A Burden Too Heavy to Bear

2018 ◽  
pp. 23-48
Author(s):  
Diane Miller Sommerville
Keyword(s):  
Psychological Distress ◽  
Civil War ◽  
Suicidal Behavior ◽  
Mental Distress ◽  
Psychological Impact ◽  
White Men ◽  
War Trauma ◽  
Fear Of Failure ◽  
Internal Pressures ◽  
And Control

Examines the psychological impact of the Civil War on Confederate soldiers who suffered debilitating psychological and emotional wounds that sometimes resulted in institutionalization in insane asylums, or in suicidal behavior. Historians have not focused on Civil War participants as victims of war trauma until recently. This chapter deepens our understanding of these experiences by asserting that external war-related pressures like witnessing death and mayhem combined with internal pressures like fear of masculine failure or being called a coward heavily taxed soldiers and their psyches. Factors that contributed to psychological distress among Confederate servicemen include: exposure to battle, fear of being called a coward, fear of failure, youthfulness, homesickness, and depression.Suicide offered southern white men a way to maintain mastery and control over their deaths in war zones where chaos and disorder prevailed. Attitudes toward Confederates who killed themselves during the war were more supportive and less stigmatizing than one might think. Many soldiers also ended up institutionalized in asylums after being diagnosed as insane. Caregivers and family members rarely connected signs of mental distress with wartime experiences.

scholarly journals Potentially Prolonged Psychological Distress from Postponed Olympic and Paralympic Games during COVID-19—Career Uncertainty in Elite Athletes

2020 ◽  
Vol 18 (1) ◽  
pp. 2
Author(s):  
Anders Håkansson ◽  
Karin Moesch ◽  
Caroline Jönsson ◽  
Göran Kenttä
Keyword(s):  
Psychological Distress ◽  
Female Athletes ◽  
Job Insecurity ◽  
Elite Athletes ◽  
Psychological Impact ◽  
Sporting Events ◽  
Travel Restrictions ◽  
Career Uncertainty ◽  
Paralympic Games

The coronavirus disease 2019 (COVID-19) pandemic has had a significant impact on the world of sports due to periods of home quarantine, bans against public gatherings, travel restrictions, and a large number of postponed or canceled major sporting events. The literature hitherto is sparse, but early indications display signs of psychological impact on elite athletes due to the pandemic. However, beyond acute effects from lockdown and short-term interrupted athletic seasons, the postponed and still uncertain Olympic and Paralympic Games may represent a major career insecurity to many athletes world-wide, and may lead to severe changes to everyday lives and potentially prolonged psychological distress. Given the long-term perspective of these changes, researchers and stakeholders should address mental health and long-term job insecurity in athletes, including a specific focus on those with small financial margins, such as many female athletes, parasports athletes, athletes in smaller sports, and athletes from developing countries. Implications and the need for research are discussed.

scholarly journals Experiences of Mental Distress during COVID-19: Thematic Analysis of Discussion Forum Posts for Anxiety, Depression, and Obsessive-Compulsive Disorder

2021 ◽  
pp. 105413732110239
Author(s):  
G. Brewer ◽  
L. Centifanti ◽  
J. Castro Caicedo ◽  
G. Huxley ◽  
C. Peddie ◽  
...  
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Mental Distress ◽  
Psychological Impact ◽  
Discussion Forum ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Care Workers ◽  
Positive Experiences ◽  
Anxiety Depression ◽  
The Impact

The psychological impact of the COVID-19 pandemic on coronavirus patients, health care workers, and the general population is clear. Relatively few studies have, however, considered the impact of the pandemic on those with pre-existing mental health conditions. Therefore, the present study investigates the personal experiences of those with anxiety, depression, and obsessive-compulsive disorder during COVID-19. We conducted a qualitative study utilising Reddit discussion forum posts. We conducted three separate thematic analyses from 130 posts in subreddit forums aimed for people identifying with anxiety, depression, and obsessive-compulsive disorder. We identified a number of similar discussion forum themes (e.g., COVID-19 intensifying symptoms and a lack of social support), as well as themes that were unique to each forum type (e.g., hyperawareness and positive experiences during the pandemic). Findings should guide future practice and the support provided to those living with mental distress.

scholarly journals Alleviating psychological distress associated with a positive cervical cancer screening result: a randomized control trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yukari Isaka ◽  
Ai Hori ◽  
Rie Tanaka ◽  
Masao Ichikawa
Keyword(s):  
Cervical Cancer ◽  
Psychological Distress ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Control Groups ◽  
And Control ◽  
Screening Result

Abstract Background The method of communicating a positive cancer screening result should seek to alleviate psychological distress associated with a positive result. We evaluated whether the provision of information through a leaflet would help reduce psychological distress in a randomized controlled trial. Methods The participants were women aged 20–69 years who were about to undergo cervical cancer screening at health centers. Before the screening, they received hypothetical screening results, with a leaflet (intervention group, n = 493) or without it (control group, n = 479), randomly. Their psychological distress and intention to undergo further examination were then compared between the intervention and control groups. Results After the intervention (providing a leaflet with hypothetical screening results), psychological distress appeared to be higher in the control group than in the intervention group among those who received a hypothetical positive screening result (odds ratio: 2.57, 95% confidence interval: 1.87–3.54), while 95% and 97% of those in the intervention and control groups, respectively, reported that they would undergo further examination. Conclusions Information provision might help reduce psychological distress but not hinder further examination among women who screen positive for cervical cancer. Trial registration: UMIN Clinical Trials Registry UMIN000029894. Date of Registration: November 2017.

OP08 Levels and sources of stress reported by first year paramedic students associated with their first ambulance placement

2021 ◽  
Vol 38 (9) ◽  
pp. A4.2-A4
Author(s):  
Matthew Warren-James ◽  
Julie Hanson ◽  
Belinda Flanagan ◽  
Mary Katsikitis ◽  
Bill Lord
Keyword(s):  
Death And Dying ◽  
Educational Interventions ◽  
Fear Of Failure ◽  
Anxiety And Depression ◽  
Control Group ◽  
First Year ◽  
Before And After ◽  
Quasi Experimental ◽  
And Control ◽  
Experimental Group

BackgroundWhilst there is evidence to suggest paramedics experience significant stress when working in the ambulance setting little is known about the experiences of first year paramedic students. This research aimed to: (i) identify whether levels of stress, anxiety and depression experienced by first year paramedic students changed after ambulance placement compared to a control group, and (ii) identify the main perceived and actual sources of stress around ambulance placement.MethodsA before-and-after quasi-experimental design was used to compare whether the experience of ambulance placement altered the levels of stress, anxiety and depression in an experimental group that attended an ambulance placement (n = 20) and the control group who did not (n = 10). Online surveys encompassing the Depression, Anxiety and Stress Scale (DASS-21) and qualitative questions about sources of stress were concurrently deployed to both the experimental and control groups before and after the ambulance placement. Participants were first year paramedic students working in Queensland Ambulance Service, Australia.ResultsThere was a significant reduction in levels of stress in participants after undertaking their first ambulance placement (Mdn = -4.00) when compared to a control group (Mdn = 0.00), U = 52.5, p = .035, n2 = 0.15. Responses to survey questions suggest anticipation about experiencing death and dying of patients was the most frequently reported stressor of student paramedics before undertaking ambulance placements, however insecurity about knowledge, competence and fear of failure was the most frequently experienced stressor reported after completing ambulance placements.ConclusionsThe findings from this study suggest that the fear of the unknown may be worse than the reality. Anticipatory stress is the foremost problem for first year paramedic students attending their first ambulance placement. Placement pre-briefing should focus on educational interventions to build knowledge and skills competency to reduce stress levels and fear of failure.

FISCAL EQUIVALENCE: PRINCIPLE AND PREDATION IN THE PUBLIC ADMINISTRATION OF JUSTICE

2021 ◽  
Vol 38 (1) ◽  
pp. 244-265
Author(s):  
Emily C. Skarbek
Keyword(s):  
Public Administration ◽  
Equivalence Principle ◽  
Justice System ◽  
Service Providers ◽  
The Political ◽  
The Public ◽  
Local Police ◽  
Administration Of Justice ◽  
Internal Pressures ◽  
And Control

AbstractFiscal equivalence in the public administration of justice requires local police and courts to be financed exclusively by the populations that benefit from their services. Within a polycentric framework, broad based taxation to achieve fiscal equivalence is a desirable principle of public finance because it conceptually allows for the provision of justice to be determined by constituent’s preferences, and increases the political accountability of service providers to constituents. However, the overproduction of justice services can readily occur when the benefits of the justice system are not enjoyed equally. Paradoxically, the same properties that make fiscal equivalence desirable by imposing restraint and control between constituents and local government also create internal pressures for agents of the state to engage in predatory, revenue-generating behavior.

Communication Processes about Predictive Genetic Testing within High-Risk Breast Cancer Families: A Two-Phase Study Design

2021 ◽  
Author(s):  
Chiara Lena Blomen ◽  
Aliaksandra Pott ◽  
Alexander E. Volk ◽  
Lars Budäus ◽  
Isabell Witzel
Keyword(s):  
Psychological Distress ◽  
Genetic Testing ◽  
Psychological Impact ◽  
Family Members ◽  
Focus Group Interviews ◽  
Two Phase ◽  
Mutation Carriers ◽  
Communication Processes ◽  
Phase Study ◽  
Group Interviews

Abstract Background: The detection of a pathogenic variant in the BRCA1 or BRCA2 gene has medical and psychological consequences for both, affected mutation carriers and their relatives. This study analyzed the psychological impact of genetic testing and mutation-positive test result as well as associated family communication processes from the perspective of BRCA1 or BRCA2 mutation carriers and their family members.Methods: We conducted a two-phase study with explanatory sequential mixed methods design to understand the perspective of psychological process regarding genetic testing more efficiently. First, we analyzed a survey data of 79 carriers of a BRCA1 or BRCA2 mutation. Second, we conducted focus group interviews of 10 family members to deepen understanding of communication processes in high-risk families.Results: The average age of the BRCA1 or BRCA2 mutation carriers was 48 years, 58% had a history of cancer. The majority (64.6%) had general psychological distress independent of cancer diagnosis in the patients’ history. The point prevalence of depression was 16.9%. The main motives for undergoing genetic testing were desire for safety, prevention and risk assessment for the own children. The mutation carriers were satisfied with the decision to undergo genetic testing. Contrary to their subjective perception, the respondents' knowledge about those mutations was moderate. The familial communication was merely partially successful. In contrast to the high rate of disclosure to at-risk relatives (100%), the reported uptake of genetic testing among informed at-risk relatives was low (45.6%). In-depth focus group interviews with 10 family members revealed significant barriers to accessing genetic counseling including anxiety, uncertainty about the benefits of testing and the own cancer risk, particulary among males.Conclusion: The detection of a BRCA1 or BRCA2 mutation has psychological impact not only on mutation carriers but also on their family members. An adequate knowledge of the genetic background is required to reduce the level of psychological distress and to support the familial communication process. Therefore, the quality of information sources for affected individuals and relatives and also the awareness of health care professionals have to be improved.

scholarly journals Psychological distress among adult urban population of Puducherry

2018 ◽  
Vol 5 (8) ◽  
pp. 3265
Author(s):  
Murugan N. ◽  
Amit Kumar Mishra ◽  
Ramesh Chand Chauhan ◽  
Velavan A.
Keyword(s):  
Mental Health ◽  
Psychological Distress ◽  
Sampling Method ◽  
Mental Distress ◽  
Adult Population ◽  
General Health Questionnaire ◽  
Public Health Problem ◽  
Major Public Health Problem ◽  
Systematic Random Sampling ◽  
Study Population

Background: A large proportion of population in the community with psychological distress goes unnoticed. This study was done to assess the psychological distress among adult population of an urban area of Puducherry.Methods: The study was conducted among 569 individuals of age 18 years and above. Systematic random sampling method was used to select the households in the study area and from each household one adult was randomly selected. The General Health Questionnaire-12 (GHQ-12) was used to assess the psychological distress among the study participants.Results: Majority of the participants had low psychological distress (60.5%) followed by typical (19.3%), more than typical (10%), evidence of psychological distress (6.2%) & severe distress (4%). One-fifth (20.2%) of the participants had psychological distress which needs attention. The mental health status of the participants was significantly associated with the age, sex, marital status, religion and education (p<0.05).Conclusions: The psychological distress is a major public health problem in the study population. Focused interventions to improve the mental health of population are required to decrease the mental distress in the community. 

scholarly journals Effectiveness of a Need-Based Program in Relieving Psychological Distress of Family Caregivers of Leukemia Patients: A Randomized Clinical Trial

2021 ◽  
Author(s):  
Mehrdad Abdullahzadeh ◽  
Narjes Khosravi
Keyword(s):  
Clinical Trial ◽  
Psychological Distress ◽  
Family Caregivers ◽  
Psychological Needs ◽  
Anxiety And Depression ◽  
Study Group ◽  
Control Groups ◽  
Significant Difference ◽  
The Mean ◽  
And Control

Abstract PurposeThe family of leukemia patients, due to their caring role, often feel psychological distress. This paper describes the efficacy of a designed family-need-based program on relieving depression, anxiety, and stress of family caregivers of leukemia patients by meeting the specific psychological needs of caregivers.MethodsIn this clinical trial, 64 family caregivers of leukemia patients referring to a medical center in Iran were recruited by convenience sampling and divided into study and control groups randomly. The study group attended a designed need-based program. The control group did not receive the intervention. Stress, anxiety, and depression before, right after, and one month after the intervention in family caregivers were compared using DASS-42. Data were analyzed using descriptive and inferential statistics; the significance level adopted was 5%.ResultsBefore the intervention, the mean score of depression, anxiety, and stress scale in both study and control groups showed no considerable difference (P > 0.05). After the intervention, the mean score of DASS-42 revealed a significant difference between the two groups and the study group did better on outcomes (P < 0.001).ConclusionThis family-need-based program can decrease the level of stress, anxiety, and depression of the family caregivers of leukemia patients and may potentially alleviate the psychological distress of family caregivers over their caring role.Trial registration number: IRCT2013093011895N2. Date of registration: 2014-05-06

scholarly journals Social Capital as a Moderator for Caregivers’ Psychological Distress: A Dynamic Panel Data Model Analysis in Japan

2021 ◽  
Author(s):  
Takashi Oshio ◽  
Kemmyo Sugiyama
Keyword(s):  
Social Capital ◽  
Psychological Distress ◽  
Panel Data ◽  
Family Caregiving ◽  
Positive Impact ◽  
Psychological Impact ◽  
Dynamic Panel Data ◽  
Moderating Effect ◽  
Dynamic Panel ◽  
Dynamic Framework

Abstract Background: The adverse impact of caregiving on caregivers’ mental health and the positive impact of social capital (SC) on health are both well understood. This study examined the moderating effect of SC on the association between family caregiving and caregivers’ psychological distress (PD).Methods: We used longitudinal data from 27,869 individuals born between 1946 and 1955. The data were collected from a 14-wave nationwide longitudinal survey conducted from 2005 to 2018. We estimated dynamic panel data (DPD) models, which could control for an individual’s time-invariant attributes in a dynamic framework. We did this to examine how SC moderated the association between informal caregiving and a caregiver’s PD (defined by a Kessler score of 13 or higher). We also examined how the results varied over time, as the caregiver’s age advanced.Results: Of the respondents aged 50–73 years, 12.5% of women and 8.4% of men provided care to their older parents or spouses. The DPD model results showed that the onset of caregiving increased the probability of PD (M 3.4%) by 2.1% (95% confidence interval [CI]: 1.6%–2.7%) and 1.1% (95% CI: 0.5%–1.6%) for women and men, respectively. SC moderated the association between caregiving and a caregiver’s PD by 53.4% (95%: 30.4%–76.4%) and 84.9% (95% CI: 62.0%–107.8%) for women and men, respectively. We also observed that the moderating effect of SC on a caregiver’s PD increased as the caregiver’s age advanced in both women and men, preventing a deterioration in the psychological impact of caregiving. Conclusions: The results underscore the moderating effect of SC on the association between caregiving and PD. This suggests the need to keep family caregivers from being socially isolated, especially as they get older.

772 Examining sleep difficulties and suicide ideation among those reporting abuse and dependence on illicit drugs and alcohol

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A300-A301
Author(s):  
Rebecca Robbins ◽  
Ralph J DiClimente ◽  
Matthew Weaver ◽  
Catherine Di Gangi ◽  
Isabel Chalem ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Drug Abuse ◽  
Alcohol Use ◽  
Sleep Disturbance ◽  
Suicidal Behavior ◽  
Illicit Drugs ◽  
Illicit Drug ◽  
Drugs And Alcohol ◽  
Illicit Drug Abuse ◽  
The Relationship

Abstract Introduction Sleep disturbance is associated with poor mental health and may contribute to initiating or continuing use/abuse of alcohol and drugs. Using data from a nationwide survey, we examined the relationship between sleep disturbance and suicide behaviors among youth and adults, including those who report drug/alcohol use and abuse. Methods We analyzed data from the 2018 National Survey on Drug Use and Health (NSDUH), an annual survey collecting information about the use of illicit drugs and alcohol among non-institutionalized U.S. youth (age 12–17) and adults (age&gt;17). The 2018 survey included 9,398 youth and 43,026 adult respondents. Depression was assessed in adults with the Kessler-6 and in youth with several questions assessing psychological distress. Those who scored at risk for psychological distress were also asked about sleep disturbance and suicidal behaviors (i.e., ideation, planning, attempt). All were asked to report their drug/alcohol use and/or abuse. Our study population included those who reported psychological distress. We conducted binary logistic regression to examine the relationship between suicidal behavior and sleep disturbance in this population. We also conducted sub-analyses to explore the relationship between suicidal behavior and sleep disturbance among those reporting drug/alcohol use and abuse. Results Youth were 29% male and 71% female, adults were 36% male and 64% female. Adult participants, 39% were 18 to 25, 22% were 26 to 34, and 39% were age 35 and older. Among those with psychological distress, suicidal behavior was more likely among those who reported sleep disturbance (youth: OR=2.7, 95%CI:1.8–4.0; adults: OR=1.3, 95%CI:1.2–1.5). Also, among those with psychological distress, suicidal behavior was more likely among those who reported concomitant sleep disturbance and either alcohol abuse/alcoholism (youth: OR:3.3, 95%CI:1.6–7.0; adults: OR=1.4, 95%CI:1.1–1.7); illicit drug abuse (youth: OR=3.5, 95%CI:1.6–7.4; adults: OR=1.3, 95%CI:1.0–1.6); or alcohol and illicit drug abuse (youth: OR=3.2, 95%CI:1.5–6.9; adults: OR=1.4, 95%CI:1.1–1.7). Conclusion Youth and adults with psychological distress and sleep disturbance are more likely to also report suicidal behaviors. Alcohol and drug use or abuse increase their risk for suicidal behavior compared to those who do not report sleep disturbance. Future work should include examination of causality and of interventions. Support (if any) NIH K24-HL105664, P01-AG009975, T32-HL007901, K01HL150339, 1R56HL151637

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