Psychological Distress Variables Research Articles

The Effect of Acculturation and Immigration on the Victimization and Psychological Distress Link in a National Sample of Latino Women

Distinct bodies of research have examined the link between victimization and psychological distress and cultural variables and psychological health, but little is known about how cultural variables affect psychological distress among Latino victims. Substantial research has concluded that Latino women are more likely than non-Latino women to experience trauma-related symptoms following victimization. In addition, examination of different types of cultural adaptation has found results supporting the idea that maintaining ties with one's culture of origin may be protective against negative mental health outcomes. The present study evaluates the effect of victimization, immigrant status, and both Anglo and Latino orientation on psychological distress in a national sample of Latino women. Results indicate that along with the total count of victimization experiences, Anglo and/or Latino orientation were strong predictors of all forms of psychological distress. Anglo orientation also functioned as a moderator between victimization and psychological distress measures for anger, dissociation, and anxiety. The results suggest a more nuanced and complex interaction between cultural factors, victimization, and psychological distress.

Unmet Need for Assistance to Perform Activities of Daily Living and Psychological Distress in Community-Dwelling Elderly Women

Community-dwelling seniors increasingly require physical assistance to perform the activities of daily living (ADL). To examine the possible association of this need with psychological distress, we conducted a prospective cohort study of community-dwelling people age 75 and older in Montreal, Canada. We report the results for women only (n = 530). Multivariable linear regression was used to examine the association between met and unmet need in instrumental ADL (IADL) and personal ADL (PADL) with concomitant psychological distress. Unmet IADL need was associated with elevated psychological distress [β = 0.42 (95% CI: 0.26, 0.60)], as was met IADL need [β = 0.19 (95% CI: 0.06, 0.33)], but not met and unmet PADL need. The full model explained 32.8 per cent of the total variance in psychological distress. Receiving assistance to meet IADL needs is associated with elevated psychological distress. Not receiving assistance, however, is associated with even greater distress.

Social support and psychological distress in rheumatoid arthritis: a 4-year prospective study

Introduction: The objective of the study was to investigate the course of psychological distress in early rheumatoid arthritis patients and to explore the strength of its associations with disease-related variables over time. A further aim focused specifically on the associations between social support and psychological distress. Methods: The study had a longitudinal design, with four annual measurements over consecutive years. The course and stability of psychological distress on the individual level were investigated via test–retest correlation coefficients and changes over time were studied using the Friedman test for repeated measurements. Hierarchical regression analysis was performed to analyze the multilinear associations of disease activity, functional disability, joint tenderness, pain and social support with psychological distress. Results: Significant cross-sectional associations were found among functional disability, joint tenderness, pain, emotional support, instrumental support and psychological distress. However, after controlling for the erratic pattern of the disease and the relevant variables, only initial psychological distress and emotional support retained a significant relationship with psychological distress. The final regression model, in which functional disability, pain, emotional support and initial psychological distress were significant variables, explained 36% of the variance in psychological distress. Conclusion: The study stresses the importance of initial psychological distress, which was found to have the highest correlation with psychological distress experienced 4 years later. In addition, higher emotional support and lower pain were found to be the only variables independently associated with lower levels of psychological distress after controlling for the relevant variables.Implications for RehabilitationPsychological distress is a relevant problem in rheumatoid arthritis patients and should be recognized early in the disease as it might reflect a lack of social resources which can be crucial in the further course of the disease.Special attention should be paid to different types of social support in relation to psychological distress, which might improve targeting psychosocial interventions.

The Role of Mindfulness and Psychological Flexibility in Somatization, Depression, Anxiety, and General Psychological Distress in a Nonclinical College Sample

The current study investigated whether mindfulness and psychological flexibility uniquely and separately accounted for variability in psychological distress (somatization, depression, anxiety, and general psychological distress). An ethnically diverse, nonclinical sample of college undergraduates (N = 494, 76% female) completed a Web-based survey that included the self-report measures of interest. Consistent with prior research, psychological flexibility and mindfulness were positively associated with each other, and tested separately, both variables were negatively associated with somatization, depression, anxiety, and general psychological distress. Results also revealed that psychological flexibility and mindfulness accounted for unique variance in all 4 measures of distress. These findings suggest that mindfulness and psychological flexibility are interrelated but not redundant constructs and that both constructs are important for understanding the onset and maintenance of somatization, depression, anxiety, and general distress.

Disordered Eating and Psychological Distress among Adults

The majority of our knowledge about eating disorders derives from adolescent and young adult samples; knowledge regarding disordered eating in middle and later adulthood is limited. We examined the associations among known predictors of eating disorders for younger adults in an age-diverse sample and within the context of psychological distress. Using data from 567 adults (ages 18 to 88 years), we tested a path model in which age, gender, eating-related cognitions, and satisfaction with appearance predicted eating disorders which, in turn, predicted psychological distress. The model fit the data well (chi2 (DF = 11, N = 567) = 30.58, p < .001; GFI = .987, NFI = .963; RMSEA = .056), explaining 20.1% of the variance in psychological distress.

Psychological distress among family carers of oesophageal cancer survivors: the role of illness cognitions and coping

The research aimed to determine the extent to which illness cognitions and coping explain psychological distress (fear of cancer recurrence, anxiety and depression symptoms) among family carers of survivors of oesophageal cancer. Carers of patients registered with the Oesophageal Patients' Association in the UK were mailed a questionnaire booklet containing questions about medical and demographic variables, the Illness Perception Questionnaire-Revised, the Cancer Coping Questionnaire, the Concerns about Recurrence Scale and the Hospital Anxiety and Depression Scale. Complete responses were received from 382 family carers (75% male; mean (SD) age=62 (10.91) years). Regression models indicated that the variables measured could explain between 35 and 49% of the variance in psychological distress among carers. Illness cognitions (particularly perceptions of the cause of, consequences of and personal control over oesophageal cancer and the carer's understanding of the condition) explained the majority of this variance. Positive focus coping strategies were also found to be important in explaining psychological distress. The results of this study are consistent with previous research demonstrating that illness cognitions are significant correlates of adaptive outcomes, thereby suggesting that cognition-based interventions could potentially be effective in minimizing emotional distress among family carers of oesophageal cancer survivors.

The Firefighter Coping Self-Efficacy Scale: measure development and validation

The authors evaluated the psychometric properties of the Firefighter Coping Self-Efficacy (FFCSE) Scale, a new measure developed to assess firefighters’ perceived competence in managing stressful and traumatic experiences encountered on the job. Two samples of firefighters completed the FFCSE Scale at two different time points. Exploratory factor analysis yielded a unidimensional structure, which was further supported with confirmatory factor analysis using a second sample. Internal consistency of the measure was excellent. Analysis of cross-sectional data indicated FFCSE was positively associated with measures of psychological well-being and social support, and negatively associated with work-related stress and psychological distress. FFCSE also uniquely contributed to the variance in psychological distress, over and above variables previously shown to be associated with distress among this population. Implications and suggestions for future research are discussed.

Prevalence of Psychological Distress, as Measured by the Kessler 6 (K6), and Related Factors in Japanese Employees

The aim of this study was to examine the prevalence of and related factors for psychological distress among employees. The employees in Akita prefecture, Japan, were invited to complete the Kessler 6 (K6). A value of 13 or higher on the K6 scale indicated high psychological distress. Furthermore, we identified the relationships among the prevalence of high psychological distress, socio-demographic status, and employment-related variables. The data of 1,709 employees indicated that 10.8% of the employees had high psychological distress; the proportion of psychological distress found in the present study was high compared to that found in previous studies. The identified socio-demographic and occupation-related factors included young age groups associated with a high risk and clerical or administrative tasks associated with a low risk of psychological distress. The data of this study can be used as K6 benchmark values, which enhance the significance of future corporate health risk appraisal surveys.

The Relationships Between Perceived Levels of Control, Psychological Distress, and Legal System Variables in a Sample of Sexual Assault Survivors

Information regarding psychological distress, perceived levels of temporal control, and legal system success and satisfaction ratings were collected from 41 survivors of sexual assault. Results suggest that self-blame and offender blame may differentially impact posttraumatic stress disorder (PTSD) and depressive symptom severity. In addition, participants who perceived a greater risk of future assault reported higher levels of depressive and PTSD symptoms. Furthermore, perceptions of present control over the recovery process were related to lower levels of psychological distress. For those who reported the assault to police, lower levels of legal system success and satisfaction were linked to higher levels of perceived control over present recovery.

Measuring multiple minority stress: The LGBT People of Color Microaggressions Scale.

Lesbian, gay, and bisexual individuals who are also racial/ethnic minorities (LGBT-POC) are a multiply marginalized population subject to microaggressions associated with both racism and heterosexism. To date, research on this population has been hampered by the lack of a measurement tool to assess the unique experiences associated with the intersection of these oppressions. To address this gap in the literature, we conducted a three-phase, mixed method empirical study to assess microaggressions among LGBT-POC. The LGBT People of Color Microaggressions Scale is an 18-item self-report scale assessing the unique types of microaggressions experienced by ethnic minority LGBT adults. The measure includes three subscales: (a) Racism in LGBT communities, (b) Heterosexism in Racial/Ethnic Minority Communities, and (c) Racism in Dating and Close Relationships, that are theoretically consistent with prior literature on racial/ethnic minority LGBTs and have strong psychometric properties including internal consistency and construct validity in terms of correlations with measures of psychological distress and LGBT-identity variables. Men scored higher on the LGBT-PCMS than women, lesbians and gay men scored higher than bisexual women and men, and Asian Americans scored higher than African Americans and Latina/os.

Ego defense mechanisms in COPD: impact on health-related quality of life and dyspnoea severity

To assess chronic obstructive pulmonary disorder (COPD) patients' defensive profile compared with healthy participants and to test whether specific ego defense mechanisms are associated with health-related quality of life (HRQoL) and self-reported dyspnoea severity. In a cross-sectional study, we assessed, in 80 patients with COPD and 80 age- and gender-matched healthy participants, psychological distress (Hospital Anxiety and Depression Scale) and defense mechanisms/styles (Defense Style Questionnaire). Patients had their HRQoL evaluated with the St. George's Respiratory Questionnaire and underwent a comprehensive clinical evaluation with determination of functional parameters and dyspnoea severity. COPD patients presented higher scores in undoing, acting out, autistic fantasy, denial, and splitting defenses compared with healthy controls. Overall, patients showed a more immature (P=0.001) and/or neurotic (P=0.006) defensive profile. Higher scores of denial (P=0.044), somatization (P=0.009), and undoing (P=0.032) defenses were associated with poorer HRQoL, independently of the anticipated significant associations of clinical and psychological distress variables with impaired HRQoL. Somatization was strongly independently associated with more severe self-reported dyspnoea. COPD patients exhibit a relatively immature and neurotic defensive profile. Clinicians and consultation-liaison psychiatrists should consider the patients' underlying personality structure, especially somatization tendencies, since it is independently associated with HRQoL and dyspnoea severity.

W09-02 - The role of psychological distress, somatization and personality traits in the formation of IBD patients' health-related quality of life (HRQOL) and smoking habits

IntroductionClinical parameters predict HRQoL in inflammatory bowel disease (IBD), however some patients have impaired HRQoL despite clinical remission; furthermore, Crohn's disease (CD) is associated with smoking, while ulcerative colitis (UC) is largely a nonsmokers’ disease, indicating that psychological distress and personality variables might mediate the relationship of clinical variables with HRQoL and smoking.AimsTo assess psychological distress and personality traits in IBD and their contribution to the formation of HRQoL and smoking habits.MethodsIn 76 IBD outpatients we compared psychological distress symptoms and defensive profile between CD and UC. In another study of 185 IBD patients, we tested the relation of psychological distress, defense mechanisms and personality traits with HRQoL, smoking, and nicotine dependence.ResultsCD patients presented a more immature defensive profile. The more psychologically mature IBD patients had lower relapses and surgical operations’ rates. Psychological distress was associated with impaired HRQoL in a dose-response fashion. Somatization was independently associated with impaired HRQoL and mediated the relationships of anxiety and depression with HRQoL. In CD, the relationship of the smoking-linked personality characteristic “impulsive sensation seeking” with current smoking and nicotine dependence was stronger.ConclusionsIBD patients exhibit several specific psychological difficulties in adaptation to stressors. Apart from addressing timely psychological distress and somatization symptoms, clinicians and consultation-liaison psychiatrists should consider the patients’ defensive profile, since such personality traits, although usually underestimated, are strongly independently associated with the disease's outcome. Our findings might be also relevant to more effective interventions targeting smoking cessation in CD patients.

Cumulative Victimization, Psychological Distress, and High-Risk Behavior Among Substance-Involved Women

This research addressed two questions: (a) What is the relationship between different patterns of cumulative victimization and psychological distress? And (b) How does the pattern of cumulative victimization and psychological distress influence women's engagement in substance- and sex-related risk behavior? Data were analyzed from interviews with 149 sexually active, crack-using women who completed a follow-up interview after participating in the Kentucky National Institute on Drug Abuse (NIDA) AIDS Cooperative Agreement. Findings from the multivariate analyses indicated that victimization accounted for 5% and 39% of the variance in psychological distress and high-risk behavior, respectively; cumulative victimization and psychological distress accounted for 6% to 11% of the variance in the high-risk behaviors. Results highlight the affects of childhood and adult victimization on psychological distress and the associations between different types of psychological distress and risk behavior.

The development of fibromyalgia – I: Examination of rates and predictors in patients with rheumatoid arthritis (RA)

We determined rates and predictors of future development of fibromyalgia in patients with rheumatoid arthritis (RA). After excluding patients with fibromyalgia and those with high levels of fibromyalgia symptoms (fibromyalgianess score>10) at baseline, we studied fibromyalgia development in 9739 RA patients during 42,591 patient-years of follow-up. We defined fibromyalgia using a modification of the ACR 2010 fibromyalgia criteria. We used Cox regression to predict future fibromyalgia, and examined the accuracy of predictions using Harrell’s C concordance coefficient. At the last observation, 7.4% of patients satisfied criteria, although 19.8% satisfied criteria at some point during follow-up, an incidence rate of 5.3 (95% CI 5.1, 5.6) per 100 patients years, and at rates that were similar in men (7.0%) and women (8.1%). Among those satisfying criteria, during 11,363years of follow-up from the time of first fibromyalgia diagnosis, half of follow-up time was fibromyalgia+and was associated with markedly abnormal RA variable and FM variable scores. Demographic factors were weak predictors of fibromyalgia (C=0.604). Demographic plus RA variables (C=0.720) and demographic plus fibromyalgia variables (C=0.765), and all predictors (C=0.782) increased accuracy. Clinically important hazard ratios were noted for cognition, depression, comorbidity, and high levels of RA and FM continuous variables Overall, study results indicate that multiple, inter-correlated factors that include social disadvantage, psychological distress, comorbidity, RA severity, and fibromyalgia variables predict future development of fibromyalgia, but there is little evidence of the effect of underlying causes. After diagnosis, patients move in both directions across the diagnostic criteria cut points.

Self‐Concealment and Willingness to Seek Counseling for Psychological, Academic, and Career Issues

Cramer's (1999) model of self‐concealment and willingness to seek counseling was extended to examine the role of positive and negative social experiences in a sample of 235 college students reporting a psychological, academic, or career issue. Structural equation modeling indicated that self‐concealment predicted willingness through the mediators of negative social experiences and psychological distress. Forty‐eight percent of the variance in psychological distress and 6% of the variance in willingness were accounted for in the model.

Dyadic adjustment, sexuality and psychological distress in older couples

The following study gives results on the association between psychological distress and sexual and marital aspects from the Quebec Health Survey of Older Couples (Enquête sur la santé des aînés au Québec/Volet Couple). In this study, 508 francophone couples (508 women, 508 men), aged 65 years old and over, answered several questionnaires about psychological distress (e.g. Psychological Distress Index) and marital (e.g. Dyadic adjustment scale) and sexual aspects of their life (e.g. Derogatis Sexual Functioning Inventory, International Index of Erectile Function, Female Sexual Function Index). Participants answered general questions at home in the presence of an interviewer and they answered to specific questionnaires about their sexuality and marital life on a computer to ensure confidentiality. Results indicate that dyadic adjustment, sexual satisfaction and gender predict psychological distress and explain 14.2% of the variance of psychological distress among older couples. The same predictor variables were found in men and women considered separately. Moreover, participants with low marital functioning show more than twice as much psychological distress and poorer sexual functioning.

Predictors of psychological distress in patients starting IVF treatment: infertility-specific versus general psychological characteristics

The distress that couples experience in IVF treatment is well-documented though research exploring factors that might contribute to the distress is scarce and the role of infertility-specific versus more general psychological characteristics in predicting psychological distress remains unexplored. This exploratory study aimed to describe, explore and test a self-constructed conceptual framework designed to understand the relative impact of infertility-specific and general psychological characteristics, in predicting psychological distress. Validated self-report questionnaires that measured the concepts of the encompassing framework (personality characteristics self-criticism and dependency, attachment in the partner relationship, child wish, coping, intrusiveness, infertility-related stress and general psychological distress) were completed by 106 women and 102 men before starting the first IVF/ICSI treatment at a university hospital-based fertility centre. Data were analysed by hierarchical multivariate linear regression analysis and path analysis. The overall conceptual psychological framework explained 55% of the variance in psychological distress. The strongest predictors of psychological distress were general psychological characteristics: passive and active coping, self-criticism and dependency and intrusiveness. A path analysis confirmed the framework and highlighted the mediating role of coping and intrusiveness. In the final analysis, none of the infertility-specific variables significantly predicted psychological distress. The current study of patients starting IVF-treatment demonstrated that general psychological characteristics, specifically active and passive coping, personality characteristics, dependency and self-criticism and intrusiveness, are more important in predicting the variability in psychological distress than infertility-specific concerns. The results raise important questions for infertility counselling. However, the cross-sectional nature of the study only allows for insight into baseline measurement (before starting the first IVF-treatment) and therefore this area of research could benefit from additional longitudinal studies.

Testing an Attachment Model of Latina/o College Students’ Psychological Adjustment

The present study examined the influence of attachment relationships on the psychological adjustment of Latina/o university students ( N = 80) attending predominantly White institutions of higher education.A path analysis conducted to test a hypothesized model of parent and peer attachment, self-esteem, and psychological distress indicated that the final model provided good model-to-data fit, explaining 21% of the variance in self-esteem and 50% of the variance in psychological distress. Furthermore, bootstrapping procedures suggested that perceptions of self-worth mediated the relationships between parent and peer attachment and psychological distress. Results indicate that attachment theory may provide a useful framework from which to conceptualize the psychological adjustment of Latinas/os attending predominantly White institutions of higher education. Implications for universities and helping professionals are discussed.

Police stress: the role of the psychological contract and perceptions of fairness

PurposeThe overall purpose of this paper is to examine the extent to which breaches in psychological contracts and perceptions of organizational fairness account for variations in job stress experienced by operational police officers (as measured by psychological distress and employee performance), after controlling for the variance associated with more established job stressors (i.e. job demands, job control and social support).Design/methodology/approachThis study is based on data collected through a self‐report survey involving operational members of a large Australian police force (n=582).FindingsResults of hierarchical multiple regression analyses indicate that vast majority of explained variance in psychological distress and extra‐role performance is attributed to the additive effects of demand, control, and support. Furthermore, only one of the social exchange dimensions (interpersonal fairness) is predictive of either target variable.Research limitations/implicationsThe limitations that need to be taken into account are the cross‐sectional nature of the study design and the focus on a single police service.Practical implicationsDespite the generally weak support for the social exchange variables, there are signs that dimensions of justice (particularly interpersonal justice) should be included in future police‐stress investigations. The results also suggest that job characteristics such as job demand, job control and social support should be taken into account when developing strategies to prevent and/or reduce chronic job stress in policing services.Originality/valueThis is one of the first studies to examine the relationships between psychological contract breach, perceptions of fairness and police stress.

Supervisors are Central to Work Characteristics Affecting Nurse Outcomes

To examine the predictive capability of the demand-control-support (DCS) model, augmented by organizational justice variables, on attitudinal- and health-related outcomes for nurses caring for elderly patients. The study is based on a cross-sectional survey design and involved 168 nurses working with elderly patients in facilities of a medium to large Australian organization. Participants were asked to complete a questionnaire consisting of scales designed for measuring independent (e.g., demand, control, support, organizational justice) and dependent (e.g., job satisfaction, organizational commitment, wellbeing and psychological distress) variables. Multiple regression analyses were undertaken to identify significant predictors of the outcome variables. The DCS model explains the largest amount of variance across both the attitudinal and health outcomes with 27% of job satisfaction and 49% of organizational commitment, and 33% of psychological distress and 35% of wellbeing, respectively. Additional variance was explained by the justice variables for job satisfaction (5%), organizational commitment (4%), and psychological distress (23%). Using organizational justice variables to augment the DCS model was valuable in better understanding the work conditions experienced by nurses caring for elderly patients. Inclusion of curvilinear effects added clarity to the potentially artifactual nature of certain interaction variables. The results indicated practical implications for managers of nurses caring for elderly patients in terms of developing and maintaining levels of job control, support, and fairness, as well as monitoring levels of job demands. The results particularly show the importance of nurses' immediate supervisors.