Religious Coping, Psychological Distress and Disability Among Patients with End-Stage Pulmonary Disease

A growing body of literature suggests that individuals who face life-threatening situations turn to religion to help them cope. Religion has been cited as the most frequently used resource to cope with stressful events (K. I. Pargament, 1997). The present study was the first to investigate the religious coping methods of patients with lung disease who are awaiting transplant and to identify which coping methods are associated with distress and disability. The study was an exploratory, cross-sectional analysis of 90 patients with end-stage pulmonary disease who were being evaluated for transplant. Results indicated that religiosity was highly prevalent. Patients employed a combination of religious coping efforts, but mostly used coping methods considered positive. Patients with late-onset pulmonary diseases used religious coping strategies more frequently than patients with cystic fibrosis. Hierarchical regression analyses identified a subset of religious coping strategies that predicted 27%, 14%, and 34% of the unique variance in depression, overall disability, and psychosocial disability, respectively.     

A Model of Psychological Distress for Mothers of Children with Attention-Deficit Hyperactivity Disorder

We functionally defined and tested a model of psychological distress for mothers of children diagnosed with Attention-Deficit Hyperactivity Disorder (ADHD). This operationalized model includes three latent constructs which are hypothesized to influence mother's psychological symptomatology: Parenting Stress, Parent Characteristics, and Environment Characteristics. Structural equation modeling was used to reformulate and test the measurement models and the overall model. Data supported a model with some empirically-based model revisions founded on both comparisons of best fit and by an examination of statistical modification indices. The final model maintained the Parenting Stress and Parental Characteristics constructs, but replaced independent environmental variables with a more generalized construct of life stress.     

Role of Secondary Stressors in the Parental Death–Child Distress Relation

This study examined the psychological consequences and secondary stressors associated with death of a parent. The sample (N = 116) consisted of 26 youths who had lost a parent to homicide, 45 youths who had lost a parent to natural death, and 45 nonbereaved youths. Youngsters completed face-to-face interviews, while their guardians completed measures assessing the children's functioning. Results based on both child and guardian reports indicated that parental death was associated with an increase in secondary stressors, regardless of the mode of death. Findings based on guardian reports also revealed that parental death was related to increased internalizing distress, and that parental death due to homicide was related to increased externalizing distress. Furthermore, secondary stressors mediated the parental death–child distress relation such that parental death led to an increase in stressors, which in turn led to increased child distress. Implications for secondary and tertiary preventive interventions are discussed.     

Mother–infant interaction and maternal postnatal psychological distress are associated with negative emotional reactivity among infants and toddlers— A FinnBrain Birth Cohort study

Studies have reported mixed findings regarding the effects of mother-infant interaction and maternal distress on children’s negative emotional reactivity. In the current study (N = 134 and 107), we examined the effects of maternal Emotional Availability (sensitivity, structuring, non-intrusiveness and non-hostility) and maternal psychological distress on negative reactivity among children in the FinnBrain birth cohort study. In addition, the possible moderating effect of mother-infant interaction on the associations between maternal psychological distress and children's negative reactivity was examined. We used questionnaires to asses maternal psychological distress, observations of mother-infant interaction and observations as well maternal reports of child temperament to overcome the key limitations of many studies relying on single-method assessments. Our results showed that higher maternal sensitivity and structuring at 8 months of child’s age were associated with lower mother-reported negative reactivity among children at 24 months. Higher maternal postnatal distress associated with higher parent-reported negative reactivity in children at 12 and 24 months of age when the effects of prenatal distress and the quality of mother-infant interaction were controlled for. Mother-infant interaction and maternal psychological distress did not associate with observations of child negative reactivity. We found no moderation effects of mother-infant interaction regarding the associations between maternal distress and children’s negative emotional reactivity. Our findings reflect the importance of developing interventions to reduce the maternal distress symptoms while enhancing maternal sensitivity and structuring to prevent the possible harmful effects of these on child negative reactivity.     

Acceptance and commitment therapy (ACT) for people with dementia experiencing psychological distress: A hermeneutic single-case efficacy design (HSCED) series

Introduction

People with dementia have a high prevalence of psychological distress but are underserved with evidence-based psychological interventions. To promote choice and improve clinical outcomes, there is a necessity to test different psychological intervention options for this population.

Purpose

This study aimed to investigate the effectiveness and acceptability of acceptance and commitment therapy (ACT) for people with dementia, considering carer-supported, remote delivery and necessary therapy adaptations.

Methods

A hermeneutic single-case efficacy design series was used to analyse the therapy process and change for three clients with dementia and psychological distress. A matrix of quantitative and qualitative data was collated (“rich case records”) and subject to critical analyses by three independent psychotherapy experts (“judges”) who identified change processes and determined the outcome for each client.

Results

Adjudication concluded that one client made positive changes, specifically reliable reductions in psychological distress, which were largely attributable to ACT. Two clients remained unchanged.

Discussion/Conclusion

Where change was achieved, the ACT-specific processes of values, committed action and acceptance, in combination with non-specific therapy factors, including a strong client–carer relationship, existing client interests and individualised therapy adaptations, were facilitative. Hence, ACT may be a feasible and effective vehicle for therapeutic change by helping carers to better meet the needs of their loved ones. Future research to optimise ACT delivery in this population may be beneficial. Furthermore, the assessment of carer factors (e.g., their psychological flexibility and the client–carer relationship) may strengthen the evidence base for systemic ACT use.     

The relationship between wives' estimates of time spent doing housework,support and wives' well-being

This study examines the relationship between the distribution of labour at home and employed women's psychological distress. The distribution of labour at home is measured by wives' estimates of their own and their husbands' time spent doing housework. It is hypothesized that what is more important to women's well-being is their estimates of their husbands' time spent doing housework rather than their own time. It is further hypothesized that one pathway in which wives' estimates of husbands' time spent doing housework influences their well-being is through perceptions of support. In a sample of 153 employed married women, using regression analyses, results are consistent with the predictions made. First, wives' estimates of their husbands' time spent doing housework is a better predictor of their well-being than their estimates of their own time spent. Second, support acts as a partial mediator in this relationship. These findings are discussed with respect to recent work in the area. © 1997 John Wiley & Sons, Ltd.     

Unemployment and Health: Selection Effects

A large number of studies have shown that the unemployed are less healthy, both physically and psychologically, than the employed. The explanation may be that unemployment has negative health effects. An alternative, or additional, explanation is that healthy persons are less likely to become unemployed or more likely to find new employment if they become unemployed. Such effects of health on employment status are generally referred to as selection effects. The present paper analyses to what extent such selection effects are present in the Norwegian labour market. Panel data with observations made in 1989 and 1993 are used. The analyses show that people with psychological problems are more likely to be laid off, and there is also some evidence that psychological or physical health problems may reduce the chances of finding a new job if one has become unemployed. It is of particular interest that these selection effects can be documented for a country like Norway, which has strong legislation supporting worker rights and a quite high degree of unionization.     

Distinguishing Caregiver Strain from Psychological Distress: Modeling the Relationships Among Child, Family, and Caregiver Variables

Although both have been used in studies of the impact of mental illness on the family, the constructs of caregiver strain (often referred to as burden of care) and psychological distress have not been clearly distinguished. The vagueness surrounding these constructs, and the lack of a cohesive conceptual framework for understanding how they relate, leads to contradictory interpretations of results. This compromises the building of the knowledge base needed to develop and evaluate interventions to support families as they struggle to meet the needs of their children with emotional and behavioral challenges. We utilized the ABCX Model as a framework for understanding caregiver strain and its relationship to psychological distress. Structural equations modeling was used to test the hypothesized relationship between caregiver strain and psychological distress, as well as the role of key child and family variables. These included child symptoms, stressful life events, social support, family functioning, and material resources. Our findings indicated that caregiver strain and psychological distress, although related, have distinct correlates and different implications in the family context.