Treatment Of Emotional Distress Research Articles

Parents' and children's intolerance of uncertainty and their reactions to COVID-19: A story of remarkable similarity.

The COVID-19 viral outbreak is a one in 100year public health crisis. In addition to the stunning morbidity and mortality rates related to infection, multiple psychiatric sequelae erupted. Unfortunately, children and adolescents are neither immune to infection nor to the emotional consequences associated with the pandemic. Not surprisingly, the field's understanding of the psychological consequences of the viral outbreak are nascent. Consequently, this study examines the relationship between parents' and children's intolerance of uncertainty (IU) and their reactions to COVID-19. Seventy-three parents and 62 children participated in the on-line survey utilizing innovative measures of IU and COVID-19- related thoughts/behaviors. The results revealed remarkable similarities in parents' and children's responses. Parents' and children's reports of the impact of COVID on their lives were highly correlated (r = .53, df = 60, p < .001). Parents' perceptions of children's COVID-19 thoughts and behaviors were strongly aligned with the youths' self-report of their COVID reactions (r = .69, df = 60, p < .001) as well as the appraisal of the virus' impact on their lives (r = .-.42, df = 60, p < .001). Finally, children's reports of their COVID-19 related thoughts and behaviors were significantly linked to their IU (r = .60, df = 60, p < .001). Methodological limitations notwithstanding, the study's findings provide compelling implications for the conceptualization, assessment, and treatment of emotional distress in the peri- and post-pandemic periods.

Physician Mental Health During COVID-19: A Call to Action

Physician Mental Health During COVID-19: A Call to Action

How Memory Structures Influence Distress and Recovery.

The treatment of emotional distress has stalled. There has been no improvement in depression outcomes for 30 years, and recent opinions have highlighted the lack of clear validity for the mechanisms involved in current models of complex psychological interventions. Emotional distress is a phenomenon that underpins a swathe of apparently diverse mental health conditions. Childhood trauma has been found to be endemic and common in those with poor psychological adjustment in adults. Executive processes cause a split between knowledge of an event and knowledge of its negative ongoing emotional effects so making integration of the memory of such events and resolution of its effects is a challenge. Recent research into the relationship between well-being and memory structures has converged with research into episodic memories and their key role in goal programming, giving an opportunity to describe a new model with plausible mechanisms for emotional distress, regulation, resilience, and recovery. Humans seek goals that fulfil their universal basic psychological need for self-determination, and the structures of memory networks drive behavioral algorithms that can satisfy or thwart that goal. We propose that a single underlying deficit in memory networks could underpin the psychopathology of emotional distress and that a new formulation of distress and recovery could drive a useful update on the mechanisms of psychological interventions with greater validity and utility for recovery and propose the NEMESIS (Negative MEmorieS Integration Systems) model.

Physical Injury, PTSD Symptoms, and Medication Use: Examination in Two Trauma Types

Physical injury is prevalent across many types of trauma experiences and can be associated with posttraumatic stress disorder (PTSD) symptoms and physical health effects, including increased medication use. Recent studies suggest that PTSD symptoms may mediate the effects of traumatic injury on health outcomes, but it is unknown whether this finding holds for survivors of different types of traumas. The current study examined cross-sectional relationships between injury, PTSD, and pain and psychiatric medication use in 2 trauma-exposed samples, female survivors of motor vehicle accidents (MVAs; n= 315) and intimate partner violence (IPV; n= 167). Data were obtained from participants at 2 trauma research clinics who underwent a comprehensive assessment of psychopathology following the stressor. Regression with bootstrapping suggested that PTSD symptoms mediate the relationship between injury severity and use of pain medications, R(2) = .11, F(2, 452)= 28.37, p< .001, and psychiatric medications, R(2) = .06, F(2, 452)= 13.18, p< .001, as hypothesized. Mediation, however, was not moderated by trauma type (ps > .05). Results confirm an association between posttraumatic psychopathology and medication usage and suggest that MVA and IPV survivors alike may benefit from assessment and treatment of emotional distress after physical injury.

Improving Psychological Adjustment Among Late-Stage Ovarian Cancer Patients: Examining the Role of Avoidance in Treatment

Data suggest that individuals dealing with a cancer diagnosis are less likely to suffer from depression, anxiety, and psychological distress when they cope with their condition from a stance of emotional and cognitive acceptance (e.g. Dunkel, et al., 1992; Stanton, et al., 2000). Although traditional CBT often includes some acceptance-oriented elements, recent variants of CBT, such as Acceptance and Commitment Therapy (ACT), have acceptance as a central focus. ACT targets emotional distress directly through acceptance of difficult thoughts and emotions. The current study is a preliminary comparison of ACT and treatment as usual (TAU) in the treatment of emotional distress among women with late-stage ovarian cancer. Forty-seven women diagnosed with Stage III or IV ovarian cancer were randomly assigned to one of two treatment conditions. Treatment consisted of 12 face-to-face meetings with a therapist, each following a TAU or ACT protocol. Results indicate that both groups showed improved mood and quality of life following the intervention. The ACT group showed significantly greater improvements compared to the TAU group. Furthermore, mediation analyses indicate that the effects of treatment were mediated by cognitive avoidance. Although the study is limited by the implementation of treatment in both conditions by a single therapist, the TAU group showed improvements that were consistent with effect sizes available in the literature, suggesting that the intervention was a credible and effective control treatment. These findings provide preliminary support for the use of ACT in ovarian cancer populations. Further work is needed to investigate the effectiveness in other oncology populations as well as investigate potential patient characteristics which may interact with these interventions.

Effects of befriending on depressive symptoms and distress: systematic review and meta-analysis

High rates of emotional distress and depressive symptoms in the community can reflect difficult life events and social circumstances. There is a need for appropriate, low-cost, non-medical interventions for many individuals. Befriending is an emotional support intervention commonly offered by the voluntary sector. To examine the effectiveness of befriending in the treatment of emotional distress and depressive symptoms. Systematic review of randomised trials of interventions focused on providing emotional support to individuals in the community. Compared with usual care or no treatment, befriending had a modest but significant effect on depressive symptoms in the short term (standardised mean difference SMD = -0.27, 95% CI -0.48 to -0.06, nine studies) and long term (SMD = -0.18, 95% CI -0.32 to -0.05, five studies). Befriending has a modest effect on depressive symptoms and emotional distress in varied patient groups. Further exploration of active ingredients, appropriate target populations and optimal methods of delivery is required.

Family caregiver social problem-solving abilities and adjustment to caring for a relative with vision loss.

To examine the prevalence of persons at risk for depression among family caregivers of visually impaired persons and the extent to which social problem-solving abilities are associated with caregiver depressive symptomatology and life satisfaction. Family caregivers were defined as adults who accompanied their adult relative to an appointment at a low-vision rehabilitation clinic and self-identified themselves as the primary family caregiver responsible for providing some form of assistance for their relative due to vision impairment. Demographic variables, depressive symptoms, life satisfaction, caregiver burden, and social problem-solving abilities were assessed in caregivers. The patient's visual acuity and depressive symptoms and their relationship to the caregiver's depressive symptoms and life satisfaction were also examined. Ninety-six family caregivers were enrolled. Of those, 35.4% were identified as at risk for depression. Among caregivers, dysfunctional or ineffective social problem-solving abilities were significantly associated with greater depressive symptomatology and decreased life satisfaction after adjustment for caregiver burden and demographic and medical variables for both the caregiver and the visually impaired patient. Problem orientation or motivation to solving problems was also significantly associated with caregiver depression and satisfaction with life. A substantial number of caregivers of visually impaired adults experience psychosocial distress, particularly among those who possess poor social problem-solving abilities. These results underscore the need for routine screening and treatment of emotional distress among individuals caring for relatives with vision impairments. Future research should examine the extent to which psychosocial interventions targeting caregiver social problem-solving skills may be useful not only in improving caregiver quality of life but also in subsequently enhancing rehabilitation outcomes for the visually impaired care recipient.

The Efficacy of Cognitive Behavior Therapy in the Treatment of Emotional Distress After Acquired Brain Injury

Bradbury CL, Christensen BK, Lau MA, Ruttan LA, Arundine AL, Green RE. The efficacy of cognitive behavior therapy in the treatment of emotional distress after acquired brain injury. Objective To evaluate the efficacy of cognitive behavior therapy (CBT), adapted to meet the unique needs of individuals with acquired brain injury (ABI), and modified for both group and telephone delivery. Design Matched-controlled trial, with multiple measurements across participants, including pretreatment baseline assessment plus posttreatment and 1-month follow-up. Setting Outpatient community brain injury center. Participants Participants (N=20) with chronic ABI. Ten were assigned to the CBT treatment group and 10 to education control. All were experiencing significant emotional distress at the onset of the study. Intervention Eleven sessions of CBT (or education control), including 1 introductory individual session plus 10 further sessions administered in either group format or by telephone. The CBT was designed to decrease psychologic distress and improve coping. Specific adaptations were made to the CBT in order to better accommodate individuals with cognitive difficulties. Main Outcome Measures Primary outcome measures included the Symptom Checklist-90-Revised (SCL-90-R) and the Depression Anxiety Stress Scales (DASS-21). Secondary outcome measures included the Community Integration Questionnaire (CIQ) and the Ways of Coping Scale, Revised. Results Significant CBT treatment effects (in both group and telephone formats) were observed on the SCL-90-R and the DASS-21, whereas no significant effects were observed in the education control group. No significant effects of treatment were observed on the CIQ or Ways of Coping Scale, Revised. Conclusions Results suggest that adapted CBT—administered by telephone or in a face-to-face group setting—can significantly improve emotional well-being in chronic ABI.

Healing Scents: An Overview of Clinical Aromatherapy for Emotional Distress

Individuals in emotional distress are often treated with psychotherapeutic agents, but other treatment options exist. One safe and effective adjunct for the prevention and treatment of emotional distress is aromatherapy. This article describes the physiological effects of scent, reviews the research on aromatherapy, presents practical information on the use of clinical aromatherapy for emotional distress, and suggests resources for additional training and education.

Cardiovascular Symptoms in Coronary-Artery Disease Patients Are Strongly Correlated With Emotional Distress

The relationship of cardiovascular events and cardiovascular symptoms is unclear, and physical symptoms, including most cardiovascular symptoms, are known to be influenced by emotional distress. Authors examined the relative strength of association of multiple measures of emotional distress and accepted cardiac risk factors with five common cardiac symptoms (chest pain, fatigue, palpitations, presyncope, and dyspnea). The authors tested the association of multiple cardiovascular symptoms with various measures of emotional distress (i.e., the scales of the Symptom Checklist-90-Revised) and the putative risk factors for disease status in 109 patients with documented coronary artery disease. Measures of emotional distress were stronger correlates of patient-rated distress due to the symptoms than were traditional risk factors. Treatment of emotional distress may be a viable strategy for symptom-control in cardiovascular disease.

Cognitive complaints after mild traumatic brain injury: Things are not always what they seem

Objective To compare nonreferred, emergency department (ED)-admitted mild traumatic brain injury (MTBI) patients with and without self-reported cognitive complaints on (1) demographic variables and injury characteristics; (2) neuropsychological test performance; (3) 12-day self-monitoring of perceived cognitive problems; and (4) emotional distress, physical functioning, and personality. Methods (Neuro)psychological assessment was carried out 6 months post-injury in 79 patients out of a cohort of 618 consecutive MTBI patients aged 18–60, who attended the ED of our level I trauma centre. Cognitive complaints were assessed with the Rivermead Postconcussional Symptoms Questionnaire (RPSQ). In addition, patients monitored concentration problems and forgetfulness during 12 consecutive days. Results Self-reported cognitive complaints were reported by 39% of the patients. These complaints were strongly related to lower educational levels, emotional distress, personality, and poorer physical functioning (especially fatigue) but not to injury characteristics. Severity of self-reported cognitive complaints was neither associated with the patients' daily observations of cognitive problems nor with outcome on a range of neuropsychological tests. Conclusion Self-reported cognitive complaints were more strongly related to premorbid traits and physical and emotional state factors than to actual cognitive impairments. In line with previous work, this suggests that treatment of emotional distress and fatigue may also reduce cognitive complaints. Cognitive outcome assessment of symptomatic MTBI patients should not be restricted to checklist ratings only, but also include a (neuro)psychological screening. In addition, daily monitoring of complaints is a useful method to gather information about the frequency and pattern of cognitive problems in daily life.

The Problem of Distress in Patients With Cancer: More Effective Assessment

This article provides oncology nurses with an overview of the incidence, diagnosis, and treatment of emotional distress in patients with cancer. Oncology nurses tend to focus more on the physical symptoms of their patients, and the assessment and treatment of distress in patients with cancer often are overlooked. A brief discussion of the National Comprehensive Cancer Network practice guidelines for distress management and signs and symptoms of distress are included, especially in the context of somatic symptoms. Barriers to nursing assessment of distress are included. Signs and symptoms are considered, especially in the context of patients' somatic symptoms.

Emotional distress in chronic hepatitis C patients not receiving antiviral therapy

Background/Aims : The aim of our study was to determine the prevalence, type, and severity of emotional distress in a large group of consecutive chronic hepatitis C (CHC) patients not receiving anti-viral therapy. Methods : The brief symptom inventory and a 67-item questionnaire with the SF-36 embedded within it were used to study 220 outpatients with compensated CHC. Results : Seventy-seven (35%) participants reported significantly elevated global severity index (GSI) T-scores compared to an expected frequency of 10% in population controls. In addition, significantly elevated depression, anxiety, somatization, psychoticism, and obsessive-compulsive subscale T-scores were reported in 28–40% of subjects. Subjects with an active psychiatric co-morbidity had significantly higher GSI and subscale T-scores compared to subjects with active medical co-morbidities and subjects without medical or psychiatric co-morbidities ( P<0.01 ). However, patients with CHC alone also had a higher frequency of elevated GSI T-scores compared to population controls (20 versus 10%). GSI and subscale T-scores were strongly associated with SF-36 summary scores ( P<0.001 ). Conclusions : Clinically significant emotional distress was reported in 35% of CHC patients not receiving antiviral therapy. In addition to depression, a broad array of psychological symptoms were observed. Further investigation into the etiopathogenesis and treatment of emotional distress in CHC patients is warranted.

Emotional distress before coronary bypass grafting limits the benefits of surgery

Background The inclusion of large, heterogeneous groups of patients for coronary bypass grafting (CABG) surgery has resulted in a more mixed treatment outcome. Thus it becomes important to identify patients who are less likely to benefit from surgery or who may require additional support to improve treatment outcome. The aim of the present study was to examine whether psychological status measured before CABG can contribute to prediction of short- and long-term outcomes of the surgery. Methods and Results One hundred seventy-one consecutive patients from two large university hospitals in Stockholm completed a psychosocial questionnaire before being scheduled for surgery. One year after CABG, patients again completed the questionnaire. Follow-up of medical charts was conducted during the first 3 years after surgery. All major cardiac events (cardiac death, definite myocardial infarction, revascularization, and unstable angina verified by angiography or myocardial scintigraphy) were recorded. Although the overall effect of surgery was excellent in the majority of cases, the patients exhibiting a high degree of distress (anxiety, depression, and tiredness) before surgery assessed their status as being much worse both before the operation and at the 1-year follow-up. Equally important was the fact that patients considered distressed before surgery had significantly higher rates of cardiac events (16%) in the 3-year follow-up period compared with nondistressed patients (5%) (chi-square = 5.11, degrees of freedom = 1, p < 0.02). Conclusions Systematic evaluation and treatment of emotional distress in the candidates for coronary revascularization may be expected to result in more optimal subjective results and a reduction in the number of serious cardiac events after surgery. (Am Heart J 1998;136:510-7.)

Recognition of emotional distress in physically healthy primary care patients who perceive poor physical health

This study examines the recognition and treatment of emotional distress in physically healthy primary care patients who perceive themselves to be in fair or poor physical health. Patients (N = 892) from three private primary care practices completed a mental health screening form prior to their medical visit which included an overall assessment of their physical health (1 = excellent, 2 = good, 3 = fair, 4 = poor). Following the visit, their physicians completed a questionnaire that included the same physical health assessment item. The study group, physically healthy patients who perceive poor physical health (HPPPH), included those patients who rated their physical health as 2 or 3 points more impaired than it was rated by their physician. HPPPH (N = 39) were significantly more likely than other patients (N = 853) to report a prior psychiatric hospitalization (p < 0.05), marital difficulties (p < 0.01), recent missed work due to a mental health problem (p < 0.001), and a range of anxiety, depressive, and psychosomatic symptoms. However, HPPPH were also significantly more likely than other patients to receive excellent emotional health ratings (p < 0.001) from their physicians and were less likely to receive mental health treatment (p < 0.05). Detection of emotional distress may be particularly difficult in physically healthy patients who have low physical health perceptions. Identification of pessimistic physical health perceptions may serve as an indicator for underlying emotional distress.

Irrational beliefs in the cause and treatment of emotional distress: A critical review of the rational-emotive model

The rational-emotive model of emotional adjustment and psychotherapy (Ellis, 1962) has had a significant impact in clinical psychology during the past two decades. This model has generated a substantial body of research concerning the role of irrational beliefs in the cause and therapeutic alteration of emotional distress. While this body of literature is often cited as supportive evidence for the rational-emotive model, recent criticism of such conclusions have underscored the need for a more critical review of this literature. The present review represents an attempt to critically evaluate the literature concerning the assessment of irrational beliefs, the role of irrational beliefs in causing emotional distress, and the role of irrational beliefs in the treatment of emotional distress. While little disconfirming evidence is found in this literature and a substantial amount of the research findings are consistent with the rational-emotive model, methodological problems and gaps in the literature preclude more than tentative conclusions regarding the model's accuracy. These methodological problems and gaps in existing research as well as suggestions for future research and theory are discussed.

The severely emotionally distressed: A conceptual framework and potential roles for clergy and church

The importance of the clergy in the treatment of emotional distress can not be overestimated. Yet throughout the literature, there is a curious absence of attention to the role of the clergy and church in aiding severely emotionally distressed persons, i.e., those manifesting psychotic symptoms. This study first presents a clinical conceptual framework within which the severely disturbed may be understood. Second, potential roles of the pastor in helping such persons are described, followed by an examination of several common clinical syndromes. Finally, models used by the church on national and local levels to aid the severely distressed are discussed.