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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: 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.

Background: The study aimed to investigate the efficacy of a 12-week physical activity intervention for caregivers of patients with schizophrenia. Method: Family caregivers of patients with schizophrenia were recruited and randomized into either a physical activity group (n = 31) or a control group (n = 31). The 12-week "Physical Activity Program" consisted of 10 minutes of warm-up activities as the initial segment, 20 minutes of rhythmic exercises as the activity segment, 10 minutes of cool-down exercises as the final segment, and 40 minutes of free walking. The physical activity program was designed to accommodate the ergonomics and physiological structure of the caregiver. The program consisted of 12 sessions. The Zarit Caregiver Burden Scale and the Beck Depression Inventory were used to the physical activity and control groups before the program's implementation. Results: A total of 62 caregivers were randomized to the intervention (n = 31) or control group (n = 31). Postintervention measurement was completed by 61 caregivers, and all the caregivers completed the intervention. Mean scores of Zarit Caregiver Burden Scale score and Beck Depression Inventory score in the physical activity group of caregivers at postintervention, significantly reduced at <.05 level than their mean baseline scores. Conclusions: Engagement in a 12-week physical activity intervention can improve the perceived burden of caregiving and symptoms of depression. Future research should examine with larger sample groups, carry out interventions, and apply the physical activity intervention by targeting caregivers, along with different interventions. [ABSTRACT FROM AUTHOR]

BACKGROUND: Shortness of breath occurs in 10%-70% of oncology patients. Very little is known about interindividual variability in its severity and distress and associated risk factors. Using latent profile analyses (LPAs), purpose was to identify subgroups of patients with distinct severity and distress profiles for shortness of breath as single symptom dimensions. In addition, a joint LPA was done using patients severity AND distress ratings. For each of the three LPAs, differences among the shortness of breath classes in demographic, clinical, symptom, stress, and resilience characteristics were evaluated. METHODS: Patients completed ratings of severity and distress from shortness of breath a total of six times over two cycles of chemotherapy. All of the other measures were completed at enrollment (i.e., prior to the second or third cycle of chemotherapy). Separate LPAs were done using ratings of severity and distress, as well as a joint analysis using severity AND distress ratings. Differences among the latent classes were evaluated using parametric and nonparametric tests. RESULTS: For severity, two classes were identified (Slight to Moderate [91.6%] and Moderate to Severe [8.4%]). For distress, two classes were identified (A Little Bit to Somewhat [83.9%] and Somewhat to Quite a Bit [16.1%]). For the joint LPA, two classes were identified (Lower Severity and Distress [79.9%] and Higher Severity and Distress [20.1%]). While distinct risk factors were associated with each of the LPAs, across the three LPAs, the common risk factors associated with membership in the worse class included: a past or current history of smoking, poorer functional status, and higher comorbidity burden. In addition, these patients had a higher symptom burden and higher levels of cancer-specific stress. CONCLUSIONS: Clinicians can use the information provided in this study to identify high-risk patients and develop individualized interventions.

Polycystic ovarian syndrome is the most common endocrine disorder that affects women. The focus on inflammatory PCOS will be the basis of understanding how hormonal imbalances are due to inflammatory diets, stress, and environmental factors that impact symptom severity. The objective of this paper was to provide a systematic review that would determine if symptom severity was associated with psychological stress on polycystic ovarian syndrome (PCOS). It is important to note that PCOS does not have a cure but symptom severity may only be treated, this is due to the cause being unknown and PCOS being used as an umbrella term for issues related to the ovaries and reproductive cycle. As a result, the most commonly suggested findings were to improve diet, improve exercise habits, and seek psychological help if feeling distressed by the symptoms of PCOS.

AbstractBackgroundAimsMethodsResultsConclusionsLimited evidence exists regarding how sex differences in mental health are changing over time, especially in the context of recent health and economic adversities.To examine the temporal shifts in mental health issues among males and females, and explore the influence of education and loneliness on these trends.Data were utilized from the 2020 to 2023 Monitor study, a repeated cross-sectional survey of adults 18 years and older in Ontario, Canada. The study employed a Qualtrics-based web panel survey (n = 5,317). Mental health was assessed using Kessler-6 questionnaire, and analyses were performed using Generalized Linear Model (GLM) with gamma distribution.The results showed that there was a significant three-way interaction effect between sex, time and education with psychological distress (p = 0.014), suggesting that psychological distress increased between 2020 and 2023 among males who had less than college education. However, it remained stable among males with college/university degrees and females overall. Interaction between sex and feeling lonely on psychological distress was also evident (p = 0.004).Mental health issues remained a significant public health challenge among adults, especially psychological distress increasing among males with less than a college education. This underscores the importance of targeted interventions addressing males’ mental health. [ABSTRACT FROM AUTHOR]

Psychedelic use has been increasingly accepted socially and legally. However, there is a gap in understanding how religion can influence the relationship between psychedelics and mental health. This study aims to explore this relationship by examining the impact of lifetime classic psychedelic use (LCPU), religious attendance, and religious salience on monthly psychological distress, using the K6 scale. The data for this project is sourced from the National Survey of Drug Use and Health (NSDUH) from 2008 to 2019, with a sample size of 458,372. The analysis utilizes several Ordinary Least Square regression models conducted in Stata 17. The results indicate that both religion and psychedelic use are associated with lower levels of psychological distress. While increased religious salience is linked to reduced distress, this effect is weakened by psychedelic use, as higher salience is associated with higher levels of distress among individuals who have used psychedelics. However, a three-way interaction analysis reveals that individuals with high religious salience and attendance experience the lowest levels of distress. [ABSTRACT FROM AUTHOR]

The commentators of this book symposium have written insightful reflections on the philosophical, theoretical, and ethical implications that arise from my work on the moral psychology of perpetrators and their emotional reactions. In this reply, I have organized my response in three thematic blocks. I begin with a discussion of my use of normative language raised by Kim Wagner, then consider the question of motivation in emotions discussed by Jessica Sutherland, Marco Viola, and Juan Loaiza and Diana Rojas-Velásquez, and conclude by discussing some perspectives on how a contextual view of emotions can be expanded to other domains. [ABSTRACT FROM AUTHOR]

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: Parallel process modeling (PPM) can be used to analyze co-occurring relationships between health and psychological variables over time. A demonstration is provided using data obtained from the British Household Panel Survey (years 2005, 2006, 2007, and 2008), examining predictors of ongoing changes in their distress and life satisfaction of a subsample from the survey. Research Method: In the 2005 survey, data were available from 7,970 participants based on the following demographic variables: gender, age, ever registered as disabled, and ever experienced any strokes (before or at 2005). Time-varying variables included distress and life satisfaction collected yearly from 2005 to 2008. Time-invariant variables included age (65 or older), gender, disability condition, and stroke survivor status. Results: Steps of fitting the PPM are presented. Four distinct distress trajectory groups—chronic, recovery, delayed, and resilient—were identified from the PPM estimates. Resilient and recovery groups showed a positive trend in life satisfaction. The delayed distress and chronic groups had a slight decrease in satisfaction. The time-invariant covariates only significantly predicted baseline levels of distress and satisfaction (i.e., their intercepts). Conclusions: PPM is a relatively simple and powerful tool for simultaneously studying relations between multiple processes. A step-by-step approach on decomposing the significant predictive relation from the change of distress to the change of satisfaction is presented. Properly decomposing any significant growth factor regressed on another growth factor is necessary to fully comprehend the intricate relationships within the results. Practical implications and additional methodological information about fitting PPM are discussed. Impact and Implications: Parallel process modeling (PPM) can be used to analyze several time-varying variables over time and model (predict) their co-occurring relationships from one process to another. Rehabilitation psychology research often encounters clinical, methodological, and theoretical complications (e.g., expected relationships with multiple time-varying variables, missing data, varying measurement occasions) that may be circumvented with PPM, as illustrated in this article. We emphasize the importance of properly decomposing the predictive relation between processes (e.g., the growth factor of one process significantly regressed on the growth factors of another process) and offer a step-by-step demonstration. [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]

Present-day college students are particularly impacted by the disconcerting effects of Covid-19 because of their vulnerability towards mental health struggles. The current study identified coping strategies used by students in the United States and how those strategies are associated with trauma-related distress. Results showed acceptance, emotional processing, and social support were the most commonly used coping strategies. Furthermore, avoidance coping related to higher distress than more helpful approaches (e.g., humor). Demographic findings revealed that Black students used more religious coping than did White and Asian students. Additionally, older and upper-year students used substances to cope more than did other students, including those with higher grade point averages. Our discussion focuses on how the findings of the present study can be used to enhance student support, resiliency, academic performance, and retention. [ABSTRACT FROM AUTHOR]

AbstractPurposeMethodsResultsConclusion\nIMPLICATIONS FOR REHABILITATIONRecovering from compensable injuries can be influenced by a variety of factors including the claimant’s experience of distress during the claims process. In order to develop cross-scheme, nation-wide strategies to improve claimants’ interactions with the compensation system, reduce claimant distress, and improve claimant outcomes, it is important to understand sources of claims-related distress from the perspective of both claimants and clinicians.An exploratory qualitative design was undertaken using semi-structured interviews with 13 claimants and 26 clinicians from four injury compensation schemes in five Australian states. A collaborative and reflexive thematic analysis was undertaken with an inductive approach to coding, and themes were constructed for claimants and clinicians across compensation schemes.Claimants and clinicians interviews revealed four main sources of distress, including (1) complexity and delays in administrative processes, (2) interruptions to recovery caused by treatment delays, (3) non-individualised approaches to care, and (4) a lack of support for navigating the claims process.Sources of claims-related distress identified by claimants and clinicians in the present study point to the urgent need for nationwide systems level changes to reduce claimant distress in the pursuit of better claimant outcomes.People who have a compensable insurance claim experience often experience interactions with the insurer and claims process as stressful.Providing information about the claims process to people with a compensable injury may help to reduce claim-related distress during recovery.Finding opportunities to provide social support and reassurance to people with a compensable injury may help them feel supported and reduce distress.Reducing distress for people who are recovering from a compensable injury may lead to better recovery outcomes.People who have a compensable insurance claim experience often experience interactions with the insurer and claims process as stressful.Providing information about the claims process to people with a compensable injury may help to reduce claim-related distress during recovery.Finding opportunities to provide social support and reassurance to people with a compensable injury may help them feel supported and reduce distress.Reducing distress for people who are recovering from a compensable injury may lead to better recovery outcomes. [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]

The diagnostic of sexual desire disorders is based on not only physiological and psychological symptoms but also on the extent of distress about these symptoms. Using data from a 2022 national survey of 3,000 respondents in Austria, this paper explores the range of relational distress individuals experience about their level of sexual desire. Participants were asked, ‘Have you ever been ostracised or ridiculed in your life for feeling too much (not enough) sexual desire? If yes, in what way?’ Gender and sexual minorities were more likely than cisgender and heterosexual participants to report negative reactions to their level of desire. The paper presents the results of a thematic analysis of the 341 written answers to the latter question. The analysis identified three themes: a) harassment, such as mocking, bullying, or public humiliation; b) the pathologization of desire as a sexual disorder; and c) negative social classification with respect to gender, age, or sexual orientation. By investigating different types of negative social reactions that individuals experience with respect to their level of sexual desire, the paper critically questions an individualised notion of sexual distress that has often been the basis for biomedical and psychological interventions by highlighting social factors that produce distress in the first place. [ABSTRACT FROM AUTHOR]

Tertiary education students experience higher levels of distress than the general public and their age-matched peers. Preventive health programs targeting tertiary education students are needed to combat high levels of distress in this population. This article investigates strengths-based theories of resilience which state that improvements in coping with stress also improve resilience. It utilized hierarchical regression to determine the amount of variance in mental health and resilience outcomes associated with the stress management resources, namely paying attention to the present moment (mindfulness) and engaging in personally meaningful activities (engagement), in a sample of 1,072 Australian tertiary education students. The results found that mindfulness and engagement are negatively associated with symptoms of depression and anxiety and positively associated with psychological well-being and resilience in tertiary education students. We also found that the amount of variance in mental health outcomes associated with engagement and mindfulness is additive. When a second stress management resource was added to the modeling, the amount of variance in the measured mental health outcomes explained by the coping resources increased. These findings help to provide a conceptual framework that can be used to design resilience training programs in tertiary education students to address the high levels of mental health disorder in this population. [ABSTRACT FROM AUTHOR]

Aims Methods Results Conclusions Diabetes distress (DD) refers to the emotional and behavioural challenges associated with managing this demanding chronic disease over time. DD is alarmingly common and it has a significant impact on self‐management behaviours and clinical outcomes. Thus, there is growing recognition that DD is a pressing problem that deserves careful attention in clinical care. Translating the application of validated DD assessment and intervention protocols from the research to the clinical setting, however, presents challenges that require a reconsideration of some common assumptions about what DD is, how prevalent it is, how it presents itself clinically, how it might best be assessed and by whom.We employed data from six large‐scale studies using five common DD measures. Using these data, we review and challenge several common assumptions about DD.These data suggest that, because of its relative ubiquity, DD should not be viewed as a ‘co‐morbidity’ or ‘complication’ of diabetes and it should not be seen as a mental health/illness ‘condition’. Furthermore, we argue that DD assessment should: (1) be accepted as a standard part of comprehensive diabetes care, (2) occur regularly using broad rather than brief screening measures and (3) be addressed directly by diabetes clinicians, rather than exclusively by behavioural specialists.The results form the basis of a series of suggestions to enhance the translation, adoption and implementation of DD knowledge derived from the research setting directly into the real world of clinical care. [ABSTRACT FROM AUTHOR]

The purpose of this study was to identify the correlates of depressive symptoms and the prevalence of depression, distress, and demoralization among patients with cancer in Taiwan in relation to their sociodemographics. A cross-sectional study design with convenience sampling was used to recruit 191 consecutive patients with cancer from the Cancer Center of a teaching hospital in northern Taiwan. Multiple linear regression was applied to analyze the determinants of depressive symptoms. The prevalence rates of depression (including suspected cases), distress, and demoralization were 17.8%, 36.1%, and 32.5%, respectively. The regression model explained 42.2% of the total variance, with significant predictors including marital status, life dependence, comorbidity, demoralization, and distress. The results demonstrated that higher levels of distress and demoralization were associated with more depressive symptoms. Demoralization and distress played vital roles in moderating depressive symptoms among patients with cancer. Nursing interventions should integrate appropriate mental health services, such as alleviating distress and demoralization, to prevent the occurrence of depression in patients with cancer. [ABSTRACT FROM AUTHOR]

Social interactions that are simultaneously characterized by positive and negative aspects—i.e., ambivalent relationships—have been found to be related to distress and poor mental health. As the university setting is also characterized by several social interactions, this study aimed to investigate for the first time to what extent objective and subjective ambivalence towards lecturers or instructors are linked to university students' distress levels and mental health indicators. A notable relationship of ambivalence with the outcomes was found in 1105 students from Germany. The association with psychological distress was more pronounced for objective than for subjective ambivalence (adjusted betas = 0.342 vs. 0.261, p-values < 0.001), while both also had an independent association. The association with mental health was comparable for both types (adjusted beta = −0.206 vs. −0.191, p-values < 0.001). For paradoxical emotions, the relationship with objective ambivalence was stronger, and only this remained significant in the mutually adjusted model (adjusted beta = 0.376, p-value < 0.001). This study provided evidence of a previously unconsidered stressor at the university—ambivalence towards lecturers—associated with negative health effects among students. Future studies are needed to establish this connection and to create the basis for preventative measures. [ABSTRACT FROM AUTHOR]

In the early Buddhist discourses, distressing experiences like fear and disgust are evaluated in contradictory modes. These upsetting emotions are considered both a detriment and an advantage for those seeking liberation from suffering. This ambivalence is reflective of the classical Buddhist conception of distress. The earliest scholastic Buddhist texts (i.e., Abhidharma sources) have sought to resolve the ambivalence surrounding this conception. The Abhidharma texts thus explain precisely how, when, where and for whom distress can prove favorable. By tracing this intellectual endeavor, I examine in this article the systematic and philosophical treatments of distress (saṃvega) in early Buddhist scholasticism. I outline the reasons for considering the experience of distress to be beneficial, unveiling the religious framework within which distress is rendered positive and even essential. My central claim is that early Abhidharma sources conceive of distress as a potential source of energy that facilitates one's progress on the religious path and determines how rapidly one can understand the truth. [ABSTRACT FROM AUTHOR]

Objective: Biopsychosocial distress is a common yet often underestimated complication in cancer care. We sought to translate and evaluate the psychometric properties of SupportScreen distress assessment tool in Brazil. Methods: A cancer cohort study was conducted at a public hospital in Brazil. The SupportScreen tool underwent transcultural translation into Portuguese. Eligible patients completed the SupportScreen, Distress Thermometer (DT), Hospital Anxiety and Depression Scale (HADS), and Functional Assessment of Cancer Therapy‐General version (FACT‐G). Statistical analyses included confirmatory and exploratory factor analyses (CFA and EFA), comparisons with established distress tools, and assessments of associations with patients' characteristics. Results: A total of 302 patients were assessed (M:F 35.4%:64.6%; median age: 55). Most patients were diagnosed with breast (29.1%) and gastrointestinal cancer (20.5%), at advanced disease stage (78.8%). CFA identified optimal models for emotional and physical distress; EFA revealed two factors for the logistics of medical care: practical and medical system distress. The concurrent validity of subscales demonstrated significant correlations between distress domains. Sensitivity analyses indicated good performance of emotional and physical domains in identifying distress compared to gold standard criteria. Female patients were more likely to report high emotional distress, while younger age and late disease stage were associated with higher physical distress. Additionally, late disease stage was linked to higher practical distress. Conclusion: Emotional and physical domains demonstrated validity and reliability, aligning with validated measures. Logistics of medical care distress revealed practical and medical system dimensions, expanding understanding of patient challenges. The SupportScreen tool exhibited concurrent validity and sensitivity in identifying distress. [ABSTRACT FROM AUTHOR]

Introduction: Medical students have been known to face numerous mental health issues at disproportionately high rates. Of pertinence, medical students have been shown to have high rates of suicidal thoughts and behavior. However, little is known about the risks and warning signs for death by suicide in this group. We therefore conducted a systematic review regarding the factors associated with medical student suicide mortality. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted searches in six different databases. Studies with stratified data on at least one suicide death by a medical student were eligible for inclusion. Results: Searches produced a total of 1744 articles, and of those, 13 articles were eligible for inclusion. There was a pooled total of 362 suicide deaths of medical students across five different countries. 67.6% of deaths occurred among male students, primarily in their early twenties. Students in their later years of medical school were shown to be more likely to die by suicide, as were those with a history of psychiatric issues such as depression. Motivations for suicide were academic stress/failure, harassment/bullying, and relationship issues. Warning signs for suicide among medical students were recent changes in mood/behavior and leaving a suicide note. Discussion: Numerous risks and warning signs of suicide have been described in our review. Medical schools may have an important role in lowering suicide deaths by medical students; impactful change can occur through better support, changes in curriculum, and appropriate data collection. HIGHLIGHTS: Numerous modifiable risk factors have been linked to suicide in medical students Warning signs include recent changes in mood/behavior, and leaving a suicide note Medical schools need proactive, multi-level approaches to reduce medical student suicide [ABSTRACT FROM AUTHOR]

The main aim of this study was to investigate adolescents' eustress–distress and mindfulness by examining mental toughness (MT) using network and mediator analyses. The study included 414 adolescents. The results showed that MT was positively related to eustress and mindfulness, but distress was negatively related to MT. Based on the network analysis findings, we tested mindfulness' mediating role in the relationship between eustress–distress and MT. The findings showed that mindfulness played a significant mediating role. However, the mediating role of mindfulness was negative for the relationship between distress and toughness and positive for eustress. These findings advance eustress, distress, and mindfulness as mechanisms for understanding the effects of MT. Considering current knowledge of MT, eustress, distress, and mindfulness, the results are discussed. [ABSTRACT FROM AUTHOR]

Research has evidenced that purpose in life helps to minimise the strains of providing informal care to a significant other, but little is known about whether this psychological resource influences the paths from stressors to the health outcomes of family caregiving and through which mechanisms it can exert this protective effect. This study aimed to explore the moderating role of purpose in life on the (mediated through adaptive coping) relationship between caregiver burden and psychological distress in haemodialysis caregivers. A cross‐sectional study was conducted with a convenience sample of family caregivers (n = 173; M = 55.9, SD = 15.6 years old) of adults undergoing haemodialysis. A moderated‐mediation model was computed to explore the interaction effects of purpose in life on the path between burden and distress, having adaptive coping behaviours as parallel mediators. Results showed that purpose in life had a buffering effect on the mediated (through acceptance coping) relationship between burden and distress (index of partial moderated‐mediation: bsimple = −0.029, 95% bootstrap confidence interval (CI) [‐0.070, −0.002]), and that this conditional effect was lowest at high levels of the moderator (at +1SD: bsimple = 0.038, SE = 0.026, 95% bootstrap CI [0.001, 0.098]). Use of emotional support (F(1,159) = 4.395, p = 0.038) and positive reframing (F(1,159) = 5.648, p = 0.019) also mediated this path. This study expands knowledge about the modifiable internal resources through which purpose in life can help promote psychosocial adjustment to the haemodialysis caregiving process. Mental health promotion initiatives aimed at this population need to consider combining different intervention approaches to foster purpose in life and train adaptive (and flexible) coping skills. [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]

Despite a growing literature, experiments directly related to attachment are still needed. We explored brain processes involved in two aspects of attachment, distress and comfort. Seventy-eight healthy adult males with different attachment styles (secure, avoidant, and anxious) viewed distress, comfort, complicity-joy and neutral images (picture database BAPS-Adult) in an fMRI block design. ROIs from the modules described in the functional Neuro-Anatomical Model of Attachment (Long et al. 2020) were studied. Secure participants used more co- and self-regulation strategies and exhibited a higher activation of the reward network in distress and comfort viewing, than insecure participants. Avoidant participants showed the lower brain activations. Their approach and reward modules were the least activated in distress and comfort. Anxious participants presented both higher activations of the approach and aversion modules during complicity-joy. In addition, comfort and complicity-joy were processed differently according to attachment styles and should be differentiated among positive stimuli to disentangle attachment processes. [ABSTRACT FROM AUTHOR]

Peer-delivered training of criminal offenders for aggression control and distress management was implemented for the first time in Correction Facility in Niš, Serbia. The aim of the manuscript is to present the method of the peer-delivered training and to evaluate the change in the levels of aggression and distress reaction of the participants after completing the program. In the first phase, prison administration chose offenders who completed training for the peer-workers, supervised by engaged professionals. In the second phase, those six convicts trained the sample of 106 fellow prisoners, randomly assigned to the program, through 12 workshops in order to learn and recognize their own dysfunctional reactions and to adapt social desirable behaviour. An independent evaluator compared pre to post-training differences in levels of aggression and distress also presence of psychopathic traits, and socio-demographic characteristics of the subjects, using Buss & Perry Aggression Scale, Psychopathic Personality Traits Scale DS-14 Questionnaire and Socio-demographic Questionnaire. Results indicate increased levels of aggression and decreased levels of distress after the training. Prisoners with longer sentences had increased levels of anger, physical, verbal aggression, psychopathic traits and distress compared to subgroup with sentences shorter than 5 years. Program is beneficial for prisoners with sentences less than 5 years and with high education level. [ABSTRACT FROM AUTHOR]

Objective: The aims of this study were to investigate trajectories of anxiety and depression symptoms among gynaecological cancer (GC) patients having curative-intent radiotherapy (RT) treatment and identify which patient characteristics predict anxiety and depression trajectories. Methods and measures: Latent profile analysis (LPA) was used to identify unique trajectories of anxiety and depression symptoms, spanning prior to the start of RT until 12-month post-RT, among 151 GC patients in the PeNTAGOn randomized control trial. Demographic and clinical characteristics were assessed at baseline, and anxiety and depression symptoms were assessed five times over 12 months. A bias-adjusted 3-step maximum likelihood approach was used to identify demographic and clinical predictors of trajectory profiles. Results: Four latent profiles each were identified for anxiety and depression trajectories. Most patients had minimal to mild levels of anxiety or depression that remained steady or declined over 12 months following treatment. A minority of patients were in profiles that exhibited clinically significant distress; either 'High fluctuating' anxiety or 'Mild-moderate fluctuating' depression. Anxiety and depression profiles were predicted by clinical and demographic factors, such as age, living arrangements, RT type, cancer stage, physical symptom distress and use of support services. Conclusions: Psychological care of patients in the higher distress trajectories is paramount and, importantly, they could be identified prior to treatment based on the factors identified. Review for at least a month post-RT is warranted. [ABSTRACT FROM AUTHOR]

This study examined mental adjustment to breast cancer, that is, coping strategies. Participants were 130 women undergoing breast cancer treatment in two medical settings in Accra, Ghana. They completed questionnaires assessing mental adjustment to cancer, psychological distress (anxiety and depression), negative religious coping, body change stress, and illness perceptions. Data were analyzed using hierarchical linear regression. Results showed that patients who reported higher depression were more likely to engage in anxious preoccupation (worry and thinking about breast cancer). Higher depression was associated with a greater sense of helplessness/hopelessness. Moreover, patients higher in negative religious coping were more likely to experience a greater sense of helplessness/hopelessness. Illness perception facets of personal control and emotional response were positively associated with fatalism and anxious preoccupation, respectively. The results suggest that screening breast cancer patients for psychological morbidity could help identify patients with increased risks for maladaptive adjustment to the disease. [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 describe the behaviors of infants who were born preterm, their parents, and clinicians during 2-, 6-, 12-, and 18-month vaccinations. Vaccination sessions were video recorded for 3-5 minutes. The proportion of 5-second intervals in which distress and soothing behavior by infants, parents, and clinicians was coded using the Measure of Adult and Infant Soothing and Distress. Coding consisted of three phases: baseline/anticipatory (60 seconds prior to first needle), procedure (first needle to removal of final needle), and recovery (up to 180 seconds after removal of final needle). A total of 64 infants were included. Distress behavior by infants during the baseline phase ranged from 13% (12-month vaccinations) to 29% (2-month). There was limited anticipatory soothing behavior from parents (10% [12-month] to 50% [2-month]) and clinicians (6% [12-month] to 17% [2-month]). Distress behavior in infants during the procedure ranged from 43% (18-month) to 96% (2-month). There was limited soothing behavior during the procedure from parents (10% [12-month] to 81% [12-month]) and clinicians (13% [12-month] to 71% [2-month]). Few infants received additional pain-reducing interventions, including skin-to-skin contact, 24% oral sucrose, and topical anesthetic. Despite infant distress, there was limited anticipatory behavior from parents and clinicians. Two-month-old infants displayed the most distress across all time points yet received the least amount of treatment and proximal parent and clinician behavior. Additional implementation efforts are required to increase awareness and practice uptake among parents and clinicians to ensure infants receive equitable and effective pain management. [ABSTRACT FROM AUTHOR]

Objective: This paper reports on the initial outcomes of a new mHealth intervention to reduce diabetes distress (DD) in families of school-age children living with type 1 diabetes (T1D) entitled, 'Remedy to Diabetes Distress' (R2D2). Methods: We randomized 34 families (mean child age = 10 ± 1.4 years; 53% male, 85% White, mean HbA1c = 7.24 ± 0.71%) to one of three delivery arms differing only by number of telehealth visits over a 10-week period: zero visits = self-guided (SG), three visits = enhanced self-guided (ESG), or eight visits = video visits (VV). All families had 24 × 7 access to digital treatment materials for 10 weeks. We examined the feasibility and acceptability of R2D2. We used the Problem Areas in Diabetes-Child (PPAIDC and PAIDC, parent and child, respectively) to examine treatment effects by time and delivery arm. We performed sensitivity analyses to characterize families who responded to R2D2. Results: It was feasible for families to access R2D2 mHealth content independently, though attendance at telehealth visits was variable. Parents and children reported high satisfaction scores. There were significant pre-post reductions in PPAIDC (p = 0.026) and PAIDC (p = 0.026) scores but no differences by delivery arm. There were no differences in child age, sex, race, or pre-treatment HbA1c for responders versus non-responders, though families who responded reported higher PPAID-C scores pre-treatment (p = 0.01) and tended to report shorter diabetes duration (p = 0.08). Conclusions: Initial results support the acceptability and treatment effects of R2D2 regardless of the frequency of adjunctive virtual visits. Characterizing responders may help to identify families who could benefit from R2D2 in the future. [ABSTRACT FROM AUTHOR]

Genome sequencing (GS) has the potential to reduce the "diagnostic odyssey" that many parents of children with rare undiagnosed conditions experience. While much research has considered the impact of receiving a diagnostic result, research has rarely focused solely on the impact of receiving a "no primary finding" (NPF) result. This study aimed to investigate the experience of parents of children with rare and undiagnosed conditions following an NPF result from GS. Nine parents whose child had an NPF result from GS were recruited through the social media platform of the charity SWAN (Syndromes Without A Name) UK. Semi‐structured telephone interviews were conducted, transcribed verbatim, and analyzed using grounded theory. Analysis led to the emergence of two main themes. The first theme "Striving to Solve the Unsolved Puzzle" concerned the experience of striving to end the "diagnostic odyssey." The second theme "Navigating Hope, Lost then Found" plots the trajectory of hope raised by the promise of a new technology, dashed by the NPF, and the eventual return of small and distant hope for the future. Taken together, these themes allowed for a proposed theory: "The Disequilibrium of Hope," which highlights the dynamic and modifiable experience of hope participants experience in their GS journey. These results suggest GS can be an emotional rollercoaster for parents. While hope plays an important role in coping with the day‐to‐day life of living with a rare disease, careful management of expectations from GS is important during pre‐test counseling, and continued follow‐up and support are needed beyond result disclosure. An understanding of the disappointment and distress caused by an NPF result is valuable for healthcare professionals in this field to ensure counseling can be tailored. Further research should consider how to support parents after an NPF result. [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]

Background: Prior pandemic research has focused on physicians and nurses who provide direct patient care. Literature on the experiences of nonnurse/physician clinicians and nonclinical health care professionals is sparse. Methods: An observational, cross-sectional study was conducted over threetime points to examine the impact of COVID-19 on clinical and nonclinical healthcare professionals (n = 464). Findings: There were no significant differences in distress across survey waves, except for anger (p =.046). No significant differences in distress scores were found between job types. Multiple linear regression results varied. Both the threat and interrupted plans scores were significant predictors of distress. Resources available to healthcare providers (HCPs) were underutilized in all three waves. Conclusions: Healthcare professionals' distress increases with exposure. Integrating self-care resources for staff may mitigate the impact and maintain a healthy work environment. Application to practice: Occupational health providers should incorporate these findings when developing opportunities to address the needs of health care professionals in the workplace. [ABSTRACT FROM AUTHOR]

BackgroundMethodsResultsDiscussionNon-clinical voice-hearers (NCVHs) have been the subject of a growing body of psychological research, a primary aim of which is the development of new therapeutic techniques to support those who struggle with voice-hearing. However, relatively little research has examined non-clinical voice-hearing experiences beyond their relationship with clinical voice-hearing.The present study consists of a qualitative re-analysis of 17 semi-structured interviews conducted as part of an NCVH neuroimaging study which included items from the Psychotic Symptoms Rating Scale (PSYRATS) and Positive and Negative Syndrome Scale (PANSS). Results were generated using thematic analysis.Analysis of interview responses showed that participants often experience negative voice content and negative emotion, but have frameworks which normalize a range of voice-hearing experiences. Participants also reported experiences which are not captured by standard clinical scales, as well as reporting comfort with uncertainty and ambiguity surrounding voices.These results indicate that much of the experience of NCVHs may be missed by clinical measures and concepts, suggesting a need to approach them in ways that go beyond typical understandings of the psychosis continuum. [ABSTRACT FROM AUTHOR]

The present study examined the predictive role of social media use on adults’ psychological distress through the mediating role of one of the digital stress factors, i.e. information overload. A sample of 295 participants aged 18–41 (M age = 21.15, SD = 3.67, 82% females) filled out self-reported questionnaires measuring social media integration, anxiety, depression, and stress symptoms, as well as cyber-based and place-based information overload. Results suggested significant associations between social media integration and emotional connection, cyber-based information overload, and psychological distress symptoms. Cyber-based information overload was positively associated with place-based information overload and psychological distress symptoms. SEM analyses suggested a partial positive and statistically significant mediation between social integration and emotional connection and psychological distress by information overload: high scores on social integration and emotional connection were marginally positively associated with high scores on information overload and with high scores on psychological distress as direct effects. However, on the second mediation path, high scores on information overload were positively associated with high scores on psychological distress, but no significant total effect was observed. We discuss the present findings considering their implications for digital stress awareness and practical strategies for preventing information overload-related negative outcomes. [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]

Introduction: Chronic non-communicable diseases (NCDs) are the leading cause of mortality globally and in Thailand. They affect the physical, psychosocial, and spiritual dimensions. Spiritual distress impacts the spiritual health of patients with chronic illnesses. Materials and methods: This study surveyed spiritual distress among patients with chronic NCDs. The sample comprised 400 patients with chronic NCDs from 8 provinces of Thailand, selected using a multistage sampling technique. A Spiritual Distress Scale for Thai Patients with Chronic Non-Communicable Diseases (SDS-Thai-NCDs) was used for data collection. Descriptive statistics, including frequency, percentage, mean, and standard deviation, were applied for data analysis. Results: Research findings revealed that the overall spiritual distress among participants was at a mild level (72.65±30.21). Moreover, individual dimensions of spiritual distress were at a mild level, including: 1) Physical expression (9.16±3.54) 2) Loss of relationships with oneself and others (18.36±8.56) 3) Loss of relationship with nature and a higher power (8.49±4.10) 4) Loss of self-esteem, meaning, and purpose of life (21.96±10.16), and 5) Loss of hope and inner strength (14.68±7.63). Conclusion: The overall and individual dimensions of spiritual distress among participants were at a mild level. This finding can be useful in providing spiritual care for patients with NCDs and in further studies on spiritual distress in other groups and research areas. [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]

There has been a lack of research on the Arab American population despite a noted increase in divorce and marital discord among Arabs and Arab American couples. Moreover, knowledge is limited on ways to enhance existing couple-based treatments to become more sensitive toward the unique intersection that Arab American couples are faced with. One consideration when improving treatment is to examine and better understand the negative attributions Arab American spouses make about each other's behavior, as they can be detrimental to the satisfaction of the relationship. In this study, a sample of 142 married Arab Americans were asked to complete the Relationship Attribution Measure, Patient Health Questionnaire, and the Dyadic Adjustment Scale (DAS). A large portion of the participants fell within the distressed range of the DAS. Attributions, especially motivations and blame, were significant predictors of relationship satisfaction. Both causal and responsibility attributions were associated with depression, while only responsibility attributions were associated with anxiety. Results are discussed in terms of how future research and couple-based interventions can integrate cultural considerations within this group. [ABSTRACT FROM AUTHOR]

In neuropsychology and clinical psychology, the efficacy of virtual reality (VR) experiences for knowledge acquisition and the potential for modifying conduct are well documented. Consequently, the scope of VR experiences for educational purposes has expanded in the health field in recent years. In this study, we sought to assess the effectiveness of ViveDe in a psychoeducational caregiver program. ViveDe is a VR application that presents users with possible daily life situations from the perspective of individuals with dementia. These situations can be experienced in immersive mode through 360° video. This research aimed to ascertain the associations between the sense of presence that can be achieved in VR and some users' psychological characteristics, such as distress and empathetic disposition. The study involved 36 informal caregivers of individuals with Alzheimer's disease. These participants were assessed using scales of anxiety and depression, perceived stress, empathy, and emotional regulation. They were asked to participate in a six-session psychoeducation program conducted online on dementia topics, in addition to experiencing the ViveDe application. The immersive VR sessions enabled the caregivers to directly experience the symptoms of dementia (e.g., spatial disorientation, agnosia, difficulty in problem-solving, and anomia) in everyday and social settings. The results indicated that although the experience in ViveDe (evaluated using the XRPS scale and five questions about emotional attunement) showed efficacy in producing a sense of first-person participation in the symptoms of dementia, further research is needed to confirm this. The structural equation model provided evidence that the characteristics of individuals who enjoy the VR experience play a determining role in the perceived sense of presence, which in turn affects the efficacy of the VR experience as a psychoeducational tool. Further research will be conducted to ascertain the potential role of these elements in conveying change in the caregivers of people with dementia. This will help us study the long-term effectiveness of a large-scale psychoeducation program in VR. [ABSTRACT FROM AUTHOR]

Background: Foot complications in diabetes are common and destructive, resulting in substantial healthcare costs and high rates of morbidity. Coastal areas have a significantly higher burden of disease. People with diabetes experience disproportionately high rates of psychological health issues, including anxiety, depression and diabetes distress. These can affect self‐management and concordance with preventive measures and treatments of foot complications, negatively impacting on outcomes. Access to psychological health services is variable across the United Kingdom and there is a paucity of high‐quality evidence for the effectiveness of treatments for diabetes distress. This study aimed to explore experiences of psychosocial burden and perceptions and experiences of psychosocial support, among patients with diabetes and foot complications living in a coastal area. Methods: Patients were eligible to participate if they had experienced diabetes‐related foot complications (amputation, ulceration and/or Charcot neuroarthropathy) within the last 5 years and scored positive for diabetes distress on a validated screening tool (DDS2). Eligible patients completed cross‐sectional questionnaires describing symptoms of diabetes distress (DDS17), anxiety (GAD‐7) and depression (PHQ‐9) and to take part in a face‐to‐face, semi‐structured interview. Questionnaires were analysed using frequencies and interviews were analysed using reflexive thematic analysis. Results: A total of 183 patients completed the DDS2 screening questionnaire. Of these, 56 (30.6%) screened positive for diabetes distress. Twenty‐seven patients completed DDS17, GAD‐7 and PHQ‐9 questionnaires. Eleven (40.7%) participants indicated high levels of diabetes distress and four (14.8%) indicated moderate distress. Seventeen participants (age range 52–81 years; 12 men) took part in an interview. Four key themes were identified: impact of living with foot problems; emotional consequences of foot problems; experiences and perceptions of psychological support; and strategies to cope with the emotional impact of foot problems. Conclusion: Diabetes distress was prevalent among patients with diabetes‐related foot complications. Foot problems impacted on participants' daily activities, social lives and ability to work. Despite expressing feelings of ongoing fear, worry and depression relating to their foot problems, only one participant had accessed formal psychological support. Many participants relied on talking to podiatrists at routine appointments and described developing various strategies to cope. The psychosocial burden of living with foot complications in diabetes must not be overlooked by health professionals. Findings from this study can inform the design of future services and interventions. [ABSTRACT FROM AUTHOR]

Background In today’s world, alcoholism poses a significant global public health concern. Persistent alcohol use not only impacts the individual but also exerts effects on family members. The spouse of alcoholics often experiences significant trauma and stress in their domestic environment, leading to profound psychological problems in them. The spouse’s ability to cope efficiently seems to be affected by the psychological distress and consequently, their overall quality of life is compromised. Aim This study aimed to assess the psychological distress, quality of life and coping styles in alcoholic spouses. Methods This cross-sectional study was carried out at Rama Medical College, Hospital and Research Centre, Kanpur among the wives of patients fulfilling the alcohol-dependence criteria as per ICD-10 DCR guidelines. Patients attending the OPD of the psychiatry department were recruited serially till the required sample size was reached. The total sample consists of 50 participants. Socio-demographic information was obtained through a semi-structured questionnaire. Kessler Psychological Distress Scale, WHOQOL-BREF, and Brief COPE were administered to participants to assess psychological distress, quality of life and coping mechanisms. Results and Discussion According to the study, it was found that the majority of the participants had moderate levels of psychological distress, all 4 domains of quality of life were affected. It was observed that spouses predominantly leaned towards employing emotion-focused coping strategies, which encompassed seeking emotional support, acceptance, and turning to religion for solace. Conclusion Alcohol dependence syndrome not only affects individuals but also has a profound impact on their families. The spouse of individuals struggling with alcoholism may employ diverse coping mechanisms to mitigate the negative impact of their partner’s drinking habits. It's crucial to develop interventions focused on easing their distress and enhancing their mental well-being and overall quality of life. [ABSTRACT FROM AUTHOR]

Around 42% of individuals with cancer experience distress. Acceptance and commitment therapy (ACT) can reduce distress, but effects are small, and mechanisms unclear. This review aimed to identify associations between ACT processes and distress in cancer. Search terms included cancer, ACT processes, self-compassion, and distress. Six online databases and grey literature were searched until March 2022. Of 6555 papers screened, 108 studies were included with 17,195 participants. Five meta-analyses of 77 studies were conducted. Random effects meta-analyses of correlations revealed higher scores on flexible processes (acceptance, present moment awareness, self-compassion) were associated with lower distress (rpooled = -0.24, -0.39, -0.48, respectively); whilst higher scores on inflexible processes (experiential avoidance, cognitive fusion) were associated with higher distress (rpooled = 0.58, 0.57, respectively). Meta-analyses displayed moderate-to-high heterogeneity with most studies assessed as low risk of bias. Meta-regressions revealed no significant moderators (stage, time since diagnosis, gender and age). This review provides a theoretically aligned evidence base for associations between ACT processes and distress in cancer, supporting elements of ACT theory and providing targeted directions for intervention development. Due to limited evidence, future research should focus on self-as-context, values and committed action and conduct mediation analysis in controlled trials of ACT processes on distress in cancer. [ABSTRACT FROM AUTHOR]

Background: Psychological distress can cause burnout, which affects mental and physical well‐being. It is important to identify factors associated with psychological distress and physical discomfort and how nurses deal with these problems. Aim: The aim was to investigate distress, burnout and coping among community nurses (CN) and hospital nurses (HN). Approach and Methods: In this cross‐sectional study, 409 nurses completed three questionnaires: Perceived Stress Scale (PSS), Copenhagen Burnout Inventory (CBI) and Ways of Coping (WOC). Findings: Participants younger than 40 demonstrated significantly more distress and burnout than those older than 40 years. Participants who had moderate and high distress on the PSS were significantly more at risk for experiencing personal, work‐related and patient‐related burnout. A significant positive correlation was found between distress and behavioural escape‐avoidance, cognitive escape‐avoidance and distancing. Significant positive correlations were also seen between all the subscales of the CBI and behavioural escape‐avoidance, cognitive escape‐avoidance and distancing. Positive significant correlation was also obtained between staff resources and distress and personal‐related and work‐related burnout. Negative correlation was demonstrated between staff resources and patient‐related burnout. Participants with longer work experience were less likely to report moderate or high distress, and those who scored higher on personal burnout and behavioural escape‐avoidance were more likely to have moderate or high distress. Conclusion: The results of this study call for increased attention to the younger generation in the nursing profession. The results also validate the need to investigate further the correlation between distress, burnout and coping and how these issues might influence each other among nurses working in the community and hospitals. Findings should be taken with precaution, they do not describe in detail what underlying factors contribute to distress and discomfort found in this study, they do, however, indicate certain coping strategies nurses use to deal with distress and burnout. [ABSTRACT FROM AUTHOR]

The current research evaluates the Perfectionism Social Disconnection Model (PSDM) by considering the links between measures of trait perfectionism and perfectionistic self-presentation and measures of social support, loneliness, and distress in cross-sectional research. A particular focus is on perfectionism and levels of social support as assessed by the Social Provisions Scale. The current study also uniquely evaluates levels of perfectionism and perfectionistic self-presentation in undergraduate students, medical students, and law students. The results across samples provided evidence that loneliness mediates the link between interpersonal perfectionism and distress in keeping with the predictions of the PSDM. Correlational results found robust links between loneliness and low levels of social support. Moreover, socially prescribed perfectionism and perfectionistic self-presentation were associated negatively with social support, and this was especially evident in terms of the facet tapping the nondisclosure of imperfections. Group comparisons of perfectionism yielded few significant differences in accordance with expectations. Levels of perfectionism tended to be lower among medical students. However, the links between perfectionism and distress were clearly evident among undergraduates, medical students, and law students, thus attesting to the vulnerability of perfectionistic students in general. Overall, the results further confirm the relevance of perfectionism in distress among students and applicability of the PSDM in various types of students. [ABSTRACT FROM AUTHOR]

This study introduces an integrated approach to enhance county pavement management, emphasising operational efficiency in determining the Remaining Service Interval (RSI) for rigid and flexible pavements. It establishes a robust methodology for systematically processing raw county road data through dynamic segmentation and summarisation to create a structured pavement database. It also incorporates innovative approaches and input configurations in employing Artificial Neural Networks (ANNs) to predict current and future county pavement performance indicators, including International Roughness Index (IRI), rutting, transverse, and longitudinal cracks, even with limited data. Evaluation of the ANN models on independent county road databases exhibited high prediction accuracies (0.86 < R2 < 0.99), varying with specific performance indicators. The study results in an automation tool for expediting road performance estimation over multiple years. This tool seamlessly integrates the ANN models, empowering county engineers to make data-driven decisions and optimise resource allocation for effective pavement management, achieving significant cost savings. [ABSTRACT FROM AUTHOR]