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PubMed2001

Psychological distress and work and home roles: a focus on socio-economic differences in distress.

BACKGROUND: Home and work factors have been linked to psychological status, but less is known about their contribution to social inequalities in psychological status. We examine whether social inequalities in psychological distress can be explained by work-home factors and whether the impact of these potential explanatory factors is similar for men and women. METHODS: Data are from the 1958 British birth cohort study. We sought to explain social class differences in psychological distress at age 33. Explanatory factors were classified as work-home roles: i.e. employment, marital status, domestic responsibility, children and elderly care; and work-home characteristics: i.e. job-strain, insecurity, unsocial working hours, youngest child's age, number of children and level of involvement in childcare. RESULTS: A social gradient in psychological distress was found: odds ratios for classes IV and V v. I and II were 2.65 (men) and 3.02 (women). Work factors had consistently stronger associations with psychological distress and with social class among men than women. Work factors had a greater impact on class differences in psychological distress in men. Associations for home roles and characteristics were less consistent and their combined effect on class differences in distress was negligible for both sexes. CONCLUSION: Explanations for the social gradient differ for men and women. Work may be more important for men than women, but the impact of home factors was not strong during the early adulthood of this cohort.

Activities of Daily Living↗

PubMed1992

The Distress and Risk Assessment Method. A simple patient classification to identify distress and evaluate the risk of poor outcome.

The integration of physical and psychological assessment is frequently problematic. Psychological tests are often cumbersome and difficult to interpret. There would appear to be a need for a simple assessment method that would identify distress and help alert the clinician to the need for a more comprehensive assessment. The Distress and Risk Assessment Method is derived from a simple set of scales validated for use with patients with low-back pain. It offers a simple classification of patients into those showing no psychological distress, those at risk of developing major psychological overlay, and those clearly distressed. Four patient types can be identified on the basis of scores on two short questionnaires. The construction of the Distress and Risk Assessment Method is described and validity data (both clinical and psychological) are presented. The use of the Distress and Risk Assessment Method in the prediction of outcome of treatment is presented, and the paper concludes with general guidelines for its use.

Adult↗

PubMed1991

Idioms of distress: somatic responses to distress in everyday life.

In-depth interviews were conducted among 50 subjects residing in the industrial town of Newcastle, Australia. Half of these subjects were from the general population and half were currently seeking counselling for personal/family problems. None of the subjects were receiving any medical care at the time of interview, though seven had done so during the episode of distress they were discussing. The study shows that while the subjects psychologized their 'problems', members of both groups tended to somatize at a rate proportional to the level of distress. Subjects were unaware of any relationship between the distress they were experiencing and their physical complaints. The results of this study support previous research which argues that those experiencing distress and those who tend to introspect are also those who are likely to amplify somatic symptoms. At the same time these results depart from findings in the United States which suggest that in the West, people learn to express social and personal distress in psychological terms, thereby reducing the level of somatization. Though not representative of the population as a whole, the findings raised questions warranting further study.

Adaptation, Psychological↗

PubMed2000

Social class, income, education, area of residence and psychological distress: does social class have an independent effect on psychological distress in Antalya, Turkey?

AIM: The aim of this study is to determine the separate effects of social class, income, education and area of residence on psychological distress. The study also assesses whether the association between prevalence of high score on the 12-item General Health Questionnaire (GHQ 12) and social class is independent of other variables. METHOD: Psychological distress was assessed by means of the GHQ 12. The study covered 1,092 adults aged 15 years or more living in two different quarters of Antalya. Social class status was defined by occupational position, with income, education and area of residence treated as confounders. Chi-square and logistic regression analyses were used to evaluate the data. RESULTS: Large inequalities in psychological distress by all variables were observed. Psychological distress was significantly associated with class status, after adjusting for income, education, area of residence and other potential confounders (age, sex and marital status). Class inequalities in psychological distress were observed between blue-collar workers/unqualified employees and bourgeoisie. CONCLUSIONS: These findings support the view that the recent widening of inequalities among social classes in Turkey pose a substantial threat to health.

Adolescent↗

PubMed1990

Distress associated with cancer as measured by the illness distress scale.

Over 400 cancer patients were given the Illness Distress Scale (IDS), a brief measure of the physical and emotional distress related to serious illness. Physical manifestations of the disease proved to be the source of greatest discomfort among these patients. Greater distress was reported by younger patients and by those who were unmarried. Also, patients with more advanced disease scored higher on the scale. The IDS appeared to measure four dimensions of distress related to the experience of illness, including loss of meaning, physical disease, medical treatment and social isolation. Scores on the instrument correlated highly with a measure of depression, the Beck Depression Inventory. The IDS appears to be a reliable and valid measure of distress associated with serious illness.

Adaptation, Psychological↗

PubMed2001

Family reports of dying patients' distress: the adaptation of a research tool to assess global symptom distress in the last week of life.

Understanding dying patients' symptom distress is an important component of efforts to improve care at the end of life. It can, however, be problematic to conduct research with dying patients. Family members can serve as sources of information about decedents' last days of life. In order to assess family reports of decedents' global symptom distress in the last week of life, we adapted the Memorial Symptom Assessment Scale Global Distress Index (MSAS-GDI), a brief measure of patient global symptom distress, for use in a retrospective study of family reports about end-of-life care. It was administered to a sample of 103 family members to assess the psychometric properties of the instrument in bereaved family members. The Family MSAS-GDI consists of questions about 11 psychological and physical symptoms commonly experienced by dying patients. The majority of family members were able to respond to the scale items. The mean Family MSAS-GDI score was 1.14 (SD = 0.87) with a range of 0 to 3.73. The scale demonstrated good internal consistency (alpha = 0.82). The average item-total correlation was r = 0.49 and the average inter-item correlation was r= 0.30, suggesting items were moderately correlated with the overall total scale and with each other. The Family MSAS-GDI could prove to be a useful tool in assessing and tracking global symptom distress in dying patients.

Aged↗

PubMedDate not supplied

Assessing psychological distress in psychiatric patients: validation of the Talbieh Brief Distress Inventory.

The present study examined the psychometric properties of the Talbieh Brief Distress Inventory (TBDI), a 24-item self-report instrument used to measure psychological distress, for use in psychiatric patients. A case-control and partly longitudinal design was used to test the TBDI among 431 psychiatric outpatients and inpatients and 197 gender- and age-matched nonpatients. All respondents were interviewed using the ICD-10 Symptom Checklist, and patients additionally with psychopathology rating scales. Internal consistency of the TBDI distress index was 0.92. A cutoff of 2.0 was associated with 96% sensitivity and 56% specificity. Mean TBDI scores were significantly lower for nonpatients than for both outpatients and inpatients, and for schizophrenic patients compared with patients suffering from schizoaffective/mood disorders and from neurotic/personality disorders. The TBDI shows good capacity to discriminate levels and symptoms of distress between control subjects and mentally ill patients. The TBDI is a brief, valid, and useful tool for stress-related research that allows comparison of the psychological responsiveness of distinct patients and groups of patients and facilitates assessment of distress levels across cultural or language barriers.

Adolescent↗

PubMedDate not supplied

The Female Sexual Distress Scale (FSDS): initial validation of a standardized scale for assessment of sexually related personal distress in women.

Recent consensus-based characterizations of female sexual dysfunction have emphasized personal distress as an essential component of their definition. To assist researchers and clinicians, we developed a new scale, the Female Sexual Distress Scale, to measure sexually related personal distress in women. In this article, we describe the initial stages in the development and validation of this instrument. Three studies involving a total of approximately 500 women were performed to evaluate the reliability and validity of the scale in different samples of sexually functional and dysfunctional women. Results indicated a unidimensional factor structure in both the original 20-item version and in a "polished" 12-item version. We observed a high degree of internal consistency and test-retest reliability in both versions across all three studies. Additionally, the scale showed a high degree of discriminative ability to distinguish between sexually dysfunctional and functional women in each of the studies. One study also showed a strong sensitivity to treatment response. Finally, we observed moderate positive correlations with other conceptually related nonsexual measures of distress, supporting the construct validity of the scale. Overall, these findings provide solid support for the FSDS as a valid and reliable measure for assessing sexually related personal distress in women.

Adult↗

PubMed1996

Psychological distress among recent immigrants from the former Soviet Union to Israel, I. Correlates of level of distress.

In most migrations some selection takes place either by the absorbing country and/or the individuals who emigrate. Israel has an open-door policy for immigrants and the recent large wave of immigrants from the former Soviet Union was made up of entire families rather than individuals. This provided an opportunity to examine the issue of migration and psychological distress more directly. A nationwide sample of 600 immigrants who arrived during the preceding year were interviewed in December 1990. Their psychological distress was measured by the PERI Demoralization questionnaire. For both genders, the mean demoralization score of the immigrant sample was found to be significantly higher than that reported for the Israeli-born population (after controlling for education). The factors that were found to be correlated with the level of distress were mostly individual characteristics of the immigrants (e.g. profession, religiousness, former residence in the Chernobyl region, previous contact with the health profession because of psychological problems). Increased distress was also significantly related to perceived lack of social support in Israel, which may in fact be partly determined by personality traits.

Acculturation↗

PubMed1999

Illness-related distress: does it mean the same for men and women? Gender aspects in cancer patients' distress and adjustment.

Gender differences were investigated in a sample of 149 married cancer patients (82 males, 67 females) undergoing outpatient chemotherapy. A cross-sectional design was used and evaluation included medical assessments and self-rating questionnaires. Tumour sites varied, and advanced stages of disease were predominant. Overall, the results suggest gender differences as well as some similarities. Although female patients reported symptoms and higher overall distress because of illness more frequently than male patients did, general satisfaction with life did not differ between genders, suggesting comparable adjustment. From the results of multivariate analyses physical impairment, such as older age, primarily explained female patients' distress, whereas men's distress was closely linked to their psychological condition. Men and women also differ in the way they make use of social support. Assessment of the distinctive aspects contributing to male and female cancer patients' distress could improve the provision of adequate support adapted to gender-specific requirements.

Adaptation, Psychological↗

PubMed1997

Economic hardship, family relationships, and adolescent distress: an evaluation of a stress-distress mediation model in mother-daughter and mother-son dyads.

This study evaluated a stress-distress mediation model of the relationships among economic hardship, maternal financial strain, maternal marital happiness, the parent-child relationships, and adolescent distress in a group of 188 sixth and 210 eighth graders and their mothers. The model predicted that economic hardship would increase maternal financial strain which was predicted to lead to more distress in the adolescent children by decreasing the mothers' marital happiness and the quality of the mother-child relationship. Separate latent variable path analyses with partial least squares (LVPLS) were conducted for the mother-daughter and the mother-son dyads. The results supported the hypothesized paths between economic hardship, mothers' financial strain, the mother-child relationship, and adolescent distress in both the mother-daughter and mother-son dyads.

Adolescent↗

PubMedDate not supplied

The Talbieh Brief Distress Inventory: a brief instrument to measure psychological distress among immigrants.

The purpose of this study was to develop and test the Talbieh Brief Distress Inventory (TBDI), a 24-item self-report questionnaire that measures psychological distress among immigrants. The TBDI combines items from the Brief Symptom Inventory (BSI) and the Psychiatric Epidemiology Research Interview Demoralization Scale (PERI-D). It includes a global score and six scales (obsessiveness, hostility, sensitiveness, depression, anxiety, and paranoid ideation). A convenience sample of 966 recent immigrants to Israel from the former Soviet Union were asked to complete a Russian-language version of the BSI and PERI-D as part of a study on immigrants' psychological adjustment. The TBDI is a combination of 13 items from the BSI and 11 items from the PERI-D. Items for inclusion were based on results of a separate factor analysis for the BSI and PERI-D and removal of repetitive items. We compared the total score with the total PERI-D and BSI and developed gender-specific cutoff points of caseness for the TBDI by comparison to known PERI-D and BSI cutoff points. We also checked for reliability using Cronbach's alpha. The TBDI correlated highly with the PERI-D (r = .93) and with the BSI (r = .82). Reliability of the scales and the overall instrument ranged from Cronbach's alpha of .60 to .89. TBDI caseness cutoff points were in close agreement with the BSI and PERI-D as reflected by kappa scores that ranged from .66 to .79. The TBDI is a promising instrument for screening populations for psychological distress and symptomatology. It is available in English, Hebrew, and Russian.

Adult↗

PubMed1989

Marital distress, depression, and attributions: is the marital distress-attribution association an artifact of depression?

We examined whether the association between marital distress and attributions is an artifact of depression. Study 1 showed that the attributions of 40 wives recruited from the community accounted for variance in their marital satisfaction after the effects of depression had been taken into account. Study 2 compared the attributions of 20 clinically depressed and maritally distressed wives (respondents to an advertisement offering therapy for depression and marital problems), 20 nondepressed but distressed wives (clients seeking marital therapy at a clinic), and a control group of 20 nondepressed and nondistressed wives (respondents to an advertisement for participants in a research project). The first two groups did not differ in attributions, but the attributions of both groups differed from those of the control group. Both studies therefore suggest that the association between attributions and marital satisfaction is not due to depression.

Adult↗

PubMed1983

Interaction patterns and communication skills in sexually distressed, maritally distressed, and normal couples: two experimental studies.

Two experiments are reported evaluating the behavioral deficits in communication skills found in couples with secondary sexual dysfunction (primarily of the female partner). Groups of satisfied couples and couples experiencing primarily marital distress served as controls. In Experiment 1 which analyzed the most frequently chosen behavioral reactions to 22 situations in a questionnaire (KIP), sex clients and maritally distressed couples were distinguished from the normal control group. In Experiment 2, videotaped conflict discussions were analyzed. Results show that clients with sexual dysfunctions, especially a subgroup with high scores on depressed mood, have even worse ratings on influence strategies, self-acceptance, and nonverbal expression than both maritally distressed and normal couples. Implications for theory and especially for setting treatment goals and selecting treatment interventions are discussed.

Adult↗

PubMed1990

Classification of natural and supernatural causes of mental distress. Development of a Mental Distress Explanatory Model Questionnaire.

This paper describes the background and development of a Mental Distress Explanatory Model Questionnaire designed to explore how people from different cultures explain mental distress. A 45-item questionnaire was developed with items derived from the Murdock et al. categories, with additional items covering western notions of physiological causation and stress. The questionnaire was administered to 261 people, mostly college students. Multi-dimensional scaling analysis shows four clusters of mental distress: a) stress; b) western physiological; c) nonwestern physiological; and d) supernatural. These clusters form two dimensions: western physiological vs. supernatural and impersonal vs. personalistic explanations. Natural and stress items are separated from supernatural and nonwestern physiological items along the first dimension. Brain damage, physical illness, and genetic defects have the greatest separation along the first dimension. Being hot, the body being out of balance, and wind currents passing through the body most strongly represent the non-western physiological category. The questionnaire has the potential to be used for community health screening and for monitoring patient care, as well as with students in the health sciences and with health practitioners.

Asia, Southeastern↗

PubMed2002

Psychological distress in cancer patients: hypothesis of a distress model.

A substantial body of research suggests links between stress, coping and cancer. Research also implicates the immune system as a link between stressful events and cancer. The current trend in research in the area of psycho-oncology attempts to define the types of stress and coping mechanisms being used in order to identify predictors of psychological distress. Based on the available review of literature, the impact of distress does seem to play a prominent role in the transition from a state of health to that of ill-health or even a terminal event. In the light of these studies, a distress model for the cancer patient has been hypothesized here.

Humans↗

PubMed2003

Impact of imagery rehearsal treatment on distressing dreams, psychological distress, and sleep parameters in nightmare patients.

We investigated the impact of imagery rehearsal treatment (IRT) on nightmare frequency, psychological distress, and sleep quality using polysomnography (PSG). 12 chronic nightmare patients completed prospective dream logs, measures of psychological distress, and underwent PSG prior to and 8.5 weeks following a single IRT session. Post-treatment, significant reductions were observed in retrospective nightmare frequency (d = 1.06, p = .007), prospective bad dream frequency (d = 0.53, p = .03), and anxiety scores (d = 1.01, p = .004). Minimal sleep alterations were found post-IRT, and varied as a function of nightmare etiology. The results independently replicate the efficacy of IRT for alleviating disturbing dreams and psychological distress. Sleep improvement may occur later in the recovery process.

Adult↗

PubMed2000

Diuretics for respiratory distress syndrome in preterm infants.

BACKGROUND: Lung edema may complicate respiratory distress syndrome (RDS) in preterm infants. OBJECTIVES: The aim of this review was to assess the risks and benefits of diuretic administration in preterm infants with RDS. SEARCH STRATEGY: We used the standard search method of the Cochrane Neonatal Review Group. We searched Medline, Embase and the Cochrane Controlled Trials Register from the Cochrane Library, using the following keywords: and . In addition, we searched the abstract books of the American Thoracic Society and Pediatric Research Societies. SELECTION CRITERIA: We only included trials in which preterm infants with RDS and less than 5 days of age were randomly allocated to diuretic administration. Of those trials, we only included studies in which at least one of the following outcomes measures was evaluated: mortality, patent ductus arteriosus, hypovolemic shock, intraventricular hemorrhage, renal failure, duration of oxygen supplementation, duration of mechanical ventilation, need for oxygen supplementation at 28 days of life, oxygen supplementation at 36 weeks of postconceptional age (gestational age + postnatal age), length of stay, number of rehospitalizations during the first year of life, and neurodevelopmental outcome. DATA COLLECTION AND ANALYSIS: We used the standard method for the Cochrane Collaboration which is described in the Cochrane Collaboration Handbook. Two investigators extracted, assessed and coded separately all data for each study. Any disagreement was resolved by discussion. MAIN RESULTS: Six studies met inclusion criteria. Studies available for this systematic review were all done before the current era of prenatal steroids, surfactant, indomethacin and fluid restriction. Furosemide administration had no long-term benefits. Furosemide-induced transient improvement in pulmonary function did not outweigh an increased risk for patent ductus arteriosus and for hemodynamic instability. REVIEWER'S CONCLUSIONS: There are no current data to support routine diuretic administration in preterm infants with RDS. Elective administration of furosemide or any diuretic to any patient with RDS should be carefully weighed against the risk of precipitating hypovolemia. In addition, elective administration of furosemide should be weighed against the risk of developing a symptomatic patent ductus arteriosus.

Diuretics↗