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Objective: We examined the role of personal identity vis-à-vis COVID-related outcomes among college students from seven U.S. campuses during spring/summer 2021. Participants: The present sample consisted of 1,688 students (74.5% female, age range 18-29). The sample was ethnically diverse, and 57.3% were first-generation students. Procedures: Students completed an online survey assessing personal identity synthesis and confusion, COVID-related worries, general internalizing symptoms, positive adaptation, and general well-being. Results: Personal identity synthesis was negatively related to COVID-related worries and general internalizing symptoms, and positively related to positive adaptation, both directly and indirectly through life satisfaction and psychological well-being. Personal identity confusion evidenced an opposing set of direct and indirect associations with outcome variables. Conclusions: Personal identity may potentially be protective against pandemic-related distress among college students, in part through its association with well-being. Reducing identity confusion and promoting identity synthesis are essential among college students during this and future pandemics. [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]

Repetitive negative thinking and intolerance of uncertainty are risk and maintenance factors for emotional disorders. Although emerging evidence suggests that intolerance of uncertainty predicts increases in distress through repetitive negative thinking, these relationships have yet to be investigated among veterans. The present study examines if repetitive negative thinking mediates the relationships of intolerance of uncertainty with stress, disordered symptoms and impairment among a mixed clinical sample of veterans. Two hundred and forty-four treatment-seeking veterans with diagnoses of major depressive disorder, panic disorder, or posttraumatic stress disorder completed measures of intolerance of uncertainty, repetitive negative thinking, stress, impairment, depression, panic, and posttraumatic stress prior to receiving treatment. Mediation models revealed indirect effects of intolerance of uncertainty through repetitive negative thinking on stress and impairment in the full sample, and on disordered symptoms in subsamples with major depressive disorder and posttraumatic stress disorder. Conversely, intolerance of uncertainty did not have direct or indirect effects on disordered symptoms in a panic disorder subsample. Findings suggest that repetitive negative thinking and intolerance of uncertainty uniquely contribute to stress, impairment, and disordered symptoms, but repetitive negative thinking, may, in part, drive intolerance of uncertainty's contribution to emotional disorders. Interventions for repetitive negative thinking might improve the efficacy of existing transdiagnostic treatment protocols. Cross-sectional data is a limitation of the present study. Prospective designs in civilian samples can better establish the temporality of these relationships and if they are generalizable to the larger population. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To determine the incidence and trajectory of distress, pain, and nausea and vomiting at postoperative day (POD) 1 and at POD 14 following breast-conserving surgery. SAMPLE & SETTING: 75 women aged 18 years or older receiving breast-conserving surgery with sentinel lymph node biopsy for treatment of early-stage primary breast cancer at an ambulatory surgery center. METHODS & VARIABLES: This prospective, repeatedmeasures study assessed distress, pain, and nausea and vomiting using the National Comprehensive Cancer Network Distress Thermometer and Problem List on POD 1 and POD 14. RESULTS: Pain and distress scores were highest on POD 1. The number of women who reported depression increased from POD 1 to POD 14. Thematic analysis revealed that family concerns, fears and worries, and postoperative issues contributed to pain and distress. IMPLICATIONS FOR NURSING: Women experience pain and distress during recovery at home after breastconserving surgery. Nurses can use these results to apply evidence-based practice to reduce this symptom burden. Future nursing research should focus on targeted interventions outside of the hospital setting. [ABSTRACT FROM AUTHOR]

Objective: Traumatic experiences are prevalent among people with serious mental illness and can significantly worsen outcomes. This study aimed to identify an urban cluster of trauma types, compare continuous distress ratings versus categorical experience of trauma for predicting outcomes such as depression and quality of life, and investigate the mediating role of recovery orientation in the impact of trauma exposure on outcomes. Method: Data came from an intervention study on African Americans with serious mental illness living in a large urban area; 212 participants completed baseline self-report measures of past trauma experiences, related distress levels, recovery, depression, and quality of life. Data were assessed using correlations and regressive path modeling. Results: Overall, 56.6% of participants reported experiences with trauma. Analyses suggested an urban cluster of trauma types that was self-reported by over 25% of participants. Distress due to trauma strongly correlated with greater depression as well as reduced quality of life and recovery. Interestingly, the categorical presence of trauma history (yes/no) had no significant relationship with any outcomes. Path analyses revealed that recovery mediated the impact of trauma distress on depression and quality of life, specifically implicating the recovery subfactor of hope. Conclusions and Implications for Practice: Results suggested that cognitive reframing focused on positive appraisals of overall recovery, and the hope subfactor can have a positive influence on trauma outcomes. The study supported the role of recovery in posttraumatic growth and suggests that hope can be used to help patients process trauma healthily. Impact and Implications: This study identified a cluster of traumas commonly experienced by urban African Americans with serious mental illness. Distress ratings—but not categorical presence of trauma history—predicted outcomes of depression and reduced quality of life, mediated by cognitive appraisal of recovery and specifically the hope subfactor of hope. Practitioners might use cognitive reframing toward schemas of recovery and hope to facilitate posttraumatic growth and improve patient outcomes. Research should further examine trauma clusters and their impact on outcomes. [ABSTRACT FROM AUTHOR]

Alexithymia is an important transdiagnostic risk factor for emotion-based psychopathologies. However, it remains unclear whether alexithymia questionnaires actually measure alexithymia, or whether they measure emotional distress. Our aim here was to address this discriminant validity concern via exploratory factor analysis (EFA) of the 20-item Toronto Alexithymia Scale (TAS-20) and the Perth Alexithymia Questionnaire (PAQ). United States general community adults (N = 508) completed the TAS-20, PAQ, and the Depression Anxiety Stress Scales-21 (DASS-21). EFA was used to examine the latent dimensions underlying these measures' scores. Our EFA extracted two higher-order factors, an "alexithymia" factor and a "general distress" factor (i.e., depression, anxiety, stress). All PAQ scores loaded cleanly on the alexithymia factor, with no cross-loadings on the distress factor. However, for the TAS-20, Difficulty Identifying Feelings (DIF) facet scores cross-loaded highly on the distress factor. Our sample consisted of general community adults; future work in clinical settings will be useful. Our data indicate that the PAQ has good discriminant validity. However, the TAS-20 appears to have significant discriminant validity problems, in that much of the variance in its DIF facet reflects people's current levels of distress, rather than alexithymia. The TAS-20, which has traditionally been the most widely used alexithymia questionnaire, may therefore not be the optimal alexithymia tool. Our findings add to the body of evidence supporting the validity and utility of the PAQ and suggest that, moving forward, it is a superior option to the TAS-20 for alexithymia assessments. • Alexithymia is an important risk factor for psychopathology and is most commonly assessed with self-report questionnaires. • However, there is ongoing uncertainty about whether alexithymia questionnaires might actually measure distress. • We explored this issue by examining the discriminant validity of the TAS-20 and PAQ. • The PAQ had good discriminant validity against markers of distress, but the TAS-20 did not. • Our data suggest that the PAQ is preferable over the TAS-20 as an alexithymia measure in psychopathology research. [ABSTRACT FROM AUTHOR]

PROBLEM IDENTIFICATION: Most patients with breast cancer are diagnosed at an early stage, when surgery remains the primary treatment. This scoping literature review explores the frequency and severity of symptoms; which patients are at the highest risk for pain, nausea, and distress; and the relationships between coping strategies and these symptoms. LITERATURE REVIEW: This review included articles found in the MEDLINE®, CINAHL®, PubMed®, PsycINFO®, APA PsycArticles®, and Cochrane Library databases and published from 2010 through 2022, using combinations of the following keywords: coping, cancer, distress, surgery, and breast. DATA EVALUATION: Initial search results yielded 111 research articles, and 13 were included in the review. Extracted data included the purpose, study design, sample size, time point, instrument, and conclusion. SYNTHESIS: Nausea, pain, and distress are substantial problems for women following breast cancer surgery. The relationships among predictors, pain, nausea, and distress are clear, but the direction and strength of these relationships remain unknown. A better understanding of the relationships among these factors is important to improve the experience of women with breast cancer. IMPLICATIONS FOR RESEARCH: Nursing research should focus on developing targeted interventions to reduce these symptoms. [ABSTRACT FROM AUTHOR]

Objective: Extant literature has seldom examined the naturalistic role of reaction to threat on downstream emotional distress while also considering buffers, such as perceived social support, to acute negative mental health outcomes. The present study examined how trauma symptoms, in reaction to a global stressor, predicted increased psychological distress via elevated emotional hostility and whether perceived social support modified such effects. We predicted a priori that increased exposure to trauma would be associated with increased hostility and global psychological distress, but that this path would be attenuated by greater levels of perceived social support, as individuals who report greater support exhibit greater emotional coping. Methods: We recruited 408 adults from a large university in the Midwestern United States to participate in a survey assessing past‐week trauma, hostility, distress, and perceived social support following the initial COVID‐19 lockdown. The survey was conducted in March 2020, directly after strict shelter‐in‐place orders were locally mandated. To test our hypotheses, we employed a moderated mediation analysis approach. Results: Results demonstrate that higher trauma predicted increased hostility, which in turn predicted increased distress, and trauma predicted distress via hostility (an indirect effect). As hypothesized, higher perceived social support attenuated the association between trauma and hostility. Conclusion: Results support a hostile emotional pathway that may increase distress in the context of increased traumatic impact; however, social support likely buffers these effects, particularly in the face of new or novel threats and stressors. Findings suggest broad application for understanding the relation between the introduction of stressors, psychological distress, and social support. [ABSTRACT FROM AUTHOR]

Responding to calls for additional research that identifies effective distress screening (DS) processes, including referral practices subsequent to screening and receipt of recommended care, we engaged in qualitative research as part of a larger (mixed methods) study of distress screening. This qualitative inquiry of oncology professionals across different facilities in the United States examined routine DS implementation, facilitators and challenges staff encounter with DS processes, and staff members' perceived value of DS. We conducted key informant interviews and focus groups with staff in 4 Commission on Cancer (CoC)-accredited oncology facilities (a total of 18 participants) to understand implementation of routine DS within oncology care. We used a rigorous data analysis design, including inductive and deductive approaches. Respondents believe DS enhances patient care and described ways to improve DS processes, including administering DS at multiple points throughout oncology care, using patient-administrated DS methods, and enhancing electronic health records infrastructure to better collect, record, and retrieve DS data. Respondents also identified the need for additional psychosocial staff at their facilities to provide timely psychosocial care. Results reinforce the value of DS in cancer care, including the importance of follow-up to screening with psychosocial oncology providers. Understanding and resolving the barriers and facilitators to implementing DS are important to ensure appropriate psychosocial care for people with cancer. Insights from oncology staff may be used to enhance the quality of DS and subsequent psychosocial care, which is an essential component of oncology care. [ABSTRACT FROM AUTHOR]

Epidemiological evidence suggests that regular physical activity (PA) positively impacts individuals' mental health (MH). The PA-MH relationship may be critical among immigrants owing to psycho-social-cultural influences. This scoping review of 61 studies employed a holistic bio-psycho-socio-cultural framework to thoroughly investigate the complex relationship between PA (across life domains) and immigrants' MH in Western countries. A systematic search of five electronic databases (Medline, PubMed, Embase, PsycINFO and Anthropology Plus) was conducted to locate relevant articles. No limitations were applied to study design, age, gender, home country, MH condition or PA type. A bio-psycho-socio-cultural-informed conceptual model guided the analysis of the multi-domain PA-MH relationship. Immigrant PA-MH studies were conducted and reported most commonly in the USA (38%), Australia (18%), and Canada (11%). Overall, PA was positively related to MH. Each domain-specific PA appeared to be associated with unique MH-promoting pathways/mechanisms. Leisure-related PA may support MH by enhancing self-agency and minimizing risky behaviors, whilst travel- and domestic-related PA may promote self-accomplishment and physical engagement. Ethnic sports appeared to enhance resilience. Occupational-related PA was associated with either positive or negative MH, depending on the type of occupation. A bio-psycho-socio-cultural-informed model is required to gain an encompassing and integrated understanding of immigrants' health. The first iteration of such a model is presented here, along with an illustration of how the model may be used to deepen analysis and understanding of the multi-domain PA-MH relationship among immigrants and inform public health planners and practitioners. [ABSTRACT FROM AUTHOR]

Aims and objectives: To describe the levels of insomnia, fatigue and intershift recovery, and psychological well‐being (burnout, post‐traumatic stress and psychological distress), and to examine differences in these measures based on work‐related characteristics among nursing staff during COVID‐19 pandemic in the United States. Background: The COVID‐19 pandemic has created a major physical and psychological burden on nursing staff in the United States and worldwide. A better understanding of these conditions will lead to tailored support and resources for nursing staff during and after the pandemic. Design: Cross‐sectional study. Methods: Hospital nurses and nursing assistants (N = 587) were recruited online between May–June 2020. The survey included measures on insomnia (Insomnia Severity Index) fatigue and intershift recovery (Occupational Fatigue and Exhaustion Recovery‐15), burnout (Maslach Burnout Inventory‐Human Services Survey), post‐traumatic stress (Short Post‐Traumatic Stress Disorder Rating Interview) and psychological distress (Patient Health Questionnaire‐4), and questions on work and demographics. The STROBE checklist was followed for reporting. Results: The sample had subthreshold insomnia, moderate‐to‐high chronic fatigue, high acute fatigue and low‐to‐moderate intershift recovery. The sample experienced increased emotional exhaustion and depersonalisation, increased personal accomplishment, moderate psychological distress and high post‐traumatic stress. Nurses who cared for COVID‐19 patients had significantly scored worse on almost all measures than their co‐workers. Certain factors such as working hours per week and the frequency of 30‐min breaks were significant. Conclusion: Nursing staff experienced poor sleep, fatigue and multiple psychological problems during the COVID‐19 pandemic. Moreover, staff who were involved in the care of COVID‐19 patients, worked more than 40 h per week and skipped 30‐min breaks showed generally worse self‐reported outcomes. Relevance to clinical practice: Nursing administration is recommended to monitor for fatigue and distress on nursing units, re‐visit current scheduling practices, reinforce rest breaks and provide access to mental health and sleep wellness resources with additional support for their front‐line nursing groups. [ABSTRACT FROM AUTHOR]

Background Approximately 26% of adult women in the United States suffer from female sexual arousal disorder (FSAD), yet little has been done to compare the experience of FSAD in pre- and postmenopausal women, which is critical to enhance the current understanding of FSAD and inform the development and assessment of treatment options for these patient populations. Aim To explore the experience of condition-associated symptoms and the relative importance of FSAD symptoms, including their severity, bother, and impact, on participants' health-related quality of life (HRQoL) in pre- and postmenopausal women with FSAD. Methods In-depth, qualitative, semistructured concept elicitation interviews were conducted with premenopausal (n = 23) and postmenopausal (n = 13) women who were clinically diagnosed with FSAD by a trained sexual medicine clinician. All interviews were audio recorded and transcribed verbatim by a professional transcription company. Thematic analysis was performed with the assistance of NVivo qualitative analysis software. Outcomes Outcomes included qualitative interview data about FSAD symptoms and HRQoL, as well as a comparison between pre- and postmenopausal populations. Results The most frequently reported symptom in both cohorts was "inability or difficulty with orgasm" (premenopausal, n = 21; postmenopausal, n = 13). The symptom that premenopausal women most desired to have treated was lubrication, and for postmenopausal women, it was a lack of lubrication or wetness and loss of feeling/sensation. In total, 21 of 23 premenopausal women and all 13 postmenopausal women reported a lack of feeling or sensation in the genitals. The most frequently reported HRQoL impact in both groups was decreased confidence. Clinical Implications Results from this study suggest that the manifestation and experience of FSAD are similar in pre- and postmenopausal women and that the unmet need for an FSAD treatment in the postmenopausal population is just as great as that of the premenopausal population. Strengths and Limitations This study involved in-depth qualitative interviews with a relatively small group of women (N = 36) recruited from only 5 study sites across the United States. Conclusion The analysis of qualitative data from the concept elicitation interviews revealed a substantial physical and emotional burden of FSAD, underscoring the need for Food and Drug Administration–approved treatment options for pre- and postmenopausal women with FSAD. [ABSTRACT FROM AUTHOR]

Background and Objectives Within relationships, sexual motives and stress are independent determinants of psychological health, with notable gendered patterns. However, previous research largely focuses on young adults and different-sex couples. Both sexual motives and levels of stress may be uniquely important to psychological health in midlife, and in potentially different ways for same-sex and different-sex couples. This study examined how the associations between sexual motives, stress, and depressive symptoms differ for midlife men and women in same-sex and different-sex marriages. Research Design and Methods Using dyadic data from same-sex and different-sex midlife married couples (N = 830 individuals; 415 couples), we examined the associations of intrinsic (e.g. sex for enjoyment and pleasure) and extrinsic (e.g. sex to please one's spouse) motives for having sex with depressive symptoms and tested whether these associations differed by levels of stress for same-sex and different-sex spouses. Results Intrinsic sexual motives were associated with fewer depressive symptoms only for same-sex married couples under high stress. Extrinsic sexual motives were related to greater depressive symptoms for women in low-stress conditions and men in high-stress conditions, and this did not differ for same-sex compared to different-sex marriages. Discussion and Implications Results show that the interplay between sexual motives and stress varies for men and women in same-sex and different-sex marriages. These findings underscore the importance of considering both gender and sexuality in studying sexual motives in midlife and suggest sexual motives as a useful treatment focus for protecting the psychological health of midlife married couples. [ABSTRACT FROM AUTHOR]

Although the economic burden of cancer care is an emerging concern in the United States, the potential financial toxicity of breast cancer care at the patient level remains poorly understood. This study aims to characterize the scope of the contributors to financial distress on breast cancer patients and the resources utilized to address them. Adult female patients diagnosed with invasive breast cancer or ductal carcinoma in situ between 2014 and 2019 at a single institution were retrospectively evaluated. Those who enrolled in copay assistance or indicated financial concerns on an intake distress screen were provided a web-based survey assessing financial changes, resources used, and financial engagement with providers. Semi-structured interviews further explored sources of financial distress and were analyzed by two researchers using grounded theory methodology. Sixty-eight patients completed the online survey, 15 of the 68 also participated in semi-structured phone interviews. On the online survey 74% of participants endorsed a financial distress score ≥5 on a scale of 0-10. Seventy-four percent changed their budget, 72% used their savings, and 60% cut down on spending. However, only 40% used resources such as financial counseling or financial assistance. Interviews revealed three major contributors to financial distress: (1) unexpected medical and nonmedical expenses, (2) lost revenue from missed work, and (3) altered budgeting. Many breast cancer patients experience significant financial distress without access to the resources they need. This study highlights the need for financial transparency, supportive financial services counseling at the time of diagnosis, throughout treatment and beyond. [ABSTRACT FROM AUTHOR]

This study applied a hermeneutic phenomenological approach to better understand pharmacy workplace wellbeing and resilience using respondents' written comments along with a blend of the researchers' understanding of the phenomenon and the published literature. Our goal was to apply this understanding to recommendations for the pharmacy workforce and corresponding future research. Data were obtained from the 2021 APhA/NASPA National State-Based Pharmacy Workplace Survey, launched in the United States in April 2021. Promotion of the online survey to pharmacy personnel was accomplished through social media, email, and online periodicals. Responses continued to be received through the end of 2021. A data file containing 6973 responses was downloaded on 7 January 2022 for analysis. Usable responses were from those who wrote an in-depth comment detailing stories and experiences related to pharmacy workplace and resilience. There were 614 respondents who wrote such comments. The findings revealed that business models driven by mechanized assembly line processes, business metrics that supersede patient outcomes, and reduction of pharmacy personnel's professional judgement have contributed to the decline in the experience of providing patient care in today's health systems. The portrait of respondents' lived experiences regarding pharmacy workplace wellbeing and resilience was beyond the individual level and revealed the need for systems change. We propose several areas for expanded inquiry in this domain: (1) shared trauma, (2) professional responsibility and autonomy, (3) learned subjection, (4) moral injury and moral distress, (5) sociocultural effects, and (6) health systems change. [ABSTRACT FROM AUTHOR]

Context: People living with HIV infection (PLWH) in the United States continue to experience a high symptom burden despite improvements in antiretroviral therapy.Objectives: The purpose of this study was to determine if the number and types of symptom clusters differed based on whether symptom occurrence rates or distress ratings were used to create the clusters.Methods: Data from 2,000 patients with complete symptom occurrence rates and distress scores on the 20-item HIV Symptom Index from their first ambulatory clinic visit at one of six national HIV centers of excellence in the Center for AIDS Research Network of Integrated Clinical Systems were used in these analyses. Exploratory factor analysis was used to create the symptom clusters.Results: The same four symptom clusters (i.e., gastrointestinal, psychological, pain, body image) were identified using occurrence rates and distress ratings. For both dimensions of the symptom experience, the psychological, pain, and body image clusters each had the same symptoms. For the gastrointestinal cluster, four symptoms loaded on the occurrence dimension and six symptoms loaded on the distress dimension.Conclusion: The number and types of symptom clusters were relatively similar across the occurrence and distress dimensions of the symptom experience. Symptom clusters in PLWH may provide insights into the development of targeted interventions for multiple co-occurring symptoms. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has exacerbated disparities in access to healthcare and mental health, often forcing healthcare social workers into ethical and moral dilemmas as they endeavor to provide equitable, humanistic care to their patients and caregivers. The purpose of this mixed method study was to explore how COVID-19-related personal and professional grief and losses impacted healthcare social worker's distress and resilience. Participants were recruited through healthcare social work professional organizations from September-November 2020. Participants (N = 246) completed an online survey capturing sociodemographic variables, as well as mental distress, pandemic-related meaning-making, and resilience. Data analysis included correlations and regressions pertaining to meaning-making, emotional distress, and resilience, as well as thematic analysis of participants' open-ended survey responses. Approximately one-third of participants reported emotional distress and difficulty in finding meaning from their pandemic-related losses. Participants reported a lower level of resilience when compared with the United States general population. Three themes emerged from social workers' qualitative responses: the hardest year of my career; the collective loss of our normal; and we were built for this. Pandemic-related grief permeates social workers' daily lives; yet their training and resilience foster hope to positively impact their clients, communities, and families. [ABSTRACT FROM AUTHOR]

Background: Evidence suggests that disabled people have worse mental health than non-disabled people, but the degree to which disability contributes to mental health is unclear., Objective: This paper uses 2021 National Health Interview Survey (NHIS) data to estimate the association between disability and depression and anxiety diagnoses as well as psychological distress among adults., Methods: We calculated disability population prevalence and mental health diagnoses and associated symptoms among 28,534 NHIS respondents. Logistic regressions estimated the odds of depression or anxiety diagnoses and recent psychological distress, controlling for disability and mental health diagnoses. We measured disability using binary and continuum measures of functional disability with the Washington Group Short Set on Functioning., Results: Disabled people have significantly greater odds of both depression and anxiety diagnoses compared to non-disabled people. Those with high functional disability have 552 % greater odds of an anxiety diagnosis (95 % CI: 5.61-7.58; p < 0.01) and 697 % greater odds of a depression diagnosis (95 % CI: 6.97-9.12; p < 0.01) compared to those with no functional disability. Similarly, those with any level of functional disability are more likely to have elevated psychological distress in the past 30 days compared to those with no functional disability., Conclusions: Findings support the idea that mental health is worse for disabled people compared to non-disabled people, with increasing functional disability associated with worse mental health. This suggests that mental health is not being adequately addressed for those with the greatest functional disability. Future work should seek to better understand the systemic causes of disparities., Competing Interests: Declaration of competing interest The authors have no conflicts of interest to declare., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Objective: Crisis line callers experience reductions in distress and suicidal ideation and utilize more health care following calls. The purpose of this study was to determine whether changes in distress and suicidal ideation during a call are associated with later healthcare contact and utilization., Method: Veterans Crisis Line calls from 599 veterans were extracted with call dates between 12/1/2018 and 11/30/2019. Calls were coded for changes in distress and suicidal ideation and linked with VA medical records to obtain healthcare data. Generalized Linear Mixed Modeling was used to examine the associations of changes in distress and suicidal ideation with healthcare contact (yes/no) and utilization (days of treatment) in the month (30 days) following the call., Results: Reductions in distress were associated with behavioral (i.e., mental and substance use) healthcare utilization, F(1, 596) = 4.52, p = 0.03, and reductions in suicidal ideation were associated with any healthcare utilization, F(1, 596) = 6.45, p = 0.01. Changes in distress and suicidal ideation were not associated with healthcare contact., Conclusion: Responders need to help resolve distress and suicidal ideation and link callers with treatment. Unresolved distress and suicidal thoughts may signify later problems with treatment utilization. Research is needed to determine causality., (© 2024 American Association of Suicidology.)

Negative life events are unpleasant, stressful, and uncontrollable experiences found to be risk factors for increased psychological distress and decreased life satisfaction in college students. In addition, distress and life satisfaction are closely related to college students' quality of life and academic performance. Conversely, positive psychological states have been hypothesized to buffer the effects of negative life events. Data from 738 college students in the U.S. were analyzed to examine the moderating effects of three positive psychological variables on negative life events: optimism, hope, and gratitude. The results showed that negative life events positively predicted distress and negatively predicted life satisfaction. The results also revealed that optimism, hope, and gratitude moderated the effects of negative life events. The authors conclude that the evidence supports positive psychology interventions in college counseling to combat the effects of negative life events through the positive psychological states of optimism, hope, and gratitude. The specific clinical implications for practicing counselors and educational settings are suggested. [ABSTRACT FROM AUTHOR]

Support for a spouse with psychological distress can be expressed in many different ways. Previous research indicates that support expression is shaped by gender, but we do not know much about how support within marriage is provided in response to a spouse's distress outside of a different-sex couple context. In this study, we analyze dyadic data from 378 midlife married couples (35–65 years; N = 756 individuals) within the U.S. to examine how men and women in same- and different-sex relationships provide support when they perceive that their spouse is experiencing distress. We find women in different-sex couples are less likely to report taking care of their distressed spouse's tasks or giving their distressed spouse more personal time and space compared to women in same-sex couples and men. We also find that men in different-sex couples are less likely to report encouraging their spouse to talk compared to men in same-sex couples and women. Being personally stressed by a spouse's distress is positively associated with providing support to that spouse, whereas feeling that a spouse's distress is stressful for the marriage is negatively associated with providing support. This study advances understanding of gendered provisions of support in response to psychological distress in marriage, moving beyond a framing of women as fundamentally more supportive than men to a consideration of how these dynamics may be different or similar in same- and different-sex marital contexts. [ABSTRACT FROM AUTHOR]

The current study examined anxiety and distress among members of the first community to be quarantined in the USA due to the COVID-19 pandemic. In addition to being historically significant, the current sample was unusual in that those quarantined were all members of a Modern Orthodox Jewish community and were connected via religious institutions at which exposure may have occurred. We sought to explore the community and religious factors unique to this sample, as they relate to the psychological and public health impact of quarantine. Community organizations were trusted more than any other source of COVID-19-related information, including federal, state and other government agencies, including the CDC, WHO and media news sources. This was supported qualitatively with open-ended responses in which participants described the range of supports organized by community organizations. These included tangible needs (i.e., food delivery), social support, virtual religious services, and dissemination of COVID-19-related information. The overall levels of distress and anxiety were elevated and directly associated with what was reported to be largely inadequate and inconsistent health-related information received from local departments of health. In addition, the majority of participants felt that perception of or concern about future stigma related to a COVID-19 diagnosis or association of COVID-19 with the Jewish community was high and also significantly predicted distress and anxiety. The current study demonstrates the ways in which religious institutions can play a vital role in promoting the well-being of their constituents. During this unprecedented pandemic, public health authorities have an opportunity to form partnerships with religious institutions in the common interests of promoting health, relaying accurate information and supporting the psychosocial needs of community members, as well as protecting communities against stigma and discrimination. [ABSTRACT FROM AUTHOR]

Purpose: Little is known about how breast cancer may impact survivors' financial well-being. This study aims to investigate the financial status, burden, and opinions of breast cancer survivors who received short-term financial assistance, emotional support, and resource navigation from a community organization during treatment.Methods: Clients previously served by the community organization were mailed a 16-question survey (n = 751) to elicit their perspective on financial status and burden before, during, and after diagnosis and treatment along with general demographic and opinion items.Results: 136 surveys (18.1%) were returned yielding 118 (15.7%) suitable for analyses. Clients' average age was 54.3 years. Most were female (99.2%), Caucasian (66.1%), and diagnosed with Stage 1 or 2 breast cancer (58.5%). Clients reported significantly worse (p < 0.001) financial status after being diagnosed compared to before diagnosis. Financial distress was highest during cancer treatment (mean = 3.92, SD = 0.85), lowest prior to treatment (mean = 2.48, SD = 1.05), and remained high after treatment (mean = 3.59, SD = 1.05). Those with higher distress after treatment were significantly (p = 0.01) more likely to report lower social support during treatment.Conclusions: Breast cancer survivors reported worsening financial status and distress after being diagnosed and during treatment despite receiving short-term financial assistance, emotional support, and resource navigation. Survivors' financial distress after treatment remained higher than before treatment. However, most felt receiving financial assistance improved their quality of life and made them feel more in control of financial decision-making. Breast cancer survivors who feel they have low social support during treatment may feel higher financial distress posttreatment. [ABSTRACT FROM AUTHOR]

Objective: To identify risk and protective factors associated with greater emotional distress and suicide ideation among international college students. Participants: International students (n = 435) from two Midwestern and two Southeastern universities in the US. Methods: Online surveys were administered that measured emotional distress, past-year suicide ideation, entrapment, cultural stress, family conflict, perfectionism, ethnic discrimination, interpersonal needs, ethnic identity, and cultural sanctions against suicide. Results: In final linear regression analyses, higher levels of entrapment, unmet interpersonal needs, and ethnic discrimination were significantly associated with increased emotional distress. Only unmet interpersonal needs remained significantly associated with greater past-year suicide ideation in a multivariate regression analysis. Conclusions: Clinicians working with international students and prevention programmers targeting this population should address students' perceptions of entrapment, ethnic discrimination, and especially unmet interpersonal needs in efforts to decrease or prevent students' feelings of emotional distress and suicide ideation. [ABSTRACT FROM AUTHOR]

Objectives: One in five children have a learning and attentional disability (LAD). Parents of children with LAD are vulnerable to distress, but an evidence-based treatment has not been developed. Methods: From June 2016 to November 2017, we conducted a mixed methods study to adapt and assess the virtual delivery of a mind-body group resiliency program, the Stress Management and Resiliency Training-Relaxation Response Resiliency Program (SMART-3RP), to meet the needs of parents of children with LAD; this is an 8-session weekly group intervention. In the first phase, we conducted 4 parent focus group interviews, 2 professional focus group interviews, and 5 professional individual interviews, and 1 pilot group to adapt the SMART-3RP to target the needs of parents of children with LAD. In the second phase, we conducted a pilot wait-list controlled study to assess the feasibility, acceptability, and preliminary efficacy of a videoconferencing delivery of the adapted program. Parents were randomized to an immediate intervention group (IG) or wait-list control group (WC). Surveys were administered at baseline (time 1), end of intervention for the IG or 3 months post-baseline for the WC (time 2), and 3 months post treatment for the IG or end of intervention for the WC (time 3). Results: Qualitative findings illustrated high levels of parental stress, with primary stressors including navigating the educational system, interactions with other parents, familial concerns, and financial and professional sacrifices. We adapted the manual to target these stressors and modified session logistics and delivery. Fifty-three parents (mean age = 46.8; 90.6% female) participated nationally in the pilot trial. 62.5% of participants completed ≥ 6/8 sessions; 81.8% reported continued daily/weekly relaxation response exercise practice. T1–T2 comparisons found that IG versus WC participants showed significant improvements in distress [VAS], ∆M = − 1.95; d =.83 and resilience [CES], ∆M = 6.38; d =.83, as well as stress coping [MOCS-A] ∆M = 8.69; d = 1.39; depression and anxiety [PHQ-4], ∆M = − 1.79; d =.71; social support [MOS-SSS], ∆M = 5.47; d =.71; and empathy [IRI], ∆M = 3.17; d =.77; improvements were sustained at the 3 month post intervention follow-up. Conclusion: Pilot wait-list randomized trial findings showed promising feasibility, acceptability, and preliminary efficacy for the SMART-3RP intervention adapted for parents of children with LAD. This virtually-delivered resiliency intervention improved parents' distress, resiliency, and stress coping, which were sustained. Clinical Trials ID: NCT02772432. [ABSTRACT FROM AUTHOR]

Cardiovascular disease (CVD) is the leading cause of death in the United States, costing billions of dollars per year in direct and indirect costs, and its prevalence is projected to increase exponentially over the next 15 years. Additionally, low-income and ethnic minority populations are especially at risk for CVD and CVD-related adverse health outcomes. This study aimed to examine the influence of a 12-hr, evidence-based relationship education (RE) program, Within Our Reach (WOR), on relational distress and satisfaction in participants with and without CVD risk factors. Findings indicated that participants significantly improved in their relationship satisfaction following the RE intervention with the female group improving in their relationship satisfaction at an amount significantly greater than the male group. However, no differences were found between CVD risk factor group and non-CVD risk factor group on their relationship satisfaction either before or after the RE intervention. Clinical implications and future directions for research in this area are also discussed. [ABSTRACT FROM AUTHOR]

Introduction: Distress related to disease burden has been defined and described among people with chronic diseases including diabetes and cancer. In these populations, disease‐specific distress is associated with health outcomes. Haemophilia‐related distress is less understood. Aim: To identify qualitative features of haemophilia‐related distress among affected adults to ultimately inform the creation of a measurement tool. Methods: Adults with haemophilia A or B associated with a large haemophilia treatment centre in the south‐eastern U.S. were recruited to participate in this qualitative study. Fifteen participants completed semi‐structured telephone interviews. Interviews lasted 1‐2 hours and explored experiences of distress related to various aspects of haemophilia. Interviews were audio taped, transcribed and coded using NVIVO, software for organizing, managing and analysing qualitative data. Coding was deductive and inductive, and the analysis was thematic. Results: Haemophilia‐related distress was broadly related to feelings of isolation and vulnerability which incorporated health system factors, physical functioning, caretaker roles and psychological considerations. Specific features associated with haemophilia‐related distress included lack of trust in the knowledge of haemophilia and care provided by staff in community healthcare settings, concerns about the future such as health insurance access and ageing/disability, long‐standing feelings of being different from others and feeling like an outsider, treatment burdens and fear of acute bleeds. Protective factors included supportive relationships with family, friends and haemophilia care teams through which participants received practical and emotional support. Conclusion: Features of haemophilia‐related distress were identified. Results will facilitate distress measurement and intervention efforts to reduce distress in adults with haemophilia. [ABSTRACT FROM AUTHOR]

In the wake of collective traumas and acts of terrorism, media bring real graphic images and videos to TV, computer, and smartphone screens. Many people consume this coverage, but who they are and why they do so is poorly understood. Using a mixed-methods design, we examined predictors of and motivations for viewing graphic media among individuals who watched a beheading video created by the terrorist group Islamic State of Iraq and Syria (ISIS). A representative national sample of U.S. residents (N = 3,294) reported whether they viewed a video and why (or why not) via an anonymous survey administered during a 3-year longitudinal study. Accounting for population weights, about 20% of the sample reported watching at least part of a beheading video, and about 5% reported watching an entire video. Increased likelihood of watching a video was associated with demographics (male, unemployed, and Christian), frequency of typical TV watching, and both prior lifetime exposure to violence and fear of future terrorism. Watching at least part of a beheading video was prospectively associated with fear of future negative events and global distress approximately 2 years after the beheading videos went viral. The most common reasons respondents reported for watching a beheading video were information seeking and curiosity. Results suggest attentional vigilance: Preexisting fear and history of violent victimization appear to draw individuals to graphic coverage of violence. However, viewing this coverage may contribute to subsequent fear and distress over time, likely assisting terrorists in achieving their goals. [ABSTRACT FROM AUTHOR]

The tendency for blacks to report similar or better mental health than whites has served as an enduring paradox in the mental health literature for the past three decades. However, a debate persists about the mechanisms that underlie this paradox. Drawing on the stress process framework, we consider the counterbalancing roles of self-esteem and traumatic stress exposure in understanding the "black-white paradox" among U.S. adolescents. Using nationally representative data, we observe that blacks have higher levels of self-esteem than whites but also encounter higher levels of traumatic stress exposure. Adjusting for self-esteem reveals a net higher rate of mood disorders and distress among blacks relative to whites, and differences in traumatic stress exposure mediate this association. In the full model, we show that self-esteem and stress exposure offset each other, resulting in a null association between race and mood disorders and a reduced association between race and distress. [ABSTRACT FROM AUTHOR]

Growing numbers of students in college or graduate school experience high stress, resulting in adverse emotional, academic, and health outcomes. A variety of stress reduction interventions have been used with students, but their effectiveness has not been systematically examined. We used meta-analysis to evaluate the efficacy of stress reduction interventions for undergraduate and graduate students. Studies (k = 43) that used an appropriate control group and assessed distress before and after intervention were aggregated using a random-effects model. Most studies were conducted in the United States; others were from Asia, Europe, and Australia. Standardized mean gain difference effect sizes were calculated for anxiety and perceived stress for six intervention techniques. Moderators examined included student type (undergraduate and graduate) and duration of intervention. Results indicate that most interventions are effective in decreasing both outcomes in students. Cognitive–behavioral therapy, coping skills, and social support interventions were more effective in reducing perceived stress, whereas relaxation training, mindfulness-based stress reduction, and psychoeducation were more effective in reducing anxiety. Graduate students experienced greater reduction in anxiety than did undergraduates for relaxation training and psychoeducation interventions. Participants in both long- and short-term interventions showed significant reduction in anxiety and perceived stress relative to control groups, but for relaxation training, long-term interventions were more effective in reducing anxiety than were short-term interventions. Although all six techniques were effective in reducing at least one of the stress-related outcomes, the few differences in effectiveness suggest there is value in tailoring interventions toward the particular group and outcome being targeted. [ABSTRACT FROM AUTHOR]

Serious Psychological Distress (SPD) and prenatal exposure to substances are associated with adverse outcomes for pregnant individuals and their developing offspring. This study aims to examine the relationship between SPD and quantity, or frequency of substance use among pregnant women in the United States (US). Descriptive and negative binomial regression analyses of the 2015–2019 National Survey on Drug Use and Health (NSDUH) were conducted among 3373 pregnant women (18 to 44 years old) to examine the association between SPD and (1) average number of cigarettes smoked in the past 30 days, (2) number of days of binge drinking in the past 30 days, and (3) number of days of cannabis use in the past 30 days. About 6% of the study population experienced SPD in the past 30 days. Compared to pregnant women who did not report SPD, pregnant women experiencing SPD showed greater rates in the number of cigarettes smoked during the past 30 days (IRR = 2.1, 95%CI = 1.1, 4.5), the number of days of binge drinking in the past 30 days (IRR = 5.1, 95%CI = 1.7, 15.4), and the number of days of cannabis use in the past 30 days (IRR = 2.9, 95%CI = 1.3, 6.5). Our results extend findings from prior research by documenting an association between SPD and the quantity and frequency of substance use among pregnant women in the US. Individual and structural interventions addressing SPD and/or substance might help reduce the impact of these comorbid conditions on expectant parents and their offspring. • Past 30-days SPD among pregnant women is increasing in the US (4.8% vs. 6.0%). • Pregnant women with SPD smoke more cigarettes in the past 30 days than women without SPD. • Pregnant women with SPD engage in binge drinking more often than those without SPD. • Pregnant women with SPD use cannabis more frequently than women without SPD. [ABSTRACT FROM AUTHOR]

Routine distress screening in United States oncology clinics has been mandatory since 2015. Objective: This study was the first to assess distress in a geographically diverse sample of cancer patients following mandated distress screening implementation by oncology social workers. Methods: Sites were self-selected via social workers who applied to participate in the Association of Oncology Social Work's Project to Assure Quality Cancer Care, advertised through their social media outlets and conference. Electronic screening records were collected from 55 cancer treatment centers in the United States and Canada. Cases required cancer diagnoses and Distress Thermometer (DT) scores to be included. Distress rates and rates by age, sex, cancer type, and ethnicity were examined. Results: Of 4664 cases, 46% (2157) experienced significant distress (DT score ≥ 4). Being female, age 40-59, and having diagnoses of pancreatic or lung cancer was associated with increased likelihood of distress. Half of cases experience clinically-significant distress, though this need was not evenly distributed across patient or cancer types. Conclusion: Identifying those at risk for distress may help inform optimal resource allocation. Methods to address needs of distressed patients in cases of limited resources are discussed. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To assess the prevalence of supportive care needs (SCNs) and distress and to describe relationships among these and patient characteristics for ethnically diverse older adults with advanced or recurrent cancer. SAMPLE & SETTING: Cross-sectional survey in five outpatient oncology clinics in an urban academic medical center involving 100 participants receiving cancer care in an economically challenged community. METHODS & VARIABLES: The supportive care framework for cancer care guided this study, and participants completed the SCN Survey Short Form 34 and the Distress Thermometer. Study variables are cancer diagnosis, gender, helping to raise children, number of comorbid diseases, race or ethnicity, treatment status, and zip code. RESULTS: Clinically meaningful distress was found in about a third of patients. Distress was not affected by race or ethnicity. Many ethnically diverse older patients with advanced or recurrent cancer report distress and SCNs; those with high distress are more likely to report multiple SCNs. IMPLICATIONS FOR NURSING: Nursing assessment of patient SCNs and distress is integral to establishing individualized patient-centered care plans and to delivering optimal care. [ABSTRACT FROM AUTHOR]

Purpose/Objectives: To study the relationship between parental verbal and nonverbal caring behaviors and child distress during cancer-related port access placement using correlational and time-window sequential analyses. Design: Longitudinal, observational design. Setting: Children's Hospital of Michigan and St. Jude Children's Research Hospital. Sample: 43 child-parent dyads, each with two or three video recordings of the child undergoing cancer-related port placement. Methods: Two trained raters coded parent interaction behaviors and child distress using the Parent Caring Response Scoring System and Karmanos Child Coping and Distress Scale, respectively. Mixed modeling with generalized estimating equations examined the associations between parent interaction behaviors and parent distress, child distress, and child cooperation reported by multiple raters. Time-window sequential analyses were performed to investigate the temporal relationships in parent-child interactions within a five-second window. Main Research Variables: Parent caring behaviors, child distress, and child cooperation. Findings: Parent caring interaction behaviors were significantly correlated with parent distress, child distress, and child cooperation during repeated cancer port accessing. Sequential analyses showed that children were significantly less likely to display behavioral and verbal distress following parent caring behaviors than at any other time. If a child is already distressed, parent verbal and nonverbal caring behaviors can significantly reduce child behavioral and verbal distress. Conclusions: Parent caring behaviors, particularly the rarely studied nonverbal behaviors (e.g., eye contact, distance close to touch, supporting/allowing), can reduce the child's distress during cancer port accessing procedures. Implications for Nursing: Studying parent-child interactions during painful cancer-related procedures can provide evidence to develop nursing interventions to support parents in caring for their child during painful procedures. [ABSTRACT FROM AUTHOR]

This study evaluated whether a self-administered stress management training (SSMT) could improve quality of life (QOL) and reduce distress among Hispanics receiving chemotherapy across multiple community clinical settings. Participants were randomized to receive SSMT (n = 106) or usual care (UCO) (n = 113). The primary outcome-QOL (SF-36) and secondary outcomes depression (CES-D), and anxiety (STAI) were assessed longitudinally over four chemotherapy cycles. Acculturation (BAS) and patients' intervention adherence were assessed. About 63% of participants reported distress after the initial chemotherapy cycle. Hispanics with lower acculturation reported greater STAI-Trait scores (p = .003). No significant treatment effects on outcomes measures were observed for participants receiving SSMT. SSMT intervention techniques were reported useful and improved mental health scores were observed with patients on a psychotropic agent (p = .04). Hispanics experience an elevated level of distress, yet SSMT did not significantly improve primary outcomes. SSMT may be potentially effective when combined with a psychotropic agent. SSMT enhancing strategies are discussed. [ABSTRACT FROM AUTHOR]

BACKGROUND: Data suggest that acute leukemia survivors experience moderate to severe distress that does not significantly decline from diagnosis through survivorship. OBJECTIVES: The purpose of this study is to assess acute leukemia survivors' level and source of self-reported distress from active cancer treatment through six months post-treatment. METHODS: A cross-sectional group-comparison design was used. Male (n = 60) and female (n = 40) survivors aged 19-84 years were accrued from a National Cancer Institute-designated cancer center. Patients were sampled at four time points: during induction therapy, at completion, and at three and six months after the end of induction therapy. Distress was self-reported using the Distress Thermometer and its 38-item Problem List (PL). Analysis of variance and chi-square determined relationships among distress scores, PL endorsements, subscale scores, and time groups. FINDINGS: Self-reported distress was elevated for all groups. Highest distress scores were found during induction therapy. [ABSTRACT FROM AUTHOR]

Background: Brief tools are needed to screen oncology outpatients for depressive symptoms.Methods: Patients starting radiotherapy for the first diagnosis of any tumor completed distress screening tools, including the 9-item Patient Health Questionnaire (PHQ-9), the 2-item Patient Health Questionnaire (PHQ-2), the National Comprehensive Cancer Network Distress Thermometer (NCCN-DT), and the Hopkins Symptom Checklist (HSCL) (25-item version). Patients exceeding validated cutoff scores and a systematic sample of patients whose screening was negative completed the Structured Clinical Interview for DSM-IV (SCID) mood disorder modules via telephone.Results: Four hundred sixty-three patients from 35 community-based radiation oncology sites and 2 academic radiation oncology sites were recruited. Sixty-six percent of the 455 eligible patients (n = 299) were women, and the eligible patients had breast (45%), gastrointestinal (11%), lung (10%), gynecologic (6%), or other cancers (27%). Seventy-five (16.5%) exceeded screening cutoffs for depressive symptoms. Forty-two of these patients completed the SCID. Another 37 patients whose screening was negative completed the SCID. Among the 79 patients completing the SCID, 8 (10.1%) met the criteria for major depression, 2 (2.5%) met the criteria for dysthymia, and 6 (7.6%) met the criteria for an adjustment disorder. The PHQ-2 demonstrated good psychometric properties for screening for mood disorders with a cutoff score of ≥3 (receiver operating characteristic area under the curve [AUC], 0.83) and was comparable to the PHQ-9 ( > 9; AUC = 0.85). The NCCN-DT did not detect depression (AUC = 0.59).Conclusions: The PHQ-2 demonstrated good psychometric properties for screening for mood disorders, which were equivalent to the PHQ-9 and superior to the NCCN-DT. These findings support using the PHQ-2 to identify patients in need of further assessment for depression, which has a low prevalence but is a clinically significant comorbidity. These findings could inform the implementation of distress screening accreditation standards. Cancer 2017;123:485-493. © 2016 American Cancer Society. [ABSTRACT FROM AUTHOR]

Background: Racial/ethnic minority status and mental illness independently drive inequity in cigarette smoking and related morbidity. Racial/ethnic minority groups suffer a disproportionate burden of tobacco-related diseases. People with serious mental illness (SMI) smoke at up to 7 times the rate of the general population. There is a need to quantify smoking prevalence and trends among people at the intersection of both groups., Methods: This study analyzes 2008-2019 data from the National Survey on Drug Use and Health. Linear time trends of daily smoking prevalence were assessed among people with serious psychological distress (SPD; marker for SMI) and people without SPD reporting White, Black, Hispanic, and Other race/ethnicity using logistic regression, with survey year as the predictor. Models with year-by-smoking status interaction terms and F-tests assessed differential time trends., Results: The prevalence of daily smoking among people without SPD decreased over time among people reporting White (aOR=0.96, p<0.001), Black (aOR=0.96, p<0.001), Hispanic (aOR=0.95, p<0.001), and Other (aOR=0.97, p=0.002) race/ethnicity. Among people with SPD, the smoking prevalence decreased among people with White race/ethnicity (aOR=0.95, p<0.001), with no significant changes among people of Black, Hispanic, and Other race/ethnicity., Conclusions: Smoking among people with SPD who report Black and Hispanic race/ethnicity has not changed significantly in the past 11 years, despite decreasing among non-SPD and White groups. People who are Black/Hispanic and people with SPD struggle to quit smoking, which is amplified intersectionally. Tailored interventions may be a better mechanism to reduce barriers to smoking cessation in this population., Competing Interests: Declaration of Competing Interest Dr. Vilardaga is the Principal Investigator of a digital therapeutic trial funded by Twill Inc., to Duke’s Clinical Research Institute., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Over the past two decades of research, increased media consumption in the context of collective traumas has been cross-sectionally and longitudinally linked to negative psychological outcomes. However, little is known about the specific information channels that may drive these patterns of response. The current longitudinal investigation uses a probability-based sample of 5,661 Americans measured at the onset of the COVID-19 pandemic to identify a) distinct patterns of information-channel use (i.e., dimensions) for COVID-related information, b) demographic correlates of these patterns, and c) prospective associations of these information channel dimensions with distress (i.e., worry, global distress, and emotional exhaustion), cognition (e.g., beliefs about the seriousness of COVID-19, response efficacy, and dismissive attitudes), and behavior (e.g., engaging in health-protective behaviors and risk-taking behaviors) 6 mo later. Four distinct information-channel dimensions emerged: journalistic complexity; ideologically focused news; domestically focused news; and nonnews. Results indicate that journalistic complexity was prospectively associated with more emotional exhaustion, belief in the seriousness of the coronavirus, response efficacy, engaging in health-protective behaviors, and less dismissiveness of the pandemic. A reliance on conservative-leaning media was prospectively associated with less psychological distress, taking the pandemic less seriously, and engaging in more risk-taking behaviors. We discuss the implications of this work for the public, policy makers, and future research.

Objective:This study sought to investigate the unique contributions of socio-ecological, cultural and cancer treatment-related factors in predicting depressive symptoms and cancer-specific distress among Latinas. Design: Participants were 140 English or Spanish-speaking Latinas (Mage = 50.6) with non-metastatic breast cancer who were assessed within two years of diagnosis (Time 1) and three months later (Time 2). Main Measures:Hierarchical regression analyses identified predictors of depressive symptoms and cancer-specific distress at Time 1 and 2. Results:Most women scored above the clinical cut-offs for depressive symptoms and cancer-specific distress. After adjusting for socio-ecological factors, greater Latino enculturation, measured by Latino ethnic identity, was significantly associated with greater cancer-specific distress at Time 1 (β = .20,p < .05). A significant interaction (p < .01) revealed that among women high on Latino identity, lower English language use was associated with more cancer-specific distress than higher English language use. After adjusting for socio-ecological factors, greater satisfaction with surgical treatment predicted improved depressive symptoms and cancer-specific distress across time (βsrange from −.31 to −.18,ps < .01). Conclusions:Findings elucidate the complex relationship between culture and psychological outcomes in the breast cancer context and suggest that treatment satisfaction might be an important intervention target for Latinas. [ABSTRACT FROM PUBLISHER]

Purpose: Family caregivers of advanced colorectal cancer patients may be at increased risk for psychological distress. Yet their key challenges in coping with the patient's illness are not well understood. Soliciting both patient and caregiver perspectives on these challenges would broaden our understanding of the caregiving experience. Thus, the purpose of this research was to identify caregivers' key challenges in coping with their family member's advanced colorectal cancer from the perspective of patients and caregivers.Methods: Individual, semi-structured qualitative interviews were conducted with 23 advanced colorectal cancer patients and 23 primary family caregivers. Interview data were analyzed via thematic analysis.Results: In nearly all cases, patient and caregiver reports of the caregiver's key challenge were discrepant. Across patient and caregiver reports, caregivers' key challenges included processing emotions surrounding the patient's initial diagnosis or recurrence and addressing the patient's practical and emotional needs. Other challenges included coping with continual uncertainty regarding the patient's potential functional decline and prognosis and observing the patient suffer from various physical symptoms.Conclusions: Findings suggest that eliciting the perspectives of both patients and caregivers regarding caregivers' challenges provides a more comprehensive understanding of their experience. Results also point to the need to assist caregivers with the emotional and practical aspects of caregiving. [ABSTRACT FROM AUTHOR]

Purpose: In ovarian cancer patients and mouse models, psychosocial stress is associated with higher circulating markers of angiogenesis and cell migration, impaired immune response, and increasing tumor burden and aggressiveness. In the Nurses' Health Studies (NHS/NHSII), we assessed whether phobic anxiety, a marker of chronic distress, was associated with risk of incident ovarian cancer as well as survival among ovarian cancer patients.Methods: We used Cox proportional hazards regression to model the relative risks (RRs) and 95 % confidence intervals (CI) of ovarian cancer incidence and survival by categories of the Crown-Crisp phobic anxiety index (CCI).Results: We identified 779 cases of ovarian cancer during 2,497,892 person-years of follow-up. For baseline CCI (NHS: 1988; NHSII: 1993), we observed a statistically nonsignificant increased risk of epithelial ovarian cancer (RR for CCI ≥ 4 vs. 0 or 1: 1.14; 95 % CI 0.96-1.36). However, when we updated CCI (NHS: 2004; NHSII: 2005), the associations were attenuated. Pre-diagnosis CCI was not associated with ovarian cancer survival (RR for ≥4 vs. 0 or 1: 1.00; 95 % CI 0.77-1.31); results were similar for post-diagnosis CCI.Conclusions: Distress, as measured by phobic anxiety symptoms, was not associated with ovarian cancer risk, although we cannot rule out a modest association. Future research should explore the role of phobic anxiety and other forms of psychological distress and ovarian cancer risk and survival. [ABSTRACT FROM AUTHOR]

Screening for emotional distress is important, but not widely available. This study assesses the utility of the Refugee Health Screener 15 (RHS-15) in a public health setting. Refugee Health Screener 15 and diagnostic proxy (DP) instruments assessing anxiety, depression, and posttraumatic stress disorder were administered to refugees from 3 countries at their public health examination. Properties of the RHS-15 and its components were evaluated utilizing appropriate methods. Scale Cronbach α was 0.95, and a factor analysis identified 1 factor accounting for 66% of scale variance. Refugee Health Screener 15 scores and cases discriminated between refugee groups similar to DPs. Refugee Health Screener 15 case sensitivity and specificity to DPs were acceptable (≥0.87/0.77). A shorter, 13-item component had acceptable metric properties. The RHS-15 appears to be a valid screener for emotional distress of refugees. The 13-item scale may be more efficient and as efficacious for case identification. The critical public health need and recommendations for implementation are discussed. [ABSTRACT FROM AUTHOR]

This study explored whether fertility-specific distress varied by race/ethnicity among a nationally representative sample of US women. Participants were 2363 White (n = 1266), Black (n = 569), Hispanic (n = 453), and Asian (n = 51) women who participated in the National Survey of Fertility Barriers. Participants were given the Fertility-Specific Distress Scale and assessed for strength of pregnancy intent, primary versus secondary infertility, and socioeconomic hardship. Black women reported lower levels of fertility-specific distress than White women, but these were fully mediated by the strength of pregnancy intentions. Primary versus secondary infertility and economic hardship were not associated with fertility-specific distress. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to examine the associations of perceived stress, stressors, and distress with sleep disturbance and duration among Asian immigrants., Design/setting/participants: The sample included 400 Asian immigrants aged 50-75 years old recruited from primary care physicians' clinics., Methods: We 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., Results: A 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., Conclusion: Perceived 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., Competing Interests: Declaration of conflict of interest The authors have declared no conflicts of interest., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)

Bullying is reported in around 20% of children according to the US Department of Education and has been reported in the histories of individuals with genetic disorders. To our knowledge, there has never been a study surveying whether genetic counselors screen their pediatric patients for bullying. This is despite guidelines that pediatric healthcare providers should screen for bullying. The purpose of this study was to assess North American genetic counselors who see pediatric patients and enquire about their practices, attitudes, self-confidence, knowledge, and potential training needs in relation to bullying screening. In an anonymous online survey, 139 genetic counselors from the United States and Canada completed a modified version of the previously validated Healthcare Providers Practices, Attitudes, Self-Confidence, and Knowledge (HCP-PACK) instrument. Among our participant population, 85% reported they did not screen for bullying. This is despite no statistically significant difference in the amount of reported time spent on either initial or follow-up appointments between those who did or did not screen. Those who screened for bullying among their pediatric patients were more likely to view bullying as a healthcare problem (as measured on the attitude subscale) (t[135] = -2.07, p = 0.04) and had greater confidence in their ability to know how to assess for bullying (as measured on the self-confidence subscale) (t[135] = -2.90, p = 0.004) compared with participants who did not screen for bullying. Responses from genetic counselors who screened their patients for bullying demonstrated how screening for bullying can be aligned with the American Board of Genetic Counseling practice-based competencies. Even though the majority of participants did not view screening for bullying as a genetic counselor's role, 82.5% agreed that bullying was a healthcare problem and 63.6% thought genetic counselors should have additional educational opportunities to learn about bullying. Evidence-based guidance is needed to help genetic counselors interested in including screening for bullying in their practice., (© 2022 The Authors. Journal of Genetic Counseling published by Wiley Periodicals LLC on behalf of National Society of Genetic Counselors.)

Neighborhood disadvantage may increase smoking by increasing distress, while neighborhood affluence may reduce smoking by increasing positive affect. We examined whether relationships between neighborhood socioeconomic status (SES) and daily smoking operated through distress and positive affect. Simultaneous multivariate path models used pooled cross-sectional data from the 2000 and 2005 National Alcohol Surveys (15,963 respondents; weightedN = 10,753) and the 2000 Decennial Census. Multiple groups analysis assessed differences by gender and race/ethnicity. Covariates included neighborhood immigrant concentration and individual-level demographics. In the full sample, neighborhood disadvantage significantly increased smoking and neighborhood affluence significantly decreased smoking, with no indirect paths through either distress or positive affect. Unique among Hispanics, affluence resulted in decreased smoking indirectly through reduced distress. Relationships between affect and smoking also varied by race/ethnicity, with no significant differences by gender. Interventions targeting neighborhood socioeconomic status and distress may help reduce smoking, particularly for racial/ethnic minorities. [ABSTRACT FROM PUBLISHER]

In 2013, 11% of the US population experienced serious psychological distress. This problem of psychological distress is exacerbated in colleges and universities, where more than half of students report experiencing moderate to severe depression. In spite of the prevalence of this psychological distress, the vast majority of these students do not receive treatment. To address the problem of psychological distress among students, many universities have instituted animal visitation programs (AVPs). These popular programs provide opportunities for participants to interact with animals (usually dogs), with the goal of alleviating distress. However, empirical evidence for the effectiveness of these programs is lacking. We therefore conducted a randomized controlled trial to evaluate the influence of a single, brief interaction with a dog on the subjective experience of anxiety and mood in a sample of students and medical residents (n=67). We compared the impact of interactions with a dog to the effects of viewing (but not interacting with) the same dog, and the effects of a no-treatment control. We found that interacting with a dog reduced anxiety and negative mood, and increased positive mood relative to the control conditions. These effects were large, providing direct support for the model of AVPs already in widespread use in colleges and universities, as well as primary schools, hospitals, dentist's offices, courthouses, nursing homes, airports, and Veteran's Affairs facilities. In addition, our findings suggest that future research on AVPs is needed to elucidate when and how these are most potent. The results of that research may be used to maximize the benefits of these programs, which are already so widespread. [ABSTRACT FROM AUTHOR]

Racial microaggressions are everyday subtle or ambiguous racially related insults, slights, mistreatment, or invalidations. Racial microaggressions are a type of perceived racism that may negatively impact the health and well-being of people of color in the United States. This study examined the reliability and validity of the Racial Microaggression Scale distress subscales, which measure the perceived stressfulness of six types of microaggression experiences in a racially and ethnically diverse sample. These subscales exhibited acceptable to good internal consistency. The distress subscales also evidenced good convergent validity; the distress subscales were positively correlated with additional measures of stressfulness due to experiencing microaggressions or everyday discrimination. When controlling for the frequency of one's exposure to microaggression incidents, some racial/ethnic group differences were found. Asian Americans reported comparatively lower distress and Latinos reporting comparatively higher distress in response to Foreigner, Low-Achieving, Invisibility, and Environmental microaggressions. African Americans reported higher distress than the other groups in response to Environmental microaggressions. Results suggest that the Racial Microaggressions Scale distress subscales may aid health professionals in assessing the distress elicited by different types of microaggressions. In turn, this may facilitate diagnosis and treatment planning in order to provide multiculturally competent care for African American, Latino, and Asian American clients. [ABSTRACT FROM AUTHOR]

Racial minority status in the USA has been found as a risk factor of psychological distress. Serious psychological distress can lead to high personal and healthcare costs across different disease categories, life experiences and age cohort. This study aims to examine the interaction effect of race and age on psychological distress among non-Hispanic White, Asian, Black and Latino adults. This study uses data from a random sample of 43,672 adults aged 18 and older living in California, collected by the California Health Interview Survey in 2009. Younger Black respondents had the greatest prevalence of psychological distress, while the elderly White respondents had the lowest. Middle-aged Asian respondents reported a significantly smaller prevalence of psychological distress than middle-aged White respondents. Elderly Asian and Latino respondents were more likely to experience serious psychological distress than elderly White and Black respondents. There was no statistical difference in the prevalence of serious psychological distress between elderly White and Black respondents. The results of this study support our hypotheses concerning racial and age differences in serious psychological distress. The association between race and serious psychological distress was dependent on respondent's age group. [ABSTRACT FROM AUTHOR]