Comparison of the role of self-efficacy and illness representations in relation to dietary self-care and diabetes distress in adolescents with type 1 diabetes

This cross-sectional study examined the joint effects of self-efficacy and illness representations on dietary self-care and diabetes distress in adolescents with type 1 diabetes by comparing two theoretical models: the Self-regulation Model (Leventhal, H., Meyer, D., & Nerenz, D. (1980). The common-sense representations of illness danger. In S. Rachman (Ed.), Medical Psychology (Vol. 2, pp. 7–30). New York: Pergamon.) and Social Cognitive Theory (Bandura, A. (1997). Self efficacy: The exercise of control. New York: W.H. Freeman.). One hundred and fifty-one adolescents with type 1 diabetes completed self-report measures of dietary self-efficacy, illness representations, dietary self-care and diabetes distress. Data were analysed using structural equation modelling. The model best supported by the data (Leventhal's Self-regulation Model) showed that dietary self-efficacy, perceived consequences and treatment effectiveness had direct and independent effects on both dietary self-care and diabetes distress. Together with dietary self-efficacy, perceived short-term treatment effectiveness was a significant predictor of dietary self-care. Age was found to be a negative predictor of short-term treatment effectiveness beliefs. Diabetes distress was best predicted by self-efficacy and perceived consequences. It can be concluded that to target effectively dietary self-care and distress, clinicians should focus on key illness representation variables (perceived short-term treatment effectiveness and perceived consequences) in conjunction with self-efficacy.     

the relationship between pain and coping styles among hiv-positive men and women

Abstract

Pain in HIV/AIDS patients is associated with compromised quality of life and emotional adjustment. Although previous findings support a relationship between coping styles and subjective pain for various groups of chronically-ill persons, little research has examined the associations between coping and pain in HIV-positive or AIDS patients. The purpose of this study was to explore the relationship between pain and coping styles among 105 HIV-positive participants (32 women and 73 men) in a randomized clinical trial designed to examine the effect of group psychotherapy on quality of life and health behavior. Participants completed the Brief COPE, the pain scale from the Medical Outcomes Study-HIV, and a demographic and medical questionnaire. Multiple regression analysis, with pain as the dependent variable, showed that participants who reported coping through denial reported greater pain severity (p < 0.0001). These results suggest that denial as a coping strategy appears to be signficantly associated with pain for persons with HIV/AIDS. However, further research is necessary to determine the causal relationship between pain and coping through denial. These findings also point to the possibility of psychological intervention in order to modify maladaptive coping styles and to ameliorate pain in this population.     

A longitudinal study of psychosocial distress in breast cancer: Prevalence and risk factors

This longitudinal study was conducted among 102 women with non-metastasic breast cancer to identify the time evolution and prevalence of distress at specific times through diagnosis and treatment of disease: preliminary diagnosis, surgery, definitive diagnosis and chemotherapy. Additionally, the study aimed to examine the role of demographic, medical and psychosocial factors on distress. The results indicated that prevalence of distress was higher at initial diagnosis (25%) than the following time points (approximately 17%). The differences inter-individuals in the levels of distress were observed over the four assessments. No relation between distress and demographic and medical factors was found. However, psychosocial aspects were significant risk factors. Patterns of emotional suppression and specific coping responses like helplessness/hopelessness, anxious preoccupation, cognitive avoidance and fatalism were positively related to distress, whereas fighting spirit and perceived social support showed a protective role. Moreover, helplessness/hopelessness and anxious preoccupation jointly predicted 75% of cases and 98% non-cases of distress. Finally, a mediational model between emotional suppression and distress through helplessness/hopelessness was tested. Results support the necessity of routine distress screening all through the illness. Implications of data for psychosocial interventions with breast cancer patients are highlighted.     

Illness perceptions and distress in women at increased risk of breast cancer

Variation in the levels of distress in women at increased risk of breast cancer has been reported, yet there is limited understanding of the factors that are associated with heightened distress in this population. This study took a theoretical approach using Leventhal's Self Regulatory Model (SRM) to understand variation in distress levels. The study examined the associations between perceptions of breast cancer and distress in women at increased risk of breast cancer, and a comparison sample with no experience of the disease in their social environment. Questionnaire data from 117 women at increased risk of breast cancer and 100 comparison women were analysed. Women at increased risk of breast cancer showed comparable levels of general distress but significantly higher levels of cancer specific distress than the comparison group. There were few differences in illness perceptions between the samples, although a number of cognitive perceptions of breast cancer were related to both general and cancer specific distress in the increased risk sample, but not in the comparison sample. The results suggest that the SRM provides a useful framework to explore the psychological response to genetic risk. Further research is required in this population to examine illness perceptions in more detail, validate quantitative measures of illness perceptions, and examine interactions between risk perception and the SRM constructs.     

Predictors of quality of life enjoyment and satisfaction in individuals living with HIV and AIDS in a resource-constrained setting in South Africa

The burden of HIV disease is concentrated in sub-Saharan Africa, particularly in South Africa (SA). Whilst there have been many studies conducted on the biomedical and socio-psychological aspects of HIV and AIDS, insufficient attention has been paid to the quality of life of those infected with the virus. The primary purpose of the study was to determine the predictors of quality of life enjoyment and satisfaction (Q-LES) among individuals infected with HIV. A battery of questionnaires, which included the Hospital Anxiety and Depression Scale (HADS) and the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q), were administered to 121 participants. Data was analysed using SPSS. Of the total sample (n = 121), 74% were females. The study found that a large proportion (49.5%) of the sample within the age group 25–49 years old experienced psychological distress. Those who were not on antiretroviral treatment (ART) were significantly affected (66%). Psychological distress was significantly prevalent among HIV positive individuals and also the strongest predictor of Q-LES among these individuals.     

Therapeutic outcomes in the Welsh Government's school‐based counselling strategy: An evaluation

Aims: The purpose of this study was to evaluate the outcomes of school‐based counselling, as delivered in the Welsh Government's School‐based Counselling Strategy, for reducing psychological distress in young people aged 11–18. Method: The study used a quantitative cohort design, comparing levels of distress on either the Young Person's CORE (YP‐CORE) or the Strengths and Difficulties Questionnaire (SDQ) from baseline to endpoint. Data were available on 3613 episodes of counselling, across 42 datasets. Meta‐analytical procedures were used to identify the mean effect size and predictors of outcomes. Results: Within each dataset, counselling was associated with significant reductions in psychological distress, with a mean effect size (d) of 0.93(95% CI = 0.89–0.97) using a fixed effects model and 1.09 (95% CI = 0.97–1.22) using a random effects model. Datasets using the YP‐CORE had larger effect sizes than those using the SDQ, and datasets with more complete response rates had lower outcomes than those with poorer response rates. Conclusion: The results confirm that school‐based counselling, as delivered in the UK, is associated with significant reductions in psychological distress, comparable to adult counselling and psychotherapy services.     

A Typology of Anger Profiles in Couples

ABSTRACT

Few researchers have attempted to identify couples' anger management profiles. Cluster analysis was conducted using five indices of anger derived from Inventory of Anger Experience in Couples (Laughrea, Belanger, & Wright, 1996). Sample consisted of 220 couples from normal and clinical populations. Four types were identified: (a) Relaxed Couples, (b) Slightly Angry Couples, (c) Explosive Angry Couples, and (d) Dangerously Enraged Couples. Results also indicated that the higher the disturbance of anger dynamics between partners, the more psychologically and maritally distressed they were, and the lower the quality of their coping strategies. Understanding anger and its clinical implication are discussed.     

The relationship between emotional clarity and suicidal ideation among trauma-exposed adolescents in inpatient psychiatric care: does distress tolerance matter?

ABSTRACT

The present investigation examined associations between low emotional clarity (the extent to which individuals are confused about the specific emotions they are experiencing) and suicidal ideation in a diverse sample of trauma-exposed inpatient adolescents, as well as the moderating role of distress tolerance (DT) in this association. Participants (N = 50; 52.0% female; M = 15.1 years, SD = .51; 44% White) completed measures of emotion dysregulation, posttraumatic stress disorder (PTSD), and suicidal ideation/attempts, as well as a behavioral measure of DT. Controlling for age, gender, presence of mood disorder, and past history of attempts, results revealed a significant interaction between DT and low emotional clarity in relation to suicidal ideation. Specifically, lower emotional clarity was related to suicidal ideation at higher, but not lower, levels of DT. Findings suggest that presence of suicidal ideation among traumatized youth with low emotion clarity is most likely when these emotional deficits are coupled with a high tolerance for cognitive/psychological distress. Given that the ability to withstand distress is arguably a key factor in transitioning individuals from ideation to lethal suicidal behavior, attention to the presence of this construct in the context of clinical practice may be warranted.     

Goal disturbance,coping, and psychological distress in partners of myocardial infarction patients: Taking account of the dyad

Abstract

This study aims to explore the relationship between goal disturbance and levels of psychological distress in partners of myocardial infarction (MI) patients. Furthermore, the role of partner and patient coping behaviour in the context of goal disturbance is explored. Forty dyads were interviewed and completed questionnaires 1 month (T1) and 4 months (T2) post MI. All patients were men. Patients and partners do not differ on anxiety or depression scores, however, patients experience significantly more higher order goal disturbance at T1. Partners reporting more goal disturbance also show increased distress at T1. More use of approach coping by partners contributes to explained variance in their goal disturbance. Partner avoidant coping is moderated by patient avoidant coping. Approaches to reduce distress in partners should thus take account of goal disturbance and coping behaviours within the dyad.     

Experimentally testing Taylor's stress,coping and adaptation framework

Abstract

Taylor (1995) constructed a comprehensive framework of stress and adaptation, which considers internal and external resources/impediments as moderators, based on previous studies and models. However, most past research used correlation designs and has not taken into account all of the framework's components within one study. This study tested the effects of the event (minor, major), primary appraisal (benign, severe), coping (problem-focused coping (PFC) versus emotion-focused coping), external resources (with/without social support), and internal impediments (hostility), on estimated distress (dependent variable) in written imagined stressful daily scenarios. All components except hostility were experimentally manipulated within subjects in the scenarios. The scenarios were rated by 281 Dutch students. The variables event, appraisal, and social support significantly and independently affected estimated distress. Event and appraisal synergistically interacted in relation to estimated distress. Finally, appraisal interacted with coping such that the distress-reducing effects of PFC occurred only in benign events, while coping did not affect estimated distress in severely appraised events. This study experimentally tested most components of Taylor's framework, and showed that events, appraisal, and social resources were independent determinants of estimated distress, and that appraisal interacts in a complex manner with the event and with coping.