether there was an additive effect of the skills training. The experimental group was superior to the control group in all endpoints. The effect sizes were comparable to those from experimental research. Improvements in mindfulness were significantly correlated with reductions in symptom distress. The findings fit into previous research efforts and complement them with a naturalistic research perspective. The advantages and disadvantages of an experimental and naturalistic research perspective are discussed, and relevant limitations of the present study are highlighted. Skills training is an established, flexible, modular therapy program that is ideal for improving the adaptability of patients with different psychological diagnoses.

Sex (Is Not) On Fire: The Mediating Role of Cognitive Schemas Between Symptoms of Endometriosis and Sexual Distress

"The purpose of this research is to examine the cognitive schemas activated in sexual situations as mediating factors in the relationship between endometriosis symptoms and sexual distress. N=173 women diagnosed with endometriosis, who had a sexually active status during data collection, took part in the research. The survey consisted of a demographic data sheet, the ENDOPAIN-4D, the Questionnaire of Cognitive Schema Activation in Sexual Context and the Female Sexual Distress Scale - Desire/Arousal/Orgasm questionnaires. The results of the Structural Equation Modeling technique indicate that the mediation model does not show a good model fit with our data. We do not see this explanatory power regarding the relationship between pelvic pain and sexual distress sexual, or between bowel pain and sexual distress. Based on the complex indirect effect, maladaptive cognitive schemas mediate the relationship between pain during sexual intercourse and sexual distress, as well as the relationship between other symptoms of endometriosis and sexual distress. Keywords: endometriosis symptoms, maladaptive cognitive schemas, sexual distress, structural equation modeling"