Perceived stress,life events,dysfunctional attitudes,and depression in adolescent psychiatric inpatients

Hewitt, Flett, and Mosher (1992) examined the factor structure of the Perceived Stress Scale (PSS) and its relation to depression in adult psychiatric patients. This study sought to replicate and extend their findings, using a sample of 203 adolescent psychiatric inpatients. All patients admitted to the adolescent unit in a psychiatric hospital over a 3-year period were administered the PSS, as well as measures of depression, life events, dysfunctional attitudes, and intellectual abilities. Consistent with Hewittet al., two factors were found in the PSS, reflecting perceived distress and perceived coping ability. Regression analyses indicated that, for males, both factors account for independent variance in depression, whereas for females, only the distress factor is related to depression. In addition, for both male and female, dysfunctional attitudes account for significant variance in depression in addition to PSS, but negative life events do not. None of the variables were related to intellectual abilities. Implications for clinical assessment and intervention are discussed.     

Factor structure of the Perceived Stress Scale (PSS) in a sample from Mexico

The aim of this study was to analyze the cultural adaptation of the European Spanish version of the Perceived Stress Scale (PSS; Cohen, Kamarak, & Mermelstein, 1983), for its use in Mexican samples. Using a random sample of students, internal consistency was analyzed and the factor structure of the Spanish version of the PSS was compared with the factor structure found in the English version. Internal consistency was adequate (alpha = .83) and confirmatory factor analysis corroborated the factor structure. Factor 1 explained 42.8% of the variance and Factor 2 accounted for 53.2%. The goodness-of-fit measures also revealed an adequate fit. The cultural adaptation of the PSS was also evaluated with satisfactory results.     

Perceived Stress in Young Carers: Development of a Measure

We report the development of a 5-factor, 31-item, Young Carers Perceived Stress Scale (YCPSS) from an initial 50-item pool. The scale was developed and tested on 108 young carers aged between 12–18 years, and acceptable Cronbach Alpha values were obtained for the individual factors and the overall scale. In addition, both the overall scale and individual factors produced a pattern of correlations with social support, burden of care, psychological distress, and coping, supporting the initial validity and utility of the scale.     

Stress reactivity and coping in seasonal and nonseasonal depression

Stress, stress reactivity, and coping skill use were examined in individuals with seasonal depression, nonseasonal depression, and nondepressed controls. Although participants in the two depressed groups reported using more avoidance coping strategies than controls, only participants in the seasonal depressed group reported using more season-specific coping (i.e., light-related strategies) than participants in the nonseasonal depressed and control groups. Individuals in the seasonal depressed group also reporting using acceptance coping strategies less frequently than individuals in the control group. Only participants in the nonseasonal depressed group, however, exhibited greater psychophysiological arousal in reaction to a laboratory stressor (i.e., unsolvable anagram task) when compared to participants in the seasonal and nondepressed control groups. Participants in both depressed groups reported greater impact of negative life events during the past 6 months than did controls. Similarities and differences in the two types of depression may have implications for the conceptualization and treatment of seasonal depression.     

Coping and emotional distress in a sample of Swedish unemployed.

The study investigated the associations between coping and symptoms of emotional distress within a sample of 166 unemployed men and women (mean age 40 +/- 10 years, range 22 to 63 years, 52% males). All variables were measured with a questionnaire comprising sociodemographic background, length of unemployment, financial strain, coping style ("Ways of Coping Checklist"), and emotional distress (Hopkins Symptom Check List-25). Emotional distress was positively related to financial strain and more common among younger subjects, divorced subjects and those with foreign background, but less frequent among subjects who had been unemployed for more than three years. After controlling for age, gender, education, foreign background, length of unemployment and financial strain, hierarchical regression analyses showed that emotion-focused coping, i.e. self-blame and wishful thinking, was positively related to emotional distress. Problem-focused coping and cognitive restructuring were negatively associated with emotional distress. Younger subjects and divorced subjects made frequent use of both emotion-focused and problem-focused coping. Female subject and subjects with mandatory school made frequent use of emotion focused coping, if exposed to high financial strain. Problem-focused coping was less frequent among subjects with a low education coupled with low financial strain. Cognitive restructuring was less common among subjects who had been unemployed for more than three years. Younger subjects who were also divorced made less use of both problem-focused coping and cognitive restructuring. The results confirm that coping style has importance for the mental health of the unemployed, and indicate a differential use of coping strategies among subjects with different sociodemographic backgrounds and different levels of financial strain.     

Moderating Effects of Religious/Spiritual Coping in the Relation Between Perceived Stress and Psychological Well-Being

Although the relationship between stress and depressive symptoms is well documented, less is known about the role of coping strategies, in particular strategies for coping via religious or spiritual means. To investigate the relationships among these factors, data was collected with questionnaires completed by 127 MSW students at a northeastern university in 2003. Significant Stress×Religious/Spiritual Coping buffer interactions were found in the relationship between stress and depression. EQS 6.1 and hierarchical moderated regression analysis showed that religious/spiritual coping reduced the impact of stress on depression. Implications for practice are discussed.     

Perceived utility of emotion: the structure and construct validity of the Perceived Affect Utility Scale in a cross-ethnic sample

This study introduces a new measure of the perceived utility of emotion, which is the degree to which emotions are perceived to be useful in achieving goals. In this study, we administered this new measure, the Perceived Affect Utility Scale (PAUSe), to a sample of 142 European American and 156 East Asian American college students. Confirmatory factor analyses provided support for a new, culturally informed parsing of emotion and for perceived utility of emotion to be distinguishable from ideal affect, a related but separate construct. Next, we explored the potential importance of perceived utility of emotion in cultural research. Through path analyses, we found that: (a) culturally relevant variables (e.g., independence) played a mediating role in the link between ethnic group and perceived utility of emotion; and (b) perceived utility of emotion played a mediating role in the link between culturally relevant variables and ideal affect. In particular, perceived utility of self-centered emotions (e.g., pride) was found to be associated with independence and ideal affect of those same emotions. In contrast, perceived utility of other-centered emotions (e.g., appreciation) was found to be associated with interdependence, dutifulness/self-discipline, and ideal affect of those same emotions. Implications for perceived utility of emotion in understanding cultural factors are discussed.     

The tripartite model and dimensions of anxiety and depression: an examination of structure in a large school sample

This study was designed to build on recent findings that (a) factors of the tripartite model in adults are not uniformly related to all anxiety disorder dimensions as recent research has suggested (T. A. Brown, B. F. Chorpita, & D. H. Barlow, 1998; S. Mineka, D. W. Watson, & L. A. Clark, 1998), and (b) the tripartite model of emotion appears to have increasing support and utility in child samples (e.g., C. J. Lonigan, E. S. Hooe, C. F. David, & J. A. Kistner, 1999). The structural relations were evaluated among tripartite factors and dimensions representing selected anxiety disorders and depression in a large multiethnic school sample of children and adolescents. General aspects of the tripartite model were supported. For example, Negative Affect was positively related with all anxiety and depression scales, and Positive Affect was negatively correlated with the depression scale. Consistent with previous observations in adult samples, Physiological Hyperarousal was positively related with Panic only, and was not significantly positively correlated with other anxiety syndromes. The structure of the best fitting model appeared robust across different grade levels and gender. In follow-up analyses, several interactions of grade level with structural parameters emerged, such that the relation of some of the tripartite factors with anxiety and depression were noted to increase or decrease across grade level.     

The Anxiety Sensitivity Index for Children: factor structure and relation to panic symptoms in an adolescent sample

This study examines the factor structure underlying the Anxiety Sensitivity Index for Children (ASIC. J Anxiety Disord, 12 (1998) 307) in an adolescent sample. Three-hundred-and-eight adolescents, aged 12 to 18, completed the ASIC and measures of anxiety and depression. Factor analysis of the ASIC items resulted in a two-factor structure that is similar to that reported by Laurent et al. These two factors included a physical concerns dimension and a mental concerns dimension similar to those found in studies of adult anxiety sensitivity. Subscales measuring these two factors demonstrated concurrent validity, showing particularly close associations with measures of panic symptoms. In addition, both of these subscales showed incremental validity in predicting panic symptoms after controlling for the other anxiety sensitivity subscale and a measure of depression. These results provide evidence that the anxiety sensitivity construct is applicable during adolescence and support the use of the ASIC.     

Perceived Emotional Intelligence,Stress Reactivity,and Symptom Reports: Further Explorations Using the Trait Meta-Mood Scale

We examined the relationship between perceived emotional intelligence (PEI), measured by the Trait Meta-Mood Scale (TMMS), and psychophysiological measures of adaptive coping. The TMMS assesses perceived ability to (a) attend to moods (Attention), (b) discriminate clearly among moods (Clarity), and (c) regulate moods (Repair). Study 1 showed significant positive associations between PEI and psychological and interpersonal functioning. In Study 2, skill at mood Repair was associated with less passive coping and perceptions of repeated laboratory stressors as less threatening; Clarity was related to greater increases in negative mood, but lower cortisol release during repeated stress. In Study 3, Repair was associated with active coping and lower levels of rumination; Attention was associated with lowered cortisol and blood pressure responses to acute laboratory challenges. These findings suggest that psychophysiological responses to stress may be one potential mechanism underlying the relationship between emotional functioning and health.     

Insomnia in relation to depression and somatic symptoms

A sample of 358 Kuwaiti volunteer college students responded to the Insomnia Scale, the Somatic Symptoms Inventory, and the Center for Epidemiologic Studies-Depression Scale. The only significant sex difference was in somatic symptoms on which women had a higher mean score than the men. Correlations between scores on the Insomnia Scale and both Depression scales were .51 and .54 and for Somatic Symptoms were .53 and .61 (p < .01) among men and women, respectively. The factor analysis of the intercorrelations yielded a highly loaded general factor for Psychological Disorder in both samples.     

Stress and depression of facing death: Investigation of psychological symptoms in patients with mesothelioma

Cancer often results in psychological impairment, and lung cancer has been associated with greater morbidity and higher levels of psychological distress than any other form. Chronic exposure to asbestos is a significant risk factor for development of lung cancer, called mesothelioma. Few have studied the psychological consequences of chronic asbestos exposure and mesothelioma. This study investigated stress and depression symptoms in 49 men (M = 51.1 years, SD = 6.0) diagnosed with mesothelioma. Participants completed traumatic stress, depression and general psychological health questionnaires. All participants reported significant levels of traumatic stress symptoms, which was associated with increased symptoms of depression, anxiety, somatic complaints and social dysfunction. The results provide important suggestions for clinicians treating such terminally ill patients.     

The Yale-Brown Obsessive-Compulsive Scale: Confirmatory Factor Analytic Findings

The psychometric properties of the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) have recently been heavily examined. Specifically, a number of researchers have been interested in determining the factor structure of this scale to find whether it best forms a one, two, or three factor model. The present study continued this examination by considering different scaling models using confirmatory factor analysis with a sample of individuals diagnosed with Obsessive-Compulsive Disorder (OCD). One hundred and forty-six individuals diagnosed with OCD participated and were administered the Y-BOCS and scales measuring depression (Hamilton Depression Rating Scale) and anxiety (Hamilton Anxiety Rating Scale). It was found that the Y-BOCS forms two different two-factor models. One model consisted of an obsessions and compulsions factor; the other composed of disturbance and symptom severity factors. It was likewise found that depression and anxiety were related to both factors in one model (disturbance and symptom severity). The finding that depression was related to obsessions and anxiety to compulsions was found, as in a previous factor analysis of the Y-BOCS. These findings suggest that OCD may be best characterized as a multidimensional syndrome that may not be adequately examined by a single unitary factor as described in the Y-BOCS.     

The Association Between Cardiovascular Stress Responsivity and Perceived Stress Among Subjects with Irritable Bowel Syndrome and Temporomandibular Joint Disorder: A Preliminary Analysis

This study sought to evaluate the association between perceived and cardiovascular stress responsivity among subjects with Irritable Bowel Syndrome (IBS) and Temporomandibular Disorder (TMJ). Eight participants with IBS, eight participants with TMJ and 16 nonsymptomatic comparison participants took part in the experiment. Participants completed a series of personality and mood questionnaires as well as a laboratory procedure measuring aerobic fitness, cardiovascular responses (i.e., pulse rate and blood pressure), and perceived stress while performing stressful laboratory tasks (i.e., the Stroop Color Naming Test and a speech task). Although IBS and TMJ participants did not vary significantly from comparison participants in blood pressure or heart rate during the laboratory procedures, IBS and TMJ participants reported experiencing the laboratory tasks as more stressful than comparison participants. Although preliminary due to the small sample size, results suggest that IBS and TMJ sufferers may be more sensitive to perceived stress than others.     

Quality-of-life assessment in HIV-infected psychiatric outpatients: Perceived health,functional status,symptoms, and preferences for cardiopulmonary resuscitation

Abstract

The current study had two purposes: (1) to describe the reliability and validity of a measure of quality of life (QOL) in HIV-infected psychiatric outpatients, and (2) to predict cardiopulmonary resuscitation (CPR) preferences from disease stage, depression, and other QOL factors. We studied 63 patients, who were seen in one year at an HIV/AIDS psychiatry clinic. The results provide evidence for the validity of our instrument as a measure of health status in an HIV-infected psychiatric population. Overall symptoms were the strongest associates of functional limitations. disability, and perceived health, but depression was also significantly associated with all measures of QOL. Twenty-two patients (35.5%) would not have wanted to be revived if their heart stopped beating the day of the study. Disease stage and poor mental health were independent predictors of this preference, but severity of depression, social support, fatigue, perceived health, functional limitations, and life satisfaction were not.     

Evaluating the impact of a worksite stress management programme for distressed student nurses: A randomised controlled trial

Abstract

The effectiveness of a stress management intervention designed to reduce affective distress in 79 student nurses who previously reported significant distress, was evaluated by comparing stress management with wait-list control. The intervention had reliable, positive effects on affective outcomes including General Health Questionnaire-30, State and Trait Anxiety Inventory, Beck Depression Inventory, and a measure of domestic satisfaction. The intervention also led to an increase in Direct Coping use.

State Anxiety immediately preceding two important examinations, i.e. at 3 and 18 month follow-up, was lower for students receiving stress management. However, no effect was detected on sickness, absence and examination performance following this intervention. Stress management delivered in groups reduces affective distress and increases adaptive coping use in both clinical and academic settings.     

DAPP-BQ: factor structure and relations to personality disorder symptoms in a non-clinical sample

We assessed the factor structure of the DAPP-BQ (Livesley & Jackson, in press), as well as the relations between DAPP-BQ higher- and lower-order personality trait scores and DSM-IV (APA, 2000) personality disorder symptoms in a sample of approximately 300 nonclinical young adults. The four-factor structure of the DAPP-BQ was replicated, and DAPP-BQ higher-order and lower-order scores were related to personality disorder symptoms in predictable ways. Finally, regression analyses revealed that specific DAPP-BQ traits accounted for variance in individual personality disorder scores above and beyond comorbid personality disorder symptoms.     

The nature of clinical depression: symptoms, syndromes, and behavior analysis

In this article we discuss the traditional behavioral models of depression and some of the challenges analyzing a phenomenon with such complex and varied features. We present the traditional model and suggest that it does not capture the complexity of the phenomenon, nor do syndromal models of depression that dominate the mainstream conceptualization of depression. Instead, we emphasize ideographic analysis and present depression as a maladaptive dysregulation of an ultimately adaptive elicited emotional response. We emphasize environmental factors, specifically aversive control and private verbal events, in terms of relational frame theory, that may transform an adaptive response into a maladaptive disorder. We consider the role of negative thought processes and rumination, common and debilitating aspects of depression that have traditionally been neglected by behavior analysts.