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Purpose: Psychosocial screening for glioma patients is challenging because many patients suffer from neurocognitive deficits, which may impair assessment. This study's aim was to exploratively develop three screening questions for unmet needs to prospectively be applicable in patient-doctor consultation., Methods: Patient interviews, a survey for health-care professionals and a weighted scoring procedure were developed for this study. Six main areas were defined according to main areas of validated questionnaires (psyche, cognition, body, role functioning, social support, unmet needs). Patients and health-care professionals rated the importance of these areas and corresponding items, patients additionally stated whether the issues addressed affected them., Results: A total of 50 patients were included, and 36 health-care professionals participated in the online survey. The three areas (psyche, body and cognition) considered to be most relevant by both, health-care professionals and patients, generated three screening questions. If the patient was affected by the issue addressed with a screening question, a subordinate question from that area that our patient sample considered most important could additionally be asked. The elaborated screening questions are the following: (1) main area psyche: "Has your mood worsened?", (2) main area body: "Do physical changes put a strain on you?", and (3) main area cognition: "Has your memory capacity worsened?", Conclusion: These questions represent a basis for further research regarding their application in neuro-oncological clinical routine.

Rationale: Head and neck cancer (HNC) patients and survivors are a particularly vulnerable group with disproportionately high levels of psychosocial distress. Untreated psychosocial distress among HNC patients has consistently been associated with poorer health and psychosocial outcomes. Screening for distress (SFD) allows health care providers to identify and monitor patient's distress, and when needed, to subsequently provide appropriate psychosocial supports that aim to reduce suffering and improve patients' overall well-being. However, despite mounting evidence for the benefits of SFD some oncology centers continue to neglect SFD in HNC patients and survivors, thereby depriving these patients of the opportunity to have their unmet psychosocial needs appropriately addressed. The present paper reviews SFD literature and explores ethical considerations in screening HNC patients and for distress., Conclusions: Screening HNC patients for distress and facilitating the alleviation of suffering are important steps in providing ethical care. HNC oncology administrators, surgical departments, and clinicians are urged to consider the implementation of SFD for HNC patients and to take the necessary steps in implementing SFD practices and psychosocial care.

Purpose: This longitudinal study explores causal attributions in newly diagnosed head/neck cancer (HNC) patients and their caregivers., Methods: Perceptions of causal attributions and associated level of responsibility regarding each patient's HNC diagnosis at baseline (n = 72 dyads) were described and then tested as predictors of depressive symptoms, cancer worry, and perceived support 6 months later., Results: When causes were reported, tobacco and alcohol use topped the list of both patients and caregivers. Three-quarters of dyads agreed about perceptions of the patients' responsibility in causing their HNC. Some dyad-level patterns of causal attribution were associated with patients' and caregivers' cancer worry (p < 0.05) and caregivers' perceived support (p < 0.05) in unadjusted models., Conclusions: This preliminary study indicates that causal attributions warrant further exploration in HNC patient-caregiver dyads specifically, as well as studies of quality of life in patient-caregiver dyads more broadly considered.

Parents and caregivers of children with cancer are both resilient and deeply affected by the child's cancer. A systematic review of published research since 1995 identified 138 studies of moderate quality indicating that parent distress increases around diagnosis, then returns to normal levels. Post-traumatic symptoms are common. Distress may be impairing for vulnerable parents and may impact a child's coping and adjustment. Moderate quality evidence and expert consensus informed a strong recommendation for parents and caregivers to receive early and ongoing assessment of their mental health needs with access to appropriate interventions facilitated to optimize parent, child, and family well being., (© 2015 Wiley Periodicals, Inc.)

Objective: A model of psychosocial care specific for patients with multiple myeloma and their caregivers has not yet been proposed. We sought to develop a model of care that considers the specific profile of this disease., Method: The authors, representing a multidisciplinary care team, met in December of 2012 to identify a model of psychosocial care for patients with multiple myeloma and their caregivers. This model was determined by consensus during the meeting and via total agreement following the meeting. The meeting was sponsored by Onyx Pharmaceuticals., Results: The need for targeted psychosocial care for the multiple myeloma patient and caregiver throughout the disease process is essential to ensure quality of life and optimal treatment outcomes. We propose herein the first known model of care for the treatment of multiple myeloma that engages both the patient and their caregivers., Significance of Results: Innovative partnerships between psychosocial providers and other entities such as pharmaceutical companies can maximize resources for comprehensive program development. This manuscript proposes a model of care that promotes active engagement in therapies for multiple myeloma while engaging the individual patient and their family caregivers. This treatment approach must be evidence based in terms of distress screening tools, comprehensive psychosocial assessments, and, most importantly, in the interventions and measurements of response that clinicians apply to this population.

Objective: The National Institute for Health and Care Excellence recommends the use of structured tools to improve holistic care for patients with cancer. The Distress Thermometer and Problem Checklist (DT) is commonly used for screening in physical health settings. However, it has not been integrated into the clinical pathway within specialist psycho-oncology services. We used the DT to examine the broad clinical effectiveness of psycho-oncology intervention and to ascertain factors from the DT linked to an improved outcome. We also evaluated patients' satisfaction with their care., Method: We asked 111 adult outpatients referred to York Psycho-Oncology Service to complete the DT at their first appointment. Individuals offered a period of psycho-oncology care re-rated their emotional distress, problems and service satisfaction on the DT at discharge., Results: Median distress scores decreased significantly (from 6 to 4, Wilcoxon's z = -4.83, P < .001) indicating a large clinical effect size (Cohen's d = 1.22). Frequency of emotional problems (anxiety, depression and anger) fell significantly by 15-24% despite no significant change in patients' physical health or practical problems. Number of emotional problems was the best predictor of distress at discharge (beta = 0.468, P = .002). Satisfaction was high and correlated with lower distress scores (r = -0.42, P = .005) and fewer emotional problems (r = -0.31, P = .04) at discharge but not with number of appointments attended. Qualitative thematic analysis showed patients particularly value supportive listening and advice on coping strategies from professionals independent of their physical care., Conclusion: The DT is an acceptable and useful tool for enhancing the delivery of structured psycho-oncology care. It may also provide evidence to support the effectiveness of specialist psycho-oncology interventions., (Copyright © 2014 Elsevier Inc. All rights reserved.)

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.

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.

Purpose: Parallel process modeling (PPM) can be used to analyze co-occurring relationships between health and psychological variables over time. A demonstration is provided using data obtained from the British Household Panel Survey (years 2005, 2006, 2007, and 2008), examining predictors of ongoing changes in their distress and life satisfaction of a subsample from the survey. Research Method: In the 2005 survey, data were available from 7,970 participants based on the following demographic variables: gender, age, ever registered as disabled, and ever experienced any strokes (before or at 2005). Time-varying variables included distress and life satisfaction collected yearly from 2005 to 2008. Time-invariant variables included age (65 or older), gender, disability condition, and stroke survivor status. Results: Steps of fitting the PPM are presented. Four distinct distress trajectory groups—chronic, recovery, delayed, and resilient—were identified from the PPM estimates. Resilient and recovery groups showed a positive trend in life satisfaction. The delayed distress and chronic groups had a slight decrease in satisfaction. The time-invariant covariates only significantly predicted baseline levels of distress and satisfaction (i.e., their intercepts). Conclusions: PPM is a relatively simple and powerful tool for simultaneously studying relations between multiple processes. A step-by-step approach on decomposing the significant predictive relation from the change of distress to the change of satisfaction is presented. Properly decomposing any significant growth factor regressed on another growth factor is necessary to fully comprehend the intricate relationships within the results. Practical implications and additional methodological information about fitting PPM are discussed. Impact and Implications: Parallel process modeling (PPM) can be used to analyze several time-varying variables over time and model (predict) their co-occurring relationships from one process to another. Rehabilitation psychology research often encounters clinical, methodological, and theoretical complications (e.g., expected relationships with multiple time-varying variables, missing data, varying measurement occasions) that may be circumvented with PPM, as illustrated in this article. We emphasize the importance of properly decomposing the predictive relation between processes (e.g., the growth factor of one process significantly regressed on the growth factors of another process) and offer a step-by-step demonstration. [ABSTRACT FROM AUTHOR]

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

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.

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.

The main aim of this study was to investigate adolescents' eustress–distress and mindfulness by examining mental toughness (MT) using network and mediator analyses. The study included 414 adolescents. The results showed that MT was positively related to eustress and mindfulness, but distress was negatively related to MT. Based on the network analysis findings, we tested mindfulness' mediating role in the relationship between eustress–distress and MT. The findings showed that mindfulness played a significant mediating role. However, the mediating role of mindfulness was negative for the relationship between distress and toughness and positive for eustress. These findings advance eustress, distress, and mindfulness as mechanisms for understanding the effects of MT. Considering current knowledge of MT, eustress, distress, and mindfulness, the results are discussed. [ABSTRACT FROM AUTHOR]

The current research evaluates the Perfectionism Social Disconnection Model (PSDM) by considering the links between measures of trait perfectionism and perfectionistic self-presentation and measures of social support, loneliness, and distress in cross-sectional research. A particular focus is on perfectionism and levels of social support as assessed by the Social Provisions Scale. The current study also uniquely evaluates levels of perfectionism and perfectionistic self-presentation in undergraduate students, medical students, and law students. The results across samples provided evidence that loneliness mediates the link between interpersonal perfectionism and distress in keeping with the predictions of the PSDM. Correlational results found robust links between loneliness and low levels of social support. Moreover, socially prescribed perfectionism and perfectionistic self-presentation were associated negatively with social support, and this was especially evident in terms of the facet tapping the nondisclosure of imperfections. Group comparisons of perfectionism yielded few significant differences in accordance with expectations. Levels of perfectionism tended to be lower among medical students. However, the links between perfectionism and distress were clearly evident among undergraduates, medical students, and law students, thus attesting to the vulnerability of perfectionistic students in general. Overall, the results further confirm the relevance of perfectionism in distress among students and applicability of the PSDM in various types of students. [ABSTRACT FROM AUTHOR]

Background: Patients with head and neck cancer (HNC) often demonstrate stress, distress, anxiety, depression, and are at risk for suicide. These affect their quality of life (QoL) but less attention has been given to psychological variables that may impact response to treatment. Objectives: This study aims to systematically review publications during 2013–2023 to collate evidence on the effects of psychological variables on HNC treatment outcomes. Methods: We searched Ovid Medline, PubMed, Scopus, and Web of Science for articles that examined psychological factors related to treatment outcomes in patients with HNC. Results: There were 29 studies (5 before treatment, 2 during, 17 after, and 5 covering the whole management trajectory) including 362,766 patients. The psychological factors were either behavioral (adjustment and coping strategy, unrealistic ideas, self-blame), cognitive (elevated risk of psychiatric co-comorbidity), or emotional (distress, depression, anxiety, nervousness, and fear of disfigurement and complications). It was found that there was a relationship between depression and decreased survival in patients with HNC. Pretreatment pain was an independent predictor of decreased survival in a large sample of patients. The distress level was approximately 54%, emotional problems ranged between 10 and 44%, while financial difficulties were identified in 54% of the patients. Sixty-nine percent of patients were reported to have used at least one cost-coping strategy within 6 months after treatment initiation. During post-treatment period, depression increased from 15% at the baseline to 29%, while the fear of recurrence was found among at least 35% of patients. Discussion and Conclusion: Several psychological factors predict QoL and survival among HNC survivors. Distress encompasses depression and anxiety, and physical burden from HNC diagnosis and treatment. Routine screening and early interventions that target distress could improve HNC survivors' QoL. A systematic and standardized measurement approach for QoL is warranted to homogenize these findings and to understand the underlying relationships. [ABSTRACT FROM AUTHOR]

PurposeThis 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.MethodsOnline 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.ResultsThe 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.ConclusionDistress 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.

Background. Timely and accurately conducted introduction of demoralization into the differential diagnostics make it possible to define objective and subjective factors essential to demoralization, which constitute actual psychological state of a patient. It also helps to differentiate these factors from variety of syndrome signs and, therefore, to stabilize individual mental condition by making therapeutic interventions more targeted. Objectives. The aim is to elicit specific features of and to discern criteria for distinction of the notion of demoralization from variety of other concepts frequently used in clinical psychologist’s activity to describe pathological mental states that patients with severe somatic disease may have. Results. Based on the comparison of the demoralization concept and mental distortions frequent in a clinic of severely ill somatic patients, essential and pivotal sings of the phenomenon of demoralization are shown. The epidemiological data on occurrence and intensity rates, as well as demoralization comorbidity to a number of disturbed mental activity symptoms and states amid patients with different somatic nosology are given. Conclusions. As a psychological state, demoralization can be diagnosed among either inpatients or outpatients. It might also present itself singularly or be comorbid to any mental distortion yet maintaining its seminal qualities, such as distress, subjective incompetence experience and preservation of motivation. Discrimination of demoralization state might have both therapeutic and prognostic value.

ObjectiveThis study aimed to examine the associations of perceived stress, stressors, and distress with sleep disturbance and duration among Asian immigrants.Design/setting/participantsThe sample included 400 Asian immigrants aged 50-75 years old recruited from primary care physicians' clinics.MethodsWe fit multivariable regression models to examine the associations of perceived stress, stressors, and distress with self-reported sleep disturbance and duration. We tested effect modifications by language proficiency, years in the United States, acculturative stress, and social support.ResultsA total of 73 (18.3%) participants reported any sleep disturbance, and the average time in bed was 7.25 hours (SD = 1.17). Higher perceived stress (PR = 1.15, 95% CI = 1.06, 1.26), stressors (PR = 1.32, 95% CI = 1.13, 1.59), and distress (PR = 1.36, 95% CI = 1.21, 1.57) were associated with a higher prevalence of any sleep disturbance. These associations were not modified by language proficiency, years in the United States, acculturative stress, and social support. On the other hand, the associations of perceived stress and distress with time in bed were modified by years in the United States. Specifically, higher levels of distress were associated with shorter times in bed only among adults who have resided in the United States for less than 10 years.ConclusionPerceived stress, stressors, and distress were associated with a higher prevalence of sleep disturbance. Moreover, perceived stress and distress had stronger associations with times in bed among recent immigrants. Future sleep health research in Asian Americans should consider the important role of stress and distress, especially among recent immigrants.

Although many breast cancer survivors adjust to cancer treatment and survivorship, a sizable subgroup of women do not do so, resulting in psychological distress. Over time, this psychological distress can contribute to immune dysfunction and accompanying worsened physical symptoms as women navigate survivorship. Dr. Kiecolt-Glaser's work and mentorship has been integral to our understanding of breast cancer survivors' immune risks, and how behavioral factors may enhance these risks. As a postdoctoral fellow in the Stress and Health Lab, under Dr. Kiecolt-Glaser's mentorship, my research focused on understanding how distress is associated with immune functioning and physical health in breast cancer survivors. In this paper, we highlight Dr. Kiecolt-Glaser's influence on our careers as a strong female research and mentor, the work completed under her mentorship, and how the field of psychoneuroimmunology can continue to expand her research to better understand how distress in the cancer context confers long-term health risks.

Abstract Background The WHO-5 Wellbeing Index is a widely used tool for assessing psychological well-being. Despite its global application, its adaptation and validation for the Azerbaijani population had not been previously explored. This study aims to fill this gap by adapting the WHO-5 Wellbeing Index for Azerbaijani adults and examining its relationship with psychological distress, resilience, and life satisfaction. Methods A sample of 875 Azerbaijani adults aged 18 to 89 (mean age = 29.13, SD = 10.98) participated in this study. The adaptation process included confirmatory factor analysis to test the original 5-item structure of the index in the Azerbaijani context. Additionally, item response theory analysis was employed to evaluate the discriminative values of the items. Reliability was assessed through various methods, including Cronbach’s alpha, McDonald’s omega, and Guttmann’s lambda. Results Confirmatory factor analysis supported the original 5-item structure of the WHO-5 Wellbeing Index for the Azerbaijani sample, demonstrating alignment with the index’s original version. All items showed acceptable discriminative values in item response theory analysis. The index also exhibited sufficient reliability, as evidenced by Cronbach’s alpha, McDonald’s omega, and Guttmann’s lambda. Correlation and network analyses indicated significant associations of the WHO-5 Wellbeing Index with psychological distress, resilience, and life satisfaction. Specifically, the index was negatively correlated with depression, anxiety, and stress, and positively correlated with resilience and life satisfaction. Conclusion The findings suggest that the WHO-5 Wellbeing Index is a valid and reliable tool for assessing psychological well-being in the Azerbaijani population. Its significant associations with psychological distress, resilience, and life satisfaction further affirm its utility in this cultural context.

We examined the role of emotion- versus fact-focused conversations in the details children reported about a stressful event and whether the details provided were prompted or spontaneously offered. We also tested how these conversational strategies, in conjunction with children's emotion regulation skills, influenced children's event-related distress. Children (N = 100 8- to 13-year-olds) experienced a stressor in the laboratory and were randomly assigned to participate in a fact-focused conversation (prompted about objective event elements) or an emotion-focused conversation (prompted about subjective reactions to the event) with an unfamiliar adult. Caregivers reported on children's emotion regulation skills. Children reported more overall prompted and spontaneous details in the fact-focused condition, but reported proportionally more spontaneous details than prompted detail in the emotion-focused condition compared to the fact-focused condition. Children with lower emotion regulation skills found the emotion-focused conversation (but not the fact-focused conversation) about the laboratory stressor significantly less distressing than children with high emotion regulation skills (when controlling for initial distress about the task). We propose that combining both fact- and emotion-focused conversational techniques may be most effective for encouraging detailed disclosures from children and for providing a respite from distress for children with emotion-regulation difficulties.

IntroductionThis study examined the efficacy of eye movement desensitisation and reprocessing (EMDR) therapy compared with standard psychotherapy (SP) in treating post-traumatic stress disorder (PTSD) in paediatric oncology patients and their families in the early stage of cancer treatment. The secondary aim of this study was to assess whether EMDR therapy has a different impact on post-traumatic growth compared to SP.MethodsForty patients were randomly assigned to EMDR or SP groups. The Impact of Event Scale – Revised (IES-R) and the Distress Thermometer (DT) were used to assess PTSD symptoms at pre-treatment (at cancer diagnosis) and in the post-treatment stages (after 8 sessions). The Post-traumatic Growth Inventory-PTGI was administered in the post-treatment stage in order to evaluate positive changes.ResultsBoth EMDR and SP are effective in reducing PTSD, but EMDR was significantly more effective than the SP in reducing scores on the IES-R, especially regarding the intrusive symptom subscale. Also, in the EMDR group there were higher scores of PTGI than in the standard group.ConclusionEMDR thus represents a promising treatment in the paediatric psycho-oncology setting.

The aim of this research was to examine the prediction of aspects of subjective well-being based on resilience and seven basic personality traits in users of gerontological centers, and the incremental contribution of basic personality traits in explaining adaptation to old age, beyond the variance explained by resilience. The sample consisted of 151 participants (54.3% female) with an average age of 80 years. Satisfaction with life, as cognitive indicator, and emotional distress (anxiety, depression, and stress) were used as indicators of subjective well-being. The results showed that resilience, neuroticism (in the negative direction) and positive valence predicted life satisfaction in the elderly. In predicting emotional distress, neuroticism stood out as a key predictor, while the significant contribution of resilience is dimnished by introducing personality traits into the model. The results provide a more complete picture of the relationships between resilience, personality traiits, and subjective well-being in a sample of the elderly in Serbia, and confirm the importance of studying these relationships from a developmental perspective.

Background. In the article, the review of international special literature is exposed. The paper is dedicated to the concept of demoralization, which is an under-investigated realm in Russian psychological science. The notion of demoralization is applied in clinical psychologist practice, in order to make a holistic description of people’s complex of emotional struggle experience in different somatic nosology types, which may be connected to death hazard, for both inward and outward patients. The introduction of this concept is important for differential diagnosis and the selection of appropriate medication, psychotherapeutic and social-psychological support and follow-up measures. Objective. The aim is to define demoralization concept and its practical application referring to clinical psychologist practice with patients having different types of somatic disease. Results. Grounded on the analysis of international understanding of demoralization concept in clinical practice, the notion of demoralization as a holistic phenomenon having its specific content was established. It is shown, that diagnostic clues are distinct as compared to other notions. The paper presents demoralization concept as a significant one for clinical psychologist and psychiatrist, working with severely ill patients with death hazard. Conclusion. Difficult life circumstances, resulted from severe somatic disease, raise the problem of life and death. Demoralization can be understood as a state generated by actual crisis conditions of human existence in a particular situation and expressed in the subjective experience of failure to overcome it. Disclosure of specific features characteristic of the phenomenon of demoralization contributes to a deeper understanding of the content of psychological experiences in severely ill patients at risk for life. This allows to outline and implement more appropriate and targeted tactics of psychotherapeutic interventions.

Wei Liu,1 Jeffrey Hugh Gamble,2 Cui-Hong Cao,3,4 Xiao-Ling Liao,5 I-Hua Chen,1 Gordon L Flett6 1Chinese Academy of Education Big Data, Qufu Normal University, Qufu, People’s Republic of China; 2Department of English, National Changhua University of Education, Changhua, Taiwan; 3Faculty of Education, Qufu Normal University, Qufu, People’s Republic of China; 4School of Foreign Languages, Shandong Women’s University, Jinan, People’s Republic of China; 5Faculty of Education, Jiangxi Science and Technology Normal University, Nanchang, People’s Republic of China; 6Faculty of Health, York University, Toronto, ON, CanadaCorrespondence: I-Hua Chen, Chinese Academy of Education Big Data, Qufu Normal University, 57 Jingxuan West Road, Qufu, Shandong, 273165, People’s Republic of China, Tel/Fax +86 05374450537, Email aholechen@gmail.com Gordon L Flett, Faculty of Health, York University, LaMarsh Centre for Child & Youth Research, 5022K Technology Enhanced Learning – TEL Keele Campus, Toronto, ON, Canada, Tel +1 416 736 2100 Ext. 33727, Email gflett@yorku.caPurpose: Mattering is essential to university students’ mental health. Feeling valued by others or unimportant can affect their overall well-being. However, most measures for assessing mattering have been developed and tested in Western countries, with limited evaluation of the measures when administered to university students in other regions. This study evaluated the reliability and validity of three mattering-related instruments – the General Mattering Scale (GMS), Anti-Mattering Scale (AMS), and Fear of Not Mattering Inventory (FNMI) among Chinese university students using classical test theory and Rasch analysis.Methods: The study comprised 3594 university students from 19 universities across 13 provinces in mainland China, with a balanced gender distribution of 47.2% females and 52.8% males. Participants’ ages ranged from 18 to 37, averaging 20.02 years. Most (78.4%) were in four-year programs, with the rest in three-year programs. The majority were freshmen (54.2%), and 86.3% had siblings. The predominant major was engineering (43.4%), followed by roughly equal representations in science, social science, and literature/art.Results: The three scales showed high reliability and factorial validity, with Rasch analysis confirming their unidimensionality and monotonicity, although 2 of 15 items (one GMS item and one FNMI item) had lower fit. There were no substantial differences in item functioning between male and female respondents. Further analyses indicated that mattering, anti-mattering, and fear of not mattering all explained significant unique variance in levels of hope and distress.Conclusion: All three mattering-related instruments are suitable for assessing Chinese students’ mattering, anti-mattering, and fear of not mattering and changes in levels of these mattering dimensions. Moreover, each measure represents a unique element of the mattering construct in terms of associations with levels of hope and distress assessed in during the COVID-19 pandemic.Keywords: mattering, anti-mattering, fear of not mattering, university students, hope, distress

Although empathy is not a defining feature of borderline personality disorder, there is a growing body of work suggesting deficits in some components of empathy toward humans. There is no research investigating the link between borderline personality features (BPF) and empathy toward animals, which may be less threatening to individuals that struggle in interpersonal relationships and fear rejection. We examined BPF and self-reported distress and viewing times of photographs depicting dogs and children in twelve adverse circumstances in a college student sample (N = 464) with trait empathy as a mediator in Study 1. BPF predicted distress to dog but not child photos. There were significant indirect effects of BPF on distress to dog and child photos through personal distress. In Study 2 (N = 524), we further examined the processes underlying these associations by modelling a serial mediation of BPF with distress to dog and child photos through anxious and avoidant attachment to trait empathy toward animals and humans. We replicated the finding that BPF predicted distress to dog but not child photos. BPF predicted both anxious and avoidant attachment styles, which negatively predicted empathy for humans and animals. Empathy for humans mediated the associations with distress for child photos whereas empathy for animals mediated the associations with distress for dog photos. Further research is needed to determine the causal pathways between BPF, attachment, and empathy to animals and humans.

PurposeThe purposes of this study, in a sample of oncology patients (n = 1326) receiving chemotherapy, were to identify subgroups of patients with distinct anxiety profiles and evaluate for differences in demographic and clinical characteristics, stress and resilience measures, and severity of co-occurring symptoms (i.e., depression, sleep disturbance, attentional function, fatigue, pain).MethodsPatients completed self-report questionnaires a total of six times over two cycles of chemotherapy. Severity of state anxiety was evaluated using the Spielberger State Anxiety Inventory and resilience was assessed using the Connor-Davidson Resilience Scale. Symptoms were assessed using the Center for Epidemiologic Studies Depression Scale, General Sleep Disturbance Scale, Lee Fatigue Scale, Attentional Function Index and Brief Pain Inventory.ResultsBased on the findings from the latent profile analysis that utilized the six assessments of state anxiety, 47.7% of the patients were classified as "Low," 28.3% as "Moderate," 19.5% as "High," and 4.5.% as "Very High." Anxiety levels remained relatively stable across the six timepoints. Compared to the Low class, membership in the Moderate, High, and Very High classes was associated with a number of characteristics (e.g., younger age, female gender, lower functional status, more comorbidities). Those patients with higher levels of anxiety reported higher levels of stress, lower levels of resilience, and increased severity of co-occurring symptoms.ConclusionOur findings suggest that a substantial number of oncology patients may warrant referral to psychological services. Clinicians need to perform systematic assessments of anxiety, stress, and common symptoms and initiate appropriate interventions to enhance resilience and coping.

Abstract Background Suicide is a serious public health issue. Distress has been identified as a common risk factor, with research also suggesting that a lack of social connectedness is involved. Methods This quantitative, cross-sectional study investigated the role of perceived burdensomeness and thwarted belongingness in the psychological distress/suicidal ideation pathway in a community sample of 480 Australian adults. Results As expected, distress was found to be a strong predictor of suicidal ideation. Perceived burdensomeness and thwarted belongingness both moderated and mediated the relationship between distress and suicidal ideation. Specifically, distress was more strongly linked to suicide ideation when burdensomeness or thwarted belongingness were also high. This moderating effect was stronger for thwarted belongingness than it was for burdensomeness. These variables also mediated the pathway, in that higher distress related to higher burdensomeness and thwarted belonging, which in turn related to higher suicide ideation. This mediating effect was stronger for burdensomeness than for thwarted belonging. Conclusions Overall, the findings confirm the importance of our social relatedness in suicide. Increasing belongingness and reducing the perception of being a burden on others may be an important intervention strategy for weakening the link between distress and suicide ideation.

This meta-analysis examines the correlations of the number of social network site (SNS) friends with well-being and distress, based on 90 articles consisting of 98 independent samples on correlations of online social network size (OSNS) with happiness, life satisfaction, self-esteem, anxiety, depression, combined anxiety and depression, loneliness, social anxiety, social loneliness, well-being and distress. The correlations between OSNS and well-being indicators are positively weak (from .06 to .15), whereas those for distress indicators are inconclusive (from -.19 to .08). Studies recording the OSNS based on the participant profile have larger mean effect sizes for well-being (.21) and self-esteem (.31) than those based on self-reporting (.06 and .05, respectively). The correlation between OSNS and self-esteem is stronger in samples with a smaller mean network size.

Background: Family members of people with mental illness (MI) may experience a host of psychological adversities such as increased stress, burden, and reduced wellbeing. However, relatively little is known about siblings. This study aimed to characterise the experience of distress (viz. depressive and anxiety symptoms), burden, and wellbeing in siblings of people with MI. Methods: Studies reporting on quantitative measures of depression, anxiety, burden, or wellbeing in siblings; and/or qualitative findings on siblings' experience were eligible. The literature search was conducted up until 20th October 2022. Results: Sixty-two studies comprising data from 3744 siblings were included. The pooled mean percentage of depressive symptoms fell in the mild range at 15.71 (k = 28, N = 2187, 95% CI 12.99–18.43) and anxiety symptoms fell in the minimal range at 22.45 (k = 16, N = 1122, 95% CI 17.09–27.80). Moderator analyses indicate that siblings of people with a schizophrenia spectrum disorder experience greater depressive symptoms than siblings of people with other types of MI (β = −16.38, p < 0.001). Qualitative findings suggest that individuals may be particularly vulnerable during their siblings' illness onset and times of relapse. Limited communication, confusion about MI, and the need to compensate may contribute to siblings' distress and/or burden. Siblings' experience of wellbeing and caregiving were closely related. Conclusion: This review highlights the complex psychological experience of siblings and the need for greater research and clinical support for this important yet often overlooked cohort. [ABSTRACT FROM AUTHOR]

This study examined how discrimination changes over time, how discrimination is related to health and substance use, and whether discrimination spills over to affect the health of family members. Parent-adolescent dyads (N = 341) completed measures of discrimination, physical health, mental health, and substance use over 5 years. Actor-Partner Interdependence Models indicated that individuals' experiences of discrimination can spill over to some aspects of the family context, depending on who is experiencing discrimination (i.e. parent, adolescent) and the outcome (i.e. mental health, substance use). Results suggest that parent-reported discrimination may affect adolescent depression, and adolescent-reported discrimination can spill over to parents' substance use.

COVID-19 spawned many bogus beliefs (e.g., that it could be treated by ingesting household cleaners) and induced resistance to established facts (e.g., that it could be managed by vaccines). We tested whether transitory distress and insufficient psychosocial resources explain these maladaptive perspectives. According to the Resources and Perception Model (RPM; Harber et al., 2011, https://doi.org/10.1037/a0023995), distress distorts perception and judgment, but psychosocial resources (e.g., social support, self-esteem, purpose) mitigate such distortions by buffering distress. Two cross-sectional studies of COVID-19 beliefs fit within the RPM framework. General life distress was related to endorsing bogus beliefs and denying facts. COVID-specific distress was also related to bogus beliefs but not to denial of facts. Resources, in contrast, were associated with fewer bogus beliefs and with greater acceptance of facts. As per RPM, distress mediated the relation between resources and bogus beliefs. Additionally, rejection of CDC recommendations and adoption of survivalist strategies were positively associated with distress and negatively associated with resources. All results were retained even after controlling for mood and individual differences including political ideology and news sources.

In the current research we investigated how people deal with decisions in which they have to reject others, something that is unavoidably part of many selection procedures. Integrating insights derived from research on social exclusion and dehumanization, we argued that when people need to reject others, they dehumanize them. To study the association between dehumanization and rejecting in a real-life setting, we conducted two field studies, in which we examined the selection process in student houses, where residents can accept some prospective members, but have to reject others. As predicted, our findings showed that when people need to reject targets, they subtly dehumanize them. Moreover, dehumanizing rejected targets was related to lower rejection aversion. This suggests that when people dehumanize those they have to reject, rejection is easier.

ObjectiveChronic pain frequently co-occurs with clinically relevant psychological distress. A systematic review was conducted to identify the efficacy of cognitive behavioral therapy-based interventions for patients with these comorbid conditions.MethodsThe systematic search was carried out in Medline, PsycINFO, Web of Science, and Scopus up to March 18th, 2023. Four reviewers independently conducted screenings, extraction, and quality assessment.ResultsTwelve randomized controlled trials and one non-randomized controlled trial involving 1,661 participants that examined the efficacy of Cognitive Behavioral Therapy (nine studies), Mindfulness-based Interventions (three studies), Acceptance and Commitment Therapy (one study), and Behavioral Activation Therapy for Depression (one study) were included. Compared to treatment as usual, six out of eight studies of traditional Cognitive Behavioral Therapy reported significant differences in the reduction of depressive symptoms at post-treatment (d from 1.31 to 0.18) and four out of six at follow-up (d from 0.75 to 0.26); similarly, five out of six reported significant differences in the reduction of anxiety symptoms at post-treatment (d from 1.08 to 0.19) and three out of four at follow-up (d from 1.07 to 0.27). Overall, no significant differences between traditional Cognitive Behavioral Therapy and treatment as usual were reported at post-treatment and follow-up in the studies exploring pain intensity and pain catastrophizing.ConclusionThe available evidence suggests that traditional Cognitive Behavioral Therapy may produce significant benefits for the improvement of depression, anxiety, and quality of life, but not for pain intensity and pain catastrophizing. More evidence is needed to determine the effects of MBI, ACT, and BATD.Systematic review registrationPROSPERO, CRD42021219921.

Recent studies have noted a rising prevalence of common mental health issues, including suicidal ideation and self-harming behaviors, among college students globally. However, limited attention has been given to the preparedness of educational institutions in addressing these concerns. This study aims to comprehensively assess the landscape of mental health support within Indonesian universities, with a particular focus on uncovering the availability of policies and training as well as faculty members’ perceptions of students’ mental health challenges, the identification of responsible parties for providing assistance, and the specific support needs of faculty members prior to the pandemic. Employing a mixed exploratory method, the research engaged 172 faculty members from 72 universities in Indonesia who completed an online survey. The quantitative data underwent descriptive analysis, while the free-text responses were thematically categorized. The findings revealed that (1) most universities still lack formal policies on dealing with students in psychological distress; (2) there is a gap between faculty members’ willingness to discuss students’ mental health and their decision to refer students to mental health services; and (3) there is a necessity for building a multi-layered support system for this issue. Hence, universities are advised to proactively institute formal policies to address students in psychological distress, implement comprehensive mental health training for both students and faculty, and enhance the accessibility of professional psychological support services, thereby creating a robust framework for promoting and safeguarding the mental well-being of students.

IntroductionElite athletes are exposed to a variety of sport-specific stressors that may put them at particular risk for mental health symptoms and disorders. The aim of the present study was to assess data on mental health of elite athletes and investigate associations and interconnections among different variables using network analysis.MethodsA cross-sectional study was conducted from December 2021 to December 2022. The sample consisted of 275 German elite athletes (167 females) aged ≥18 years. Next to sociodemographic, medical and sport-related data, psychometric data such as psychological distress, symptoms of generalized anxiety, depression, and somatic symptom disorder have been gathered through questionnaires and analyzed by means of network analysis.ResultsOver 95.0% of the athletes showed elevated distress and 28.6% reported symptoms of depression. Results of the network analysis show, among other findings, that symptoms of somatic symptom disorder were associated with severe injuries and substance use. Moreover, elite athletes who reported a better financial situation reported fewer symptoms of depression, generalized anxiety, and somatic symptom disorder. They also reported a lower incidence of mild to moderate injuries and severe injuries, fewer years spent in elite sports, less substance use, and fewer training sessions per week. Conversely, these athletes reported a higher level of distress. Furthermore, sex, financial situation and number of training units per week emerged as significant predictors for mental health symptoms.DiscussionElite athletes showed increased numbers regarding mental health symptoms. Providing appropriate mental health interventions for elite athletes and further analysis of factors that influence the mental health of elite athletes and their interplay seem to be of central importance for the general well-being of elite athletes.

The impacts of climate change are particularly strong in Pacific Small Island Developing States. However, empirical data on mental health and well-being in the context of climate change and climate anxiety in the region remains limited. The aim of this research was to understand the emotional experiences of climate change and its impact on well-being in rural Fiji. Seventy-one Indigenous and traditional Fijian adults from seven rural villages were interviewed. Data were analyzed using an inductive latent thematic analysis. Evident was the experience of ecological grief among Indigenous and traditional Fijians. In particular, grief experiences were related to losses of species and resources, which impacted ways of life and led to the loss of culture, traditions, and customs. Anticipatory grief was also evident, relating to the loss of lifestyle for future generations, and the loss of traditional and ancestral homes through potential migration. Results provide new data from the Global South and contribute to the limited exploration of mental health in relation to climate change in the Pacific region. The results highlight the experience of ecological grief among Pacific Islanders, and underscore the significance of culture loss due to climate change and anticipatory grief.

Informal caregivers (ICs) are integral to care provided to patients facing life-threatening or incurable illnesses. This responsibility causes considerable burden, as approximately one half of ICs report clinically significant symptoms of depression and/or anxiety that persist when left untreated. Psychosocial interventions containing efficacious treatment principles (e.g., cognitive behavior therapy [CBT]) show disappointing results in reducing anxiety and depression in ICs. This may reflect failure of these interventions to specifically target crucial mechanisms underlying the central feature of distress caused by the patient's illness-notably, perseverative negative thinking (PNT). Emotion Regulation Therapy (ERT) is an efficacious CBT developed to explicitly target mechanisms underlying PNT and the emotional concomitants that arise in response to stressful situations. This open trial was conducted to evaluate the acceptability and initial efficacy of ERT adapted to the experience of cancer ICs (ERT-C). Thirty-one ICs provided informed consent and completed eight weekly individual sessions of ERT-C. Participants completed self-report measures of depression and anxiety symptoms, PNT, emotion regulation deficits, and caregiver burden before and after treatment. ERT-C was well tolerated as indicated by 22 treatment completers and feedback provided in exit interviews. ICs demonstrated reduced depression and anxiety symptoms, PNT, and emotion regulation deficits with moderate to large effect sizes (Hedge's g range: 0.36-0.92). Notably, caregiver burden was not reduced but ICs expressed more ability to confront caregiving-related challenges. Findings offer promising but preliminary support for ERT-C as a conceptual model and treatment modality for distressed cancer ICs.

Syed Irfan Karim,1,2 Farhana Irfan,2 Shazia Haris,3 Nassr Al-Maflehi,4 Abdullah MA Ahmed,2 Gominda Ponnamperuma,5 Shuaa Al Sayyari,6 Eiad Al Faris1,2 1Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia; 2King Saud University Chair for Medical Education Research and Development, Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia; 3Ministry of Health, Riyadh, Saudi Arabia; 4College of Dentistry, King Saud University, Riyadh, Saudi Arabia; 5Department of Medical Education, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka; 6College of Medicine, King Saud University, Riyadh, Saudi ArabiaCorrespondence: Syed Irfan Karim, Department of Family and Community Medicine, College of Medicine, King Saud University, PO Box 2925, Riyadh, 11461, Saudi Arabia, Tel +966114679253, Fax +966114671967, Email irfankarim1969@gmail.comPurpose: The increasing prevalence of distress among students is of global concern. Several factors such as school and family environment and ineffective study skills could influence mental health. The study explored the rate of distress symptoms among school students’ and its relationship with their study skills, stressors and demographic factors.Methods: In this cross-sectional analytical study, a sample of 215 students from a community school participated in the study. Three questionnaires, demographic questionnaire, Study Skills Inventory and the Kessler Psychological Distress Scale, were used for data collection. Data were analyzed using Student’s t-test, ANOVA, Pearson’s correlation coefficient and stepwise linear regression.Results: Response rate was 70% (n = 150). A high proportion of respondents (75%) was distressed (mean 27.28 ± 8.77). Correlation analysis showed that distress (K10 score) was negatively related to study skills (SSI total score) (r = − 0.247, p = 0.002). The rate of distress symptoms was higher among female students (79%) compared to their male counterparts (72%). The factors associated with distress included negative association of teachers’ level of help to develop competencies (p = 0.000, β = − 0.278, R2 = 0.249), unfavorable school environment (p = 0.000, β = 0.285, R2 = 0.123), inability to cope with studies (p = 0.005, β = 0.205, R2 = 0.038), family problems (p = 0.014, β = 0.184, R2 = 0.173) and lower study skills (p = 0.031, β = − 0.164, R2 = 0.270). The overall regression analysis explained 33.6% of the variance (corrected R2 = 0.336).Conclusion: Higher than expected levels of distress (75%) was found in immigrant school students. Poor study skills have a significant relationship with distress. Learning environment and related stress factors were associated with distress among students. Based on the findings, it is recommended that stakeholders in education address the hidden curriculum, as it is usually unacknowledged and might affect students’ wellbeing, and move from student centered to an interpersonal relation-centered education.Keywords: school students, distress, study skills, stressors

Abstract Background Cancer has great implications for psychological, social, economic, and emotional dimensions. Psychological distress is overwhelming among cancer patients following a confirmed diagnosis. However, little is known about the prevalence of psychological distress and associated factors among cancer patients in Africa Sub-Saharan. Thus, this study aimed to assess the prevalence of psychological distress and associated factors among cancer patients in public hospitals in Addis Ababa, Ethiopia. Methods An institution-based cross-sectional study was conducted among cancer patients from September 15, 2019, to June 30, 2020. A total of 386 cancer patients selected through a simple random sampling technique participated in the study. Data were collected by an interview-administered questionnaire to evaluate psychological distress with a distress thermometer and social support with the Oslo 3-items Social Support Scale. The collected data were entered into Epi-data version 4.2 and exported into SPSS 25 for analysis, and then binary and multivariate logistic regressions were done to identify the association between dependent and independent variables. Results A total of 386 study participants were included in the study with a response rate of 91.4%. The prevalence of psychological distress among cancer patients in public hospitals in Addis Ababa, Ethiopia was 64.5%. Age > 45 years [AOR = 0.41; 95% CI (0.22–0.77)], marital status of being divorced [AOR = 3.3; 95%CI (1.23–8.71)] and married [AOR = 3.2; 95%CI (1.03–10.40)], rural residence [AOR = 1.5; 95%CI (1.15–5.18)], cancer stage II [AOR = 3.9; 95%CI (1.90–15.50)], stage III [AOR = 3.5;95%CI (1.45–8.44)] and stage IV [AOR = 3.4; 95%CI (1.90–10.11)], co-morbidity [AOR = 0.07; 95%CI: (0.03–0.17)], and moderate social support [AOR = 0.36; 95%CI (0.14–0.60)] and strong social support [AOR = 0.06; 95%CI (0.03–0.12)] were found to be significantly associated with psychological distress. Conclusion The prevalence of psychological distress among cancer patients in public hospitals in Addis Ababa, Ethiopia was high, and age, marital status, place of residence, cancer stage, co-morbidity, and social support were associated with psychological distress. Therefore, interventions focusing on these findings require special emphasis during designing interventions aimed at decreasing psychological distress.

Background. The diagnosis and treatment of colorectal cancer are considered highly stressful and potentially traumatic events that can generate post-traumatic stress symptoms and distress among patients. Objective. This study assessed levels of post-traumatic stress symptoms, distress, and optimism, as well as differences between these conditions relative to sociodemographic and medical variables, in Mexican patients with colorectal cancer. Design. A cross-sectional descriptive study design was employed, in which 192 colorectal cancer patients over the age of 18 years participated. They filled out the following questionnaires in person: a sociodemographic and medical data questionnaire; the Event Impact Scale-Revised (EIE-R); the Hospital Anxiety and Depression Scale (HADS); and the Life Orientation Test (LOT-R). Results. The results showed that 32.3% of the patients reported post-traumatic stress symptomatology, and 21.4% reported distress. Post-traumatic stress symptoms and distress varied according to age and monthly income. Significant differences between the sexes were also observed in the levels of post-traumatic stress symptoms and distress. Post-traumatic stress was positively and significantly related to distress, and negatively and significantly to optimism. Conclusion. Based on these data, we concluded that a significant percentage of colorectal cancer patients present high levels of post-traumatic stress symptoms as well as distress, and that these levels may vary according to sociodemographic and medical characteristics.

We investigated whether anxiety sensitivity (AS) is associated with increased distress and adherence to public health guidelines during the COVID-19 pandemic among undergraduates, and whether increased distress mediates the relationship between AS and increased adherence. An online cross-sectional survey was conducted with 1318 first- and second-year undergraduates (mean age of 19.2 years; 79.5% females) from five Canadian universities. Relevant subscales of the Substance Use Risk Profile Scale (SURPS) and the Big Five Inventory-10 (BFI-10) were used to assess AS and neuroticism. Three measures tapped distress: the Patient Health Questionnaire-9 (PHQ-9) for depressive symptoms, the Generalized Anxiety Disorder-7 (GAD-7) for anxiety symptoms, and the Brief COVID-19 Stress Scales (CSS-B) for COVID-19-specific distress. The COVID-19 Adherence scale (CAD) assessed adherence to COVID-19 containment measures. AS was significantly independently associated with higher general distress (both anxiety and depressive symptoms) and higher COVID-19-specific distress, after controlling age, sex, study site, and neuroticism. Moreover, AS indirectly predicted greater adherence to COVID-19 preventive measures through higher COVID-19-specific distress. Interventions targeting higher AS might be helpful for decreasing both general and COVID-19-specific distress, whereas interventions targeting lower AS might be helpful for increasing adherence to public health containment strategies, in undergraduates.

IntroductionThe lived experiences of chronic pain (CP) among Arabic-speaking populations remain underexplored. A better understanding of these experiences and their associations with attention difficulties, coping mechanisms, and treatment options could lead to improved support for this group.MethodsThis qualitative study utilised a descriptive design and involved one-to-one interviews with 51 participants with CP who had just completed two attention tasks. Interviews were conducted using a semi-structured topic guide, transcribed verbatim and translated from Arabic to English before agreeing on the coding framework. Themes and subthemes were extracted using a framework analysis approach.ResultsThe study identified six main themes: Factors contributing towards developing or exacerbating CP, the impact of CP on psychosocial functions, including attention, the perceived role of social support, coping strategies for managing CP, perceptions about available treatments and recommendations for interventions.DiscussionCP significantly impacts individuals’ physical and psychosocial functions, and it is reciprocally associated with attentional difficulties. Despite using various approaches to manage their CP, none of the participants used psychological interventions or counselling. Understanding the diverse impacts of CP and the coping strategies employed to develop culturally sensitive interventions, review current related policies, and improve healthcare services is crucial to managing CP among this population.

Objective: This study examined whether a 4-week group-based mindfulness intervention would be superior in reducing psychological distress in colorectal cancer (CRC) patients compared to a psychoeducation and cognitive behavioural skills learning support active control group. Methods: Patients with CRC were randomized via Computerised Permuted Block Randomisation to mindfulness or active control groups (2-h weekly sessions over 4 weeks). Outcomes were measured pre-intervention, and 8 weeks and 6 months post-baseline. The primary outcome was psychological distress measured by the Hospital Anxiety and Depression Scale. Secondary outcomes were generic quality of life (QoL), disease specific QoL, mindfulness, and intervention credibility and acceptability. Results: Sixty-eight participants were randomized to mindfulness (n=35) or active control group (n=33). Uptake of potentially eligible patients consenting was low (28.0%) and the dropout rate was 33.8%. Depression scores were reduced in both groups at week 8 (P=0.020). Control participants had greater improvement in generic mental QoL scores at week 8 than mindfulness (P=0.023). In disease specific QoL, there was reduction in impotence symptom in the mindfulness group (P=0.022) and reduction in faecal incontinence in the control group (P=0.019). The embarrassment symptom had a significantly lower increase in the mindfulness group at week 8 compared to the control group (P=0.009). Both groups rated the treatments as credible and acceptable. Conclusions: Mindfulness was not superior to the active control group in terms of alleviating psychological distress but both treatments were associated with some improvements in depression. There was low uptake of both interventions. (Trial registration number: ACTRN12616001033437) [ABSTRACT FROM AUTHOR]

Objectives: The risk of opioid addiction among people with chronic pain is elevated in those using opioids to self-medicate physical or emotional pain or distress. The purpose of this study is to test the main effect of distress tolerance (DT) on opioid use disorder (OUD) status in people with chronic pain, and the potential moderating effect of DT in the relationship between known addiction risk factors and the development of OUD. Methods: One hundred twenty people with chronic pain were recruited to 1 of 3 groups according to their opioid use status (ie, current methadone or buprenorphine/naloxone for OUD [n = 60], history of OUD but current prolonged opioid abstinence [n = 30, meanabstinence = 121 weeks, SD = 23.3], and opioid naive [n = 30]). Participants completed self-report measures and a cold pressor task. Multinomial logistic regression analyses were used to test if DT associated with OUD status in people with chronic pain and to compare DT to other known indicators of OUD risk. Multinomial linear regression analyses were used to test the moderation effects of DT on the relationship between various risk factors and OUD in people with chronic pain. Results: Analyses revealed that DT was significantly related to OUD status but did not moderate the effects of most OUD risk factors. Conclusions: These results suggest that decreasing distress (eg, pain levels, craving responses, etc) may be more effective than improving tolerance to distress for the comorbid chronic pain and OUD population. [ABSTRACT FROM AUTHOR]

The following article proposes a reflection on the experience of Narrative Therapy of a group of cancer patients, non-homogeneous for sites and stages of disease, participating to a therapeutic writing path, in order to process the trauma reactive to cancer and to reflect on themselves. Taking inspiration from the assumption that “writing helps when people are faced with a stumble”, facilitating the process of distancing from life-events, each writer establishes either context, in a more intimate and true way, or memories and emotions connected to it, in order to express them to the group and to themselves too, and to identify new adaptation styles. The therapeutic path lasted eight meetings, during which some themes were chosen to guide the written reflection, which was carried out at home, and then shared with the group. The therapeutic path is an opportunity to adjust the perspective with which the specialist accompanies patients during the adaptation process to the disease, moving from the “explanation” to “comprehension”; from symptom to “sense”. The group narration is based on a relational perspective of co-construction of the meaning of experiences, highlighting the different roles and relevance of the factors involved.

The passage of time is a subjective experience and can be easily distorted by concurrent emotions. Specifically, time seems to move particularly slowly when people are in a negative emotional state. The aim of the current studies was to evaluate the bidirectional relationship between subjective time perception and distress during stressful waiting periods, during which the slow passage of time may be particularly distressing. Across studies of undergraduate students awaiting a midterm exam grade (Study 1) and law graduates awaiting bar exam results (Studies 2 and 3), results revealed consistent links between distress and time perception across the waiting periods, with tentative evidence for bidirectional relationships between these experiences. That is, people who perceived time as moving slowly while they waited tended to report greater distress across the waiting period (particularly worry, anxiety, negative emotion, and poor coping), and people who reported greater distress tended to perceive time as moving more slowly. The links between distress and time perception suggest the possibility of downward spirals during stressful waiting periods, such that distress makes time seem to slow down, which then exacerbates distress. We discuss avenues for future research and potential remedies to derail the spiral of distress and time perception.

Abstract Background In the Kingdom of Saudi Arabia (KSA), public attitudes and stigma toward mental health illness seem to prevent people from seeking psychological help, which negatively impacts an individual's life. The primary objective of this study was to investigate people's attitudes toward seeking psychological help and identify the extent to which the associated stigma is responsible for preventing them from seeking psychological help. Methods Two hundred eighteen adults recruited from the community living in the Eastern Province of the KSA completed the questionnaires, customized to create the Arabic version of Attitudes Toward Seeking Professional Psychological Help Scale-Short Form (ATSPPH-SF-A), the Arabic version of Stigma Scale for Receiving Psychological Help (SSRPH-A), and the Arabic version of Hopkins Symptom Checklist-25 (HSCL-25-A). Results Both stigma and psychological distress significantly affected attitudes toward seeking professional help. Furthermore, it indicated that attitudes were negatively correlated with stigma while positively correlated with psychological distress. No significant difference in attitudes toward psychological help-seeking was identified between male and female participants. However, males displayed higher levels of stigma, while females showed greater psychological distress. Furthermore, the groups who received psychological treatment demonstrated more favorable attitudes toward seeking psychological help. Conclusion Stigma and psychological stress influence attitudes toward treatment-seeking behavior for mental illness, making them two major predictors responsible for the underutilization of mental health services. More research is needed to assess specific sociodemographic disparities across more data sources and the factors that further contribute to stigma and psychological distress.

Patients with cancer might be particularly prone to stress caused by the COVID-19 pandemic. The aim of this study was to investigate the impact of pandemic-related stressors on oncological patients’ psychological well-being. During the second wave of the COVID-19 pandemic in Germany 122 cancer out-patients of the Comprehensive Cancer Center Munich reported on COVID-19-related stressors (information satisfaction, threat perception, and fear of disease deterioration) and answered standardized questionnaires for psychosocial distress (DT) as well as depression and anxiety symptoms (PHQ-2, GAD-2). Multiple linear regression analyses were used to identify associations of the COVID-19-related stressors with psychological symptoms, controlling for sociodemographic, psychological (self-efficacy, ASKU) and clinical (somatic symptom burden, SSS-8) variables. Initially, satisfaction with information was significantly negatively associated with all three outcome variables. Fear of disease deterioration was associated with distress and depressive symptoms. After controlling for additional variables, only satisfaction with information remained an independent determinant of anxiety (β = −0.35, p