Lung cancer patients generally experience high levels of physical and psychological distress and decreased quality of life (QOL). Sense of coherence (SOC) has been conceptualized as a personality orientation reflecting the degree to which an individual perceives their world as comprehensible, manageable and meaningful. The present study investigated the associations of SOC with QOL in lung cancer. It also examined potential psychological mediators by which SOC may exert its influences on QOL. Fifty-six participants with non-small cell lung cancer were administered self-report assessments of SOC, QOL and psychological distress. Results revealed that SOC was positively associated with QOL and this relationship may be mediated by depressive symptoms. The current study supports the notion that SOC may be a protective factor with regard to psychological adjustment and QOL in cancer survivors.

Rooted in adult identity development and social identity theories, this dissertation investigated the experiences of discrimination, ethnic and national identity, and psychological distress amongst immigrant adults (ages 40-64) in Canada. A mixed methodological approach was used to quantitatively investigate the links among discrimination, ethnic identity, and psychological distress as well as the links between social identity and identity management strategies. Open-ended questions and thematic analysis were used to identify the ways in which discrimination affects participants’ sense of belonging and connection to their ethnic group and Canadian society. The findings of this dissertation highlight the major protective function of (ethnic and national) identity affirmation, both in buffering discrimination-related stress and guiding the selection of adaptive identity management strategies. Equally, the qualitative work provides insight into the myriad of ways that individuals protect their sense of self when faced with discrimination. A major contribution of this work is an evaluation of the applicability of existing identity theories to adults in midlife and the integration of a number of disparate areas of identity theory. Clinical and policy implications as well as future directions for research are discussed. / Graduate

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The coronavirus disease 2019 (COVID-19, i.e., C-19) pandemic promulgated psychological distress among employees across the United States, necessitating the examination of its consequential negative impact. By drawing upon conservation of resource and scarcity theory, this research develops a theoretical model that demonstrates how employees’ psychological distress triggered by the C-19 pandemic (C-19PD) sways their task performance, organizational citizenship behavior (OCB), and work withdrawal via work engagement. As first-stage moderators, I propose core self-evaluations (CSE), servant leadership, and perceived organizational support (POS) as moderators of the link between C-19PD and work engagement. As second-stage moderators, I propose task interdependence, constraints, and telecommuting intensity as moderators of the link between work engagement and task performance, OCB, and work withdrawal. An individual-level survey study was designed to gather a data set of 275 currently employed workers from four public universities in the U.S., and the mediation hypotheses were supported. However, the moderating effects of CSE, servant leadership, and POS (i.e., first stage moderators) and task interdependence, constraints, and telecommuting intensity (i.e., second stage moderators) were not supported. Implications for theory, limitations, future research directions, and practical applications are discussed.

We analyze data from the South African Stress and Health Study, a nationally representative in-person psychiatric epidemiologic survey of 4,351 adults conducted as part of the World Mental Health Survey Initiative between January 2002 and June 2004. All blacks (Africans, Coloreds, and Indians) initially report higher levels of non-specific distress and anger/hostility than whites. Access to socioeconomic resources helps explain differences in non-specific distress between Coloreds and whites and Indians and whites. However, only when social stressors are considered do we find few differences in psychological distress (i.e., non-specific distress and anger/hostility) between Africans and whites. In addition, self-esteem and mastery have independent effects on non-specific distress and anger/hostility, but differences between Coloreds and whites in feelings of anger/hostility are not completely explained by self-esteem and mastery. The findings contribute to the international body of work on social stress theory, challenge underlying assumptions of the minority status perspective, and raise a series of questions regarding mental health disparities among South Africans.

Using nationally representative data from South Africa, we examine lifetime prevalence of traumas and multiple traumas (number of events). Employing multiple regression analysis, the authors study the sociodemographic risk of trauma, and the association between trauma and distress. Results indicate most South Africans experience at least one traumatic event during their lives, with the majority reporting multiple. Consistent variation in risk is evident for gender and marital status, but not other sociodemographics. Trauma is positively related to high distress, and findings also support a cumulative effect of trauma exposure. Individuals with the most traumas (6+) appear at 5 times greater risk of high distress. This study highlights the importance of considering traumatic events in the context of other traumas in South Africa.

Sexual minority individuals (lesbians, gay men, and bisexuals) suffer from stigmatization, or minority stress, which often predicts negative mental health outcomes and low self-esteem. However, specific dimensions of identity (e.g., centrality and regard) may buffer against these negative outcomes in racial minorities and other stigmatized groups, including sexual minorities. Indeed, research in other stigmatized populations has found evidence for the protective properties of identity. Yet, limited research has examined dimensions of identity that buffer or protect sexual minorities. This study aimed to explore the moderating role of identity characteristics in the relation between sexual stigma and mental health outcomes. Findings in a sample of 209 gay, lesbian, and bisexual individuals suggested that public stigma, centrality, and private regard predict psychological distress, but did not support a moderation model. Private regard emerged as a predictor of self-esteem as well. Additionally, centrality and public stigma interacted in such a way that those who reported higher centrality of sexual orientation identity did not report decrements to self-esteem in the face of public stigma to the same extent as those who reported lower centrality of sexual orientation identity. All of these suggest centrality and private regard as key factors in the psychological well-being of sexual minorities and should further be explored.

Sexual minority individuals (lesbians, gay men, and bisexuals) suffer from stigmatization, or minority stress, which often predicts negative mental health outcomes and low self-esteem. However, specific dimensions of identity (e.g., centrality and regard) may buffer against these negative outcomes in racial minorities and other stigmatized groups, including sexual minorities. Indeed, research in other stigmatized populations has found evidence for the protective properties of identity. Yet, limited research has examined dimensions of identity that buffer or protect sexual minorities. This study aimed to explore the moderating role of identity characteristics in the relation between sexual stigma and mental health outcomes. Findings in a sample of 209 gay, lesbian, and bisexual individuals suggested that public stigma, centrality, and private regard predict psychological distress, but did not support a moderation model. Private regard emerged as a predictor of self-esteem as well. Additionally, centrality and public stigma interacted in such a way that those who reported higher centrality of sexual orientation identity did not report decrements to self-esteem in the face of public stigma to the same extent as those who reported lower centrality of sexual orientation identity. All of these suggest centrality and private regard as key factors in the psychological well-being of sexual minorities and should further be explored.

Background: The burden of breast cancer may contribute to elevated psychological distress. Conversely, distress may negatively impact the development, recurrence and diagnosis of cancer as it compromises the immune system and adherence to treatment, creating a vicious cycle. With the breast cancer fatality rate significantly higher in Sub-Saharan African women than in women living in higher income countries, further research is needed to limit the devastating impact of chronic diseases on this population. Purpose: The aim of the study was to determine if Ghanaian breast cancer patients were more susceptible to higher psychological distress and lower quality of life than healthy Ghanaian women and how their lived experiences affect their mental health. Method: Sixty-four breast cancer patients and 64 healthy participants were recruited to complete the Kessler Psychological Distress Scale and World Health Organization Quality of life-BREF scale. The life experiences of women living with breast cancer were assessed through semi-structured interviews. Results: Breast cancer patients had higher psychological distress than the healthy women and also scored lower on the quality of life domains of physical health, psychological well-being and environment. The lived experiences of the breast cancer patients followed a similar journey from suspicion of ill-health to difficulty navigating the health system, feeling the effects of breast cancer and lastly, regaining confidence. Breast cancer had affected the women’s daily activities, health, female identity, roles and responsibilities. However, financial, emotional and social support, together with individual coping mechanisms such as religion and physical exercise, mitigated the impact of the breast disease. Conclusion: Patient centered care approaches could ease the psychological distress of breast cancer patients. Finally, future research should investigate methods of improving the women’s psychological well-being, physical health and environment as it may positively impact the prognosis of Ghanaian breast cancer patients. / Thesis / Master of Science (MSc)

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