Stress and depression of facing death: Investigation of psychological symptoms in patients with mesothelioma

Cancer often results in psychological impairment, and lung cancer has been associated with greater morbidity and higher levels of psychological distress than any other form. Chronic exposure to asbestos is a significant risk factor for development of lung cancer, called mesothelioma. Few have studied the psychological consequences of chronic asbestos exposure and mesothelioma. This study investigated stress and depression symptoms in 49 men (M = 51.1 years, SD = 6.0) diagnosed with mesothelioma. Participants completed traumatic stress, depression and general psychological health questionnaires. All participants reported significant levels of traumatic stress symptoms, which was associated with increased symptoms of depression, anxiety, somatic complaints and social dysfunction. The results provide important suggestions for clinicians treating such terminally ill patients.     

Resilience as positive coping appraisals: Testing the schematic appraisals model of suicide (SAMS)

Aims

The Schematic Appraisals Model of Suicide (SAMS) suggests that positive self-appraisals may be important for buffering suicidal thoughts and behaviours, potentially providing a key source of resilience. The current study aimed to explore whether positive self-appraisals buffered individuals from suicidality in the face of stressful life events.

Method

78 participants who reported experiencing some degree of suicidality were recruited from a student population. They completed a battery of questionnaires including measures of suicidality, stressful life events and positive self-appraisals.

Results

Positive self-appraisals moderated the association between stressful life events and suicidality. For those reporting moderate or high levels of positive self-appraisals, raised incidence of stressful life events did not lead to increases in suicidality.

Discussion

These results support the SAMS framework, and suggest that positive self-appraisals may confer resilience to suicide. Positive self-appraisals may be a promising avenue for further resilience research, and an important area to target for suicide interventions.     

生活事件与大学生自杀意念的关系——气质性乐观的调节作用

目的在医学生中探讨气质性乐观、生活事件与自杀意念的关系。方法采用自杀意念自评量表以及乐观问卷、青少年生活事件量表对两所医学院校的800名临床医学专业学生进行调查。结果①应激事件对医学生的自杀意念水平有正向预测作用,应激事件越严重,学生的自杀意念水平越高;②气质性乐观对应激事件与自杀意念之间的关系具有调节作用。结论气质性乐观是负性生活事件与自杀意念之间的调节器。     

压力性生活事件与青少年自尊：被动性社交网站使用和人生意义感的中介作用

采用青少年生活事件量表、被动性社交网站使用量表、生命意义感量表以及自尊量表对605名青少年施测,旨在探讨压力性生活事件对自尊的效应以及被动性社交网站使用和人生意义感的中介作用。结果发现：被动性社交网站使用和拥有人生意义感在压力性生活事件与自尊之间起中介作用,压力性生活事件分别通过被动性社交网站使用、拥有人生意义感的中介作用和被动性社交网站使用与拥有人生意义感的序列中介作用对自尊产生效应。     

Cognitive Social Maturity, Life Change Events, and Health Risk Behaviors among Adolescents: Development of a Structural Equation Model

Purpose: To examine the roles of cognitive social maturity and life change events in a structural equation model (SEM) to explain adolescents' use of marijuana, tobacco, and alcohol. Methods: Data were derived from 1322 9th and 10th graders in a HIV prevention study. Students completed a survey of their cognitive social maturity, recent life events and substance use habits. A model from a study on the metabolic control of adolescents with diabetes was modified to apply to health risk behaviors. Results: A SEM was tested and fit the data well. Lower cognitive social maturity and greater life change events significantly predicted health risk behaviors. Life events partially mediated the relationship between cognitive social maturity and health risk behaviors. Conclusions: Adolescents' social thought processes are related to their recent life events, which in turn are related to their substance use behaviors. Suggestions are made for interventions to improve adolescents' cognitive social maturity.     

Gender Group Differences in Coping with Chronic Terror: The Israeli Scene

Gender group differences in terror–stress, cognitive appraisals, ways of coping with terror, and stress reactions were explored in a sample of Israeli adults following prolonged exposure to political violence. Data were gathered at the height of the Al-Aqsa Intifada uprising (May/July 2002) from a sample of 707 adult participants (60% women and 40% men) residing in Haifa and northern Israel. Israeli women reported that they were more distressed by political violence than the men did, and they also appraised the crisis situation as more threatening and less manageable. Women reported using more problem-focused as well as emotion-focused coping than men did; both men and women used a mixture of coping strategies. Compared to men, women reported that they experienced more somatic symptoms and more frequent posttraumatic stress symptoms than men did. Negative affectivity was found to mediate gender differences in appraisals, coping, and outcomes. Overall, the nexus of relations among key variables was found to be highly similar for men and women. These data suggest that women may be more reactive to chronic political violence situations than men are. The data are discussed and explicated in the context of stress and coping theory and prior research on political violence and community disasters.     

An Intensive Outpatient Program for Veterans With Posttraumatic Stress Disorder and Traumatic Brain Injury

Post-9/11 service members may return from military service with a complicated set of symptoms and conditions, such as posttraumatic stress disorder (PTSD), depression, substance misuse, and traumatic brain injury (TBI), that interfere with reintegration and impair functioning. Although evidence-based treatments that facilitate recovery exist, their successful delivery at a sufficient dose is limited. Barriers to accessing treatment combined with challenges compiling a comprehensive treatment team further delay delivery of effective evidence-based care for PTSD, TBI, and co-occurring mental health conditions. This paper describes the development of a comprehensive, multidisciplinary, 2-week intensive day program for post-9/11 veterans with complex mental health concerns. The treatment program combines skill building groups, family education, and integrative health approaches with evidence-based individual PTSD or TBI care. Initial results from the first 132 participants were notable for a 97% completion rate, as well as statistically significant and clinically meaningful reductions in PTSD, neurobehavioral, and depression symptom severity for the 107 veterans who completed the PTSD track and the 21 who completed the TBI track. These data suggest the intensive program approach is an effective, well-tolerated model of treatment for post-9/11 veterans with PTSD and/or TBI. Future controlled studies should examine the effectiveness of this intensive model compared to standard evidence-based therapy delivery, as well as longitudinal outcomes.     

The relation between low self-esteem and depressive mood in a non-clinical sample: The role of gender and negative life events

The suggestion that self-esteem is both a protective and a risk factor for depression is well documented. However, this association is not consistently observed by empirical research. The current study investigated the main and interactive effects of low self-esteem and stressful life events on depressive mood in a sample of university students (N = 862; female = 72%; black = 67%; mean age = 21.70, SD = 13.51). The students completed the Hopkins Symptom Checklist, the Rosenberg Self-Esteem Scale, and the Perceived Stress Scale. Data were analysed using structural equation modelling (SEM); with stressful life events scores as a mediator, and gender as a moderator, of the relation between low self-esteem and depression. Results indicate that low self-esteem significantly predicted depression, and that stressful life events partially mediated that relationship. Support emerged for the vulnerability effects of low self-esteem on depression and they held across gender groups. Low self-esteem may be a significant indicator of individuals who are at risk for developing depressive mood.     

Durability of Cognitive Behavioral Therapy Effects for Youth and Adolescents With Anxiety,Depression, or Traumatic Stress:A Meta-Analysis on Long-Term Follow-Ups

Cognitive behavioral therapies (CBT) for youth with anxiety, traumatic stress, and depression have demonstrated strong effects in individual studies and meta-analyses. Relatively more attention has been given to posttreatment effects, though, and assessment of follow-up effects has been limited at the meta-analytic level. The current meta-analysis aimed to (a) examine the effects of youth CBT at posttreatment, 1-month, 3-month, 6-month, 1-year, and long-term (2 + years) follow-up as well as (b) identify research-related variables (e.g., measure respondent type) that relate to effects. Using a random effects model across 110 child and adolescent CBT groups, within-group effect sizes were large at posttreatment (g = 1.24) and from 1-month through long-term follow-up (g = 1.23–1.82), and effect sizes did not significantly differ by treatment target (i.e., anxiety, traumatic stress, depression). However, availability of outcome data for effect sizes diminished across later follow-up assessments. Moreover, effect sizes were significantly associated with outcome respondent type across assessment timing, with outcome measures from caregiver and youth respondents associated with smaller effect sizes (B = -0.97, p < 0.001) relative to outcome measures that were evaluator-reported. Results provide initial support for the durability of treatment effects for youth CBTs and highlight the importance of some confounding variables. Implications for improving treatment research standards and prioritizing assessment of long-term follow-up assessment are discussed.     

When Treatment is Traumatic: An Empirical Review of Interventions for Pediatric Medical Traumatic Stress

Pediatric medical traumatic stress (PMTS) is common among injured/ill children and is associated with elevated distress, treatment non‐adherence, and poor health outcomes. As survivorship of life‐threatening pediatric injury and illness continues to increase alongside rapid medical advancements, rates of PMTS and negative sequelae are expected to grow; however, research on prevention and treatment of PMTS is limited. The current study sought to systematically review the literature using a developmental framework to highlight research gaps. Sixteen peer‐reviewed studies were identified via a systematic literature search. Consistent with best practices for treatment of childhood trauma, caregiver involvement and CBT principles served as the foundation for most interventions. All studies reported improvements in PMTS; however, among the most methodologically rigorous, few found statistically superior reductions in PMTS between intervention and control groups. While many studies focused on a specific developmental stage and discussed developmental considerations, others took a “one‐size‐fits” approach. Interventions that demonstrated the most promising findings were online, self‐guided, or time‐limited. Future research would benefit from expanding diversity of participants, continuing to evaluate novel delivery methods, and integrating developmental considerations along with trauma‐informed care (TIC) approaches, given their useful framework for understanding child traumatic stress responses and avenues for prevention and treatment.