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The occurrence of breakthrough infections with SARS-CoV-2 in vaccinated individuals argues against abandoning mitigation efforts such as social distancing. Some public health messages, however, promote vaccination by increasing psychological distress, which interferes with social distancing. Prosocial messages present an alternative approach that may avoid this problem. Accordingly, the present study examined the relation of pandemic mitigation with scores on prosocial personality traits (i.e., altruism, sympathy, and trust) and vaccination intentions. Regression analyses indicated that while vaccination intentions increased significantly with an increase in trust, distancing increased significantly with increases in altruism and sympathy. Because older adults are much more vulnerable to COVID-19 than younger adults, these findings reveal an altruistic paradox, in which older adults, perhaps the most altruistic portion of the population, may be dependent on the altruistic behavior of younger adults, who may be the least altruistic portion. The challenge for public health messaging will be to motivate younger adults to take the consequences of their mitigation decisions for others into account.

Background Early specialist evaluation during rapid proliferative growth of complicated infantile hemangiomas (IH) is crucial. Health disparities and barriers of access-to-care for children with IH have not been examined. Objective Investigate whether socioeconomic status (SES) is associated with age at subspecialist presentation for IH evaluation. Method Retrospective cohort study of 804 children presenting to a large academic hospital. Primary outcome was age at initial presentation. Covariates included demographic, socioeconomic, geographic, and clinical characteristics. Medicaid or Children's Health Insurance Program (CHIP) were proxies for lower SES. Analysis of covariance, χ2 tests, and generalized ordered logistic regressions were performed. Results Children with lower SES had higher odds of presenting after 3 months of age (OR 2.11, 95% CI 1.31-3.38). In the subset that qualified for institutional care management program (ICMP), no risk factors were associated with delayed presentation. Limitations Use of insurance and economic distress as proxies for SES; exclusion of uninsured children may underestimate racioethnic effects; single academic center study limiting generalizability. Conclusions Children with IH and lower SES were more likely to present later to specialists, but those enrolled in an ICMP did not, suggesting that integrated ICMPs may mitigate disparities and delayed access-to-care for IH among lower SES populations.

ObjectiveThis study aimed to examine the associations of perceived stress, stressors, and distress with sleep disturbance and duration among Asian immigrants.Design/setting/participantsThe sample included 400 Asian immigrants aged 50-75 years old recruited from primary care physicians' clinics.MethodsWe fit multivariable regression models to examine the associations of perceived stress, stressors, and distress with self-reported sleep disturbance and duration. We tested effect modifications by language proficiency, years in the United States, acculturative stress, and social support.ResultsA total of 73 (18.3%) participants reported any sleep disturbance, and the average time in bed was 7.25 hours (SD=1.17). Higher perceived stress (PR=1.15, 95% CI=1.06, 1.26), stressors (PR=1.32, 95% CI=1.13, 1.59), and distress (PR=1.36, 95% CI=1.21, 1.57) were associated with a higher prevalence of any sleep disturbance. These associations were not modified by language proficiency, years in the United States, acculturative stress, and social support. On the other hand, the associations of perceived stress and distress with time in bed were modified by years in the United States. Specifically, higher levels of distress were associated with shorter times in bed only among adults who have resided in the United States for less than 10 years.ConclusionPerceived stress, stressors, and distress were associated with a higher prevalence of sleep disturbance. Moreover, perceived stress and distress had stronger associations with times in bed among recent immigrants. Future sleep health research in Asian Americans should consider the important role of stress and distress, especially among recent immigrants.

Introduction Studies in pediatric oncology have shown that hypnosis effectively reduces patients’ pain and distress during painful procedures. This remains underutilized in the healthcare system due to the staff cost and availability of hypnotherapists. To develop the use of hypnosis-derived communication, we aimed to train nurses to use hypnosis-derived communication while they perform painful procedures. Objectives This study aimed to (1) develop a brief training in hypnosis-derived communication for pediatric nurses named Rel@x, (2) pretest the training with experienced pediatric oncology nurses, and (3) refine the training based on nurses’ suggestions. Methods The Rel@x training consists of two 4-h sessions: one related to relational aspects and another one presenting one of two selected hypnotic communication techniques (“pleasant place” or “magic glove”). Rel@x makes use of manuals, cue card reminders, visual aids, videos, and an e-learning platform. To refine Rel@x, a complete training cycle was conducted with seven female pediatric oncology nurses. A mixed method study with an evaluation questionnaire and a post-training focus group interview was conducted. Results Quantitative data showed that nurses overall positively rated the training program: relevance and acceptability (median average of 5.4/6); use of hypnotic communication (median average of 5.2/6); expected effects (median average of 5.4/6); program implementation (5.6/6). Two general themes emerged from the qualitative data: perceptions of hypnotic communication and the evaluation of the Rel@x training program. Based on nurses’ suggestions, Rel@x was refined by adding more practical components, more time for practice, more time between the two sessions and additional tools (cue card reminders, keywords, virtual e-learning recap module). Conclusion and clinical implications The use of hypnosis-derived communication during painful procedures and the Rel@x training were viewed favorably amongst pediatric nurses. Rel@x offers a complete training in hypnosis-derived communication for pediatric nurses. This training fosters the optimal use of hypnosis-derived communication during care and may significantly reduce children’s procedural pain and distress.

Objectives Integrating vocational rehabilitation and mental healthcare has shown effects on vocational outcomes during sick leave with common mental disorders. In a previous paper, we showed that a Danish integrated healthcare and vocational rehabilitation intervention (INT) had a surprisingly negative impact on vocational outcomes compared to service as usual (SAU) at 6- and 12-month follow-up. That was also the case with a mental healthcare intervention (MHC) tested in the same study. This article reports the 24-month follow-up results of that same study.Method A randomized, parallel-group, three-arm, multi-centre superiority trial was conducted to test the effectiveness of INT and MHC compared to SAU.Results In total, 631 persons were randomized. Contrary to our hypothesis, SAU showed faster return to work than both INT [hazard rate (HR) 1.39, P=0.0027] and MHC (HR 1.30, P=0.013) at 24-month follow-up. Overall, no differences were observed regarding mental health and functional level. Compared to SAU, we observed some health benefits of MHC, but not INT, at 6-month follow-up but not thereafter, and lower rates of employment at all follow-ups. Since implementation problems might explain the results of INT, we cannot conclude that INT is no better that SAU. The MHC intervention was implemented with good fidelity and did not improve return to work.Conclusion This trial does not support the hypothesis that INT lead to faster return to work. However, implementation failure may explain the negative results. Objectives Integrating vocational rehabilitation and mental healthcare has shown effects on vocational outcomes during sick leave with common mental disorders. In a previous paper, we showed that a Danish integrated healthcare and vocational rehabilitation intervention (INT) had a surprisingly negative impact on vocational outcomes compared to service as usual (SAU) at 6-and 12-month follow-up. That was also the case with a mental healthcare intervention (MHC) tested in the same study. This article reports the 24-month follow-up results of that same study. Method A randomized, parallel-group, three-arm, multi-centre superiority trial was conducted to test the effectiveness of INT and MHC compared to SAU. Results In total, 631 persons were randomized. Contrary to our hypothesis, SAU showed faster return to work than both INT [hazard rate (HR) 1.39, P=0.0027] and MHC (HR 1.30, P=0.013) at 24-month follow-up. Overall, no differences were observed regarding mental health and functional level. Compared to SAU, we observed some health benefits of MHC, but not INT, at 6-month follow-up but not thereafter, and lower rates of employment at all follow-ups. Since implementation problems might explain the results of INT, we cannot conclude that INT is no better that SAU. The MHC intervention was implemented with good fidelity and did not improve return to work. Conclusion This trial does not support the hypothesis that INT lead to faster return to work. However, implementation failure may explain the negative results.

Misophonia is a common condition that causes significant distress and impairment for patients and families. Despite the growing body of literature, most treatment descriptions do not incorporate objective assessment measures or detail techniques to involve family members in addressing misophonia. This case report provides a step-by-step family-based cognitive-behavioral approach to treat youth with misophonia, uses objective rating scales to monitor therapeutic improvement, and elicits feedback on the therapeutic skills used between therapy sessions. It also provides guidance on implementing inhibitory learning exposures for youth with misophonia.

The COVID-19 pandemic is a source of mental stress, particularly for special populations. The present study identified the associations between emotional distress and HIV status among adults in 152 countries during the first wave of the pandemic. This was a cross-sectional study that gathered data via an online survey carried out between July and December 2020. The dependent variable was emotional distress (frustration/boredom, anxiety, depression, loneliness, anger, or grief/feeling of loss), and the independent variable was HIV status (positive or negative). The confounding factors were sociodemographic variables (age, sex, education level, and employment status). Multivariable logistic regression analyses were performed to assess the associations between the independent and dependent variables after adjusting for confounders. Of the 16,866 participants, 905 (5.4%) reported living with HIV. Of these, 188 (20.8%) felt frustrated/bored, 238 (26.3%) anxious, 160 (17.7%) depressed, 148 (16.4%) lonely, 84 (9.3%) angry, and 53 (5.9%) grief/a sense of loss. Individuals living with HIV had higher odds of feeling anxious (AOR:1.64), depressed (AOR:1.80), and lonely (AOR:1.35) when compared to people living without HIV. This study reveals that the COVID-19 pandemic can exacerbate emotional stress for those living with HIV, and the system in which COVID-19 impacts emotional health among different sociodemographic groups introduces further complexities regarding this observed effect.

OBJECTIVE This study aims to determine for Syrian refugee women in Turkey the effectiveness, feasibility, and acceptability of culturally adapted cognitive behavioral therapy (CA-CBT). METHOD Participants were randomly allocated to receive either CA-CBT (n = 12) or treatment-as-usual (TAU; n = 11). We used the Harvard Trauma Questionnaire (HTQ) and the Hopkins Symptom Checklist-25 (HSCL) to assess posttraumatic stress symptoms and anxious-depressive distress. CA-CBT was delivered through seven weekly group sessions. RESULTS CA-CBT had a large effect on PTSD (HTQ d = 1.17) and nearly medium effect sizes for anxious-depressive distress (HSCL d = .40). There were also low drop-out rates and an absence of adverse events. CONCLUSIONS Because CA-CBT greatly reduced PTSD symptoms as compared with TAU and had a low drop-out rate, no adverse events, and was deliverable in a short treatment frame (seven sessions) and in a group format, we conclude that the treatment is effective, acceptable, and feasible and has the potential for scalability. Clinical Impact Statement: A Syrian version of CA-CBT was effective (large effect sizes for the HTQ), feasible, and potentially scalable (easy application, conducted with trained facilitators, short-term therapy, group format), and acceptable (as evidenced by very low drop out and no adverse events). Thus, the Syrian version of CA-CBT appears to be a valuable psychological intervention for traumatized Syrian refugees, particularly given the lack of effective treatments for this group. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Over the past two years, the consequences of the severe restrictions imposed by the rapid spread of COVID-19 among the global population have been a central focus of scientific research. The pandemic has been a singular and unexpected event that found people unprepared and vulnerable in responding to its emergence, resulting in substantial psychological distress. Scientific evidence has highlighted that adolescents and emerging adults have been among those populations at greatest risk of adverse psychological outcomes, even in the long term. In particular, more than one-third of young adults reported high levels of loneliness, and nearly half of 18- to 24-year-olds felt lonely during the pandemic, experiencing both psychological and emotional distress. The lockdown, the consequent suspension of face-to-face academic activities and the severe restriction of social life have disrupted the daily routines of students already involved in coping with developmental tasks related to identity formation and the relational experience. Under such conditions, emotions and emotional regulation skills are crucial in adapting behavior to reach academic goals and face mounting levels of distress. Therefore, several studies have investigated resilience mechanisms and coping strategies of emerging adults during the pandemic. The present study focuses on university students and explores the impact of resilience and emotional regulation on adverse psychological outcomes related to persistent distress conditions associated with the COVID-19 pandemic. Students were administered a self-report assessment battery through an online platform at the beginning (T0) and the end of the lockdown (T1). A structural equation model (SEM) was used to explore the relationship between resilience, emotional regulation difficulties and psychological distress (depression, anxiety and stress). The findings indicate that psychological resilience and emotion regulation are protective factors that buffer the extent of possible distress resulting from an adverse condition such as the COVID-19 pandemic.

Continuous global warming and frequent extreme high temperatures keep the urban climate health risk increasing, seriously threatening residents’ emotional health. Therefore, analysis on spatial distribution of the health risk that the urban heat island (UHI) effect imposes on emotional health as well as basic research on the characteristics of vulnerable populations need to be conducted. This study, with Tianjin city as the case, analyzed data from Landsat remote-sensing images, meteorological stations, and digital maps, explored the influence of summer UHI effect on distress (a typical negative emotion factor) and its spatiotemporal evolution, and conducted difference analysis on the age groups, genders, family state, and distress levels of vulnerable populations. The results show: (1) During the period of 1992–2020, the level and area of UHI influence on residents’ distress drastically increased–influence level elevated from level 2–4 to level 4–7, and highlevel influence areas were concentrated in six districts of central Tianjin. (2) Influence of the UHI effect on distress varied in different age groups–generally dropping with fluctuations as residents got older, especially residents aged 50–59. (3) Men experienced a W-shaped pattern in distress and were more irritable and unsteady emotionally; while women were more sensitive to distress in the beginning, but they became more placid as temperature got higher. (4) Studies on family status show that couples living together showed sound heat resistance in the face of heat stress, while middle-aged and elderly people living alone or with children were relatively weak in adjusting to high ambient temperature.

OBJECTIVE Posttraumatic growth (PTG) has been primarily recognized as a result of experiencing a single life crisis. The current study investigated how PTG may be attributed to experiences of a multitude of highly stressful life events, and how PTG is correlated with PTSD symptoms, the severity of the event, and the total number of childhood traumas experienced. METHOD Adolescents (N = 139) participated in a survey that assessed six major life events of childhood trauma and rated the severity of each event, posttraumatic stress symptoms (PTSS), and PTG. RESULTS The majority of adolescents attributed their PTG experiences to one event, despite experiencing multiple traumas. However, experiencing more events was associated with greater PTSS and some forms of PTG such as changed priorities, increased self-reliance, and establishing a new path in life. Results from regression analyses also showed that trauma severity and PTSS were linearly correlated with PTG, and thus, a curvilinear relationship was not identified. CONCLUSIONS Cumulative traumatic events may lead to increases in a sense of personal growth, while also increasing distress, in nonclinical adolescents. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Problemas de comportamento são comuns em indivíduos com transtorno neurocognitivo maior (TNM) e estão associados à altos níveis de estresse dos cuidadores e à decisão sobre institucionalização desses idosos. Apesar de sua importância, existem poucos artigos sobre avaliações em manejo de comportamentos problemas envolvendo a população idosa, com referencial analítico comportamental. O objetivo do presente trabalho foi realizar um levantamento bibliográfico nas base de dados PsycInfo e Scielo acerca de pesquisas empíricas em Análise do Comportamento Aplicada sobre avaliação e manejo de comportamentos problemas em idosos com TNM, publicadas em revistas com avaliação por pares. A busca pelas palavras chave resultou em 73 artigos, dos quais 15 foram considerados para análise. Os comportamentos alvo envolveram vocalizações disruptivas; agressão física ou verbal; deambulação; e outros. As pesquisas apresentaram intervenções eficazes para redução de comportamentos problemas. Foram discutidas questões acerca das avaliações, assim como da viabilidade de implementação das intervenções.

Rumination means to perseveratively think about one's negative feelings and problems. It is a response to affective distress that is often referred to as maladaptive emotion regulation. According to the response styles theory and control theory, rumination may further prolong and exacerbate affective distress. This means that rumination can be viewed as both an antecedent and an outcome of negative affect (NA), and vice versa. However, at the level of short-term dynamics, state rumination and NA have previously mainly been examined as two separate outcomes. To model the reciprocal within-person effects and hence, to match theoretical assumptions, we combined the two interrelated time series in one model using dynamic structural equation modeling (DSEM). Both effects (NA on subsequent rumination and rumination on subsequent NA) were modeled simultaneously while acknowledging the autoregressive nature of both states (inert properties). We used data from two experience sampling studies (NStudy 1 = 200 Belgian university students; NStudy 2 = 70 German university students). Participants were paged on smartphones several times a day (Study 1: 10; Study 2: 6) for several days (Study 1: 7; Study 2: 9-12). In both studies, we found evidence for reciprocal effects of NA and rumination, and both processes showed autoregressive relationships. Aside from central findings, higher levels of rumination were also associated with higher rumination inertia, pointing toward more habitual rumination also being associated with prolonged rumination. Together, using DSEM, we found reciprocal associations between rumination and NA, while providing new insights into the dynamics between the two processes. (PsycInfo Database Record (c) 2022 APA, all rights reserved). ispartof: EMOTION vol:22 issue:8 pages:1773-1786 ispartof: location:United States status: published

Objective: The COVID-19 outbreak has changed the habits of people all over the world. Several hours in front of computer screens, along with the inherent instability and uncertainty produced by the pandemic, have compromised people’s psychological well-being. This study investigates the impact of the frequency of social media usage and psychological distress on the levels of body dissatisfaction before and during the COVID-19 pandemic. Method: A total of 289 Portuguese (n = 167) and British (n = 122) young women aged 18–35 participated in the study. Levels of body dissatisfaction, stress, depression, anxiety, and frequency of social media usage were assessed using self-report questionnaires before and during the COVID-19 pandemic. Student’s t test and linear regression were used for the data analysis. Results: The Portuguese group presented a higher level of body dissatisfaction before and during the COVID-19 pandemic in comparison to the British. Both groups showed increased levels of body dissatisfaction during the COVID-19 pandemic, explained by the widespread use of social media and high levels of psychological distress. Conclusions: Our study reveals that high levels of negative affect and excessive social media usage have a deleterious effect on Portuguese and British young women during the COVID-19 pandemic. It provides a theoretical foundation to motivate the design of new tools to reduce body-related distress and help moderate social media use for similar future situations.

Abstract. Background: Concerns regarding the potential iatrogenic effects of suicide assessment have long impeded suicide research. Aims: We sought to examine the effects of an intensive, suicide-focused assessment protocol on mood, suicidality, and urges to harm oneself or others. Method: Participants were adults admitted to a psychiatric inpatient unit for recent suicidal ideation or behavior, or reasons unrelated to suicide. Our study protocol included clinical interviews evaluating suicide history and laboratory tasks with suicide-related stimuli. We modified an existing measure to create a brief, 6-item interview, the Assessment Session Check-In, which was administered before and after research procedures. Results: These indicated overall reductions in distress, suicidal intent, and urges to harm oneself or others from preassessment to postassessment. Postassessment reductions in stress predicted lower likelihood of a suicide attempt at follow-up. Limitations: Although beneficial to examine a high-risk sample, it is possible that an intensive suicide-focused protocol could prove more problematic for those with lower baseline levels of negative affect and suicidal thoughts. Conclusions: Results challenge the belief that assessing suicide elevates distress or suicidality, even among a high-risk sample of adults admitted to a psychiatric inpatient unit.

The collective trauma of COVID-19 has had a negative impact on people's experiences of their bodies and eating, as demonstrated by studies showing increased disordered eating and body dissatisfaction during this time. The pandemic has also been shown to have had a unique and disproportionate impact on transgender and gender nonbinary (TGNB) individuals (e.g., lost gender affirming care access, elevated levels of job loss). Given that TGNB individuals already face increased risk of body distress and disordered eating compared to cisgender individuals in a nonpandemic context and have been disproportionately impacted by contextual changes with COVID-19, it is likely that the pandemic has had a distinct impact on TGNB individuals' experiences of body and eating distress. The present study aims to understand these impacts through an inductive, reflexive thematic qualitative approach. Participants were 13 TGNB individuals (10/13 gender nonbinary/gender queer;8/13 White). They completed semistructured audio interviews about their broad experiences of body and eating during COVID-19, as well as how they understood changes across domains of family, community, access to resources, and intersectional identities interacting with these experiences. Themes included (a) Losing Affirming Spaces and Security, (b) Gaining Affirming and Supportive Spaces Online, (c) Reflecting on Embodied Gender and Identities, (d) Realizing New Connections and Insights, and (e) Considering the Self in Social Context. Notably, each of these themes interacted with participants' self-reported experiences of body and eating distress and, in some cases, healing. Our results illuminate risk and resilience factors and areas requiring innovation during and after COVID-19. (PsycInfo Database Record (c) 2021 APA, all rights reserved) Impact Statement The current study highlights complex impacts of COVID-19 on Transgender and Nonbinary (TGNB) individuals' experiences of body and eating distress. Most participants reported increased disordered eating during COVID-19, tying these struggles to lost affirming community and financial security and increased time alone noticing gender dysphoria. Some participants reported improved disordered eating corresponding to finding affirming online spaces. Many also found time to reflect on and, in some cases, realize gender. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

ImportanceAlthough several predictors of COVID-19 vaccine hesitancy have been identified, the role of physical health has not been well-examined, and the association with mental health is unknown.ObjectiveTo examine the association of pre-pandemic mental health, physical health, and shielding with vaccine hesitancy after the announcement of the successful testing of the Oxford University/AstraZeneca vaccine.Design, Setting, and ParticipantsWe used individual-level data from a pandemic-focused investigation (COVID Survey), a prospective cohort study nested within the UK Understanding Society (Main Survey) project. In the week immediately following the announcement of successful testing of the first efficacious inoculation (November/December 2020), data on vaccine intentionality were collected in 12,035 individuals aged 16-95 years. Pre-pandemic, study members had responded to enquiries about diagnoses of mental and physical health, completed the 12-item General Health Questionnaire for symptoms of psychological distress (anxiety and depression), and indicated whether they or someone in their household was shielding.Main outcome measuresSelf-reported intention to take up a vaccination for COVID-19. To summarise our results, we computed odds ratios with accompanying 95% confidence intervals for indices of health and shielding adjusted for selected covariates.ResultsIn an analytical sample of 11,955 people (6741 women), 15.4% indicated that they were vaccine hesitant. Relative to their disease-free counterparts, shielding was associated with a 24% lower risk of being hesitant (odds ratio; 95% confidence interval: 0.76; 0.59, 0.96), after adjustment for a range of covariates which included age, education, and ethnicity. Corresponding results for cardiometabolic disease were 22% (0.78; 0.64, 0.95), and for respiratory disease were 26% (0.74; 0.59, 0.93). Having a pre-pandemic diagnosis of anxiety or depression, or a high score on the distress symptom scale, were all unrelated to the willingness to take up a vaccine.Conclusions and relevancePeople who have been prioritised for COVID-19 vaccination owing to a physical condition are more likely to take it up. These effects were not apparent for indices of mental health.

The purpose of this case series was to evaluate menstrual suppression in sex assigned at birth female adolescents identifying as male or gender non-conforming. A retrospective chart review of four gender minority youth (GMY), age 14-17, was performed for gender identity history, type and success of menstrual suppression, method satisfaction, side effects and improvement in menstrual distress. Menstrual suppression was successful in three patients, one patient discontinued use due to side effects that caused an increase in gender dysphoria. Menstrual distress and bleeding pattern improved in the majority of GMY in this series but side effects, as well as contraindications, may limit their use. In conclusion, menstrual dysphoria can be life-threatening for GMY and it is important that clinicians consider menstrual suppression in GMY with menstrual dysphoria. This series emphasizes the importance of individualized treatment plans.

Objectives The aims of this study were to estimate the incidence of the post-partum post-traumatic stress disorder (PP-PTSD) in primiparous women, and to determine the profile of women at risk of developing this disorder. Methods We conducted a descriptive, prospective and longitudinal study carried out at the maternity department of the Hedi Chaker Hospital, Sfax-Tunisia over a period of 15 months. At the first stage of the study, the Saint-Antoine pain questionnaire, the peri-traumatic dissociative experiences questionnaire and the peri-traumatic distress inventory were used respectively to assess the pain of delivery, the peri-traumatic dissociation and distress. At the second stage of the study, the questionnaires, perinatal post-traumatic stress disorder (PPQ), hospital anxiety and depression scale and the Edinburgh postnatal depression scale were used respectively for the PP-PTSD screening and the assessment of the post-partum anxious and depressive symptomatology. Results The study population consisted of 183 parturients at the first stage of the study and 150 parturients at the second stage of the study. The incidence of the PP-PTSD was 9.3 %. In the multivariate study, some factors studied were significantly associated with the development of PTSD-PP, including a history of therapeutic termination of pregnancy, a history of miscarriage, exposure to a stressful event during pregnancy, prenatal hospitalization of the mother, instrumental delivery, pain intensity especially in the affective component, peri-traumatic dissociation and avoidance of sexual intercourse for fear of a new pregnancy. However the skin to skin contact with the new-born immediately after delivery was a significant protective factor. Conclusion The psychological consequences associated with the first birth, particularly the PP-PTSD, are common. The Identification of women at risk and a systematic screening of postpartum post-traumatic stress symptoms are desirable.

Internet gaming disorder (IGD), a condition warranting further study in the Diagnostic and Statistical Manual 5, has received considerable research attention in recent years (American Psychiatric Association, 2013). Characterized by problematic and repetitive use of Internetbased games, research suggests a complex etiology and that frequent usage, in and of itself, is not necessarily always problematic. Common motivations for intense usage, such as feelings of isolation, distress, and boredom may, in part, reflect an individual’s best attempts to navigate contact with the ‘ultimate’ anxieties identified by Yalom (1980). This article reviews the research pertaining to IGD, conceptualizes the disorder from an existentialhumanistic therapy (E-H) perspective, and concludes with an explanation of how E-H can offer a unique treatment perspective from which to work with clients struggling with problematic online gaming concerns within the context of the COVID-19 pandemic and beyond. © 2021 American Psychological Association

Objective To evaluate the efficacy of perineal electrical stimulation (ES) on anxiety, depression, incontinence-related quality of life (QoL), and clinical parameters in men with urinary incontinence (UI) after radical prostatectomy (RP). Methods Fifty-eight men with UI after RP were randomized into two groups using the random numbers generator as follows: Group 1 received perineal ES (n:29), and Group 2 no treatment (n:29). Perineal ES was performed in lithotomy position via a stimulation device (Enraf Myomed 632) with surface electrodes, 3 days a week, 20 min a day, for a total of 24 sessions for 8 weeks. Men were evaluated in terms of continence rates (primary outcome), incontinence severity (24 h-pad test), incontinence episodes (3-day bladder diary), anxiety-depression (HADS), QoL (IIQ-7), and improvement rates and treatment satisfaction (Likert scale) at the baseline and the end of treatment (8th week). Results A statistically significant improvement was found in all parameters except depression in Group 1, in the severity of incontinence and QoL parameters in Group 2 at the 8th week compared to the baseline values (p < 0.05). At the end of treatment; the severity of incontinence, incontinence episodes, QoL, and anxiety were significantly improved in Group 1 compared to Group 2 (p < 0.05). No difference was found between the two groups in terms of depression (p > 0.05). The continence and improvement rates and treatment satisfaction were significantly higher in Group 1 than in Group 2 (p < 0.05). Conclusion Perineal ES is more effective than no treatment in men with UI after RP as an alternative ES option that is well tolerated and does not produce serious adverse events. Clinical Trial Registration: This study was registered with number, NCT05236140.

The COVID-19 pandemic has affected the well-being and mental health of populations worldwide. This study sought to examine whether religious coping mediated the relationship between COVID-19-related fear and death distress. We administered an online survey to 390 adult participants (66.15% females; Mage = 30.85 ± 10.19 years) across Turkey. Participants completed a series of questionnaires measuring the fear they had experienced during the COVID-19 pandemic, their levels of religious coping and their levels of death anxiety and depression. Our findings revealed that (a) fear of COVID-19 was associated with positive religious coping, negative religious coping, death anxiety and death distress; (b) negative religious coping was associated with death anxiety and depression and (c) negative religious coping mediated the relationship between fear of COVID-19 and death anxiety and depression. These results highlight the detrimental effect of negative religious coping in increasing the adverse effect of the COVID-19 fear on death depression.

Although income is an important predictor of life satisfaction, the precise forces that drive this relationship remain unclear. We propose that financial resources afford individuals a path to reducing the distressing impact of everyday hassles, thereby increasing one’s life satisfaction. More specifically, we hypothesize that financial scarcity is associated with greater distress intensity in everyday life. Furthermore, we propose that lower perceived control helps explain why financial scarcity predicts higher distress intensity and lower life satisfaction. We provide evidence for these hypotheses in a 30-day daily diary study (522 participants, 13,733 observations). A second study ( N = 376) further suggests that, although everyone relies on social support to ease stress, financial scarcity shrinks the sense one can use economic resources to reduce the adverse impact of daily hassles. Although money may not necessarily buy happiness, it reduces the intensity of stressors experienced in daily life—and thereby increases life satisfaction.

OBJECTIVE Police and emergency services personnel are at an increased risk of developing mental health issues. We sought to compare patterns of exposure to work-related and nonwork stressors and associations with posttraumatic stress symptoms and psychological distress among police and emergency services employees. METHOD A total of 14,868 employees from 33 ambulance, fire and rescue, police, and state emergency service agencies around Australia participated in a survey to assess the prevalence of exposure to work-related and nonwork stressors, and the prevalence of mental health conditions. Associations between work and nonwork stressors and mental health problems were estimated using logistic regression models and population attributable risk (PAR) percentages. RESULTS Traumatic events experienced while working in the police and emergency services sector were the most frequently reported stressor (51%). Stressful events experienced at work in the sector were associated with significantly higher levels of suspected posttraumatic stress symptoms (odds ratio = 4.5, PAR = 65%) and high psychological distress (odds ratio = 2.5, PAR = 40%) compared to stressors experienced away from the sector. CONCLUSIONS Stressors experienced at work are a risk factor for developing posttraumatic stress symptoms and distress in the sector. Organizations should have comprehensive policies and programs to help prevent the development of mental health problems and to support personnel who develop mental health problems. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

In this paper, we examine the relationship between professional financial advice (PFA) and subjective well-being (SWB). Utilizing the Dutch Household Survey 1995–2018, we find that regarding a professional financial advisor as most important source of financial advice is associated with higher levels of SWB. This association is stronger for households that experienced an increase in income, individuals who do not consider themselves financially knowledgeable, and individuals that have a weaker internal locus of control and have a lower degree of conscientiousness.

OBJECTIVES Racism is a key determinant of mental health for African Americans. Although research has started to uncover moderators and mediators of the racism-health link, additional research in this area is warranted. Constructs that have yet to be examined in this link are self-compassion and self-coldness-two distinct ways of relating to oneself during adversity. METHOD Data from 133 African American college students were used to assess parallel mediation models in which the frequency and stress appraisal of racism were the predictor variables, psychological distress was the outcome variable, and dimensions of self-compassion and self-coldness were treated as mediators. RESULTS Neither frequency nor appraisal of racism were related to the three types of self-compassion (i.e., self-kindness, common humanity, and mindfulness); yet, both racism frequency and appraisal were related to the three types of self-coldness (i.e., self-judgment, isolation, and over-identification). However, only self-judgment emerged as a significant mediator in the links between both frequency and appraisal of racism and distress, respectively. CONCLUSIONS Reducing self-coldness in the face of racism can be a promising, individual-level wellness strategy for African Americans. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Empathy is fundamental to social functioning. Although empathy involves sharing the emotional experience of another, research also highlights the importance of distinguishing the self from the other for optimal empathic responding. Without adequate self-other distinction, sharing another person's emotions can induce personal distress, a self-focused aversive reaction that often leads to withdrawing from the situation, rather than empathic concern, an other-oriented response of care. To date, no work has examined the psychological factors that might facilitate such self-other distinction in the context of empathy. We show that self-concept clarity (SCC), the extent to which the self is clearly defined, coherent, and temporally stable, predicts empathic responding. In Study 1 (N = 453, student sample), we show that low SCC is associated with more dispositional empathic personal distress and less empathic concern. We replicate these dispositional associations in Study 2 (N = 319, community sample) and, using Batson's classic Katie Banks paradigm, show that these associations hold in an actual empathy-inducing situation. Moreover, in Study 2, SCC predicts helping behavior, an effect that is mediated by feelings of personal distress and empathic concern. Finally, in Study 3 (N = 658, community sample), we again use the Katie Banks paradigm but in an experimental framework; consistent with Study 2, state SCC predicts empathic personal distress, empathic concern and helping behavior. Our findings highlight the importance of a clear, coherent and stable self-concept for empathy, and suggest that interventions aimed at increasing empathy may be futile in the presence of a weak and unclear sense of self. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Aging into later life is often accompanied by social disconnection, anxiety, and sadness. Negative emotions are self-focused states with detrimental effects on aging and longevity. Awe-a positive emotion elicited when in the presence of vast things not immediately understood-reduces self-focus, promotes social connection, and fosters prosocial actions by encouraging a "small self." We investigated the emotional benefits of a novel "awe walk" intervention in healthy older adults. Sixty participants took weekly 15-min outdoor walks for 8 weeks; participants were randomly assigned to an awe walk group, which oriented them to experience awe during their walks, or to a control walk group. Participants took photographs of themselves during each walk and rated their emotional experience. Each day, they reported on their daily emotional experience outside of the walk context. Participants also completed pre- and postintervention measures of anxiety, depression, and life satisfaction. Compared with participants who took control walks, those who took awe walks experienced greater awe during their walks and exhibited an increasingly "small self" in their photographs over time. They reported greater joy and prosocial positive emotions during their walks and displayed increasing smile intensity over the study. Outside of the walk context, participants who took awe walks reported greater increases in daily prosocial positive emotions and greater decreases in daily distress over time. Postintervention anxiety, depression, and life satisfaction did not change from baseline in either group. These results suggest cultivating awe enhances positive emotions that foster social connection and diminishes negative emotions that hasten decline. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Die sich in den USA seit Ronald Reagan vollziehende neoliberale Wende bringt Stresserfahrungen für Arbeitnehmer, Legitimitätsdefizite und Instabilitäten des polit-ökonomischen Systems mit sich. Diese werden durch den zeitgleich eröffneten war on drugs and organized crime und die damit einhergehende Masseninhaftierung von welthistorischem Ausmaß kompensiert.

Medical students are a population that is vulnerable to the development of anxiety, depression, and burnout. This observational cross-sectional study sought to assess the levels of distress and identify precipitating factors in all students enrolled in a Portuguese medical school during the academic year of 2022/23. Students (n = 768) were surveyed via validated instruments to measure anxiety, depression, and burnout. Sociodemographic information was also collected through a questionnaire. The study indicated that almost half of this population had depressive symptoms. No differences were found in distress levels between medical schools, and when comparing curricular years, higher levels of distress were found in the pre-clinical years in comparison to the clinical ones. Burnout, being a woman, the existence of physical health problems, homo- and bisexual orientations, affective family problems, problems with relationships in the academic community, difficulties in academic performance, and daily organization were identified as predictors of distress. On the other hand, satisfaction with the social support received and with academic ratings were identified as protective factors. In conclusion, there is a high prevalence of distress in medical students, which is associated with personal, physical, social, economic, and academic factors. The identification of predictive factors of distress may allow for the early identification of vulnerable students and for intervention and prevention strategies to be defined.

Bullying often results in negative coping in victims, including an increased consumption of alcohol. Recently, however, an increase in alcohol use has also been reported among perpetrators of bullying. The factors triggering this pattern are still unclear. We investigated the role of empathy in the interaction between bullying and alcohol use in an adolescent sample (IMAGEN) at age 13.97 (±0.53) years (baseline (BL), N = 2165, 50.9% female) and age 16.51 (±0.61) years (follow-up 1 (FU1), N = 1185, 54.9% female). General empathic distress served as a significant moderator of alcohol use in perpetrators (F9, 493 = 17.978, p < 0.01), which was specific for males and FU1. Male perpetrators, who are generally less sensitive to distress, might thus be more vulnerable to alcohol abuse.

Tinnitus is one of the main hearing impairments often associated with pure-tone hearing loss, and typically manifested in the perception of phantom sounds. Nevertheless, tinnitus has traditionally been studied in isolation without necessarily considering auditory ghosting and hearing loss as part of the same syndrome. Hence, in the present neuroanatomical study, we attempted to pave the way toward a better understanding of the tinnitus syndrome, and compared two groups of almost perfectly matched individuals with (TIHL) and without (NTHL) pure-tone tinnitus, but both characterized by pure-tone hearing loss. The two groups were homogenized in terms of sample size, age, gender, handedness, education, and hearing loss. Furthermore, since the assessment of pure-tone hearing thresholds alone is not sufficient to describe the full spectrum of hearing abilities, the two groups were also harmonized for supra-threshold hearing estimates which were collected using temporal compression, frequency selectivity und speech-in-noise tasks. Regions-of-interest (ROI) analyses based on key brain structures identified in previous neuroimaging studies showed that the TIHL group exhibited increased cortical volume (CV) and surface area (CSA) of the right supramarginal gyrus and posterior planum temporale (PT) as well as CSA of the left middle-anterior part of the superior temporal sulcus (STS). The TIHL group also demonstrated larger volumes of the left amygdala and of the left head and body of the hippocampus. Notably, vertex-wise multiple linear regression analyses additionally brought to light that CSA of a specific cluster, which was located in the left middle-anterior part of the STS and overlapped with the one found to be significant in the between-group analyses, was positively associated with tinnitus distress level. Furthermore, distress also positively correlated with CSA of gray matter vertices in the right dorsal prefrontal cortex and the right posterior STS, whereas tinnitus duration was positively associated with CSA and CV of the right angular gyrus (AG) and posterior part of the STS. These results provide new insights into the critical gray matter architecture of the tinnitus syndrome matrix responsible for the emergence, maintenance and distress of auditory phantom sensations., Brain Structure and Function, 228 (6), ISSN:1863-2661, ISSN:1863-2653

After hospital discharge, patients experience a period of generalized risk for adverse mental and physical health outcomes (post-hospital syndrome [PHS]). Hospital stressors can explain these effects in patients (e.g., sleep disruption, deconditioning). Patients’ partners also experience adverse outcomes following patient hospitalization, but mechanisms of these effects are unknown. The purpose of this study was to test whether greater times and nights of patient hospitalization (proxies for partner exposure to hospital stressors) are prospectively associated with greater increases in partner depression and in partner self-reported poor health. Participants were 7,490 married couples (11,208 individuals) enrolled in the Health and Retirement Study. Outcomes were prospective changes in depressive symptoms and self-reported poor health, and primary predictors were spouse hospitalization over the past 12 months (yes/no), spouse hospitalized ≥ two times (yes/no), and spouse spent ≥ eight nights in-hospital (yes/no). Covariates included age, gender, race, ethnicity, income, own hospitalization experiences during the past 12 months, and one’s own and spouse comorbidities. Having a spouse who experienced two or more hospitalizations was associated with an increase in one’s own depression over time, as was having a spouse who spent eight or more nights in-hospital. Spouse hospitalization was not associated with prospective changes in self-reported health. Results suggest that PHS mechanisms may account for adverse post-hospitalization outcomes in patients’ partners.

Objective Cognitive models posit negative trauma appraisals as maintaining symptoms of posttraumatic stress disorder. Recent research has demonstrated that alienation appraisals (feeling disconnected from the self and others) are salient in trauma-related distress. Studies show that alienation appraisals fully mediated the relationship between trauma exposure and symptoms of posttraumatic stress disorder (PTSD) in trauma-exposed adults. This study explored alienation appraisals in student and clinical samples, assessing whether alienation significantly mediated the relationship between cumulative trauma and trauma-related distress. It also explored whether alexithymia, social support, and loneliness also mediated the relationship between cumulative trauma and markers of trauma-related distress, clarifying the role of alienation. Method Mediation and hierarchical regression models were tested with questionnaire data from a student sample (N = 100) and clinical sample of trauma-exposed treatment-seeking adults (N = 93). Results In the student sample, alienation (B = 1.27) fully mediated the relationship between cumulative trauma and posttraumatic stress, but not depression. When alexithymia, social support, and loneliness were entered as parallel mediators, only alienation appraisals (B = 1.03) significantly mediated the relationship between cumulative trauma and posttraumatic stress. For the clinical sample, alienation appraisals (β = .53) were the only significant predictor of posttraumatic stress, while alienation appraisals (β = .75) and, to a lesser extent, social support (β = .19) and loneliness (β = .30) significantly predicted depression. Conclusions Alienation was a salient predictor of posttraumatic distress. Clinical assessment of alienation appraisals is recommended to inform psychological interventions for trauma survivors. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Abstract. Background: The differences in emotional reactions toward media reports of celebrity suicides between distressed and non-distressed individuals have rarely been explored. Aim: We aimed to explore differences in reaction patterns to the news coverage of a celebrity’s suicide between distressed and nondistressed individuals in Taiwan. Method: We conducted an Internet survey to assess the impact of the news coverage of a celebrity’s suicide. A series of χ2 tests, Spearman’s rank correlations, and logistic regression analyses were performed to compare the differences in emotional involvement and psychological impact after exposure to suicide news between distressed and nondistressed individuals. Results: A total of 1,258 Internet users responded to the survey (236 men and 1,020 women). Compared with nondistressed individuals, distressed individuals ( n = 537) were more likely to feel suicidal (11% vs. 2%, p < .001) after reading the news. They were less willing to seek help when in need (62% vs. 77%, p < .001). All the variables remained significant after adjustment for sociodemographic variables in regression analyses. Limitations: The Internet-based survey may suffer from selection bias. Conclusion: Extensive media reporting of suicide stories has a profound impact on readers, particularly on vulnerable groups. Responsible reporting of suicide incidents is crucial for suicide prevention.

Thought Field Therapy is an evidence-based method validated by 17 clinical trials, including five Randomized Controlled Trials. This study investigates whether a single Thought Field Therapy session can improve psychological issues such as stress, depression, and performance anxiety in university students.Fifty university students were randomly assigned to an intervention group or a waitlist control group. The intervention group received a single counseling session of Thought Field Therapy and was assessed by Subjective Units of Distress and Heart Rate Variability before and after the session. The waitlist group received Thought Field Therapy and was administered the Profile of Mood States Second Edition. All participants completed the latter after a waiting period of 1-3 weeks.The 39 students who received Thought Field Therapy showed significantly higher Heart Rate Variability post-compared to pre-therapy (p.001). The 33 students who were assessed for Subjective Units of Distress also reported significant improvements (p.001) by a 91% reduction in distress for an average duration of 36 minutes. The Profile of Mood States Second Edition score did not show significant improvements in the intervention group (n = 24) as compared to the control group (n = 15).A brief intervention of Thought Field Therapy can reduce stress and psychological distress among university students, and increase their physiological resilience in a limited timeframe, after a single session of counseling. However, the single session did not suffice to significantly improve their psychological conditions over the long term.

We investigated the process and outcome of spiritually integrated psychotherapies (SIPs) with 34 Catholic therapists and 359 clients in Asia, Africa, Europe, and Latin America using a practice-based evidence design. The three most frequently used spiritual interventions across all therapists were: "encouraging personal prayer," "affirming trusting God," and "encouraging listening to the heart," but "discussing hope" was also one of the top three in Asia and Africa, "self-control" in Asia, "spiritual confrontation" and "self-disclosure" in Latin America, and "listening to spiritual issues" in Europe. In addition, using growth curve analyses, we found a significant decrease in both spiritual and nonspiritual distress over the course of SIPs; the levels of spiritual and nonspiritual concerns were highly correlated (but distinct) at any given time point. Also, the nonspiritual outcomes at one session significantly predicted the subsequent session's spiritual outcomes, but not the other way around. Finally, a moderate number of spiritual interventions were associated with a faster decline in nonspiritual distress than was a low number, although we found mixed results regarding whether a high number of spiritual interventions was associated with a faster decline of clients' nonspiritual distress than a moderate number. Results suggest that therapists should attend to spiritual concerns in psychotherapy. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

ObjectivePsycho-oncological institutions offer specialized care for cancer patients. Little is known how this care might impact fatigue. This study aimed to identify fatigue trajectories during psychological care, examined factors distinguishing these trajectories and predicted fatigue severity after nine months of psychological care.DesignNaturalistic, longitudinal study of 238 cancer patients receiving psycho-oncological care in the Netherlands. Data were collected before initiation of psychological care (T1) and three (T2) and nine months (T3) afterwards. Latent class growth analysis, repeated measure analyses (RMA) and linear regression analysis were performed.Main Outcome MeasuresFatigue severity: Checklist Individual Strength.ResultsThree fatigue trajectories were identified: high- (30%), moderate- (62%) and low-level fatigue (8%). While statistically significant decreases in fatigue were found, this decrease was not clinically relevant. RMA showed main effects for time for fatigue trajectories on depression, anxiety, personal control and illness cognitions. Fatigue severity and physical symptoms at T1, but not demographic or clinical factors, were predictive of fatigue severity at T3.ConclusionsFatigue is very common during psycho-oncological care, and notably not clinically improving. As symptoms of fatigue, depression, anxiety and physical symptoms often cluster, supplementary fatigue treatment should be considered when it is decided to treat other symptoms first.

This issue of Transcultural Psychiatry showcases some recent work on idioms of distress – the latest in a long line of anthropological research concerned with cross-cultural concepts and experiences of distress.() Mark Nichter’s (1981) seminal paper introducing idioms of distress has become a cynosure for psychological anthropology and transcultural psychiatry. A growing body of work has since accumulated; however, the last time a collection of such research was brought together was the 2010 publication of a special issue in the journal Culture, Medicine and Psychiatry organized by Devon Hinton and Roberto Lewis-Fernández. In the decade since, new questions have arisen about the boundaries and applications of idioms of distress research. In this introduction, we provide a brief history of work on idioms of distress and related concepts. Then, we introduce several major themes explored by the papers in this special issue.

Pavement distress detection is of significance for road maintenance and traffic safety. Manual pavement distress detection suffers from high workloads, inefficiency, low accuracy, and high cost. To replace the manual operations in the pre-filling detection with the aim to improve efficiency and reduce cost, this paper proposes a three-stage automatic inspection and evaluation system for pavement distress based on improved deep convolutional neural networks (CNNs). First, the system integrates multi-level context information from the CNN classification model to construct discriminative super-features to determine whether there is distress in the pavement image and the type of the distress, so as to achieve rapid detection of pavement distress. Then, the pavement images with distress are fed into the CNN segmentation model to highlight the distress region with pixel-wise. In the segmentation model, a novel pyramid feature extraction module and a novel guidance attention mechanism are introduced. Finally, we evaluate the degree of pavement damage according to the segmentation results of the CNN segmentation model. In the experiments, we compare our classification model and segmentation model with other state-of-the-art methods on two pavement distress datasets, and the results demonstrate that the proposed models achieve out-performance on different evaluation metrics.

Functional dystonia represents a condition where psychological distress is being expressed as involuntary muscle contractions. In the foot and ankle, it most commonly presents as a sudden onset of a painful fixed ankle/hindfoot deformity in a female patient with a history of trivial trauma or surgery. The “fixed deformity” found on clinical examination is usually correctable under general anesthesia. Less commonly, it can present in the toes or may present as paroxysmal muscle movements rather than a fixed deformity. CRPS may occur concurrently with the dystonia. Failure to consider the diagnosis leads to a long delay in appropriate diagnosis, patient distress and unnecessary or even harmful surgery. A better approach to this clinical syndrome is to define it as fixed abnormal posturing that is most commonly psychogenic. Early referral to a movement disorder clinic is recommended. The prognosis is generally poor as less than a quarter of patients report subjective long-term improvement even when managed in a movement disorder clinic. Foot and ankle surgeons should, whenever possible, avoid operating on patients with functional dystonia in order to avoid symptomatic deterioration.

Psychological and psychosocial functioning of binary transgender and nonbinary youth has been understudied in settings treating individuals at risk for psychiatric hospitalization. Further, little is currently known about potential differences in baseline levels of psychiatric distress and adaptive functioning across gender-diverse youth and their psychiatrically distressed cisgender counterparts. Key differences may elucidate avenues for adapted treatment and protocols among youth presenting for psychiatric care. Archival data of 426 youth (Mage = 14.94, SD = 1.5 years) referred to a psychiatric Intensive Outpatient Program (IOP) were used to examine differences in self-reported domains of psychological (e.g., depression, anxiety, Posttraumatic Stress Disorder [PTSD], emotion dysregulation) and psychosocial (e.g., parental and interpersonal relations) functioning across gender. The group included N = 272 cisfemale (64.1%), N = 137 cismale (32.2%), N = 10 transgender (2.3%) and N = 7 nonbinary (1.6%) self-identified youth. Cismales reported the lowest levels of distress and highest levels of adaptive functioning as compared to the other groups, whereas binary transgender and cisfemale youth did not significantly differ across any measured domain. Nonbinary youth reported higher levels of anxiety, hyperactivity, psychological inflexibility, and inadequacy than cisfemales, but largely did not differ from binary transgender youth. Beyond statistical comparisons, nonbinary youth demonstrated globally elevated levels of psychiatric distress and compromised adaptive functioning, with most ratings falling in the clinically significant and/or at-risk ranges. Results highlight the need for clinicians to carefully attend to unique needs of nonbinary youth and for future research to expand upon our preliminary findings. Clinical implications are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

ObjectiveAround 25% of cancer patients experiences depressive symptoms. However, the majority does not receive formal psychological care because patients often prefer managing symptoms alone or with informal social support. Previous research has shown that adaptive coping and social support can indeed be effective in managing relatively mild depressive symptoms. However, higher depressive symptom levels rarely improve without psychological treatment. This longitudinal study examined how and to what extent coping and social support are related to reductions in depressive symptoms in cancer patients with moderate to severe depressive symptoms.MethodsRespondents were diagnosed with cancer in the past five years, experienced high depressive symptom levels (PHQ-9 ≥ 10) and were not receiving psychological care at baseline. We collected data with self-report questionnaires (including PHQ-9, brief COPE and Social Support List) at two assessments, taken three months apart.ResultsAlthough depressive symptoms decreased significantly between baseline and follow-up, the average level at follow-up was still moderate to severe. Patients using less avoidant coping, specifically less substance use, were more likely to report a reduction of depressive symptoms. We found no significant beneficial effects of approach coping and social support (coping) on the course of depressive symptoms.ConclusionsA significant group of cancer patients with high levels of depressive symptoms do not seem able to effectively manage depressive symptoms by themselves, especially those more likely to avoid dealing with their symptoms. Cancer patients can be educated about avoidant coping and its possible detrimental effects, as well as being informed about possibilities of psychosocial services.

Abstract. Background: In the United Kingdom, suicide risk is assessed in the emergency department (ED) in a face-to-face assessment with psychiatric liaison practitioners. This study aimed to explore patient experiences of psychosocial assessment after presenting with self-harm/suicidality. Method: A total of 28 patients were interviewed within 2 weeks of ED attendance for self-harm/suicidality. Interviews were transcribed and analyzed using inductive thematic analysis. Results: People described two different experiences. A therapeutic interaction was about the “person” and made people feel their life mattered and instilled hope for the future. This was characterized by: unscripted conversation; warmth promoting disclosure; psychological exploration of feelings; validation of distress; and a coproduced care plan. A formulaic assessment was about the “risk” and made people feel their life did not matter and hopeless about the future. This was characterized by: feeling judged and not worthy of help; a focus on risk and form filling; a trivial treatment plan; and loss of trust in services. Limitations: Our study comprised a single ED and used a non-diverse sample. Conclusion: Psychosocial assessment in the ED impacts on hope for people in crisis. A focus on therapeutic communication that is about the person, as well as the risk, improves patient experience, decreases distress, and instills hope that life is worth living.

Abstract. Background: High rates of psychological distress are reported in functional conditions and vascular stroke, but there is limited understanding of how patients with functional neurological symptoms in stroke settings respond to symptoms. Aims: This study compared patients with functional stroke symptoms to those with vascular stroke and chronic fatigue syndrome (CFS). Methods: A prospective cohort of 56 patients with functional stroke symptoms were age-gender matched to patients with vascular stroke and CFS. Analysis of variance compared groups on cognitive and behavioral responses to symptoms, psychological distress, and functioning. Sensitivity analyses controlled for known confounders. The proportions of clinical anxiety and depression were compared between groups. Results: The functional stroke symptom group had a higher proportion of clinical anxiety cases than the CFS group, and a higher proportion of clinical depression cases than the vascular stroke group. Patients with functional stroke symptoms reported the highest rate of “damage beliefs” and “all-or-nothing” behaviors and greater symptom focusing and resting behavior than patients with vascular stroke. Limitations: Larger cohorts and a longitudinal design would strengthen study findings. Conclusion: Compared to patients with vascular stroke or CFS, patients with functional stroke symptoms show a somewhat distinct profile of illness-related beliefs and behaviors, as well as higher rates of clinical anxiety. Understanding such group differences provides some insights into aetiology and cognitive-behavioral responses. Appropriate support and referral should be available to patients with functional stroke symptoms to address distress and reduce the likelihood of severe impairment.

Farming women have rarely been the focus of scholarly work on drought and/or distress. This article focuses on farming women's lived experience of drought and distress, drawing on a participatory filmmaking project created by a small group of farming women from Southern Australia. Feminist materialism and Barad's (2003) concept of ‘intra-action’ provides a useful lens to examine both the film as an artefact as well as the discussions among the women during its creation. Intra-action enables an exploration of how farming women's bodies come into being as distressed in moments of time through and with drought as a complex constellation of multiple ‘matter’. The film and narratives show distressed bodies emerging with dust, wind, objects and the suffering of non-human animals. For these women, distress emerges from hearing, sensing, seeing and feeling the irritation of dirt splattered against window panes, the emotional pain and economic consequences of topsoil blowing across paddocks and as feed becomes hard to source, the recognition of the suffering of sheep. The power of these animate and inanimate ‘things’—windmills, windows, troughs, work boots, animals and soil—were sensorily entangled with women's bodies. For farming women, distress materialises within their bodies through processes of intra-action in their more-than-human worlds. Refereed/Peer-reviewed

Petugas pemadam kebakaran berulang kali dihadapkan pada stres akibat peristiwa traumatis yang disebabkan oleh pekerjaan yang sangat berbahaya, penuh tekanan, mempertaruhkan nyawa mereka, dan membantu para korban. Mereka juga mungkin terkena kekerasan di tempat kerja, seperti bahaya fisik, ancaman fisik, sosial, alkoholik dan pecandu narkoba. Dibandingkan dengan masyarakat umum, petugas pemadam kebakaran memiliki risiko masalah kesehatan, kecemasan kronis, gejala kecemasan, insomnia, gangguan stres pascatrauma (PTSD) dan kesulitan kesehatan mental pascatrauma lainnya yang jauh lebih tinggi. Tujuan dari kajian literatur ini untuk mengkaji faktor-faktor yang berhubungan dengan distress pada petugas pemadam kebakaran. Pencarian literatur digunakan untuk pengumpulan data. Dalam hasil kajian literatur ditemukan bahwa tingkat pendidikan, kebiasaan kerja, jabatan, masa kerja, masa kerja, perantuan dan asal etnis mempengaruhi situasi petugas pemadam kebakaran. Mengenai variabel jenis kelamin dan usia, studi lebih lanjut masih diperlukan (gejala somatik dan ketakutan akan kematian berkorelasi positif) karena ada perbedaan yang signifikan dalam temuan penelitian dari beberapa peneliti. Pentingnya strategi koping dan dukungan sosial dalam mengurangi stres psikologis, kecemasan, trauma bedah, gejala gangguan stres pascatrauma (PTSD) dan frekuensi emosi negatif pada petugas pemadam kebakaran dalam mengurangi gangguan tidur, penggunaan alkohol dan gejala depresi yang lebih tinggi ke tingkat risiko bunuh diri pada petugas pemadam kebakaran.