Psychological distress in university students: A comparison with general population data

Objective: While the mental health of university students is recognised internationally as an important public health issue, more epidemiological data are needed that allows benchmarking with general population data. Methods: All enrolled students from two large Australian universities were invited to complete a web‐based survey. Anxiety‐mood disorders were assessed using the Kessler 10. A total of 6,479 students participated in the study with sociodemographics generally consistent with the university population. Results: The estimated prevalence for mental health problems was 19.2% with 67.4% reporting subsyndromal symptoms. These rates were significantly higher than the general population. Psychological distress was associated with disability and lower academic achievement. Predictors of distress included: full‐time status, financial stress, being aged between and 18 and 34 years, being female, and in a subsequent undergraduate year of their degree. Conclusions: The extremely high prevalence of mental health problems in university students provides evidence for this being an at‐risk population. Implications: The results highlight the need for universal early interventions to prevent the development of severe mental illness in university students.     

Prevention of marital instability and distress. Results of an 11-year longitudinal follow-up study

Divorce and destructive couple conflict are major risk factors for many forms of dysfunction and psychopathology in the family. Couple relationship education has been offered in an attempt to reduce those risks and enhance couple outcomes. The current effectiveness study had two aims: to assess (a) the long-term effects of relationship education and (b) the ability of partners to remember the skills typically taught during the communication skills training. One hundred and one couples from two studies, in which the effectiveness of the EPL (Ein Partnerschaftliches Lernprogramm für Paare [A Learning Program for Married Couples]) was investigated, were followed-up 11 years after the training. In the first study, EPL-takers had a significantly lower divorce and separation rate (27.5%) than non-EPL-takers (52.6%). This finding was replicated in a second study, showing a 20% dissolution rate in EPL-takers. For those couples still together, the rate of happy relationships was 80% at the eleven-year follow-up - thus, there is optimism for longer married couples who are willing to focus on improving their relationships. Only about 55% of the partners could remember at least one speaker skill whereas 70% remembered at least one listening skill taught during EPL. Consequences for prevention programs in the couple domain are discussed.     

Self-esteem, dispositional optimism, and health: Evidence from cross-lagged data on employees

The aims of this one-year follow-up study among Finnish employees (n=426) were twofold: first, to investigate the relationship between self-esteem and optimism and, second, to examine the prospective relationships between these two personality constructs, mental distress and physical symptoms. The results of Confirmatory Factor Analysis (CFA) showed that the latent variables of optimism and self-esteem were highly interrelated (Time 1, r=.90, Time 2, r=.87), forming the core construct of personal resilience, which turned out to be stable (stability coefficient .86) over the one-year period. The results of Structural Equation Modelling (SEM) indicated that high personal resilience measured at Time 1 reduced mental distress at Time 2. Furthermore, a high level of physical symptoms at Time 1 seemed to predict a high level of mental distress at Time 2.     

Reducing Psychological Distress in a Genetic Counseling Consultation for Breast Cancer

High levels of cancer specific distress have been found before and after genetic counseling for breast cancer. This study investigated the process of reducing distress during 111 genetic counseling consultations for familial breast cancer. Consultations were audiotaped, transcribed, and a detailed coding system developed to measure cues of emotional distress from the patient, and consultant (clinical geneticist or genetic counselor) behaviors before and after the cues. At least 1 emotional cue was given in 64 consultations, with a median of 1 cue per consultation. More emotional cues of distress occurred when the consultant responded empathetically to the first cue of distress. Satisfaction outcomes were largely positive regardless of the consultant's attentiveness to distress. Postconsultation depression scores were significantly reduced if more empathic responses were given, but anxiety remained the same. These results are discussed and recommendations are made for improving patient care.     

Minimal Contact Intervention with Autologous BMT Patients: Impact on QOL and Emotional Distress

Bone marrow transplantation (BMT) is often a last treatment option for individuals who have experienced relapse or treatment failure and is often accompanied by increased levels of distress and reductions in quality of life (QOL). Despite this, few studies have been designed to improve post-BMT QOL and reduce distress. The current study examined the course of distress and QOL in 26 autologus BMT patients and the effect on distress and QOL of providing a minimal contact workbook intervention. Physical well-being decreased following the BMT, but increased at 2- and 6-month follow-up assessments, and distress did not significantly vary over the course of the study for patients in the standard care and workbook intervention groups. Examination of the reasons for the lack of group differences revealed that approximately half of the individuals randomized to the workbook intervention did not look at the material; with those that did reporting higher QOL, decreased anxiety, more adaptive coping, and decreased religiosity. The results argue for the importance of targeting patients at need prior to the transplant procedure, triaging them based on specific characteristics, and providing treatments that match these characteristics.     

Is marriage/cohabitation beneficial for young people? Some evidence on psychological distress among Norwegian college students

Although a large number of studies have examined the association between marital status or cohabitation on the one hand and psychological distress on the other, few have looked specifically at young people. Theoretically, the effects of marriage may be expected to vary with age, and differential selection into or out of marriage/cohabitation may also have different implications at different age levels. This paper uses cross‐sectional data on about 2300 Norwegian college students aged from 19 to 30; for nearly 1000 of these two‐wave panel data are also used. Psychological distress is measured by the General Health Questionnaire (GHQ), and linear regression analysis is used. Cross‐sectional analyses show that among female students marriage/cohabitation is associated with less distress. For male students the association changes with age; in the youngest group, married/cohabiting men are more distressed than those living alone, this is reversed beyond about 23 years of age. The longitudinal analyses show that termination of marriage/cohabitation is associated with increased distress. Going from single living to marriage/cohabitation does not seem to have any effect, however. These results are interpreted as providing some tentative support for social selection effects, and for the stressfulness of terminating a marriage or relationship of cohabitation. Copyright © 2006 John Wiley & Sons, Ltd.     

Relationships with Parents, Spousal Reciprocity, and Psychological Distress in Middle-Age Adults

Data from 301 middle-age couples were employed to investigate links between their recalled parents’ parenting styles and perceptions of reciprocity with their parents, as well as their current perceptions of spousal reciprocity, on their psychological distress. The research extends Baumrind’s theory of childhood parenting styles and Youniss’ theory of late adolescents’ perceived reciprocity to a developmental model for middle-age psychological distress. Differential effects were found according to the gender of both the offspring and the parent. There were significant positive findings only if the opposite-sex parent was perceived as authoritative, and significant negative findings if the same-sex parent was perceived as authoritarian. Regression models indicated mediated, integrated relationships (through maternal and spousal reciprocity) for females, but no mediations were found for males. Significantly more variance in emotional distress was explained by spousal reciprocity than by the parent related variables, and for the men than for the women.     

Positive and Negative: Infant Facial Expressions and Emotions

One path to understanding emotional processes and their development is the investigation of early facial expressions. Converging evidence suggests that although all infant smiles index positive emotion, some smiles are more positive than others. The evidence stems both from the situations in which infants produce different facial expressions and from naive observers' ratings of the emotional intensity of the expressions. The observers' ratings also suggest that similar facial actions—such as cheek raising—lead smiles to be perceived as more positive and lead negative expressions (cry-faces) to be perceived as more negative. One explanation for this parsimony is that certain facial actions are associated with the intensification of both positive and negative emotions.     

An Exercise in Cost-Effectiveness Analysis: Treating Emotional Distress in Melanoma Patients

This study presents a retrospective assessment of a psychological intervention examined for its potential cost-effectiveness if implemented into standard care. It discusses (1) the cost of instituting a psychological intervention for distressed melanoma patients, (2) the effectiveness of that intervention for reducing distress when compared with a standard care group, and (3) the costs of providing the treatment as compared to costs of physician time to answer distress-driven questions as part of standard care. Although the per-minute cost of providing the psychological intervention was marginally greater than standard care, providing the intervention was significantly cheaper in terms of distress reduction. Inclusion of 60% payer reimbursement rates for the intervention further suggested that incorporating a psychological intervention into standard medical care for melanoma patients would potentially generate revenue.     

The Effect of a Brief Mindfulness Training on Distress Tolerance and Stress Reactivity

Poor distress tolerance (DT) is considered an underlying facet of anxiety, depression, and a number of other psychological disorders. Mindfulness may help to increase DT by fostering an attitude of acceptance or nonjudgment toward distressing experiences. Accordingly, the present study examined the effects of a brief mindfulness training on tolerance of different types of distress, and tested whether trait mindfulness moderates the effect of such training. Undergraduates (n = 107) naïve to mindfulness completed a measure of trait mindfulness and underwent a series of stress tasks (cold pressor, hyperventilation challenge, neutralization task) before and after completing a 15-minute mindfulness training or a no-instruction control in which participants listened to relaxing music. Participants in the mindfulness condition demonstrated greater task persistence on the hyperventilation task compared to the control group, as well as a decreased urge to neutralize the effects of writing an upsetting sentence. No effect on distress ratings during the tasks were found. Overall trait mindfulness did not significantly moderate task persistence, but those with lower scores on the act with awareness facet of mindfulness demonstrated greater relative benefit of mindfulness training on the hyperventilation challenge. Mediation analyses revealed significant indirect effects of mindfulness training on cold pressor task persistence and urges to neutralize through the use of the nonjudge and nonreact facets of mindfulness. These results suggest that a brief mindfulness training can increase DT without affecting the subjective experience of distress.