The differential effect of child age on the illness intrusiveness–parent distress relationship in juvenile rheumatic disease.

Objective: Examine age-related patterns of association between parent-reported illness intrusiveness and parent distress in parents of youth with juvenile rheumatic diseases (JRDs). Study Design: Cross-sectional multiple regression analysis tested child age as a moderator in the illness intrusiveness–distress relationship. Participants: Fifty-two parents of children ages 9–17 diagnosed with JRD. Main Outcome Measures: The Illness Intrusiveness Scale—Parent Version and the Brief Symptom Inventory. Results: Parent-reported illness intrusiveness demonstrated a significant main effect on distress for all parents in the sample. This was qualified by an Illness Intrusiveness × Child Age interaction. Illness intrusiveness was found to be significantly related to distress among parents of older youth, but was only marginally related to distress for parents of younger children. Conclusions: Results are consistent with family life cycle development models of adjustment to childhood chronic illness. The clinical implications of the findings are also discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cultural syndromes and age moderate the emotional impact of illness intrusiveness in rheumatoid arthritis.

Objective: The authors investigated cultural syndromes (multidimensional vectors comprising culturally based attitudes, values, and beliefs) and age as moderators of the emotional impact of illness intrusiveness—illness-induced lifestyle disruptions—in rheumatoid arthritis (RA) and examined illness intrusiveness effects in total and separately for three life domains (relationships and personal development, intimacy, and instrumental). Research Method/Design: People with RA (n = 105) completed the Illness Intrusiveness Ratings, Individualism–Collectivism, and Center for Epidemiologic Studies—Depression scales in a one-on-one interview. Results: Controlling for disease and background characteristics, the association between illness intrusiveness (total score and the Relationships and Personal Development subscale) and distress was inverse when young adults with RA endorsed high horizontal individualism. Illness intrusiveness into intimacy was associated with increased distress, and this intensified when respondents endorsed high vertical individualism, horizontal collectivism, vertical collectivism, or low horizontal individualism. The negative emotional impact of illness intrusiveness into intimacy diminished with increasing age. Conclusion: Given an aging and increasingly pluralistic society, diversity can no longer be ignored in addressing the psychosocial impact of chronic, disabling disease. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perceived Uncertainty, Spiritual Well-Being, and Psychosocial Adaptation in Individuals With Multiple Sclerosis.

Objective: To examine the role of spiritual well-being as a mediator and moderator between perceived uncertainty and psychosocial adaptation to multiple sclerosis (MS). Participants and Design: Fifty individuals (40 women, 10 men) diagnosed with multiple sclerosis. Main Outcome Measures: Self-report measures on illness uncertainty, spiritual (religious and existential) well-being, and psychosocial adjustment to illness were analyzed by a series of hierarchical multiple regression analyses. Results: Both uncertainty and spiritual well-being independently predicted psychosocial adjustment to MS after the influence of demographic and disability-related variables were considered. Spiritual well-being demonstrated a mediator effect but, mostly, failed to show a moderator effect. Conclusion: Spiritual well-being exerts an appreciable influence on adaptation to MS and also acts to mitigate the impact of uncertainly on adaptation. Rehabilitation psychologists may wish to consider its beneficial role as part of their clinical work. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Coping style, perceived uncertainty in illness, and distress in individuals with Parkinson's disease and their caregivers.

Examined the relationship of coping style and illness uncertainty to psychological distress in individuals with Parkinson's disease (PD) and their primary caregivers. Design: Correlational methods, within-group theory-driven hierarchical regression analyses, and transactional analyses. Ss were 44 dyads composed of individuals with PD and their caregivers. Main Outcome Measures: Hoehn and Yahr Clinical Disability Rating Scale, Instrumental Activities of Daily Living Scale, Symptom Distress Checklist-90—Revised, Mischel Uncertainty in Illness Scale-Community Form, and Revised Ways of Coping Checklist. Results: Emotion-focused coping was associated with higher levels of distress for persons with PD, whereas both emotion-focused coping and perceived uncertainty were associated with distress for the caregivers. Transactional analyses between patients and caregivers indicated that higher levels of patient problem-focused coping and perceived uncertainty in illness were associated with increased problems in caregiver distress. Adjustment to PD is influenced by several patient and caregiver variables. The results warrant consideration of a variety of clinical interventions involving patient and caregiver education about the disease and methods for managing the associated symptoms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Stability and determinants of psychosocial well-being in multiple sclerosis.

Illness-induced lifestyle disruption was hypothesized to compromise psychosocial well-being (PW) in multiple sclerosis (MS) by (1) interfering with continued involvements in valued activities and interests and (2) decreasing personal control over important life domains. Three categories of illness-related variables (IRVs) were hypothesized to contribute to increased illness intrusiveness (ILI): burden of illness, functional deficits, and physical disabilities. Measures of ILI, personal control, PW, and IRVs were obtained from 94 people with MS on 3 occasions over 18 mo. Regression analyses supported the proposed model and indicated that each of the hypothesized determinants was significantly and uniquely related to the perception of ILI. Approximately two-thirds of the Ss achieved a positive psychosocial adjustment to MS, but the rest reported elevated levels of emotional distress. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychosocial impact of illness intrusiveness moderated by self-concept and age in end-stage renal disease.

This study assesses whether a person's self-concept as a "chronic kidney patient" differentially moderates the psychosocial impact of illness intrusiveness—illness-induced lifestyle disruptions—across the life span. Renal transplant (n?=?52) and maintenance dialysis patients (n?=?49) completed the Illness Intrusiveness Ratings Scale, a semantic-differential self-concept measure, and structured interviews measuring psychosocial well-being and emotional distress. Across ages, distress rose with increasing illness intrusiveness when self-concept was similar, but not dissimilar, to the chronic kidney patient stereotype. The relation between illness intrusiveness and psychosocial well-being differed significantly between younger and older respondents depending on whether they construed themselves as similar versus dissimilar to the chronic kidney patient. Although self-definition moderates the psychosocial impact of chronic disease, this varies across the life span and across affect states. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Children's Perceived Illness Uncertainty as a Moderator in the Parent-Child Distress Relation in Juvenile Rheumatic Diseases.

Objective: Examine children's perceived illness uncertainty as a potential moderator in the parent-distress/child-depressive-symptom relation in youths with juvenile rheumatic disease (JRD). Participants and Study Design: 50 youths between the ages of 9 and 17 and their parents completed self-report measures. Main Outcome Measures: Parents completed the Brief Symptom Inventory (L. R. Derogatis & N. Melisaratos, 1983); youths completed the Children's Depression Inventory (M. Kovacs, 1992) and the Children's Uncertainty in Illness Scale (L. L. Mullins & V. L. Hartman, 1995). Results: Children's perceived illness uncertainty moderated the parent-distress/child-depressive-symptom relation. Parent distress was associated with child depressive symptoms only under conditions of high child-perceived uncertainty; under conditions of low illness uncertainty, parent distress was unrelated to child depressive symptoms. Conclusions: Results highlight the role of children's cognitive appraisals in parent-child adjustment relations in JRD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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)     

Illness uncertainty, attributional style, and psychological adjustment in older adolescents and young adults with asthma

Examined psychological adjustment in a college sample of older adolescents and young adults (n = 49) with histories of childhood asthma. A substantial number of subjects evidenced clinically significant levels of overall distress. In addition, greater perceived asthma uncertainty and increased stable attributions for negative events were significantly associated with poorer psychological adjustment after controlling for demographic and disease variables. Further analyses revealed a moderating influence of uncertainty on attribution-adjustment relationships. These findings provide initial support for a cognitive diathesis-stress view of adjustment in long-standing asthma. Results also support a growing body of evidence suggesting that the focus of efforts to enhance adjustment to asthma need to be expanded beyond childhood and early adolescence.     

Catastrophizing mediates associations between pain severity, psychological distress, and functional disability among persons with spinal cord injury.

Objective: To examine associations between pain severity, psychological distress, catastrophizing, and indices of functional disability in a sample of persons with spinal cord injury (SCI). Catastrophizing was examined as a potential mediator of associations between pain severity, psychological distress, and functional disability. Design and Participants: Questionnaires assessing pain severity, psychological distress, catastrophizing, pain interference, and community integration were completed by 237 persons with SCI. Results: Psychological distress and pain severity were associated significantly with greater functional disability. Moreover, the association between pain severity and functional disability was strongest among persons with high psychological distress. Catastrophizing appeared to mediate the associations between pain severity, psychological distress, and functional disability. Conclusions: Pain severity and psychological distress have the potential for both direct and interactive effects on functional disability, possibly through the mediating effects of catastrophizing. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

La relation entre l'abus sexuel subi durant l'enfance et la satisfaction conjugale chez l'homme.

The goal of the present study was to evaluate the relationship between child sexual abuse and men's dyadic adjustment, using a theoretical model integrating attachment, that is anxiety about abandonment and avoidance of proximity, and psychological distress. Participants were 316 men forming a probabilistic sample of French-Quebecer living in couple. Structural equation analyses showed that sexual abuse predicted dyadic adjustment through anxiety about abandonment and psychological distress. Moreover, there was no relationship between sexual abuse and avoidance of proximity, while this variable was associated to dyadic adjustment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A replicated prospective investigation of life stress, coping, and depressive symptoms in multiple sclerosis

Life stress and coping responses jointly contribute to psychological adjustment in many chronic illness populations, but their significance in multiple sclerosis (MS) has not been extensively investigated. Physical disability, cognitive status, negative life stress, coping strategies, and depressive symptoms were prospectively assessed in 27 adults with definite or probable MS. Of the original subjects, 22 provided two additional assessments at 6-month intervals. After accounting for cognitive status and physical disability, life stress was positively correlated with current as well as future depressive symptoms; the prospective relationship was replicated within the second pair of prospective data waves. Escape avoidance was the only coping strategy that added to the prediction of future mood symptoms, but this was not replicated. Results suggest that MS-related depressive symptoms are a function of prior disease-related impairment, life stress, and possibly escape avoidance coping.     

Adjustment to multiple sclerosis: Application of a stress and coping model.

This study examined the use of a stress and coping model of adjustment to multiple sclerosis (MS). A total of 122 MS patients were interviewed and completed self-administered scales at Time 1 and 12 months later, Time 2 (n?=?96). Predictors included stressful life events, illness (duration, severity, and disability), social support, appraisal (threat and control/challenge), and coping (problem focused and emotion [wishful thinking, self-blame, and avoidance] focused). Adjustment outcomes were Time 2 depression, global distress, social adjustment, and subjective health status. Results from hierarchical regression analyses indicated that after controlling for the effects of Time-1 adjustment, better Time-2 adjustment was related to less disability, greater reliance on problem-focused coping, and less reliance on emotion-focused coping. There was limited support for the stress buffering effects of coping and social support. Findings offer some support for the use of a stress and coping model of adaptation to MS. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Bone harvesting from the oral cavity]

BACKGROUND AND METHODS: We examined the effect on health perceptions of a diagnostic workup in 172 patients with suspected multiple sclerosis (MS) using two questionnaires (Mishel, Rand Medical Outcome Study) and three visual analogue scales measuring distress. Patients were categorized into "MS," "not MS," or "still uncertain" groups. RESULTS: Patients with a definitive diagnosis reported a significant decrease in uncertainty (analysis of variance [ANOVA] P = .0004). The Medical Outcome Study showed a slightly worsened perceived current health status (ANOVA P = .02) and future health outlook (ANOVA P = .001) in the MS group compared with the other two groups. Distress over physical symptoms decreased in all three groups and anxiety was more likely to decrease than increase even in those with MS. Prognostic uncertainty distress decreased in the not MS group and still uncertain groups, whereas it remained unchanged in the MS group (P = .9156). CONCLUSION: Significant and generally beneficial changes in patient health perceptions are seen associated with a neurologic workup in suspected MS, irrespective of the final diagnosis.     

Positive Coping and Stress-Related Psychological Growth Following Lower Limb Amputation.

Objective: To present a cross-sectional qualitative exploration of how individuals cope with a lower limb amputation and to examine the influence of positive coping and stress-related psychological growth on adjustment. Participants: 12 patients with a lower limb amputation. Setting: Artificial Limb and Appliance Centre in South Wales, United Kingdom. Design: Semistructured interviews, using grounded theory for analysis. Measures: The Hospital Anxiety and Depression Scale (A. Zigmond & R. Snaith, 1983) and the Rosenberg Self-Esteem Scale (M. Rosenberg, 1965). Results: No evidence of psychological distress among participants. Qualitative analysis revealed 5 categories of coping, and a theoretical model of positive coping following lower limb amputation was generated. Conclusions: Coping strategies evolve, reflecting the changes in psychological demands postamputation. Positive coping and psychological growth facilitates psychological adjustment. Clinicians may facilitate adaptive outcomes by appreciating the positive psychology perspective. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Making sense of multiple sclerosis.

Objective: In this study, the aim was to examine the dimensional structure of a multi-item measure of sense making in people with multiple sclerosis (MS) and to investigate relations between sense making and both positive and negative adjustment outcomes. Method: Participants were 408 persons with MS and 232 caregivers. Questionnaires were completed at the initial assessment (Time 1) and 12 months later (Time 2). Results: Factor analysis of the Sense Making Scale (SMS) revealed 6 psychometrically sound factors: Redefined Life Purpose, Acceptance, Spiritual Perspective, Luck, Changed Values and Priorities, and Causal Attribution. Results of regression analyses indicated that the Time 2 SMS factors accounted for significant amounts of variance in each of the Time 2 adjustment outcomes (life satisfaction, positive states of mind, anxiety, depression, caregiver adjustment rating of the care receiver), after controlling for Time 1 adjustment and relevant demographic and illness variables. Conclusions: Findings delineate the dimensional structure of sense making in MS and the differential links between sense making dimensions and adjustment and have implications for the measurement of sense making. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adjustment following the mass shooting at Virginia Tech: The roles of resource loss and gain.

Unfortunately, many individuals will be exposed to traumatic events during their lifetime. The experience of loss and gain of valued resources may represent important predictors of psychological distress following these experiences. The current study examined the extent to which loss and gain of interpersonal and intrapersonal resources (e.g., hope, intimacy) predicted psychological distress among college women following the mass shooting at Virginia Tech (VT). Participants were 193 college women from whom preevent psychological distress and social support data had been obtained. These women completed surveys regarding their psychological distress, coping, and resource loss and gain 2- and 6-months after the VT shooting. Structural equation modeling supported that resource loss predicted greater psychological distress 6 months after the shooting whereas resource gain was weakly related to lower levels of psychological distress. The study also revealed that social support and psychological distress prior to the shooting predicted resource loss, and social support and active coping with the shooting predicted resource gain. Implications of the results for research examining the roles of resource loss and gain in posttrauma adjustment and the development of interventions following mass trauma are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The association between threat appraisals and psychological adjustment in partners of people with spinal cord injuries.

Objective: To explore the psychological factors associated with adjustment in partners of people with spinal cord injuries (SCIs). Participants and Design: Forty partners of people with SCIs. The study had a cross-sectional design. Main Outcome Measures: Beck Depression Inventory, the State Trait Anxiety Inventory Form Y-1, Social Provisions Scale, COPE, and an appraisal scale. Results: Approximately one third of partners reported levels of anxiety and depressive symptoms above the clinical cut-off points indicating elevated levels of emotional distress. Factors hypothesized to account for levels of emotional distress on the basis of the cognitive-appraisal model of stress and coping were found to be explanative. In particular, high threat appraisal, higher use of avoidance (emotion-focused) coping, and lack of approach (problem-focused) coping were found to predict higher levels of anxiety and depressive symptoms. Conclusions: Partners of people with SCIs are at risk of emotional distress. Factors that might help identify at-risk partners are identified and psychological interventions that might help partners are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Distress, personality, and mammography utilization among women with a family history of breast cancer.

The authors examined the impact of psychological distress and the personality construct of conscientiousness (as measured by the Neuroticism, Extraversion, and Openness—Five Factor Inventory) on mammography utilization among women who were at increased risk for breast cancer. Participants were 200 women who had at least 1 first degree relative with breast cancer. Overall, 80% of the participants had obtained a mammogram in the previous year. Analyses controlling for potential confounders (perceived risk, decisional balance, and physician recommendation for mammography), revealed that distress was negatively associated with mammography utilization among participants who were low in conscientiousness. Distress was not significantly related to mammography utilization among highly conscientious women. The results are discussed in terms of their implications regarding interventions designed to increase mammography utilization in this population. (PsycINFO Database Record (c) 2010 APA, all rights reserved)