Perceived control, coping efficacy, and avoidance coping as mediators between spouses' unsupportive behaviors and cancer patients' psychological distress.

This study examined whether avoidance, coping efficacy, and perceived control mediate the effects of spouses' unsupportive behaviors on patient psychological distress among 191 married individuals enrolled in cancer treatment. Results of the structural equation analyses suggested that avoidance and coping efficacy mediated the relationship between spouses' unsupportive behaviors and patient psychological distress. Perceived control of emotional aspects of the illness, including emotional responses and relationships with family and friends, and perceived control of the medical course of the cancer did not mediate the relationship between spouses' unsupportive behaviors and patient psychological distress. These findings suggest 2 mechanisms to explain why unsupportive responses from spouses may be associated with psychological distress among cancer patients.     

Association of Poor Kin Relations,College Adjustment and Psychological Well-Being among African American Undergraduates

The purpose of this study was twofold. The first was to examine the association of poor kin relations with students’ psychological distress and college adjustment in a sample of 83 African American undergraduates. The second was to assess whether the relationship of poor kin relations with both psychological distress and college adjustment was mediated by perceived stress and self-esteem. Fifty-nine female and 24 male African American undergraduates were administered the study measures via online survey. Findings revealed that poor kin relations were positively associated with psychological distress and negatively related to college adjustment. Evidence of the meditational role of perceived stress and self-esteem was found. Poor relations with kin were linked to increased vulnerability to stress and decreased self-esteem, which in turn, was associated with increase in psychological distress and decrease in college adjustment. For counselors, administrators and faculty concerned with the adjustment and retention of ethnic minority undergraduates, understanding the role of extended family and other off-campus relations in students’ psychological well-being may be highly important.     

Discrepancies between patients' and partners' perceptions of unsupportive behavior in chronic obstructive pulmonary disease

The literature on chronic diseases indicates that partner support, as perceived by patients, contributes to well-being of patients in either a positive or a negative way. Previous studies indicated that patients' and partners' perceptions of unsupportive partner behavior are only moderately related. Our aim was (1) to investigate whether discrepancies between patients' and partners' perceptions of two types of unsupportive partner behavior-overprotection and protective buffering-were associated with the level of distress reported by patients with chronic obstructive pulmonary disease (COPD) and (2) to evaluate whether the direction of the differences between patients' and partners' perceptions was associated with distress (i.e., whether patient distress was associated with greater patient or greater partner reports of unsupportive partner behavior). A cross-sectional study was performed using the data of a sample of 68 COPD patients and their spouses. Distress was assessed using the Hopkins Symptom Checklist-25. Patients' and partners' perceptions of unsupportive partner behavior were assessed with a questionnaire measuring overprotection and protective buffering. Distress was independently associated with patients' perceptions of protective buffering and discrepancies in spouses' perceptions of overprotection. Regarding the direction of the discrepancy, we found that greater partner reports of overprotection as compared with patient reports were related to more distress in COPD patients. Our study showed that patients' distress was associated not only with patients' perceptions, but also with discrepancies between patients' and partners' perceptions of unsupportive partner behavior.     

Discrimination and Women’s Mental Health: The Mediating Role of Control

Perceived discrimination is a stressor, related to both negative physical and mental health outcomes. Utilizing a sample of 259 undergraduate females from the northeast region of the U.S., the present study examined a model that tested the direct, indirect, and mediated relations among perceived sexist discrimination, psychological distress, self-esteem, and sense of personal control. Path analysis of the model indicated that (a) perceived sexism was related to greater psychological distress, with personal control partially mediating this link and (b) perceived sexism was not related to self-esteem. The path model accounted for 28% of the variance in self-esteem and 37% of the variance in psychological distress. Implications of the findings for women’s health are discussed.     

The relational context of social support: Relationship satisfaction moderates the relations between enacted support and distress

In two studies of kidney transplant patients and their significant others, the authors examined whether the relations between enacted social support and patient distress were moderated by patients' satisfaction with their relationship with the support provider (i.e., their significant other). In Study 1 (n = 121 couples), unsupportive spousal behaviors were associated with more distress only among patients who were less satisfied with their marital relationship. In Study 2 (n = 112 couples), the relations between unsupportive behaviors and distress again varied as a function of the patient's relationship satisfaction, although the particular pattern of the interaction depended on the specific unsupportive behaviors offered to the patient. In both studies, relationship dissatisfaction was associated with higher levels of patient distress. Supportive behaviors were not related to distress and did not interact with relationship satisfaction. Implications for future research on social support in marriage are discussed.     

The role of objective versus perceived life threat in the psychological adjustment to cancer

Several studies in the oncology literature have used disease stage as a measure of life threat. According to the transactional model of stress (Lazarus and Folkman, ), however, the individual's perception of a threatening situation is more strongly related to distress than the objective event itself. Thus, the present study examined whether cancer patients’ perceived life threat (PLT) is more strongly associated with psychological adjustment than a more objective index of disease prognosis (i.e., cancer stage). In addition, based on cognitive processing theories, this study examined whether intrusive thoughts and avoidance, cognitive characteristics of posttraumatic stress disorder (PTSD), mediate the relationship between PLT and distress. Patients diagnosed with various types of cancer (N = 97) completed questionnaires assessing PLT, cancer-related intrusive thoughts and avoidance, distress, and quality of life. Consistent with theoretical predictions, regression analyses showed that PLT, but not disease stage, was significantly related to psychological distress and quality of life. In addition, intrusive thoughts and avoidance mediated the relationship between PLT and distress. Taken together, these findings suggest that cancer patients’ PLT is more strongly related to distress than is cancer stage and that this association is partly due to cognitive symptoms that are part of PTSD symptomatology. Thus, patients who appraise their illness as life threatening may benefit from cognitive interventions aimed at reducing distress associated with intrusive thoughts.     

Advisory working alliance, perceived English proficiency, and acculturative stress

The aim of this study was to examine the moderators of (a) general or cross-cultural advisory working alliances and (b) perceived English proficiency on the association between acculturative stress and psychological distress. A total of 143 East Asian international students completed an online survey. Results from a hierarchical regression indicated significant three-way interactions of (a) General Advisory Working Alliances × Perceived English Proficiency × Acculturative Stress on Psychological Distress and (b) Cross-Cultural Advisory Working Alliances × Perceived English Proficiency × Acculturative Stress on Psychological Distress. Specifically, the present results indicated that acculturative stress was significantly associated with psychological distress only when students perceived lower English proficiency and had a stronger general or cross-cultural advisory working alliance. However, acculturative stress was not significantly related to psychological distress when these students perceived lower English proficiency and had a weaker advisory working alliance (i.e., general or cross-cultural). In addition, acculturative stress was also not significantly related to psychological distress when these students perceived higher English proficiency and had a stronger or weaker advisory working alliance (i.e., general or cross-cultural).     

Filipino Americans and racism: A multiple mediation model of coping

Although the literature on Asian Americans and racism has been emerging, few studies have examined how coping influences one's encounters with racism. To advance the literature, the present study focused on the psychological impact of Filipino Americans' experiences with racism and the role of coping as a mediator using a community-based sample of adults (N = 199). Two multiple mediation models were used to examine the mediating effects of active, avoidance, support-seeking, and forbearance coping on the relationship between perceived racism and psychological distress and self-esteem, respectively. Separate analyses were also conducted for men and women given differences in coping utilization. For men, a bootstrap procedure indicated that active, support-seeking, and avoidance coping were mediators of the relationship between perceived racism and psychological distress. Active coping was negatively associated with psychological distress, whereas both support seeking and avoidance were positively associated with psychological distress. A second bootstrap procedure for men indicated that active and avoidance coping mediated the relationship between perceived racism and self-esteem such that active coping was positively associated with self-esteem, and avoidance was negatively associated with self-esteem. For women, only avoidance coping had a significant mediating effect that was associated with elevations in psychological distress and decreases in self-esteem. The results highlight the importance of examining the efficacy of specific coping responses to racism and the need to differentiate between the experiences of men and women.     

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.     

Social anxiety and interpersonal stress generation: the moderating role of interpersonal distress

Background and Objectives: Existing models of social anxiety scarcely account for interpersonal stress generation. These models also seldom include interpersonal factors that compound the effects of social anxiety. Given recent findings that two forms of interpersonal distress, perceived burdensomeness and thwarted belongingness, intensify social anxiety and cause interpersonal stress generation, these two constructs may be especially relevant to examining social anxiety and interpersonal stress generation together.

Design: The current study extended prior research by examining the role of social anxiety in the occurrence of negative and positive interpersonal events and evaluated whether interpersonal distress moderated these associations.

Methods: Undergraduate students (N?=?243; M?=?20.46 years; 83% female) completed self-report measures of social anxiety, perceived burdensomeness, and thwarted belongingness, as well as a self-report measure and clinician-rated interview assessing negative and positive interpersonal events that occurred over the past six weeks.

Results: Higher levels of social anxiety were associated only with a higher occurrence of negative interpersonal dependent events, after controlling for depressive symptoms. This relationship was stronger among individuals who also reported higher levels of perceived burdensomeness, but not thwarted belongingness.

Conclusions: It may be important to more strongly consider interpersonal stress generation in models of social anxiety.     

Social Comparison in Medically High-Risk Pregnant Women1

The present study examined social comparison processes in 147 pregnant women at high risk of incurring an adverse birth outcome such as fetal loss or preterm delivery. These women typically undergo physical and psychological changes which elevate uncertainty and distress. Theoretically derived hypotheses concerning the impact of threat, self-esteem, perceived control, age, and gravidity (previous pregnancy) on social comparison were tested. Women experiencing low pregnancy-related threat and those with higher self-esteem were more likely to compare themselves favorably to other pregnant women. Younger women who had not been pregnant before compared most frequently; comparisons of physical state were more common than comparisons of emotional well-being or interpersonal relationships. Results are contrasted with social comparison processes in other populations facing stressful life events.     

Discrimination, acculturation, acculturative stress, and Latino psychological distress: a moderated mediational model

Prior research has found that perceived discrimination is associated with adverse mental health outcomes among Latinos. However, the process by which this relationship occurs remains an understudied area. The present study investigated the role of acculturative stress in underlying the relationship between perceived discrimination and Latino psychological distress. Also examined was the ability of acculturation to serve as a moderator between perceived discrimination and acculturative stress. Among a sample of Latino adults (N = 669), moderated mediational analyses revealed that acculturative stress mediated the perceived discrimination-psychological distress relationship, and that the link between perceived discrimination and acculturative stress was moderated by Anglo behavioral orientation but not Latino behavioral orientation. The findings are discussed within a stress and coping perspective that identifies the psychological consequences associated with perceived discrimination and acculturative stress.     

Protective buffering and psychological distress among couples coping with breast cancer: The moderating role of relationship satisfaction.

This study examined whether the association between protective buffering and psychological distress was moderated by relationship satisfaction. Protective buffering is defined as hiding worries, denying concerns, and yielding to one's partner in an effort to avoid disagreement and reduce one's partner's upset and burden. Two hundred thirty-five women diagnosed with early stage breast cancer and their partners completed measures of protective buffering, psychological distress, and relationship satisfaction at 3 time points over an 18-month period after cancer diagnosis. The authors hypothesized that protective buffering would result in more distress among patients and partners reporting higher relationship satisfaction than among patients and partners reporting lower levels of relationship satisfaction. Patients' protective buffering predicted more distress among patients rating their relationships as more satisfactory, whereas the patients' buffering did not predict distress among patients rating their relationships as less satisfactory. Partner relationship satisfaction also moderated the association between patients' buffering and partners' distress. These findings elucidate conditions under which protective buffering may have detrimental effects.     

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.     

Negative Interpretations of Interpersonal Situations and the Relation Between Low Perceived Support and Psychological Distress Among Divorced Adults1

This research tested hypotheses for a mechanism by which low perceived support may lead to psychological distress. According to social‐cognitive models, perceived support guides the interpretation of interpersonal situations. People with low perceived support interpret these situations more negatively than do people with high perceived support, and these negative interpretations lead to psychological distress. This mechanism is hypothesized to be distinct from similar mechanisms involving other social‐cognitive constructs, such as dysfunctional attitudes. These hypotheses were tested in 2 samples of adults adjusting to divorce. The data were consistent with predictions. Implications for understanding low perceived support's relation to distress and adults' adjustment to divorce were discussed.     

Living with the unexplained: coping,distress, and depression among women with chronic fatigue syndrome and/or fibromyalgia compared to an autoimmune disorder

Chronic fatigue syndrome (CFS) and fibromyalgia are disabling conditions without objective diagnostic tests, clear-cut treatments, or established etiologies. Those with the disorders are viewed suspiciously, and claims of malingering are common, thus promoting further distress. It was hypothesized in the current study that levels of unsupportive social interactions and the coping styles used among those with CFS/fibromyalgia would be associated with perceived distress and depressive symptoms. Women with CFS/fibromyalgia (n = 39), in fact, reported higher depression scores, greater perceived distress and more frequent unsupportive relationships than healthy women (n = 55), whereas those with a chronic, but medically accepted illness comprising an autoimmune disorder (lupus erythematosus, multiple sclerosis, rheumatoid arthritis; n = 28), displayed intermediate scores. High problem-focused coping was associated with low levels of depression and perceived distress in those with an autoimmune condition. In contrast, although CFS/fibromyalgia was also accompanied by higher depression scores and higher perceived distress, this occurred irrespective of problem-focused coping. It is suggested that because the veracity of ambiguous illnesses is often questioned, this might represent a potent stressor in women with such illnesses, and even coping methods typically thought to be useful in other conditions, are not associated with diminished distress among those with CFS/fibromyalgia.     

Neurotic perfectionism, perceived stress, and self-esteem among Japanese men: a prospective study

The present study examined the relationship between self-report scores of neurotic perfectionism and of perceived stress and self-esteem 6 wk. later among 146 Japanese male college students. Hierarchical regression analysis indicated that scores for neurotic perfectionism accounted for statistically significant but functionally small variance (4% and 3%) in scores for perceived stress and self-esteem obtained at Time 2 (6 wk. later), after controlling for the scores for perceived stress and self-esteem at Time 1, respectively.     

Unemployment,Self-Esteem,and Depression: A Social Comparison Theory Approach

A social comparison theory approach to the relation between unemployment, self-esteem, and depression was tested using a cross-sectional questionnaire design (N = 88). Personal attributes were used as the domain of comparison, and four types of comparisons-intrapersonal, interpersonal, intragroup, and intergroup-were operationalized. Employment status affected the salience of intrapersonal comparisons. Comparisons with the past self were highly predictive of psychological distress among unemployed respondents, whereas comparisons with the ideal self predicted distress among the employed. Individual-level and group-level social comparisons had different associations with the dependent measures for unemployed respondents. Intrapersonal and interpersonal comparisons were significantly related to depression and self-esteem scores, whereas intragroup and intergroup comparisons were related only to self-esteem. Social comparisons with unemployed people were related to reduced depression levels among employed respondents. Results also showed that unemployed people had more negative social comparison scores relative to their employed counterparts. Results are discussed in terms of recent developments in social comparison theory. Suggestions for future research are outlined.     

Faces of Shame: Implications for Self-Esteem,Emotion Regulation,Aggression, and Well-Being

There is an increasing interest in psychological research on shame experiences and their associations with other aspects of psychological functioning and well-being, as well as with possible maladaptive outcomes. In an attempt to confirm and extend previous knowledge on this topic, we investigated the nomological network of shame experiences in a large community sample (N = 380; 66.1% females), adopting a multidimensional conceptualization of shame. Females reported higher levels of shame (in particular, bodily and behavioral shame), guilt, psychological distress, emotional reappraisal, and hostility. Males had higher levels of self-esteem, emotional suppression, and physical aggression. Shame feelings were associated with low self-esteem, hostility, and psychological distress in a consistent way across gender. Associations between characterological shame and emotional suppression, as well as between bodily shame and anger occurred only among females. Moreover, characterological and bodily shame added to the prediction of low self-esteem, hostility, and psychological distress above and beyond the influence of trait shame. Finally, among females, emotional suppression mediated the influence of characterological shame on hostility and psychological distress. These findings extend current knowledge on the nomological net surrounding shame experiences in everyday life, supporting the added value of a multidimensional conceptualization of shame feelings.     

Self-Esteem,Perceived Stress,and Gender During Adolescence: Interactive Links to Different Types of Interpersonal Relationships

The goal of this study was to analyze the relationships between self-esteem, perceived stress, the quality of different types of interpersonal relationships, and gender in adolescents. This study used a sample of 1614 adolescent high school students and robust data analytic techniques to test the proposed relationships. The results partially supported the initial hypothesis in that perceived stress mediated the relationships between self-esteem and four of the types of interpersonal relationships (i.e., same-sex peer relationships, opposite-sex peer relationships, parent–child relationships, and teacher–student relationships) and moderated the relationship between self-esteem and same-sex peer relationships. In addition, a moderated role of gender was also partially supported in that perceived stress mediated the relationships between self-esteem and same-sex peer relationships, opposite-sex peer relationships, and the parent–child relationship for girls, but not boys. On the basis of these findings, it was concluded that perceived stress plays an intervening role in the relationship between self-esteem and different types of interpersonal relationships and that gender seems to be a moderator for some of the patterns of the relationships between these variables. These findings are discussed in light of the possible mechanisms by which the variables could influence each other. Implications for theory and practice as well as some directions for future research were also suggested.