Functional impairment, marital quality, and patient psychological distress as predictors of psychological distress among cancer patients' spouses.

This study investigated contextual determinants of psychological distress among 197 spouses of cancer patients. women, 30–82 years old). It was hypothesized that higher levels of patient functional impairment would lead to greater patient distress. Patient distress, in turn, would lead to lower spouse marital satisfaction and ultimately to higher spouse distress. Spouses completed measures of distress and marital quality at three time points. Cancer patients rated their functional impairment and psychological distress at the same time points. Results indicated that at all time points, greater patient impairment was associated with higher levels of patient distress which, in turn, was related to lower marital satisfaction. However, marital quality was related to spouse distress at only 1 time point, but spouse distress was directly associated with patient distress at each time point. Implications for cancer patients and spouses are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Identification and prediction of distress trajectories in the first year after a breast cancer diagnosis.

Objective: In this article, we aim to (a) identify distinct trajectories of psychological distress in the first year after a breast cancer diagnosis in women treated with adjuvant therapy and (b) explore possible predictors of these trajectories, that is, demographic, medical, and personal characteristics. Method: The 171 patients were assessed after diagnosis, after surgery, after adjuvant treatment, in the reentry phase, and in the (short-term) survivorship phase (2 and 6 months after the end of treatment, respectively). Main Outcome Measure: Psychological distress was assessed with the 12-item General Health Questionnaire. Results: There were four trajectories of distress: a group that experienced no distress (36.3%), a group that experienced distress only in the active treatment phase (33.3%), a group that experienced distress in the reentry and survivorship phase (15.2%), and a group that experienced chronic distress (15.2%). Personality and physical complaints resulting from adjuvant treatment could distinguish the distress trajectories. Mastery was the only unique predictor. Conclusion: Most patients were not distressed in response to breast cancer or only temporarily so. Yet, a minority of patients became or remained distressed after the end of treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The role of emotional dysregulation in perfectionism and psychological distress.

Data from a sample of university students (N = 349) were used to test a model in which emotional dysregulation (a composite of emotional reactivity and splitting) was expected to account for the effect of perfectionism on general psychological distress. Significant positive effects were observed between maladaptive perfectionism and distress, whereas significant inverse effects were found for adaptive perfectionism. Structural equations analyses revealed support for a possibly mediational role of emotional dysregulation. Future research suggestions as well as counseling recommendations are proposed that target emotional regulatory features of the client with perfectionistic tendencies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Protective buffering and psychological distress among couples coping with breast cancer: The moderating role of relationship satisfaction.

This study examined whether the association between protective buffering and psychological distress was moderated by relationship satisfaction. Protective buffering is defined as hiding worries, denying concerns, and yielding to one's partner in an effort to avoid disagreement and reduce one's partner's upset and burden. Two hundred thirty-five women diagnosed with early stage breast cancer and their partners completed measures of protective buffering, psychological distress, and relationship satisfaction at 3 time points over an 18-month period after cancer diagnosis. The authors hypothesized that protective buffering would result in more distress among patients and partners reporting higher relationship satisfaction than among patients and partners reporting lower levels of relationship satisfaction. Patients' protective buffering predicted more distress among patients rating their relationships as more satisfactory, whereas the patients' buffering did not predict distress among patients rating their relationships as less satisfactory. Partner relationship satisfaction also moderated the association between patients' buffering and partners' distress. These findings elucidate conditions under which protective buffering may have detrimental effects. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predicting hopelessness and psychological distress: The role of perfectionism and coping.

This study investigated an integrative model involving the relationship between perfectionism (P. L. Hewitt & G. L. Flett, 1991) and coping (C. S. Carver, A F. Scheier. & J. K. Weintraub, 1989) to predict changes in hopelessness and general psychological distress among college students. Results indicated that changes in psychological well-being (4-5 weeks later) were predicted by socially prescribed perfectionism, and, as theorized, avoidance coping moderated the link between perfectionism and psychological well-being beyond initial levels of distress. Support was also found for the adaptive effects of cognitive reconstruction coping and other-oriented perfectionism, whereas, under certain conditions, self-oriented perfectionism was shown to be maladaptive. These findings offer support for the proposed model. Implications for intervention and suggestions for future research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological Response to Test Results in an Ovarian Cancer Screening Program: A Prospective, Longitudinal Study.

To identify the psychological impact of receipt of an abnormal yet benign screening test result, the authors examined the response to a transvaginal ultrasound screening (TVS) test for ovarian cancer (OC) in asymptomatic women (N=540) undergoing an initial TVS screening test. Interviews were conducted prior to undergoing TVS screening and at 2 weeks and 4 months following this baseline. Women receiving an abnormal yet benign TVS test result (n=33) reported elevated OC-specific, but not general, distress at 2-week follow-up. Distress returned to baseline levels at 4-month follow-up. Consistent with the monitoring process and cognitive-social health information processing models, response to an abnormal TVS result was moderated by a monitoring coping style, low optimism, and a family history of OC. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sex trading and psychological distress among women on methadone.

This study examined the relationship between sex trading and psychological distress among a nonrandom sample of women recruited from 3 methadone maintenance clinics in New York City. Face-to-face interviews with 280 women (M age?=?40.7) revealed that 32% had traded sex for money or drugs in the previous year. Compared to other participants, these women reported less education and higher rates of incarceration in the past year, sexually transmitted diseases, childhood sexual abuse, partner abuse, and current regular crack/cocaine and alcohol use. Hierarchical multiple regression analysis indicated that sex traders scored 0.41 units higher than non-sex traders on the General Severity Index of the Brief Symptom Inventory after controlling for all relevant covariates. The findings emphasize the need to consider the interrelation of psychological distress, abuse, and addiction in designing public health interventions addressing methadone maintained women. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The prospective relationship of interpersonal forgiveness and psychological distress symptoms among college women.

Forgiveness has frequently been theorized to be related to decreased psychological distress, and longitudinal survey research is important for the examination of this relationship. The prospective relation of forgiveness to psychological distress symptoms (i.e., depression, anxiety, and stress) at a later time point (an average of 36 weeks later) was examined in a sample of 182 female undergraduate students. Through use of structural equation modeling, it was observed that offense-specific (as compared with dispositional) forgiveness toward an offender of a self-identified interpersonal transgression was significantly negatively related to psychological distress symptoms at Time 2, above and beyond the impact of symptom levels at Time 1. Perceived severity and time since the offense at Time 1 were examined as possible moderators of this relationship; time since offense was found to moderate the relationship between forgiveness and change in psychological distress symptoms between Time 1 and Time 2. Implications for acceptance-based interventions and prevention of psychopathology are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The impact of psychological distress on absence from work.

The aims of this study were to examine the impact of psychological distress on absence from work; to compare psychological distress and job satisfaction as predictors of absence; and to compare the relative effects of 2 components of psychological distress, depression and anxiety, on absence. Organizational records of absence over a 3-year period were obtained for 323 health service staff in the United Kingdom, who also completed self-report measures of psychological distress and job satisfaction at the beginning of the study and 2 years later. Psychological distress, particularly depression, was found to predict absence, with higher levels of distress predicting a greater number of days and number of times absent. Job satisfaction and psychological distress independently predicted levels of absence. The psychological distress-absence relationship was not moderated by demographic variables. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Screening for marital and relationship discord.

Based on recent findings suggesting that marital discord is taxonic (i.e., that couples in discordant relationships differ qualitatively, and not just quantitatively, from couples in nondiscordant relationships), this study was designed to develop a brief screening measure for detecting the relationship discord taxon. A national, representative sample of 1,020 married couples completed the Marital Satisfaction Inventory—Revised. Data from this sample were used to create a 10-item screening measure. Using the cut scores from the original study that found evidence of taxonicity as a point of reference, the 10-item screen demonstrated good diagnostic performance in assessing the relationship discord taxon. Taxon classification based on the brief scale demonstrated good short-term stability. The scale is easily administered and scored, making it appropriate for use in clinical and research settings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Impairment and distress associated with relationship discord in a national sample of married or cohabiting adults.

The clinical importance of relationship discord was examined through evaluating the association between relationship discord and multiple measures of impairment and psychological distress in a population-based sample of married and cohabiting adults (N = 2,677). In comparison to people that were not in discordant relationships, individuals in discordant relationships reported greater social role impairment with relatives and friends and greater work role impairment. They also reported higher levels of general distress and poorer perceived health and were more likely to report suicide ideation. With the exception of suicide ideation, the associations between relationship discord and impairment and psychological distress remained significant when controlling for current mood, anxiety, and substance use disorders, suggesting that relationship discord is incrementally related to impairment and psychological distress over and above the effects of psychiatric disorders. (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)     

When distress hits home: The role of contextual factors and psychological distress in predicting employees' responses to abusive supervision.

We developed a model of the relationships among aggressive norms, abusive supervision, psychological distress, family undermining, and supervisor-directed deviance. We tested the model in 2 studies using multisource data: a 3-wave investigation of 184 full-time employees (Study 1) and a 2-wave investigation of 188 restaurant workers (Study 2). Results revealed that (a) abusive supervision mediated the relationship between aggressive norms and psychological distress, (b) psychological distress mediated the effects of abusive supervision on spouse undermining, (c) abusive supervision had a direct positive relationship with supervisor-directed deviance, (d) the positive relationship between psychological distress and spouse undermining was stronger for men as opposed to women, and (e) employees engaged in relationship-oriented occupations reported greater levels of abusive supervision and psychological distress. Implications for theory and practice are discussed. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Social connectedness, dysfunctional interpersonal behaviors, and psychological distress: Testing a mediator model.

The study examined the relationship among social connectedness, dysfunctional interpersonal behaviors, and psychological distress. The authors specifically hypothesized that the direct negative effect of social connectedness on psychological distress would be mediated by dysfunctional interpersonal behaviors. Prior to testing the hypothesis, the authors revised the original Social Connectedness Scale (SCS; R. A Lee and S. B. Robbins, 1995). Studies 1 and 2 describe the revision and validation of the SCS on separate samples of college students. In Study 3, the authors surveyed 194 college students and found support for the mediation hypothesis on general psychological distress. The importance of assessing social connectedness and tailoring counseling interventions for people with low connectedness and dysfunctional interpersonal behaviors is 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)     

The relationship between social support and psychological distress among Hispanic elders in Miami, Florida.

This study compared 5 psychological models of the relationship between social support (SS) and behavioral health. These theoretical models, which have garnered some level of prior empirical support, were as follows: (a) main effects, (b) buffering effects, (c) social exchange, (d) equity, and (e) protective health outcomes of providing SS. A population-based sample of 273 community-dwelling Hispanic elders drawn from East Little Havana, Florida (ages 70-100 years old; 86% Cuban) completed self-report measures of SS, financial strain, and psychological distress (PD). Hierarchical multiple regression analyses were used to test the competing SS models. Results indicated that satisfaction with received SS was, as specified in the main-effects model, associated with lower PD, whereas received SS was unexpectedly associated with heightened PD. Reciprocal exchanges of SS (equity model) or exchanges where Hispanic elders provided more SS than they received (protective health outcomes of providing SS model) were also associated with lower PD. The feasibility of a 6th model in which the effects of SS are contingent upon the elder's preexisting PD level is proposed. Limitations, implications, and directions for future research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Maladaptive perfectionism, hassles, coping, and psychological distress in university professors.

This study examined the roles of hassles, avoidant and problem-focused coping, and perceived social support as mediating the relationship between maladaptive perfectionism and psychological distress in a sample of university professors. Hassles and avoidant coping both partially mediated a strong association between maladaptive perfectionism and psychological distress. These results are discussed in terms of the need to better understand how coping styles and social support are associated with the negative impact of perfectionism on the lives of university professors. The implications of these findings for counseling practice are also explored. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Hypnotic discontinuation in chronic insomnia: Impact of psychological distress, readiness to change, and self-efficacy.

Objective: To compare individuals who were successful in discontinuing hypnotic medications against those who were not on measures of insomnia severity, medication withdrawal symptoms, psychological symptoms, perceived health, readiness to change and self-efficacy. Design: Secondary analyses of a randomized clinical trial comparing a hypnotic taper intervention with or without self-help treatment for insomnia. Main Outcome Measures: Self-report measures of insomnia severity, medication withdrawal symptoms, depression and anxiety symptoms, physical and mental health, stages of change, readiness to change, decisional balance, and general and situational self-efficacy. Results: There were no significant differences at baseline between medication-free individuals and those still using sleep medication at the end of a taper intervention. Group differences emerged midway through the 8-week withdrawal program and were accentuated after the intervention; participants who remained medication-free during the next six months had less severe insomnia and anxiety symptoms, a more positive perception of their health and higher self-efficacy to refrain from hypnotic use in various situations. Contrary to expectations, there were no differences between drug-free and nondrug-free participants on both readiness to change and stages of change. Conclusions: Chronic users of hypnotic medications entered a taper intervention with equal levels of psychological distress, health, self-efficacy, and readiness to change. Successful hypnotic discontinuation was associated with overall improvement of insomnia, anxiety and distress symptoms, perceived health and self-efficacy. More intensive and individualized therapeutic attention may be warranted for individuals experiencing worsening of insomnia symptoms, more withdrawal symptoms and psychological distress, and lower self-efficacy during medication discontinuation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Work time, work interference with family, and psychological distress.

Despite public concern about time pressures experienced by working parents, few scholars have explicitly examined the effects of work time on work-family conflict. The authors developed and tested a model of the predictors of work time and the relationships between time, work interference with family (WIF), and psychological distress. Survey data came from 513 employees in a Fortune 500 company. As predicted, several work and family characteristics were significantly related to work time. In addition, work time was significantly, positively related to WIF, which in turn was significantly, negatively related to distress. The results suggest that work time fully or partially mediates the effects of many work and family characteristics on WIF. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The interpersonal expression of perfection: Perfectionistic self-presentation and psychological distress.

A concept involving the interpersonal expression of perfection, perfectionistic self-presentation, is introduced. It is argued that perfectionistic self-presentation is a maladaptive self-presentational style composed of three facets: perfectionistic self-promotion (i.e., proclaiming and displaying one's perfection), nondisplay of imperfection (i.e., concealing and avoiding behavioral demonstrations of one's imperfection), and nondisclosure of imperfection (i.e., evading and avoiding verbal admissions of one's imperfection). Several studies involving diverse samples demonstrate that perfectionistic self-presentation is a valid and reliable construct and a consistent factor in personal and interpersonal psychological distress. It is argued that the need to promote one's perfection or the desire to conceal one's imperfection involves self-esteem regulation in the interpersonal context. (PsycINFO Database Record (c) 2010 APA, all rights reserved)