Improvement in measures of psychological distress amongst amphetamine misusers treated with brief cognitive-behavioural therapy (CBT)

This trial of cognitive-behavioural therapy (CBT) based amphetamine abstinence program (n = 507) focused on refusal self-efficacy, improved coping, improved problem solving and planning for relapse prevention. Measures included the Severity of Dependence Scale (SDS), the General Health Questionnaire-28 (GHQ-28) and Amphetamine Refusal Self-Efficacy. Psychiatric case identification (caseness) across the four GHQ-28 sub-scales was compared with Australian normative data. Almost 90% were amphetamine-dependent (SDS 8.15 +/- 3.17). Pretreatment, all GHQ-28 sub-scale measures were below reported Australian population values. Caseness was substantially higher than Australian normative values {Somatic Symptoms (52.3%), Anxiety (68%), Social Dysfunction (46.5%) and Depression (33.7%). One hundred and sixty-eight subjects (33%) completed and reported program abstinence. Program completers reported improvement across all GHQ-28 sub-scales Somatic Symptoms (p < 0.001), Anxiety (p < 0.001), Social Dysfunction (p < 0.001) and Depression (p < 0.001)}. They also reported improvement in amphetamine refusal self-efficacy (p < 0.001). Improvement remained significant following intention-to-treat analyses, imputing baseline data for subjects that withdrew from the program. The GHQ-28 sub-scales, Amphetamine Refusal Self-Efficacy Questionnaire and the SDS successfully predicted treatment compliance through a discriminant analysis function (p

Can illness perceptions and coping predict psychological distress amongst allergy sufferers?

Objective. The aim of the present study was to measure the extent to which illness perceptions and coping strategies are associated with the levels of psychological distress amongst allergy sufferers. Design and method. One hundred and fifty-six allergy sufferers (all members of Allergy U.K.) completed a postal survey consisting of the Revised Illness Perception Questionnaire (IPQ-R) and the COPE. Psychological distress was measured using the General Health Questionnaire (GHQ-28) and the Perceived Stress Scale (PSS). Results. Multiple regression analyses indicated that illness perceptions explained between 6 and 26% of variance on measures of psychological distress; coping strategies explained between 12 and 25%. A strong illness identity and emotional representations of the allergy were associated with higher levels of psychological distress; as were less adaptive coping strategies such as focusing on and venting of emotions. Strong personal control beliefs were associated with the lower levels of distress, as were adaptive coping strategies such as positive reinterpretation and growth. Coping partially mediated the link between the illness perceptions and the outcome; however, illness identity, emotional representations and personal control retained an independent significant association with psychological distress. Conclusion. The findings support a role for illness perceptions and coping in explaining levels of psychological distress amongst allergy sufferers. This has implications for targeted health interventions aimed at reducing the strength of illness identity and emotional representations and increasing a sense of control and the use of more adaptive coping strategies.

The role of illness perceptions:psychological distress and treatment seeking delay in patients with genital warts.

This study examined the relationships between illness perceptions, psychological distress and treatment-seeking delay in genital warts patients. Sixty-six genital warts patients were approached while attending a sexual health clinic. They completed a questionnaire assessing their illness perceptions, psychological distress and treatment-seeking delay. Negative perceptions of illness consequences and control and a perceived cyclical timeline were associated with increased psychological distress. Perceived illness consequences maintained significance in a multiple regression equation, which accounted for 25% variance in distress. Depression was associated with treatment-seeking delay (r = 0.28, P = 0.03). In conclusion, illness perceptions may play an important role in the experience of psychological distress in genital warts patients. The implications of these findings for the design of health-care interventions are discussed.

The use of Acceptance and Commitment Therapy to address psychological distress experienced by caregivers: a randomised controlled feasibility trial

Background: An extensive research literature has documented the impact of caring for an individual with acquired brain injury (ABI) on caregivers and family members, including role adjustment, psychological distress, social isolation, family tension and coping with the cognitive and behavioural difficulties of the injured person. Given these findings it is important this population have access to services and supports. Acceptance and Commitment Therapy (ACT) is an intervention that helps individuals to accept difficult experiences and commit to behaviour that is consistent with their values. Research into the effectiveness of ACT to support caregivers is at a preliminary stage. Aim: To investigate the feasibility of using ACT to reduce psychological distress and increase psychological flexibility in ABI caregivers. A secondary aim was to gain an understanding of the experience of caregivers in this context and how this can inform the development and delivery of interventions for this population. Method: Phase one was a randomised controlled feasibility trial of an ACT intervention for use with ABI caregivers. The parameters of this study were formulated around the PICO (population, intervention, control, and outcome) framework. Eighteen carers were recruited and randomised to ACT or an enhanced treatment as usual (ETAU) group. ACT was implemented over 3 sessions; and ETAU was implemented over 2 sessions. The General Health Questionnaire, Valuing Questionnaire, Acceptance and Action Questionnaire, Experiential Avoidance of Caregiving Questionnaire and the Flexibility of Responses to Self-Critical Thoughts Scale were administered to both groups at baseline and following the final session. Phase two used a retrospective qualitative design that involved conducting semi-structured interviews with four participants from phase one. Results: ACT and control participants were successfully recruited. Positive feedback was obtained from ACT participants suggesting that the intervention was acceptable. There were no significant differences between the ACT and ETAU groups on outcome measures. However, there were challenges retaining participants and the overall attrition rate was high (44.44%). Therefore a number of participants did not complete the full complement of sessions, which may have impacted on this result. Qualitative results illustrated the challenges this population face including significant adjustments in their life, the emotional impact of having a loved one with a brain injury and trying to adapt to the changes in the injured person. In addition, findings elucidated the types of support that this population would find helpful and the barriers to accessing same. Conclusions: Findings from this study highlight factors that will help the development of this intervention further for a caring population. Recommendations for future implementation include completing some preparatory work with carers before beginning the intervention, consideration of a larger sample and wider recruitment strategy from local services, barriers to attending interventions and the possibility of holding groups in local venues.

The Influence of Pre-Migration Factors and Post-Migration Climate of the Receiving Community on the Psychological Distress of Latino Immigrants

Over forty million foreign-born residents currently live in the United States. Latinos make up the largest population of immigrants living in the U.S. Previous research suggests that Latino immigrants often experience pre-migration stressors, such as traumatic experiences, political upheaval, and unplanned migration. These stressors may have a negative impact on immigrants’ post-migration mental health. Research also suggests that the post-migration climate of the receiving community may inform the connection between pre-migration experiences and post-migration mental health. The current study examined the relationship between Latino immigrants’ reasons for migration, migration planning, and pre-migration experience of political and/or interpersonal violence, and post-migration symptoms of psychological distress. In addition to examining the effect of these pre-migration factors, the current study also examined the community “climate” experienced by Latino immigrants post-migration by assessing the influence of three post-migration factors: 1) community support and engagement, 2) discrimination, and 3) employment. The study was a secondary analysis of data collected for the National Latino and Asian American Study, which focused on the mental health and service utilization of Latinos and Asian Americans. Participants included 1,629 Latino immigrants from across the United States. Results indicated that pre-migration experience of political and/or interpersonal trauma, post-migration experience of discrimination, and female sex were positively associated with psychological distress. Post-migration employment was negatively associated with psychological distress. In addition, discrimination modified the association between unplanned migration and psychological distress; the relationship between unplanned migration and psychological distress decreased for participants who reported more discrimination. Furthermore, employment modified the association between political and/or interpersonal trauma and psychological distress; the connection between trauma and psychological distress increased among those who reported having less employment. Recommendations for further research were presented. Policy and clinical practice implications were discussed, particularly given the current climate of high anti-immigrant sentiment and hostility in the U.S.

Psychosocial experience of cancer : surpassing mere survival and recognising the potential for posttraumatic growth as well as distress.

The publication of the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994) introduced the notion that a life-threatening illness can be a stressor and catalyst for Posttraumatic Stress Disorder (PTSD). Since then a solid body of research has been established investigating the post-diagnosis experience of cancer. These studies have identified a number of short and long-term life changes resulting from a diagnosis of cancer and associated treatments. In this chapter, we discuss the psychosocial response to the cancer experience and the potential for cancer-related distress. Cancer can represent a life-threatening diagnosis that may be associated with aggressive treatments and result in physical and psychological changes. The potential for future trauma through the lasting effects of the disease and treatment, and the possibility of recurrence, can be a source of continued psychological distress. In addition to the documented adverse repercussions of cancer, we also outline the recent shift that has occurred in the psycho-oncology literature regarding positive life change or posttraumatic growth that is commonly reported after a diagnosis of cancer. Adopting a salutogenic framework acknowledges that the cancer experience is a dynamic psychosocial process with both negative and positive repercussions. Next, we describe the situational and individual factors that are associated with posttraumatic growth and the types of positive life change that are prevalent in this context. Finally, we discuss the implications of this research in a therapeutic context and the directions of future posttraumatic growth research with cancer survivors. This chapter will present both quantitative and qualitative research that indicates the potential for personal growth from adversity rather than just mere survival and return to pre-diagnosis functioning. It is important to emphasise however, that the presence of growth and prevalence of resilience does not negate the extremely distressing nature of a cancer diagnosis for the patient and their families and the suffering that can accompany treatment regimes. Indeed, it will be explained that for growth to occur, the experience must be one that quite literally shatters previously held schemas in order to act as a catalyst for change.

Posttraumatic growth and posttraumatic depreciation as predictors of psychological adjustment

Informed by current trauma literature, this study explored the relationships between Posttraumatic Growth (PTG; Tedeschi & Calhoun, 1995), Posttraumatic Depreciation (PTD; Cann et al., 2010) and other post-trauma outcomes including well-being, psychological flourishing, and psychological distress. The predictive utility of PTG and PTD was also examined. The sample comprised 104 trauma survivors who completed the Posttraumatic Growth Inventory – 42 (Baker et al., 2008) and several outcome measures. As expected, PTD showed strong linear correlations with well-being, flourishing and distress, and emerged as a significant predictor of scores on such measures. However, PTG showed negligible correlations with well-being, flourishing and distress. This reaffirms that PTG and PTD measure conceptually distinct and independent dimensions of experience, which has implications for therapeutic practice.

The psychological experiences of adult heart transplant recipients : a systematic review and meta-summary of qualitative findings

Background Psychosocial factors and physical health are associated with increased psychological distress post-heart transplant. Integrating findings from qualitative studies could highlight mechanisms for how these factors contribute to psychological well-being, thus aiding the development of interventions. Objective To integrate qualitative findings regarding adult heart transplant recipients experiences, such as their emotions, perceptions and attitudes. Methods A systematic review and meta-summary were conducted. Data from seven studies were categorized into 16 abstracted findings. Results The most prominent finding across the studies related to recipients’ perceptions of the importance of social support. Other prominent findings related to factors that promoted psychological well-being, such as faith, optimism and sense of control. Conclusions Psychological well-being may be improved by enhancing perceived control over health and daily life, promoting an optimistic outlook by facilitating access to social support from other heart transplant recipients and ensuring post-transplant recipient-caregiver partnerships adequately support the transition back to independence.

The effectiveness of non-pharmacological interventions in improving psychological outcomes for heart transplant recipients : a systematic review

Background Post-heart transplant psychological distress may both directly hinder physiological health as well as indirectly impact on clinical outcomes by increasing unhealthy behaviours, such as immunosuppression non-adherence. Reducing psychological distress for heart transplant recipients is therefore vitally important, in order to improve patients’ overall health and well-being but also clinical outcomes, such as morbidity and mortality. Evidence from other populations suggests that non-pharmacological interventions may be an effective strategy. Aim To appraise the efficacy of non-pharmacological interventions on psychological outcomes after heart transplant. Method A systematic review was conducted using the Joanna Briggs Institute methodology. Experimental and quasi-experimental studies that involved any non-pharmacological intervention for heart transplant recipients were included, provided that data on psychological outcomes were reported. Multiple electronic databases were searched for published and unpublished studies and reference lists of retrieved studies were scrutinized for further primary research. Data were extracted using a standardised data extraction tool. Included studies were assessed by two independent reviewers using standardised critical appraisal instruments. Results Three studies fulfilled the inclusion and exclusion criteria, which involved only 125 heart transplant recipients. Two studies reported on exercise programs. One study reported a web-based psychosocial intervention. While psychological outcomes significantly improved from baseline to follow-up for the recipients who received the interventions, between-group comparisons were not reported. The methodological quality of the studies was judged to be poor. Conclusions Further research is required, as we found there is insufficient evidence available to draw conclusions for or against the use of non-pharmacological interventions after heart transplant.

Improving dental and medical students’ psychological health using a self-development coaching program : a pilot study

Introduction: Dental and medical students worldwide, including in Saudi Arabia, have been reported to have a high incidence of poor psychological health, such as depression, stress, anxiety, and lowlife satisfaction. Self-development coaching programs have become an increasingly popular way to improve individuals’ lives. However, few studies have evaluated the psychological effects of such programs among dental and medical students. Moreover, no studies have been conducted on self-development coaching programs in Saudi Arabia. Aims: The aim of this study was to assess the feasibility of a larger study via a pilot study and to acquire preliminary findings about the effectiveness of a self-development coaching program on psychological health among dental and medical students in Saudi Arabia. Methods: A pre-post interventional study design was used to test a self-development coaching program (How to be an Ultra-Super Student) with a sample of medical students (n=17) at Umm Al-Qura University at Saudi Arabia. The outcome measures were students’ psychological distress (depression, anxiety, and stress), life satisfaction, self-efficacy, the coach, and coaching program characteristics. Results: The study showed that there was a significant improvement in depression (p=0.04), self-efficacy (p=0.02), and satisfaction with life (p=0.04), which supported the feasibility of a large study in the future. Conclusions: The study’s findings encourage the implementation of a randomized, controlled trial study with a larger sample to further test the effectiveness of using self-development coaching programs with medical and dental students in Saudi Arabia to improve their psychological health.

A group psychological intervention to enhance the coping and acculturation of international students

There is a shortage of psychological interventions to aid the acculturation of international students. To address this issue, the present study developed and trialled a brief group psychological intervention, the STAR program: Strengths, Transitions, Adjustments, and Resilience. This program was developed using suggestions from international students and university professional and academic staff that had significant dealings and designated roles to guide support international students. It comprises of four weekly two-hour sessions, and is experiential and cognitive-behavioural in nature. The STAR program aims to enhance coping, which is predicted to subsequently improve psychological adaptation (an acculturation outcome). Sixteen international students participated in the pilot trial of the STAR program. The participants completed measures on coping self-efficacy, social self-efficacy, psychological adaptation, and psychological distress pre-intervention, post-intervention, and one-month follow-up. Results showed that participants’ psychological adaptation and coping self-efficacy significantly increased from pre to post, with the treatment gain maintained at the one-month follow-up for psychological adaptation. Increases in social self-efficacy were evident, but these did not reach significance, possibly due to a lack of power. The STAR program did not have an impact on psychological distress; however, participants were only minimally distressed at the commencement of the program. The qualitative feedback gathered from the participants, provided suggestions for further refinement, as well as information about the clinical utility of the STAR program.

Losing sleep : examining the cascading effects of supervisors' experience of injustice on subordinates' psychological health

In this paper, we identify two types of injustice as antecedents of abusive supervision and ultimately of subordinate psychological distress and insomnia. We examine distributive justice (an individual's evaluation of their input to output ratio compared to relevant others) and interactional injustice (the quality of interpersonal treatment received when procedures are implemented). Using a sample of Filipinos in a variety of occupations, we identify two types of injustice experienced by supervisors as stressors that provoke them to display abusive supervision to their subordinates. We examine two consequences of abusive supervision - subordinate psychological distress and insomnia. In addition, we identify two moderators of these relationships, namely, supervisor distress and subordinate self-esteem. We collected survey data from multiple sources including subordinates, their supervisors, and their partners. Data were obtained from 175 matched supervisor-subordinate dyads over a 6-month period, with subordinates' partners providing ratings of insomnia. Results of structural equation modelling analyses provided support for an indirect effects model in which supervisors' experience of unfair treatment cascades down the organization, resulting in subordinate psychological distress and, ultimately in their insomnia. In addition, results partially supported the proposed moderated relationships in the cascading model. © 2010 Taylor & Francis.