Psychological distress and well-being in advanced cancer: The effects of optimism and coping

This study examined the relations among optimism, coping, functional status, and psychological adjustment in 75 adults diagnosed with cancer. Both the positive and the negative aspects of psychological adjustment were assessed. All participants had been diagnosed with advanced stages of cancer (i.e., Stages II, III, and IV). Participants completed three assessments across a 4-month time period. Both optimism and coping were associated with psychological adjustment, even after controlling for functional status and prior adjustment. Additionally, optimism and coping were differentially related to distress and well-being. Optimism was strongly and positively associated with well-being and inversely related to distress. Escape-Avoidance coping was positively associated with distress and Accepting Responsibility coping was negatively associated with well-being. Comparisons between the current and prior studies indicated that individuals who are diagnosed with more advanced stages of cancer or who have survived bone marrow transplantation exhibit higher levels of optimism than do healthy individuals and individuals with early-stage disease.     

A path analysis of factors associated with distress among first-degree female relatives of women with breast cancer diagnosis.

Patterns and predictors of psychological distress in first-degree female relatives (N = 624) of newly diagnosed breast cancer patients were explored. First-degree female relatives who were high monitors reported greater cancer-specific and general distress than did low monitors. Greater optimism was associated with lower cancer-specific distress. Optimism's effect on general distress was moderated by women's level of monitoring. Greater optimism was associated with lower general distress for both high and low monitors, but the effect was stronger for high monitors than for low monitors. Avoidance and engaged coping were associated with higher distress. A close relationship with the cancer patient was related to higher cancer-specific distress but lower general distress. Further understanding of the process of adjustment in these women awaits longitudinal study.     

Rational beliefs,happiness and optimism: An empirical assessment of REBT's model of psychological health

This study sought to test the validity of the psychological health model of Rational Emotive Behaviour Therapy (REBT). Specifically, this study sought to investigate if rational beliefs were associated with happiness and optimism. A multinational sample of 397 university students completed self‐report measures of rational beliefs, happiness and optimism. Structural equation modelling (SEM) was used in order to test the validity of the REBT model of psychological health. The result of the SEM analysis provided empirical support for REBT's psychological health model of happiness and optimism. The model as a whole explained 33% of variance in levels of happiness and 40% of variance in levels of optimism. Self‐acceptance beliefs were positively and directly associated with happiness and optimism. Preference beliefs were positively and indirectly associated with happiness and optimism via self‐acceptance beliefs. REBT may offer a viable psychotherapeutic method to not only alleviate psychological distress, but also build positive emotion. Current findings may help to bridge the divide between the fields of positive psychology and clinical psychology.     

"Learning to live with what you can't rise above": control beliefs, symptom control, and adjustment to tinnitus.

The relations between 3 types of perceived control, symptom severity, and 2 adaptational outcomes, depressive symptoms and psychological well-being, were examined in a sample of 319 people with tinnitus. Consistent with previous studies of control and adjustment to chronic health conditions, general health and symptom control were associated with better psychological adjustment, and retrospective control was associated with worse psychological adjustment. Only symptom control emerged as a significant moderator in the symptom severity-adjustment relationship, such that stronger beliefs in one's ability to control symptoms were most strongly associated with better adjustment among those with more severe tinnitus symptoms. These findings were consistent with coping perspectives and cognitive adaptation theory and suggest that symptom-related perceptions of control may be an effective coping resource to nurture in chronic health contexts with severe symptoms.     

Severity of homelessness and adverse birth outcomes.

Predictors and the prevalence of adverse birth outcomes among 237 homeless women interviewed at 78 shelters and meal programs in Los Angeles in 1997 were assessed. It was hypothesized that they would report worse outcomes than national norms, that African Americans would report the worst outcomes because of their greater risk in the general population, and that homelessness severity would independently predict poorer outcomes beyond its association with other adverse conditions. Other predictors included reproductive history, behavioral and health-related variables, psychological trauma and distress, ethnicity, and income. African Americans and Hispanics reported worse outcomes than are found nationally, and African Americans reported the worst outcomes. In a predictive structural equation model, severity of homelessness significantly predicted low birth weight and preterm births beyond its relationship with prenatal care and other risk factors.     

The link between religion and spirituality and psychological adjustment: the mediating role of optimism and social support

Although optimism, social support, religiousness, and spirituality are important predictors of adjustment, rarely have studies examined these variables simultaneously. This study investigated whether optimism and social support mediated the relationship between religiousness and adjustment (distress and life satisfaction) and between spirituality and adjustment. Findings indicate that the relationship between intrinsic religiousness and life satisfaction and between prayer fulfillment and life satisfaction was mediated by optimism and social support. Furthermore, the relationship between religiousness and adjustment varied depending on how religiousness was operationalized and whether positive versus negative adjustment indicators were used. That is, intrinsic religiousness and prayer fulfillment were associated with greater life satisfaction, but extrinsic religiousness was not associated with life satisfaction. These findings were significant even after accounting for covariates (age, gender, ethnicity, social desirability). Results suggest religiousness and spirituality are related but distinct constructs and are associated with adjustment through factors such as social support and optimism.     

Asian adolescents’ perceptions of parent, peer, and school support and psychological adjustment: The mediating role of dispositional optimism

This investigation examines the respective contributions of perceived support from parents, peers, and school to the psychological adjustment of 519 thirteen-year-old Asian adolescents from a middle school in Singapore, and the mediating role dispositional optimism plays in these relationships. The findings suggest that positive supportive relationships with parents, peers, and the school are important contextual factors influencing the psychological well-being of these adolescents. Dispositional optimism partially mediates support from each of these three sources and psychological adjustment. Sex differences were noted. This study contributes to a small body of research highlighting the role of a positive mechanism that underpins emotional wellbeing and psychological adaptation in the three developmental contexts that are important in shaping the beliefs, thinking and behavior of the growing Asian adolescent, particularly with respect to girls. Implications arising from this study are discussed. This study was supported by the Academic Research Fund grant (RI 5/04 YLS) from National Institute of Education to Lay See Yeo.     

The relationship between beliefs about emotions and quality of life in irritable bowel syndrome

Suppression of undesirable emotions, as well as beliefs about the unacceptability of experiencing and expressing emotions, have both been shown to be related to poorer health-related outcomes in several clinical groups. Potential models through which these variables relate have yet to be tested in those with irritable bowel syndrome (IBS) and are therefore examined in the current article. Online questionnaires were administered to people with IBS (n = 84) to test a mediation model in which beliefs about the unacceptability of emotions are associated with greater emotional suppression, which in turn relates to increased affective distress and consequently poorer quality of life. An alternate model to test the direction of effect along with two further models using support-seeking as mediators of the same predictor and outcome were also tested. Emotional suppression and affective distress (in that particular order) mediate the relationship between beliefs about emotions and quality of life IBS. The models using support-seeking as mediators of the relationship between beliefs about emotions and the two outcomes were not supported. These findings suggest a role for emotional processing in medically unexplained symptoms and imply the need to address such beliefs about emotions in psychological therapies.     

The Nature and Correlates of Psychological Adjustment in Gay Men with AIDS-Related Conditions1

This study assessed differences in the psychological adjustment of gay men who tested positive for the antibody to the human immunodeficiency virus (HIV). Twenty-one were symptomatic for AIDS, and 27 were asymptomatic. A group of 15 gay men who tested negative for the HIV was included as a comparison group. Men in the three groups were equivalent on demographic variables. Symptomatic men reported more health problems than either asymptomatic or seronegative men. Relative to men who were symptomatic, those who were asymptomatic reported more death anxiety, less optimism, and greater severity of psychological distress, and reported more frequent use of avoidance and distancing as coping strategies. The poor psychological functioning of asymptomatic subjects was attributed to the uncertainty regarding their future health status. Generally, positive psychological well-being of symptomatic and asymptomatic men was related to the infrequent use of avoidance coping strategies and high satisfaction with perceived social support.     

Organization of partner knowledge: relationship outcomes and longitudinal change

This study examined the association between organization of knowledge about a romantic partner (partner structure) and relationship status (ongoing or ended) 1 year later. Ironically, partner structures that were associated with more positive feelings about one's partner at Time 1 were associated with greater rates of breakup by Time 2. These results are interpreted in terms of the vulnerability of compartmentalized partner structures to shifts in the salience of negative beliefs and the hypothesized difficulty of maintaining integrative structures for an extended period of time. Change in partner structure during 1 year's time was consistent with the predictions of the dynamic model that evaluative integration should increase when negative beliefs become salient. Such change (which may represent a transient shift) was associated with couples' longevity when relationship conflict was low, supporting the view that integration reflects a struggle with negative attributes that may or may not be successful.     

Psychological factors and depressive symptoms in ischemic heart disease.

The aim of this study was to determine whether learned helplessness, cognitive distortions, self-efficacy, and dispositional optimism assessed at Time 1 (T1; questionnaires mailed at 1 month postdischarge) would predict depressive symptoms at Time 2 (T2; questionnaires mailed at 1-year follow-up) in a sample of 86 patients hospitalized with ischemic heart disease. Multiple regression results indicated that optimism and cognitive distortions at T1 were significantly associated with T1 depressive symptoms after controlling for confounding variables. When the T1 psychological factors were analyzed with T2 depressive symptoms, only optimism continued to predict depressive symptoms after controlling for confounds and T1 depressive symptoms. The global expectancies that optimism assessed appeared to be more stable over time than the statelike beliefs of cognitive distortions and may have accounted for why optimism predicted T2 depressive symptoms.     

Testing the bidirectional relationship between belief in COVID-19 conspiracy theories and psychological distress: A five-wave longitudinal study

Previous studies have primarily focused on understanding why people believe conspiracy theories, especially during societal crises (e.g., the COVID-19 pandemic). The investigation of how such conspiracy beliefs would influence people's mental well-being has just begun recently. The present research aims to address this crucial question by testing the relationships between psychological distress and COVID-19 conspiracy beliefs with a five-wave longitudinal study. On the one hand, COVID-19 conspiracy beliefs could be more appealing to people with heightened distress, as these theories apparently help people to make sense of the uncertainty and life-threatening disease outbreak. On the other hand, conspiracy theories could be a source of existential threat and thus, would induce rather than reduce psychological distress. We tested these possibilities empirically by a series of cross-lagged model analyses. Using the random intercept cross-lagged panel model analysis, we only found a between-person association but not a cross-lagged within-person relationship between the two. COVID-19 conspiracy beliefs was predicted by being more politically conservative. These findings were further corroborated by the supplementary latent growth curve analyses. Overall, our findings suggest that conspiracy beliefs may not induce or reduce psychological distress in the context of COVID-19.     

Optimism, perceived risk of breast cancer, and cancer worry among a community-based sample of women.

Optimism is frequently inversely associated with distress; however, less is known about the mechanisms underlying this relationship. Optimism can be defined as having a generalized positive expectancy about the future. The authors hypothesized that a specific expectancy might mediate the relationship between optimism and distress. That model was tested using perceived risk of breast cancer as a specific measure of expectancy and cancer worry as a measure of distress in a community-based sample of 1,366 women. It was hypothesized that optimism would be inversely associated with cancer worry and that perceived risk of breast cancer would mediate the relationship between optimism and cancer worry. Multiple regression analyses revealed that perceived risk partially mediated the relationship between optimism and cancer worry.     

Justifying Outcomes Versus Processes: Distributive and Procedural Justice Beliefs as Predictors of Positive and Negative Affectivity

System justifying beliefs can have adaptive consequences for individuals that include enhanced coping and decreased emotional distress. The present study examined whether individual differences in two kinds of system justifying beliefs uniquely predict dispositional affect. Participants from across the United States were recruited via internet to complete dispositional measures of procedural and distributive justice beliefs, and also brief measures of positive and negative affectivity. While belief in fair outcomes (distributive just world beliefs) was generally associated with greater positive affectivity, belief in fair processes (procedural just world beliefs) was modestly associated with decreased negative affectivity. In addition, positive and negative affectivity were predicted by interactions between procedural and distributive just world beliefs, with each accentuating the general emotional benefit provided by the other. Finally, an interactive effect of procedural just world beliefs and social class was obtained for positive affectivity, with greater positive affectivity occurring for disadvantaged (lower income) individuals who had strong procedural just world beliefs. In general, these results suggest the potential for unique and interactive relationships between particular system justifying beliefs and measures of emotion, especially among members of advantaged versus disadvantaged groups.     

Conservatives are happier than liberals, but why? Political ideology, personality, and life satisfaction

Political conservatives are happier than liberals. We proposed that this happiness gap is accounted for by specific attitude and personality differences associated with positive adjustment and mental health. In contrast, a predominant social psychological explanation of the gap is that conservatives, who are described as fearful, defensive, and low in self-esteem, will rationalize away social inequalities in order to justify the status quo (system justification). In four studies, conservatives expressed greater personal agency (e.g., personal control, responsibility), more positive outlook (e.g., optimism, self-worth), more transcendent moral beliefs (e.g., greater religiosity, greater moral clarity, less tolerance of transgressions), and a generalized belief in fairness, and these differences accounted for the happiness gap. These patterns are consistent with the positive adjustment explanation.     

Illness representations and psychological distress in patients undergoing coronary artery bypass graft surgery

Preoperative psychological distress has been shown to predict both postoperative distress and subsequent cardiac morbidity in patients undergoing coronary artery bypass graft (CABG) surgery. This study assessed the associations between illness perceptions and psychological well-being among 56 patients awaiting CABG surgery using the Profile of Mood States (POMS) and the Illness Perception Questionnaire-Revised (IPQ-R). Patient perceptions of their illness as chronic were associated with reduced beliefs in both personal control over illness and efficacy of treatment, and increased perceived consequences of illness in terms of life functioning. In addition, psychological distress regarding illness was significantly correlated with psychological distress in general. Reduced illness coherence was also associated with increased psychological distress. Preoperative psycho-education aimed at helping patients better understand their illness, treatment, and its effects may reduce psychological distress, and perhaps improve future well-being as a result.     

Effects of relationship education on emerging adults' relationship beliefs and behaviors

In this multisite study, we used a randomized controlled trial to examine how a relationship education intervention affected emerging adults' maladaptive relationship beliefs, mutuality, relationship decision making, relationship quality, and psychological distress. In addition, we explored whether one intervention modality (i.e., facilitated group discussion) was more/less effective than another (i.e., self‐facilitated online) and whether there were differential effects for participants in a relationship. We found that the facilitated group evidenced a decline in maladaptive relationship beliefs and an improvement in deliberate decision making. Moreover, facilitated group participants in a relationship reported higher levels of mutuality. Contrary to our hypothesis, there were no changes in relationship quality or psychological distress. Implications for the content and delivery of relationship education for emerging adults are discussed.     

Religious coping,stigma, and psychological functioning among HIV-positive African American women

The present study examined the role of religious coping in psychological distress and adjustment both cross-sectionally and longitudinally among 141 HIV-positive African American women. Cross-sectional analyses showed that negative religious coping was associated with poorer mental health and functioning, and greater perceptions of stigma and discrimination. Longitudinal analyses revealed that greater negative religious coping at baseline significantly predicted greater changes in mental health in a negative direction 12 months later. Positive religious coping was not associated with any measures of psychological well-being, nor did it predict any mental health outcomes at 12 months. However, participants who experienced high levels of HIV-related stigma and reported high levels of positive religious coping were less depressed than those who reported lower levels of positive religious coping. These results suggest that for this population, negative religious coping was a more salient determinant of psychological distress than positive religious coping was of psychological health.     

Trajectories of Adjustment to Couple Relationship Separation

To test a stress‐diathesis model of adjustment to separation, the current study describes the trajectories of different aspects of separation adjustment in people formerly married or cohabiting, and moderators of those trajectories. A convenience sample of 303 recently separated individuals (169 women; 134 men) completed assessments of their emotional attachment to the former partner, loneliness, psychological distress, and coparenting conflict at two time points 6 months apart. Multilevel modeling of the overlapping multicohort design was used to estimate the trajectories of these different aspects of adjustment as a function of time since separation, marital status, gender, presence of children from the relationship, who initiated separation, social support, and anxious attachment. Attachment to the former partner, loneliness, and psychological distress were initially high but improved markedly across the 2 years after separation, but coparenting conflict was high and stable. Adjustment problems were similar in men and women, and in those formerly married or cohabiting, except that reported coparenting conflict was higher in men than women. Low social support and high anxious attachment predicted persistent attachment to the former partner, loneliness, and psychological distress. Coparenting conflict is a common, chronic problem for many separated individuals, and individuals with certain psychological vulnerabilities also experience chronic personal distress.