Does a self management intervention lower distress in woman diagnosed with breast cancer?1

Psychological distress is particularly common with any cancer diagnosis. This paper examined the psychological distress in a cohort of women newly diagnosed with breast cancer and postulates on the underlying theory. A longitudinal study of a cohort of women (n = 147) diagnosed with breast cancer (within the past 1 year), was conducted at University Malaya Medical Centre, Kuala Lumpur. Data were collected at baseline and at post 4‐week intervention. Analysis of variance was conducted to examine for any significant differences in the change‐scores between the experimental group (n = 69) and the control group (n = 78). Using the change scores, analyses of variance showed significant differences between groups for stress, F(1, 140) = 13.68, p < .0001, anxiety F(1, 140) = 8.44, p < .004, and depression, F(1, 140) = 11.57, p < .0001. Levels of stress, anxiety and depression generally decreased significantly in the experimental groups, p < .05, but either maintained or increased in the control group. This study indicates that the level of psychological distress of women with breast cancer can be ameliorated with a 4‐week self‐management intervention. Lower stress levels were also found in women who reported engagement in higher physical activity than women with low physical activity.     

Ethnicity,Coping, and Distress Among Korean Americans,Filipino Americans,and Caucasian Americans

Abstract

The authors examined appraisal, coping, and distress among Korean American, Filipino American, and Caucasian American Protestants. No interaction effects emerged among ethnic groups, but there were significant ethnic main effects for appraisal and coping. Compared with the Caucasian Americans, both Asian American groups appraised stressors as more challenging, and the Korean Americans appraised them also as greater losses. Both Asian American groups reported using more strategies of accepting responsibility, religious coping, distancing, and escape-avoidance than the Caucasian Americans did; the Filipino Americans also reported more problem-solving strategies than the Caucasian Americans. For all participants, challenge appraisals predicted adaptive coping (problem solving and positive reappraisal) and less distress. Problem solving, seeking social support, and positive reappraisal predicted less distress; self-control, accepting responsibility, and escape-avoidance predicted greater distress. The authors stressed the value of assessing ethnicity in coping research.     

Temporal Relationship Between Change in Subjective Distress and PTSD Symptom Decrease During Prolonged Exposure Therapy for Posttraumatic Stress Disorder

There is growing evidence that change in distress is an indicator of change during Prolonged Exposure (PE) for posttraumatic stress disorder (PTSD). However, temporal sequencing studies investigating whether change in distress precedes PTSD symptom decline are lacking. These studies are essential since the timeline between indicators of change and treatment outcome is a key assumption for mediation. The aim of the present study was to assess the temporal relationship between within- and between-session change in subjective distress and PTSD symptom decrease. We analyzed session data from 86 patients with PTSD. Data were analyzed using dynamic panel models. We distinguished temporal effects (within-persons) from averaged effects (between-persons). Results regarding the temporal effect showed that within-session change in subjective distress preceded PTSD symptom improvement while the reversed effect was absent. Averaged within-session change in subjective distress was also related to PTSD symptom improvement. Results regarding the temporal effect of between-session change in subjective distress showed that it did not precede PTSD symptom improvement. Averaged between-session change in subjective distress was related to PTSD symptom improvement. This study provides evidence for within- but not between-session change in subjective distress as indicator of change during PE. We also found that the way of modeling potential indicators of change affects results and implications. We recommend future studies to analyze mediators during treatment using temporal rather than averaged effects.     

Changes in Distress Intolerance and Treatment Outcome in a Partial Hospital Setting

Despite the well-established role of distress intolerance (DI) in a wide range of psychological disorders, few studies have examined whether DI improves during treatment and whether these changes are associated with symptom outcomes. Patients (N = 626) enrolled in a brief cognitive-behavioral partial hospital program completed pre- and posttreatment measures of DI. Results indicated that DI decreased significantly during treatment, with more than 30% of the sample exhibiting a reduction of more than 2 standard deviations from the sample mean. Women reported higher DI than men at baseline; however, there were no gender differences in changes in DI over time. Participants also completed a pre- and posttreatment measure of depression and a subset completed a measure of anxiety (n = 167). DI was associated with more severe depression and anxiety at pre- and posttreatment, with participants who reported a decrease in DI also reporting lower depression and anxiety symptoms at post-treatment. These results further highlight the transdiagnostic relevance of DI and suggest that DI may be a relevant factor in treatment outcome for depression and anxiety.     

A Multifaceted Assessment of Emotional Tolerance and Intensity in Hoarding

Hoarding is characterized by emotionally reinforced saving behaviors, which often combine with excessive acquisition to give rise to clutter, distress, and impairment. Despite the central role emotional processes are thought to play in hoarding, very little research has directly examined this topic. There is suggestive evidence linking hoarding with several facets of emotional intolerance and avoidance, though one key limitation of this past research has been the exclusive reliance on self-report questionnaires. The aim of the current study was to conduct a multimethod investigation of the relationship between hoarding and perceptions of, and cognitions about, negative emotional states. A large unselected sample of nonclinical young adults (N = 213) completed questionnaires, behavioral tasks, and a series of negative mood inductions to assess distress tolerance (DT), appraisals of negative emotions, and emotional intensity and tolerance. Hoarding symptoms were associated with lowered tolerance of negative emotions, as well as perceiving negative emotions as more threatening. Individuals high in hoarding symptoms also experienced more intense emotions during the mood inductions than individuals low in hoarding symptoms, though there was no association with poorer performance on a behavioral index of DT. Across measures, hoarding was consistently associated with experiencing negative emotions more intensely and reporting lower tolerance of them. This relationship was particularly pronounced for the difficulty discarding and acquiring facets of hoarding. Our results offer initial support for the important role of emotional processes in the cognitive-behavioral model of hoarding. A better understanding of emotional dysfunction may play a crucial role in developing more effective treatments for hoarding.     

Perceived Racism as Moderator Between Self‐Esteem/Shyness and Psychological Distress Among African Americans

In the spirit of the mission of social justice in counseling, this study examined perceived racism as a moderator on the association between self‐concept (i.e., self‐esteem, shyness) and distress among African Americans. The authors examined whether perceived racism changed the relationship between self‐esteem/shyness and psychological distress by investigating a sample of 394 African Americans. With a moderation analysis, the authors found significant interaction effects of Self‐Esteem × Perceived Racism and Shyness × Perceived Racism on distress.     

Sense of coherence as a protective factor for psychological distress among gay men: a prospective cohort study

Gay men face a greater risk of psychological distress than heterosexual men, yet research on protective factors among gay men has been limited. This prospective cohort study investigated whether a sense of coherence (SOC), as a form of coping, helps to protect against psychological distress among middle-aged and older gay men. A nationwide online survey was conducted among a baseline sample of 1135 Australian gay-identified men aged 40 years and older, with a follow-up survey 12 months later. SOC was measured using the 13-item SOC Scale. Psychological distress was measured using the K10 Psychological Distress Scale. Hierarchical regressions were conducted, with analyses controlling for several potential risk factors for distress. Over half of participants had moderate or high psychological distress. However, baseline distress was significantly lower among those with stronger baseline SOC. In addition, baseline SOC significantly predicted distress 12 months later. This predictive effect of SOC was independent of baseline distress levels and occurred despite a strong correlation between baseline and follow-up distress. With SOC appearing to be a protective factor, strategies among middle-aged and older gay men that strengthen SOC may assist in the prevention and treatment of anxiety and other psychological distress in this vulnerable population.     

Daily hassles,marital functioning and psychological distress among community-dwelling older couples

ObjectivesThis study attempts to examine the association between stress induced by daily hassles, marital functioning and psychological distress among a sample of older couples living at home without assisted living facilities. Moreover, the study looks to assess the moderator role of marital functioning on the association between stress and psychological distress.MethodsThe study included a representative sample of 508 older couples living at home where at least one spouse was aged 65 years or older. To take into account of the non-independence of the data, dyadic analyses were conducted.ResultsFor men, marital functioning and stress induced by daily hassles explained the variance of psychological distress 4.71% and 2.56% respectively. For women, these variables explained 10.96% and 2.43% respectively of this variance. Results found also that marital functioning can play a protective role between the association of stress and psychological distress among men, but not for women. Men with lower marital functioning present a significant higher level of psychological distress when they present stress than those who do not have stress. For those with high marital functioning, no significant differences have been found on psychological distress between those groups.ConclusionStress induced by daily hassles and marital functioning are significantly related to psychological distress among older people, and, for men, marital functioning can play a protective role in the association between those variables.     

The Dark Night of the Soul: spiritual distress and its psychiatric implications

The Dark Night of the Soul is an expression describing phases in a person's spiritual life associated with a crisis of faith or spiritual concerns about the relationship with God, and which has intrinsic aspects of spiritual growth. This paper is concerned with the way in which those going through periods of angst and disillusionment do not see them as pathological phenomena. On the contrary, through a process of attribution of religious meaning they view them as opportunities for reflecting on their lives and as agents for beneficial change. Similarities and differences between the Dark Night and a depressive episode are discussed and illustrated using the accounts of five important religious figures. Their narratives have been constructed using original texts and their biographies. The Dark Night has clinical implications owing to the risk of its being pathologised, serving as a reminder of the importance of incorporating existential issues into clinical practice.     

An examination of attachment,religiousness, spirituality and well-being in a Baptist faith sample

The purpose of this research was to examine a mediational model of attachment, religiousness and spirituality in predicting well-being in people of Christian faith. One hundred and eighty-five participants were recruited from Baptist churches and 19 from a Baptist-based university. Whereas no support was found for a mediational model of attachment, religiousness and spirituality in predicting well-being, support was found for a path model whereby greater levels of insecure attachment to God were associated with lower levels of religious spirituality (RS). In turn, lower levels of RS were associated with greater levels of emotional distress (ED). Therefore, for this sample of Baptists, having a secure attachment to God was related to an increase in religious behaviours, fulfilment with one's prayer life and belief in a purpose for life. It seems that increases in these religious and spiritual variables are related to less ED. This suggests that heightened connection with God, both through religious behaviours and heightened spirituality, is a beneficial pursuit for people of Christian faith.