The Effect of Experiential Knowledge on Construction of Risk Perception in Hereditary Breast/Ovarian Cancer

The purpose of this study was to explore the connection between experiential knowledge of hereditary breast/ovarian cancer and understandings of personal cancer risk. Using a qualitative research design, the investigator conducted in-depth interviews with 53 individuals (45 female, 8 male) from families at high-risk for hereditary breast/ovarian cancer. Study results showed that two forms of experiential knowledge, empathetic and embodied knowledge, were integral to participants constructions of their cancer risk. They also illustrated that knowledge derived from experience often took precedence over objective clinical estimates of risk. The paper discusses the clinical implications of these findings and suggests that counseling strategies, which expand upon patients lived experience and knowledge of the disease, may enhance communication of genetic risk. Assessment of experiential knowledge promises to suggest new ways to frame genetic information that will enable people to better understand their objective risk or to modify exaggerated and/or inaccurate risk perceptions.     

The belief in a just world and distress at school

This article investigates the relationship between the belief in a just world (BJW) and distress at school. On the basis of just world theory, the authors argue that strong student BJW should be associated with low school distress. Two questionnaire studies with German secondary school students attending grades 7–13 are reported. Both studies found strong BJW to be associated with less distress at school, better grades, and the evaluation of grades and teachers as more just. Moreover, the relationship between strong BJW and low school distress persisted when controlled for grades, justice of grades, and teacher justice. This relationship held for all students, independently of their school track, grade level, or gender. Overall, the pattern of results reveals school distress to have a unique association with BJW and school-specific justice cognitions.     

The role of mindfulness and compassion in early adults' subsequent mental health,coping and compliance with health guidelines during the COVID-19 pandemic: A prospective longitudinal study

The present study explored prospective links between trait mindfulness and compassion on subsequent coping and compliance with Centers for Disease Control (CDC) guidelines and indirect effects via well-being and internalized distress during the COVID-19 pandemic. The study included N = 736 US college students who participated in a three-wave longitudinal study across a single academic year. The first two assessment waves took place in 2018 and 2019, respectively, while the third wave took place in May 2020 during the COVID-19 pandemic. Participants completed self-report measures of trait mindfulness, compassion, well-being, internalized distress, coping, and compliance with CDC health guidelines. Results of a series of autoregressive, cross-lagged panel models revealed that trait mindfulness was associated with better coping via indirect effects of greater well-being and lower internalized distress. Greater compassion was linked with greater adherence to CDC guidelines. Findings suggest that trait mindfulness and compassion may play a role in college students' coping and compliance during the pandemic.     

Perceived COVID-induced racism and contextual predictors of fear and psychological distress among Black men

The present study examined if Black men's perceptions of COVID-induced racism (i.e., the extent to which racism increased during the beginning months of the COVID-19 pandemic) were associated with their reported fear of COVID-19 and psychological distress. Self-report COVID-related variables and psychological distress data from 231 Black men in the U.S. were analyzed alongside archival percentages of confirmed cases and deaths by participants' county at the time of participation. Hierarchical regressions identified perceptions of COVID-induced racism as a significant predictor of Black men's psychological distress over and above contextual (e.g., county-level COVID-19 case %) and individual-level predictors (i.e., perceived race-related infection risk and self-reported COVID-related stressful life events). This work contributes to the growing literature on health inequities during the COVID-19 pandemic with a snapshot of Black men's experiences during the COVID-19 and racism pandemics of 2020 in the U.S.     

Unemployment and Psychological Distress: Mediator Effects

The study concerned possible mediators and moderators in the relationship between unemployment and psychological distress. The sample consisted of 58 unemployed and 177 employed 36-year-old Finnish people drawn from the ongoing Jyväskylä Longitudinal Study of Personality and Social Development. Data were gathered by means of a mailed questionnaire, a semistructured interview, and personality inventories. The results showed that poor economic situation, and poor self-esteem as measured by Rosenberg's Self-Esteem Scale, mediated the relationship between unemployment and psychological distress even after controlling for the prior level of self-esteem. Psychological distress was defined as psychological ill-health (the General Health Questionnaire), depressive symptoms (the General Behavior Inventory), and anxiety (the Karolinska Scales of Personality). However, support was also found for an alternative model, in which depressive symptoms functioned as a mediator between long unemployment and poor self-esteem, suggesting that individuals may react to unemployment in different ways.     

System influences on posthomicide beliefs and distress

Criminal justice system experiences in 150 family members of homicide victims were investigated. The study had two goals: (a) to document the experiences of homicide survivors in the criminal justice system, including case outcomes, criminal justice system activities, and satisfaction with system personnel; and (b) to determine if experiences with the police impacted posthomicide beliefs (cognitive assumptions about the world and one’s relationship to it) and psychological distress. The sample, which was identified through the Medical Examiner’s Office, was drawn from all criminal homicides from 1.5 to 5 years prior to selection. Results showed that family members of homicide victims were very dissatisfied with their experiences in the criminal justice system. Additionally, whereas objective system outcomes (e.g, arrest) did not directly affect posthomicide beliefs and distress, subjective system outcomes (e.g., police satisfaction) directly affected beliefs and indirectly affected distress. There was some support for both equity theory and a cognitive theory of change, the two theories that guided the model specification. This study was funded by a predoctoral National Research Service Award fellowship to Martie Thompson, from the Violence and Traumatic Stress Research Branch at the National Institute of Mental Health. We thank Paula Vardaman for her help with sample recruitment and data collection, Nancy Deore and Kelly Harlan for their help with data collection, and Ann Price for help with data entry. Additionally, we would like to thank Lieutenant Agan of the Atlanta Homicide Division, the staff at the Fulton County Medical Examiner’s Office, and the staff at the Victim Witness Assistance Program for making this study possible by providing access to their files. Finally, we thank Morton Bard for his feedback in quastionnaire development and study design.     

Gender differences in patterns of emotional distress following heart transplantation

The study provides the first empirical evaluation of gender differences in psychological symptomatology and DSM-III-R major depressive disorder (MDD) across the first year following heart transplantation. An important goal was to identify physical health-related and psychosocial factors that could account for, or mediate, any association between gender and psychological distress. The sample for the present analyses was drawn from a larger cohort of 172 heart recipients and included all 28 women in the cohort plus 118 men who were matched demographically with the group of women. Detailed patient assessments were completed at 2, 7, and 12 months posttransplant. As expected, women's symptom levels were consistently higher than men's. However, while men's symptom levels in all areas declined with time posttransplant, women's distress in the area of depression initially improved but then worsened by the 12-month assessment. The distribution of episodes of MDD showed a temporal pattern of gender differences similar to that of depressive symptoms. The most important mediators of the gender-depression relationship were factors related to early posttransplant daily functional limitations: women reported more impairments in daily activities. Higher levels of such impairments, in turn, predicted subsequently higher depression levels by 12 months posttransplant. Several additional variables pertaining to transplant-related concerns and a low sense of personal mastery—while not serving as mediators—exerted their own independent effects on 12-month depression levels. The findings are relevant to the tailoring of educational and clinical interventions to the individual needs of women and men who receive heart transplants.Roberta G. Simmons, Ph.D., died on February 15, 1993, during data collection for this paper.     

The relationship among the transtheoretical model of behavioral change,psychological distress,and diet attitudes in obesity: Implications for primary care intervention

Obesity is prevalent but undertreated in primary care. Family practice volunteer outpatients (N=454) were administered the Stage of Change for Weight (URICA), the Brief Symptom Inventory (BSI), and the Diet Readiness Test (DRT) to assess the relationship between these variables and obesity. The body mass index (BMI) was used to classify obesity revealing 197 patients with elevated BMI's. There was no significant difference between the obese and the nonobese on any of the psychological measures. The obese reported significantly more difficulty setting diet goals and less control over their eating, ate more to emotional situations, and exercised less than the nonobese. The obese sample (46.7%) reported being in the Action stage of change for weight management. Implications for intervention in primary care include targeting attitudes (DRT) and dispelling physician attitudes that obese individuals have increased levels of psychological distress. Addressing Stage of Change for weight management can facilitate tailoring the appropriate intervention when used in concert with the DRT variables.     

Psychopathology and response styles in the SCL-90 responses of acutely distressed persons

Using the responses of 197 suicidal and nonsuicidal patients of a crisis and short-term intervention unit, the item factor structure of the SCL-90 was examined. Results suggested a reduced dimensionality for the checklist rather than supporting the nine scales associated with the instrument's scoring key. The influence of various response styles on the SCL-90's dimensionality was also explored. Although a social desirability response style was strongly related to all SCL-90 subscales and factors, it did not offer a complete explanation for the checklist's apparent unidimensionality. Other explanations relating to methods of test construction and to patients' inability to differentiate symptoms were also preferred. Finally, although subscale scores may facilitate clinical interpretation, it was suggested that the SCL-90 might best be scored as a single index of general symptomatology.We wish to thank G. C. Fekken and R. N. MacLennan for their assistance with this project.This work was supported in part by Social Sciences and Humanities Research Council of Canada Grant 410-85-1043 and by an Ontario Ministry of Health Research Personnel Award.     

Living alone,marital status,gender and health

Non-married people have generally been found to be less healthy than the married. It has been suggested that this difference may be brought about by the greater lack of social integration of those living alone. This hypothesis was tested by comparing the health of those living alone with those living with another person in the four non-married categories of never married, separated, divorced and widowed for women and men separately, initially controlling for age, education and income and subsequently adding five proximate indices of social integration. The person lived with was further categorized as an adult, cohabitee, child aged 4 or under, child aged 5 to 17, adult child, parent, relative or non-relative. The three indices of health were the 30-item General Health Questionnaire of psychological distress. a 15-item checklist of common physical symptoms and alcohol intake. The main differences obtained were that women living alone drank more alcohol than those cohabiting or living with a child aged 4 or under, and that widowers living alone were more psychologically distressed than those living with an adult child, even when social integration was controlled. The results suggested that living alone was not generally associated with poor health and so could not account for the difference between the married and non-married.