Counterfactuals, coping strategies and psychological distress among breast cancer patients

The aim of this primary study was to predict the effect of counterfactuals, coping strategies, personal resources (age and education) and stage of the illness on psychological distress in a sample of 64 breast cancer patients. The main findings indicated that upward counterfactuals played an important role in the patients' psychological distress and coping process with the illness. Patients who used a high level of upward counterfactual thinking were found to have a high level of psychological distress. Downward counterfactual thinking, however, was not found to be related to less psychological distress.     

Relationship orientation, quality of prior relationship, and distress among caregivers of Alzheimer's patients

Communal orientation and closeness of the caregiver-patient relationship were investigated as predictors of distress among caregivers of Alzheimer's patients. Persons high in communal orientation were less depressed than those low in communal orientation. Caregivers reporting a close relationship with the patient before illness onset felt less burdened than those whose relationship had not been close. Communal orientation interacted with closeness when data were analyzed separately for men and women. Among men, being low in communal orientation and having a relatively poor prior relationship were associated with the highest levels of depression, levels that put them at risk for clinical depression. Among women low in communal orientation, higher levels of depression were related to having a close prior relationship with the patient.     

Predicting achievement, distress, and retention among lower-income Latino youth

This study used structural equation modeling to evaluate whether a combination of social cognitive and self-determination theories [Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory. Englewood Cliffs, NJ: Prentice-Hall; Deci, E. L., & Ryan, R. M. (1987). The support of autonomy and the control of behavior. Journal of Personality and Social Psychology, 53, 1024–1037] would effectively predict high school students’ distress, achievement, and retention. Participants were 427 predominately Latino youth from an inner-city low-income high school. Results indicated that students who reported feeling connected to teachers and their school reported higher levels of autonomous motivation for attending school. Students reporting higher levels of autonomous motivation for attending school reported more confidence (i.e., self-efficacy) in their academic ability, and performed better academically. In addition, students who reported higher self-efficacy beliefs reported less physical and psychological distress and reported higher levels of achievement. Retention in school was predicted by a combination of achievement and the absence of physical/psychological distress. Implications for practice and further research on urban high school students’ academic development are described.     

Self-blame among parents of infants with perinatal complications: the role of self-protective motives

According to the literature on defensive attribution, behavioral self-blame can bolster a sense of personal efficacy and is more likely to occur when victims perceive their misfortune as severe. In this study, mothers of infants with severe perinatal complications rated the severity of their child's condition, were asked about its causes, and completed a measure of emotional adaptation. As predicted according to the defensive attribution hypothesis, behavioral self-blame was associated with greater perceived severity and preventability of recurrence. The pattern of correlations suggests that greater perceived severity may produce greater self-blame, which in turn may play an indirect role in adaptation through its association with the belief that a recurrence could be prevented. Results of a post hoc path analysis were consistent with this hypothesis. These findings are discussed in terms of the adaptive features of behavioral self-blame, its relation to perceived control, methodological issues in the study of coping with victimization, and implications for helping professionals.     

Religiosity and psychological distress among blacks

The influence of religion on mental well-being has been the subject of controversy for a long while. Yet little is known about this relationship among black Americans. Using a probability-based sample of 451 urban black Americans, this study examines gender differences in religiosity and explores the ramifications for mental health. Findings indicate that females are more religious than males as evidenced by their greater participation in organizational forms of religious practice such as meetings and other gatherings. However, for both males and females, religiosity varied significantly by age and by marital and parental status. On the other hand, there were no differences in religiosity according to levels of education, income, and employment status for either males or females. With regard to mental health, greater religiosity was associated with fewer depressive symptoms for both males and females. Further, in the event of stressful circumstances, the influence of religion on mental well-being for females was direct, while religious involvement appeared to have an indirect or stress- buffering effect for males.     

Social control, health risk taking, and psychological distress among the elderly

Most research on older adults' social networks has focused on the support-providing function of social relationships. Little gerontological research has addressed social control, or the role of social bonds in regulating deviant or risky behavior. Drawing on sociological theory, this study examined the hypothesis that social control discourages risky health practices while provoking psychological distress. Structured interviews conducted with 162 community-residing older adults assessed social control (direct attempts by other to influence participants' health practices and the existence of significant role obligations to others), health risk taking (medication misuse, alcohol consumption, cigarette smoking, and the overall level of unsound health practices), psychological functioning (depression, loneliness, and self-esteem), and interpersonal satisfaction (satisfaction with friends and family members). Analyses revealed little support for the hypothesis. Social control was only weakly related to participants' health practices and, contrary to expectation, was generally related to less psychological distress and to greater interpersonal satisfaction. Implications for social control theory and for further research are addressed.     

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.     

Ethnicity, coping, and distress among Korean Americans, Filipino Americans, and Caucasian Americans

The authors examined appraisal, coping, and distress among Korean American, Filipino American, and Caucasian American Protestants. No interaction effects emerged among ethnic groups, but there were significant ethnic main effects for appraisal and coping. Compared with the Caucasian Americans, both Asian American groups appraised stressors as more challenging, and the Korean Americans appraised them also as greater losses. Both Asian American groups reported using more strategies of accepting responsibility, religious coping, distancing, and escape-avoidance than the Caucasian Americans did; the Filipino Americans also reported more problem-solving strategies than the Caucasian Americans. For all participants, challenge appraisals predicted adaptive coping (problem solving and positive reappraisal) and less distress. Problem solving, seeking social support, and positive reappraisal predicted less distress; self-control, accepting responsibility, and escape-avoidance predicted greater distress. The authors stressed the value of assessing ethnicity in coping research.     

Daily hassles,marital functioning and psychological distress among community-dwelling older couples

ObjectivesThis study attempts to examine the association between stress induced by daily hassles, marital functioning and psychological distress among a sample of older couples living at home without assisted living facilities. Moreover, the study looks to assess the moderator role of marital functioning on the association between stress and psychological distress.MethodsThe study included a representative sample of 508 older couples living at home where at least one spouse was aged 65 years or older. To take into account of the non-independence of the data, dyadic analyses were conducted.ResultsFor men, marital functioning and stress induced by daily hassles explained the variance of psychological distress 4.71% and 2.56% respectively. For women, these variables explained 10.96% and 2.43% respectively of this variance. Results found also that marital functioning can play a protective role between the association of stress and psychological distress among men, but not for women. Men with lower marital functioning present a significant higher level of psychological distress when they present stress than those who do not have stress. For those with high marital functioning, no significant differences have been found on psychological distress between those groups.ConclusionStress induced by daily hassles and marital functioning are significantly related to psychological distress among older people, and, for men, marital functioning can play a protective role in the association between those variables.     

Unmitigated communion, social constraints, and psychological distress among women with rheumatoid arthritis

The personality trait of unmitigated communion, an extreme focus on relationships that has been associated with self-neglect, has been linked to poorer outcomes for both men and women, but is more common among women. This longitudinal study is the first to examine the influence of unmitigated communion on adaptation to a chronic illness that affects a much greater proportion of women to men. Women with rheumatoid arthritis completed measures of unmitigated communion, social constraints, and psychological distress at study entry and repeated the distress measure one year later. As expected, unmitigated communion was associated with psychological distress. Cross-sectional moderation analyses indicated that low social constraints buffered the negative effects of unmitigated communion.     

Sex role attributes, symptom distress, and defensive style among college men and women

Eighty-four male and 90 female college students completed the PRF-Andro masculinity and femininity scales, a symptom checklist, and a defense mechanism inventory. Results indicated that interrelations among sex role attributes, defense preferences, and symptom distress differed for men and women. Cross-sex-typed persons mostly accounted for differences in symptom distress within each sex: Masculine women reported relatively low and feminine men reported relatively high degrees of symptom distress. In addition, sex roles interacted with sex in determining defense preferences. We also explored the possibility that defensive styles mediated between sex role attributes and symptom distress. Among women, an association between masculine attributes and a rejection of self-blaming defenses accounted for the negative relation between masculinity and symptom distress. Among men, sex role attributes and defensive styles, for the most part, contributed independently to symptom distress.     

Urinary incontinence and psychological distress among older adults

We examined the relationship between urinary incontinence and psychological distress in a sample of community-dwelling older adults. The data are from a probability sample of Washtenaw County, Michigan residents ages 60 years and older, who were interviewed in 1983 and 1984. A total of 747 women and 541 men were included in the analyses. Experiencing urinary incontinence, particularly in a severe form, was weakly related to depression, negative affect, and low life satisfaction. These relationships are partly explained by the fact that incontinent respondents are less healthy than are continent respondents.     

Longitudinal relations among maternal behaviors, effortful control and young children's committed compliance

In a sample (n = 235) of 30-, 42-, and 54-month-olds, the relations among parenting, effortful control (EC), impulsivity, and children's committed compliance were examined. Parenting was assessed with mothers' observed sensitivity and warmth; EC was measured by mothers' and caregivers' reports, as well as a behavioral task; impulsivity was assessed by mothers' and caregivers' reports; and committed compliance was observed during a cleanup and prohibition task, as well as measured by adults' reports. Using path modeling, there was evidence that 30-month parenting predicted high EC and low impulsivity a year later when the stability of the outcomes was controlled, and there was evidence that 30- and 42-month EC, but not impulsivity, predicted higher committed compliance a year later, controlling for earlier levels of the outcomes. Moreover, 42-month EC predicted low impulsivity a year later. Fixed effects models, which are not biased by omitted time-invariant variables, also were conducted and showed that 30-month parenting still predicted EC a year later, and 42-month EC predicted later low impulsivity. Findings are discussed in terms of the importance of differentiating between effortful control and impulsivity and the potential mediating role of EC in the relations between parenting and children's committed compliance.     

Work-family conflict, and psychological distress in men and women among Canadian police officers

The present study examined the relations among sex, work-family conflict, and psychological distress in 78 Canadian police officers (50 men and 28 women). The average age of the officers was 36.1 yr. (SD=8.0), and nearly one-third of the respondents had been in policing 16 years or more. Ordinary least-squares regression was conducted to examine the association of Psychological Distress scores, as measured by the K6, with four types of work-family conflict: Time-based Work-to-Family Conflict, Time-based Family-to-Work Conflict, Strain-based Work-to-Family Conflict, and Strain-based Family-to-Work Conflict. Being single and having higher perceived Strain-based Work-to-Family Conflict were associated with greater scores on Psychological Distress. No statistically significant sex differences emerged in the self-reported type or direction of work-family conflict or in the factors associated with Psychological Distress.     

Examining associations among factor-analytically derived components of mental health stigma, distress, and psychological flexibility

Mental health stigma can be detrimental not only for the recipient, but also for the stigmatizer. As mental health stigma is often conceptualized as a multidimensional construct, Study 1 first examined the factor structure of mental health stigma as assessed by the Stigmatizing Attitudes-Believability (SAB; Masuda, Price, Anderson, Schmertz, & Calamaras, 2009). Study 2 investigated differential relations between the factor-analytically derived components of mental health stigma and psychological distress and psychological flexibility. Results of Study 1 revealed that mental health stigma consisted of two related, yet separable components: Exclusion and Course/Origin. The Exclusion component was characterized by negative emotions and cognitions associated with an increased desire for social distance. Course/Origin was marked by pessimistic views toward treatment prognosis and recovery. Results of Study 2 suggested that these two components have differential associations with psychological distress and flexibility. The Course/Origin component of stigma, but not Exclusion, was associated with psychological distress of the stigmatizer. Furthermore, this association was fully mediated by lower levels of psychological flexibility. These findings suggest the importance of conceptualizing mental health stigma multidimensionally.     

Executive functioning and compliance in HIV patients

25 adult HIV patients were evaluated in a study of appointments, medication, and compliance with restrictions on sexual activity. The Executive Interview (EXIT) was useful in assessing these patients for cognitive difficulties; compliance with medication and countertransference issues were negatively correlated with EXIT scores.     

Forbearance coping, identification with heritage culture, acculturative stress, and psychological distress among Chinese international students

Based on Berry's (1997) theoretical framework for acculturation, our goal in this study was to examine whether the use of a culturally relevant coping strategy (i.e., forbearance coping, a predictor) would be associated with a lower level of psychological distress (a psychological outcome), for whom (i.e., those with weaker vs. stronger identification with heritage culture, a moderator), and under what situations (i.e., lower vs. higher acculturative stress, a moderator). A total of 188 Chinese international students completed an online survey. Results from a hierarchical regression indicated a significant 3-way interaction of forbearance coping, identification with heritage culture, and acculturative stress on psychological distress. For those with a weaker identification with their heritage culture, when acculturative stress was higher, the use of forbearance coping was positively associated with psychological distress. However, this was not the case when acculturative stress was lower. In other words, the use of forbearance coping was not significantly associated with psychological distress when acculturative stress was lower. Moreover, for those with a stronger cultural heritage identification, the use of forbearance coping was not significantly associated with psychological distress regardless of whether acculturative stress was high or low. Future research and implications are discussed.     

Written emotional disclosure buffers the effects of social constraints on distress among cancer patients.

The aims of the present study were to examine whether written emotional disclosure would reduce distress among cancer patients and whether it would buffer the effects of high levels of social constraint (negative social responses to patients' expressions of emotion regarding their cancer) on distress. Cancer patients (N=104) were randomly assigned to write about their emotions regarding their cancer 20 min a day for 3 days or to write about a nonemotional topic. They completed questionnaires at baseline and 6 months postintervention. Results showed that written disclosure buffered the effects of social constraints on stress at the 6-month follow-up and that avoidance partly mediated these effects. The present data reinforce the notion that interventions should be tailored to patients' needs.     

Predicting medical compliance among adolescents with cystic fibrosis

This investigation evaluated the utility of a new assessment tool based on a competency/coping skills model in predicting medical compliance of adolescents with cystic fibrosis. The Medical Compliance Incomplete Stories Test (M-CIST) was administered to 40 adolescent and young adult inpatients aged 13 to 23. These data were compared to objective measures of the patient's medical compliance. The M-CIST was positively correlated with compliance (multiple R = .72, p less than .001) and discriminated compliant from noncompliant patients. Data derived from patients' responses on the assessment tool could also be used projectively to provide information useful to clinicians treating adolescents with cystic fibrosis.     

Hurricane Andrew: Psychological distress among shelter victims

This study examined psychological distress and functioning among Hurricane Andrew victims who lost their homes and were living in shelters. Four and one-half weeks after Hurricane Andrew struck southern Florida, 89 (45 males, 44 females) Blacks, Hispanics, and Whites completed a questionnaire. The questionnaire asked for information about psychological and psychophysiological symptoms, use of mental health services, coping responses, and extent of preparation for the storm. The findings suggest that loss of home and property were related to distress and depression. About one-quarter of the sample were moderately depressed. Over one-third of the sample reported experiencing psychological and psychophysiological distress. Approximately one-half of the subjects did not take the hurricane warnings seriously. White subjects began preparing earlier for the storm, and evacuated their homes more frequently than did Black subjects. Implications of the findings and future research directions are discussed.