Psychological Distress Variables Research Articles

Psychological distress and quality of life in older persons: relative contributions of fixed and modifiable risk factors

BackgroundWith a rapidly ageing population and increasing life expectancy, programs directed at improving the mental health and quality of life (QOL) of older persons are extremely important. This issue may be particularly relevant in the aged-care residential sector, where very high rates of depression and poor QOL are evident. This study aims to investigate the fixed and modifiable risk factors of psychological distress and QOL in a cohort of Australians aged 60 and over living in residential and community settings.MethodsThe study examined the relationship between demographic, health and lifestyle factors and the outcome variables of self-reported QOL and psychological distress (K10 scores) based on data from 626 Australians aged 60 and over from the 45 and Up Study dataset. Univariate and multivariate regression analyses (performed on a subset of 496) examined risk factors related to psychological distress and QOL adjusting for age and residential status.ResultsSignificant psychological distress was experienced by 15% of the residential sample and 7% of the community sample and in multivariate analyses was predicted by older age, more functional limitations, more time spent sleeping and lower levels of social support (accounting for 18% of the variance). Poorer QOL was predicted by more functional limitations and greater levels of psychological distress. Together these variables accounted for 35% of the variance in QOL ratings.ConclusionsWhile psychological distress was more common in residential settings, programs targeting modifiable risk factors have the potential to improve QOL and reduce psychological distress in older persons living in both residential and community settings. In particular, promoting health and mobility, optimising sleep-wake cycles and increasing social support may reduce levels of psychological distress and improve QOL.

The relationship between negative life events, psychological distress and life satisfaction: a population-based study

Negative life events may increase psychological distress and reduce life satisfaction (LS). This study investigates associations between negative life events and both positive and negative indicators of mental health and explores the extent to which these associations are buffered by sense of mastery and perceived social support. Data were obtained from a large (N = 4,823), nationally representative sample of Norwegians aged 16 and older. Psychological distress was measured by The Hopkins Symptom Check List (HSCL-25), LS by a single question on overall satisfaction with life and negative life events by a 12-item list of threatening experiences. Moderating variables, sense of mastery and social support, were measured using standard instruments. Adjusting for age, sex, education and income, all of the negative life events were significantly associated with both psychological distress and LS, with the exception of events pertinent to bereavement. Of the life events examined, financial strain constituted the strongest predictor. Overall, negative life events were more closely associated with psychological distress than LS. Altogether, negative life events explained 22.3 and 11.4 % of the variance in psychological distress and LS, respectively. Sense of mastery, but not perceived social support, emerged as a moderating factor between financial strain and both psychological distress and LS. Negative life events are associated with higher psychological distress and lower LS, but the strength of the associations varies across events. The impact of financial strain and conflict appears particularly strong, but may be moderated by self-perceived mastery.

Cognitive bias in the interpretation of physiological sensations, coping self-efficacy, and psychological distress after intimate partner violence.

The authors tested a mediation model of trauma-related psychological distress based on social-cognitive theory (Bandura, 1997) among a sample of women (n = 55) who had recently experienced intimate partner violence. It was proposed that survivors of intimate partner violence who reported (a) greater cognitive bias when interpreting physiological sensations and (b) lower coping self-efficacy specific to recovery demands associated with intimate partner violence would also report more severe symptoms of posttraumatic stress disorder and depression. Further, coping self-efficacy was tested as a mediator of the associations between this type of cognitive bias and psychological distress variables (i.e., PTSD & Depression). Results of the cross-sectional analysis suggest that cognitive bias influenced PTSD and depression both directly and indirectly through coping self-efficacy. Limitations and implications are discussed.

Somatic symptoms, psychological distress and sleep disturbance among infertile women with intrauterine insemination treatment

To explore sleep quality in infertile women and examine the factors that contribute to sleep disturbances during intrauterine insemination treatment. Sleep disturbance is an important factor of human health and well-being. Sleep disturbances tend to occur among infertile women during intrauterine insemination treatment. Although many studies have focused on the high percentage of somatic symptoms and psychological distress in infertile women associated with their treatment, few studies have investigated factors linked to their sleep disturbances. A cross-sectional study. The study was conducted during the period of September 2010-January 2011 in a teaching hospital in Taiwan. Infertile women (n = 117) who received assisted reproduction with intrauterine insemination treatment completed a questionnaire. Demographic data, somatic symptoms, psychological distress and perceived sleep quality were collected. More than one-third (35%) of the infertile women reported having sleep disturbances. Their nausea symptoms and psychological distress were risk factors that contributed to sleep disturbance. The variables of nausea and psychological distress significantly explained 30% of the sleep disturbances in the infertile women. The evaluation of nausea symptoms and/or psychological distress among infertile women is an important area of future research; such research should aim to identify the best compromise between infertility treatment and sleep quality. Clinical obstetrics and gynaecology nurses should develop strategies to help infertile women reduce their nausea symptoms and psychological distress during intrauterine insemination treatment to promote healthy sleep.

The Protective Power of Collective Action for Sexual Minority Women of Color

We utilize an additive intersectionality framework in the present study to examine the relations among perceived racism, sexism, and heterosexism and the psychological distress of self-identified sexual minority women of color. Participants ( N = 134) aged 19 to 75 recruited through electronic mailing lists, discussion groups, and virtual communities aimed toward sexual minority women of color completed online surveys. When each form of discrimination was examined in a single multiple regression analysis, only perceived heterosexism explained significant and positive variance in psychological distress. In addition, collective action was tested as a moderator of the effects of racism, sexism, and heterosexism on psychological distress; specifically, the potential attenuating roles of three forms of collective action (race and ethnicity, feminist, and sexual minority) in the respective racism → distress, sexism → distress, and heterosexism → distress links were investigated. Sexual minority collective action buffered the heterosexist experiences → psychological distress link. More specifically, in the context of lower collective action, perceived heterosexism positively predicted distress; however, perceived heterosexism did not predict psychological distress at higher levels of collective action. No other significant interaction effects were found. Our results suggest that discrimination experiences continue to be important to assess in research and practice with marginalized individuals. Also, encouraging clients to engage in collective action could represent a useful intervention tool for counselors.

FRI0139 The correlation of self-reported behavioral co-morbidities and disease activity in early inflammatory arthritis patients: A prospective study

BackgroundInflammatory arthritis patients experience a host of behavioral alterations that include depression, fatigue, sleep disturbances, and cognitive dysfunction. These behavioral comorbidities are apparent throughout the process of diagnosis and treatment...

The impact of the psychological contract, justice and individual differences: nurses take it personally when employers break promises

To explore affective and attitudinal outcomes of aspects of the psychological contract, organizational justice and negative affectivity in nursing. Job satisfaction, mental health and commitment to organizations and the nursing profession is important for nurse retention. The psychological contract and organizational justice are related constructs that have been linked to these outcomes, as has the characteristic of negative affectivity. Rarely have the relationships between these concepts and outcomes been examined. Cross-sectional data were collected during November, 2007. Survey data collected on Registered Nurses and midwives from a large metropolitan hospital in Australia (n=193, after removing missing cases and outliers) were analysed using structural equation modelling. The model used self-report measures of psychological contract obligations, fulfilment and breach, organizational justice and negative affectivity as predictors of job satisfaction, organizational commitment, career commitment and psychological distress. Goodness-of-fit statistics confirmed a well-fitting model. The model explained 49%, 29%, 60% and 47% of the variance in psychological distress, job satisfaction, organizational commitment and career commitment respectively. Findings support the influence of the psychological contract, fairness and individual differences on outcomes important to nurse retention. Keeping promises is more important than making promises that cannot be kept. The results support a discrepancy mechanism underlying fulfilment and breach. The impact of breach suggests that nurses take breach personally, whereas fulfilment may represent a global evaluation of discrepancies. Ultimately, fulfilling, rather than making promises, keeps nurses happy.

Psychological distress in African American grandmothers raising grandchildren: The contribution of child behavior problems, physical health, and family resources

Diminished psychological health has been identified among caregiving grandmothers. The intent of this investigation was to examine psychological distress levels, as well as their predictors, in a sample of 480 caregiving African American grandmothers, mean age 56 years. Almost 40% (39.8%) of participants had clinically elevated psychological distress scores. Results of hierarchical multiple regression indicated that internalizing and externalizing child behavior problems, poor grandmother physical health, younger age of grandmother, and lack of family resources predicted 31% of the variance in psychological distress. Results provide direction for nursing interventions aimed at enhancing the psychological well-being of caregiving grandmothers.

Associations among Religious Coping, Daily Hassles, and Resilience

The purpose of this study is to examine relationships among religious coping styles, the experience of daily hassles, and resiliency. Through the use of a set of questionnaires, positive and negative religious coping styles (Brief RCOPE) are identified and analyzed in relation to a direct measure of resiliency (CD-RISC), level of psychological distress (BSI), and level of daily hassles (BCSHS). Negative religious coping is positively related to psychological distress, while individuals who experience more daily hassles but use higher levels of positive religious coping have greater resiliency than individuals who use higher levels of negative religious coping. Additionally, the combination of daily hassles, major life stressors, level of positive religious coping, and resiliency accounted for a significant proportion of the variability in psychological distress. Post hoc analyses removed questions of spirituality from the resiliency scale that could possibly overlap with the measure of religious coping. These exploratory analyses indicate that negative religious coping is negatively correlated with non-spiritual resiliency. Exploratory analyses also indicate that individuals who experience more daily hassles but use higher levels of positive religious coping do not have greater levels of non-spiritual resiliency than individuals who use negative religious coping.

1079 – Effects of psychological distress and social support on mental fitness among patients of mental health services

Introduction Life events and accompanying psychological and behavioral reactions frequently have an impact upon people's daily lives and are believed to predispose them to disease. Psychological stressors impact many physiological and pathological disease outcomes, including mental illness. Positive social interactions have in turn been shown to exert powerful beneficial effects on health outcomes and longevity. Objectives The Objective of this study was to analyze the relationships of Psychological Distress, Social Support, and Mental Fitness among patients of mental health services. Aims This article aims to discuss the evidence supporting the mediating effect of social support between psychological stress and mental health. Methods This study was performed on patients who visited the mental health services in Daejeon from October to December 2011. In total, 395 patients were evaluated with Mental Fitness Scale, Kessler Psychological Distress Scale(KPDS), and Multidimensional Scale of Perceived Social Support(MSPSS). Results Correlations among variables of psychological distress and social support on subordinate variable of mental fitness of patients were significant. The result of the regression analysis, psychological distress and social support have a positively significant influence on mental fitness of patients. social support showed mediating effects between psychological distress and mental fitness. Conclusion These results suggest that health care providers ought to seek social support for patients, in order to provide positive mental fitness of patients.

Racial and ethnic minority college students' stigma associated with seeking psychological help: Examining psychocultural correlates.

Many college students underuse professional psychological help for mental health difficulties. The stigma associated with seeking such help appears to be one of the reasons for this underuse. Levels of psychological distress and past use of counseling/psychotherapy have been found to be important correlates of stigma associated with seeking psychological help (Obasi & Leong, 2009; Vogel, Wade, & Haake, 2006). For racial and ethnic minorities, the hindering effects of self-stigma and perceived stigmatization by others on treatment seeking may further be compounded by their relationships with their own ethnic groups, with other ethnic groups, and with the dominant society. This study used structural equation modeling (SEM) to test a model that explored the effects of psychological distress and psychocultural variables (i.e., ethnic identity, other-group orientation, perceived discrimination) on perceived stigmatization by others and self-stigma for seeking psychological help, controlling for past use of counseling/psychotherapy. The sample consisted of 260 African American, 166 Asian American, and 183 Latino American students. SEM multigroup analyses indicated measurement invariance, but partial structural invariance, across racial/ethnic groups. Across all 3 groups, higher levels of psychological distress and perceived racial/ethnic discrimination, respectively, predicted higher levels of perceived stigmatization by others for seeking psychological help, which, in turn, predicted greater self-stigma for seeking psychological help. Higher levels of other-group orientation predicted lower levels of self-stigma of seeking psychological help across groups. Higher levels of ethnic identity predicted lower levels of self-stigma of seeking psychological help only for African Americans. Implications for research and practice are discussed.

Socioeconomic Status and Mortality

OBJECTIVEAlthough several studies have examined the association between socioeconomic status (SES) and mortality in the general population, few have investigated this relationship among people with diabetes. This study sought to determine how risk of mortality associated with measures of SES among adults with diagnosed diabetes is mitigated by association with demographics, comorbidities, diabetes treatment, psychological distress, or health care access and utilization.RESEARCH DESIGN AND METHODSThe study included 6,177 adults aged 25 years or older with diagnosed diabetes who participated in the National Health Interview Surveys (1997–2003) linked to mortality data (follow-up through 2006). SES was measured by education attained, financial wealth (either stocks/dividends or home ownership), and income-to-poverty ratio.RESULTSIn unadjusted analysis, risk of death was significantly greater for people with lower levels of education and income-to-poverty ratio than for those at the highest levels. After adjusting for demographics, comorbidities, diabetes treatment and duration, health care access, and psychological distress variables, the association with greater risk of death remained significant only for people with the lowest level of education (relative hazard 1.52 [95% CI 1.04–2.23]). After multivariate adjustment, the risk of death was significantly greater for people without certain measures of financial wealth (e.g., stocks, home ownership) (1.56 [1.07–2.27]) than for those with them.CONCLUSIONSThe findings suggest that after adjustments for demographics, health care access, and psychological distress, the level of education attained and financial wealth remain strong predictors of mortality risk among adults with diabetes.

Women’s Reactions to Interpersonal Violence Research

This study assessed women's immediate and long-term reactions to completing self-report measures of interpersonal violence. College women completed surveys at the beginning and end of a 2-month academic quarter for course credit. Results showed that 7.7% of participants experienced immediate negative emotional reactions to research participation. Greater immediate negative reactions were related to interpersonal victimization and psychological distress variables. Attrition from the study over the 2-month follow-up was not predicted by participants' immediate negative emotional reactions to the research or anticipation of future distress. Of the participants who returned for the follow-up, 2.1% of participants reported experiencing distress over the interim period as a result of their initial participation in the study. These long-term reactions were bivariately related to a number of victimization, psychological distress, and reaction variables measured at the first study session. However, in the regression analyses, only immediate negative emotional reactions to the research and anticipation of future distress predicted long-term negative emotional reactions.

A dyadic analysis of negative emotion personality predisposition effects with psychological distress in neonatal intensive care unit parents.

The relation of parents’ personality predisposition to guilt, shame, and fear of death with symptoms ofposttraumatic stress, anxiety, and depression was examined in 67 couples who were the parents of sicknewborn infants previously hospitalized in a Neonatal Intensive Care Unit. The Actor-Partner Interde-pendence Model method of dyadic analysis was used to determine the relation of parents’ predispositionto guilt, shame, and fear of death to their own posttraumatic stress, anxiety, and depression (actor effect),and to the posttraumatic stress, anxiety, and depression of their partners (partner effect). The couplemembers were not statistically distinguishable by gender. Guilt had a significant actor effect withposttraumatic stress, anxiety, and depression, and a significant partner effect with anxiety and depression.Guilt explained 15–18% of the variance in these measures of psychological distress. Fear of death hada significant actor effect with all measures of psychological distress, but none of the partner effects wasstatistically significant. Shame did not predict posttraumatic stress or anxiety, but there was a significantactor effect with depression. Fear of death and shame explained only small proportions (3–6%) of thevariance in the psychological distress variables with which they had statistically significant relationships.The guilt effects with psychological distress were intrapersonal (actor) and interpersonal (partner),whereas the fear of death and shame effects were intrapersonal. These emotions, particularly fear of deathand shame, tend to be elusive as well as aversive, but they are important forerunners of psychopathologyand deserve specific attention in psychological counseling.Keywords: parents, neonatal intensive care, posttraumatic stress, anxiety, depression

Abstract 183: Psychosocial Risk Profiles in Patients with Acute Coronary Syndrome: First Findings from TRACE-CORE

Background: Psychological distress variables (depression, anxiety, stress) and social support are associated with health outcomes in patients with acute coronary syndrome (ACS), as are low quality of life (QoL) and socioeconomic status (SES). Distress variables are often correlated and, together with social support, may generate categories of psychosocial vulnerability that could be useful in predicting cardiovascular outcomes. We examined the feasibility of generating psychosocial risk profiles based on these factors and, as an initial test of validity, hypothesized that high psychosocial risk would be associated with low SES and low QoL. Methods: Adults (n = 793 to date) in Worcester, MA and Macon, GA were interviewed during hospitalization for ACS in an ongoing longitudinal study within the Transitions, Risk, and Actions in Coronary Events Center for Outcomes Research and Education (TRACE-CORE). Patients completed assessments of depression (PHQ-9), perceived stress (PSS), anxiety (GAD-7), social support (MOS), social network (LSNS), and generic (SF-36), and condition-specific (SAQ), QoL measures. K-means cluster analysis identified groups with different risk profiles using standardized summary scores of distress (PHQ-9, PSS and GAD-7) and social support (LSNS and MOS). We tested relationships of these clusters with demographic characteristics and QoL. Results: Average patient age was 61 years, 35% were women, 76% non-Hispanic White, 13% African American. We identified 3 clusters designated low, moderate and high risk (Table 1). The low-risk cluster had low distress and high social support scores; moderate-risk group had average distress and low social support; high-risk group had high distress and average social support. Moving from low to high cluster risk, we found increasing proportions of women and patients with lower SES. In contrast age and QoL decreased as cluster risk increased. Conclusions: Data-driven psychosocial risk stratification correlates as predicted with QoL and socioeconomic indicators If these clusters remain stable over time and are related to short- and long-term ACS outcomes as well (a testable hypothesis as TRACE-CORE progresses) they may facilitate developing tailored interventions to improve ACS patient outcomes.

Coping in long‐term survivors of childhood cancer: relations to psychological distress

The goal of this study was to describe coping strategies and their associations with psychological distress in young adult survivors of childhood cancer. One hundred and sixty-four childhood cancer survivors, at least 7 years after diagnosis, completed questionnaires assessing demographics, health information, psychological distress, and different ways of coping (return rate: 61%). The Brief Symptom Inventory-18 (BSI-18) and the Post-traumatic Diagnostic Scale's (PDS) eight-item short form were used to measure psychological distress. Coping was assessed with the Cognitive Control Strategies Scale (CCSS), the Illness Perception Questionnaire-Revised (IPQ-R), and the White Bear Suppression Inventory (WBSI). Higher levels of distress were associated with the female sex, not being in a relationship, and with the presence of medical late effects. These predictors explained 12% of the variance in psychological distress. When coping variables were also entered into the equation, the amount of explained variance increased to 50%. The most important determinants of psychological distress in our sample were a tendency to suppress negative thoughts and a low level of optimism. These results contribute to a better understanding of the correlates of difficulties in long-term psychological adjustment after childhood cancer. Cognitive strategies, which are associated with or may increase the risk for concurrent psychological distress, in specific, avoidance of negative thoughts and a lack of positive future expectations, should be addressed in psychological counseling with survivors suffering from symptoms of distress.

Factors Predicting Relationship Satisfaction, Investment, and Commitment When Women Report High Prevalence of Psychological Abuse

Relationship satisfaction, investment, and commitment in women experiencing extensive psychological abuse were examined to determine predictive factors. Participants were the top quartile of a national sample of women in conflictual relationships (N = 81) experiencing psychological maltreatment. Relationship satisfaction, investment, and commitment were each used as criterion variables with conceptually related factors as the predictors (e.g., reactions to the psychological abuse; mental health indicators; personality variables; perceived harm; problematic relationship schemas; response styles; demographics). These relationship markers were differentially predicted within this group of women. Three independent clusters of women, based on patterns of satisfaction, investment, and commitment scores, were compared regarding physical abuse, reactions to psychological abuse, ratings of perceived harm, endorsement of relationship schemas, psychological distress variables, and personality variables. The cluster of women reporting higher satisfaction, investment, and commitment in these seemingly aversive relationships frequently demonstrated differences from the other two clusters. Implications for clinical applications are discussed.

The Role of Mindfulness and Disordered Eating Cognitions in Psychological Distress among College Females with Elevated Disordered Eating

The present study investigated whether mindfulness and different forms of maladaptive eating-related cognitions (i.e., fear of gaining weight, belief that social approval is contingent on weight/appearance, and self-worth from feeling in control of eating) separately and independently accounted for unique variance in psychological distress among adult females with elevated eating pathology. Ethnically diverse nonclinical college females (N = 738) completed a web-based survey; data from 91 of these participants who endorsed elevated eating pathology were selected for analyses. Mindfulness and fear of gaining weight, but not self-worth or perceived importance of appearance for gaining social approval, accounted for unique variance in psychological distress after controlling for age, ethnicity and body mass index (BMI). The present study suggests that not all forms of disordered eating cognitions are uniquely associated with psychological distress among females with elevated eating pathology and that mindfulness is a useful concept for understanding psychological distress in this group.

Life Role Salience Dimensions and Mental Health Outcomes Among Female Expatriate Spouses in Turkey

Using life role salience theory, we investigated the extent to which occupational, parental, marital, and home care roles explained mental health outcomes among female expatriate spouses. Participants ( N = 86) were from English-speaking Northern American or Western European countries; the average age was 38. Results of a two-way within-subject analysis of variance suggested that the occupational role was least important. In a comparison of role expectations, participants had greater value for (than commitment to) their parental role; the reverse was true for the marital role. Results of a path analysis explained 10% of the variance in psychological distress via a direct path from career role importance (β = .14) and an indirect path from the marital role importance through marital satisfaction (β = −.12). Three paths (parental role importance, β = .14; home care role importance, β = .15; indirectly from marital role importance through marital satisfaction, β = .18) explained 24% of the variance in psychological well-being.

Acceptability and Preliminary Feasibility of an Internet/CD-ROM-Based Education and Decision Program for Early-Stage Prostate Cancer Patients: Randomized Pilot Study

BackgroundProstate cancer is the most common cancer affecting men in the United States. Management options for localized disease exist, yet an evidence-based criterion standard for treatment still has to emerge. Although 5-year survival rates approach 98%, all treatment options carry the possibility for significant side effects, such as erectile dysfunction and urinary incontinence. It is therefore recommended that patients be actively involved in the treatment decision process. We have developed an Internet/CD-ROM-based multimedia Prostate Interactive Educational System (PIES) to enhance patients’ treatment decision making. PIES virtually mirrors a health center to provide patients with information about prostate cancer and its treatment through an intuitive interface, using videos, animations, graphics, and texts.Objectives(1) To examine the acceptability and feasibility of the PIES intervention and to report preliminary outcomes of the program in a pilot trial among patients with a new prostate cancer diagnosis, and (2) to explore the potential impact of tailoring PIES treatment information to participants’ information-seeking styles on study outcomes.MethodsParticipants (n = 72) were patients with newly diagnosed localized prostate cancer who had not made a treatment decision. Patients were randomly assigned to 3 experimental conditions: (1) control condition (providing information through standard National Cancer Institute brochures; 26%), and PIES (2) with tailoring (43%) and (3) without tailoring to a patient’s information-seeking style (31%). Questionnaires were administrated before (t1) and immediately after the intervention (t2). Measurements include evaluation and acceptability of the PIES intervention, monitoring/blunting information-seeking style, psychological distress, and decision-related variables (eg, decisional confidence, feeling informed about prostate cancer and treatment, and treatment preference).ResultsThe PIES program was well accepted by patients and did not interfere with the clinical routine. About 79% of eligible patients (72/91) completed the pre- and post-PIES intervention assessments. Patients in the PIES groups compared with those in the control condition were significantly more likely to report higher levels of confidence in their treatment choices, higher levels of helpfulness of the information they received in making a treatment decision, and that the information they received was emotionally reassuring. Patients in the PIES groups compared with those in the control condition were significantly less likely to need more information about treatment options, were less anxious about their treatment choices, and thought the information they received was clear (P < .05). Tailoring PIES information to information-seeking style was not related to decision-making variables.ConclusionsThis pilot study confirms that the implementation of PIES within a clinical practice is feasible and acceptable to patients with a recent diagnosis of prostate cancer. PIES improved key decision-making process variables and reduced the emotional impact of a difficult medical decision.