The illusion of mental health.

Argues that researchers' reliance on "objective" mental health scales and disregard for clinical judgment has led to many mistaken conclusions. Specifically, standard mental health scales appear unable to distinguish between genuine mental health and the facade or illusion of mental health created by psychological defenses. Evidence is presented indicating that (1) many people who look healthy on standard and mental health scales are not psychologically healthy and (2) illusory mental health (based on defensive denial of distress) has psychological costs and may be a risk factor for medical illness. Clinical judges could distinguish genuine from illusory mental health, whereas "objective" mental health scales could not. The findings call into question the conclusions of many previous studies that rest on standard mental health scales. They suggest new ways of understanding how psychological factors may influence health. Finally, they suggest that clinical methods (which researchers often malign) may have an important role to play in meaningful mental health research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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)     

Somatic symptoms, social support, and treatment seeking among sexual assault victims.

In an effort to clarify the relationship between the experience of sexual assault and physical health, rape victims and a matched comparison group were repeatedly assessed for somatic symptoms, psychological distress, health care use, and self-rated health perceptions during the year immediately after the assault. Women who experienced sexual assault reported more somatic complaints, poorer perceptions of physical health, greater psychological distress, and increased use of medical services. However, victims did not show a significantly higher use of mental health services and continued to seek medical attention at the end of the year after the assault, when health perceptions and somatic symptoms were no longer significantly elevated. The use of mental health services and social support as moderating variables are examined, and implications for the medical and psychological treatment of sexual assault victims are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychosocial sequelae of violent victimization in a national youth sample.

In a national telephone sample of youths aged 10–16 years, over one third reported having been the victims of an assault. Victimized respondents displayed significantly more psychological and behavioral symptomatology than did non victimized respondents (more symptomatology related to post traumatic stress disorder, more sadness, and more school difficulties), even after controlling for some other possible sources of distress. Sexual assault was associated with particularly high levels of symptomatology. However, victims of other forms of assault—nonfamily assaults involving weapons or physical injury (aggravated assaults), assaults by parents, violence to genitals, and attempted kidnappings—also evidenced levels of distress that were not statistically lower than those suffered by victims of sexual assault. The findings suggest that substantial mental health morbidity in the general child and adolescent population is associated with victimization. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mental health professionals versus non-mental-health professionals: Childhood trauma and adult functioning.

Research on childhood family environments of mental health professionals suggests that therapists are often raised in dysfunctional families and experience significant psychological distress in adult life. This study examined the prevalence of childhood trauma, family dysfunction, and current psychological distress among female mental health professionals (N?=?340) and compared it with the prevalence among women working in other professions (N?=?2,623). Psychotherapists reported higher rates of physical abuse, sexual molestation, parental alcoholism, psychiatric hospitalization of a parent, death of a family member, and greater family dysfunction in their families of origin than did other professionals. As adults, psychotherapists experienced less anxiety, depression, dissociation, sleep disturbance, and impairment in interpersonal relationships than did women in professions other than mental health. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Posttraumatic distress and physical functioning: A longitudinal study of injured survivors of community violence.

This study examines the cross-lagged relationships between posttraumatic distress symptoms and physical functioning, using a sample of 413 persons who were hospitalized for injuries resulting from community violence. Posttraumatic distress was assessed at 1 week, 3 months, and 12 months postinjury, and posttraumatic physical functioning was assessed at 3 months and 12 months. Structural equation modeling was used to assess the prospective relationship between posttraumatic distress symptoms and physical functioning while controlling for demographic characteristics and objective measures of injury severity. Results indicate that posttraumatic distress and physical functioning are reciprocally related. Individuals with high levels of psychological distress at 1 week posttrauma have worse physical functioning at 3 months. Psychological distress at 3 months was not significantly associated with subsequent change in physical functioning at 12 months. Individuals with poor physical functioning at 3 months had higher than expected levels of psychological distress at 12 months. These findings demonstrate a reciprocal relationship between physical and mental health following traumatic injury. Interventions targeting physical recovery may influence subsequent mental health, and therapies aimed at improving early mental health may also have long-term benefits for physical recovery. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Housing quality and mental health.

This study examined the potential link between housing quality and mental health. First, the development of a psychometrically sound, observer-based instrument to assess physical housing quality in ways conceptually relevant to psychological health is reported. Then 2 different studies, including a prospective longitudinal design, demonstrate that physical housing quality predicts mental health. Possible underlying psychosocial processes for the housing quality–psychological distress link are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predictors of mental health among adolescents from immigrant families in Portugal.

The aims of this study were to investigate the degree of mental health problems among adolescents with immigrant background in Portugal and the factors that may predict mental health problems. The study sample consisted of 755 immigrant adolescents from seven ethnocultural groups (Cape Verdeans, Angolans, Indians, Mozambicans, East Timorese, Sao Tomese, and Guineans) and 320 native Portuguese adolescents. Generally, most respondents did not report major psychological adjustment problems. Adolescents from immigrant families reported fewer mental health problems than their native Portuguese counterparts, and girls reported more mental health problems than did boys. Predictive factors—sociodemographic, intercultural contact, and psychosocial adjustment variables—were significantly linked to youths’ mental health. Major predictors of poor psychological adjustment were perceived discrimination, social difficulties, and behavioral problems. As expected, different factors explained the psychological adaptation of adolescents by gender. Implications of the study for counselors are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of disability and bereavement on the mental health and recovery of older adults.

We investigated the role of two major stressors, recent disability and conjugal bereavement, in older adults' self-reports of mental health and recovery from stress. A sample of 246 older adults between the ages of 60–80 was interviewed monthly for 3 months by trained elderly interviewers; Month-10 interview data were also analyzed. Control subjects, who were not experiencing the stressors, were carefully selected from a sample of adults matched on age, sex, and socioeconomic status. Dependent variables were psychological distress and psychological well-being, each with component subscales. The disabled group evidenced significantly lower positive well-being and significantly greater distress than did the other groups. Bereaved subjects demonstrated high levels of depression compared with the disabled subjects, but showed less anxiety. Bereaved subjects showed recovery on several indicators of mental health, but disabled subjects continued to show considerable psychological upset in comparison with the other groups. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive mediation of rape's mental, physical and social health impact: Tests of four models in cross-sectional data.

Four nested, theoretically specified, increasingly complex models were tested representing cognitive mediation of rape's effects on mental, physical, and social health. Data were cross-sectional (N = 253 rape survivors). Outcomes were standardized assessments of social maladjustment, physical, and psychological symptoms, including posttraumatic stress disorder (PTSD). The best-fitting model was not fully cognitively mediated. Personological and rape characteristics influenced the level of self-blame experienced and the intensity of maladaptive beliefs about self and others. Self-blame and maladaptive beliefs predicted psychological distress, which strongly influenced all health outcomes. Self-ratings of rape memory characteristics contributed little to predicting postrape distress. The model accounted for 56% of the variance in general distress, including 91% of psychological symptom severity; 54% of PTSD symptoms; 65% of social maladjustment; and 17% of physical symptoms. Longitudinal replication is planned. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Acculturation, enculturation, psychological distress and help-seeking preferences among Asian American college students.

We examined the relationship between Asian American college students' levels of acculturation, enculturation, and psychological distress. We also explored the methods Asian American college students prefer when seeking help for psychological concerns. The sample included 601 Asian American students from a large public university in Southern California. Respondents completed an online questionnaire, which included instruments assessing acculturation and enculturation levels as well as psychological distress and help-seeking preferences. Regression analyses indicated that when Asian American students hold a greater degree of European values they are less likely to experience psychological distress. A repeated-measures ANOVA found that Asian American students prefer more covert approaches to mental health treatment. These findings both compliment and contradict previous studies of acculturation, enculturation, psychological distress and help-seeking among the Asian American college student population. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

The challenge of double jeopardy: Toward a mental health agenda for aging women.

The elderly may be considered a group at risk with regard to mental health and the mental health system. Aging women experience a double jeopardy arising from social, economic, and psychological conditions surrounding age and gender—in particular, poverty, widowhood, and the dynamics of family caregiving. This double jeopardy translates into a vulnerability within the mental health system that is seen in issues of service utilization, therapist–client interactions, and diagnosis, most notably in diagnoses of Alzheimer's disease, alcohol and drug misuse, and depression. The failure of the mental health system to consider elderly individuals as psychological survivors further suggests an implicit assumption that mental decline is a normative part of the aging process. Recommendations for change include addressing gender and age interactions in mental health policy and in psychological research, training, and practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Toward mental health: The benefits of psychological androgyny.

Addresses the importance of psychological androgyny—defined as possessing a high degree of instrumental and expressive qualities—to considerations of sex roles, equality, and mental health. The personality and behavioral correlates of androgyny are summarized, implications for mental health professions, such as readjustment of their conceptions of what constitutes "healthy" personal value systems, are discussed. (38 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Collective self-esteem as a coping resource for male-to-female transsexuals.

The fear of experiencing discrimination often provokes symptoms of psychological distress. One coping resource is positive identification with one's social group--known as collective self-esteem. This preliminary study investigated whether collective self-esteem was related to fears regarding a transsexual identity and psychological distress among 53 self-identified male-to-female transsexuals (mean age = 50.79 years). Participants were recruited from transgender events held in Arizona and California. The majority (81%) reported living full-time as women (mean length of time living as a woman = 6.33 years). Negative feelings about the transsexual community and fears regarding the impact of a transsexual identity were positively related to psychological distress. A regression model revealed that the fear of how a transsexual identity would affect one's life was the best predictor of the severity of psychological distress. These results are consistent with findings from other historically marginalized groups, whereby the stress of being stigmatized by society adversely affects mental health. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Knee pain and disability in the Nottingham community: association with poor health status and psychological distress

OBJECTIVE: To assess the prevalence of knee pain, disability and health status in the community, and to examine the association of pain with psychological distress. METHODS: A postal survey was sent to 4057 men and women aged 40-79 yr in Nottingham. Health status was assessed using the SF-36 instrument, with the specific dimensions of physical function and mental health used to measure disability and psychological distress. RESULTS: The overall response rate was 81.9%. The prevalence of knee pain was 28.7%, rising with age. Disability was more common in those with knee pain compared to those without pain (P < 0.001). Subjects with knee pain had lower scores for all dimensions of health. When adjusted for potential confounders, low mental health scores associated with increased odds for pain and disability (2.1, 95% CI 1.7-2.6; and 4.7, 95% CI 3.7-6.1). CONCLUSIONS: Knee pain is common in this population and is associated with poor perceived health and significant disability. Psychological distress strongly associates with both pain and disability.     

Social desirability, psychological distress, and consumer satisfaction with mental health treatment.

The purpose of the present study was to determine the strength of the relationship between social desirability, psychological distress, and consumer satisfaction with mental health treatment. More specifically, our goal was to assess whether socially desirable responding accounts for much more variance in reports of client satisfaction than in self-reports of psychological distress. The sample consisted of 82 clients in therapy at the Center for Eclectic Psychology, a clinic affiliated with a large francophone university. Subjects completed the Balanced Inventory of Desirable Responding, the Symptom Checklist-10, and the Client Satisfaction Questionnaire. Correlational analyses revealed that both consumer satisfaction reports and psychological distress scores were contaminated by socially desirable responding. These findings are discussed in terms of the validity of client satisfaction measures. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Fear of psychological treatment and its relation to mental health service avoidance.

We evaluated whether a measure of mental health treatment fearfulness is associated with past mental health treatment history and/or current treatment status. Student Ss who either were or were not about to begin psychotherapy responded to the fear measure and a measure of psychological distress, and they also answered questions about their mental health treatment-seeking history. Analysis indicated that increased treatment fearfulness was associated retrospectively with a history of service underconsumption and cross-sectionally with a nonclinical treatment status. We conclude that treatment fears are associated with treatment-seeking decisions and suggest that future studies focus on delineating the causal relation of these variables and on the role that treatment fears may play in treatment compliance and behavior change. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mental Health of Lesbian, Gay, Bisexual, and Heterosexual Siblings: Effects of Gender, Sexual Orientation, and Family.

Self-identified lesbian, gay male, and bisexual (LGB) individuals were recruited via convenience sampling, and they in turn recruited their siblings (79% heterosexual, 19% LGB). The resulting sample of 533 heterosexual, 558 lesbian or gay male, and 163 bisexual participants was compared on mental health variables and their use of mental health services. Multilevel modeling analyses revealed that sexual orientation predicted suicidal ideation, suicide attempts, self-injurious behavior, use of psychotherapy, and use of psychiatric medications over and above the effects of family adjustment. Sexual orientation was unrelated to current psychological distress, psychiatric hospitalizations, and self-esteem. This is the 1st study to model family effects on the mental health of LGB participants and their siblings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Multiple dimensions of affective and cognitive disturbance: Latent-variable models in a community sample.

A clear understanding and confirmation of the structure of psychological distress has been hampered by different theoretical perspectives, ranges of measures, and methodologies. This study examined the latent construct structure of psychological distress as reflected in 27 self-report measures of psychological functioning from a community sample of 614 young adults. Models that hypothesized a single dimension of distress or 2 first-order factors (positive and negative affect) poorly fit the data. A model that fit well contained 9 first-order latent constructs, including Emotional Distress, Self-Derogation, Purpose in Life, Psychoticism, Depression, Anxiety, Hostility, Suicide Ideation, and Disorganized Thinking. Second and third higher order models achieved greater parsimony but were statistically inferior to the 9-factor model. Models are contrasted and discussed in terms of prior theory and current conceptualizations of mental health. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Illness intrusiveness, uncertainty, and distress in individuals with multiple sclerosis.

Objective: To examine the relation of illness intrusiveness and illness uncertainty to psychological distress in patients with multiple sclerosis (MS). Study Design: Participants were recruited from regional support groups and local neurologists. Participants completed self-report measures of illness intrusiveness, illness uncertainty, and psychological distress. Disease status was assessed by administration of a mental status exam and an index of ambulation. Participants: The sample included 78 (55 women, 23 men) individuals diagnosed with MS. Main Outcome Measure: The Symptom Checklist—90—Revised Global Severity Index. Results: Hierarchical regression analyses indicated that illness intrusiveness and illness uncertainty independently predicted adjustment problems above and beyond demographic and illness variables. No mediator or moderator relationships were found for illness intrusiveness. Conclusions: Psychological appraisals of illness are salient predictors of adjustment even after statistically controlling for the influence of age, education, and objective indices of physical and cognitive impairment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)