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Purpose: This study examined the relationship between multidimensional patient concerns and anxiety and depression in a national sample of older adults with cancer (OACs ≥ 65 years) and the buffering effect of visiting providers across disciplines (e.g., oncology, allied health, primary care, mental health) on these relationships. Methods: Participants completed a cross-sectional survey through the Cancer Support Community's Cancer Experience Registry (CER), an online community-based research initiative. Eligible participants were 65 years and older and diagnosed with cancer in the past five years. Participants completed self-report measures of (1) the severity of their concerns across multiple domains, (2) anxiety and depression, and (3) whether they received care for "symptoms and side effects" from various providers. Results: The sample consisted of 277 OACs; 45% endorsed elevated anxiety and 31% endorsed elevated depression. The most severe concerns were in the domains of body image and healthy lifestyle and symptom burden and impact. More severe concerns were associated with higher levels of anxiety and depression. The relationship between concern severity and distress was weaker in OACs who saw a palliative care, mental health, physical or occupational therapy provider, pharmacist, or primary care provider relative to OACs who did not. A visit with an oncology provider did not moderate most relationships between concerns and distress. Conclusions: The relationship between OACs' concerns and distress was attenuated by treatment with a specialty provider. Interdisciplinary team care may be a vital component of comprehensive patient-centered care for OACs. [ABSTRACT FROM AUTHOR]

Mast cells are commonly found in pancreatic ductal adenocarcinoma (PDAC), yet their role in the disease remains uncertain. Although mast cells have been associated with depression in several diseases, their connection to PDAC in this context remains unclear. This study explored the correlation between mast cells and psychosocial stress in patients with PDAC. Prior to surgery, 40 patients with PDAC (n = 29 primary resected, n = 11 neoadjuvant treated) completed four questionnaires assessing stress and quality of life. Immunostaining was performed on the resected tumor tissue. Spearman analysis was employed to correlate mast cells with distress and neuropeptides serotonin and beta-endorphin serum and tissue levels. Patients with PDAC exhibited elevated levels of distress and worry. Lower number of mast cells within the tumor correlated with greater psychological burden. Among primary resected patients, mast cell count moderately correlated with joy and inversely with worries. Following neoadjuvant chemotherapy, strong inverse correlation was observed between anxiety, depression, and mast cell quantity. No correlation was found between mast cells and serotonin or beta-endorphin levels. In summary, mast cell presence inversely correlates with psychosocial stress, suggesting a link between immune cells and psychological well-being in pancreatic cancer. Targeting mast cells might offer therapeutic avenues for addressing cancer-induced depression and anxiety. [ABSTRACT FROM AUTHOR]

Purpose: Few digital interventions target patients with advanced cancer. Hence, we feasibility-tested Finding My Way-Advanced (FMW-A), a self-guided program for women with metastatic breast cancer. Methods: A single-site randomised controlled pilot trial was conducted. Participants were recruited through clinicians, professional networks, and social media and randomised to intervention or usual-care control. Participants were randomly allocated to either the intervention (FMW-A; a 6-week, 6-module CBT-based online self-directed psychosocial program for women with MBC + usual care resources) or control (usual care resources: BCNA’s Hope and Hurdles kit). Feasibility outcomes included rates of recruitment, uptake, engagement, and attrition. Distress, QOL, and unmet needs were evaluated for signals of efficacy, and qualitative feedback was collected to assess acceptability. Results: Due to COVID-19 and funding constraints, the target recruitment of 40 was not reached (n = 60 approached; n = 55 eligible; n = 35 consented). Uptake was high (n = 35/55; 63.6%), engagement modest (median 3/6 modules per user), and attrition acceptable (66% completed post-treatment). Efficacy signals were mixed: compared to controls, FMW-A participants experienced small improvements in fear of progression (d = 0.21) and global QOL (d = 0.22) and demonstrated a trend towards improvements in cancer-specific distress (d = 0.13) and role functioning (d = 0.18). However, FMW-A participants experienced small-to-moderate deteriorations in general distress (d = 0.23), mental QOL (d = 0.51), and social functioning (d = 0.27), whereas controls improved. Qualitatively, participants (n = 4) were satisfied with the program, perceived it as appropriate, but noted some sections could evoke transient distress. Conclusion: The study demonstrated feasibility (high uptake and acceptable retention) and generated realistic recruitment estimates. While FMW-A appears promising for targeting cancer-specific distress and fear of progression, the mixed findings in quality of life and general distress warrant further revisions and testing. [ABSTRACT FROM AUTHOR]

Accuracy of memory is critical in legal and clinical contexts. These contexts are often linked with high levels of emotional distress and social sources that can provide potentially distorting information about stressful events. This study investigated how distress was associated with susceptibility to misinformation about a trauma analogue event. We employed an experimental design whereby in Phase 1, participants (N = 243, aged 20–72, 122 females, 117 males, 4 gender diverse) watched a trauma film (car crash) and heard an audio summary that contained misinformation (misled items), true reminders (consistent items), and no reminders (control items) about the film. Participants rated their total distress, and symptoms of avoidance, intrusions, and hyperarousal, in response to the film. They then completed cued recall, recognition, and source memory tasks. One week later in Phase 2, participants (N = 199) completed the same measures again. Generalised linear mixed models were used. A significant misinformation effect was found, and importantly, participants with higher distress levels showed a smaller misinformation effect, owing to especially poor memory for consistent items compared to their less distressed counterparts. Distress was also associated with improved source memory for misled items. Avoidance of the film's reminders was associated with a smaller misinformation effect during immediate retrieval and a larger misinformation effect during delayed retrieval. Findings suggest that distress is associated with decreased susceptibility to misinformation in some cases, but also associated with poorer memory accuracy in general. Limitations are discussed, and the need for further research is highlighted. [ABSTRACT FROM AUTHOR]

This study aimed to examine the impact of a pilgrimage on the Way of St. James on psychological distress and subjective well-being, and to compare these outcomes with a control group on non-pilgrimage vacations. Additionally, the study explored psychological process variables that may mediate the pilgrimage's beneficial effects. A nonrandomized pretest-posttest design was used, involving 444 pilgrims and 124 controls. Participants completed baseline and post-experience self-reported measures of psychological distress, subjective well-being, and psychological processes (i.e., mindfulness, nonattachment, engaged living). A 3-month follow-up was conducted only in the pilgrim group. Mediation analyses examined psychological processes as potential mediators of pre-post change in the pilgrim group (vs. control). Within-group analyses revealed that the pilgrim group experienced improvements in psychological distress, subjective well-being, and psychological processes immediately post-experience, with most measures sustaining improvement at the 3-month follow-up. Compared to the control group, pilgrims showed significantly greater increases in positive affect, life satisfaction, and valued living, alongside greater reductions in anxiety, depression, and perceived stress. Valued living partially mediated the relationship between pilgrimage and positive affect, and fully mediated the effects on perceived stress, negative affect, life satisfaction, and subjective happiness. Pilgrimage on the Way of St. James effectively reduced psychological distress and enhanced subjective well-being, with greater benefits observed compared to a non-pilgrimage vacation control group. Consistent with the concept of pilgrimage as a transformative experience, significant improvements in valued living were noted, which mediated some of the positive outcomes post-pilgrimage. The Way of St. James may serve as a valuable complementary approach for alleviating distress and promoting well-being. Further studies exploring the effects of this pilgrimage on specific populations and using more robust study designs are warranted. Trial Registration ClinicalTrials.gov Identifier NCT04141813. [ABSTRACT FROM AUTHOR]

Positive psychological therapy has been found to be effective in psychological health in the broader cancer patient population. However, specific evidence regarding its effectiveness for adolescent and young adult (AYA) cancer patients remains limited. More research is needed to determine the optimal approaches for alleviating distress in this particular group. We evaluated the efficacy of character strength-based cognitive-behavioral therapy (CS-CBT) versus cognitive-behavioral therapy (CBT) for distress in AYA patients with cancer. In a randomized controlled three-arm trial, cancer patients aged 15-39 years were assigned to one of three groups using a random number table to ensure equal group sizes: (1) CS-CBT, which incorporated specific exercises focused on identifying and utilizing character strengths within the CBT framework; (2) CBT; or (3) control group. The primary outcome was improvement in patients' overall mental health on the Distress Thermometer and the Hospital Anxiety and Depression Scale 3 months after assignment to the groups. Analyses used generalized estimating equations. A total of 162 AYAs were randomly and equally assigned to three groups. Improvements in primary outcomes were significantly greater after CS-CBT than after CBT, and no significant differences were found between the CBT and control group. Among all primary and secondary outcomes, the only non-significant difference found was in quality of life with CS-CBT compared to CBT. AYA cancer patients rated their overall mental health and sense of thriving as more improved after CS-CBT than after CBT. However, quality-of-life indicators supported equal intervention effects in both groups. These findings support the effectiveness of the use of CS-CBT intervention in reducing distress and improving thriving. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine barriers and facilitators to compliance for cancer care in patients utilizing an emergency department (ED)–based assessment. Adult ED patients who either had active cancer or a history of cancer were enrolled between August 2020 and Jan 2022 for this prospective cohort study. We piloted the National Comprehensive Cancer Network (NCCN) Distress Thermometer. Multivariable regression analyses were used to assess the predictors of high distress. Of the 152 patients enrolled, 73% were Black patients, 11% were non-Hispanic White, and 16% included patients from other racial and ethnic groups (including 10.5% Hispanic patients); 73% of the sample had active cancer. The current ED visit was cancer related for 44%. The mean score on the Distress Thermometer was 4 (SD = 2; range 0–8) with 30% having a high distress level of ≥ 6. Having an active cancer and race/ethnicity were significant predictors of high distress. Patients who had active cancer had three times (aOR = 3.01; 95% CI 1.12–8.10) higher odds of experiencing high distress in the past week compared to those who did not have active cancer, after adjusting for race/ethnicity and reason for visit. Practical problems and physical problems were the most common, with 43% (n = 66) and 40% (n = 61) of the patients reporting these problems, respectively. Despite significant progress in cancer care, cancer patients/survivors face difficulty in transitioning between care environments and end up seeking episodic care in the ED and experience a high level of distress. [ABSTRACT FROM AUTHOR]

Breast cancer impacts the psychological well-being of women, leaving them at risk of developing depression, anxiety, and other stress-related disorders. The Depression Anxiety Stress Scales (DASS-21) is a widely used measure, although empirical evidence regarding its psychometric properties in the breast cancer population is limited. The purpose of this study was to conduct an exhaustive analysis of the psychometric properties of the DASS-21 in a sample of Spanish women diagnosed with breast cancer. Participants were 289 breast cancer patients who completed the DASS-21 and other questionnaires measuring life satisfaction, positive and negative affect, flourishing, perceived stress, and breast cancer-specific stressors. In terms of validity evidence based on the internal structure of the DASS-21, adequate fit indices were obtained for the model based on three first-order factors (depression, anxiety, stress) and one second-order factor (general psychological distress). Reliability coefficients (McDonald's omega) ranged from.84 to.95. Validity evidence based on relationships with other variables was also provided by moderate and strong correlations with well-being indicators and stress measures. The results support the use of the DASS-21 for measuring general psychological distress in the breast cancer context, where it may provide useful information for the design of psychological interventions with patients. [ABSTRACT FROM AUTHOR]

Repetitive negative thinking and intolerance of uncertainty are risk and maintenance factors for emotional disorders. Although emerging evidence suggests that intolerance of uncertainty predicts increases in distress through repetitive negative thinking, these relationships have yet to be investigated among veterans. The present study examines if repetitive negative thinking mediates the relationships of intolerance of uncertainty with stress, disordered symptoms and impairment among a mixed clinical sample of veterans. Two hundred and forty-four treatment-seeking veterans with diagnoses of major depressive disorder, panic disorder, or posttraumatic stress disorder completed measures of intolerance of uncertainty, repetitive negative thinking, stress, impairment, depression, panic, and posttraumatic stress prior to receiving treatment. Mediation models revealed indirect effects of intolerance of uncertainty through repetitive negative thinking on stress and impairment in the full sample, and on disordered symptoms in subsamples with major depressive disorder and posttraumatic stress disorder. Conversely, intolerance of uncertainty did not have direct or indirect effects on disordered symptoms in a panic disorder subsample. Findings suggest that repetitive negative thinking and intolerance of uncertainty uniquely contribute to stress, impairment, and disordered symptoms, but repetitive negative thinking, may, in part, drive intolerance of uncertainty's contribution to emotional disorders. Interventions for repetitive negative thinking might improve the efficacy of existing transdiagnostic treatment protocols. Cross-sectional data is a limitation of the present study. Prospective designs in civilian samples can better establish the temporality of these relationships and if they are generalizable to the larger population. [ABSTRACT FROM AUTHOR]

Potholes are a significant hazard, causing severe damage to vehicles and potentially leading to fatal accidents. The automatic detection of potholes is crucial for timely maintenance and reducing these risks. This research evaluates the performance of three pre-trained Convolutional Neural Network models—ResNet 50, ResNet 18, and MobileNet—in classifying pavement images. Initially, the models distinguish between images containing potholes and those without (Potholes vs. Normal). Subsequently, they categorize pavement images into three classes: Small Pothole, Large Pothole, and Normal. Pavement images were captured from two different heights: 3.5 feet (waist height) and 2 feet. Among the models, MobileNet v2 demonstrated the highest accuracy of 98% for detecting potholes. For images taken at 2 feet, the classification accuracies for large potholes, small potholes, and normal pavement were 87.33%, 88.67%, and 92%, respectively. For images taken from waist height, the accuracies increased to 98.67%, 98.67%, and 100%, respectively. The study highlights the potential of these models in enhancing road safety through reliable and automated pothole detection, providing valuable insights for infrastructure maintenance. Article Highlights: Potholes are dangerous and can cause serious vehicle damage. Train CNN models for the classification of potholes These CNNs, for different sizes of potholes can be used for the rehabilitation of potholes. Among all CNN modes, MobileNet v2 achieves 98% accuracy in detecting the presence of a pothole. [ABSTRACT FROM AUTHOR]

Background: Patients with head and neck cancer (HNC) often demonstrate stress, distress, anxiety, depression, and are at risk for suicide. These affect their quality of life (QoL) but less attention has been given to psychological variables that may impact response to treatment. Objectives: This study aims to systematically review publications during 2013–2023 to collate evidence on the effects of psychological variables on HNC treatment outcomes. Methods: We searched Ovid Medline, PubMed, Scopus, and Web of Science for articles that examined psychological factors related to treatment outcomes in patients with HNC. Results: There were 29 studies (5 before treatment, 2 during, 17 after, and 5 covering the whole management trajectory) including 362,766 patients. The psychological factors were either behavioral (adjustment and coping strategy, unrealistic ideas, self-blame), cognitive (elevated risk of psychiatric co-comorbidity), or emotional (distress, depression, anxiety, nervousness, and fear of disfigurement and complications). It was found that there was a relationship between depression and decreased survival in patients with HNC. Pretreatment pain was an independent predictor of decreased survival in a large sample of patients. The distress level was approximately 54%, emotional problems ranged between 10 and 44%, while financial difficulties were identified in 54% of the patients. Sixty-nine percent of patients were reported to have used at least one cost-coping strategy within 6 months after treatment initiation. During post-treatment period, depression increased from 15% at the baseline to 29%, while the fear of recurrence was found among at least 35% of patients. Discussion and Conclusion: Several psychological factors predict QoL and survival among HNC survivors. Distress encompasses depression and anxiety, and physical burden from HNC diagnosis and treatment. Routine screening and early interventions that target distress could improve HNC survivors' QoL. A systematic and standardized measurement approach for QoL is warranted to homogenize these findings and to understand the underlying relationships. [ABSTRACT FROM AUTHOR]

Children with negative procedural experiences have an increased risk of fear and distress, with psychological consequences for subsequent procedures and future healthcare behaviors. Gaining control and feeling trust are important aspects for children to decrease fear. To enable professionals providing personal care during medical procedures, a systematic, evidence-based approach that supports children in expressing their preferences is needed. This study will gain insight into the experiences and needs of professionals involved in small invasive medical procedures to meet the coping strategies and preferences of children undergoing these procedures. A qualitative design was used to gain insight into professionals' perspectives. Data were collected through online focus groups with various professionals involved in medical procedures, such as anesthetists, laboratory staff, nurses, and pediatricians. Five interdisciplinary focus groups, with a total of 32 participants, were held. One overarching theme was revealed: "Balancing between different actors within the context of the hospital." Professionals reported they had to deal with different actors during a medical procedure: the child, the parent, the colleague, and themselves. Each actor had its own interests. They were aware of the child and parents' priority to gain control and feel trust. Nevertheless, they perceive organizational and personal aspects that hinder addressing these needs. Conclusion: To provide personalized care, professionals experience balancing between the needs and interests of diverse actors during medical procedures. The findings underscore the importance of a policy supporting HCPs in integrating patient-centered care into practice through practical tools and training initiatives such as scenario training. What is Known: • Unresolved pain and stress arising from medical procedures can have significant short- and long-term impacts on children. Empowering children to gain control and fostering a sense of trust are crucial factors in reducing fear associated with medical procedures. • Children and parents expect to receive child-tailored care from professionals including respect for their own, unique needs, and boundaries. Professionals should build trustful relationships and provide appropriately tailored autonomy around medical procedures. What is New: • Healthcare professionals vary in their awareness of children's needs during a medical procedure. Beside this, the organizational dynamics of the hospital, along with the presence of actors such as the child, parent, colleague, and oneself, collectively influence the conduct of medical procedures. • Providing person-centered care during medical procedures can present challenges. The results highlight the significance of a policy to assist healthcare professionals in incorporating patient-centered care into their practice through practical tools and a culture of self-reflections regarding patient-centered values. [ABSTRACT FROM AUTHOR]

The influence of naps on tinnitus was systematically assessed by exploring the frequency, clinical and demographic characteristics of this phenomenon. 9,724 data from two different tinnitus databases (Tinnitus Hub: n = 6115; Tinnitus Research Initiative (TRI): n = 3627) were included. After separate analysis of the databases, these results were then compared with each other. In the Tinnitus Hub survey database, a total of 31.1% reported an influence on tinnitus by taking a nap (26.9% in the TRI database), with much more frequent worsening after a nap than improvement (23.0% a little or a lot worse; TRI: 17.7% worse; 8.1% a little or a lot better; TRI: 9.2% better). The influence of napping on tinnitus was associated in both databases with other clinical features, such as the dependence of tinnitus on night quality, stress and somatosensory maneuvers. The present study confirms the clinical observation that more tinnitus sufferers report worsening after a nap than tinnitus sufferers reporting an improvement. It was consistently shown that tinnitus sufferers reporting nap-induced modulation of tinnitus also report more frequently an influence of night sleep on their tinnitus. Further clinical and polysomnographic research is warranted to better understand the interaction between sleep and tinnitus. [ABSTRACT FROM AUTHOR]

Although substantial advances have been made in the field, only scant research has been conducted on substance use among women. In the current study (n = 132), we examined possible intermediate processes that could underline the high comorbidity between substance use disorders (SUDs), compulsive sexual behavior (CSBD), and risky sexual behaviors (RSB) among women: emotion regulation, distress, and perceived social support (PSS). Results indicate that women with SUDs have more prevalent RSB and higher CSBD symptoms than healthy controls. Using a model with SUD as a dependent measure, intermediate factors as mediators, and CSBD and RSB as outcomes, we found that women with SUDs had more significant sensations of distress and lowered PSS than healthy controls. However, only distress mediated the association between SUDs, CSBD, and RSB. The findings provide insights into the intermediate processes that intertwined addictive behaviors and an opportunity for developing novel and successful treatments for women. [ABSTRACT FROM AUTHOR]

Purpose: We aimed to evaluate the prevalence of anxiety and depression traits in Italian patients with metabolic dysfunction-associated steatotic liver disease (MASLD), and the possible relation with the severity of liver disease. Methods: Demographic, anthropometric, clinical and laboratory parameters were collected in patients referred to a metabolic unit for a comprehensive evaluation of possible liver disease. Hepatic steatosis and fibrosis were evaluated by surrogate biomarkers. Imaging (controlled attenuation parameter-CAP and vibration-controlled transient elastography-VCTE). Beck depression inventory (BDI) and state-trait anxiety inventory-Y (STAI-Y) were used to define depressive/anxiety states; calorie intake and lifestyle were self-assessed by questionnaires. Results: The whole sample comprised 286 patients (61.9% females; mean age 52.0 years; BMI, 34.6 kg/m2); 223 fulfilled MASLD criteria. BDI and trait anxiety scores were lower in the MASLD cohort, and the prevalence of both moderate/severe depression and severe trait anxiety was reduced compared with non-MASLD cases, despite VCTE-diagnosed fibrosis F3–F4 present in over 15% of cases. However, after correction for demographic and anthropometric confounders, MASLD was not associated with a lower risk of moderate/severe depression or severe anxiety trait (odds ratio, 0.34; 95% confidence interval, 0.12–1.01 and 0.79, 0.27–2.34). Additional adjustment for the severity of fibrosis did not change the results. No differences in state anxiety were observed. Conclusion: The risk of anxiety and depression in MASLD is not different from that generated by diabetes and obesity per se. MASLD patients do not perceive liver disease as a specific source of psychological distress, possibly as a consequence of the unawareness of progressive liver disease. [ABSTRACT FROM AUTHOR]

This study aimed to investigate distress levels, using the distress thermometer (DT), and the factors associated with distress in postoperative patients with pancreatobiliary cancer. This study retrospectively investigated 155 patients who underwent surgery for pancreatobiliary cancer between December 1, 2019 and September 30, 2021. The DT and problem list were used to measure distress. Descriptive statistics, t-test, and multivariate logistic regression analysis were used to analyze the data. Of the 155 patients, 16.8% (n = 26) and 83.2% (n = 129) were in the mild-distress and moderate-to-severe distress groups, respectively. The average DT score was 6.21; that for the mild-distress and moderate-to-severe distress groups was 2.46 and 6.97, respectively. More patients in the moderate-to-severe distress group reported having problems of "sadness" (χ2 = 4.538, P < 0.05), "indigestion" (χ2 = 10.128, P < 0.001), "eating" (χ2 = 6.147, P < 0.013), and "getting around" (χ2 = 4.275, P < 0.039) than in the mild-distress group. In addition, occupation status (odds ratio [OR] = 0.342, 95% confidence interval [CI] = 0.133–0.879, P = 0.026) and indigestion (OR = 5.897, 95% CI = 1.647–21.111, P = 0.006) were independent risk factors for the presence of severe distress. Patients with pancreatobiliary cancer demonstrated elevated levels of psychological distress. Healthcare providers should therefore be vigilant when evaluating patients for distress and providing appropriate referrals, particularly those who are unemployed or have indigestion. [ABSTRACT FROM AUTHOR]

Recent clinical trials have found that the serotonergic psychedelic psilocybin effectively alleviates anxiodepressive symptoms in patients with life-threatening illnesses when given in a supportive environment. These outcomes prompted Canada to establish legal pathways for therapeutic access to psilocybin, coupled with psychological support. Despite over one-hundred Canadians receiving compassionate access since 2020, there has been little examination of these 'real-world' patients. We conducted a prospective longitudinal survey which focused on Canadians who were granted Section 56 exemptions for legal psilocybin-assisted psychotherapy. Surveys assessing various symptom dimensions were conducted at baseline, two weeks following the session (endpoint), and optionally one day post-session. Participant characteristics were examined using descriptive statistics, and paired sample t-tests were used to quantify changes from baseline to the two-week post-treatment endpoint. Eight participants with Section 56 exemptions (four females, Mage = 52.3 years), all with cancer diagnoses, fully completed baseline and endpoint surveys. Significant improvements in anxiety and depression symptoms, pain, fear of COVID-19, quality of life, and spiritual well-being were observed. Attitudes towards death, medical assistance in dying, and desire for hastened death remained unchanged. While most participants found the psilocybin sessions highly meaningful, if challenging, one reported a substantial decrease in well-being due to the experience. These preliminary data are amongst the first to suggest that psilocybin-assisted psychotherapy can produce psychiatric benefits in real-world patients akin to those observed in clinical trials. Limited enrollment and individual reports of negative experiences indicate the need for formal real-world evaluation programs to surveil the ongoing expansion of legal access to psychedelics. [ABSTRACT FROM AUTHOR]

Breast cancer is the most commonly diagnosed cancer among women worldwide. Breast cancer patients experience significant distress relating to their diagnosis and treatment. Managing this distress is critical for improving the lifespan and quality of life of breast cancer survivors. This study aimed to assess the level of distress in breast cancer survivors and analyze the variables that significantly affect distress using machine learning techniques. A survey was conducted with 641 adult breast cancer patients using the National Comprehensive Cancer Network Distress Thermometer tool. Participants identified various factors that caused distress. Five machine learning models were used to predict the classification of patients into mild and severe distress groups. The survey results indicated that 57.7% of the participants experienced severe distress. The top-three best-performing models indicated that depression, dealing with a partner, housing, work/school, and fatigue are the primary indicators. Among the emotional problems, depression, fear, worry, loss of interest in regular activities, and nervousness were determined as significant predictive factors. Therefore, machine learning models can be effectively applied to determine various factors influencing distress in breast cancer patients who have completed primary treatment, thereby identifying breast cancer patients who are vulnerable to distress in clinical settings. [ABSTRACT FROM AUTHOR]

College students' mental health concerns have dramatically increased in prevalence and severity over the past decade, overwhelming the capacity of counseling centers to meet demand for services. In response, institutions of higher education (IHEs) increasingly emphasize prevention, education, and outreach efforts aimed at improving well-being. Although this focus has prompted an increase in research on student well-being, few studies have investigated the unique contributions of malleable psychosocial factors on student outcomes. This study aims to address this gap in the literature by examining the relative impact of an array of psychosocial factors—adaptive and maladaptive perfectionism, coping self-efficacy, social connectedness, perceived burdensomeness, grit, resilience, and meaning in life—on academic performance and distress and suicidality in a sample of 7505 students from 15 U.S. IHEs. Controlling for institutional selectivity and non-malleable aspects of students' identities and pre-college experiences, facets of perfectionism, grit, and emotion-focused coping self-efficacy were the psychosocial factors most strongly associated with GPA, and perceived burdensomeness, social connectedness, emotion-focused coping self-efficacy, and resilience were most strongly associated with distress and suicidality. Among non-malleable factors, race/ethnicity explained the most variance in GPA and gender identity explained the most variance in distress and suicidality. Results are discussed in light of persistent, identity-based disparities in academic achievement and suicide risk and the potential of psychosocial factors as intervention targets to improve academic performance and reduce suicide risk. [ABSTRACT FROM AUTHOR]

Purpose: This longitudinal study investigated distress rates in patients with advanced ovarian cancer during the COVID-19 pandemic and examined whether time, illness representations, and coping strategies predicted distress levels. Methods: UK patients with stage 3 or 4 ovarian cancer were recruited between September 2020 and March 2021. Data were collected at baseline (T0), 2 months (T1), and 4 months (T2) post-enrolment. Validated questionnaires assessed distress (anxiety, depression, PTSD, fear of progression) and predictors (coping strategies and illness perceptions), analysed via multilevel modelling. Results: Seventy-two participants returned a questionnaire at T0, decreasing to 49 by T2. High distress was observed, with over 50% of participants experiencing anxiety and depression consistently. Nearly 60% reported clinical levels of fear of progression at some point. PTSD rates resembled the general population. Although distress levels remained stable over time, some individual variability was observed. Time had minimal effect on distress. Coping strategies and illness perceptions remained stable. Threatening illness perceptions consistently predicted distress, while specific coping strategies such as active coping, acceptance, self-blame, and humour predicted various aspects of distress. Together, these factors explained up to half of the distress variance. Conclusion: The findings have implications for routine screening for distress and the inclusion of psychological treatment pathways in advanced ovarian cancer care. Addressing illness representations is crucial, with attention to informational support. Future research should explore the long-term effects of heightened distress and the effectiveness of interventions targeting illness perceptions. This study informs current clinical practice and future pandemic preparedness in cancer care. [ABSTRACT FROM AUTHOR]

Purpose: Comprehensive cancer-related financial toxicity (FT) measures as a multidimensional construct are lacking. The aims of this systematic review were to (1) identify full measures designed explicitly for assessing FT and evaluate their psychometric properties (content validity, structural validity, reliability, and other measurement properties) using Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN), and (2) provide an analysis of the domains of FT covered in these measures. Methods: MEDLINE, CINAHL, Web of Science, and Cochrane CENTRAL were searched for quantitative studies published from January 2000 to July 2023 that reported psychometric properties of FT measures in cancer survivors. The psychometric properties of FT measures and study risk of bias were analysed using COSMIN. Each FT measure was compared against the six domains of FT recommended by Witte and colleagues. Results were synthesized narratively. The detailed search strategies are available in Table S1. Results: Six FT tools including the COST-FACIT, PROFFIT, FIT, SFDQ, HARDS, and ENRICh-Spanish were identified. The COST-FACIT measure had good measurement properties. No measure reached an excellent level for overall quality but was mostly rated as sufficient. The SFDQ, HARDS, and ENRICh-Spanish were the most comprehensive in the inclusion of the six domains of FT. Conclusion: This review emphasizes the need for validated multidimensional FT measures that can be applied across various cancer types, healthcare settings, and cultural backgrounds. Furthermore, a need to develop practical screening tools with high predictive ability for FT is highly important, considering the significant consequences of FT. Addressing these gaps in future research will further enhance the understanding of FT. [ABSTRACT FROM AUTHOR]

Objective: Patients with heart failure may experience thirst distress. There is, however, no measurement tool to define patients' thirst distress in Turkey. The study aimed to determine psychometric properties of the translated Turkish version of the Thirst Distress Scale-Heart Failure (TDS-HF) in a sample of heart failure patients. Design: This methodologically planned study was conducted in two different training and research hospitals in Istanbul. Content validity, confirmatory factor analysis and concurrent validity were used in the validity analysis following the language validity analysis. Reliability coefficients were analysed by calculating Cronbach's alpha, McDonald's Omega and test-retest reliability coefficients. Validity and reliability analysis involved 116 patients, and test-retest analysis was carried out among 36 patients who volunteered to participate in the study. Results: The patients had a mean age of 55.2 ± 14.9. The factor structure and the examined fit indices of the one-dimensional eight-item scale indicated that the Turkish version of the scale was consistent with the original model. Item-total correlations were between 0.84 and 0.93, Cronbach's alpha coefficient was 0.90, the test-retest reliability coefficient was 0.97 and the McDonald's omega coefficient was 0.93, demonstrating that the scale is highly reliable. Conclusion: The Turkish version of the Thirst Distress Scale-Heart Failure was found to be valid and reliable. [ABSTRACT FROM AUTHOR]

Purpose: To develop and test the measurement properties of the HD-DT-C, a new tool designed to facilitate the screening of psychological distress and its sources in family caregivers of adults on hemodialysis. Methods: The present investigation was carried out in three phases: Phase 1 focused on the process of developing and exploring the content validity and clinical utility of the HD-DT-C using a mixed-methods approach and feedback panels; Phase 2, where the psychometric properties of this new tool were tested in a cross-sectional study (n = 106 caregivers); and Phase 3, where the European Portuguese version of the HD-DT-C was translated and culturally adapted into American English using a forward–backward translation procedure, followed by an expert panel review. Results: Findings suggested that the HD-DT-C was perceived by feedback panels as practical, appropriate, and useful for increasing dialysis provider/family caregiver communication in nephrology centers. The European Portuguese version of the HD-DT-C showed good test–retest reliability (ICC = 0.991 for the barometer and κ ≥ 0.80 in 77% of the checklist items), high diagnostic accuracy (AUC = 0.956), and strong convergent validity (all r ≥ 0.50) with reference measures that assess quality of life, caregiver burden, and symptoms of anxiety and depression. Cutoff scores with good clinical utility (CUI + ≥ 0.70) were recommended for screening distress in research (≥ 6) and clinical practice (≥ 5). Conclusion: The HD-DT-C is a brief, reliable, valid, and acceptable measure for identifying self-reported psychological distress and its sources among people caring for a family member or friend on hemodialysis. Future research is needed to explore the measurement properties of the American English version of this new tool. [ABSTRACT FROM AUTHOR]

Background: Childhood-onset glomerular disease often requires ongoing treatment and follow-up into adulthood. However, few studies have analyzed the associated impact and distress experienced by patients with this condition during the transition from childhood to adolescence and adulthood. Methods: At three facilities, we recruited patients who developed idiopathic nephrotic syndrome or IgA nephropathy during childhood and were at least 18 years old at the time of study entry. Among them, a questionnaire-based survey was administered to patients who consented to participate, and the results were analyzed in conjunction with clinical information. Results: Data from a total of 38 patients were analyzed. Of these patients, 15 had idiopathic nephrotic syndrome and 23 had IgA nephropathy. The age of transition from pediatrics to the adult medicine department was correlated with the number of recurrences. Many patients also reported being significantly affected by exercise restrictions and physical decline associated with their diseases and medications. Various impacts, including distress, affected decision-making regarding higher education, with patients engaging in higher education at a significantly higher rate compared with the regional average (66.7% vs. 46.9%, p = 0.028). Conclusion: We analyzed the impact of childhood-onset glomerular disease and distress during the transition period from pediatric to adult care. This study highlighted the significant impact of medications and exercise restrictions on patients' decisions regarding higher education. Future prospective studies will be needed to examine patients' distress in more detail and establish management approaches to enhance patient quality of life. [ABSTRACT FROM AUTHOR]

One way that benevolent sexism contributes to gender inequality is by offering wellbeing benefits to women and men who fulfil idealised gender roles, such as taking on differentiated parenting roles and priorities. Yet, how benevolent sexism relates to parenting outcomes has received little attention. Extending a pre-pandemic study of heterosexual couples with young children (N = 175 dyads), we provide initial tests of the associations between benevolent sexism, parenting strain, and psychological distress. We assess whether benevolent sexism predicted parenting strain and psychological distress during two lockdowns at the beginning of the COVID-19 pandemic (Lockdown 2020) and 17 months later (Lockdown 2021). Accounting for pre-pandemic psychological distress, actors' and partners' higher pre-pandemic benevolent sexism was associated with lower psychological distress, and these associations were accounted for by lower parenting strain during lockdowns. However, the associations between mothers' benevolent sexism and parenting outcomes dissipated at Lockdown 2021, suggesting that any protective benefits benevolent sexism offers to women are precarious. These results provide novel, preliminary evidence for the palliative function of benevolent sexism in the parenting domain, and advance understanding on why benevolent sexism is appealing and helps sustain gender inequalities. [ABSTRACT FROM AUTHOR]

Ruxolitinib is beneficial in patients with myelofibrosis (MF) and polycythemia vera (PV). Information on ruxolitinib adherence is scant. The Ruxolitinib Adherence in Myelofibrosis and Polycythemia Vera (RAMP) prospective multicenter study (NCT06078319) included 189 ruxolitinib-treated patients. Patients completed the Adherence to Refills and Medications Scale (ARMS) and Distress Thermometer and Problem List (DTPL) at the earliest convenience, after registration in the study, and at later timepoints. At week-0, low adherence (ARMS > 14) and high distress (DT ≥ 4) were declared by 49.7% and 40.2% of patients, respectively. The main reason for low adherence was difficult ruxolitinib supply (49%), intentional (4.3%) and unintentional (46.7%) non-take. In multivariable regression analysis, low adherence was associated to male sex (p = 0.001), high distress (p < 0.001), and treatment duration ≥ 1 year (p = 0.03). Over time, rates of low adherence and high distress remained stable, but unintentional non-take decreased from 47.9% to 26.0% at week-48. MF patients with stable high adherence/low distress were more likely to obtain/maintain the spleen response at week-24. Low adherence to ruxolitinib represents an unmet clinical need that require a multifaceted approach, based on reason behind it (patients characteristics and treatment duration). Its recognition may help distinguishing patients who are truly refractory and those in need of therapy optimization. [ABSTRACT FROM AUTHOR]

Introduction: Parents of children with cancer can experience increased emotional distress. This study aimed to assess the feasibility (i.e., reach, treatment fidelity, and social validity) of Taking Back Control Together (TBCT). Methods: We assessed reach with the enrollment and dropout ratios. We assessed treatment fidelity using items from existing programs, controlling for the reliability of the items. For social validity, we used an adapted version of the Treatment Evaluation Inventory and compared means with theoretical cut-points. Results: 42 participants enrolled in the intervention. The enrollment and dropout ratios were 39% and 38%, respectively. Treatment fidelity was 77.3–84.3% (95%CI 75.3–86%). Acceptability (M = 90%), satisfaction (M = 87%), and relevance (M = 82%) were significantly positive. Conclusion: This study suggests that certain elements of TBCT need to be reassessed before the intervention is pilot tested. Although reach was likely impacted by the COVID-19 pandemic, it could be improved with some modifications to the intervention. [ABSTRACT FROM AUTHOR]

Identifying and promoting students' social-emotional strengths is essential in building their mental health. Covitality, representing the co-occurrence of psychological strengths, is a helpful framework for characterizing students' well-being. This study used latent profile analysis to identify adolescents' (n = 11,217; 50.3% female, 37.8% male; grades 9 [33.7%], 10 [21.0%], 11 [28.9%], and 12 [16.5%]) covitality patterns across 12 social-emotional health domains. We investigated whether student demographic characteristics (i.e., sex, parent educational attainment, ethnic identification) were related to profile membership. We further examined profiles' relations to students' proximal academic and mental health outcomes, including self-reported grades, school connectedness, life satisfaction, and psychological distress. Four covitality profiles were identified—High, Moderate-High, Moderate-Low, and Low. Profile membership was statistically significantly related to students' sex and socioeconomic circumstances but with small effect sizes. We identified consistent differences across covitality profiles on student self-reported proximal outcomes. Overall, students in profiles with higher covitality levels (High and Moderate-High) reported (a) higher grades, school connectedness, and life satisfaction and (b) less psychological distress, with students in the High profile reporting the most favorable outcomes. Assessing students' strengths and providing interventions focused on building strengths across domains are recommended. [ABSTRACT FROM AUTHOR]

Purpose: Distress Thermometer (DT) was adopted to evaluate distress in neuro-oncology on a scale from 1 to 10. DT values above 4 indicate major distress and should initiate psycho(onco)logical co-therapy. However, data about peri-operative distress is scarce. Hence, we evaluated peri-operative distress levels in a neurosurgical patient cohort with various intracranial tumors using the DT. Methods: We conducted a retrospective study including inpatients with brain tumors who underwent surgery in our department between October 2015 and December 2019. Patients were routinely assessed for distress using the DT before or after initial surgery. A comparative analysis was performed via Wilcoxon rank-sum test. Results: 254 patients were eligible. Mean DT value of the entire cohort was 5.4 ± 2.4. 44.5% (n = 114) of all patients exceeded DT values of ≥ 6. In our cohort, poor post-operative neurological performance and occurrence of motor deficits were significantly associated with major distress. When analysed for peri-operative changes, DT values significantly declined within the male sub-cohort (6.0 to 4.6, p = 0.0033) after surgery but remained high for the entire cohort (5.7 and 5.3, p = 0.1407). Sub-cohort analysis for other clinical factors revealed no further significant changes in peri-operative distress. Conclusion: Distress levels were high across the entire cohort which indicated a high need for psychological support. Motor deficits and poor post-operative neurological performance were significantly associated with DT values above 6. Distress levels showed little peri-operative variation. [ABSTRACT FROM AUTHOR]

Objectives: Psychological distress is common among university students globally. A culturally relevant internet-based mindfulness intervention could be a potential solution for addressing students' distress in low- and middle-income countries (LMICs), including Indonesia. However, internet-based mindfulness interventions are new in Indonesia. In this study, we evaluated the feasibility, acceptability, and mental health outcomes of a counsellor-guided, culturally adapted, internet-delivered mindfulness intervention for Indonesian university students experiencing psychological distress. Method: This open pilot trial used a single-arm pre-post-test design. Indonesian university students with elevated distress (n = 40) enrolled in a 4-week counsellor-guided internet-delivered mindfulness intervention. Participants completed the Indonesian adaptation of the Depression Anxiety Stress Scales (DASS-21) at screening, baseline, and post-treatment. They also completed the Indonesian version of Kessler's Psychological Distress Scale (K-10) prior to each lesson, Five Facet Mindfulness Questionnaire (FFMQ) and Indonesian Well-Being Scale (IWBS) at baseline and post-treatment, and questionnaires to evaluate the feasibility, acceptability, and treatment satisfaction. Results: Results showed the feasibility and acceptability of our guided culturally adapted Indonesian internet-delivered mindfulness intervention, with good completion rates (70%). We also found large and significant improvements in distress, mindfulness, and well-being (Hedges' g = 0.85–1.68) from pre- to post-treatment. Participants reported that the program was satisfactory. Conclusions: This study suggested that a counsellor-guided culturally adapted internet-based mindfulness intervention was feasible, acceptable, and associated with improvements in psychological distress, well-being, and mindfulness among university students in Indonesia. A randomized controlled trial with follow-up is needed to evaluate the intervention's effectiveness. Preregistration: This trial was preregistered on the Australian New Zealand Clinical Trial Registry (ACTRN12620000135910). [ABSTRACT FROM AUTHOR]

Purpose: Living with diabetes can be challenging, particularly when it comes to dealing with psychological distress and requiring self-care directives. Patients may feel frustrated, angry, overwhelmed, and discouraged. This study aimed to investigate the diabetes-related distress and quality of life among people with type 2 diabetes mellitus (T2DM). Methods: A cross-sectional study carried out at the Clinical Research Centre at the University of Campinas, Brazil, between September 2020 and April 2021. Patients answered data regarding demographic and clinical variables, the Brazilian version of the Diabetes Distress Scale and the Diabetes Quality of Life (QOL) Measure by telephone contact. The data were managed using the RedCap System. For statistical analysis of the data, the Mann–Whitney and Kruskal–Wallis tests were applied for comparisons, and the Chi-square test for associations. The correlations were evaluated using the Spearman correlation coefficient. Results: Out of the 302 participants we recruited, 50.33% exhibited significant diabetes-related distress. Those with elevated diabetes-related distress scores had shorter education levels (p < 0.05), lower HbA1c levels (p < 0.05), and lower total scores in Diabetes QOL Measure (p < 0.0001), particularly in the QOL impact (p < 0.0001), social/vocational worry (p < 0.05), and diabetes worry (p < 0.0001) subscales compared to the group with the lowest diabetes-related distress. Conclusion: Elevated diabetes-related stress scores significantly affect patients' QOL. Therefore, early screening of individuals at risk for this condition, using well-coordinated protocols, could mitigate adverse QOL effects and enhance their overall experience during disease management. [ABSTRACT FROM AUTHOR]

To translate, validate and test the reliability of Kannada version of "EORTC QLQ-H&N43" and "NCCN Distress Thermometer and Problem list" version 2.2022. The English version of "EORTC QLQ H&N43" and "NCCN Distress thermometer and Problem List" version 2.2022 tools were translated into Kannada language according to standard guideline. The translated version was validated by EORTC and by using content validity index (CVI). Further, the reliability of validated tools was established via test–retest and internal consistency method whereas construct was determined via spearman rank correlation. The Cronbach alpha value > 0.7 and correlation coefficients (ρ) < 0.05 was considered as significant. The Kannada version of "EORTC QLQ-H&N43" was validated by EORTC as well as by experts whereas NCCN distress tool was validated only by experts with average CVI score of 1 and 0.97 respectively. Out of total 80 patients, 50% were head and neck cancer (HNC) patients and 50% belonged to other cancer types. Kannada version of EORTC QLQ-H&N43 and NCCN distress tool was found to be reliable among HNC and general cancer patients respectively with the Cronbach alpha value between 0.819–1 and 0.71–1 for all the domains. Further, only 7.72% of EORTC QLQ-H&N43 and 13.33% of NCCN distress tool construct were significantly correlated with construct of EORTC QLQ-C30 (p < 0.05). The Kannada version of QoL and distress instrument was found to be valid and reliable to use among HNC and/ general cancer patients respectively. Thus, this method of translation, validation and reliability testing can be used as a novel practice in healthcare. [ABSTRACT FROM AUTHOR]

Unspecific symptoms of anxiety and distress are frequently encountered in patients in both general practice and acute psychiatric services. Minor tranquillizers may be a treatment option when non-pharmacological interventions are insufficient or unavailable. We conducted a systematic review with network meta-analysis of the evidence for short-term (1–4 weeks) pharmacological treatment of newly onset symptoms of anxiety and distress. We searched the PsycInfo, MEDLINE, EMBASE and Cochrane Library databases and extracted data following a predefined hierarchy of outcomes. We assessed risk of bias using the Cochrane Risk of Bias tool and the certainty of the evidence using the Grading of Recommendations Assessment, Development and Evaluation framework (GRADE). We included 34 randomized trials comprising a total of 7044 patients with adjustment disorders or anxiety spectrum disorders. The network meta-analysis showed that regarding the critical outcome symptoms of anxiety within 1–4 weeks benzodiazepines (SMD − 0.58, 95% CI − 0.77 to − 0.40), quetiapine (SMD − 0.51, 95% CI − 0.90 to − 0.13) and pregabalin (SMD − 0.58, 95% CI − 0.87 to − 0.28) all performed better than placebo with no statistically significant difference between the drugs. Data on other important outcomes were inconsistently reported. Adverse effects varied, but overall, it was uncertain whether adverse effects differed between interventions. The evidence regarding the risk of dependence was uncertain, but dependence may be a concern in susceptible individuals even with short-term treatment. Overall, the certainty of the evidence according to GRADE was rated as low to very low across outcomes. Despite the limitations in the evidence, the results of this review can inform treatment guidelines, supporting clinicians in the choice of minor tranquillizer in this prevalent and help-seeking, clinically heterogeneous population. [ABSTRACT FROM AUTHOR]

Purpose: Patients with gynaecological cancer often experience psychological issues due to multiple stressors. Psychological disturbances have debilitating effects on patients with gynaecological cancer. In recent decades, digital psychosocial interventions have rapidly advanced and been incorporated into mental health interventions. Digital psychosocial interventions could provide patients with several benefits over traditional in-person interventions, including convenience, anonymity, flexible scheduling, and geographic mobility. The aim of this systematic review was to synthesize the effectiveness of digital psychosocial intervention in reducing psychological distress, depression, and anxiety and improving health-related quality of life in patients with gynaecological cancer. Methods: Three-step extensive search was performed on 22 December 2022 from nine bibliographic databases, trial registries and grey literature. Experimental studies involving patients with gynaecological cancer utilizing digital psychosocial interventions for the improvement of mental health outcomes were included. Meta-analysis was conducted using RevMan 5.4 software. Heterogeneity was analysed by Cochran’s Q test and I2. Subgroup analyses were attempted to evaluate relative effect sizes of subgroup features. Results: Meta-analysis of nine studies revealed small effect size in reduction of depression post-intervention (d = 0.24, 95% CI − 0.46 to − 0.02) and medium effect size in reduction of psychological distress post-intervention (d = 0.51, 95% CI − 0.81 to − 0.21) and follow-up (d = 0.65, 95% CI − 1.25 to − 0.05) compared to the control group. The effects of digital psychosocial interventions on anxiety and health-related quality of life were not statistically significant. Conclusions: Digital psychosocial interventions probably reduced psychological distress and slightly reduced depression amongst patients with gynaecological cancer compared to the control group, which can be integrated into clinical practice. Additional trials with rigorous methodology and bigger sample sizes are needed to validate findings. Trial registration: PROSPERO (CRD42023389502). [ABSTRACT FROM AUTHOR]

There are various interpersonal interaction modalities in this current digital age, such as social media networks. The literature on the effects of social media on health and well-being indicators is saturated with studies that primarily focus on the frequency of social media use or amount of time spent on social media, neither of which captures the quality of social interactions. To address this gap in the literature, the present study aimed to (a) measure satisfaction with social interactions—for both social media and in-person interactions—and examine its links to indices of mental health (distress, anxiety, depression, anger, and loneliness), and (b) test one's sense of social connectedness as the mediator in the relation between satisfaction with social interactions and psychological well-being. Data were collected through a web-based survey that was administered to 2,782 incoming undergraduate students. The results showed that, after controlling for gender and race, both satisfaction with social interactions through social media and with in-person interactions were significantly and inversely related to self-reports of distress, anxiety, depression, anger, and loneliness. In addition, the findings from robust mediation tests indicated that social connectedness mediated the path between satisfaction with social interactions and the indices of well-being, and the indirect effects were all significant. The study contributed to our understanding of how satisfaction with interpersonal interactions—digitally or in-person—can impact psychological well-being directly and indirectly, with important implications for students, educators, and practitioners. [ABSTRACT FROM AUTHOR]

Purpose: This paper asks whether the separation of mental health from its wider social context during the UK benefits assessment processes is a contributing factor to widely recognised systemic difficulties, including intrinsically damaging effects and relatively ineffective welfare-to-work outcomes. Methods: Drawing on multiple sources of evidence, we ask whether placing mental health—specifically a biomedical conceptualisation of mental illness or condition as a discrete agent—at the core of the benefits eligibility assessment process presents obstacles to (i) accurately understanding a claimant's lived experience of distress (ii) meaningfully establishing the specific ways it affects their capacity for work, and (iii) identifying the multifaceted range of barriers (and related support needs) that a person may have in relation to moving into employment. Results: We suggest that a more holistic assessment of work capacity, a different kind of conversation that considers not only the (fluctuating) effects of psychological distress but also the range of personal, social and economic circumstances that affect a person's capacity to gain and sustain employment, would offer a less distressing and ultimately more productive approach to understanding work capability. Conclusion: Such a shift would reduce the need to focus on a state of medicalised incapacity and open up space in encounters for more a more empowering focus on capacity, capabilities, aspirations, and what types of work are (or might be) possible, given the right kinds of contextualised and personalised support. [ABSTRACT FROM AUTHOR]

Opinion Statement: As a palliative care specialist and a hypnotherapist, I use therapeutic communication and conversational hypnosis daily in my patient – doctor relationship. Formal hypnotherapy sessions are integrated in my practice whenever patients are open or wish for such an approach in relation to a specific symptom, for better overall management of their disease burden and/or enhanced well-being. Although hypnosis has been used for centuries in medical practice and for thousands of years in healing practices in ancient cultures all over the world, the evidence remains scarce. Nevertheless, in the last 10 years several randomised controlled trials have been conducted, building up an evidence base. In contrast to most oncological treatments, hypnotherapy is far from being considered evidence-based "standard care". It is however, if practiced by a trained health care professional, almost free of side effects and therefore potentially has a very favourable benefit-to-harm ratio. The question arises whether hypnotherapy will ever become a standard of care intervention? This seems unlikely since its efficacy may be influenced by the patient's belief in hypnosis and compliance to therapy. Furthermore, a fundamental necessity is a personalised approach that moves hypnotherapy more into the category of individual-centred care rather than standard care. [ABSTRACT FROM AUTHOR]

Introduction: Several state policies were introduced to offer protection and legislative remedies for the hardship experienced by transgender people. However, the impact of such policies is still unclear whether these state policies impact all transgender people the same way or to only a select subset of them. We study the effect of state policies on distress among those who used gender-affirming medical care and those who did not. Methods: The study used the 2015 US Transgender Survey (collected by the National Center for Transgender Equality) to examine the relationship between transgender anti-discrimination policies and health. The study utilized 27,050 cases from 50 states, and linear regression modeling to see how the relationship between policy and distress differs based on the use of gender-affirming medical care. Results: Non-discrimination, public accommodation, hate crime, and ban on Medicaid exclusion legislation were each associated with less distress only for those who did not use gender-affirming medical care, and no effect on those who did. Furthermore, having more people know about one's transgender identity reduced distress, especially among those who used gender-affirming medical services. Conclusions: This study found state-level anti-discrimination legislation varies in its protection of transgender people from distress. Specifically, policies were only effective for those who did not use medical services like hormones or surgeries. Policy Implications: Transgender populations are very diverse and need policy that can encompass the diversity among transgender people. While protection from violence and discrimination is vital, so can policy protecting their access to gender-affirming care. [ABSTRACT FROM AUTHOR]

Effectively responding to children's noncompliance and/or temper tantrums can be challenging for parents. It is even more challenging in the context of parents' own need to regulate their emotions. Recent reviews emphasized the role of parents' emotion regulation abilities in children's mental health. The present study aims to investigate two sequential mediation models of the relationship between authoritarian parenting style, parental practices, and children's externalizing problems, by examining the mediating role of rational/irrational parental beliefs regarding child noncompliance, parental emotion regulation strategies, and parental distress. Participants (N = 238) are parents of children (ages 2–8) identified as having elevated levels of noncompliance and/or temper tantrum behaviors. We examined the two sequential mediation models via path analyses. Authoritarian parenting style was significantly and positively associated with parental irrational beliefs, parental emotion regulation difficulties, parental distress, harsh and inconsistent parental practices, and children's externalizing problems. Our results support both models of mediation, with the model investigating the link between authoritarian parenting style and parental practices indicating a better fit. This study offers a better understanding of the emotional and cognitive parental mechanisms involved in children's externalizing problems and the use of parenting practices. Implications of the findings are discussed considering the development of innovative and focused parental interventions for targeting specific interpersonal, emotional and cognitive mechanisms in the case of parents who deal with children's noncompliance and/or temper tantrum behaviors. [ABSTRACT FROM AUTHOR]

Low partner relationship satisfaction is a strong predictor of perinatal depression and anxiety symptoms. However, little is known about the potential mechanisms via which partner relationship satisfaction may exert its effects on the mental health of perinatal women. Therefore, the aim of this exploratory study was to examine the direct and indirect effects, via maternal self-efficacy and psychological flexibility in sequence, of partner relationship satisfaction on the complete mental health of women at high risk for postpartum depression (PPD). The sample for this study comprised 963 early postpartum women presenting high-risk for PPD, as determined by the clinical cutoff score obtained through the Postpartum Depression Predictors Inventory-Revised. The assessment protocol further included self-report measures of partner relationship satisfaction, maternal self-efficacy, psychological flexibility, depression, anxiety, and positive mental health. Correlation analyses were conducted to ascertain associations between variables, and structural equation modelling (path analysis) was performed to examine direct and indirect effects. The observed results revealed that higher levels of partner relationship satisfaction were related to lower levels of postpartum psychological distress and higher levels of positive mental health. Moreover, those links were found to be sequentially mediated by maternal self-efficacy and psychological flexibility. These findings suggest that increased maternal self-efficacy, boosted by satisfactory partner relationships, may improve the psychological flexibility of women at high risk for PPD, and ultimately their complete mental health. Accordingly, intervention efforts to prevent PPD may increase their effectiveness by addressing partner relationship satisfaction as a key variable for the promotion of complete perinatal mental health. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to systematically review the literature on the association between adverse childhood events (ACEs) and mental health problems in cancer survivors. Methods: This review was conducted in line with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Four databases (PubMed, PsychINFO, Web of Science, and Cochrane) were searched on 27–08-2023. Results: Of the 1413 references yielded by the literature search, 25 papers met inclusion criteria and were reviewed. Most studies were performed in the USA, most included breast cancer survivors, and the number of included participants ranged between 20 and 1343. ACEs were relatively prevalent, with self-report rates ranging between 40 and 95%. Having been exposed to ACEs was a risk factor for heightened levels of emotional distress, anxiety, depressive symptoms, and fatigue during cancer treatment. Results varied depending on the variables included, and per subscale, but were consistent across different cultures and heterogenous patient groups. Conclusion: The association between ACE and mental health outcomes was significant in most studies. In order to improve treatment for this vulnerable population, it may be necessary to screen for ACEs before cancer treatment and adjust treatment, for example, by means of trauma-informed care (TIC), which recognizes and responds to the impact of trauma on individuals seeking healthcare. [ABSTRACT FROM AUTHOR]

Access to health information can have positive effects in the form of increased health awareness. However, self-diagnosis based on information available on websites can be dangerous, causing distress as an increasing amount of time is spent on searching. The main aim of the study was to determine the role of emotional functioning in the relationship between health anxiety and cyberchondria. The study included N = 615 participants aged 18 to 83 years (M = 43.86, SD = 14.57). The authors used the Cyberchondria Severity Scale, the Short Health Anxiety Inventory, the Life Orientation Test, the Difficulties in Emotion Regulation Scale, and the Kessler 6 Psychological Distress Scale. The results demonstrate that health anxiety is significantly related to cyberchondria and that pessimism and difficulties in emotion regulation act as mediators in this relationship. [ABSTRACT FROM AUTHOR]

Informal caregivers of children with special healthcare needs (SHCN) are at risk for negative affect and poor quality of life (QOL). Inherent, or trait, mindfulness is thought to attenuate stress, depression, and anxiety (negative affect) and improve QOL. We aimed to investigate differences between caregiver groups (caregivers of children with and without SHCN), while exploring the effects of trait mindfulness on the relationship between caregiver group, QOL, and negative affect. A cross-sectional design was used with 120 informal caregivers of children with and without SHCN. Analysis included independent samples t-tests for between group differences and PROCESS Macro (Model 4) with 5000 bootstrapping was used to test the indirect effect of trait mindfulness on negative affect and QOL. Informal caregivers of children with SHCN had poorer negative affect, QOL, and lower levels of trait mindfulness than those caring for typically developing, healthy children. Trait mindfulness was found to significantly affect the relationship between caregiver group and QOL and partially accounted for the relation between caregiver group and negative affect individually in simple mediation models. Trait mindfulness may explain why some caregivers have higher levels of negative affect and worse QOL than others. Future research should explore the effects of severity of the child's illness and caregiver gender on affect and QOL. Moreover, mindfulness in combination with other protective factors such as social support should be explored to gain a more complete understanding of how we can protect the wellbeing of those caring for vulnerable children. [ABSTRACT FROM AUTHOR]

More than 50% of children report considerable pain during venipuncture or intravenous cannulation. Despite the tools and techniques may be employed to reduce pain and distress in everyday clinical practice, the care offered is frequently insufficient. Music's potential effect in healthcare settings has received increasing attention. This study aimed to verify if the active production of music with a Leap Motion Controller could help decreasing pain and distress during venipuncture in children and adolescents. We conducted an open-label randomized controlled clinical trial with parallel arms. Children aged 8 to 17 were enrolled at the blood-drawing center of the Institute for Maternal and Child Health IRCCS Burlo Garofolo of Trieste, Italy. We hypothesized that in order to demonstrate an adequate improvement in the pain score in the intervention group, at least 200 children, 100 in each group, were needed, with alpha 5% and 1-beta 80%. Differences between the groups were evaluated with the nonparametric Mann–Whitney U-test. The subjects were randomly assigned either to the active production of music group or to the standard of care group. The primary outcome was the median self-reported procedural pain score between experimental and standard of care group. Secondary outcomes were: the median pain and distress scores according to parental judgment and operators' judgment between the experimental and control group. Three hundred subjects entered the study and were randomized, 150 in the active production of music group and 150 in the standard of care group. Median self-reported pain scores were 1 (0–2) in the active production of music group and 2 (1–2) in the standard of care group and this difference was statistically significant (p = 0.0016). Median procedural distress was 1 (0–3) in the active production of music group and 3 (1–6) in the standard of care group, according to parental judgment, and this difference was statistically significant (p = 0.0000016). Conclusion: This research showed that the active production of music is a valuable distraction technique to decrease venipuncture related pain and distress in children and adolescents. Trial registration: The study protocol was registered with ClinicalTrial.gov (June 28[th] 2022, NCT05441241) before the start of the subjects' enrolment. What is Known: • The benefits of music on pain and anxiety are well known and have been tested during different painful procedures. • The effect of active production of music has never been tested in children during venipuncture. What is New: • In our study median self-reported pain scores and median procedural distress, according to parental judgment, were lower in the active production of music group than in the standard of care group and these differences were statistically significant. [ABSTRACT FROM AUTHOR]

Invasive medical procedures in hospitals are major sources of stress in children, causing pain and fear. Non-pharmacological interventions are indispensable in effective pain and fear management. However, these interventions must be personalized to be effective. This qualitative study aims to gain insight into children's and parents' experiences, needs, and wishes related to supporting children to develop and express their coping preferences for dealing with pain and fear during minor invasive medical procedures in order to decrease pain and fear. A qualitative study using thematic analysis was performed. Data were collected through semi-structured interviews with children and parents who had undergone at least five minor invasive medical procedures in the last year. Nineteen children (8–18 years) and fourteen parents were interviewed individually. The experiences, needs, and wishes expressed in the interviews could be classified into one overarching theme, that of the personal process, and two content-related sub-themes: feeling trust and gaining control. The personal process was divided into two different phases, that of developing and of expressing coping preferences. Children and parents both reported it as a continuous process, different for every child, with their own unique needs. Children and parents expected personalized attention and tailored support from professionals. Conclusion: Professionals must combine clinical skills with child-tailored care. In the process of searching for and communicating about coping preferences, children's unique needs and personal boundaries will thereby be respected. This gives children and parents increased trust and control during invasive medical procedures. What is Known: • Untreated pain and stress caused by medical procedures can have severe and important short- and long-term consequences for children. Personalized non-pharmacological interventions are an essential element of procedural pain management. What is New: • A personalized coping strategy is important for children when undergoing medical procedures. Each individual child has a personal way of expressing their own coping strategy. Children and their parents need information and the space to develop and express their individual coping preferences. • Children and parents expect to receive child-tailored care from professionals including respect for their own, unique needs and boundaries. Professionals should build trustful relationships and provide appropriately tailored autonomy around medical procedures. [ABSTRACT FROM AUTHOR]

Background: Cutaneous graft-versus-host disease (cuGVHD) is a complication of allogeneic hematopoietic stem cell transplantation that presents with varying severity and can significantly affect one's quality of life (QOL). No trials have yet tested nonpharmacologic interventions to improve the QOL of patients with cuGVHD. The primary objective of the Expressive Helping in Support Groups for Cutaneous GVHD (EXPRESS-C-GVHD) Trial is to evaluate the effect of a support group that employs expressive writing on cutaneous and systemic GVHD symptoms, general distress, and QOL immediately after the intervention. Secondary objectives include evaluating the impact of the intervention on QOL at 1 month post intervention, as well as willingness to participate, compliance, feasibility, and satisfaction. Methods: The EXPRESS-C-GVHD Trial will include patients with chronic cuGVHD who are at least 18 years old and able to use a writing utensil, have access to Zoom, an online video conference platform, and attend all four live support group sessions. Subjects will be recruited from the Department of Dermatology, Northwestern University, Chicago, IL and will participate in a 4 week program via Zoom. Program activities will be 1 h long and consist of 40 min of participant-led verbal reflection and discussion in a group setting in response to prompts, and 20 min of expressive writing. Participants will fill out a baseline willingness survey, follow-up surveys after every session, and post-intervention surveys at 2 weeks and 1 month after intervention. Discussion: The EXPRESS-C-GVHD Trial is a pilot trial and will assess whether a Zoom-based expressive writing intervention within the framework of a support group is feasible and can improve QOL outcomes among individuals with cuGVHD. Trial Registration: The trial is registered under number NCT05694832. [ABSTRACT FROM AUTHOR]

The South Carolina cystic fibrosis (CF) newborn screening (NBS) program changed in 2019 to include CFTR genotyping for babies with top 4% immunoreactive trypsinogen, which improves sensitivity and timeliness but increases carrier detection. Carrier identification has genetic implications for the family and parents of NBS+ babies have increased emotional distress. Genetic counseling (GC) may increase parent understanding and reduce anxiety yet is not uniformly offered at CF centers. We report our early results after implementing GC for NBS+ families at the time of sweat chloride testing based on GC availability, which resulted in an unselected GC− control arm. Sixteen mothers (GC+ = 9, GC− = 7) participated in an online survey about their experience. Responses were analyzed in aggregate and for differences between GC+ and GC− groups. All-respondent sadness and anxiety increased with notification of the NBS+ result and decreased after sweat test results. Anxiety and sadness were greater in GC− compared to GC+ until after the diagnosis was resolved, though emotional differences between the groups were not statistically significant. On a scale of 0 = not at all to 10 = extremely, GC was rated very helpful (mean 9.0, range 5–10), informative (mean 8.9, range 4–10), comforting (mean 9.1, range 6–10), and minimally distracting (mean 1.8, range 0–9). All participants correctly identified that a risk for a child to have CF exists when both parents are (at least) carriers. Delivery of NBS results to respondents varied by timing, informant, and information given. The child's pediatrician notified 10 (62.5%) of the NBS+ result. Parents felt they were notified in a timely manner (68.8%), by someone knowledgeable about NBS (62.5%), the sweat test (62.5%), CF (43.8%), and genetics (43.8%) and who cared about them (81.3%). Parents felt worried (81.3%), confused (81.3%), empowered (25%), and other (sad, shocked, scared, overwhelmed, devastated, defeated). Data from this single-center study suggest benefit of GC, that families would value earlier contact with an expert, and that prompt diagnostic resolution may reduce duration of parental distress. [ABSTRACT FROM AUTHOR]

In the first years of a teaching career, teachers experience high levels of distress, and the attrition rate appears to be high. Early-career teachers do not always feel well prepared for their job and feel insufficient support during their first experiences as a teacher. Induction programs, professional development, and school support could equip early-career teachers with the additional teaching repertoire they need and improve their well-being. The current study aimed to contribute insights into the importance of the level of preparedness, professional development, and working conditions for early-career teachers' well-being. Based on multi-level regression analysis of TALIS 2018 data of more than 77,000 teachers in 24 European countries, the impact of the level of preparedness, professional development, and working conditions have been examined on teachers' feelings of distress during their first years of teaching. Early-career teachers have been divided into two groups: novice teachers (with no more than 2 years of teaching experience) and advanced beginners (with between 2 and 5 years of teaching experience). These two groups were compared with mid-and late-career teachers (with more than 5 years of teaching experience). Level of preparedness and professional development variables were only weakly related to teachers' feelings of distress, whereas working conditions were strongly related to early-career teachers' feelings of distress. In particular, high workload and classroom discipline issues were strongly and positively related to teachers' feelings of distress. Differences between the two early-career teacher groups and the group of mid- and late-career teachers were marginal. Yet, additional research is needed into the quality and the variety of initial teacher education and induction programs to come to more rigorous conclusions about the potential effects of different programs. [ABSTRACT FROM AUTHOR]

This study develops a theoretical model to explain the impacts of uncertainty events such as Covid-19 pandemic on consumers' distress and the resulting impulsive buying behavior. Different from the extant perspective, two types of uncertainties are theorized to impact on distress differently. Moreover, two key moderators which are culture- and religiousness-related including mindfulness and afterlife belief are examined on the process toward the impulsive buying behavior. This can be considered as an important answer to the call by scholars to understand the roles of cultural and religious beliefs in defining consumer behaviors. A data sample of 410 consumers in Vietnam collected provides support for the hypotheses. Thus, our study contributes to the current literature related to the cultural and religious view on consumer behavior. Practical implications are also discussed. Finally, recommendations for further research are provided. [ABSTRACT FROM AUTHOR]

Coping flexibility refers to one's ability to abandon a coping strategy (strategies) appraised as ineffective and implement an alternative coping strategy (strategies). According to the coping flexibility hypothesis, greater coping flexibility leads to lower psychological dysfunction, including psychological distress, and greater life satisfaction. This study adopted a longitudinal design to examine the associations among coping flexibility, psychological distress, and life satisfaction. The participants comprised 222 female and 188 male college students who completed questionnaires on coping flexibility, psychological distress, life satisfaction, and rumination about stress (the concept of which partially overlaps with that of coping flexibility). Hierarchical multiple regression analyses revealed that higher coping flexibility was associated with lower psychological distress and higher life satisfaction 38 weeks later, even after controlling for the effects of rumination on stress, psychological distress, and life satisfaction at baseline. The findings of this study imply that coping flexibility plays an important role in affecting college students' psychological dysfunction and life satisfaction. [ABSTRACT FROM AUTHOR]