The stability and clinical significance of distress: A rejoinder to pepper and coyne

Past research has established that some individuals with high Beck Depression Inventory (BDI) scores at one time point have scores that are lower at a second time point. Recently, we provided evidence indicating that the temporal instability of certain BDI scores may be due partly to the regression to the mean phenomenon. Pepper and Coyne (1996) question this statistical interpretation; they argue that distress among students is unstable for substantive reasons. In the current paper, we reaffirm our view that statistical and measurement factors may account, in part, for changes in BDI scores over time. Given this possibility, inferences about distress or depression as a latent construct in student samples are not warranted if these inferences are based on the administration of a single instrument such as the BDI; any conclusions about distress as a psychological construct must be qualified by acknowledging the possible roles of error and method variance. Clearly, empirical research is needed in order to obtain a better understanding of the nature of distress as a latent variable, especially in light of evidence which indicates that subthreshold levels of depression have a high degree of clinical significance.     

The predictable instability of psychological distress in college students: A comment on Flett,Vredenburg, and Krames

Flett, Vredenburg, and Krames (1995) claim that their data support the view that the apparent instability in distress among college students is artifactual. However, they have merely demonstrated that distress among college students is an unstable phenomena. Their argument that changes in distress scores have statistical rather than substantive explanations erroneously assumes that instability in distress scores is equivalent to error of measurement.     

Modelling change in self-narratives and embodied experience: A multicase study and autoethnography

The article documents a multicase study of the researcher’s own clinical work with four clients who each presented with embodied expressions of distress. The researcher practised within a ‘narrative-dialogical’ framework and set out to build theories of therapeutic change. However, a parallel thesis emerged during the project: an autoethnographic account in which the researcher’s uses of supervision, personal therapy, dreams and life events capture data on the ways in which the therapist’s theories of change are modelled in the therapeutic space—with varying degrees of confidence and success. Sessions were audio-recorded and coded for qualitative markers indicating the emergence of novel self-narratives. A reflexive narrative running throughout the work highlights the superordinate role of reflexivity in theory development. Therapeutic change was typified by an evolving internalised map of self and world, with corresponding change in embodied experience. The article highlights techniques deployed by the therapist in highlighting and building upon moments of innovation with the therapeutic process. As an analysis of one therapist’s practice and the experiences of their clients, the study generates theories for ongoing exploration and study. The continuous evolution of change concepts reflects the theory-building work of clinicians in their everyday practice. The study highlights the use of self as research instrument and offers a candid and intimate example of how practitioner research might be structured and delivered.     

Mindfulness and Forgiveness Buffer Distress: Associations With Interpersonal Transgression Blameworthiness

This study examined psychopathological symptom outcomes in victims of interpersonal transgressions (IPTs) based on differences in offender blameworthiness attributions. Mindfulness and forgiveness were hypothesized to serve as protective factors against depression, anxiety, and stress symptoms. The results highlight the buffering influence of dispositional mindfulness and forgiveness on symptoms of depression, anxiety, and stress. These results provide initial evidence that mindfulness‐ and forgiveness‐based procedures may have beneficial therapeutic outcomes for individuals who experience psychopathology as the result of IPTs, specifically IPTs deemed intentional by the victim.     

Do emotional stimuli enhance or impede recall relative to neutral stimuli? An investigation of two “false memory” tasks

Many eyewitness memory situations involve negative and distressing events; however, many studies investigating “false memory” phenomena use neutral stimuli only. The aim of the present study was to determine how both the Deese–Roediger–McDermott (DRM) procedure and the Misinformation Effect Paradigm tasks were related to each other using distressing and neutral stimuli. Participants completed the DRM (with negative and neutral word lists) and viewed a distressing or neutral film. Misinformation for the film was introduced and memory was assessed. Film accuracy and misinformation susceptibility were found to be greater for those who viewed the distressing film relative to the neutral film. Accuracy responses on both tasks were related, however, susceptibility to the DRM illusion and Misinformation Effect were not. The misinformation findings support the Paradoxical Negative Emotion (PNE) hypothesis that negative stimuli will lead to remembering more accurate details but also greater likelihood of memory distortion. However, the PNE hypothesis was not supported for the DRM results. The findings also suggest that the DRM and Misinformation tasks are not equivalent and may have differences in underlying mechanisms. Future research should focus on more ecologically valid methods of assessing false memory.     

The buffering effect of family functioning on the psychological consequences of headache

The current study aimed to examine whether high family functioning mitigates the association between headache intensity and distress. The sample consisted of 124 patients with chronic or recurrent headache. Patients completed validated questionnaires about headache intensity, family functioning, and distress. Hierarchical regression analyses were performed to examine the interaction between headache intensity and family functioning on distress. Headache intensity was positively associated with distress (r = .28, p = .002). As hypothesized, family functioning moderated this association (B = ?.01, p = .023). More specifically, the positive association between headache intensity and distress was significant only among patients with lower family functioning (B = .01, p < .001) and not among patients with higher levels of family functioning (B = .006, p = .075). Functional families appear to buffer the distress level in patients; they showed relatively low levels of distress regardless of the severity of their headache. In contrast, patients with dysfunctional families who experienced more pain reported more distress, presumably because they did not receive adequate help and support from these families. This study underlines the importance of a broader perspective on family dynamics in coping with pain.     

Psychological distress and coping in nasopharyngeal cancer: an explorative study in Western Europe

Nasopharyngeal carcinoma (NPC) is the head and neck cancer with the greatest impact on patients’ quality of life. The aim of this explorative study is to investigate the psychological distress, coping strategies and quality of life of NPC patients in the post-treatment observation period. Twenty-one patients disease-free for at least two years were assessed with a medical and a psycho-oncological evaluation. Clinically relevant depressive symptoms (CRD) were present in 23.8% of patients and 33.3% reported clinically relevant anxiety symptoms (CRA). Patients with CRD and CRA showed a significantly higher score in the use of hopelessness/helplessness and anxious preoccupation coping strategies and a worse quality of life. Even in the post-treatment period, about a quarter of patients showed CRD and CRA. Results showed that patients with high anxiety or depressive symptoms seem to use dysfunctional coping strategies, such as hopelessness and anxious preoccupation, more than patients with lower levels of anxiety and depression. The use of these styles of coping thus seems to be associated to a higher presence of CRA or CRD symptomatology and to a worse quality of life.     

Maternal Childhood Sexual Trauma and Early Parenting: Prenatal and Postnatal Associations

Existing research suggests that approximately 19% of females experience childhood sexual trauma (CST). Little is known, however, about the parenting behaviour of mothers who have experienced CST. Using propensity‐matched controls, the present study examines prenatal psychosocial distress, postnatal depressive symptomatology, and caregiving behaviours of women reporting CST at or before the age of 14. Data for these analyses were obtained from mother reports and from observational protocols from a longitudinal study of low‐income, rural families. Propensity score methodology was used to create a contrast group matched on family of origin variables in an effort to isolate and examine the long‐term associations of CST beyond the effects of other childhood adversities such as poverty. Study findings provide evidence that women with CST histories report greater prenatal psychosocial distress compared to women without trauma histories. Findings further provide evidence for a spillover process from prenatal distress to the broader caregiving system including less sensitive parenting through postnatal depressive symptoms for women with CST histories. These results highlight the importance of screening for CST and psychosocial distress and depression prenatally. Interventions for women with CST histories and directions for future study are proposed. Copyright © 2016 John Wiley & Sons, Ltd.     

Identity Problems,Ego Strengths,Perceived Stress,and Adjustment During Contextual Changes at University

We present a 2-year time-lag study in which Canadian and Spanish students’ perceptions of stress, identity problems, and psychosocial maturity (ego strengths) were examined in relation to academic, social, and personal-emotional adjustment to university under different conditions of macro-environmental disruption (i.e., academic and economic) and no disruption (stability). In the academic disturbance context, students reported increased stress and the economic disruption situation was associated with greater identity problems. The expected relationships were found among the variables in the study. Students reported greater social maladjustment at university related to economic disruption in comparison with the academic and no disruption contexts. Ego strengths moderated the relationship between perceived stress with academic and social adjustment, respectively. In other words, delayed psychosocial development in conjunction with high perceived stress was associated with deficient academic and social functioning at university. The findings are considered in terms of psychosocial development and the role of proximal and distal perception of stressors in the functional well-being of university students.