Trait Versus Task-Induced Emotional Reactivity and Distress Intolerance in Hoarding Disorder: Transdiagnostic Implications

Evidence from analogue samples suggests that deficits in emotional functioning, namely elevated emotional reactivity and distress intolerance, are implicated in the development and maintenance of hoarding disorder. We aimed to extend previous research in this area by investigating emotional reactivity and distress intolerance in a sample of individuals diagnosed with hoarding disorder (n = 24) in comparison to clinical controls (n = 21) and nonclinical community controls (n = 26) using a combination of self-report, physiological, and behavioral measures. We found that trait distress intolerance was significantly and independently associated with greater hoarding severity. The hoarding and clinical control groups reported more trait emotional reactivity and distress intolerance than the community control group, but did not differ from each other on these traits. The hoarding group reported more subjective distress before beginning a frustrating behavioral task, but did not evidence more physiological arousal. Moreover, the hoarding group experienced similar increases in distress during the task and did not differ from either group in regard to time persisting on this task. The clinical control group, however, terminated the frustrating task significantly faster than the community control group, who tended to persist until the task timed out. Lastly, trait distress intolerance evidenced a small-to-moderate but nonstatistically significant independent relationship with task persistence time. Given the desynchrony between subjective distress and physiological arousal, we encourage researchers to utilize multimodal assessment in the future. We also suggest that clinicians start to use behavioral experiments, as has been done with other psychological disorders, to improve distress intolerance among persons who experience hoarding disorder.     

Examining a structural model of the relationships among alcohol use,marijuana/hashish use,their effects,and emotional and psychological problems over time in a cohort of high‐risk youths

Using data collected in a longitudinal study of detained juveniles, we test a model of the relationships among alcohol and marijuana or hashish use, reported adverse effects of the use of these substances, and emotional and psychological problems. Significant interrelationships were found among these factors over time. Degree of involvement in alcohol and marijuana or hashish use (measured either by self‐reports or both self‐reports and urine test results) was significantly related at Time 1 with the number of reported averse effects of the use of each specific substance; a similar relationship was found at Time 2 for marijuana or hashish use. In addition, emotional and psychological problems were significantly associated with reported adverse effects of the use of alcohol or marijuana or hashish at each time period. The results further indicate that youths who become more involved in the use of alcohol or marijuana or hashish over time report more adverse effects of their use of each of these substances. These findings highlight a network of interconnected experiences that add insight into the youths’ functioning over time. At the same time, the youths’ Time 2 emotional and psychological problems, reported effects of their alcohol use, and reported effects of their marijuana or hashish use are weakly predicted by the variables in the model; these findings suggest considerable change in these experiences over time. Theoretical and policy implications of these findings are discussed.     

When does partner devaluation predict emotional distress? Prospective moderating effects of reassurance-seeking and self-esteem

Coyne's (1976b) interpersonal theory of depression asserts that devaluation and rejection by relationship partners may exacerbate depressive symptoms. We tested this assertion empirically and investigated two theoretically based moderators of this effect: reassurance-seeking and self-esteem level. Dating women (N= 134) completed measures of depression, reassurance-seeking, and self-esteem at Time 1 and a measure of depression at Time 2 six weeks later. Male partners completed a measure of devaluation of the women. Partner devaluation was not associated with increased emotional distress for women across the entire sample. However, significant moderating effects of both reassurance-seeking and self-esteem level were found. Partner devaluation predicted increased emotional distress among women who reported high levels of reassurance-seeking and among women who reported low levels of self-esteem. Results are discussed in terms of convergence with Coyne's theory.     

War zone stress, personal and environmental resources, and PTSD symptoms in Gulf War veterans: a longitudinal perspective

Cross-sectional research has demonstrated a link between personal and environmental resources and development of emotional distress after war zone service. Less is known about the longitudinal relationship between resources and distress. The authors addressed this issue in a study of 348 Gulf War returnees tested at 2 time points. Resources decreased and posttraumatic stress disorder (PTSD) symptoms increased over time. Time 1 avoidance and family cohesion predicted PTSD symptoms at Time 2. Regression analyses revealed a bidirectional relationship over time between resources and PTSD symptoms. Time 1 resources predicted Time 2 psychopathology after accounting for Time 1 emotional distress. PTSD symptoms at Time 1 also predicted changes in coping and family relationships, even after accounting for Time 1 resources. Findings are consistent with the concept of a loss spiral (Hobfoll, 1989), in which resource factors and emotional sequelae to war stress exert reciprocal effects.     

The role of optimism in patients with tinnitus and in patients with hearing impairment

Abstract

Optimism was investigated in a sample of audiology clinic patients, consisting of one group of tinnitus sufferers (N = 30) and one group of hearing impaired subjects not experiencing tinnitus (N = 44). Optimism was measured by the Life Orientation Test (LOT). In the tinnitus group the LOT correlated significantly with measures of tinnitus related distress and in the hearing impaired group with measures of disability and emotional reactions due to the hearing impairment. Cronbach's alphas for the measures used were generally high. Principal components analysis of the LOT confirmed earlier findings by showing two separate factors; one with the positively worded LOT items reflecting the presence of optimism and one with the negatively worded LOT items reflecting the presence of pessimism. The results indicate that dispositional optimism is an usable concept in research with audiological samples, and that optimism is related with tinnitus distress and experienced disability and emotional reactions due to hearing impairment. Further research should investigate the possible role of personality factors in tinnitus and hearing impairment.     

The Reliability and Validity of a Brief Self-Report Questionnaire to Screen for Mental Health Problems: The Health Dynamics Inventory

Mental health problems are underrecognized in medical settings, leading to inadequate treatment. The present paper describes the development of the Health Dynamics Inventory (HDI), a brief, self-report questionnaire developed to evaluate mental health functioning. The HDI was written to evaluate the three aspects of mental disorders as described in the Diagnostic and Statistical Manual of Mental Disorders (DSM): (1) the experience of emotional or behavioral symptoms; (2) emotional distress; and (3) psychosocial impairment. This study evaluated the psychometric properties and construct validity of its items, scales, and subscales. Results indicated that the items distinguish patients from nonpatients, that the instrument's scales and subscales are reliable, and that the scales and subscales discriminates between persons with mental health concerns or diagnosable problems and those without such concerns or problems. The utility of the instrument for screening mental health problems in primary care settings is discussed.     

Problems Expressed by Career and Non-Career Help Seekers: A Comparison

Students seeking help at a university counseling center were asked to mark on a problem checklist what type of career, educational, personal, or social problems they experienced at the time. Few differences in endorsement were found between counseling center help seekers with career concerns and counseling center help seekers without career concerns, but both types of help seekers indicated concerns with study habits, emotional distress, and relationships. These issues also significantly correlated with help seekers' degree of clarity and stability of career goals. When compared with non-help-seeking students, significantly more help seekers with career concerns indicated worrying about issues concerning emotional distress, decision making, independence, and eating problems. Suggestions regarding conceptualizations of career problems as well as career guidance are offered.     

What is told when the story is retold? Consistency of victimization reports in psychiatric patients

The use of retrospective self‐reports is a major methodological concern when ascertaining the occurrence of victimization experiences, with additional concerns when assessing psychiatric patients. The test for consistency can overcome some of these concerns, increasing the confidence in the information reported. Our aim was twofold: (1) to know the consistency of victimization reports; and (2) to test the role of changes on emotional distress in predicting report discrepancies, in a sample of 34 adult psychiatric patients. Participants were assessed twice, with a year interval. Sexual abuse was the experience that presented the higher level of consistency for childhood victimization, while assault with a weapon had the higher consistency level for adolescent and adult victimization. We found that increases on emotional distress predicted report discrepancies, and more specifically, increases in the report of victimization. Our results displayed acceptable consistency levels, suggesting some stability in the reporting of victimization over time. Considering that inconsistencies tended either to increases and decreases in the reporting of victimization, it would be important to consider the impact of such experiences when intervening with psychiatric patients.     

Illness perception patterns in patients with Coronary Artery Disease

The purpose of this study is to identify patterns of illness perception in patients with angiografically verified Coronary Artery Disease. A total of 166 patients (age: 64.4 ± 12.1, 80.7% male) were recruited after angiography. Cluster analysis on the items of the Brief Illness Perception Questionnaire was used to identify patterns of illness perception. The resulting groups were characterized with regard to Quality of Life (MacNew), anxiety and depression (GAD-7 and PHQ-9) and resilience (RS-13). The analysis revealed 4 distinct groups differing with regard to the items covering the perception of the physical and emotional impact of disease. Stronger perceptions in these domains were associated with lower Health Related Quality of Life and higher levels of emotional distress. Group 1 (33.1%) reported the strongest perceptions of the physical and emotional impact of disease and expressed low treatment control, high chronic timeline and significantly higher levels of depression than the other groups. Group 2 (27.7%) was characterized by more moderate perceptions of the emotional and physical impact of disease together with low scores on illness coherence and chronic timeline. Groups 3 (25.3%) and 4 (13.9%) reported smaller physical and emotional impact of illness but differed in chronic timeline. Our results correspond largely to recent findings in patients with other chronic diseases. Further research is needed to explore if stratification of patients according patterns of illness perception can help to inform patient–physician communication strategies.     

The Adaptation of Patients During the Hospitalization Period of Bone Marrow Transplantation

A longitudinally study was conducted among 42 bone marrow transplantation (BMT) patients to investigate the association between pretransplant psychosocial variables and psychophysiological outcomes during the immediate convalescence period. Family relationships (cohesion, expressiveness, and conflict) and coping resources (cognitive, social, emotional, spiritual/philosophical, and physical resources) were assessed on the admission day (Day –7 Time 1). Data on psychological distress and pain intensity were obtained on Day +7 (Time 2) and Day +14 (Time 3). The average scores at Times 2 and 3 were computed to indicate the overall adjustments of the patients during the hospitalization period after the day of actual transplant (Day 0). It was shown that higher expressiveness family relationships and higher resources to cope effectively with stressful situations were associated with less psychological distress during the above period. Both pretransplant psychosocial variables were not associated with pain intensity during hospitalization. Allogeneic transplant patients reported higher pain intensity than did autologous transplant patients. Psychological distress and pain intensity were positively correlated with each other. Our findings show that pretransplant family relationships and coping resources associate moderately with psychological distress during the immediate convalescent period of BMT. The present findings support the family-centered approach to BMT care and provide a scientific basis for pretransplant psychosocial interventions.     

Characteristics of Blood-Injection-Injury Fears in People Receiving Intravenous Chemotherapy

Blood-Injection-Injury (BII) phobia is associated with distress and avoidance in response to blood, injury, or receiving injections. BII phobia can therefore create problems for those receiving medical procedures such as chemotherapy. The prevalence rate of BII in the general population has been estimated to be less than 5% but as many as 19% of outpatients receiving chemotherapy surveyed by Carey and Harris (Behaviour Change 22:5–90, 2005) reported BII concerns. This study examined the extent and characteristics of BII concerns among outpatients receiving chemotherapy for the first time (n = 124). Almost 17% of the sample had scores on the Mutilation Questionnaire comparable to samples with clinical BII phobia. Those assigned to a high BII concern group based on Mutilation Questionnaire scores reported higher somatic and fainting responses to BII stimuli and elevated disgust sensitivity, compared to groups selected for low BII concerns. Females had significantly higher Mutilation Questionnaire scores than males. Thus, the BII concerns of outpatients receiving chemotherapy appear qualitatively similar to the concerns reported by clinical BII phobia samples and analogue student samples. We suggest that the standard inclusion of a brief, reliable screening measure of BII concerns for outpatients scheduled for chemotherapy, coupled with brief, effective interventions to reduce BII-related distress, may be warranted.     

Stability and change of attachment representations during emerging adulthood: An examination of mediators and moderators of change

Using Bartholomew’s model of attachment (K. Bartholomew, 1990; K. Bartholomew & L. Horowitz, 1991), we explored stability and change of attachment in a group of young adults graduating from university and examined reasons for change of attachment. Consistent with previous research, we found that attachment dimensions were moderately stable; however, several variables predicted change. We explored the effect of changing relationship status and parental divorce on attachment and found that individuals who remained single reported lower stability of avoidance over time. Next, we tested whether distress reported before the transition would mediate stability of attachment. The results provided some support for J. Bowlby’s (1969/1982) proposal that distress would be associated with stability and change of attachment. We found that participants who reported low distress at Time 1 (T1) were more likely to report changes in attachment anxiety than participants who reported high distress at T1.     

Predictors of psychological outcomes in a longitudinal study of Latina breast cancer survivors

Objective: This study sought to investigate the unique contributions of socio-ecological, cultural and cancer treatment-related factors in predicting depressive symptoms and cancer-specific distress among Latinas. Design: Participants were 140 English or Spanish-speaking Latinas (M_age = 50.6) with non-metastatic breast cancer who were assessed within two years of diagnosis (Time 1) and three months later (Time 2).

Main Measures: Hierarchical regression analyses identified predictors of depressive symptoms and cancer-specific distress at Time 1 and 2.

Results: Most women scored above the clinical cut-offs for depressive symptoms and cancer-specific distress. After adjusting for socio-ecological factors, greater Latino enculturation, measured by Latino ethnic identity, was significantly associated with greater cancer-specific distress at Time 1 (β = .20, p < .05). A significant interaction (p < .01) revealed that among women high on Latino identity, lower English language use was associated with more cancer-specific distress than higher English language use. After adjusting for socio-ecological factors, greater satisfaction with surgical treatment predicted improved depressive symptoms and cancer-specific distress across time (β_s range from ?.31 to ?.18, p_s < .01).

Conclusions: Findings elucidate the complex relationship between culture and psychological outcomes in the breast cancer context and suggest that treatment satisfaction might be an important intervention target for Latinas.     

PARENTAL CHILDHOOD ADVERSITY,DEPRESSIVE SYMPTOMS,AND PARENTING QUALITY: EFFECTS ON TODDLER SELF‐REGULATION IN CHILD WELFARE SERVICES INVOLVED FAMILIES

Parents who are involved with child welfare services (CWSI) often have a history of childhood adversity and depressive symptoms. Both affect parenting quality, which in turn influences child adaptive functioning. We tested a model of the relations between parental depression and child regulatory outcomes first proposed by K. Lyons‐Ruth, R. Wolfe, A. Lyubchik, and R. Steingard (2002). We hypothesized that both parental depression and parenting quality mediate the effects of parental early adversity on offspring regulatory outcomes. Participants were 123 CWSI parents and their toddlers assessed three times over a period of 6 months. At Time 1, parents reported on their childhood adversity and current depressive symptoms. At Time 2, parents’ sensitivity to their child's distress and nondistress cues was rated from a videotaped teaching task. At Time 3, observers rated children's emotional regulation, orientation/engagement, and secure base behavior. The results of a path model partly supported the hypotheses. Parent childhood adversity was associated with current depressive symptoms, which in turn related to parent sensitivity to child distress, but not nondistress. Sensitivity to distress also predicted secure base behavior. Depression directly predicted orientation/engagement, also predicted by sensitivity to nondistress. Sensitivity to distress predicted emotion regulation and orientation/engagement. Results are discussed in terms of intervention approaches for CWSI families.     

Life Satisfaction and Positive Adjustment as Predictors of Emotional Distress in Men With Coronary Heart Disease

This two-wave longitudinal study examines the ability of life satisfaction and adjustment strategies to predict anxious and depressive symptoms in coronary heart disease male patients. Studies have shown that most heart attack survivors report these symptoms, which may worsen the prognosis of the disease. At Time 1, immediately after the first cardiac episode, eighty-eight men reported their life satisfaction levels, adjustment strategies used, and anxious and depressive symptoms experienced. At Time 2, six months later, sixty-three of those patients reported only their anxious and depressive symptoms again. The results showed that, after controlling for demographic variables, anxious and depressive symptoms at Time 1 were predicted by positive adjustment and life satisfaction. At Time 2, after controlling for both demographic variables and Time 1-emotional symptoms, none of the psychological variables predicted anxious symptoms, while depressive symptoms were only predicted by life satisfaction. It is concluded that an adequate level of life satisfaction may help to decrease emotional distress, both short and long term, while the use of positive adjustment strategies is especially important immediately after diagnosis.     

Fibromyalgia: Predicting openness to counselling referrals

Fibromyalgia (FM) is a chronic pain condition that can negatively impact on all aspects of patients’ lives. The purpose of this study was: first, to explore the biopsychosocial factors that may contribute to adjustment to FM symptoms; second, to investigate how referrals to counselling related to patients’ ratings of their relationship with their physicians; and, last, to examine if self-reports of illness distress, emotional problems, and practical problems can predict who will be open to counselling referrals. For this cross-sectional study, data from 190 people were collected through an online survey. Statistical analysis revealed that emotional problems reported were the best predictor of variance in illness distress and contentment scores. Further, results indicated that referrals made in accord with patients’ perceptions that they would benefit from counselling may have a positive influence on how patients rate their relationships with their physicians. Finally, self-reported scores of illness distress, number of emotional problems, and number of practical problems accurately predicted who would be open to counselling referrals in 67% of cases. Research results provide support for addressing emotional issues to facilitate adjustment to FM symptoms, and for use of psychosocial measures to determine when patients with FM will be open to counselling referrals.     

Perceived emotional and life change impact of AIDS on homosexual men in two countries

Abstract

A comprehensive self-administered life event inventory examining both general life stress and stress from events specific to the homosexual and bisexual male population was developed in order to assess the impact of AIDS and HIV infection on homo- and bisexual men. Ranking of questions revealed that while general stressors affected homosexuals similarly to heterosexuals, there were critical stressors affecting homosexuals not measured by conventional inventories. Specifically, emotional distress from receiving an HIV antibody positive result was not significantly different to that caused by a diagnosis of AIDS or ARC, the diagnosis of AIDS in a lover or the death of a lover. A sharp discrepancy in emotional distress between current safer sex behaviour and current unsafe sexual behaviour was also found, and the implications for behavioural modification in this area noted. Those who were HIV antibody positive tended to evaluate the anticipated impact of further AIDS related diagnoses as having a greater emotional impact than those who had tested negative. There would appear to be a closer relationship between emotional distress and life change in homosexual men than in heterosexual samples. The relative emotional impacts and life change assessments of AIDS and HIV infection are discussed.     

A Longitudinal Perspective on Differentiation of Self,Interpersonal and Psychological Well-Being in Young Adulthood

The over-time relationship between differentiation of self and interpersonal and psychological well-being was examined in a sample of young adults in order to test the hypothesis that greater differentiation of self—that is, lower emotional reactivity, better capacity to take an “I” position in relationships, less emotional cutoff, and lower fusion with others—predicted greater interpersonal and psychological health. Results of hierarchical regression analyses confirmed that greater Time 1 differentiation of self predicted lower Time 2 psychological and interpersonal distress after controlling for Time 1 distress levels. Further, canonical correlation analyses revealed several significant patterned associations between aspects of differentiation of self and specific interpersonal problems. Implications for family interventions are discussed.     

Evaluation of a psychosocial intervention on social support, perceived control, coping strategies, emotional distress, and quality of life of breast cancer patients

The purpose of this research was to demonstrate that a specific psychosocial intervention changes reactions to cancer and quality of life. This study was carried out on 66 patients with a first breast cancer. Patients were randomly divided into two groups: a specific intervention group (G1, 8 sessions) or a support group (G2, 8 sessions). A control group (G3) was composed of patients who refused to participate in psychological intervention. Social support, perceived control, repression of emotions, coping strategies, emotional distress, and quality of life were assessed one week before (T1) and at the end (T2) of the psychological intervention. Results showed that G1 did not have significantly modified quality of life or psychological scores. Patients of G2 had poorer emotional quality of life, use of internal causal attributions, and minimized their illness at T1 as compared to patients of G3. At Time 2 these differences were not observed.     

Just how Emotionally Intelligent are Religious Leaders in Britain? A Study among Anglican Clergy in Wales

This study explores the profile of 364 Anglican clergy serving in the Church in Wales (264 clergymen, 93 clergywomen, and 7 who did not disclose their sex) on the Schutte Emotional Intelligence Scale. The data confirm the finding from three earlier studies of church leaders in Britain that both male and female clergy in Britain record significantly lower levels of emotional intelligence in comparison with the standardization data published for this scale. Closer investigation of the scale items, however, questions whether this instrument may offer a fair assessment of the kind of emotional intelligence best suited for pastoral ministry.