Predictors of help seeking for emotional distress among Chinese Americans: Family matters.

Using data from the Chinese American Psychiatric Epidemiological Study, the authors examined longitudinal predictors of help seeking for emotional distress in a community sample of 1,503 Chinese Americans. Specifically, they assessed the relative contribution of family relational variables (e.g., levels of family support and family conflict) in predicting help seeking for medical, mental health, and informal services. After traditional need, predisposing, and enabling factors were controlled for in hierarchical logistic regression analyses, family conflict predicted both mental health and medical service use, whereas family support was not predictive of help seeking. In addition to family conflict, mental health service use was predicted by negative life events, emotional distress, and insurance coverage. Implications of the findings for assessing and treating Asian American clients are explored. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social support versus companionship: Effects on life stress, loneliness, and evaluations by others.

In recent years, much interest has focused on delineating and contrasting specific functions of social relationships that contribute to psychological well-being. Five studies contrasted the roles of companionship and social support in buffering the effects of life stress, in influencing feelings of loneliness and social satisfaction, and in affecting others' judgments. Study 1 analyzed data from a community survey and found that companionship had a main effect on psychological well-being and a buffering effect on minor life stress, whereas social support had only a buffering effect on major life stress. Studies 2, 3, and 4 analyzed data from two college student samples and a different community survey to evaluate how companionship and social support contributed to relationship satisfaction and feelings of loneliness. The results of these studies indicated that companionship was the strongest predictor of these dimensions of social satisfaction. Study 5 used an experimental design to test the hypothesis that a deficit of companionship elicits more negative reactions from others than does a deficit of social support. This hypothesis received partial support. Considered together, the results of these studies suggest that companionship plays a more important and more varied role in sustaining emotional well-being than previous studies have acknowledged. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

How and when does emotional expression help?

The paradox of distress expression is that expression of negative feelings is both a sign of distress and a possible means of coping with that distress. This article describes research illustrating the paradox of distress expression. It reviews evidence concerning 3 possible mechanisms by which expression might alleviate distress, focusing on the role of expression in (a) reducing distress about distress, (b) facilitating insight, and (c) affecting interpersonal relationships in a desired way. The authors conclude by highlighting the circumstances under which expression is most likely to be adaptive. Overall, the authors argue that expression of negative feelings is adaptive to the extent that it leads to some kind of resolution involving the source or significance of distress. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Culture and social support.

Social support is one of the most effective means by which people can cope with stressful events. Yet little research has examined whether there are cultural differences in how people utilize their social support networks. A review of studies on culture and social support presents evidence that Asians and Asian Americans are more reluctant to explicitly ask for support from close others than are European Americans because they are more concerned about the potentially negative relational consequences of such behaviors. Asians and Asian Americans are more likely to use and benefit from forms of support that do not involve explicit disclosure of personal stressful events and feelings of distress. Discussion centers on the potential implications of these findings for intercultural interactions and for the use of mental health services by Asians and Asian Americans. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of chronic exercise on feelings of energy and fatigue: A quantitative synthesis.

The authors investigated the effect of chronic exercise on feelings of energy and fatigue using meta-analytic techniques. Chronic exercise increased feelings of energy and lessened feelings of fatigue compared with control conditions by a mean effect delta of 0.37. The effect varied according to the presence or absence of a placebo control or whether chronic exercise was completed alone or in combination with an additional therapy. Investigations that used a placebo control and examined chronic exercise alone found no effect of chronic exercise on feelings of energy and fatigue. Certain placebo controls may increase feelings of energy and lessen feelings of fatigue when used with older adults or people with psychological distress. The results highlight the need for research identifying the most useful control conditions for accurately interpreting mental health outcome data obtained in chronic exercise investigations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Expectant parents' representations of early attachment relationships: Associations with mental health and family history.

The association between adult representations of early attachment relationships and history of individual and family mental health was examined in a sample of 233 expectant mothers and fathers. As predicted, security of attachment was linked to mental health. Parents classified as Preoccupied were more likely than other parents to report suicidal ideation, whereas parents classified as Unresolved more- often reported suicidal ideation, emotional distress, and substance abuse. With respect to family history, Unresolved and Preoccupied attachment classifications were significantly related to child abuse involving a relative and parental separation or divorce. These findings support theoretical conceptualizations regarding the link between adult attachment and mental health in middle-class American adults. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Spouses' provision of health-related support and control to patients participating in cardiac rehabilitation.

The authors examined spouses' provision of health-related support and control as predictors of health behavior and mental health among patients participating in cardiac rehabilitation (N = 94 couples). Cross-sectional analyses revealed that spouses' support was positively associated with patient health behavior. Prospective analyses of change over 6 months (N = 65 couples) revealed that spouses' support predicted increased patient mental health, whereas spouses' control predicted decreased patient health behavior and mental health. Findings suggest that spouses' efforts to facilitate patients' healthy lifestyle behaviors are associated with patients' health behavior and mental health, but not always as spouses might intend. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

The Costly Pursuit of Self-Esteem.

Researchers have recently questioned the benefits associated with having high self-esteem. The authors propose that the importance of self-esteem lies more in how people strive for it rather than whether it is high or low. They argue that in domains in which their self-worth is invested, people adopt the goal to validate their abilities and qualities, and hence their self-worth. When people have self-validation goals, they react to threats in these domains in ways that undermine learning; relatedness; autonomy and self-regulation; and over time, mental and physical health. The short-term emotional benefits of pursuing self-esteem are often outweighed by long-term costs. Previous research on self-esteem is reinterpreted in terms of self-esteem striving. Cultural roots of the pursuit of self-esteem are considered. Finally, the alternatives to pursuing self-esteem, and ways of avoiding its costs, are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of psychosocial and situational variables on substance abuse among homeless adults.

Finding direct and indirect influences of salient psychosocial and situational variables on problem substance use among homeless people is important in designing evidence-based, effective, and relevant interventions for this special population. A stress-coping paradigm in conjunction with situational items specialized for homeless people was used to explore predictive relationships in a sample of homeless adults (N = 664) among (a) psychosocial variables of self-esteem, social support, positive and negative coping, and emotional distress, (b) situational variables of homelessness history and quality of recent housing, and (c) outcomes of alcohol use, injection drug use (IDU), and non-IDU. Lower self-esteem predicted greater emotional distress, lower positive coping, greater negative coping, and more alcohol use. Social support predicted less emotional distress and more positive coping. Chronic homelessness predicted more emotional distress, less positive coping, greater alcohol use, and IDU. Poor housing was associated with more alcohol use and IDU. Substance abuse interventions among the homeless should have a dual focus that includes attention to psychological issues and negative coping patterns while also addressing situational, environmental factors, including encouraging provision of permanent supportive housing. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reactions to racial discrimination: Emotional stress and help-seeking behaviors.

This study examines Black, Latino, Asian American, American Indian and Biracial participants' (N = 260) emotional and psychological reactions to encounters with racism, and the help-seeking strategies they used to deal with those reactions. This class of participants is important to study because its members are likely to live and/or work in racially diverse environments. Participants who reported direct experiences with racism had higher levels of anxiety, guilt/shame, hypervigilance, and positive emotions than those who did not. Racial harassment (hostility) was associated with more hypervigilant and anxious reactions than racial discrimination (avoidance). Help-seeking patterns indicated that people of Color were more likely to seek help from friends and family than from mental health professionals. Practice and research implications are addressed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Marital distress and mental health care service utilization.

Objective: This study was designed to evaluate the association between marital distress and mental health service utilization in a population-based sample of men and women (N = 1,601). Method: The association between marital distress and mental health care service utilization was evaluated for overall mental health service utilization and for specific sectors of treatment providers, including psychiatrist, other mental health provider, other medical provider, and religious services provider. Interviews were used to assess past-year service utilization and presence of anxiety, mood, and substance use disorders. Results: Approximately 12% of married individuals sought help for problems with their emotions, nerves, or substance use during the 12 months preceding the interview. Marital distress was significantly associated with (a) overall mental health service utilization and service utilization provided by each of the sectors of providers when controlling for demographic variables and (b) overall mental health service utilization and receiving treatment from a psychiatrist when additionally controlling for past-year anxiety, mood, or substance use disorders. There was little evidence that the associations between marital distress and service utilization were moderated by gender or presence of psychiatric disorders. Conclusion: The finding that marital distress is associated with greater mental health care service utilization suggests that clinicians should assess both individual and relationship factors among individuals presenting for treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Patients' perspectives on the management of emotional distress in primary care settings

OBJECTIVE: To investigate how important treatment for emotional distress is to primary care patients in general and to primary care patients with depression, and to evaluate the types of mental health interventions they desire. DESIGN: Patient surveys. SETTING: Five private primary care practices. MEASUREMENTS AND MAIN RESULTS: Patients' desire for treatment of emotional distress and for specific types of mental health interventions were measured, as well as patients' ratings of the impact of emotional distress, the frequency of depressive symptoms, and mental health functioning. Of the 403 patients, 33% felt that it was "somewhat important" and 30% thought it was "extremely important" that their physician tries to help them with their emotional distress. Patient desire for this help was significantly related to a diagnosis of depression (p < .001), perceptions about the impact of emotional distress (p < .001), and mental health functioning (p < .001). Among patients with presumptive diagnoses of major and minor depression, 84% and 79%, respectively, felt that it was at least somewhat important that they receive this help from their physician. Sixty-one percent of all primary care patients surveyed and 69% of depressed patients desired counseling: 23% of all patients and 33% of depressed patients wanted a medication: and 11% of all patients and 5% of depressed patients desired a referral to a mental health specialist. CONCLUSIONS: A majority of these primary care patients and almost all of the depressed patients felt that it was at least somewhat important to receive help from their physician for emotional distress. The desire for this help seems to be related to the severity of the mental health problem. Most of the patients wanted counseling, but relatively few desired a referral to a mental health specialist.     

Perceptions of children and community members concerning the circumstances of orphans in rural Zimbabwe

This study examined two groups of people who were pursuing treatment for obesity: either medical intervention (a hospital group; N = 20) or support for dietary restriction (a community group; N = 18). This study addressed four questions: (1) Were there differences between the two groups in terms of their psychological distress (as measured by the Symptom Checklist)? (2) Does binge eating moderate psychological distress? (3) Do feelings of ineffectiveness moderate psychological distress? and (4) Which variables best accounted for group membership (i.e., type of treatment sought)? Results suggested that the hospital group was significantly more distressed than the community group. However, there were no differences between the two groups with respect to binge eating or feelings of ineffectiveness. These findings suggest that it is the effects of morbid obesity that are most likely to moderate psychological distress.     

Roles of perceived sexist events and perceived social support in the mental health of women seeking counseling.

The authors of the present study contribute to research on the role of sexist events in women's mental health by examining the sexism-distress relation (a) with a sample of women who are seeking mental health services and (b) in the context of the additional roles of perceived social support in positive self-appraisal (i.e., empowerment and self-esteem) and psychological distress. A path analysis was conducted with data from 157 women who were seeking counseling services. Results supported the generalizability of previously observed links between the frequency of perceived sexist events and psychological distress. Results also indicated that the sexism-distress link was significant in the context of an additional significant indirect relation of perceived social support with psychological distress, which was mediated through empowerment but not through self-esteem. Implications for future research and practice are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

When accuracy hurts: Reactions of anxious–ambivalent dating partners to a relationship-threatening situation.

Why are anxious–ambivalent individuals especially likely to have turbulent and unstable relationships? To help answer this question, the authors use 3 theoretical perspectives to examine how heightened empathic accuracy in a relationship-threatening situation is associated with personal and relational distress. Dating couples inferred their partners' thoughts and feelings from a videotaped interaction which they each rated slides of opposite-sex individuals. Highly anxious–ambivalent individuals were more empathically accurate in this relationship-threatening situation; however, their self-reported thoughts and feelings indicated greater distress and less confidence in their partners and relationships. The more anxious–ambivalent women reported a slight decrease in the perceived closeness of the relationships. Four months later, more anxious–ambivalent men's relationships were more likely to have ended. These findings are discussed in terms of their theoretical and applied implications. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Role of Acceptance and Job Control in Mental Health, Job Satisfaction, and Work Performance.

Acceptance, the willingness to experience thoughts, feelings, and physiological sensations without having to control them or let them determine one's actions, is a major individual determinant of mental health and behavioral effectiveness in a more recent theory of psychopathology. This 2-wave panel study examined the ability of acceptance also to explain mental health, job satisfaction, and performance in the work domain. The authors hypothesized that acceptance would predict these 3 outcomes 1 year later in a sample of customer service center workers in the United Kingdom (N = 412). Results indicated that acceptance predicted mental health and an objective measure of performance over and above job control, negative affectivity, and locus of control. These beneficial effects of having more job control were enhanced when people had higher levels of acceptance. The authors discuss the theoretical and practical relevance of this individual characteristic to occupational health and performance. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The temporal relationship between emotional distress and cigarette smoking during adolescence and young adulthood.

Empirical evidence regarding the causal nature of the relationship between emotional distress and tobacco use in male and female adolescents provides support for both the distress-to-use and the use-to-distress hypotheses. Using a cross-lagged model with 3 waves of data from 2,961 adolescents followed into young adulthood, the authors tested the hypothesis that this relationship changes over time. As hypothesized, emotional distress in Grade 10 was associated with increased smoking in Grade 12 for both boys and girls. Smoking in Grade 12 was in turn associated with increased emotional distress in young adulthood. The addition of 3 third factors (rebelliousness, deviance, and family problems) to the model did not alter the results. Results suggest that the relationship between tobacco use and emotional distress is a dynamic one in which distress initially leads to use but then becomes exacerbated by it over time. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prevalence of mental disorders, psychological distress, and mental services use among lesbian, gay, and bisexual adults in the United States.

Recent estimates of mental health morbidity among adults reporting same-gender sexual partners suggest that lesbians, gay men, and bisexual individuals may experience excess risk for some mental disorders as compared with heterosexual individuals. However, sexual orientation has not been measured directly. Using data from a nationally representative survey of 2,917 midlife adults, the authors examined possible sexual orientation-related differences in morbidity, distress, and mental health services use. Results indicate that gay-bisexual men evidenced higher prevalence of depression, panic attacks, and psychological distress than heterosexual men. Lesbian-bisexual women showed greater prevalence of generalized anxiety disorder than heterosexual women. Services use was more frequent among those of minority sexual orientation. Findings support the existence of sexual orientation differences in patterns of morbidity and treatment use. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Help-seeking attitudes and utilization patterns for mental health problems of Surinamese migrants in the Netherlands.

The authors explored help-seeking behaviors and attitudes regarding psychosocial problems of Surinamese people in the Netherlands. Data of Surinamese citizens in the general population (n?=?292) and of Surinamese (n?=?96) and native Dutch (n?=?89) outpatients in mental health care were collected. Results suggest length of residence in the Netherlands to be an important predictor of both behavior and attitudes, with the more recently migrated most in need of education on the utility of Dutch mental health services. The health symptoms and help-seeking orientations of the Surinamese people are quite similar to those of the indigenous Dutch. Ethnic background nevertheless remains a moderately important factor. Satisfaction with the mental health services appeared to be quite high, although more practical help is often wanted. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Distress among young adults from divorced families.

Researchers find that most children from divorced families function normally, but some clinicians assert that young people are disturbed even many years after a divorce. These accounts may be less discrepant than they appear, because research typically focuses on notably problematic behavior (disorder), whereas case studies emphasize more subtle inner turmoil (distress). In Study 1 college students reported painful feelings, beliefs, and memories about their parents divorce on a reliable new measure, but they also reported accepting the divorce and having few psychological symptoms. Distress about family life was greater among students from divorced than from married families. Study 2 replicated these findings in a community sample of young people from low-income divorced families. In both studies, greater distress was associated with children's residence, frequency of contact with fathers, interparental conflict, and psychological symptoms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)