Understanding psychological distress in Meniere's disease: a systematic review

It has long been suspected that psychological disturbance is common in Meniere's disease (MD), but there has been no systematic review of research on this topic since 1977. The aim of this review was to investigate whether components of post-traumatic stress disorder (PTSD) or health anxiety contribute to distress, so that support and psychological therapy can be tailored better to the particular problems of people with MD. We systematically identified all studies of psychological factors associated with MD between 1977 and 2004. We then tabulated the findings from each of the 28 studies to match them to the components of PTSD and health anxiety. Levels of psychosocial impairment and distress were comparable to patients with similar illness. Evidence was found for some of the components of both PTSD and health anxiety. We conclude that more specific research into PTSD-like symptoms and health anxiety in MD is needed. There was a general lack of research into psychological mechanisms contributing to distress in this population, many studies had methodological weaknesses, and only one qualitative and one longitudinal study had been carried out.     

Prenatal Maternal Distress: A Risk Factor for Child Anxiety?

The deleterious association between various types of prenatal maternal psychological distress (PNMS, anxiety, depression, psychological distress, stress) and childhood anxiety symptomatology (internalizing behaviors, anxiety symptoms) has been established using both retrospective and prospective longitudinal studies across varied demographic cohorts and throughout development. Yet, the existing literature cannot claim maternal distress during pregnancy to be a specific risk factor for anxiety symptomatology, as studies utilizing such observational designs are unable to adequately account for confounding of potential genetic factors and the postnatal environment. In this review, we examine studies that attempt to minimize such confounding and thus disentangle the unique intrauterine exposure effect of varying types of PNMS on childhood anxiety symptomatology. Such methodologies include paternal versus maternal comparison studies, sibling comparisons, prenatal cross-fostering designs and timing of exposure studies (including disaster studies). Of the identified studies, findings indicate that prenatal maternal distress is likely to constitute a risk factor for anxiety symptomatology, although more studies are needed to replicate current findings in order to determine whether there are clear differences in effects across specific types of PNMS and for specific subpopulations. We review the methodological limitations and strengths of the literature prior to exploring avenues of future research and implications for theory and clinical practice.     

Psychological Distress,Anxiety, and Depression of Cancer-Affected BRCA1/2 Mutation Carriers: a Systematic Review

Understanding the intermediate- and long-term psychological consequences of genetic testing for cancer patients has led to encouraging research, but a clear consensus of the psychosocial impact and clinical routine for cancer-affected BRCA1 and BRCA2 mutation carriers is still missing. We performed a systematic review of intermediate- and long-term studies investigating the psychological impact like psychological distress, anxiety, and depression in cancer-affected BRCA mutation carriers compared to unaffected mutation carriers. This review included the screening of 1243 studies. Eight intermediate- and long-term studies focusing on distress, anxiety, and depression symptoms among cancer-affected mutation carriers at least six months after the disclosure of genetic testing results were included. Studies reported a great variety of designs, methods, and patient outcomes. We found evidence indicating that cancer-affected mutation carriers experienced a negative effect in relation to psychological well-being in terms of an increase in symptoms of distress, anxiety, and depression in the first months after test disclosure. In the intermediate- and long-term, no significant clinical relevant symptoms occurred. However, none of the included studies used specific measurements, which can clearly identify psychological burdens of cancer-affected mutation carriers. We concluded that current well-implemented distress screening instruments are not sufficient for precisely identifying the psychological burden of genetic testing. Therefore, future studies should implement coping strategies, specific personality structures, the impact of genetic testing, supportive care needs and disease management behaviour to clearly screen for the possible intermediate- and long-term psychological impact of a positive test disclosure.     

Examining How Romantic Relationship Quality Influences Individual Psychological Distress Over Time for Men and Women

Poor relationship quality can increase an individual’s psychological distress. There is substantial debate regarding the influence of relationship quality for men and women. Some have found that women’s psychological distress is affected more by poor relationship quality compared to men. Others have found that psychological distress is equally affected for men and women, but it may look different—depressive symptoms for women and total alcohol consumption for men. In this study we examined how men and women differed in changes in relationship quality and changes in psychological distress. Then, we examined how changes in one manifestation of psychological distress and changes in relationship quality were related and how this association differed for men and women. Women reported lower initial relationship quality and total alcohol consumption but higher initial depressive symptoms. Men and women only differed on changes in total alcohol consumption, with women decreasing less than men over 25 years. Finally, both changes in total alcohol consumption and changes in depressive symptoms were related to changes in relationship quality for women, but not men. The reverse direction did not differ by gender, although change in depressive symptoms was related to change in relationship quality. Implications for future research are discussed.     

Anxiety symptomatology: the association with distress tolerance and anxiety sensitivity

Research focused on psychological risk factors for anxiety psychopathology has led to better conceptualization of these conditions as well as pointed toward preventative interventions. Anxiety sensitivity (AS) has been well-established as an anxiety risk factor, while distress tolerance (DT) is a related construct that has received little empirical exploration within the anxiety psychopathology literature. The current investigation sought to extend the existing literature by examining both DT and the relationship between DT and AS across a number of anxiety symptom dimensions, including panic, generalized anxiety, social anxiety, and obsessive-compulsive anxiety. Participants (N = 418) completed a number of measures that assessed DT, AS, anxiety symptomatology, and negative affect. Findings indicated that DT was uniquely associated with panic, obsessive compulsive, general worry, and social anxiety symptoms, but that DT and AS were not synergistically associated with each of these symptom dimensions. These findings indicate that an inability to tolerate emotional distress is associated with an increased vulnerability to experience certain anxiety symptoms.     

To be or not to be at risk: Spontaneous reactions to risk information

Rheumatoid arthritis (RA) is a chronic disease, which can lead to considerable psychological distress. The present study evaluated anxiety and depression symptoms for this chronic and painful illness within the framework of the conservation of resources (COR) theory. Coping strategies, coping self-efficacy, religiousness and social support are very important personal resources, which have been found to protect individuals from psychological distress. The aim of the present study was to examine the predictive values of socio-demographic and illness-related variables, perceived social support, ways of coping, religiousness, arthritis self-efficacy and resource loss for psychological distress in a sample of 117 RA patients from Turkey, a secular, Islamic, non-western developing country. The results revealed that RA patients experience considerable anxiety and depressive symptoms. The results of the regression analysis showed that gender, helplessness coping and resource loss are significant predictors of anxiety, whereas arthritis self-efficacy and resource loss are significant predictors of depression. Resource loss appeared as an important predictor for both anxiety and depression. This finding was consistent with the COR theory. The clinical implications of these findings are discussed.     

Coping,life stress,and psychological and somatic distress

Theory and research have focused on the relationships among coping processes, stressful life events, and psychological and physical distress. This study was designed to examine the relationship of stressful life events and three styles of coping—emotion oriented, task oriented, and avoidance oriented—to physical and psychological distress. Questionnaires measuring coping styles, recent life stressors, and both physical symptoms and psychological symptoms were completed by 205 undergraduates (101 males and 104 females). It was hypothesized that task-oriented coping would negatively predict distress and that emotion-oriented coping would positively predict distress. The relationships of two types of avoidance-oriented coping (distraction and social diversion) to distress were also examined. Multiple regression analyses revealed that task-oriented coping was negatively related to distress, but only for males. Emotion-oriented coping was significantly positively predictive of distress for both males and females. The two subcomponents of avoidance-oriented coping—distraction and social diversion—were differentially related to measures of distress. Life event stress positively predicted distress, both as an independent contributor of variance and in interaction with several coping styles.     

Psychological Distress in Patients Presenting for Initial Renal Transplant Evaluation

The comorbidity of psychological disorders with end-stage renal disease (ESRD) presents challenges for renal transplantation, including increased likelihood of medication noncompliance and poorer quality of life. Estimates of rates and severity of affective and anxiety disorders have varied significantly across studies of renal transplant patients, possibly due in part to variation in the methodology and timing of evaluations. To this point, few researchers have examined the psychological condition of patients who are newly referred for renal transplantation. This study examined rates of psychological distress using the Patient Health Questionnaire (PHQ) in a sample of 518 ESRD patients at the specific time point of first contact with the transplant center. In this sample, 15.1% of patients endorsed symptoms consistent with a depressive condition and 7.6% of patients endorsed an anxiety condition. These rates were lower than expected, which may be due to decreased distress in this sample, selection biases, or underreporting of symptoms due to patients’ motivation to present themselves positively.     

Patterns of psychological distress in mothers of preterm infants

Mothers of preterm infants experience significant psychological distress, with elevated levels of inter-correlated depressive, stress, anxiety and post-traumatic stress symptoms. In a sample of racially and ethnically diverse mothers of preterm infants, we identified differing patterns of psychological distress during infant hospitalization and examined the effect of these psychological distress patterns on longitudinal trajectories of each psychological distress measure and on maternal perceptions of the child over the first year of the infant's life. Mothers of preterm infants (N = 232) completed five questionnaires assessing depressive symptoms, anxiety, post-traumatic stress symptoms, stress due to infant appearance, and stress due to parental role alteration during enrollment during the neonatal hospitalization, discharge, and at 2, 6, and 12 months of age adjusted for prematurity. Latent class analysis on the enrollment psychological distress variables allowed us to identify five sub-groups of mothers exhibiting similar patterns of psychological distress, differing primarily in degree and type: low distress, moderate distress, high NICU-related distress, high depressive and anxiety symptoms, and extreme distress. These classes continued to show different longitudinal trajectories for the psychological distress measures through 12 months corrected age. Mothers in the extreme distress class and, to a lesser degree, mothers in the high depressive and anxiety symptom class remained at risk of significant psychological distress one year after discharge and had less positive perceptions of their child (greater worry and higher perceptions of child vulnerability). In conclusion, distinctive sub-groups of mothers during hospitalization had different patterns of psychological distress throughout the 12-month period and may require different interventions in the NICU.     

Individual differences in emotion regulation moderate the associations between empathy and affective distress

Individual differences in empathy can have positive and negative psychological outcomes. Yet, individual differences in the processing and regulation of empathy-induced emotion have not been fully explored within this dynamic. This study was designed to explore whether individual differences in emotion regulation strategies moderated the effects of empathy on common forms of affective distress. Eight hundred and forty four participants completed survey measures of trait empathy, emotion regulation strategies, and symptoms of depression, anxiety, and stress. Affective empathy typically predicted greater affective distress, but the effects on depression and anxiety were offset when people were effective at reappraising their emotions. Cognitive empathy predicted lower distress on average, but this beneficial effect on anxiety and stress was absent in those who typically suppressed their emotions. Finally, suppression unexpectedly reduced the depression and stress reported for people high in affective empathy. Individual differences in emotion regulation are an important moderator between empathy and psychological health, and thus a useful target for intervention.     

Psychological interventions for infertile patients: a review of existing research and A new comprehensive approach

The usefulness of psychological support for infertile patients has been highlighted in the literature over the past number of years. This article provides a review of existing research on psychological interventions for infertile patients, and presents the Fertility Group Intervention as an example of the application of existing research. There is clear empirical evidence of high levels of depressive symptoms, anxiety, and distress among infertile patients undergoing assisted reproductive treatment (ART). Infertile patients need and require increased psychological support. Various studies indicate the efficacy of psychological interventions for infertile patients with respect to their mental health and, in part, pregnancy rates. However, many such studies exhibit methodological problems. Therefore, in future research, additional studies of high‐quality design are needed to achieve more definitive answers on the efficacy and indication of psychological interventions for infertile patients. Currently, the Fertility Group Intervention represents a comprehensive therapeutic approach integrating established empirical and theoretical approaches with the aim of helping infertile patients – particularly those undergoing ART – cope with distress related to their infertility and medical treatment. This article further outlines the therapeutic background and structures, treatment goals, practical implications, and feasibility of the Fertility Group Intervention.     

Personality factors associated with psychological distress in testicular cancer survivors

The aim of this study was to investigate symptoms of anxiety and depression in testicular cancer survivors (TCSs) and to identify personality traits associated with psychological distress in these patients by means of the MMPI (Hathaway & McKinley, 1943). A total of 50 TCSs and 50 age-adjusted healthy men participated in the study, and we used the following self-report instruments: Montgomery-Asberg Depression Rating Scale (Montgomery & Asberg, 1979), Hamilton Anxiety Rating Scale (Hamilton, 1959, 1969), Spielberger's State-Trait Anxiety Inventory (Spielberger, 1970, 2005), and the MMPI. TCSs displayed higher rates on all psychopathology scales studied compared to controls, but the majority of the patients' scores were within the "normal range," indicating rather mild psychological distress. TCSs' MMPI profiles showed higher rates on Scales 1, 3, 6, and 9 compared to controls; and within the TCSs sample, symptoms of depression were most closely associated with Scales 3 and 5. Similarly, anxiety symptoms were mainly associated with Scale 3. These findings indicate that TCSs present mild symptoms of psychological distress, mainly anxiety and depressive symptoms, suggesting that careful assessment and consultation in TC patients is essential to help them deal with distress after treatment and to minimize possible risk factors.     

Physiological and psychological reactivity in women with asthma: the effects of anxiety and menstrual cycle phase.

The relation between menstrual cycle timing, panic attacks, and diagnosis of asthma was explored in this study. Women with or without asthma and with or without a history of panic attacks engaged in a psychophysiological task during either the intermenstrual or premenstrual cycle phase and completed self-report measures of menstrual symptoms and attitudes, general psychological symptoms, and attitudes toward illness. No significant differences were identified for psychological or psychophysiological measures with menstrual cycle phase as a factor. However, women with both asthma and a history of panic attacks reported more general psychological distress than women in the other groups, and more state anxiety than controls. Women in the asthma, asthma and panic, and panic groups reported higher anxiety sensitivity than the control group. After listening to asthma-related scenes, women with asthma exhibited a decrease in peak expiratory air flow, and women with asthma and panic exhibited increased skin conductance response magnitude. Implications for the role of anxiety in lung function are discussed, as well as directions for future research with asthma and anxiety populations.     

Rates and Correlates of DSM-IV Diagnoses in Women Newly Diagnosed with Breast Cancer

Although the presence of psychological distress has been documented in women with breast cancer, previous studies have not established rates of DSM-IV diagnoses in this population, nor have prior investigations compared the utility of diagnostic interviewing vs. symptom checklists to assess distress. DSM-IV diagnoses of anxiety disorders and major depression, symptoms of anxiety and depression, and quality of life were examined in 207 women with newly diagnosed breast cancer. Eighteen percent of breast cancer patients met criteria for a current DSM-IV anxiety or depressive disorder and 54% met criteria for a disorder at some point in their lifetime. These rates are comparable to those found in recent community epidemiological studies (e.g., R. C. Kessler, K. A. McGonagle, S. Zhao, C. B. Nelson, M. Hughes, S. Esheman, et al., 1994). Sensitivity, specificity, and positive predictive value for anxiety and depression symptoms as predictors of DSM disorders were relatively poor. However, after accounting for demographic, treatment, and cancer variables, self-reported anxiety symptoms were significantly related to the presence of an anxiety disorder and self-reported depressive symptoms were significantly related to a diagnosis of a depressive disorder. Symptoms of anxiety and depression contributed significantly and uniquely to physical, medical, and sexual quality of life; DSM-IV diagnoses were not significantly related to quality of life after controlling for symptoms of depression and anxiety. The importance of measuring both symptoms of distress and psychiatric diagnoses in cancer patients and the clinical practice implications of the results are discussed.     

蒙汉族大学生父母教养方式、成人依恋与心理困扰的关系研究

通过整群抽样方法抽取了576名大学生,对其施测父母养育方式量表、亲密关系体验量表和心理困扰量表,运用结构方程模型技术,分别考察了父母养育方式的蒙汉族差异以及成人依恋模式在父母养育方式和心理困扰间的中介作用。结果表明:(1) 蒙古族父母对孩子的关爱程度和给孩子的自主性要显著高于汉族;(2) 汉族的成人依恋模式在父母过度保护与抑郁-焦虑-压力之间起着部分中介作用,而蒙古族成人依恋的中介作用不明显,但母亲的冷漠拒绝和过度保护会导致个体依恋回避和依恋焦虑,父亲的冷漠拒绝和过度保护会影响个体的抑郁和焦虑,母亲的过度保护和父亲的冷漠拒绝会影响个体的压力。     

Distress of Japanese parents of children with intellectual disabilities: Correlations with age of parent and negative mood regulation expectancies

Parents caring for a child with an intellectual disability (ID) face many challenges. Few studies in Japan have focused on parents of children with an ID. We investigated the psychological factors that might help these parents maintain well‐being, in particular negative mood regulation expectancies (NMRE). NMRE are beliefs about one's ability to diminish one's negative moods. Research has shown NMRE to buffer the effects of stress: stronger NMRE are associated with less symptoms of distress, including depression and anxiety. We examined the associations of NMRE, coping, and severity of the child's ID with parental distress (somatization, depression, and anxiety) among 106 Japanese parents (mean age = 56.7 years) caring for at least one child with an ID. The age of the parent was negatively associated with parental distress, particularly anxiety. NMRE were also negatively related to distress, independent of the age of the parent and coping. The severity of the child's ID was not related to coping or parental distress. Stronger beliefs that they could control their negative moods and being older seemed to protect parents of an ID child from symptoms of distress.     

A Model for Primary Care Psychology With General Thoracic Surgical Patients

This study examined a model for brief psychological assessment for providing primary psychological care to patients within a surgical, specialty outpatient clinic to provide early and accurate detection of psychological distress in patients to increase compassionate care. Questionnaires were completed by 351 outpatients and 227 of these outpatients were provided a model of primary care (brief psychological intervention). Patients were assessed and provided coping strategies, patient education, and a brief evaluation of anxiety and depressive symptoms. Psychologists, in a brief interview (mean = 12 min) identified individuals experiencing significant psychological distress. The ratings of emotional status also predicted health quality of life and anxiety. Younger individuals presenting for medical care appear to be more vulnerable to psychological distress. Brief psychological interventions provide accurate, efficient assessment of psychological distress and can be an effective way of increasing compassionate care. The results support the use of primary care psychology and brief psychological interventions in the management of medical patient care.     

Maternal distress in the context of their child’s type 1 diabetes: exploring the role of adaptive maternal emotion regulation on child outcomes

Parents of children with Type 1 diabetes (T1D) experience high levels of distress, which may negatively impact child functioning. However, little is known about mechanisms that may buffer the adverse impact of parental distress. The current study explored the possible buffering role of maternal adaptive cognitive emotion regulation (CER) for the relationship between maternal distress and child psychological functioning. Forty-three children with T1D (8–15 years) completed measures assessing trait anxiety and depressive symptoms. Their mothers reported on general distress, illness-related parenting stress, and adaptive CER. Maternal illness-related parenting stress (but not general distress) was significantly associated with child psychological functioning. No buffering role for maternal adaptive CER was observed. As the current study is rather preliminary, future research using other methods to examine maternal adaptive CER, and examining other parental variables that may buffer against the negative impact of parental distress is warranted.     

The Conceptualization of Anxiety: An Exploratory Study of Japanese American Older Adults

Few empirical studies exist on the mental health of Japanese American older adults. This study focused on how Japanese American older adults conceptualize anxiety. Participants were presented with a checklist, which included anxiety and depression symptoms identified in a previous qualitative study conducted by the authors, as well as symptoms from Generalized Anxiety Disorder in the Statistical Manual of Mental Disorders, Fourth Edition (DSM-IVrpar;. They were asked to imagine a Japanese American older adult who was experiencing anxiety and check off the symptoms he/she would be experiencing. Results indicated that these Japanese American participants conceptualized anxiety by using more depressive symptoms than anxiety symptoms. In addition, contrary to previous research and speculation about how Asian Americans experience psychological distress, participants also checked a larger number of cognitive symptoms as opposed to somatic symptoms. The present data suggest that Japanese American older adults conceptualize anxiety differently from the traditional psychiatric conceptualization of anxiety. Thus, clinicians and researchers should not generalize symptoms of psychological distress developed and researched on nonminority older adults to ethnic minority adults, and should consider such ethnic group differences in their assessment and treatment methods for ethnic minority adults.     

Stress mindset in athletes: Investigating the relationships between beliefs,challenge and threat with psychological wellbeing

ObjectiveStress is omnipresent in daily life and can be acutely experienced by athletes due to additional circumstances such as deselection and injury. Trait beliefs athletes have about the stress they experience as well as the cognitive appraisals of this stress may be important in determining psychological wellbeing. The present study aimed to investigate the relationships between stress mindset, irrational beliefs, cognitive appraisals and psychological wellbeing in athletes using path analysis. Broadly speaking, it was hypothesised that stress mindset would relate negatively to depressive symptoms and positively to vitality through appraisals (i.e., challenge and threat), while irrational beliefs would relate to positively to depressive symptoms and negatively to vitality through appraisals.Methods415 athletes (227 females, Mage = 33.86 years, SD = 17.73) completed an online questionnaire pack assessing stress mindset, irrational beliefs, challenge and threat appraisals, depressive symptoms, and vitality. Using path analysis, the tested hypothesised model demonstrated an excellent fit to the data.ResultsFindings demonstrate that the relationships between stress mindset, irrational beliefs and psychological wellbeing is linked by direct and indirect effects of challenge and threat in athletes. Stress mindset was positively associated with challenge and negatively associated with threat, whilst self-depreciation and awfulizing demonstrated significant positive associations with threat. Self-depreciation was found to significantly relate to stress mindset, challenge, threat and depressive symptoms to a greater extent than the other types of irrational beliefs.ConclusionsFindings suggest practitioners should be aware of the role that stress mindset and other irrational beliefs have in potentially influencing athlete psychological wellbeing.