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ObjectivesIncreasingly diverse caregiver populations have prompted studies examining culture and caregiver outcomes. Still, little is known about the influence of sociocultural factors and how they interact with caregiving context variables to influence psychological health. We explored the role of caregiving and acculturation factors on psychological distress among a diverse sample of adults.DesignSecondary data analysis of the California Health Interview Survey (CHIS).ParticipantsThe 2009 CHIS surveyed 47,613 adults representative of the population of California. This study included Latino and Asian American Pacific Islander (AAPI) caregivers and non-caregivers (n = 13,161).MeasurementsMultivariate weighted regression analyses examined caregiver status and acculturation variables (generational status, language of interview, and English language proficiency) and their associations with psychological distress (Kessler-6 scale). Covariates included caregiving context (e.g., support and neighborhood factors) and demographic variables.ResultsFirst generation caregivers had more distress than first-generation non-caregivers (β=0.92, 95% CI: (0.18, 1.65)); the difference in distress between caregivers and non-caregivers was smaller in the third than first generation (β=-1.21, 95% CI: (-2.24, -0.17)). Among those who did not interview in English (β=1.17, 95% CI: (0.13, 2.22)) and with low English proficiency (β=2.60, 95% CI: (1.21, 3.98)), caregivers reported more distress than non-caregivers.ConclusionsNon-caregivers exhibited the "healthy immigrant effect," where less acculturated individuals reported less distress. In contrast, caregivers who were less acculturated reported more distress.

Recent clinical trials have found that the serotonergic psychedelic psilocybin effectively alleviates anxiodepressive symptoms in patients with life-threatening illnesses when given in a supportive environment. These outcomes prompted Canada to establish legal pathways for therapeutic access to psilocybin, coupled with psychological support. Despite over one-hundred Canadians receiving compassionate access since 2020, there has been little examination of these real-world patients. We conducted a prospective longitudinal survey which focused on Canadians who were granted Section 56 exemptions for legal psilocybin-assisted psychotherapy. Surveys assessing various symptom dimensions were conducted at baseline, two weeks following the session (endpoint), and optionally one day post-session. Participant characteristics were examined using descriptive statistics, and paired sample t-tests were used to quantify changes from baseline to the two-week post-treatment endpoint. Eight participants with Section 56 exemptions (four females, Mage = 52.3 years), all with cancer diagnoses, fully completed baseline and endpoint surveys. Significant improvements in anxiety and depression symptoms, pain, fear of COVID-19, quality of life, and spiritual well-being were observed. Attitudes towards death, medical assistance in dying, and desire for hastened death remained unchanged. While most participants found the psilocybin sessions highly meaningful, if challenging, one reported a substantial decrease in well-being due to the experience. These preliminary data are amongst the first to suggest that psilocybin-assisted psychotherapy can produce psychiatric benefits in real-world patients akin to those observed in clinical trials. Limited enrollment and individual reports of negative experiences indicate the need for formal real-world evaluation programs to surveil the ongoing expansion of legal access to psychedelics.

Abstract: Identifying and promoting students’ social-emotional strengths is essential in building their mental health. Covitality, representing the co-occurrence of psychological strengths, is a helpful framework for characterizing students’ well-being. This study used latent profile analysis to identify adolescents’ (n = 11,217; 50.3% female, 37.8% male; grades 9 [33.7%], 10 [21.0%], 11 [28.9%], and 12 [16.5%]) covitality patterns across 12 social-emotional health domains. We investigated whether student demographic characteristics (i.e., sex, parent educational attainment, ethnic identification) were related to profile membership. We further examined profiles’ relations to students’ proximal academic and mental health outcomes, including self-reported grades, school connectedness, life satisfaction, and psychological distress. Four covitality profiles were identified—High, Moderate-High, Moderate-Low, and Low. Profile membership was statistically significantly related to students’ sex and socioeconomic circumstances but with small effect sizes. We identified consistent differences across covitality profiles on student self-reported proximal outcomes. Overall, students in profiles with higher covitality levels (High and Moderate-High) reported (a) higher grades, school connectedness, and life satisfaction and (b) less psychological distress, with students in the High profile reporting the most favorable outcomes. Assessing students’ strengths and providing interventions focused on building strengths across domains are recommended.

BACKGROUND: Shortness of breath occurs in 10%-70% of oncology patients. Very little is known about interindividual variability in its severity and distress and associated risk factors. Using latent profile analyses (LPAs), purpose was to identify subgroups of patients with distinct severity and distress profiles for shortness of breath as single symptom dimensions. In addition, a joint LPA was done using patients severity AND distress ratings. For each of the three LPAs, differences among the shortness of breath classes in demographic, clinical, symptom, stress, and resilience characteristics were evaluated. METHODS: Patients completed ratings of severity and distress from shortness of breath a total of six times over two cycles of chemotherapy. All of the other measures were completed at enrollment (i.e., prior to the second or third cycle of chemotherapy). Separate LPAs were done using ratings of severity and distress, as well as a joint analysis using severity AND distress ratings. Differences among the latent classes were evaluated using parametric and nonparametric tests. RESULTS: For severity, two classes were identified (Slight to Moderate [91.6%] and Moderate to Severe [8.4%]). For distress, two classes were identified (A Little Bit to Somewhat [83.9%] and Somewhat to Quite a Bit [16.1%]). For the joint LPA, two classes were identified (Lower Severity and Distress [79.9%] and Higher Severity and Distress [20.1%]). While distinct risk factors were associated with each of the LPAs, across the three LPAs, the common risk factors associated with membership in the worse class included: a past or current history of smoking, poorer functional status, and higher comorbidity burden. In addition, these patients had a higher symptom burden and higher levels of cancer-specific stress. CONCLUSIONS: Clinicians can use the information provided in this study to identify high-risk patients and develop individualized interventions.

Introduction: The experience of cancer among relatives is characterized by an increase in anxiety and depression, stress, and a reduction in quality of life. However, there is a paucity of psychosocial support programmes for relatives and a dearth of evidence-based, manualized interventions. Accordingly, the present study aims to assess the acceptability, defined as participant drop-out and satisfaction, and feasibility, in terms of mental health improvement, of a novel manualized psycho-educational group intervention. Methods: The manual was developed on the basis of previous research into psychotherapy. A total of 33 relatives of cancer patients were recruited from the West German Tumor Center and participated in the five modules of the RELIEVE treatment which included an introduction, communication skills, stress and anxiety management and self-care. The primary outcome was assessed using a range of measures, including anxiety (GAD-7), depression (PHQ-8), stress (PSQ), self-efficacy (SES), need for support (SCNSP&C-G), and quality of life (WGOQOL-BREF) before and after the completion of the treatment programme. A paired samples T-test was employed to assess the feasibility of the treatment, with pre- and post-scores being compared. The secondary outcome of treatment acceptance was evaluated by calculating the drop-out rate and scoring a treatment satisfaction questionnaire. Results: A high level of satisfaction was reported by participants. The drop-out rate for the treatment was minimal, at only 2.86%. Following the completion of the treatment programme, there were significant improvements in anxiety, depression and stress scores, as well as an improvement in quality of life. No significant improvements were observed in self-efficacy, work and social security needs, and quality of life in the social relationships domain. Discussion: The RELIEVE intervention demonstrated high feasibility and acceptance among emotionally affected relatives of cancer patients, addressing a gap in previous interventions that were often limited in scope and lacked standardised manuals. Conclusion: This feasibility study on treatment acceptance underlines the importance of measures that are tailored to the specific needs of cancer patients' relatives, and of integrating them into the general healthcare system. [ABSTRACT FROM AUTHOR]

Background: Research on achieving a good death for terminally delirious patients is scarce, with limited knowledge about the level of good death and influencing factors. This study investigates the level of good death among delirium patients, factors influencing it, and the correlation between distress, end-of-life care needs, and achieving a good death by surveying bereaved family members of deceased patients in Chinese hospitals. Methods: This cross-sectional study from January 2022 to January 2024 was conducted among bereaved family members of patients using an online questionnaire. The questionnaires consisted of (1) participants' demographic and disease-related questionnaires; (2) the Good Death Inventory (GDI) China version; (3) Terminal Delirium-Related Distress Scale (TTDS) China version; (4) the Care Evaluation Scale - short form (CES) China version. All data were analyzed using descriptive statistics, and the associated factors influencing good death were analyzed by multiple linear regression analyses. Result: A total of 263 subjects were enrolled. More males (63.5%) participated than females (36.5%), the mean age was 75.35 ± 13.90 years. Good quality of death was significantly and negatively related to the distress in patients with irreversible terminal delirium (r = -0.458, P<0.01).The multiple linear regression model indicates that TDDS score, CES score, types of diseases, smoking history, nutritional deficiency are important factor affecting the good quality of death. Conclusions: The good quality of death from the perspective of bereaved family, a negative correlation was found between the distress in patients with irreversible terminal delirium and good death. Medical staff should be more aware of good quality of death in patients, future research should expand sample sizes to include more demographic data, and explore the concept of a good death across different cultural contexts. [ABSTRACT FROM AUTHOR]

Abstract:Introduction: Informal caregiving can lead to burnout. The relationship between burnout and negative states has been the subject of extensive research. This study analyzes the mediation role of a positive psychological variable – the quality of the carer-patient relationship – between psychological distress and informal carers' burnout. Methods: We recruited Portuguese informal carers of adult cancer patients online (N = 92) to answer the Quality of Carer-Patient Relationship Scale gauging relationship quality, the Depression, Anxiety, and Stress Scales assessing psychological distress, and the Maslach Burnout Interview-Human Services Survey evaluating the dimensions of burnout, depersonalization, emotional exhaustion, and reduced personal accomplishment. The cross-sectional data were analyzed through descriptive statistics, correlations, multiple regressions, and simple mediation analysis. Results: Our results show that psychological distress variables directly affect burnout dimensions, and that relationship quality has a significant indirect effect on each burnout dimension, suggesting that relationship quality partially mediates the association between each distress dimension – depression, anxiety, and stress – and each of the burnout components – depersonalization, emotional exhaustion, and personal accomplishment. Discussion/Conclusion: This study underscores the importance of intervening in informal caregiver mental health and patient-caregiver relationships and encourages further investigation into the dynamics of the studied variables. [ABSTRACT FROM AUTHOR]

Background: Serum C-reactive protein (CRP) levels are correlated with patient outcomes in cancer. This study aimed to determine associations between the CRP level and the dietary intake, symptoms, and eating-related distress (ERD). Methods: We conducted a multicenter survey among advanced cancer patients. Information on patient characteristics was retrieved from the electronic medical records. Data on patient outcomes were obtained through the questionnaire. Patients were categorized into the low CRP group (<5 mg/dL) and the high CRP group (≥5 mg/dL). Comparisons were calculated using the Mann–Whitney U test or chi-squared test. To assess associations between CRP levels and ERD, multivariate logistic regression analysis was performed. Results: A total of 191 patients were enrolled and divided into the low CRP group (n = 117) and the high CRP group (n = 74). The high CRP group had a more reduced dietary intake (p = 0.002) and more severe appetite loss (p = 0.008). The total scores of the ERD questionnaire (both the long and short versions) were significantly higher in the high CRP group (p = 0.040 and 0.029). The high CRP group also had significantly higher risks for ERD, as assessed using the long and short versions of the questionnaire (odds ratio [OR] 2.13, 95% confidence interval [CI] 1.10–4.11; OR 2.06, 95% CI 1.05–4.05). Conclusions: High CRP levels were significantly associated with reduced dietary intake, appetite loss, and ERD. A serum CRP value of 5 mg/dL may be a useful indicator for initiating cancer cachexia care. [ABSTRACT FROM AUTHOR]

Background: Psychological distress impacts 35–40% of cancer patients, significantly affecting their quality of life, treatment adherence, and relationships with healthcare professionals. Given this, there is a critical need to enhance nursing competencies to effectively monitor and address psychological distress. Previous studies have highlighted discrepancies in capabilities based on nurses' training status, emphasizing trained nurses' critical role in providing appropriate psycho–social referrals. Objective: To evaluate the impact that trained nurses have on the detection of distress and the timely referral of patients for a psycho–oncology consultation. Methods: A blinded, random, descriptive, monocentric pilot study was conducted. The participants were adult patients in Day Hospital 1 of the National Cancer Institute Regina Elena, Rome, irrespective of illness stage. Tools used included a socio-demographic and clinical data form, distress thermometer (DT), and visual analogic scale (VAS). Patients were randomly divided into two groups: Group A, where questionnaires were administered by trained nurses, and Group B, where non-trained nurses administered questionnaires. Nurses indicated whether patients needed a psycho–oncology consultation. All patients were then seen by a psycho–oncology specialist to determine whether the nurse's referral was appropriate. Patients and psycho–oncologists were all unaware of the nurses' training status. The effectiveness of the training was measured by the degree of agreement between evaluators. Results: This study involved 20 patients and four nurses. The average DT score was 5, mainly related to physical and emotional problems. Agreement between evaluators was higher in the trained nurses' group. Conclusions: Specific training on DT enabled nurses to acquire advanced skills to accurately refer patients for psychological consultations. [ABSTRACT FROM AUTHOR]

Background: Access to essential and emergency newborn care services remains a challenge in low- and middle-income countries (LMICs), especially in rural and remote areas where various factors increase maternal and newborn vulnerability. The scarcity of midwives on a global scale further strains obstetric and neonatal services, as midwives work at the forefront in many LMICs. In Ghana, neonatal deaths at birth and within 24 h contribute significantly to infant mortality rate, with midwives caring as frontline health workers. However, there is limited exploration of midwives' experiences in managing these situations. This study aimed to unveil the meanings and articulate the experiences of midwives who face newborns with respiratory distress at birth in rural southern Ghana. Methods: Interpretive Phenomenological approach was used to explore thirteen (13) midwives' experiences of managing newborns in respiratory distress in rural birth settings amidst scare life saving resources, skilled staff shortage and limited advanced health care. The midwives were purposively sampled from the Shai-Osudoku district and data were collected through face-to-face interviews. Content analysis was conducted on the interview transcripts and rich narratives developed in the research report. Results: Rural midwives have limited access to newborn lifesaving equipment, adequate training, skill staff support, and timely advance care for newborns. These issues are driving factors for newborn referral in rural health care, but transportation gaps impede timely advance care delivery. Rural midwives' inadequate psychosocial support and lack of enabling work environment engender moral distress with emotional burden requiring sustained attention from national leadership, as well as midwifery professional networks and regulatory bodies. Conclusion: Newly qualified midwives require sustainable support as they struggle in birth spaces where ethical questions emerge as family members are engaged as support persons in neonatal resuscitation. Future research is needed to investigate Chiefs, Queen Mothers and Community Elders' engagement in community-based interventions to support timely access to quality care and midwives' heroic practices of saving maternal/newborn lives in rural Ghana to help achieve SDG 3.2. [ABSTRACT FROM AUTHOR]

Background: Gliomas, the most common primary brain tumours, are classified based on histology and molecular genetics. Glioblastomas (GBM) are highly aggressive and are graded as WHO grade 4, while astrocytoma and oligodendrogliomas fall under WHO grades 2-3 (4). Gliomas affect 6 per 100,000 people, with a higher incidence in men. GBM has the poorest prognosis, whereas grade 2 astrocytoma and oligodendrogliomas show better outcomes. Quality of life (QoL) is now a crucial therapeutic goal alongside survival. Despite the impact of gliomas on QoL, especially given their incurability and progressive neurological deficits, research specifically comparing QoL and psycho-oncological stress in GBM versus grade 2 gliomas (glioma_2) remains limited. This study aims to fill that gap using validated measurement methods. Methods: This retrospective, single-centre study investigated differences in QoL among neuro-oncological patients using the Karnofsky Performance Score (KPS), Distress Thermometer (DT), Hospital Anxiety and Depression Scale (HADS), and EORTC-QLQ-C30-BN20. Data were collected before chemotherapy or radiotherapy to avoid therapy impact on QoL. Out of 2258 patients screened until June 30, 2022, 639 had glioblastoma or WHO grade 2 gliomas, with 223 meeting inclusion criteria for analysis. Results: The study included 161 GBM and 62 Glioma_2 patients, with 64% of all patients being male. The mean age was 58.11 years (SD ± 16.186). The DT did not show significant differences between GBM and glioma_2 glioma patients (median GBM:6 vs. 5 in glioma_2, p=0.480). However, the HADS-D indicates that GBM patients experience significantly more depression (median GBM 4.5 vs. 4 in glioma_2, p=0.033), though anxiety levels are similar in both groups (median GBM. 6 vs. 6 in glioma_2, p=0.867). The KPS (median GBM 70 vs. 90 in glioma_2, p<0.001) and specific aspects of the EORTC-QLQ-C30-BN20 questionnaire demonstrate that GBM patients have notably greater physical impairments than glioma_2 patients at diagnosis. Overall, GBM patients report worse quality of life compared to glioma_2 patients (median GBM 50 vs. 67 in glioma_2, p<0.001). Conclusion: This study showed that distress is present in glioma patients regardless of their histopathological grading, even though GBM patients show higher depression levels and more physical limitations. Targeted anxiety management and early depression screening are essential for all glioma patients. Early QoL screening and making QoL a therapeutic goal benefits patient care and society. [ABSTRACT FROM AUTHOR]

Objectives: To examine the role of purpose in life in a sample of patients with Parkinson's disease and its correlations with well-being, quality of life, psychological distress, and motor function; and to compare patients reporting higher versus lower levels of purpose in life. Method: 59 patients completed the Purpose in Life subscale Scales and other questionnaires concerning quality of life, personal well-being, and psychological distress. Their motor function was assessed with the Short Physical Performance Battery. They were divided into (1) High purpose in life individuals—HPIL—(n = 23); (2) Low purpose in life individuals—LPIL—(n = 36). Bivariate correlations between questionnaires and ANOVA between-group were calculated. Results: Purpose in life was significantly and positively correlated to well-being, quality of life and motor function, and negatively to psychological distress. After controlling for age, gender, marital status, years from diagnosis and dopamine medication, HPIL individuals reported significantly higher levels of well-being, quality of life, better physical functioning and lower distress. Discussion: Purpose in life is strongly associated with mental well-being and motor function in patients with Parkinson's disease. These findings suggested the importance of developing interventions to promote purpose in life also in this population. [ABSTRACT FROM AUTHOR]

Medical practice exposes physicians to numerous stressors, leading to high rates of psychological distress and burnout, a problem that begins during medical school. Scientific evidence suggests that promoting compassion among physicians could improve their well-being and promote patient-centered care. However, the mechanisms underlying these benefits remain unclear. This study aimed to examine the mediators and moderators of changes in psychological distress and well-being following Compassion Cultivation Training (CCT) among medical students. A randomized controlled trial with 40 medical students assigned to an 8-week CCT program or a waitlist control group was conducted. Participants were assessed at pre-intervention, post-intervention, and a 2-month follow-up on measures of psychological distress, well-being, mindfulness, compassion, emotion regulation, and burnout. Results indicated that CCT led to significant reductions in stress and anxiety immediately after the program, mediated by improvements in emotion regulation and mindfulness skills. Gender moderated changes in stress, anxiety, depression, and well-being at post-intervention, with women benefiting more than men, though these differences were not sustained at follow-up. In conclusion, this study contributes to the growing body of literature on the benefits of compassion training in healthcare and provides insights into the mechanisms through which compassion could support physicians and medical students. [ABSTRACT FROM AUTHOR]

Women diagnosed with gynecological cancer are likely to face additional consequences beyond those common to all cancer patients leading to significant physical and psychological morbidity. Longitudinal studies addressing the prevalence of psychological distress, anxiety, or psychosexual health during follow-up in patients diagnosed with borderline ovarian tumors are lacking. This study explores this prevalence compared with controls who underwent comparable surgical treatment for benign ovarian tumors. A prospective 1:1 nonmatched case-control study was set up, registered on ClinicalTrials.gov under number NCT 04253327. Thirty early stage borderline ovarian tumor patients participated, and 30 controls were included. The study materials consisted of different questionnaires. A general one on patient's sociodemographic and medical information. A questionnaire about anxiety and distress made up of three validated questionnaires: Hospital Anxiety and Depression Scale, Perceived Stress Scale and Body Image Scale. As last one the psychosexual health questionnaire consisted of the Female Sexual Function Index, the Female Sexual Distress Scale and two European Organisation for Research and Treatment of Cancer questionnaires. Both groups were comparable and did not differ significantly in terms of demographic characteristics. Patients with early stage borderline ovarian tumors experience a significant higher burden of mental health issues due to disease and treatment and/or are more worried about their future health. Surprisingly, both early stage borderline ovarian tumor patients and controls showed high levels of anxiety and moderate stress. Many patients in both groups experience sexual dysfunction and distress. These findings support active screening for anxiety, depression and psychosexual perturbance during postoperative follow-up to accommodate this. [ABSTRACT FROM AUTHOR]

Following Wright's theory, the process of acceptance of disability helps persons with an acquired disability to change their attitudes toward it. Consequently, a sense of self-satisfaction was developed, a de-emphasis on disability salience was placed, and compensatory behavioral qualities were acquired. Together, these factors promote an individual's adjustment according to disability-related strengths and difficulties. Our cross-sectional study examines how acceptance of disability influences flourishing, characterized by high well-being and low distress. Due to the exploratory nature of the study, two research questions were formulated: Would each factor of acceptance of disability positively predict each dimension of well-being? (RQ1); Would each factor of acceptance of disability negatively predict distress? (RQ2). Additionally, we considered gender effects. 107 Italian adults with acquired physical disabilities [Myear (SD) = 48.12 (14.87)] filled out an e-survey. Measures of acceptance of disability, well-being, and distress were used. The results indicate that self-satisfaction is a key predictor of flourishing while de-emphasizing disability salience only predicts purpose in life. Compensatory behavioral qualities predicted personal growth, positive relationships, life purposes, and self-acceptance. Gender did not significantly affect outcomes. Despite being preliminary, these initial results support the acceptance of disability as a personal resource for promoting flourishing. They suggest the potential for interventions to help individuals with disabilities process grief and accept their new self-representation. [ABSTRACT FROM AUTHOR]

Background: Optimum efficiency and responsiveness to callers of mental health helplines can only be achieved if call priority is accurately identified. Currently, call operators making a triage assessment rely heavily on their clinical judgment and experience. Due to the significant morbidity and mortality associated with mental illness, there is an urgent need to identify callers to helplines who have a high level of distress and need to be seen by a clinician who can offer interventions for treatment. This study delves into the potential of using machine learning (ML) to estimate call priority from the properties of the callers' voices rather than evaluating the spoken words. Method: Phone callers' speech is first isolated using existing APIs, then features or representations are extracted from the raw speech. These are then fed into a series of deep learning neural networks to classify priority level from the audio representation. Results: Development of a deep learning neural network architecture that instantly determines positive and negative levels in the input speech segments. A total of 459 call records from a mental health helpline were investigated. The final ML model achieved a balanced accuracy of 92% correct identification of both positive and negative instances of call priority. Conclusions: The priority level provides an estimate of voice quality in terms of positive or negative demeanor that can be simultaneously displayed using a web interface on a computer or smartphone. [ABSTRACT FROM AUTHOR]

Objective: In this pilot study a binaural pulse modulator was tested to see if it leads to a change in self-reported measures of distress. This binaural pulse modulator produces two frequencies that combine to create a binaural pulse to stimulate the nervous system through a differential auditory tone presentation and the response of the user can be adjusted to the appropriate target tone for effective treatment use. Each individual calibrated the binaural pulse to increase the level of emotion experienced while imagining an experience with a similar emotional valence or while engaged in a cognitive function while also listening to the sound. "Treatment" is based on the client's control of the binaural pulses to achieve the desired state. Training focuses on specific aspects of their psychological difficulties while listening to an auditory tone, turning a knob until the sound becomes uncomfortable. Finally, another knob is turned to cancel out the uncomfortable noise which appears to be associated with a reduction in distress. Case presentations: Four adult Hispanic participants (three females and one male) were studied with self-reported measures of distress (generalized anxiety disorder 7, Coronavirus Disease Stress Scale, posttraumatic stress disorder checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and Beck depression scale II) were completed at screening, before treatment, after treatment, 4-weeks post-treatment, and 12-weeks post-treatment. Quantitative electroencephalogram and functional magnetic resonance imaging were also performed before and after treatment. Results: Preliminary findings indicated that at the end of treatment with binaural pulse modulator there were reported reductions in self-reported levels of distress. Quantitative electroencephalogram as well as functional magnetic resonance imaging changes in brain state were also noted when comparing pre- to post-treatment. Conclusions: binaural pulse modulator use appears to result in temporary changes in self-reported levels of distress during treatment. Limitations of the study are reviewed and directions for further research are offered. [ABSTRACT FROM AUTHOR]

According to the incongruence model, unemployed people experience incongruence between their actual as compared to their desired employment status, which is an important source of distress. In contrast to other theories, this model is able to explain why unemployed people feel worse not only compared to employed people but also compared to people in other life situations, such as students, homemakers and retirees, who are assumed to experience low levels of incongruence. The current study analysed two longitudinal samples (n = 1066 and n = 1036 at T1) that were followed over 2.5 and 1.5 years, with six and five measurement points, respectively. The results show that (1) unemployed people who found new jobs experienced a reduction in their incongruence levels; (2) changes in incongruence were associated with changes in mental health; (3) changes in incongruence mediated the effects of changes in employment status on mental health. In addition, (4) mental health changes associated with other employment status changes such as entering (or leaving) the labour force (i.e., becoming a student, homemaker or retiree) were also mediated by changes in incongruence levels. Furthermore, the effects remained stable when the influence of the latent and manifest functions of employment was controlled. [ABSTRACT FROM AUTHOR]

Purpose: This study examined the relationship between Distress Tolerance, defined as the individual's ability to withstand psychological stress or endure negative emotions, and Life Satisfaction, the cognitive component of the individual's subjective wellbeing, among Saudi young adults aged 20–30. The study aimed to understand the overall scores of distress tolerance, life satisfaction, and gender differences in these variables. Methods: Online questionnaires were distributed to 348 participants selected based on inclusion/exclusion criteria, using self-report scales: the Distress Tolerance Scale (DTS) and the Satisfaction with Life Scale (SWLS). The sample consisted of 77 males and 271 females, with a mean age of 1.8793 years (SD = 0.81931). Data were analyzed using the SPSS program. Results: The findings supported our hypotheses that (1) Saudi young adults have high overall scores of distress tolerance and life satisfaction, (2) there is a significant positive correlation between distress tolerance and life satisfaction, (3) there are no significant differences between males and females regarding overall distress tolerance and life satisfaction levels, although (4) a significant gender difference was found in the emotional regulation subscale of DTS. A linear regression analysis also showed that distress tolerance significantly predicts life satisfaction. Conclusion: Distress tolerance and life satisfaction are positively associated among Saudi young adults, with no significant gender differences in overall levels. However, differences in specific subscales, such as emotional regulation, warrant further investigation. These findings provide valuable insights for interventions to enhance this population's wellbeing. [ABSTRACT FROM AUTHOR]

Background: Previous studies had found the effects of stress on eating behaviors. The aim of this study was to explore the effects of perceived stress on dietary quality by sexes in Chinese adults. Methods: The study population consisted of individuals aged 18 to 59 years participating in the China Health and Nutrition Survey. Perceived stress levels were measured using the 10-item Perceived Stress Scale (PSS-10), with scores ranging from 0 to 40. Dietary quality was evaluated by Chinese Dietary Guidelines Index (CDGI) ranging 0-110. Using a two-level mixed effects model with community as level 2 and individual as level 1, the study analyzed the impact of PSS-10 scores on CDGI. Additionally, a two-level mixed effects structural equation model was employed to explore the effects of distress factor scores and coping stressor factor scores on dietary quality among different sexes within the population. Results: This study involved in 2515 males and 3165 females, and the average age was 45.9 ± 9.6.The PSS-10 score and CDGI were 14.6 ± 5.1 and 44.8 ± 11.6, separately. After adjusting for confounders, there were no effects of PSS-10 score, distress factor score, and coping stressors factor score on CDGI in males. After adjusting for confounders, CDGI in the highest tertile of PSS-10 score group was 1.64 lower than that in the lowest tertile group in females(P = 0.001). The distress factor score was not associated with CDGI (standardized β=-0.164, P = 0.488), while the coping with stressors factor score was significantly negative with CDGI (standardized β=-0.834, P < 0.001) in females. CDGI in the highest tertile of coping with stressors factor score group was 4.36 lower than that in the lowest tertile group (P < 0.0001). Conclusions: There was no association between perceived stress and dietary quality in adult males. The perceived stress, especially the insufficient capacity to cope with stressors, was negatively associated with dietary quality in adult females. [ABSTRACT FROM AUTHOR]

Background: Research indicates that sexual assault can lead to severe and long-term consequences for survivors; therefore, therapeutic interventions in this field are very important. The present study was conducted with the aim of c the effectiveness of the integrative transdiagnostic and the solution-focused intervention methods on distress tolerance (DT) in sexual assault victims. Methods: This study was semi-experimental research conducted with two experimental groups and one control group, using pre-test, post-test, and follow-up design. Based on this, three groups of 12 women who were victims of sexual assault were purposefully selected and randomly assigned to the groups. Experimental group 1 received integrative transdiagnostic intervention, while experimental group 2 received solution-focused intervention in individual sessions. To collect data, the Simons and Gaher Distress Tolerance Scale (DTS) was used. The data were analyzed using repeated measures analysis of variance (ANOVA). Results: There was a significant difference between the mean scores of pre-test and posttest stages in the integrative transdiagnostic group [F = 19.63, mean difference (MD) = 12.33, P < 0.05], and between the mean scores of pre-test and follow-up stages (F = 19.63, MD = 13.0, P < 0.05), in terms of DT. Moreover, there was a significant difference between the mean scores of pre-test and post-test stages in the solution-focused therapy group (F = 19.63, MD = 7.58, P > 0.05), and between the mean scores of pre-test and follow-up stages (F = 19.63, MD = 7.08, P < 0.05) in the aspect of DT. Conclusion: According to the results, it can be concluded that the integrative transdiagnostic and solution-focused therapy can help to improve the DT of sexual assault victims. [ABSTRACT FROM AUTHOR]

Mast cells are commonly found in pancreatic ductal adenocarcinoma (PDAC), yet their role in the disease remains uncertain. Although mast cells have been associated with depression in several diseases, their connection to PDAC in this context remains unclear. This study explored the correlation between mast cells and psychosocial stress in patients with PDAC. Prior to surgery, 40 patients with PDAC (n = 29 primary resected, n = 11 neoadjuvant treated) completed four questionnaires assessing stress and quality of life. Immunostaining was performed on the resected tumor tissue. Spearman analysis was employed to correlate mast cells with distress and neuropeptides serotonin and beta-endorphin serum and tissue levels. Patients with PDAC exhibited elevated levels of distress and worry. Lower number of mast cells within the tumor correlated with greater psychological burden. Among primary resected patients, mast cell count moderately correlated with joy and inversely with worries. Following neoadjuvant chemotherapy, strong inverse correlation was observed between anxiety, depression, and mast cell quantity. No correlation was found between mast cells and serotonin or beta-endorphin levels. In summary, mast cell presence inversely correlates with psychosocial stress, suggesting a link between immune cells and psychological well-being in pancreatic cancer. Targeting mast cells might offer therapeutic avenues for addressing cancer-induced depression and anxiety. [ABSTRACT FROM AUTHOR]

Background The Middle East and North Africa (MENA) region is expected to witness a significant increase in the burden of cancer. Contrary to Western literature, the burden of psycho-oncology is yet to be established within the MENA region. This study reviews all available evidence characterizing the psychological burden among patients with cancer across the MENA region. Methods We systematically explored the PubMed/MEDLINE, Cochrane/CENTRAL, and Web of Science (WoS) databases for reports on the psychiatric burden among patients with cancer residing within the MENA region from January 2000 until January 2023. Raw proportion were extracted and analyzed using a random-effects model. Findings Eighty-three studies comprised of 16 810 participants, representing 14 countries, met our inclusion criteria. Across the MENA region, the prevalence of depression, anxiety, and distress were 44% (95% CI, 39%-50%), 47% (95% CI, 40%-54%), and 43% (95% CI, 30%-56%), respectively. Prevalence of depression was significantly different across countries, with Palestine (73%; 95% CI, 42%-91%) reporting the highest rate while Morocco (23%; 95% CI, 7%-56%) reported the lowest. Similarly, anxiety significantly differed across MENA nations ranging from 64% (95% CI, 3%-99%) in Morocco to 28% (95% CI, 18%-42%) in Tunisia. Rates of depression and anxiety were significantly different across measurement tools but not between Arabic-speaking versus Persian/Farsi-speaking countries. Meta-regression models showed that neither publication year nor age affected the prevalence of both anxiety and depression (P  = .374 and.091 for depression and P  = .627, and.546 for anxiety, respectively). Interpretation We report an abnormally high rate of psychiatric burden among patients with cancer in the MENA region. Thus, establishing appropriate psycho-oncologic interventions within the MENA region is of utmost importance. [ABSTRACT FROM AUTHOR]

Background: Optimum efficiency and responsiveness to callers of mental health helplines can only be achieved if call priority is accurately identified. Currently, call operators making a triage assessment rely heavily on their clinical judgment and experience. Due to the significant morbidity and mortality associated with mental illness, there is an urgent need to identify callers to helplines who have a high level of distress and need to be seen by a clinician who can offer interventions for treatment. This study delves into the potential of using machine learning (ML) to estimate call priority from the properties of the callers’ voices rather than evaluating the spoken words. Method: Phone callers’ speech is first isolated using existing APIs, then features or representations are extracted from the raw speech. These are then fed into a series of deep learning neural networks to classify priority level from the audio representation. Results: Development of a deep learning neural network architecture that instantly determines positive and negative levels in the input speech segments. A total of 459 call records from a mental health helpline were investigated. The final ML model achieved a balanced accuracy of 92% correct identification of both positive and negative instances of call priority. Conclusions: The priority level provides an estimate of voice quality in terms of positive or negative demeanor that can be simultaneously displayed using a web interface on a computer or smartphone.

The COVID-19 pandemic had a great impact on the mental health of healthcare workers (HCW) worldwide. Studies have reported a high prevalence of anxiety, depression, insomnia, and post-traumatic stress disorder among HCWs, with frontline workers experiencing higher rates of mental health issues. This comprehensive review focuses on the prevalence of mental health problems among HCWs in the aftermath of the pandemic, discussing contributing factors and examining interventions. Factors leading to this increased prevalence include increased workload, high levels of stress, lack of personal protective equipment, stigmatization, and pre-existing mental health disorders. Initiatives to improve the mental health of HCWs may include providing psychosocial support, strengthening organizational backing, offering appropriate training and education, implementing flexible work schedules, conducting mental health screenings, and encouraging self-care practices. Further research is needed to understand long-term outcomes, factors influencing resilience, vulnerability and the impact on HCWs in different settings.

Latar belakang. Respiratory Distress Syndrome adalah masalah kesehatan yang umum, terutama pada bayi prematur. Diagnosis RDS ditegakkan secara klinis ketika sistem pernapasan bayi tidak mampu melakukan pertukaran gas secara normal tanpa bantuan. Derajat distress pernapasan dapat dinilai menggunakan Down score, yang merupakan alat ukur kegawatan pernapasan pada neonatus yang cepat dan sederhana. Down score juga digunakan sebagai acuan untuk menentukan jenis terapi oksigen yang akan diterapkan. Penanganan awal yang tepat sangat menentukan prognosis bayi dengan distress pernapasan di masa mendatang. Tujuan. Penelitian ini bertujuan untuk mengetahui efektivitas Early Bubble CPAP sederhana terhadap perbaikan Down Score pada bayi prematur di Rumah Sakit Umum Daerah Sambas, Kalimantan Barat. Metode. Penelitian ini menggunakan desain kuantitatif dengan pendekatan observasional analitik secara prospektif. Teknik pengambilan sampel yang digunakan adalah accidental total sampling, dan analisis data dilakukan menggunakan SPSS dengan uji Wilcoxon. Hasil. Rata-rata Down score responden sebelum perlakuan adalah 4,50, sedangkan setelah perlakuan rata-rata menjadi 2,82. Hasil analisis menunjukkan nilai Z sebesar 4,097 dan nilai signifikansi sebesar 0,001 (p

Abstract Background Previous studies had found the effects of stress on eating behaviors. The aim of this study was to explore the effects of perceived stress on dietary quality by sexes in Chinese adults. Methods The study population consisted of individuals aged 18 to 59 years participating in the China Health and Nutrition Survey. Perceived stress levels were measured using the 10-item Perceived Stress Scale (PSS-10), with scores ranging from 0 to 40. Dietary quality was evaluated by Chinese Dietary Guidelines Index (CDGI) ranging 0-110. Using a two-level mixed effects model with community as level 2 and individual as level 1, the study analyzed the impact of PSS-10 scores on CDGI. Additionally, a two-level mixed effects structural equation model was employed to explore the effects of distress factor scores and coping stressor factor scores on dietary quality among different sexes within the population. Results This study involved in 2515 males and 3165 females, and the average age was 45.9 ± 9.6.The PSS-10 score and CDGI were 14.6 ± 5.1 and 44.8 ± 11.6, separately. After adjusting for confounders, there were no effects of PSS-10 score, distress factor score, and coping stressors factor score on CDGI in males. After adjusting for confounders, CDGI in the highest tertile of PSS-10 score group was 1.64 lower than that in the lowest tertile group in females(P = 0.001). The distress factor score was not associated with CDGI (standardized β=-0.164, P = 0.488), while the coping with stressors factor score was significantly negative with CDGI (standardized β=-0.834, P

Polycystic ovarian syndrome is the most common endocrine disorder that affects women. The focus on inflammatory PCOS will be the basis of understanding how hormonal imbalances are due to inflammatory diets, stress, and environmental factors that impact symptom severity. The objective of this paper was to provide a systematic review that would determine if symptom severity was associated with psychological stress on polycystic ovarian syndrome (PCOS). It is important to note that PCOS does not have a cure but symptom severity may only be treated, this is due to the cause being unknown and PCOS being used as an umbrella term for issues related to the ovaries and reproductive cycle. As a result, the most commonly suggested findings were to improve diet, improve exercise habits, and seek psychological help if feeling distressed by the symptoms of PCOS.

Following Wright’s theory, the process of acceptance of disability helps persons with an acquired disability to change their attitudes toward it. Consequently, a sense of self-satisfaction was developed, a de-emphasis on disability salience was placed, and compensatory behavioral qualities were acquired. Together, these factors promote an individual’s adjustment according to disability-related strengths and difficulties. Our cross-sectional study examines how acceptance of disability influences flourishing, characterized by high well-being and low distress. Due to the exploratory nature of the study, two research questions were formulated: Would each factor of acceptance of disability positively predict each dimension of well-being? (RQ1); Would each factor of acceptance of disability negatively predict distress? (RQ2). Additionally, we considered gender effects. 107 Italian adults with acquired physical disabilities [Myear (SD) = 48.12 (14.87)] filled out an e-survey. Measures of acceptance of disability, well-being, and distress were used. The results indicate that self-satisfaction is a key predictor of flourishing while de-emphasizing disability salience only predicts purpose in life. Compensatory behavioral qualities predicted personal growth, positive relationships, life purposes, and self-acceptance. Gender did not significantly affect outcomes. Despite being preliminary, these initial results support the acceptance of disability as a personal resource for promoting flourishing. They suggest the potential for interventions to help individuals with disabilities process grief and accept their new self-representation.

Detecting stress is important for improving human health and potential, because moderate levels of stress may motivate people towards better performance at cognitive tasks, while chronic stress exposure causes impaired performance and health risks. We propose a Brain–Computer Interface (BCI) system to detect stress in the context of high-pressure work environments. The BCI system includes an electroencephalogram (EEG) headband with dry electrodes and an electrocardiogram (ECG) chest belt. We collected EEG and ECG data from 40 participants during two stressful cognitive tasks: the Cognitive Vigilance Task (CVT), and the Multi-Modal Integration Task (MMIT) we designed. We also recorded self-reported stress levels using the Dundee Stress State Questionnaire (DSSQ). The DSSQ results indicated that performing the MMIT led to significant increases in stress, while performing the CVT did not. Subsequently, we trained two different models to classify stress from non-stress states, one using EEG features, and the other using heart rate variability (HRV) features extracted from the ECG. Our EEG-based model achieved an overall accuracy of 81.0% for MMIT and 77.2% for CVT. However, our HRV-based model only achieved 62.1% accuracy for CVT and 56.0% for MMIT. We conclude that EEG is an effective predictor of stress in the context of stressful cognitive tasks. Our proposed BCI system shows promise in evaluating mental stress in high-pressure work environments, particularly when utilizing an EEG-based BCI.

Abstract Breast cancer impacts the psychological well-being of women, leaving them at risk of developing depression, anxiety, and other stress-related disorders. The Depression Anxiety Stress Scales (DASS-21) is a widely used measure, although empirical evidence regarding its psychometric properties in the breast cancer population is limited. The purpose of this study was to conduct an exhaustive analysis of the psychometric properties of the DASS-21 in a sample of Spanish women diagnosed with breast cancer. Participants were 289 breast cancer patients who completed the DASS-21 and other questionnaires measuring life satisfaction, positive and negative affect, flourishing, perceived stress, and breast cancer-specific stressors. In terms of validity evidence based on the internal structure of the DASS-21, adequate fit indices were obtained for the model based on three first-order factors (depression, anxiety, stress) and one second-order factor (general psychological distress). Reliability coefficients (McDonald’s omega) ranged from .84 to .95. Validity evidence based on relationships with other variables was also provided by moderate and strong correlations with well-being indicators and stress measures. The results support the use of the DASS-21 for measuring general psychological distress in the breast cancer context, where it may provide useful information for the design of psychological interventions with patients.

Moral injury is a psychological wound resulting from deep-rooted traumatic experiences that corrode an individual’s sense of humanity, ethical compass, and internal value system. Whether through witnessing a tragic event, inflicting injury on others, or failing to prevent a traumatic injury upon others, moral injury can have severe and detrimental psychological and psychosomatic outcomes that may last a lifetime. Post-traumatic experiences do not have to be a permanent affliction, however. From moral injury can come post-traumatic growth—the recovery from trauma in which personal betterment overshadows moral injury. Moral injury may lead to substantial personal growth, improved capacity and resilience. Based on these observations, it seems that from struggles and darkness, there can be positivity and hope. This review will summarize the current concepts of post-traumatic growth and consider potential mechanisms leading to resilience and recovery through post-traumatic growth. These considerations are gaining more importance in light of a growing number of existential threats, such as violent conflicts, natural disasters and global pandemics.

Introduction: Lockdown during the initial wave of the COVID-19 pandemic and isolation were discovered to have a negative psychological influence on the general population’s mental health and wellbeing. Aim: This study aims to Trace and compares the impact of the COVID-19 pandemic on mental health in terms of psychological well-being (PWB), distress and family functioning during the first and second wave. Materials and Methods: A convenient purposive sampling method was used to conduct an online survey during the first COVID wave (May 2020–July 2020) in India, and the same demographic group was re-contacted (March 2021–May 2021) during the second wave. The institute ethical committee was consulted in advance for approval, and participants’ digital consent was obtained. The first and second waves of the COVID-19 epidemic in India were evaluated using the PWB scale, the depression anxiety stress scale 21, and the brief family relationship scale. Results: Among all individuals, there was a 25.4%, 39.3%, and 30% prevalence of stress, anxiety, and depression, respectively in our study. Participant’s well-being and family relationships were negatively impacted by anxiety and depression. Older participants reported more favorable relationships and higher levels of well-being than younger participants did. Women scored significantly lower on psychological well-being measures and much higher on stress, anxiety, and depression measures than men. Conclusion: The first wave, which has contributed to a significant increase in psychiatric morbidity, affected the general population at a moderate intensity. The present study’s findings may be useful for developing policies, intervention programs, and offering psychosocial help to the community.

Background: Different clinical manifestations were revealed by the distinct waves of the coronavirus. The pandemic had a multifaceted impact on mental health, sleep patterns, and associated fear. MATERIALS AND METHODS: It was an observational online survey using by using Google Forms in the city of Chandigarh between April 2020 and April 2021 across three waves of the coronavirus outbreak (first wave from March 2020 to May 2020, second wave from June 2020 to January 2021, and third wave from February 2021 to April 2021). Fear of coronavirus disease (COVID), preventive behaviors, insomnia-related problems, and impact of the event were assessed by using standardized scales. Results: The participants who were infected during the first phase exhibited significantly higher levels of distress, loss of control over their reactions, increased fear of coronavirus and sleep problems, and also greater adherence to preventive behaviors compared to those who were infected during the second and third waves. A tendency to emerge post-traumatic stress disorder (PTSD) was seen in 68 (58.1%) of the participants (Peritraumatic Distress Inventory (PDI) score >14) and 34 (29.1%) of all the participants (PDI score >23). Overall, 66 (56.4%) participants reported having insomnia. About 24 people (20.5%) had clinical concerns about PTSD, 20 people (17.1%) had probable PTSD diagnoses, and 16 people (13.7%) experienced a severe coronavirus disease 2019 (COVID-19) pandemic impact on their lives. Conclusion: The first wave of COVID-19 had a greater psychological impact than subsequent waves. Further research must fill important gaps in our knowledge of the clinical range and long-term effects.

The purpose of this study was to identify the correlates of depressive symptoms and the prevalence of depression, distress, and demoralization among patients with cancer in Taiwan in relation to their sociodemographics. A cross-sectional study design with convenience sampling was used to recruit 191 consecutive patients with cancer from the Cancer Center of a teaching hospital in northern Taiwan. Multiple linear regression was applied to analyze the determinants of depressive symptoms. The prevalence rates of depression (including suspected cases), distress, and demoralization were 17.8%, 36.1%, and 32.5%, respectively. The regression model explained 42.2% of the total variance, with significant predictors including marital status, life dependence, comorbidity, demoralization, and distress. The results demonstrated that higher levels of distress and demoralization were associated with more depressive symptoms. Demoralization and distress played vital roles in moderating depressive symptoms among patients with cancer. Nursing interventions should integrate appropriate mental health services, such as alleviating distress and demoralization, to prevent the occurrence of depression in patients with cancer.

Background. Diabetes-related distress (DRD) is a psychological syndrome with worsened prognosis in uncontrolled diabetic patients. Risk of DRD progression is increased with uncontrolled diabetes, development of complications, concomitant medical conditions, and complicated treatment regimens. In addition to the di­sease burden, there are other factors that increase the risk of DRD such as lower level of education, younger age, se­dentary lifestyle, unhealthy diet, and poor self-care behavior. The current study purposed to assess the factors contributing to DRD among the Ukrainian population using the Diabetes Distress Scale (DDS-17) score and its sub-scores. Materials and methods. A cross-sectional analysis was conducted between January and June 2024 enrolling 125 diabetic patients from five Ukrainian regions. The survey included two parts: the first section gathe­red sociodemographic data and the second one focused on assessing the DDS-17 score. Results. Participants aged 46 years old and above had higher emotional distress compared to younger patients. Those with a primary educational level showed significantly higher emotional distress than those with a secondary level of education. Participants who were treated with both insulin and non-insulin medications or had a diastolic blood pressure of more than 90 mm Hg showed significant moderate to high distress. Participants who lived in rural areas showed higher distress. Obese and overweight people had significant moderate to high distress. The association between medical history with total distress showed that participants with glycated hemoglobin (HbA1c) of more than 8.0 followed by those who had HbA1c between 7.1 and 8.0 showed moderate to high total distress. Conclusions. It is concluded that the prevalence of DRD is high in Ukraine, more common among rural residents, and among participants with high HbA1c, low educational level and those on complex treatment regimens. Screening for DRD and providing better support can optimize clinical outcomes.

Abstract Background Digital health technologies such as sensor systems are intended to support healthcare staff in providing adequate patient care. In the Department of Palliative Medicine (University Medical Center Freiburg), we developed and implemented a noninvasive, bed-based sensor system in a pilot study. The aim was to detect distress in patients who were no longer able to express themselves by monitoring heart and respiratory rates, vocalizations, and movement measurements. The sensor system was intended to supplement standard care, which generally cannot guarantee constant monitoring. As there is a lack of data on how healthcare professionals experience such a techno-digital innovation, the aim of this study was to explore how the multiprofessional palliative care team who piloted the sensor system perceived its potential benefits and limitations, and how they experienced the broader context of healthcare technology and research in palliative care. Methods We conducted a qualitative interview study with 20 members of the palliative care team and analyzed the recorded, verbatim transcribed interviews using qualitative content analysis. Results The sensor system was described as easy to use and as helpful support for patients, care staff, and relatives, especially against the backdrop of demographic change. However, it could not replace human interpretation of stress and subsequent treatment decisions: this remained the expertise of the nursing staff. A potential reduction in personnel was expected to be a risk of a digital monitoring system. The special conditions of research and digital health technologies in an end-of-life context also became clear. Specifically, healthcare staff were open to health technologies if they benefited the patient and were compatible with professional nursing and/or palliative care attitudes. Additionally, a patient-protective attitude and possible interprofessional differences in priorities and the resulting challenges for the team became apparent. Conclusions A potential digital solution for distress monitoring was considered useful by palliative care practitioners. However, interprofessional differences and compatibility with existing palliative care practices need to be considered before implementing such a system. To increase user acceptability, the perspectives of healthcare professionals should be included in the implementation of technological innovations in palliative care.

Abstract Background Now affecting one in six couples in Canada, infertility is defined as a lack of conception after 12 or more months of regular, unprotected heterosexual intercourse. Infertility is associated with immense psychological burden, particularly for individuals assigned female at birth. Yet existing psychological interventions are not specialized to this population and have been shown to be only marginally effective at relieving distress related to infertility. Thus, a new online self-directed psychological intervention was co-created with a panel of women experiencing infertility, and ultimately consisted of six 10-min video modules addressing the cognitive, emotional, and interpersonal aspects of infertility-related distress. Methods In the current study, 21 women experiencing reduced quality of life related to infertility were recruited to participate in a one-arm pre-post pilot testing the feasibility, acceptability, and preliminary efficacy of the program. Participant adherence and retention were monitored, and participants rated the credibility of the program and the helpfulness of each module as well as provided feedback on the content and format of the program. Pre-to-post changes in fertility quality of life, anxious symptoms, depressive symptoms, and relationship satisfaction were examined. Results The program modules were highly rated by participants, with average helpfulness ratings ranging from 7.5 to 8.2/10. Two participants became pregnant and therefore stopped prematurely, 79% of the remaining participants completed all six modules, and participants reported completing 52.8 (SD = 82.0) min of homework per week. Participants perceived the intervention as highly credible and generally approved of the format, length, and speed; however, 68% of participants had recommendations for additional content to be included in the intervention. While relationship satisfaction did not change significantly over time, large pre-to-post improvements in fertility quality of life, depression, and anxiety were observed (p

Abstract The influence of naps on tinnitus was systematically assessed by exploring the frequency, clinical and demographic characteristics of this phenomenon. 9,724 data from two different tinnitus databases (Tinnitus Hub: n = 6115; Tinnitus Research Initiative (TRI): n = 3627) were included. After separate analysis of the databases, these results were then compared with each other. In the Tinnitus Hub survey database, a total of 31.1% reported an influence on tinnitus by taking a nap (26.9% in the TRI database), with much more frequent worsening after a nap than improvement (23.0% a little or a lot worse; TRI: 17.7% worse; 8.1% a little or a lot better; TRI: 9.2% better). The influence of napping on tinnitus was associated in both databases with other clinical features, such as the dependence of tinnitus on night quality, stress and somatosensory maneuvers. The present study confirms the clinical observation that more tinnitus sufferers report worsening after a nap than tinnitus sufferers reporting an improvement. It was consistently shown that tinnitus sufferers reporting nap-induced modulation of tinnitus also report more frequently an influence of night sleep on their tinnitus. Further clinical and polysomnographic research is warranted to better understand the interaction between sleep and tinnitus.

Background: Anxiety and depression during the postpartum period can have a significant impact on mothers’ perceived sense of responsive caregiving, causing considerable distress. This association may be affected by mothers’ perception about social support. In the context of low-and-middle-income countries where prevalence rates of maternal mental illnesses are high and access to health care services is limited, informal supports become more relevant. Aim: The study aims to understand the lived experience of mothers who had postpartum depression or anxiety and their perceived distress related to infant care giving. It also explores the role of social support in the motherhood experience. Methods: Six mothers with postpartum depression or anxiety were interviewed to understand their experience of postpartum depression and/or anxiety and their perceptions about social support. The interviews were analyzed using a reflexive thematic analysis approach. Results: The thematic analysis revealed four themes, namely, (a) uncertainty and helplessness, (b) misattunement with the immediate family, (c) personal strength rooted in the family support system, and (d) other means of coping. Mothers with postpartum anxiety and depression can have emotional, informational, and tangible social support needs in the context of uncertainty and helplessness, which are associated with different challenges and barriers for infant care in the Indian context. Conclusion: Support from family members is viewed as a pillar of comfort and recovery for the mothers. At the same time, if it is not adequately attuned to the needs of the mother, it can become a major source of distress.

Abstract Accuracy of memory is critical in legal and clinical contexts. These contexts are often linked with high levels of emotional distress and social sources that can provide potentially distorting information about stressful events. This study investigated how distress was associated with susceptibility to misinformation about a trauma analogue event. We employed an experimental design whereby in Phase 1, participants (N = 243, aged 20–72, 122 females, 117 males, 4 gender diverse) watched a trauma film (car crash) and heard an audio summary that contained misinformation (misled items), true reminders (consistent items), and no reminders (control items) about the film. Participants rated their total distress, and symptoms of avoidance, intrusions, and hyperarousal, in response to the film. They then completed cued recall, recognition, and source memory tasks. One week later in Phase 2, participants (N = 199) completed the same measures again. Generalised linear mixed models were used. A significant misinformation effect was found, and importantly, participants with higher distress levels showed a smaller misinformation effect, owing to especially poor memory for consistent items compared to their less distressed counterparts. Distress was also associated with improved source memory for misled items. Avoidance of the film’s reminders was associated with a smaller misinformation effect during immediate retrieval and a larger misinformation effect during delayed retrieval. Findings suggest that distress is associated with decreased susceptibility to misinformation in some cases, but also associated with poorer memory accuracy in general. Limitations are discussed, and the need for further research is highlighted.

Accuracy of memory is critical in legal and clinical contexts. These contexts are often linked with high levels of emotional distress and social sources that can provide potentially distorting information about stressful events. This study investigated how distress was associated with susceptibility to misinformation about a trauma analogue event. We employed an experimental design whereby in Phase 1, participants (N = 243, aged 20–72, 122 females, 117 males, 4 gender diverse) watched a trauma film (car crash) and heard an audio summary that contained misinformation (misled items), true reminders (consistent items), and no reminders (control items) about the film. Participants rated their total distress, and symptoms of avoidance, intrusions, and hyperarousal, in response to the film. They then completed cued recall, recognition, and source memory tasks. One week later in Phase 2, participants (N = 199) completed the same measures again. Generalised linear mixed models were used. A significant misinformation effect was found, and importantly, participants with higher distress levels showed a smaller misinformation effect, owing to especially poor memory for consistent items compared to their less distressed counterparts. Distress was also associated with improved source memory for misled items. Avoidance of the film's reminders was associated with a smaller misinformation effect during immediate retrieval and a larger misinformation effect during delayed retrieval. Findings suggest that distress is associated with decreased susceptibility to misinformation in some cases, but also associated with poorer memory accuracy in general. Limitations are discussed, and the need for further research is highlighted. [ABSTRACT FROM AUTHOR]

BACKGROUND: Fibromyalgia (FM) has been associated with decreased health-related quality of life (HRQoL), which has been linked to psychological variables such as anxiety, depression, coping, and social support. This study aimed to simultaneously analyse the association of these variables with HRQoL in FM patients and explore their mediating role in the relationship between somatic symptoms and HRQoL. PARTICIPANTS AND PROCEDURE: A cross-sectional sample of 134 FM patients (97% women) with no other rheumatologic diseases followed in specialized healthcare services completed self-report questionnaires to evaluate pain, fatigue, sleep, anxiety, depression, coping, social support, and HRQoL. RESULTS: The results indicated that FM patients experienced a negative impact on all dimensions of HRQoL, with anxiety primarily affecting the mental dimensions, and depression and social support affecting both physical and mental dimensions. Anxiety, depression, dysfunctional coping, and low social support were independent predictors of HRQoL and mediated the effect of somatic symptoms in the mental component of HRQoL. CONCLUSIONS: FM patients experience a negative impact on HRQoL, and anxiety, depression, coping and social support play an important role as independent predictors of this decrease, and as mediators of the effect of somatic symptoms in the mental dimensions of HRQoL. This underscores the importance of considering these psychological variables in the therapeutic approach to FM and suggests the need for interventions targeting anxiety, depression, dysfunctional coping, and low social support to improve HRQoL in FM patients. [ABSTRACT FROM AUTHOR]

Social interactions that are simultaneously characterized by positive and negative aspects—i.e., ambivalent relationships—have been found to be related to distress and poor mental health. As the university setting is also characterized by several social interactions, this study aimed to investigate for the first time to what extent objective and subjective ambivalence towards lecturers or instructors are linked to university students' distress levels and mental health indicators. A notable relationship of ambivalence with the outcomes was found in 1105 students from Germany. The association with psychological distress was more pronounced for objective than for subjective ambivalence (adjusted betas = 0.342 vs. 0.261, p-values < 0.001), while both also had an independent association. The association with mental health was comparable for both types (adjusted beta = −0.206 vs. −0.191, p-values < 0.001). For paradoxical emotions, the relationship with objective ambivalence was stronger, and only this remained significant in the mutually adjusted model (adjusted beta = 0.376, p-value < 0.001). This study provided evidence of a previously unconsidered stressor at the university—ambivalence towards lecturers—associated with negative health effects among students. Future studies are needed to establish this connection and to create the basis for preventative measures. [ABSTRACT FROM AUTHOR]

In the early Buddhist discourses, distressing experiences like fear and disgust are evaluated in contradictory modes. These upsetting emotions are considered both a detriment and an advantage for those seeking liberation from suffering. This ambivalence is reflective of the classical Buddhist conception of distress. The earliest scholastic Buddhist texts (i.e., Abhidharma sources) have sought to resolve the ambivalence surrounding this conception. The Abhidharma texts thus explain precisely how, when, where and for whom distress can prove favorable. By tracing this intellectual endeavor, I examine in this article the systematic and philosophical treatments of distress (saṃvega) in early Buddhist scholasticism. I outline the reasons for considering the experience of distress to be beneficial, unveiling the religious framework within which distress is rendered positive and even essential. My central claim is that early Abhidharma sources conceive of distress as a potential source of energy that facilitates one's progress on the religious path and determines how rapidly one can understand the truth. [ABSTRACT FROM AUTHOR]

Objective: This paper reports on the initial outcomes of a new mHealth intervention to reduce diabetes distress (DD) in families of school-age children living with type 1 diabetes (T1D) entitled, 'Remedy to Diabetes Distress' (R2D2). Methods: We randomized 34 families (mean child age = 10 ± 1.4 years; 53% male, 85% White, mean HbA1c = 7.24 ± 0.71%) to one of three delivery arms differing only by number of telehealth visits over a 10-week period: zero visits = self-guided (SG), three visits = enhanced self-guided (ESG), or eight visits = video visits (VV). All families had 24 × 7 access to digital treatment materials for 10 weeks. We examined the feasibility and acceptability of R2D2. We used the Problem Areas in Diabetes-Child (PPAIDC and PAIDC, parent and child, respectively) to examine treatment effects by time and delivery arm. We performed sensitivity analyses to characterize families who responded to R2D2. Results: It was feasible for families to access R2D2 mHealth content independently, though attendance at telehealth visits was variable. Parents and children reported high satisfaction scores. There were significant pre-post reductions in PPAIDC (p = 0.026) and PAIDC (p = 0.026) scores but no differences by delivery arm. There were no differences in child age, sex, race, or pre-treatment HbA1c for responders versus non-responders, though families who responded reported higher PPAID-C scores pre-treatment (p = 0.01) and tended to report shorter diabetes duration (p = 0.08). Conclusions: Initial results support the acceptability and treatment effects of R2D2 regardless of the frequency of adjunctive virtual visits. Characterizing responders may help to identify families who could benefit from R2D2 in the future. [ABSTRACT FROM AUTHOR]

The purpose of this study was to identify the correlates of depressive symptoms and the prevalence of depression, distress, and demoralization among patients with cancer in Taiwan in relation to their sociodemographics. A cross-sectional study design with convenience sampling was used to recruit 191 consecutive patients with cancer from the Cancer Center of a teaching hospital in northern Taiwan. Multiple linear regression was applied to analyze the determinants of depressive symptoms. The prevalence rates of depression (including suspected cases), distress, and demoralization were 17.8%, 36.1%, and 32.5%, respectively. The regression model explained 42.2% of the total variance, with significant predictors including marital status, life dependence, comorbidity, demoralization, and distress. The results demonstrated that higher levels of distress and demoralization were associated with more depressive symptoms. Demoralization and distress played vital roles in moderating depressive symptoms among patients with cancer. Nursing interventions should integrate appropriate mental health services, such as alleviating distress and demoralization, to prevent the occurrence of depression in patients with cancer. [ABSTRACT FROM AUTHOR]

There has been a lack of research on the Arab American population despite a noted increase in divorce and marital discord among Arabs and Arab American couples. Moreover, knowledge is limited on ways to enhance existing couple-based treatments to become more sensitive toward the unique intersection that Arab American couples are faced with. One consideration when improving treatment is to examine and better understand the negative attributions Arab American spouses make about each other's behavior, as they can be detrimental to the satisfaction of the relationship. In this study, a sample of 142 married Arab Americans were asked to complete the Relationship Attribution Measure, Patient Health Questionnaire, and the Dyadic Adjustment Scale (DAS). A large portion of the participants fell within the distressed range of the DAS. Attributions, especially motivations and blame, were significant predictors of relationship satisfaction. Both causal and responsibility attributions were associated with depression, while only responsibility attributions were associated with anxiety. Results are discussed in terms of how future research and couple-based interventions can integrate cultural considerations within this group. [ABSTRACT FROM AUTHOR]

In neuropsychology and clinical psychology, the efficacy of virtual reality (VR) experiences for knowledge acquisition and the potential for modifying conduct are well documented. Consequently, the scope of VR experiences for educational purposes has expanded in the health field in recent years. In this study, we sought to assess the effectiveness of ViveDe in a psychoeducational caregiver program. ViveDe is a VR application that presents users with possible daily life situations from the perspective of individuals with dementia. These situations can be experienced in immersive mode through 360° video. This research aimed to ascertain the associations between the sense of presence that can be achieved in VR and some users' psychological characteristics, such as distress and empathetic disposition. The study involved 36 informal caregivers of individuals with Alzheimer's disease. These participants were assessed using scales of anxiety and depression, perceived stress, empathy, and emotional regulation. They were asked to participate in a six-session psychoeducation program conducted online on dementia topics, in addition to experiencing the ViveDe application. The immersive VR sessions enabled the caregivers to directly experience the symptoms of dementia (e.g., spatial disorientation, agnosia, difficulty in problem-solving, and anomia) in everyday and social settings. The results indicated that although the experience in ViveDe (evaluated using the XRPS scale and five questions about emotional attunement) showed efficacy in producing a sense of first-person participation in the symptoms of dementia, further research is needed to confirm this. The structural equation model provided evidence that the characteristics of individuals who enjoy the VR experience play a determining role in the perceived sense of presence, which in turn affects the efficacy of the VR experience as a psychoeducational tool. Further research will be conducted to ascertain the potential role of these elements in conveying change in the caregivers of people with dementia. This will help us study the long-term effectiveness of a large-scale psychoeducation program in VR. [ABSTRACT FROM AUTHOR]