Psychological Distress Variables Research Articles

Client Psychological Distress: An Important Factor in Career Counseling

The authors explored client psychological distress as a variable in career counseling. Forty‐two clients in a naturalistic setting were seen for a total of 290 sessions by 21 counselors‐in‐training. The results indicated that (a) 60% of the clients were psychologically distressed, (b) clients' scores decreased significantly from pretest to posttest on psychological distress variables, (c) significant linear growth occurred in the clients' perception of the working alliance across sessions, and (d) the psychological distress outcome variables were significantly related to both the first session level of the working alliance and its linear growth.

Sensitization studies in chemically intolerant individuals: implications for individual difference research.

Chemical intolerance (CI) is an individual difference trait in which persons report feeling ill in multiple physiological systems from low levels of a wide range of chemically unrelated environmental substances. This paper discusses the neural sensitization model for progressive host amplification of polysymptomatic responses elicited by chemical exposures following an initiating event. The sensitization model accommodates hypotheses for initiating and eliciting CI in human populations that involve both environmental chemicals and physical or psychological stressors. Recent studies in this laboratory have demonstrated sensitization in individuals with CI over repeated sessions for dependent variables such as electroencephalographic (EEG) activity and diastolic blood pressure. Psychological distress variables alone do not explain these findings. Individuals with CI and/or vulnerability to sensitization share specific characteristics, for example, female gender, certain genetic background (offspring of alcohol-preferring parents), and personal preference for high sugar/ carbohydrate intake. Overall, the data suggest that the 15-30% of the general population who report heightened CI are highly sensitizable. Sensitizability may serve an adaptive, sentinel function in threatening environments with poor signal-to-noise ratios. However, as sensitization gradually shifts operating set points of physiological systems out of the normal range in response to allostatic load, this process may contribute to the development of chronic, polysymptomatic health conditions such as multiple chemical sensitivity and/or fibromyalgia. Individual response specificity and stereotypy rather than toxicant properties may determine which types of central, autonomic, and/or peripheral nervous system dysfunctions manifest at subclinical and clinical levels.

Parental communication of BRCA1/2 genetic test results to children

The aim of this study was to evaluate the likelihood, correlates, and psychological impact of parental communication to children of parents’ BRCA1/2 genetic test results for breast cancer risk. Subjects were 133 adult members of high risk families. Sociodemographic, clinical, and psychological distress variables were assessed during a baseline telephone interview conducted prior to patient education and test result notification. Parental communication of test results to children and parental psychological distress and coping efforts were assessed 1 month post-genetic counseling and receipt of test results. Mothers (versus fathers), and persons with higher levels of baseline general distress, were significantly more likely to communicate their test results to children. Post-counseling coping efforts, both active and avoidant, were positively associated with post-counseling distress levels. However, communication of test results to children did not relate to changes in distress. In conclusion, parents with higher levels of pre-counseling general psychological distress may be more likely to communicate their genetic test results to children; however, this act does not minimize their distress and could possibly generate distress in their youngsters. Research is needed to evaluate the process and content of post-test disclosure episodes and the impact on participant, child, and family functioning.

Perceived Variability in Social Relations and Psychological Distress: Toward a Variability Approach to Subclinical Depression

The present research aimed at (a) identifying different types of social relations with distinct extents of perceived variability, and (b) examining how perceived variability in social relations was related to psychological distress in a sample of 120 Chinese university students (Study 1) and 50 Chinese working adults (Study 2). Using questionnaires, three types of perceived social relations were identified in Study 1, namely supportive relations with more perceived support and less perceived conflict, conflictive relations with more perceived conflict and less perceived support, and variable relations with more perceived support and more perceived conflict. Using daily logs, three participant groups with distinct extents of perceived variability in daily relational experience were identified in Study 2, namely the low-variability, medium-variability, and high-variability groups. Moreover, results from both studies revealed that participants perceiving a high variability in their social relations experienced the highest level of psychological distress.

The stress-support patterns and psychological distress of immigrants

The effects of various stressors and sources of social support on the psychological distress of immigrants were examined. Key variables were measured using the Perceived Immigration Related Stressors Scale, the Multidimensional Scale of Perceived Social Support and the Talbieh Brief Distress Inventory. Data were collected from a community-based sample of 565 adult individuals who recently emigrated from the former Soviet Union to Israel. The most significant stressors reported by immigrants were material-related, followed by culture-, information-, and health-related stressors. Those who perceived that social support was readily available had lower distress ratings than others who believed that social support was not forthcoming. Subjects reported significantly greater social support from family and significant others, than from friends. Social resources (especially support from friends) deterred distress under low stress conditions, but lost the deterring effect as stressors increased. Multiple regression analyses indicated that various combinations of stressors and social support resources explained 50 per cent of the variance in psychological distress under low stress conditions and 27 per cent of the variance as stress intensity increased. In conclusion, the study demonstrates that (1) social-stress factors affect psychological distress and symptoms, (2) social support resources mediate the effects of stressors on psychological distress, and (3) variability in psychological distress is rooted in differential stress-support patterns. Copyright © 2000 John Wiley & Sons, Ltd.

Attitudes towards emotional expression, relational competence and psychological distress.

The association between life events and psychological distress was found to be mediated by attitudes towards emotional expression for those with low social support but not for those with high social support. Passive interpersonal behaviour significantly accounted for additional variance in psychological distress to that accounted for by life events and attitudes.

The relationships among uncertainty, social support, and psychological distress in adolescents recently diagnosed with cancer

Uncertainty in illness about diagnosis, symptoms, prognosis, treatments, and relationships with health professionals is a major psychosocial stressor for adolescents recently diagnosed with cancer. In this study, the theoretical linkages of the uncertainty in illness theory of perceived social support, uncertainty, and psychological distress were tested. Respondents consisted of 60 adolescents between the ages of 14 and 22 years who were recently diagnosed with cancer. Data were generated by three questionnaires and analyzed using Pearson product moment coefficients and multiple regressional analyses. Hypotheses tested were that among adolescents with cancer (1) there will be an inverse relationship between perceived social support and uncertainty; (2) there will be a positive relationship between uncertainty and psychological distress; (3) there will be an inverse relationship between perceived social support and psychological distress; and (4) there will be an inverse relationship between perceived social support and psychological distress when controlling for uncertainty. Findings were as follows: the first three hypotheses were supported; there was no relationship between perceived social support and psychological distress when controlling for uncertainty. An interaction effect of perceived social support and uncertainty explained 39% of the variance in psychological distress.

The relationships among uncertainty, social support, and psychological distress in adolescents recently diagnosed with cancer.

Uncertainty in illness about diagnosis, symptoms, prognosis, treatments, and relationships with health professionals is a major psychosocial stressor for adolescents recently diagnosed with cancer. In this study, the theoretical linkages of the uncertainty in illness theory of perceived social support, uncertainty, and psychological distress were tested. Respondents consisted of 60 adolescents between the ages of 14 and 22 years who were recently diagnosed with cancer. Data were generated by three questionnaires and analyzed using Pearson product moment coefficients and multiple regressional analyses. Hypotheses tested were that among adolescents with cancer (1) there will be an inverse relationship between perceived social support and uncertainty; (2) there will be a positive relationship between uncertainty and psychological distress; (3) there will be an inverse relationship between perceived social support and psychological distress; and (4) there will be an inverse relationship between perceived social support and psychological distress when controlling for uncertainty. Findings were as follows: the first three hypotheses were supported; there was no relationship between perceived social support and psychological distress when controlling for uncertainty. An interaction effect of perceived social support and uncertainty explained 39% of the variance in psychological distress.

The relationship between psychological distress and traditional clinical variables: a 2 year prospective study of 216 patients with early rheumatoid arthritis.

In this longitudinal study (12 and 24 months follow-up) of 216 patients with early rheumatoid arthritis (RA) (< or = 4 yr duration), we assessed the strength and stability of the relationship between psychological distress and traditional clinical variables examined the ability of these clinical variables to predict changes in mental distress, and explored the directionality between mental distress and the other clinical variables. Study variables were symptoms of anxiety and depression measured by the Arthritis Impact Measurement Scales, tender joint counts, erythrocyte sedimentation rate (ESR), and self-reported pain and disability. Psychological distress showed high levels of stability over time. Pain and disability were the two variables most strongly and consistently related to mental distress. High levels of disability predicted an increase in depression during the next year; otherwise, changes in psychological distress were not predicted by disease-related variables. Attempts at causal modelling of the temporal relationship between mental distress, pain and disability failed to yield consistent results.

Acculturation, health, stress, and psychological distress among elderly Hispanics

A structural equations model is proposed to identify direct, indirect, and total effects of selected predictors of psychological distress in a national-area probability sample of Mexican American, Puerto Rican and Cuban elderly. Multivariate regression procedures vis-\,a-vis LISREL-7 techniques are used. The findings indicate that the modified path model explains 29% of the variance in psychological distress. Measures of acculturation have significant indirect effects on psychological distress via other intervening variables in the model. All selected measures of health and stress included in the model have significant direct effect on psychological distress. Implications of the findings for future research and public policy are discussed. jg]Key words gw]Acculturation gw]Health gw]Psychological distress gw]Stress gw]Elderly Hispanics gw]USA.

The Use of Pain Coping Strategies by Patients with Phantom Limb Pain

Previous research has demonstrated a relationship between the use of pain coping strategies and the level of pain and psychological distress experienced by patients suffering from a variety of chronic pain syndromes. The present study assessed coping strategy use in patients suffering from phantom limb pain by means of the Coping Strategies Questionnaire (CSQ). Sixty phantom limb pain patients completed the CSQ and measures of pain and psychological distress. The factor structure of the CSQ was found to be broadly similar to that obtained in other studies of chronic pain. Three factors reflecting 'Cognitive Coping', 'Helplessness' and 'Pain Denial' were found. Both pain report and psychological distress were found to be related to use of strategies within factor 2 (Helplessness), the number of different drugs patients used, and the time they had experienced phantom limb pain. Twenty percent of the variance in pain scores and 19% of the variance in psychological distress were significantly explained by coping strategies included in the 3 factors on the CSQ. Patient history variables significantly explained a further 14% of the variance in pain scores and 14% of the variance in psychological distress. Examination of regression analyses of the subscales of the CSQ revealed that catastrophising explained the largest proportion of the variance in pain report and psychological distress.

Psychological distress of adolescents exposed to Hurricane Hugo.

To ascertain the effects of a natural disaster on adolescents, 1482 South Carolina high school students who were exposed to Hurricane Hugo were surveyed 1 year after the disaster. Subjects completed a self-administered questionnaire measuring Hugo exposure, nonviolent and violent life events, social support, self-efficacy, and psychological distress. Results showed that the students reported minimal exposure to the hurricane and psychological distress variables approximated national norms. As exposure increased, adolescents reported increased symptoms of psychological distress; i.e., anger, depression, anxiety, and global mental distress. Females and white students experienced higher levels of distress. In most cases, other stressful life events were at least as strong a predictor of psychological distress as was exposure to the hurricane. Self-efficacy and social support were protective.

Psychological distress of adolescents exposed to Hurricane Hugo

AbstractTo ascertain the effects of a natural disaster on adolescents, 1482 South Carolina high school students who were exposed to Hurricane Hugo were surveyed 1 year after the disaster. Subjects completed a self‐administered questionnaire measuring Hugo exposure, nonviolent and violent life events, social support, self‐efficacy, and psychological distress. Results showed that the students reported minimal exposure to the hurricane and psychological distress variables approximated national norms. As exposure increased, adolescents reported increased symptoms of psychological distress; i.e., anger, depression, anxiety, and global mental distress. Females and white students experienced higher levels of distress. In most cases, other stressful life events were at least as strong a predictor of psychological distress as was exposure to the hurricane. Self‐efficacy and social support were protective.

Causal Attributions and Recovery from Rape and Other Stressful Life Events

The purposes of this study were (a) to examine a new model of the relations between attributions and long-term recovery among rape survivors and (b) to test the applicability of this model to other life events that differ in terms of controllability (i.e., bereavement and relationship loss). Among rape survivors, both behavioral and characterological self-blame were associated with poorer recovery, as was more often thinking about why the rape occurred; the belief that future assaults are less likely was associated with better recovery; and beliefs about past control were unrelated to beliefs about future control. Self-blame was associated with poorer recovery and perceptions of past and future control were unrelated for both bereavement and relationship loss

The use of pain coping strategies by patients with phantom limb pain

Previous research has demonstrated a relationship between the use of pain coping strategies and the level of pain and psychological distress experienced by patients suffering from a variety of chronic pain syndromes. The present study assessed coping strategy use in patients suffering from phantom limb pain by means of the Coping Strategies Questionnaire (CSQ). Sixty phantom limb pain patients completed the CSQ and measures of pain and psychological distress. The factor structure of the CSQ was found to be broadly similar to that obtained in other studies of chronic pain. Three factors reflecting ‘Cognitive Coping’, ‘Helplessness’ and ‘Pain Denial’ were found. Both pain report and psychological distress were found to be related to use of strategies within factor 2 (Helplessness), the number of different drugs patients used, and the time they had experienced phantom limb pain. Twenty percent of the variance in pain scores and 19% of the variance in psychological distress were significantly explained by coping strategies included in the 3 factors on the CSQ. Patient history variables significantly explained a further 14% of the variance in pain scores and 14% of the variance in psychological distress. Examination of regression analyses of the subscales of the CSQ revealed that catastrophising explained the largest proportion of the variance in pain report and psychological distress.

Unemployment and psychological distress among graduates: A longitudinal study

A longitudinal study which addresses the relationship between unemployment and psychological distress in Dutch technical college graduates is presented.Two samples were studied: sample 1 (N = 635) consisted of students leaving technical college and sample 2 (N = 487) consisted of technical college graduates who had been unemployed for more than one year.In contrast to the results of many recent published studies, unemployment was only found to be associated with psychological distress among those unemployed for more than two years. Males and females were not found to react differently to unemployment. Less psychologically distressed graduates were more likely to become employed than more distressed graduates, and the mean level of psychological distress decreased significantly over time for both employed and unemployed technical graduates. Individual vulnerability explained about twice as much variance in psychological distress of these respondents compared with changes in their employment status. Furthermore, this study indicates the importance of taking into account group‐specific aspects (i.e. level of education) as well as the (Dutch) structural and cultural context in understanding the consequences of unemployment.

Stress, appraisal, and coping in mothers of disabled and nondisabled children.

The cognitive-behavioral model of stress and coping provided the framework for this study of mothers of physically disabled children (n = 69) and mothers of nondisabled children (n = 63). The first aim was to test for differences between groups in responses to stressful parenting events. As hypothesized, mothers of disabled children reported higher levels of depressive symptomatology. Differences in psychological distress and health status approached significance. The second aim was to explore the mediating influences of coping strategies and cognitive appraisals. As predicted, emotion-focused coping was related to increased psychological distress in mothers of disabled children whereas problem-focused coping was associated with decreased distress. Both relationships were significant even after controlling for differences in type of parenting stressor. Hierarchical regressions showed that 58 and 25% of the variance in psychological distress was explained by the independent variables; however, the predictors were different for the two groups of mothers. Factors that may explain the differential effectiveness of coping and appraisal, and clinical implications of this study are discussed.

Type A behaviour pattern, extraversion, neuroticism and psychological distress

The factorial structure of a nine-item Framingham Type A Scale, the 30-item General Health Questionnaire, the 57-item Eysenck Personality Inventory and a 20-item checklist of predominantly physical symptoms was examined in a nationally representative sample of 3065 women and 2520 men. For both women and men, the six principal components extracted from the 116 items and orthogonally rotated clearly corresponded to the six variables of psychological distress, neuroticism, symptoms, extraversion, the Lie scale and the Type A behaviour pattern. While Type A was positively correlated with neuroticism, psychological distress, extraversion and symptoms, there was no support for the idea that it could be more parsimoniously subsumed under these variables. Type A also showed a significant but very small positive association with self-reported coronary heart disease in men, although the correlations between heart disease and psychological distress, neuroticism and symptoms were more positive.

Analyzing chronic low back pain: the relative contribution of pain coping strategies

Sixty-two chronic low back pain patients were administered the Coping Strategies Questionnaire (CSQ) to assess the frequency of use and perceived effectiveness of a variety of cognitive and behavioral pain coping strategies. Analysis of individual variables revealed that CSQ factors, gender, physical examination findings, and chronicity of pain had significant effects on one or more of a series of pain, psychological distress or behavioral measures. To assess the relative contribution of each of these variables hierarchical stepwise regression analyses were carried out. These analyses revealed that the Helplessness factor of the CSQ explained 50% of the variance in psychological distress (Global Severity Index of the SCL-90R), and 46% of the variance in depression (Beck Depression Inventory). Patients scoring high on this CSQ factor had significantly higher levels of psychological distress. None of the demographic or medical status variables explained a significant proportion of variance in the psychological distress measures. The Diverting Attention and Praying factor of the CSQ explained a moderate (9%), but significant amount of variance in pain report. Patients scoring high on this factor had higher scores on the McGill Pain Questionnaire. Coping strategies were not strongly related to pain behavior measures such as guarding or uptime. A consideration of pain coping strategies may allow one to design pain coping skills training interventions so as to fit the needs of the individual low back pain patient.

Predicting temperament-mental health relationships: A covariance structure latent variable analysis

A structural equation latent variable methodology was used to investigate temperament-mental health relationships for a sample of 153 late adolescents/early adults. Explicit measurement models with three indicators each were specified for the two endogenous latent variables of Psychological Well-Being and Psychological Distress; the five exogenous latent variables of General Extraversion, Emotional Stability, General Activity, Adaptability, and Task Orientation were measured by eleven indicators derived from selected scale scores of three different self-report measures. Alternative structural equation models were specified and tested in regard to their adequacy to account for the interrelationships among manifest variables in the observed variance-covariance matrix. The most parsimonious model which plausibly fit the data indicated that Emotional Stability was a strong predictor of both Psychological Distress and Psychological Well-Being. While not as strong a predictor as Emotional Stability, General Extraversion was a significant predictor of Psychological Well-Being, and General Activity was a significant predictor of Psychological Distress. The overall findings support the role of temperament in the prediction of mental health for late adolescents/early adults.