Perceived control, coping efficacy, and avoidance coping as mediators between spousal unsupportive behaviors and psychological distress.

This study examined whether avoidance, coping efficacy, and perceived control mediate the effects of spouses" unsupportive behaviors on patient psychological distress among 191 married individuals enrolled in cancer treatment. Results of the structural equation analyses suggested that avoidance and coping efficacy mediated the relationship between spouses" unsupportive behaviors and patient psychological distress. Perceived control of emotional aspects of the illness, including emotional responses and relationships with family and friends, and perceived control of the medical course of the cancer did not mediate the relationship between spouses" unsupportive behaviors and patient psychological distress. These findings suggest 2 mechanisms to explain why unsupportive responses from spouses may be associated with psychological distress among cancer patients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perceived discrimination experiences and mental health of Latina/o american persons.

With a sample of 128 Latina/o persons, the present study examined a model that tested direct, indirect, and mediated relations among perceived discrimination, psychological distress, self-esteem, sense of personal control, and acculturation to Latina/o and U.S. cultures. Path analysis of the model indicated that (a) perceived discrimination was related to greater psychological distress, with personal control partially mediating this link; (b) perceived discrimination was also related, indirectly through personal control, to lower self-esteem; (c) self-esteem partially mediated the relation between personal control and distress; (d) Latina/o and U.S. acculturation were related, indirectly through personal control, to greater self-esteem and lower distress; and (e) U.S. acculturation was related directly to greater distress. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Couple-Focused Group Intervention for Women With Early Stage Breast Cancer.

This study examined the efficacy of a couple-focused group intervention on psychological adaptation of women with early stage breast cancer and evaluated whether perceived partner unsupportive behavior or patient functional impairment moderated intervention effects. Two hundred thirty-eight women were randomly assigned to receive either 6 sessions of a couple-focused group intervention or usual care. Intent-to-treat growth curve analyses indicated that participants assigned to the couples' group reported lower depressive symptoms. Women rating their partners as more unsupportive benefited more from the intervention than did women with less unsupportive partners, and women with more physical impairment benefited more from the intervention group than did women with less impairment. Subgroup analyses comparing women attending the couple-focused group intervention with women not attending groups and with usual care participants indicated that women attending sessions reported significantly less distress than did women receiving usual care and women who dropped out of the intervention. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Coping disposition, perceived risk, and psychological distress among women at increased risk for ovarian cancer.

The authors examined predictors of psychological distress among women who were at increased risk for ovarian cancer. Participants were 103 women who had at least 1 first degree relative with ovarian cancer. Specifically, the authors tested the relationship between the dispositional attentional style of monitoring (the tendency to scan for threat-relevant information), perceptions of risk for ovarian cancer, intrusive thoughts regarding ovarian cancer, and psychological distress. Overall, this sample exhibited moderately high levels of psychological distress. High scores on monitoring were associated with high perceived risk for ovarian cancer and elevated levels of intrusive thoughts and psychological distress. Finally, the authors proposed and tested a path model describing the interrelationships between these variables. Results of this study are discussed in terms of their implications for treating the psychological distress associated with being at increased risk for ovarian cancer. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Spousal support and changes in distress over time in couples coping with cancer: The role of personal control.

This longitudinal study has examined the associations between perceived supportive and unsupportive spousal behavior and changes in distress in couples coping with cancer. We tested whether people relatively low in their sense of personal control were more responsive to spousal supportive and unsupportive behavior than were people relatively high in personal control. Patients with colorectal cancer and their partners (n = 70) completed questionnaires at two assessment points: 3 (at baseline) and 9 months (at follow-up) after the diagnosis. We assessed perceived spousal supportive (SSL) and unsupportive (SSL-N) behavior, sense of personal control (Pearlin & Schooler's Mastery), and depressive symptoms (CES-D) in both patients and partners. Multilevel analysis (MLwiN) was used to examine changes in distress over time in a dyadic context. Patients and partners who perceived more spousal support reported less distress over time, but this only applied to those relatively low in personal control. Moreover, partners who perceived more unsupportive spousal behavior reported more distress, again only if they were relatively low in personal control. Patients and partners relatively high in personal control reported relatively low levels of distress, regardless of spousal behavior. In conclusion, people relatively low in personal control may be more adversely affected by unsupportive behavior and benefit more from supportive behavior than people relatively high in personal control. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Prospective predictors of posttraumatic stress disorder symptoms: Direct and mediated relations.

This study assessed the relations between pretrauma risk (neuroticism, negative affect, prior distress) and protective (self-esteem, optimism) factors and posttraumatic stress disorder (PTSD) symptoms and potential mediators (subjective event-related distress, unsupportive social interactions, perceived control) of those relations. Students (N = 1,528) at four U.S. universities completed online surveys assessing pretrauma risk and protective factors at Time 1 (T1); 84% (N = 1,281) completed a survey 2 months later (T2). PTSD symptoms and the three potential mediators were assessed among those who experienced potentially traumatic events between T1 and T2 (n = 264). PTSD symptoms related to prior traumas were controlled in all analyses. In structural equation modeling (SEM) analyses, the relation between risk factors and PTSD symptoms was mediated by unsupportive social interactions. Protective factors did not independently predict PTSD symptoms when risk factors also were included in the SEM models. Implications for research and practice are discussed. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Body consciousness, illness-related impairment, and patient adherence in hemodialysis.

Recent theory and evidence suggests that bodily self-focusing tendencies (e.g., private body consciousness [PBC]) may be associated with medical regimen adherence among chronically ill patients. The present study examined the joint effects of PBC and degree of illness-related physical impairment on treatment regimen adherence in a sample of 52 hemodialysis patients. It was predicted that the effect of PBC on adherence would vary as a function of patients' level of illness-related physical impairment. For patients experiencing more severe impairment, higher PBC scores were associated with poorer adherence to the prescribed medication and dietary regimen. In contrast, for patients experiencing a relatively low degree of disease-related physical impairment, higher PBC was associated with more favorable adherence. Results are discussed in terms of self-focused attention and behavioral self-regulation theories. Implications for future research and clinical intervention are also discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Filipino Americans and racism: A multiple mediation model of coping.

Although the literature on Asian Americans and racism has been emerging, few studies have examined how coping influences one’s encounters with racism. To advance the literature, the present study focused on the psychological impact of Filipino Americans’ experiences with racism and the role of coping as a mediator using a community-based sample of adults (N = 199). Two multiple mediation models were used to examine the mediating effects of active, avoidance, support-seeking, and forbearance coping on the relationship between perceived racism and psychological distress and self-esteem, respectively. Separate analyses were also conducted for men and women given differences in coping utilization. For men, a bootstrap procedure indicated that active, support-seeking, and avoidance coping were mediators of the relationship between perceived racism and psychological distress. Active coping was negatively associated with psychological distress, whereas both support seeking and avoidance were positively associated with psychological distress. A second bootstrap procedure for men indicated that active and avoidance coping mediated the relationship between perceived racism and self-esteem such that active coping was positively associated with self-esteem, and avoidance was negatively associated with self-esteem. For women, only avoidance coping had a significant mediating effect that was associated with elevations in psychological distress and decreases in self-esteem. The results highlight the importance of examining the efficacy of specific coping responses to racism and the need to differentiate between the experiences of men and women. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Intrusive thoughts and psychological distress among cancer patients: The role of spouse avoidance and criticism.

This study examined whether perceived spouse criticism and avoidance impacted cognitive processing in 129 cancer patients. It was hypothesized that intrusive thoughts would be associated with an increase in psychological distress among patients who felt their spouses were critical or avoiding them and that intrusive thoughts would not be positively associated with distress among patients who did not feel their spouses were critical or avoidant. The impact of spouse criticism was predicted to be stronger than the impact of spouse avoidance. A moderating effect for spouse criticism on the association between early intrusive thoughts and later distress was present. Spouse avoidance did not have a significant moderating effect on the relation between intrusive thoughts and later distress. Results suggest spouse criticism and avoidance may have differential effects on the cognitive processing of cancer. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relationships of self-esteem and efficacy to psychological distress in mothers of children with chronic physical illnesses.

This study examined relationships of children's illness-related functional limitations and 2 maternal psychological resources, self-esteem and efficacy, to symptoms of psychological distress in 365 urban mothers of 5- to 9-year-old children with diverse chronic illnesses. Multiple regression controlling for sociodemographic variables indicated that presence of functional limitations in the child and lower resources each were associated with higher maternal scores on a psychological symptom scale. Self-esteem had a main effect on maternal distress; however, a significant Efficacy?×?Functional Status interaction term suggested that mothers experienced greater distress when their children had illness-related functional limitations and maternal efficacy was low. Interventions aimed at enhancing maternal psychological resources may reduce the likelihood of distress in mothers of children with chronic illness. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Stressful life events, psychological well-being, and parenting in African American mothers.

The association of stressful negative life events with mothers' psychological well-being and parenting was examined in 79 African American mothers living in 1 and 2-percent households. Findings reveal that family disruption and work problems were associated with lower maternal acceptance. Family disruption was also positively associated with mothers' firm control of behavior. Family disruption and work-related stress also were negatively associated with mothers' self-esteem. Health-related stress was positively related to mothers' psychological distress. Mothers' self-esteem was positively associated with mothers' acceptance and negatively related to firm control. Mothers' self-esteem mediated the association of family disruption and work-related stress with mothers' acceptance. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Partner unsupportive responses, avoidant coping, and distress among women with early stage breast cancer: Patient and partner perspectives.

This 18-month longitudinal study examined the associations among partner unsupportive behavior, avoidant coping, and distress experienced by 219 women with early stage breast cancer. The role of patient and partner ratings of unsupportive behavior were evaluated. Results indicated that patient and partner ratings of unsupportive behavior were highly correlated. Growth curve modeling suggested that unsupportive behavior, from both patient and partner perspectives, predicted more avoidant coping and distress. When partner and patient perceptions were placed in the same model, patient perceptions mediated the association between partners' ratings of their unsupportive behavior and patient distress. Avoidance also mediated the association between unsupportive behavior and distress, extending prior cross-sectional findings. Results highlight the long-term detrimental effects of partners' unsupportive behavior on the quality of life of women with early stage breast cancer. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perceived coping as a mediator between attachment and psychological distress: A structural equation modeling approach.

This study examined perceived coping (perceived problem-solving ability and progress in coping with problems) as a mediator between adult attachment (anxiety and avoidance) and psychological distress (depression, hopelessness, anxiety, anger, and interpersonal problems). Survey data from 515 undergraduate students were analyzed using structural equation modeling. Results indicated that perceived coping fully mediated the relationship between attachment anxiety and psychological distress and partially mediated the relationship between attachment avoidance and psychological distress. These findings suggest not only that it is important to consider attachment anxiety or avoidance in understanding distress but also that perceived coping plays an important role in these relationships. Implications for these more complex relations are discussed for both counseling interventions and further research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Optimism, Perceived Risk of Breast Cancer, and Cancer Worry Among a Community-Based Sample of Women.

Optimism is frequently inversely associated with distress; however, less is known about the mechanisms underlying this relationship. Optimism can be defined as having a generalized positive expectancy about the future. The authors hypothesized that a specific expectancy might mediate the relationship between optimism and distress. That model was tested using perceived risk of breast cancer as a specific measure of expectancy and cancer worry as a measure of distress in a community-based sample of 1,366 women. It was hypothesized that optimism would be inversely associated with cancer worry and that perceived risk of breast cancer would mediate the relationship between optimism and cancer worry. Multiple regression analyses revealed that perceived risk partially mediated the relationship between optimism and cancer worry. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Family moderators of the relation between hassles and behavior problems in inner-city youth

Qualitative data from individual interviews with 18-29 year old African American men, who have sex with men (n = 76) were used to examine the relationship of negative attitudes toward homosexuality, self-esteem, and risk for HIV. Respondents perceived members of their communities as holding negative attitudes toward homosexuality, and many thought the African American community was less accepting of homosexuality than the white community. There was evidence that these negative attitudes are internalized by some of the young African American men themselves. Respondents mentioned several ways that negative attitudes toward homosexuality could lead to lower self-esteem and psychological distress in young gay and bisexual men. In addition, respondents articulated several mechanisms by which low self-esteem and psychological distress might be associated with sexual behaviors that put one at risk for HIV. We concluded that addressing and changing society's negative views of homosexuality are important components of a comprehensive approach to reducing the transmission of HIV, especially among young people in communities of color.     

Perfectionism, stress, and social (dis)connection: A short-term study of hopelessness, depression, and academic adjustment among honors students.

This study tested models of perfectionism predicting psychological distress and academic adjustment and moderators and mediators of those associations in 2 successive cohorts of high-achieving university honors students (N = 499). Participants completed measures early and late in the semester. Adaptive (high standards) and maladaptive (self-critical perceptions of inadequacy in meeting performance expectations) dimensions of perfectionism were found to be significantly associated, in generally expected directions, with concurrent and prospective perceived stress, social connectedness, depression, hopelessness, and perceived academic adjustment. However, some perfectionism effects were reduced when earlier psychological distress and adjustment were controlled in analyses predicting later distress and adjustment. Several effects were moderated and at least partially mediated by perceived stress and social connection. The results suggest several counseling implications for high-achieving, perfectionistic students. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Stress, coping, and marital satisfaction in couples with a depressed wife.

Evaluated the relationships among psychological distress, perceived stress, marital satisfaction, and coping in 20 couples in which the pregnant wife suffered major depression, 20 couples in which the pregnant wife suffered minor depression, and 40 control couples in which the pregnant wife was nondepressed. Consistent with a systems conceptualization of depression, the depressed Ss and their husbands both reported greater dissatisfaction in their marriages and used more dysfunctional coping strategies than did the nondepressed control couples. Whereas both the minor and major depressed Ss differed from the nondepressed Ss with respect to psychological distress and perceived stress, only husbands of the minor depressed Ss differed significantly on these measures from husbands of the nondepressed Ss, reporting greater distress and a higher level of perceived stress. (French abstract) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Coping Strategies as Mediators of the Relations Among Perceived Control and Distress in Sexual Assault Survivors.

Two studies assessed whether coping strategies mediate the relations among 2 forms of perceived control (past and present control) and postassault distress among female sexual assault survivors. In Study 1, longitudinal data were gathered from 2 weeks to 1 year postassault (N=171). Past control (behavioral self-blame) was associated with more distress partly because it was associated with greater social withdrawal. Present control (control over the recovery process) was associated with less distress partly because it was associated with less social withdrawal and more cognitive restructuring. In Study 2, cross-sectional data were gathered from a community sample of nonrecent survivors of sexual assault (N=131). Coping strategies again mediated the relations among the measures of past and present control and distress. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Preoperative preparation for cardiac surgery facilitates recovery, reduces psychological distress, and reduces the incidence of acute postoperative hypertension.

This study evaluated whether preoperative preparations for cardiac surgery (a) reduced psychological distress and facilitated physical recovery, (b) reduced preoperative anxiety by making patients feel well-informed or by increasing their sense of control over recovery, and (c) reduced the incidence of sympathetically mediated, acute postoperative hypertension. Information-only and information-plus-coping preparations were compared with a contact-control preparation. Preoperatively (1 day after preparation), both experimental groups were significantly less anxious and fearful than the control group. The experimental groups did not differ from each other. Both experimental preparations increased patients' belief in control over recovery. Consistent with Lazarus's theory of stress, belief in control over recovery best predicted preoperative anxiety. Regression analyses indicated that information reduced anxiety by increasing feelings of control. Postoperatively, both experimental groups (a) reported less emotional distress, (b) were judged by nurses as making better physical and psychological recoveries, and (c) had a 32.5% lower incidence of postoperative hypertension. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adjustment in aging: The roles of life stress, hassles, and self-efficacy.

Examined the relationship of life stress, daily hassles, and perceived self-efficacy to adjustment in a community sample of 32 men and 32 women (aged 65–75 yrs). In a structured interview, negative life change events, daily hassles, self-efficacy, depression, psychosomatic symptoms, and negative well-being were assessed. Both negative life events and daily hassles were related to psychological distress and physical symptoms for men, and hassles were associated with psychological distress and physical symptoms for women. An inverse relationship between self-efficacy and maladjustment was also found. Hassles showed the most powerful relationship to distress. (PsycINFO Database Record (c) 2010 APA, all rights reserved)