Psychological investigation of genital herpes recurrence: prospective assessment and cognitive-behavioral intervention for a chronic physical disorder

Previous studies suggest that anxiety and/or depressed mood are associated with recurrence of genital herpes lesions. The present study sought to extend the assessment of factors associated with genital herpes and to investigate the impact of psychological therapy on features of the disorder. Sixteen genital herpes patients received 5 weeks of either structured discussion or cognitive restructuring (CR) therapy in a group format. Measures of attitude about herpes, global coping, distress, loneliness, health locus of control, and recurrence frequency were administered at pretreatment, posttreatment, and 3 months follow-up. Patients also made daily reports during the 5 weeks of treatment from which information was extracted regarding their herpes symptoms, dysphoria, anxiety, and ongoing coping process. Therapy did not produce the expected reductions in reported distress or loneliness. The CR procedure, however, was associated with reduced frequency of lesion recurrence at follow-up. Avoidant coping was associated with lower recurrence rates, and loneliness scores were associated with higher recurrence rates. Prospective data indicated that recurrences were preceded by elevated anxiety that was independent of prodromal symptoms. These results provide support for the general proposals that psychological factors influence health status and that psychological intervention may reduce disease recurrence.     

A comparison of primary stressors, secondary stressors, and depressive symptoms between elderly caregiving husbands and wives: the Caregiver Health Effects Study

The present study examined gender differences in the experience of primary and secondary caregiving stressors, depressive symptoms, and their interrelationships using a sample of 283 elderly spouse caregivers (145 women, 138 men). Two primary stressors, two secondary stressors, and depressive symptoms were assessed. In general, t-tests indicated that caregiving husbands experience fewer stressors and depressive symptoms than their female counterparts. Multiple group analysis revealed that the primary stressors were more useful in explaining variance associated with the secondary stressors for women than men and that the path coefficients linking amount of caregiving assistance to caregivers' activity restriction was significantly different across men and women. Other paths linking primary stressors, secondary stressors, and depressive symptoms, however, were statistically equivalent across men and women. Hence, although caregiving women and men may vary in their reports of caregiving stressors, the complexity of the caregiving experience appears to be quite uniform for both groups.     

Gender responses to psychological distress among Palestinians: Risk and protective factors

This study investigated the extent to which differences in the presence of trauma, political and normative stressors, resources, coping, and hardiness could account for variation in gender responses to psychological distress among Palestinians. Participants were 624 males and females aged 27–56 years. Questionnaires were administered in an interview format with participants at home. Results indicated that female gender has been associated with psychological distress. The females in this study reported feeling distressed by intrafamily strains, whereas males reported feeling distressed by work and family strains as well as losses. Political stressors were more predictive of psychological distress than was the presence of trauma or normative stressors. The sociodemographics had different patterns of relations with psychological distress. Females' education was negatively related to psychological distress, whereas the family income was negatively related to psychological distress in males. No significant differences between males and females were found in their coping responses. However, cognitive and behavioural strategies Family Crisis Oriented Personal Evaluation Scales (F‐COPES) seem to combine and had an impact on psychological distress of females only. Also, family hardiness was evidenced to have an influence on perceived psychological distress in both genders. The clinical and policy implications of these conclusions were discussed.     

Co-Rumination Exacerbates Stress Generation among Adolescents with Depressive Symptoms

Through stress generation, individuals’ own thoughts and behaviors can actually lead to increases in their experience of stress. Unfortunately, stress generation is especially common among individuals who are already suffering from elevated depressive symptoms. However, despite the acknowledgement that some individuals with depressive symptoms generate greater stress than others, few studies have identified specific factors that could exacerbate stress generation among individuals with depressive symptoms. The present study examines co-rumination as a factor that might exacerbate stress generation among adolescents with depressive symptoms using a short-term longitudinal design. Considering these processes among adolescents was critical given that many youth experience increases in depressive symptoms at this developmental stage and that co-rumination also becomes more common at adolescence. Participants were 628 adolescents (326 girls; 302 boys) who reported on their depressive symptoms, experiences of stress, and co-rumination with a best friend. Interpersonal stressors (peer and family stress) and non-interpersonal stressors (school and sports stress) were assessed. Consistent with past research, adolescents with depressive symptoms experienced greater interpersonal and non-interpersonal stress over time. Importantly, co-rumination interacted with both depressive symptoms and gender in predicting increases in peer stress. Depressive symptoms predicted the generation of peer stress only for girls who reported high levels of co-rumination with friends. Implications for protecting youth with depressive symptoms against stress generation are discussed.     

The influence of hardiness on the relationship between stressors and psychosomatic symptomatology

Thirty male and 58 female students responded to questionnaires based on a 9-month period in a prospective study of the impact of hardiness, life events, and hassles on reports of somatic symptoms. The data were analyzed utilizing cross-lagged panel analyses, analyses of variance, and multiple regression analyses. The results suggested that life events, hassles, and symptoms were significantly related in a recursive, mutually interactive manner. Although life events shared a high degree of variance with hassles, hassles consistently contributed above and beyond life events in predicting somatic symptoms. In addition, hardiness tended to have additive and opposite effects to that of stressors in its impact on symptomatology. Finally, and perhaps most important, compared to lower-hardy individuals, those higher in hardiness tended to experience less frequent stressors and to perceive the minor events they did experience as less stressful.     

Children's coping with peer rejection: the role of depressive symptoms,social competence,and gender

The present study investigated children's anticipated emotional response and anticipated coping in response to peer rejection, as well as the qualifying effects of gender, depressive symptoms, and perceived social competence. Participants (N = 234), ranging in age between 10 and 13 years, were presented with two written vignettes depicting peer rejection. The most highly endorsed coping strategies were behavioural distraction, problem‐focused behaviour, and positive reappraisal. Results indicate that children higher in depressive symptoms reported a more negative anticipated mood impact. Moreover, children higher in depressive symptoms were less inclined to endorse behavioural and cognitive coping strategies typically associated with mood improvement (e.g., behavioural distraction, positive reappraisal). Independent of depression, children scoring higher on perceived social competence reported more active, problem‐oriented coping behaviour in response to the stressors. Types of coping were largely unaffected by gender, however girls reported higher levels of anticipated sadness than boys in response to the rejection vignettes. Theoretical and clinical implications are discussed. Copyright © 2006 John Wiley & Sons, Ltd.     

GENDER AS A MODERATOR OF THE RELATION BETWEEN RACE-RELATED STRESS AND MENTAL HEALTH SYMPTOMS FOR AFRICAN AMERICANS

The present study tested gender as a moderator of the relationship between race-related stress and mental health symptoms among African American adults. Because African American women are exposed to stressors associated with race and gender, we hypothesized that African American women would have higher levels of race-related stress and more severe mental health outcomes related to experiences of race-related stress compared to African American men. Multivariate analyses revealed that African American men had higher stress appraisals for institutional racism than did women. No significant gender differences were found for cultural and individual racism. Moderated regression analyses revealed that increases in stress appraisals for individual racism were associated with increases in anxiety and obsessive-compulsive symptoms for African American women. Race-related stress had no significant effects on mental health symptoms for African American men. The findings suggest that gender is an important factor in determining the impact of race-related stress on mental health.     

The relationship among genital herpes simplex virus, stress, and social support

Despite widespread popular belief in the activation of recurrent lesions in genital herpes simplex virus (HSV) by psychosocial stress, little empirical evidence supports that contention. This study retrospectively examined the role of stress in activation of HSV lesions as mediated by social support. Participants were 59 volunteers who had self-reported culture-positive genital HSV for at least 10 months. Measures of stress proneness (State-Trait Anxiety Inventory; STAI-Trait), recent stressful events (Schedule of Recent Events; SRE), and subjective appraisal of stress (global self-rating) were administered along with measures of general social support and herpes-specific social support. When retrospective reports of HSV symptoms were examined using a multiple-regression approach, duration of disease and amount of herpes-specific social support were found to be significant moderators of the relation between stress and number of HSV recurrences in the preceding 12 months. When duration of disease was short (less than 4 years), stress (SRE) and number of recurrences were positively associated; when disease duration was longer, there was no relationship. Similarly, at low levels of herpes-specific social support, a positive relation between stress (SRE) and number of recurrences was found. However, at higher levels of herpes-specific social support, no association was found. No relation was found between stress proneness (STAI-Trait) and HSV symptoms. However, subjective appraisal (global rating) of stress in the preceding 12 months was positively and significantly correlated with reported number of recurrences. Results are discussed in terms of their clinical implications.     

Reliability and validity of the Revised Children's Manifest Anxiety Scale (RCMAS) across samples of Mexican,Mexican American,and European American children: a preliminary investigation1 Table of means,standard deviations,and correlations of the RCMAS indicators are available from the first author upon request.

Abstract

The relationship between work and home-based stressors in predicting burnout symptoms was examined amongst 120 drug and alcohol service employees. Staff who reported high levels of burnout on the Maslach Burnout Inventory across all three scales of Emotional Exhaustion, Depersonalization and Personal Accomplishment were compared with a sample of low burnout employees. High burnout was associated with younger age, larger agency size, high levels of total work stressors, work overload, and daily hassles and a lower level of peer cohesion. Regression analyses revealed that male gender, younger age, work overload, role ambiguity and daily hassles were significant predictors of Emotional Exhaustion. Younger age was also a significant predictor of Depersonalization. Marked differences were found in the way in which males and females responded to work and non-work stressors and the interaction between these variables. For women, a significant interaction was found between total work stressors and home-based stressors in the prediction of Emotional Exhaustion and a trend in this direction was evident for Depersonalization. Low levels of home problems appeared to protect women from the adverse impact of work stressors. The burnout levels of women were relatively unaffected by work stressors, unless home stressors were also high. The level of daily hassles had a direct effect upon symptoms of Emotional Exhaustion, but did not interact with work stressors in predicting Emotional Exhaustion for women. Burnout levels of male employees on Emotional Exhaustion and Depersonalization scales were strongly linked to the level of work stressors and were not predicted by total home stressors nor the interaction between these variables. Symptoms of Emotional Exhaustion in males were predicted by severity of daily hassles, but this variable did not interact with work stressors in predicting Emotional Exhaustion.     

Residents’ reactions to environmental stressors in Kathmandu: A Comparison of the inner city versus the outskirts

Residents of eight different locations in Kathmandu, four in the inner city and four on the outskirts, were interviewed about environmental stressors, mental distress, and physical symptoms. There were significant gender and location differences on all three measures. Compared to men, women reported more mental distress and more physical symptoms, but fewer environmental stressors. Compared to residents of the inner city, residents of the outskirts reported more mental distress, more physical symptoms, and fewer environmental stressors. Environmental stressors were linked to mental distress among residents in the outskirts but were not linked to mental distress among residents in the inner city. Results suggested that residents’ belief in perceived control of their lives by God partially explained this effect.     

Current and Military‐Specific Gender Minority Stress Factors and Their Relationship with Suicide Ideation in Transgender Veterans

Research suggests the prevalence of suicide ideation and suicide attempts in the transgender veteran community may be upwards of 20 times higher than nontransgender veterans, who are known to be at increased risk than the general US population. This study aimed to understand the potential influence of external and internal minority stress experienced during and after military service on past‐year and recent suicide ideation in a sample of 201 transgender veterans. Nonparametric bootstrapping analyses indicated past‐year transgender‐specific discrimination and rejection (external minority stress) indirectly predicted frequency of both past‐year and past 2‐week suicide ideation through past‐year shame related to gender identity (internal minority stress). This result was significant when controlling for symptoms of depression and demographics. Similar patterns emerged when examining relationships among military external and internal minority stress on suicide outcomes. These results suggest that attempts to reduce both the experience and impact of minority stressors related to gender identity during and after military service may be an important avenue for suicide prevention.     

The relationship between daily hassles,ways of coping,and menstrual cycle symptomatology

The purpose of this study was to investigate the relationships found among daily hassles, the use of specific coping strategies, and reported menstrual cycle symptoms. One hundred and sixty-seven female undergraduate psychology students completed a series of questionnaires assessing their most recent menstrual cycle experience, how they coped with those symptoms, and the frequency and severity of daily stressors experienced in the past month. Frequency and severity of daily hassles were positively correlated with symptoms for all phases of the menstrual cycle. A significant negative correlation was obtained between premenstrual symptoms and the use of distancing, as a coping strategy. In addition, distancing was negatively related to menstrual tension symptoms.Northwestern State University     

Relations of SARS-related stressors and coping to Chinese college students' psychological adjustment during the 2003 Beijing SARS epidemic

This study examined the main and interactive relations of stressors and coping related to severe acute respiratory syndrome (SARS) with Chinese college students' psychological adjustment (psychological symptoms, perceived general health, and life satisfaction) during the 2003 Beijing SARS epidemic. All the constructs were assessed by self-report in an anonymous survey during the final period of the outbreak. Results showed that the relations of stressors and coping to psychological adjustment varied by domain of adjustment. Regression analyses suggested that the number of stressors and use of avoidant coping strategies positively predicted psychological symptoms. Active coping positively predicted life satisfaction when controlling for stressors. Moreover, all types of coping served as a buffer against the negative impact of stressors on perceived general health. These findings hold implications for university counseling services during times of acute, large-scale stressors. In particular, effective screening procedures should be developed to identify students who experience a large number of stressors and thus are at high risk for developing mental health problems. Intervention efforts that target coping should be adapted to take account of the uncontrollability of stressors and clients' cultural preferences for certain coping strategies. A multidimensional battery of psychological adjustment should be used to monitor clients' psychological adjustment to stressors and evaluate the efficacy of intervention.     

Anxiety symptoms in Japanese and in German children

The purpose of this study was to compare the frequency of anxiety symptoms and their association with gender and age in Japanese and German children using the Spence Children's Anxiety Scale (SCAS). A total of 1837 children (862 from Germany and 975 from Japan) between the age of 8 and 12 years were investigated. Results revealed that German children reported significantly higher symptoms of separation anxiety, social phobia, obsessive compulsive disorder, and generalized anxiety disorder than Japanese children. Conversely, Japanese children reported significantly higher scores on symptoms related to physical injury fear. In both countries, girls scored higher than boys on all the scales of the SCAS. Symptoms of separation anxiety and panic decreased with age, whereas social phobia increased with age. The findings underscore the impact of culture on children's anxiety.     

Women's daily physical health symptoms and stressful experiences across adulthood

This study investigated the extent to which the experience of daily stressors was related to women's age and daily health symptomology, such as flu and cold symptoms. Respondents were 562 women (aged 25–74) who were a part of the National Study of Daily Experiences (NSDE), a telephone diary study examining daily stressful events. The respondents were interviewed by telephone on eight consecutive nights, which resulted in a total of 3978 days of information analysed. Overall, women had at least one physical symptom on 59% of the study days and at least one daily stressor on 40% of the study days. Results from a series of ANOVAs showed that young and middle-aged women reported more frequent physical symptoms than did the older women. This age pattern was similar to the incidence of daily stressful experiences. Furthermore, daily stressors, specifically interpersonal tensions, were shown to significantly mediate the age–symptom relationship. These findings suggest that women who are exposed to events that threaten their interpersonal relationships are at a greater risk for symptoms of ill-health.     

Gender Differences in Problem Drinking and Depression: Different “Vulnerabilities?”

This study examines the relationship between stressors and resources and the functioning of a sample of 515 men and women who had a drinking problem. At a one-year follow-up, both women and men had improved on three functioning measures: alcohol consumption, days intoxicated, and depression. There were no gender differences at Time 2 on alcohol consumption, but men had more days intoxicated and women had more symptoms of depression. The impact of stressors and resources varied by life domain, functioning criterion, and gender. Although the predictors varied, the amount of variance in depression accounted for was the same for women and men. The most striking gender difference was the stronger impact of friendships for women on all aspects of functioning. This study provides support for reconsideration of the stress vulnerability of women and men.     

Coping among children and adolescents with chronic illness

The present study was aimed to investigate age and gender effects on coping with everyday stressors among children and adolescents with chronic illness and healthy controls. Patients (8–13 years of age) with asthma (n=47), atopic dermatitis (n=52), and cancer (n=57) were compared to healthy controls (n=158) matched by age, gender, and grade. Self-report data on coping with academic and interpersonal stressors were collected. The primary results indicated that coping with everyday stressors was improved in children and adolescents with chronic illness compared to healthy controls. Thus, patients reported less passive avoidance on cross-situational coping and tended to show more situation-specific coping with social and school-related stressors than healthy controls. Additionally, among the clinical groups, patients with atopic dermatitis and cancer scored higher on positive self-instructions than patients with asthma. Conclusively, the results suggest that coping with a chronic illness may lead to more effective coping with everyday stressors. Implications for evaluating coping styles in patients with chronic illness are discussed.     

A school-based assessment of secondary stressors and adolescent mental health 18 months post-Katrina

The goals of the current study were to examine the prevalence of secondary stressors related to Hurricane Katrina and to determine their impact on posttraumatic stress disorder (PTSD) symptoms among a sample of high school students. In addition, the moderating role of problem substance use was examined to determine whether it increased the risk of PTSD symptoms in the face of secondary stressors. A total of 271 ethnically and socioeconomically diverse adolescents completed an anonymous survey. Results indicated that problem substance use potentiated the positive relation between secondary stressors and PTSD symptoms, specifically symptoms of re-experiencing. The findings highlight the need for school-based assessment of and interventions for the long-term psychological effects of disasters.     

Dispositional and stressor-related emotion regulation in the context of a chronic, life-limiting stressor

In the context of efforts to regulate emotion during chronic stressors, both dispositional response tendencies (affect intensity, negative and positive expressivity) and stressor‐related coping through emotional approach (processing and expressing emotions) are relevant to adjustment. In women with metastatic breast cancer (N = 103), contributions of self‐reported emotional processing and expression related to cancer, as well as dispositional expressivity to adaptive outcomes across 3 months were examined. In the context of high dispositional expressivity, an increase in emotional expression predicted improvements in depressive symptoms and life satisfaction. Emotional processing at study entry predicted increased depressive symptoms and intrusive thoughts, and declining life satisfaction among highly expressive women. Increasing emotional processing predicted improved depressive symptoms in the context of high expressivity. Increases in emotional approach coping were associated with a more arduous cancer experience. Findings highlight the importance of the person‐situation fit in linking emotion‐related constructs to adjustment during unremitting stressors.     

Memory consistency for traumatic events in Dutch soldiers deployed to Iraq

Retrospective accounts of traumatic events are consistently associated with symptoms of post-traumatic stress disorder (PTSD). This has often been interpreted as causal impact of such events on psychological functioning, but recent studies suggest that the causal direction is (partly) reversed: high levels of PTSD symptoms may be associated with amplified recollections of precipitating traumatic events. The aim of this prospective study was to index the consistency with which Dutch Army soldiers reported traumatic stressors and nontraumatic stressors on their deployment to Iraq, and to examine to what extent PTSD symptoms and pre-existing reporting biases, such as that arising from neuroticism, affect memory inconsistency. Retrospective accounts of stressors were highly variable over time. Individuals with higher levels of PTSD symptoms and neuroticism, lower levels of extraversion, and fewer prior missions, were more prone to increased reporting over time.