A preliminary study of the psychological differences in infertile couples and their relation to the coping styles

BackgroundStudies from Western countries have observed that couples undergoing infertility treatment suffer various physical and psychological difficulties at a higher frequency than the comparable general population. These relate to treatment challenges and other psychosocial stressors, often influenced by coping style, personality factors and available support systems. There is paucity of studies in non-Western populations.ObjectiveThe aim of this pilot investigation was to evaluate characteristics and gender differences in perceived psychological difficulties reported by infertile Malaysian couples. In particular, depression, anxiety and stress, along with correlated coping styles, were examined between spouses.MethodsDemographic information, including age, ethnicity and duration and causes of infertility, were collected from participants treated within a fertility clinic. The Depression, Anxiety and Stress Scale (DASS) and Coping Inventory for Stressful Situation (CISS) were completed to measure psychological distress and coping styles.ResultsDepression, anxiety and stress-related difficulties were reported at significantly higher frequency by wives than husbands (p < 0.05). There were no significant differences in coping styles between wives and husbands. However, emotional-oriented coping style was associated with significantly higher levels of depression, anxiety and stress (p < 0.05) within the overall sample with odds ratios of 2.5, 3.0 and 1.5, respectively.ConclusionThe study confirms that, as with Western subjects, Malaysian infertile couples demonstrate the vulnerability to psychological distress that occurs more frequently among wives than husbands. As anticipated, emotional coping style was associated with greater distress in both genders.     

The interaction of perceived maternal and paternal parenting styles and their relation with the psychological distress and offending characteristics of incarcerated young offenders.

A shortened form of the Parental Bonding Instrument (PBI) (Pederson, 1994) was used to examine the relationship between parenting styles and the psychological distress and offending patterns of a group of young male offenders held in custody in Scotland. High levels of psychological distress were linked with low parental care, but there was no association between psychological distress and parental control. Parental care was not a distinguishing factor in offending patterns, although high paternal control was linked with a younger age of first arrest. When interactions of paternal and maternal parenting styles were examined, young offenders who perceived poor parenting (i.e. neglectful parenting or affectionless control) from both parents had the highest levels of psychological distress overall.     

Social learning, affective state and passive coping in irritable bowel syndrome and inflammatory bowel disease

The association between the use of passive coping strategies to deal with pain and reported levels of anxiety, depression, and parental reinforcement of illness behavior was examined in individuals with Irritable Bowel Syndrome (IBS) and Inflammatory Bowel Disease (IBD). Individuals with IBS and IBD recruited primarily from outpatient clinics completed questionnaire measures of pain-coping (the Vanderbilt Pain Management Inventory, VPMI) as well as measures of anxiety and depression, parental reinforcement of illness behavior and physical symptoms. Factor analysis of the passive coping sub-scale of the VPMI indicated that it was comprised of two components corresponding to emotional and behavioral facets of passive coping. Higher levels of behavioral passive coping were associated with higher levels of parental reinforcement of illness behavior and higher levels of depression, but only amongst individuals with IBS. In contrast emotional passive coping was associated in both groups with higher levels of anxiety and depression (but not illness-related social learning). Different factors predict the use of emotional and behavioral passive coping strategies in IBS and IBD. It is suggested that illness-related social learning occurring during childhood influences the development of habitual illness behaviors and that, because of the more benign nature of symptoms in IBS, individuals with IBS may be more likely than individuals with IBD to revert to such habitual behaviors to cope with symptoms. The degree to which the emotional component of passive coping, associated with psychological distress in both groups, can be considered in terms of 'coping strategies', rather than markers of illness-related distress, is discussed.     

Cobalamin level is related to self-reported and clinically rated mood and to syndromal depression in bereaved HIV-1(+) and HIV-1(-) homosexual men

OBJECTIVE: An examination of the relationship of plasma cobalamin (vitamin B(12)) level to overall psychological distress, specific mood states, and major depressive disorder was conducted in 159 bereaved men (90 HIV-1(+) and 69 HIV-1(-)). METHODS: The relationship of a continuous measure of cobalamin level to psychological distress was examined, while controlling for HIV-1 serostatus, life stressors, social support, and coping styles. RESULTS: Of this sample, 23.9% were either overtly or marginally cobalamin deficient; however, the deficiency rate was not significantly different by HIV-1 serostatus. Cobalamin level was inversely related to self-reported overall distress level and specifically to depression, anxiety, and confusion subscale scores, as well as to clinically rated depressed and anxious mood. Lower plasma cobalamin levels also were associated with the presence of symptoms consistent with major depressive disorder. CONCLUSION: These findings suggest that cobalamin level may be physiologically related to depressed and anxious mood level, as well as to syndromal depression.     

失眠症患者心理社会因素分析

目的:探讨失眠症患者的应付方式,心理健康状况和社会支持状况.方法:采用应付方式问卷(CSQ)、症状自评量表(SCL-90)和社会支持量表(SSS)对失眠症患者和正常对照者各88例进行测评.结果:失眠症组自责、幻想和退避分量表的得分显著高于对照组,求助分量表的得分显著低于对照组(P＜0.01);失眠症组SCL-90总分及躯体化、抑郁、焦虑、睡眠障碍各因子分与对照组比较,有显著差异(P＜0.01).失眠症组社会支持总分、客观支持和对社会支持的利用度评分显著低于正常对照组(P＜0.05).失眠症组自责与躯体化症状、焦虑、抑郁等因子及总分呈显著正相关,而求助与焦虑、抑郁、偏执和总分呈显著负相关(P＜0.05).结论:失眠症患者多采用不成熟的应付方式,且有较多的心身症状,应付方式和身心健康有相关性.失眠症患者缺乏社会支持.     

Emotional distress and quality of life in caregivers of patients awaiting lung transplant

OBJECTIVE: The aims of this study are to characterize the levels of emotional distress and quality of life among caregivers of lung transplant candidates and to examine the relation of coping styles and perceived caregiver burden to caregivers' self-reported emotional distress. METHODS: A consecutive series of primary caregivers of potential lung transplant candidates completed a battery of psychosocial measures, including the Beck Depression Inventory-II (BDI-II), State-Trait Anxiety Inventory, Medical Coping Modes Questionnaire (MCMQ), Scale for Caregiver Burden (SCB), and Medical Outcomes Survey, Short Form-36 (SF-36). RESULTS: Only 12 of the 82 caregivers (14.6%) who volunteered for the study reported clinically significant levels of depression (BDI-II > or =14), and only 2 caregivers (2.4%) reported clinically significant levels of anxiety (STAI > or =60). Passive coping strategies were associated with higher levels of emotional distress; specifically, resignation was associated with increased depression (r=.27, P<.04), while avoidance was associated with increased anxiety (r=.29, P<.04). In addition, caregivers who reported greater perceived caregiver burden experienced higher levels of depression (r=.45, P<.001) and anxiety (r=.43, P<.01). Moreover, the social functioning of caregivers of lung transplant patients was more than one standard deviation from a normative sample of the population (Cohen's d=1.16), indicating that caregivers of transplant patients experienced greater impairment in this area. DISCUSSION: Although most caregivers of transplant patients do not report significant impairment in functioning, assessing caregivers' coping strategies and caregiving burden may identify those caregivers who experience increased emotional distress.     

Coping, affective distress, and psychosocial adjustment among people with traumatic upper limb amputations

OBJECTIVE: This study investigated the prevalence of symptoms of depression and anxiety in a sample of predominantly elderly males with acquired upper limb amputations (n=138) and examined the contribution of coping strategies to the prediction of psychosocial adjustment. METHOD: One hundred and thirty-eight men with injury-related upper limb amputations completed self-report questionnaires assessing coping strategies, symptoms of anxiety and depression, and psychosocial adaptation to prosthesis use. RESULTS: Prevalence of significant depressive symptoms was 28.3% [Hospital Anxiety and Depression Scale, Depression subscale (HADS-D) score > or =8]. Prevalence of significant anxiety symptoms was 35.5% [HADS Anxiety subscale (HADS-A) score > or =8]. Coping styles emerged as important predictors of psychosocial adaptation. In particular, avoidance was strongly associated with psychological distress and poor adjustment. CONCLUSIONS: These findings suggest the potential benefits of interventions to reduce reliance on avoidant coping and stimulate more problem-focused approaches to coping with difficulties and challenges in order to facilitate adaptation and prevent problems in psychosocial functioning postamputation.     

Emotional state and coping style among gynecologic patients undergoing surgery

The aim of the present study was to investigate changes in emotional state and the relationship between emotional state and demographic/clinical factors and coping style among gynecologic patients undergoing surgery. Using the Japanese version of the Profile of Mood States (POMS), 90 patients (benign disease: 32, malignancy: 58) were examined on three occasions: before surgery, before discharge, and 3 months after discharge. They were also examined using the Coping Inventory for Stressful Situations (CISS) on one occasion before discharge. The scores for the subscales depression, anger, and confusion were the highest after discharge while those for anxiety were the highest before surgery. The average scores of the POMS subscales for all subjects were within the normal range. With regard to the relationship between these emotional states and other factors, multiple regressions showed that the principal determinants of anxiety before surgery were religious belief, psychological symptoms during hospitalization and emotion-oriented (E) coping style; further, it was found that depression after discharge could be explained by chemotherapy, duration of hospitalization, and E coping style. The principal determinants of anger after discharge and vigor before surgery were length of education and E coping style, and severity of disease, chemotherapy, E coping style and task-oriented coping style, respectively. Those of post-discharge fatigue and confusion were length of education, psychological symptoms, and E coping style. In summary it is suggested that the following should be taken into account in patients undergoing gynecologic surgery: anxiety before surgery, depression, anger, and confusion after surgery, including coping styles.     

Postdisaster emotional distress,depression and event-related variables: findings across child and adolescent developmental stages

OBJECTIVE: Developmental approaches have not been widely used in child and adolescent posttraumatic stress disorder research, and little is known about developmental differences in response to postdisaster trauma. Our objective was to investigate postdisaster depression and emotional distress psychopathology across a broad child and adolescent developmental range. METHOD: Six months following a bushfire disaster, 2379 grade 4-12 school students -completed an extensive self-report battery, which included the Impact of Event Scale and the Birleson Depression Inventory. Generalized linear models were constructed to model the effects of multiple covariates on continuous outcome measures of depression and emotional distress. RESULTS: Significant independent predictors of persisting depressive symptoms were increased symptoms of emotional distress; increased symptoms of anxiety; evacuation experience; and school grade. Significant independent predictors of emotional distress were persisting depressive symptoms; perception of threat to self or to parents; evacuation experience; and school grade. Gender was not a significant predictor in either the depression or emotional distress multivariate models. Complex, non-linear relationships between depression, emotional distress and school grade were found. CONCLUSION: This study suggests that important developmental differences in postdisaster psychological responses exist across a broad spectrum of developmental stages in children.     

Examining stress and coping as a mediator for internalizing symptomatology: A comparison between sexual minority and majority first-year college students

Sexual and gender minority (SGM) adolescents experience unique stressors and elevated internalizing symptoms. This study examines differences in coping styles between SGM and heterosexual adolescents and the potential mediating roles of stress and coping styles. Analyses indicated that SGM (N = 75) adolescents reported higher levels of internalizing symptoms (depression, anxiety, and distress), higher use of maladaptive coping styles (denial and blame), lesser use of adaptive coping styles (reframing and religion), and greater experiences of stress, compared to their heterosexual counterparts (N = 1702). Bootstrapping analyses revealed the relationship between sexual identity and internalizing symptoms measured approximately 3 months later was not mediated by stress and coping, adjusting for gender, age, and baseline symptomatology. Findings suggest that earlier adolescent differences in internalizing symptoms presage increasing symptomatology across the transition to college, and other mediators during the college transition explain the continued increases in internalizing symptoms.     

Predictors of mental distress in early adulthood: a five-year follow-up of 709 high-school students

Mental health risk factors in adolescence were examined as predictors of mental distress in early adulthood. A cohort of 709 Finnish adolescents was studied in 1990 (mean age 16.8) and in 1995. Trait anxiety, defence styles, life events, self-esteem and somatic symptoms were evaluated as predictors of high scores in the General Health Questionnaire in adulthood. Females (36%) were more likely to be distressed than males (23%). High trait anxiety and somatic symptom scores among adolescent females, and high immature defence style scores among males predicted mental distress. Males with low trait anxiety in adolescence had less distress. The results indicate trait anxiety as an important predictor of mental distress. Gender differences in other predictors suggest gender differences in coping.     

Early symptom predictors of chronic distress in Gulf War veterans

Although there is evidence that specific early hyperarousal, avoidance, and emotional numbing symptoms are associated with later posttraumatic stress disorder (PTSD) symptomatology among veterans, little is known about predictors of later non-PTSD-related psychological symptoms. One and 2 years after serving in the Gulf War, 348 military reservists were assessed for severity of war zone stress, PTSD, psychological distress, and stress-mediated physical complaints. Overall PTSD symptomatology and emotional numbing and hyperarousal symptom clusters increased over time, whereas re-experiencing and avoidance symptoms showed no change. Emotional numbing and hyperarousal symptoms at 1 year predicted generalized distress, depression, anxiety, hostility, and somatic symptoms at 2 years, whereas re-experiencing and avoidance symptoms did not. Findings highlight the importance of targeting early emotional numbing and hyperarousal symptom clusters to reduce longer-term psychological distress.     

Structured group intervention model for AIDS patients

We have gathered and analyzed data on 50 gay men with AIDS before and after a ten-week structured group intervention aimed at reducing psychological distress and improving coping skills. Among the major findings have been information relating coping strategies to depression and anxiety, information about the support networks of people with AIDS, and the relationships between coping strategies, support networks and psychological mood states. We have also found that structured group interventions comprised of problem solving techniques, health education, relaxation training and emotional support are helpful in reducing anxiety and depression and in teaching people more positive ways of coping with their illness.     

Depressive personality styles and interpersonal problems in young adults with difficulties in establishing long-term romantic relationships

This research examined Blatt's personality styles in relation to overall interpersonal distress and problems in affiliation and dominance of young adults with difficulties in establishing long-term romantic relationships. Participants were 141 (73 males and 68 females) young adults comprising two groups: with difficulties in establishing long-term romantic relationships and without such difficulties. They completed the Depressive Experiences Questionnaire and the Mental Health Index (MHI), and they and their friend completed the Inventory of Interpersonal Problems (IIP-C). Self-criticism and dependency contributed to greater self-reported interpersonal distress, over and above MHI depression and anxiety, while efficacy moderated the effects of these vulnerabilities. Self-criticism contributed to the friend's report of interpersonal distress only for those without difficulties in long-term romantic relationships. The findings are discussed in terms of Blatt's theory on interpersonal relatedness and self-definition in young adult's personality development and the complementary ways the personality styles influence the interpersonal world.     

Do juveniles bully more than young offenders?

This study compares bullying behaviour among juvenile and young offenders and incorporates two different methods to measure bullying. Ninety-five male juvenile and 196 male young offenders completed two questionnaires, one that measured bullying directly and one that measured behaviours indicative of "being bullied" or of "bullying others". Juveniles perceived a higher extent of bullying than young offenders. Juveniles reported significantly more physical, psychological or verbal and overall direct forms of bullying behaviour than young offenders. A number of differences were found between juveniles and young offenders with regard to the types of prisoners likely to become victims, who they would advise a victim to speak to and how bullying could be prevented. The results are discussed in relation to developmental theories of aggression and how bullying behaviour can be defined and measured among prisoners.     

Post-traumatic symptoms,emotional distress and quality of life in long-term survivors of breast cancer: a preliminary research

The present study is a preliminary study assessing long-term psychological effects in survivors of breast cancer. Thirty-nine long-term female survivors of breast cancer were compared with 39 matched women who had not been exposed to any chronic disease regarding post-traumatic stress disorder (PTSD), quality of life (QoL), emotional distress and coping styles. Survivors revealed significantly higher rates of full and partial PTSD, scored significantly higher on emotional distress, scored significantly lower on physical and psychological QoL and exhibited coping styles significantly different from those of the control group. PTSD was associated with the coping style of suppression. Multiple regression analysis showed that receiving chemotherapy and disease stage, as well as the interaction between chemotherapy and disease stage, were significant predictors of hyperarousal. The findings show that post-traumatic symptoms are a common sequel after recovery from cancer. Furthermore, finding suggest a conceptual distinction between PTSD symptoms and QoL in the study of long-term effects of cancer.     

Avoidance-oriented coping as a predictor of panic-related distress: a test using biological challenge

The present experimental psychopathology study sought to investigate the extent to which pre-experimental levels of avoidance-oriented coping predict anxious and fearful responding during acute physical stress, relative to other theoretically relevant variables. Participants included 80 individuals with no known history of psychological or physical health problems. Dependent measures include self-reported anxiety, DSM-IV panic symptoms, and physiological indices of heart rate and skin conductance. Consistent with our hypotheses, the tendency to engage in avoidance-oriented coping predicted increased physical panic symptoms and self-reported anxiety elicited by biological challenge, relative to specific anxiety sensitivity (AS) dimensions. These findings are discussed in terms of how specific types of coping are associated with prototypical indices of panic distress, with implications for forwarding future work on emotional regulation in panic disorder.     

Post-disaster service provision following proactive identification of children with emotional distress and depression

OBJECTIVE: Proactive, school-based psychological testing for emotional distress and depression was employed 6 months after a bushfire disaster. The service provision aim was to provide children with the greatest emotional distress the relatively limited therapeutic resources available in the post-disaster environment. Specific hypotheses were tested: that the prevalence of emotional distress and depression would be elevated 6 months post disaster; that emotional distress would be correlated with traumatic events; and that depression would be related to experiences of loss. METHOD: Six months after a bushfire disaster grade 4, 5, and 6 students (n = 601) participated in screening using a test battery measuring emotional distress, depressive symptoms and trait anxiety. RESULTS: Twelve percent (n = 72) of children experienced severe emotional distress 6 months after the bushfire. Rates of depression were similar to rates in non-traumatised child community samples. Multivariate analysis suggested that emotional distress was significantly associated with trait anxiety, evacuation experience, the perception that parents may have died during the bushfire, and depressive symptoms. Depressive symptoms were associated with total distress score, trait anxiety and perception of threat to the parents. CONCLUSIONS: Substantial mental health morbidity was identified 6 months after a bushfire disaster. The usefulness of post-disaster service provision influenced by proactive screening is discussed and reasons for further research highlighted.     

Reciprocal dynamics between self-rated sleep and symptoms of depression and anxiety in young adult women: a 14-day diary study

ObjectivesThe objective of this study was to characterize the day-to-day associations among sleep disturbance, depression, and anxiety in a sample of young adult women.MethodsOne hundred and seventy-one women (20.1 ± 3.3 years) completed in-laboratory baseline assessment followed by daily online surveys across a two-week period. Daily measures included the Mood and Anxiety Symptom Questionnaire-Short Form to assess shared and disorder-specific symptoms of depression and anxiety (general distress, anhedonic depression, and anxious arousal), as well as self-reported total sleep time (TST), sleep-onset latency (SOL), and sleep quality (SQ).ResultsFindings supported bidirectional day-to-day relationships between sleep and affective symptoms. When women felt greater general distress (shared features of anxiety and depression), they experienced longer SOL and worse SQ at night. Specificity among depression, anxiety, and sleep disturbance was observed such that higher levels of depression-specific anhedonia presaged longer SOL, shorter TST, and poorer SQ. In the other direction, when women had poor-quality sleep, they later experienced greater anhedonic depression and anxious arousal. The influence of TST on anhedonia was complex such that a single night of short sleep led to less anhedonic depression the next day, whereas women who obtained shorter sleep across the two-week period reported greater anhedonia.ConclusionsReciprocal dynamics between nightly sleep disturbance and daily experiences of depression and anxiety may serve as a process by which insomnia, depression, and anxiety develop into comorbid clinical states over time in women. The associations of anhedonic depression with nightly sleep disturbance and chronic short sleep were especially toxic, offering insight into daily mechanisms driving the most prevalent phenotype of comorbid insomnia.     

Illness perceptions among carer-survivor dyads are related to psychological distress among Oesophageal cancer survivors

Objective

To examine the extent to which the illness perceptions of Oesophageal cancer survivors and the illness perceptions of their carers explain the survivors' levels of psychological distress (in terms of anxiety and depression symptoms) relative to demographic and biomedical variables and patients' coping strategies.

Method

Everyone registered with the Oesophageal Patients' Association in the UK was mailed a questionnaire booklet containing questions about medical and demographic variables, the Illness Perception Questionnaire-Revised, the Cancer Coping Questionnaire, and the Hospital Anxiety and Depression Scale. Patients were asked to pass a modified version of the Illness Perception Questionnaire-Revised to someone they identified as a carer. Complete responses were received from 317 dyads.

Results

Regression models indicated that the variables measured could explain 56% of the variance in anxiety and 54% of the variance in depression. Patients' illness perceptions explained the majority of this variance. Positive focus coping strategies were also found to be important in explaining psychological well-being. Some of the carers' illness perceptions made a significant contribution to the explanation of the patients' levels of psychological distress, and in some instances, carer perceptions were found to moderate the relationship between patients' perceptions and psychological distress.

Conclusion

The findings suggest that cognition-based interventions could potentially be most effective in minimizing emotional distress among survivors of Oesophageal cancer. This study also shows that these interventions could usefully be delivered at the level of the patient-carer dyad.