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At least 19 recordsLinked to original sources

Association of psychological distress with psychological factors in rescue workers within two months after a major earthquake.

BACKGROUND AND PURPOSE: Studies of the health of rescue workers after a major disaster have frequently focused on posttraumatic stress disorder. This study aimed to determine the characteristics of psychological distress and its psychosocial predictors in rescue workers within a 2-month period after an earthquake that struck central Taiwan on September 21, 1999. METHODS: A total of 1,104 rescue workers serving in the earthquake were enrolled in the study. Psychological distress was measured using the Brief Symptom Rating Scale (BSRS), personality traits using the Maudsley Personality Inventory (MPI), and family function using APGAR (adaptability, partnership, growth, affection, and resolve) indexes. These measurements were performed within 2 months of the earthquake. Univariate and multivariate analyses were applied to examine the association between psychological distress and various psychosocial factors. RESULTS: BSRS assessment revealed severe psychological distress in 137 (16.4%) subjects. The most common symptom dimension was phobic-anxiety (18.7%), followed by hostility (17.6%), obsessive-compulsive symptoms (16.2%), depression (14.9%), paranoid ideation (14.2%), interpersonal sensitivity (13.3%), psychoticism (11.9%), anxiety (10.8%), additional symptoms (8.5%), and somatization (6.2%). Pre-disaster major life events (R2 = 0.03) and most of the factor scores of the MPI (including moodiness, anxiety-prone, outgoing, conscientiousness, activity, and sociability factors; R2 = 0.25) predicted the severity of psychological distress. Time of arrival at the scene, previous exposure, age, and family function had no or trivial predictive power. CONCLUSION: The results of this study indicated that prevalence of general psychological distress is high among rescue workers in the first 2 months after a major earthquake. Personality traits and pre-disaster life adjustment had a dominant predictive power for psychological distress. Immediate psychosocial intervention should be considered to ameliorate the distress related to disaster rescue work.

Adult↗

Screening for breast cancer is associated with a low degree of psychological distress.

Psychological distress was measured among women on the day of recall after mammography in an official screening programme, and 4 weeks after the diagnosis was given. The Hospital Anxiety and Depression Scale (HADS) and a questionnaire to assess reactions to the examination were completed by 213 (97%) women aged 50-69 years. Among those without cancer, there were 45 (24.3%) who were anxiety cases and eight (4.3%) depression cases (HADS) on the day of recall mammography and 12 (7.3%) and three (1.8%) respectively after 4 weeks (P<0.001). Among those with cancer, the corresponding figures were seven (28.0%) and one (4.8%) before and six (24.0%) and three (12%) after screening (n.s.). A total of 194 (97%) women were definitely satisfied with the screening programme, and 195 (98%) would recommend others to participate. In conclusion, recall after mammography is associated with transiently increased levels of anxiety and depression in women without cancer. For those with cancer, the psychological distress continues. The women were almost unanimously content with participating in the screening programme.

Journal Article↗

Impact of imagery rehearsal treatment on distressing dreams, psychological distress, and sleep parameters in nightmare patients.

We investigated the impact of imagery rehearsal treatment (IRT) on nightmare frequency, psychological distress, and sleep quality using polysomnography (PSG). 12 chronic nightmare patients completed prospective dream logs, measures of psychological distress, and underwent PSG prior to and 8.5 weeks following a single IRT session. Post-treatment, significant reductions were observed in retrospective nightmare frequency (d = 1.06, p = .007), prospective bad dream frequency (d = 0.53, p = .03), and anxiety scores (d = 1.01, p = .004). Minimal sleep alterations were found post-IRT, and varied as a function of nightmare etiology. The results independently replicate the efficacy of IRT for alleviating disturbing dreams and psychological distress. Sleep improvement may occur later in the recovery process.

Adult↗

Couples coping with congestive heart failure: role and gender differences in psychological distress.

Psychological distress and marital quality were assessed with male (n = 128) and female (n = 49) congestive-heart-failure (CHF) patients and their spouses. Hopkins Symptom Check List--25 scores were in the distressed range for 57% of patients and 40% of spouses. This role difference was greater for men than for women, and a gender difference (more distress in women than men) was greater for spouses than for patients. The patient's distress, but not the spouse's, reflected the severity of the patient's illness, and distress for both partners correlated negatively with ratings of marital quality. Female-patient couples reported better relationship quality than male-patient couples, however, and a mediation analysis indicated that the gender difference in spouse distress could be explained by marital quality. Results highlight the contextual nature of CHF distress and suggest that role differences in distress vary by gender.

Adaptation, Psychological↗

Does supported housing protect recent immigrants from psychological distress?

Psychological distress measured by the Talbieh Brief Distress inventory was compared between two groups of immigrants: consumers of supported housing (N = 302) and non-consumers living in community settings (N = 419), matched by sex, age and education level. Overall, distress level was found to be significantly lower in consumers of supported housing than in non-consumers. Consumers also exhibited significant lower hostility, obsessive-compulsive and paranoid ideation symptoms, but they were similar to nonconsumers on level of depression, anxiety and sensitivity. The results suggest that supported housing protects recent immigrants from environmental stresses to a greater extent than community residence.

Adolescent↗

The effects of psychological distress and psychological well-being on use of medical services.

In this study, the authors determined whether mental health status affects the use of general medical services, with and without adjustment for the correlated effects of general health perceptions and physical health status on such use. Data were used from the RAND Health Insurance Experiment, which has information on up to 5 years of use of medical services by a nonelderly, civilian, general population. Health status and other covariates were assessed by self-administered questionnaires at enrollment. In the absence of statistical control for general and physical health status, worse mental health status-whether assessed by a global self-report measure or its two component parts, psychological well-being and psychological distress-significantly increased the use of both inpatient and outpatient general medical services. After controlling for general health perceptions, physical health status, demographic factors, and insurance plan coverage, the effects of mental health status on use are reduced, but not eliminated. Psychological distress and psychological well-being retained independent effects on total medical expenses.

Activities of Daily Living↗

The effects of insurance generosity on the psychological distress and psychological well-being of a general population.

Reductions in the generosity of fee-for-service insurance lower the use of general medical and mental health services, but do they lead to lower mental health status for the covered population? We addressed this question using data from the RAND Corporation Health Insurance Experiment. Families in six sites in the United States were randomly assigned to one of 14 insurance plans for three- or five-year periods. On average, there were no significant adverse effects of cost-sharing plans, relative to a free-care plan, on either psychological well-being or psychological distress, when the cost-sharing plans included full catastrophic coverage. Those with high mental health status but low income at baseline had significantly more favorable mental health outcomes on the cost-sharing plans than on the free-care plan. We cannot definitively comment on the effects of insurance generosity for the sick poor. Our findings apply in the context of mandated comprehensive mental and general health coverage for a general nonelderly, nondisabled household population.

Adult↗

Functional impairment, marital quality, and patient psychological distress as predictors of psychological distress among cancer patients' spouses.

This study investigated contextual determinants of psychological distress among 197 spouses of cancer patients. It was hypothesized that higher levels of patient functional impairment would lead to greater patient distress. Patient distress, in turn, would lead to lower spouse marital satisfaction and ultimately to higher spouse distress. Spouses completed measures of distress and marital quality at three time points. Cancer patients rated their functional impairment and psychological distress at the same time points. Results indicated that at all time points, greater patient impairment was associated with higher levels of patient distress, which, in turn, was related to lower marital satisfaction. However, marital quality was related to spouse distress at only 1 time point, but spouse distress was directly associated with patient distress at each time point. Implications for cancer patients and spouses are discussed.

Adult↗

Psychological distress of patients undergoing intensified conditioning with radioimmunotherapy prior to allogeneic stem cell transplantation.

This is a pilot study comparing the emotional distress of patients receiving an intensified conditioning regimen (radioimmunotherapy=RIT) with patients receiving conventional conditioning for allogeneic stem cell transplantation. In total, 53 patients (18 received RIT) were given two questionnaires designed to measure emotional distress (HADS, POMS) before starting conditioning (t1) and at discharge (t2). During the in-patient period, patients answered questions daily relating to physical distress, psychological distress, and how they were "coping with the situation". At t2, the transplant team assessed the manner in which the patients were coping. The data displayed no relevant differences with regard to emotional distress between the two groups, both at t1 and t2. For both groups, anxiety and vigor decreased and fatigue increased between t1 and t2. On average, perceived distress was higher for those patients being treated with RIT during the in-patient time, but the differences between both groups were significant only regarding physical distress during the recovery period. No difference was found for the transplant team's assessment. We hypothesize that an intensified conditioning regimen with RIT per se has only a small distressing effect on the patients' psyche during their stay at the hospital. Differences between both groups probably result from independent factors such as, for example, the patients' pre-existing health conditions.

Adult↗

Social class, income, education, area of residence and psychological distress: does social class have an independent effect on psychological distress in Antalya, Turkey?

AIM: The aim of this study is to determine the separate effects of social class, income, education and area of residence on psychological distress. The study also assesses whether the association between prevalence of high score on the 12-item General Health Questionnaire (GHQ 12) and social class is independent of other variables. METHOD: Psychological distress was assessed by means of the GHQ 12. The study covered 1,092 adults aged 15 years or more living in two different quarters of Antalya. Social class status was defined by occupational position, with income, education and area of residence treated as confounders. Chi-square and logistic regression analyses were used to evaluate the data. RESULTS: Large inequalities in psychological distress by all variables were observed. Psychological distress was significantly associated with class status, after adjusting for income, education, area of residence and other potential confounders (age, sex and marital status). Class inequalities in psychological distress were observed between blue-collar workers/unqualified employees and bourgeoisie. CONCLUSIONS: These findings support the view that the recent widening of inequalities among social classes in Turkey pose a substantial threat to health.

Adolescent↗

Effects of chan-chuang qigong on improving symptom and psychological distress in chemotherapy patients.

The purpose of this study was to explore the effect of Chan-Chuang qigong on symptoms distress and psychological distress of breast cancer patients who underwent chemotherapy. A quasi-experimental design was adopted. Subjects were recruited from breast cancer outpatients receiving chemotherapy at an 1800-bed medical center in Taipei, Taiwan. Of these subjects, 35 were assigned to the control group and 32 to the experimental group in which Chan-Chuang qigong was administered. Assignment was not random. The instruments included a 21-item symptom distress scale and psychological distress with the symptom checklist-90-revised. Data of the symptoms and psychological distress were collected on the day before chemotherapy as baseline values, and also collected on days 8, 15 and 22 of chemotherapy. The results showed that the overall severity of symptom distress in the experimental group was significantly lower than the control group on day 22 (p < 0.05). The symptoms with significant improvement included pain, numbness, heartburn and dizziness (p < 0.05). With regard to psychological distress, the difference of overall severity between the two groups was not statistically significant (p > 0.05). However, the items of "unwillingness to live" (p < 0.05) and "hopelessness about the future" (p < 0.05) were significantly improved in the experimental group. In conclusion, Chan-Chuang qigong had the effect of attenuating the symptom distress and probably some part of the psychological distress of chemotherapy patients.

Adult↗

Divergent beliefs about psoriasis are associated with increased psychological distress.

The psychological adjustment of patients with psoriasis has been studied extensively. By comparison, no research has focused on their partners. We examined illness representations of psoriasis held by patients and their partners, and investigated whether divergent beliefs were associated with psychological distress. Fifty-eight patients with chronic plaque psoriasis and their partners completed a range of psychological assessments including beliefs about the condition, anxiety, depression, and worry. Patients also completed a self-assessment of psoriasis severity. Patients with psoriasis had significantly higher levels of anxiety, depression, and worry than their partners (t's > 2.53, p's < .05). Multiple regression analysis indicated that divergence in patients' and partners' beliefs about emotional impact of psoriasis and chronicity of timeline accounted for a statistically significant (21.3%) proportion of the variance in depression for partners. Differences in views on the consequences of having psoriasis and the cyclical nature of the condition were also significantly associated with increased levels of worry in partners. Dissimilarity in particular aspects of illness representations are associated with increased psychological distress in particular for the partners of patients with psoriasis. The results illustrate the importance of concordance between patients' and partners' models of illness in relation to adjustment, and highlight the need to consider and collaborate with both patients and their partners in managing this challenging condition.

Adaptation, Psychological↗

Validation study of a nonspecific psychological distress scale.

BACKGROUND: Psychological distress scales are often used in national epidemiological surveys to monitor the mental health status and predict demands in mental health services. These scales have the advantage of being easy to administer and inexpensive to use. The goal of this study is to assess the clinical validity of the Psychological Distress Manifestations Measure Scale (PDMMS) by comparing it to a standard criterion. METHOD: The validation study is based on data from a large-scale mental health survey conducted in 1999 in the Montreal area (Canada). The target population was constituted of adults living in private households. A telephone survey was carried out with a probability sample of 4,704 respondents using the Composite International Diagnostic Interview Simplified (CIDIS) to detect mental disorders. Then, subsequent face-to-face interviews with a subsample of 359 of these respondents were conducted to validate other measures for assessing mental health needs for care and services including the PDMMS. RESULTS: Our study showed that high psychological distress is highly associated with mental disorder (OR=5.94). However, a large majority of the people in the high psychological distress category does not have a known mental problem. CONCLUSIONS: These data confirm that like other psychological distress scales, the PDMMS is not a diagnostic tool. Rather, it is designed to explore comorbidity among symptoms, independent of caseness. The prevalence of psychological distress in the population allows us to identify people who have subclinical symptoms substantial enough to precipitate dysfunctioning in everyday life and who utilize health services more frequently. The use of this tool for epidemiological surveys is useful for mental health service planning because it provides information on the needs of individuals whose state of mental health affects social functioning even though they do not suffer from pathology.

Adolescent↗

Guarded self-disclosure predicts psychological distress and willingness to use psychological services among East Asian immigrants in the United States.

This study examined the relationship between guarded self-disclosure, psychological distress, and willingness to use psychological services if distressed among 170 (88 male, 82 female) East Asian immigrants in the United States. Participants were administered a battery of psychometrically established measures. Participants who endorsed overall guarded self-disclosure, self-concealment (i.e., unwillingness to reveal affect to others), or conflict avoidance (i.e., maintenance of harmony via suppression of feelings) were significantly more likely to report psychological distress and were significantly less likely to report willingness to use psychological services. While conflict avoidance was a significant independent predictor of psychological distress, self-concealment was a significant independent predictor of willingness to use psychological services. These findings point to the importance of assessing multiple facets of guarded self-disclosure, which appear to be differentially associated with psychological distress and willingness to use psychological services.

Adult↗

Psychological distress and patient satisfaction.

Psychologically distressed patients and clients of health care and social service organizations are found to report somewhat more dissatisfaction with services than do the nondistressed. Four explanations for this relationship are examined: 1) the psychologically distressed are generally dissatisfied; 2) service providers react negatively to the psychologically distressed; 3) psychologically distressed patients are dissatisfied when service providers do not respond to their psychological needs; and 4) patients who deny their psychological distress tend to be dissatisfied. The results show that the psychologically distressed report more dissatisfaction because of the very high levels of dissatisfaction found among patients who deny having personal problems.

Attitude to Health↗

Patients with heart rhythm disturbances: variables associated with increased psychologic distress.

The spectrum of psychologic distress in patients with serious heart rhythm disturbances (HRD) has not been well defined. A survey of personal and clinical background data and general psychologic status was made of 136 patients with serious HRD defined as sustained or symptomatic ventricular tachycardia or fibrillation. Two questionnaires were used: the SCL-90-R, a standard self-report symptom inventory of present psychologic status, and a functional capacity and occupational status questionnaire developed by us. Of the 105 respondents, 89 completed both questionnaires, the results of which form the basis of this report. The patients with HRD were found to have significantly elevated SCL-90-R scores reflective of an increase in overall psychologic distress (Global Severity Index, Positive Symptom Distress Index, and Positive Symptom Total) as well as significantly higher scores on the specific constructs. Within the HRD population, univariate analysis revealed three variables significantly correlated with increased psychologic distress: (1) requiring long-term antiarrhythmic medication, (2) being forced to modify work status, and (3) having more advanced cardiac impairment. Patients who had two or more of these variables, termed risk factors, reported significantly more symptoms and greater psychologic distress than those with zero or one risk factor. We conclude that patients with serious HRD have greater psychologic distress than do normal subjects. Within the HRD group, patients requiring long-term medical treatment for their arrhythmia, those forced to modify work status, and those with more advanced cardiac impairment are at greater risk for emotional sequelae, and patients with two or more of the identified risk factors are more likely to have elevated psychologic distress.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

The initial development of an item bank to assess and screen for psychological distress in cancer patients.

Psychological distress is a common problem among cancer patients. Despite the large number of instruments that have been developed to assess distress, their utility remains disappointing. This study aimed to use Rasch models to develop an item-bank which would provide the basis for better means of assessing psychological distress in cancer patients.An item bank was developed from eight psychological distress questionnaires using Rasch analysis to link common items. Items from the questionnaires were added iteratively with common items as anchor points and misfitting items (infit mean square >1.3) removed, and unidimensionality assessed.A total of 4914 patients completed the questionnaires providing an initial pool of 83 items. Twenty items were removed resulting in a final pool of 63 items. Good fit was demonstrated and no additional factor structure was evident from the residuals. However, there was little overlap between item locations and person measures, since items mainly targeted higher levels of distress. The Rasch analysis allowed items to be pooled and generated a unidimensional instrument for measuring psychological distress in cancer patients. Additional items are required to more accurately assess patients across the whole continuum of psychological distress.

Adolescent↗

Effects of immigration on the mentally ill--does it produce psychological distress?

This report explores psychological distress among immigrants seeking help from psychiatric outpatient clinics as compared with control nonpatient immigrants. Our hypothesis is that nonpsychotic mentally ill immigrants will react to acculturation by psychological distress similarly to healthy individuals. Three questionnaires were used in this survey: Demographic Psychosocial Inventory, Brief Symptom Inventory (BSI), and Psychiatric Epidemiology Research Interview-Demoralization Scale (PERI-D). They were completed by patient and control groups consisting of recent adult immigrants to Israel from the former Soviet Union. The patient group included 158 subjects seeking psychiatric help from outpatient clinics. Among them, 51 met ICD-10 criteria for neurotic, stress-related, and somatoform disorders; 41 for schizophrenia; 32 for mood disorders; 18 for organic illnesses; and 16 for personality disorders. The control group consisted of 222 immigrants with no previous psychiatric history, matched by gender and age to the patient group. Although all distress symptoms were significantly more severe in the patient group than in the control group, the BSI profile, showing a high level of depression, anxiety, interpersonal sensitivity, and obsessive-compulsive dimensions, was similar in both groups. The psychological distress level as measured by the PERI-D was 1.4 times higher in patients than in the control group. Within the patient group, the lowest distress level was found in patients suffering from organic disorders. No significant differences in the level of psychological distress were found among other diagnostic subgroups. The results suggest that mentally ill immigrants react to acculturation by a psychological distress syndrome similarly to nonpatient immigrants but more severely than nonpatient immigrants.

Acculturation↗