Psychosocial adjustment in children with kidney disease

Objective: To examine family environment, levels of parentingstress, and child behavior problems in children with one ofthree kidney diseases compared to healthy children and to examinepredictors of psychological distress in the full sample. Method: Parents of children with steroid sensitive nephroticsyndrome, chronic renal insufficiency, or kidney transplant (n = 41) were compared to 34 healthy children of similar demographic characteristics. Results: Mean scores on family functioning, parenting stress,and child behavior were within normal limits. Family environment variables significantly predicted child behavior and parentingstress for parents of ill and healthy children. Qualitativeresponses provided insight into developmentally specific stressorsand intervention needs in the illness groups. Conclusions: These data indicate that long-term survivors ofkidney disease function similarly to demographically matchedpeers and that the family environment may buffer stress causedby illness. Specific concerns raised by parents in the kidneydisease groups indicate the need to appropriately assess andintervene with this understudied population.     

Psychological Adjustment of Mothers of Children and Adolescents with Sickle Cell Disease: The Role of Stress, Coping Methods, and Family Functioning

Assessed the psychological adjustment of 78 mothers of childrenand adolescents (7–17 years of age) with sickle cell disease.Support was provided for a transactional stress and coping modelin delineating the processes associated with maternal adjustment.In particular, poor maternal adjustment was associated withuse of palliative coping methods and high levels of stress relatedto daily hassles. Variables of the model accounted for 55% ofthe variance in maternal psychological distress.     

Problem Behaviors and Personality of Children and Adolescents With Prader-Willi Syndrome

Objective: Compare behavioral and emotional problems of childrenand adolescents with Prader-Willi Syndrome (PWS) and clientsconsulting mental health centers (MHC) and related behavioraland emotional problems to the children's personality in thePWS group. Methods: Participants were 39 children with PWS and 585 matchedMHC dlents. Child Behavior Checklist (CBCL) syndromes were relatedto the Big-Five personality factors measured with the CaliforniaChild Q-sort (CCQ). Results: Mean CBCL Total Problems scores were not differentfor the PWS and MHC groups, but differences were found for severalof the CBCL subscales. Patterns of correlations among CBCL scaleswere similar In both groups, although coefficients were generallyhigher in the PWS group, indicating higher comorbidity or co-absenceof CBCL syndromes in children and adolescents with PWS. Personalityprofiles were specific for Internalizing and Externalizing problemsof children and adolescents with PWS.     

Sleep, stress, neurocognitive profile and health-related quality of life in adolescents with idiopathic musculoskeletal pain

OBJECTIVES:

The aims of this study were to measure levels of sleep, stress, and depression, as well as health-related quality of life, and to assess the neurocognitive profiles in a sample of adolescents with idiopathic musculoskeletal pain.

METHODS:

Nineteen adolescents with idiopathic musculoskeletal pain and 20 age-matched healthy control subjects were evaluated regarding their levels of sleep and stress, as well as quality of life, and underwent neurocognitive testing.

RESULTS:

The sample groups consisted predominantly of females (84%), and the socioeconomic status did not differ between the two groups. In addition, the occurrence of depressive symptoms was similar between the two groups; specifically, 26% of the idiopathic musculoskeletal pain patients and 30% of the control subjects had scores indicative of depression. Teenagers in the group with idiopathic musculoskeletal pain reported poorer quality of life and sleep scores than those in the control group. Regarding stress, patients had worse scores than the control group; whereas 79% of the adolescents with idiopathic musculoskeletal pain met the criteria for a diagnosis of stress, only 35% of the adolescents in the control group met the criteria. In both groups, we observed scores that classified adolescents as being in the resistance phase (intermediate) and exhaustion phase (pathological) of distress. However, the idiopathic musculoskeletal pain group more frequently reported symptomatic complaints of physical and emotional distress. The neurocognitive assessment showed no significant impairments in either group.

CONCLUSION:

Adolescents with idiopathic musculoskeletal pain did not exhibit cognitive impairments. However, adolescents with idiopathic musculoskeletal pain did experience intermediate to advanced psychological distress and lower health-related quality of life, which may increase their risk of cognitive dysfunction in the future.     

Correlates of Psychological Distress Among Mothers of Children and Adolescents with Hemophilia and HIV Infection

Evaluated the correlates of mood state (psychological distress)in a multisite study of two groups: (a) mothers of HIV–positivechildren and adolescents with hemophilia (n=91), and (b) mothersof HIV –negative children and adolescents with hemophilia(n=92). Socioeconomic status, quality of family relationshipsupport, and frequency of negative life events accounted forsignificant variance in Total Mood Disturbance (psychologicaldistress) as measured by the Profile of Mood States in the overallsample. Severity of hemophilia was unrelated to distress. Asignificant interaction between HIV status and frequency ofstressful life events indicated that this variable related morestrongly to distress among mothers of HIV–infected childrenand adolescents with hemophilia than among mothers of HIV–negativechildren with hemophilia. Findings suggest that the presenceof HIV infection in their children and adolescents may hightenthe impact of negative life events on the psychological distressexperienced by these mothers.     

An Exploratory Analysis of Fear of Recurrence among African-American Breast Cancer Survivors

Background

Fear of recurrence (FOR) is a psychological concern that has been studied extensively in cancer survivors but has not been adequately examined in African-American breast cancer survivors.

Purpose

This exploratory study describes the extent and nature of FOR in African-American breast cancer survivors. FOR is examined in relation to socio-demographic characteristics, treatment-related characteristics, psychological distress, and quality of life (QOL).

Methods

Participants completed questionnaires assessing FOR, psychological distress, QOL, and demographic and treatment characteristics. Pearson r correlations, t tests, and ANOVAs were used to determine the association between FOR and demographic and treatment-related characteristics. Hierarchical multiple regression models were performed to investigate the degree to which FOR dimensions account for the variance in QOL and psychological distress.

Results

Fifty-one African-American breast cancer survivors participated in this study. The mean age of participants was 64.24 (SD?=?12.3). Overall fears as well as concerns about death and health were rated as low to moderate. Role worries and womanhood worries were very low. Inverse relationships were observed between age and FOR dimensions. FOR was positively correlated with measures of psychological distress and negatively correlated with QOL. FOR significantly accounted for a portion of the variance in QOL and distress after controlling for other variables.

Conclusions

This study suggests that African-American women in this sample demonstrated some degree of FOR. Results indicate that FOR among African-American breast cancer survivors decreases with age and time since diagnosis and co-occurs with psychological distress as well as diminished quality of life.     

青少年心理疾病与家庭养育方式的关系

在青少年的成长过程中 ,家庭的养育方式不当是青少年心理疾病发生的重要原因。临床实践和研究证明 ,青少年的人格、情绪特点、行为方式与其家庭养育方式密切相关 ,[3] 父母的受教育程度和行为方式直接影响着青少年的人格形成。国内以往的研究多数以健康人群为对象 ,考察心理健康与养育方式的关系[1- 3] ,发现家庭养育方式与心理健康有密切关系。本研究以临床确诊的心理障碍患者为对象 ,考察家庭养育方式对青少年心理健康的影响。1　对象和方法1.1　对象对烟台市心理康复医院收治的 4 0名心理障碍患者均为青少年 ,其中包括焦虑性神经症 12名 …     

Parental distress, family functioning, and social support in families with and without a child with neurofibromatosis 1

Objective To compare parental adjustment, social support, andfamily functioning between families of children with neurofibromatosis1 (NF1) and a group of demographically similar comparison families,and to examine the impact of disease severity. Methods Questionnaireswere completed at home by parents of 54 children with NF1 (54mothers and 42 fathers) and 51 comparison children (49 mothersand 32 fathers). Results Few differences between groups wereidentified for parental distress, social support, or familyenvironment. Greater neurological impairment in children withNF1 was associated with greater distress, more family conflict,less positive mealtime interactions, and less social supportfrom the perspectives of mothers. Conclusions Overall, parentsof children with NF1 appear similar to parents of comparisonchildren. Mothers who have children with NF1 characterized bygreater neurological impairment may be at risk for more difficulties.Future work exploring long-term adjustment for these mothersas well as interventions to ameliorate any potential difficultiesmay be appropriate.     

Self-medication among traumatized youth: structural equation modeling of pathways between trauma history, substance misuse, and psychological distress

In an effort to self-medicate psychological distress stemming from exposure to traumatic life events, at-risk youth may be likely to seek intoxication via substance use. Concomitantly, self-medication with psychoactive substances is theorized to confer risk of developing future psychiatric and substance use disorders. The present study employed structural equation modeling to examine self-medication among a sample of 723 youth in residential treatment for antisocial behavior via recursive and non-recursive relationships between trauma history, substance misuse, and psychological distress. Results supported study hypotheses that: (a) the effects of trauma history on psychological distress are partially mediated by substance misuse, and (b) exposure to traumatic life events drives a feedback loop between substance misuse and psychological distress. Findings from this large-scale survey of adolescents exhibiting behavioral dysfunction suggest that identification of self-medication processes among traumatized youth may be crucial for developing targeted prevention and treatment initiatives.     

Psychological distress in high-risk youth with asthma

OBJECTIVE: To examine the relationship between asthma and psychological distress among adolescents already at-risk for adjustment problems secondary to lower economic strata and educational or vocational failure. METHOD: Twenty-five high-risk adolescents with asthma and 25 high-risk controls without asthma 16 to 21 years old completed the Brief Symptom Inventory, the Beck Depression Inventory, and the Beck Anxiety Inventory. RESULTS: Adolescents with asthma had significantly higher scores on multiple measures of psychological distress. Specifically, adolescents with asthma evidenced higher levels of anxiety, depression, and global psychological distress than those without asthma. CONCLUSIONS: High-risk adolescents with asthma may be more likely to experience psychological distress than those without asthma. Our findings suggest that asthma constitutes an additional significant independent stressor or risk factor among adolescents who already are at high risk for multiple adjustment problems.     

Emotional Distress of the COVID-19 Cluster Infection on Health Care Workers Working at a National Hospital in Korea

BackgroundFrontline healthcare workers responding to coronavirus disease 2019 (COVID-19) inevitably face tremendous psychological burden. Thus, the present study aimed to identify the psychological impact and the factors contributing to the likely increase in emotional distress of healthcare workers.MethodsThe participants include a total of 99 healthcare workers at Bugok National Hospital. Psychometric scales were used to assess emotional distress (12-item General Health Questionnaire; GHQ-12), depression symptoms (Patient Health Questionnaire-9; PHQ-9), and post-traumatic stress disorder-related symptoms (Impact of Events Scale-Revised; IES-R). A supplementary questionnaire was administered to investigate the experience of healthcare workers exposed to COVID-19-infected patients. Based on the results of GHQ-12 survey, participants were categorized into two groups: distress and non-distress. All the assessed scores were compared between the two groups. A logistic regression model was constructed to identify factors associated with emotional distress.ResultsEmotional distress was reported by 45.3% (n = 45) of all participants. The emotionally distressed group was more likely to be female, manage close contacts, have higher scores on PHQ-9 and IES-R, feel increased professional risk, and report that proper infection control training was not provided. Female gender, managing close contacts, higher scores on PHQ-9, and a feeling that proper infection control training was not provided were associated with emotional distress in logistic regression.ConclusionFrontline healthcare workers face tremendous psychological burden during the COVID-19 pandemic. Therefore, appropriate psychological interventions should be provided to the HCWs engaged in the management of COVID-19-infected patients.     

Hay fever, asthma and number of older siblings — a twin study

Background It has been suggested that allergic sensitization is inversely related to the number of siblings in the family. Objectives To study whether a similar relation can be observed for hay fever and asthma among Finnish adolescents in a population with relatively low prevalence of atopic diseases. Methods A questionnaire mailed to a nationwide sample of 1849 families with 16-year- old twins assessing the cumulative incidence of doctor-diagnosed hay fever and asthma among the adolescents and the number of older siblings in the family by parental report. Results The cumulative incidence of hay fever was significantly lower among the adolescents with three or more older siblings (3.9%, 95% CI= 1.2–6.5%) compared with adolescents with fewer older siblings (12.7%, 95% CI=11.4–14.0%). There was no difference in the cumulative incidence of asthma among the adolescents according to the number of older siblings in the family. Conclusions Large number of older siblings appears to be protective against the development of hay fever.     

Longitudinal relations between trauma-related psychological distress and physical aggression among urban early adolescents

There is convincing evidence that trauma-related psychological distress and aggressive behavior are highly related among adolescents. The evidence is less clear regarding the direction of this relation. Objective: The purpose of this study was to examine reciprocal longitudinal relations between trauma-related distress and physical aggression. Method: A predominantly African American sample of early adolescents (N = 2,271; mean age = 12.9) living in an urban, under-resourced community participated in this investigation. The current study used autoregressive cross-lagged models to examine changes across four waves of data within each grade of middle school. Results: Support was found for trauma-related distress uniquely predicting increased levels of physical aggression. This effect was consistent across gender and within and across middle school grades. Conversely, physical aggression did not predict changes in trauma-related distress. Conclusions: Violence prevention efforts should routinely screen for trauma-related distress.     

Supportive and Negative Responses in the Partner Relationship: Their Association with Psychological Adjustment Among Individuals with Cancer

This study examined the association between positive and negative aspects of spouse responses and psychological adjustment among 15S individuals with cancer. Two contextual variables, gender and disease-related functional impairment, were taken into account when examining the association between spouse responses and patient psychological distress and well-being. Results indicated that negative aspects of close relationships played a comparatively stronger role than positive aspects in their associations with both psychological distress and well-being. For negative spouse responses, patient gender did not moderate the effects of these responses upon psychological outcomes. For positive aspects of spouse support, both gender and functional disability moderated the association between spouse support and psychological outcomes. These findings are integrated with the general literature on positive and negative aspects of close relationships. Implications for clinical interventions are also discussed.     

Short Sleep Duration in Prevalent and Persistent Psychological Distress in Young Adults: The DRIVE Study

Objectives:

Young people are sleeping less. Short sleep duration has a range of negative consequences including a hypothesized link with psychological distress, which has yet to be studied

Design:

Prospective cohort study

Setting:

Community-based sample from Australia

Participants:

Twenty thousand (20,822) young adults (aged 17-24) identified through the state vehicle licensing authority. A random sample (n = 5000) was approached for follow-up 12-18 months later, with 2937 providing full data.

Main Outcome Measure:

Psychological distress, determined by a Kessler 10 score > 21, at baseline; and as both onset and persistence of distress at follow-up.

Results:

Shorter sleep duration was linearly associated with prevalent psychological distress: relative risk (RR) 1.14 (95%CI 1.12 to 1.15). Only the very short (< 5 h) sleepers among those not distressed at baseline had an increased risk for onset of psychological distress (RR 3.25 [95% CI 1.84, 5.75]). Of 945 cohort participants reporting psychological distress at baseline, 419 (44%) were distressed at follow-up. Each hour less of sleep increased the risk of psychological distress persisting after adjustment for potential confounding variables: RR 1.05 (95%CI 1.01 to 1.10). Long sleep duration showed no association with distress at any time point.

Conclusions:

Self-reported shorter sleep duration is linearly associated with prevalent and persistent psychological distress in young adults. In contrast, only the very short sleepers had a raised risk of new onset of distress. Different approaches to sleep duration measurement yield different results and should guide any interventions to improve subjective sleep duration in young adults.

Citation:

Glozier N; Martiniuk A; Patton G; Ivers R; Li Q; Hickie I; Senserrick T; Woodward M; Norton R; Stevenson M. Short sleep duration in prevalent and persistent psychological distress in young adults: the DRIVE study. SLEEP 2010;33(9):1139-1145.     

人流女青少年抑郁焦虑状况及其社会因素分析

目的研究人流女青少年的社会、心理状态,以进一步完善干预措施。方法以系统抽样的方法选择我院计划生育门诊24岁及以下未婚人流女青少年160名。采用匿名自填问卷,最后获得有效问卷154份。结果经过抑郁自评量表(SDS)和焦虑自评量表(SAS)筛查,抑郁的患病率为23.0%,焦虑的患病率为11.3%。抑郁或焦虑总患病率为25.3%。外来青少年抑郁的患病率显著高于本市户口青少年(29.2%vs10.7%,P=0.010)。经多元线性回归分析,抑郁和焦虑自评合计分与人流次数、社会自尊评分以及社会支持评分呈反比。结论有关部门应对未婚外来女青少年提供更多的关注,针对有心理问题的人流女青少年,提供心理咨询和治疗服务。     

Differences Between Treatment Seekers in an Obese Population: Medical Intervention vs. Dietary Restriction

This study examined two groups of people who were pursuing treatment for obesity: either medical intervention (a hospital group; N = 20) or support for dietary restriction (a community group; N = 18). This study addressed four questions: (1) Were there differences between the two groups in terms of their psychological distress (as measured by the Symptom Checklist)? (2) Does binge eating moderate psychological distress? (3) Do feelings of ineffectiveness moderate psychological distress? and (4) Which variables best accounted for group membership (i.e., type of treatment sought)? Results suggested that the hospital group was significantly more distressed than the community group. However, there were no differences between the two groups with respect to binge eating or feelings of ineffectiveness. These findings suggest that it is the effects of morbid obesity that are most likely to moderate psychological distress.     

Brief Report: Assessment of Body Image in Survivors of Childhood Cancer

Objective: To establish preliminary reliability and validitydata of the Body Image Instrument (Bll), a 28-Item self-reportmeasure developed to assess body image in adolescents and youngadults with cancer. Method: As part of a larger study assessinglong–term adjustment In survivors of childhood cancer,40 males and 27 females (mean age = 19.69 years, 5D = 3.87)completed the Bll and two validation measures: the SF–36health survey and the Perceived Illness Experience measure. Results: The five Bll subscales—General Appearance, BodyCompetence, Others' Reaction to Appearance, Value of Appearance,and Body Parts—exhibited moderate to high internal reliabilityand concurrent validity. No significant sex differences in bodyImage emerged, nor was age at diagnosis or time since diagnosissignificantly correlated with body image. Conclusions: The measure may be of value in clinical settings,where it could be used to Identify adjustment problems relatedto body image disturbance in pediatric cancer patients.     

Nightmare prevalence, nightmare distress, and self-reported psychological disturbance

STUDY OBJECTIVES: The relationship between nightmare prevalence, nightmare distress, and self-reported psychological disturbance was assessed prospectively. DESIGN: Differences in self-reported psychological disturbance as a function of nightmare prevalence was investigated by MANCOVA's with non-nightmare dreams as the covariate as well as Pearson correlations. The relative contribution of nightmare prevalence and distress to the prediction of psychological disturbance was investigated through multiple regression analyses. SETTING: N/A. PARTICIPANTS: 116 participants (mean age = 20 years) completed self-report indices of depression, anxiety, dissociation, psychosis-proneness, and a psychiatric symptom checklist and kept a nightmare log for 21 consecutive nights. INTERVENTIONS: N/A. MEASUREMENTS AND RESULTS: Frequent nightmares were associated with higher levels of psychological disturbance. Individuals who reported 3 or more nightmares across the 3 weeks reported more dissociation, psychosis-proneness and psychiatric symptoms than participants reporting 2 nightmares or less. However, nightmare prevalence and distress were not significantly correlated and differentially predicted to different types of waking psychological disturbance. Multiple regressions further indicated that nightmare distress accounted for much of the unique explanatory variance in predicting clinical states associated with high negative affect (anxiety and depression). Last, there was no evidence for a specific relationship between nightmares and psychosis-proneness. CONCLUSIONS: The findings suggest that it is not the incidence of nightmares which is associated with poorer waking psychological functioning, especially anxiety and depression states, but the reported distress associated with the nightmare experience which is the critical variable in predicting higher psychological disturbance.     

Patient attitudes towards twin pregnancies and SET: a questionnaire study

Sir, We read with great interest the article by Hojgaard et al.,‘Patient attitudes towards twin pregnancies and singleembryo transfer—a questionnaire study’, in Hum Reprod2007;22:2673–2678. The authors showed that most patientstreated for infertility preferred to have twins (58%) ratherthan one child at a time (37.9%). The most frequent reasonsgiven were ‘a desire for siblings, a positive attitudetowards twins and a wish to have as few IVF treatments as possible’.They concluded that ‘an obligatory single embryo policywould