A certain community within the southern region of Texas has consistently been linked to escalating poverty, high crime rates, low educational achievement, and poor physical and mental health. For the purpose of this research, this community will be referred to as Community X. Although some researchers have found that sense of community and supportive social networks are associated with healthy mental and physical functioning, others have suggested that in a debilitated community social networks can facilitate psychological distress and a strong sense of community is difficult to develop. Guided by Bronfenbrenner's ecological model, the purpose of this quantitative correlational study was to examine the combination of 3 Social Network Index (SNI) scores and 4 Sense of Community Index 2 (SCI-2) scores that affect Kessler Psychological Distress Scale (K10) scores. For the 106 Community X resident participants, as the SNI number of embedded networks increased, K10 scores tended to increase, indicating higher levels of psychological distress (consistent with the negative effect research). In a cluster analysis, two clusters emerged in which one cluster (n = 67) had positive z-score means on all SNI indices and all SCI-2 subscales, while the other cluster (n = 39) had all negative z-score means. The cluster with all positive scores had lower K10 psychological distress scores (consistent with the positive effect research), but the difference was not statistically significant. The mixed results indicated that comparative research is needed to control for communities of varying ecological distress to better relate psychological distress to sense of community and the valence of social networks to facilitate positive social change health policies and interventions that are ecological-distress sensitive.

The current study focuses on exploring the effects of previous child neglect on current psychological distress in college students. By bringing attention to the lasting impact of neglect through adulthood, mental health professionals will see the need for increased services for this population. A convenience sample of 93 Master of Social Work students responded to questions geared towards experience of neglect as a child and current psychological distress. Correlation analysis was used to examine the relationship between the two variables. No significant results were found. However, future studies are suggested as alternate versions of this study may support the need for early intervention and treatment services for individuals who have experienced neglect as a child. Recommendations for future studies include using a more diverse population and possibly including a qualitative portion to further explore correlations.

Thesis (M.A.) (Psychology) ---University of Limpopo, 2010 / The aim of the present study was to investigate the impact of teenage pregnancy on pregnant teenagers. Specifically, the study sought to determine whether or not pregnant teenagers experience psychological distress during pregnancy, and to explore the nature of such distress. Fifty two (52) pregnant teenagers were conveniently sampled to participate in the study. Their ages ranged from 15 to 20 years, with the gestation period ranging from 4 to 9 months. The sample included pregnant teenagers from high schools and tertiary institutions in the Capricorn District (Limpopo Province). Data was collected using triangulation of methods, namely quantitative and qualitative methods. For the quantitative data, a 28-item General Health Questionnaire (GHQ-28) which measures such factors as somatic complaints, anxiety and insomnia, social isolation, and depression was used. For qualitative data, three focus group interviews were conducted with the participants. The results suggested indications of psychological distress during the gestation period. These included experiences of symptoms associated with somatic complaints, anxiety and insomnia, social isolation and severe depression. Furthermore, the study showed themes of distress wherein teenagers react to the realisation of pregnancy with fear and disbelief, and thoughts of termination of pregnancy. Participants gave reports that pregnancy was seen as a shameful event for the teenagers involved. Coping strategies noted included teenagers‟ resort to avoidance of situations which were perceived to be stressful, and also associating with people they perceived as being more supportive. Based on the findings, the following recommendations were made: a) Intervention programmes should be put in place so as to help minimise the psychological and social problems experienced by pregnant teenagers, for example, crisis management skills could be offered to help deal with the trauma experienced; b) Social support structures should be made available to pregnant teenagers; and, c) Cultural practices should be incorporated in education syllabi that focus on human sexuality and reproduction. / N/A

Scant attention has been given to occupational health hazards of Australian veterinarians. This study aimed to identify the major risk factors for occupational injury and disease, emotional health and suicide rates of veterinarians. Qualitative in-depth interviews with 45 veterinarians were carried out which revealed that a significant proportion of veterinarians were both injured, stressed and had incurred zoonotic diseases. Data linkage of the names of registered veterinarians in Western Australia with four Health Department of Western Australia databases was undertaken to provide supportive statistics on the conditions identified as being important in the interviews. The results of this latter analysis were inconclusive. Therefore a self-administered questionnaire was developed, which collected quantitative data on injuries, disease, stress and risk factors from 419 veterinarians. Since the in-depth interviews had identified stress and suicide ideation as being very significant for many of those interviewed, the Kessler 10+ scale for measuring psychological distress was included in the self-administered questionnaire. The data linkage was unable to provide accurate data about numbers of deaths of veterinarians and the records of coroners in Victoria and Western Australia which provided data on 89 veterinarians, were analysed to determine suicide rates. Despite the interviews providing considerable information about rates and risk factors for injuries, disease and stress, no statistical analyses were undertaken because they provided insufficient data for quantitative analyses. / Nevertheless, statistics derived from the morbidity database using data-linkage, will be useful in comparing injuries in any future studies of this type. Data collected from the self-administered questionnaire were subjected to Chi square, and non-parametric tests and logistic regression analyses using multiple imputation for missing values. Age-standardised and age-specific rates (ASR) were calculated for data on suicide in veterinarians derived from coroners' records obtained from Western Australia and Victoria using the Rates Calculator developed by Codde.' The interviews and the survey of 464 veterinarians showed that a significant proportion of veterinarians incurred injuries and zoonotic diseases, and were highly stressed and distressed. The interviews showed that a significant proportion of veterinarians expected to be injured and/or contract zoonotic diseases. It is suggested that this acceptance may, in part, account for the number of injuries that occur. Some of these injuries, especially in mixed animal veterinarians, may be attributable to poor facilities on farms and a lack of competent support in restraint of animals. There needs to be a cultural change with regard to safety if injury is to be reduced. Using the Chi-squared analyses of the survey data, injury was associated with several risk factors including being a practice owner and being in mixed animal practice, being younger and with having taken drugs such as marijuana in the past 12 months. / When all these variables were input into a logistic regression model, several of these risk factors were eliminated providing only three risk factors as predictors of injury. These were: having a back injury; taking drugs in the previous 12 months; and being between 35 and 54 years of age. Having high distress levels was not a predictor for injury. Analyses of responses to the KlOi- scale in the self-administered questionnaire revealed that the proportion of highly distressed respondents was double that of the Western Australian, New South Wales and Australian general populations which supports the findings from the interviews. Logistic regression provided three predictors for distress: being less than 35 years of age, having taken drugs in the past 12 months, and having a back injury, however having other workplace injuries was not a predictor. The findings that the suicide rate in this study was about four times that of the general Australian adult population, should be of major concern and signal that there may be factors specific to the veterinary profession that account for this high rate. This study has shown that there are high levels of psychological distress in veterinarians, especially practitioners, which suggests that veterinary practice may, in itself, be a stressful occupation. However, it may also be that some individuals with a predilection for distress, are being recruited into the veterinary profession. / Better selection techniques for recruiting veterinary students using an aptitude test as well as interviews, could identify those who were unsuited for becoming veterinarians or who required additional mentoring and support upon graduation. This could reduce stress, distress and suicide in the veterinary profession. Overall, 17 recommendations were made directed at improving the quality of data collection to obtain more reliable statistical outcomes, and suggesting ways of reducing injury, distress and zoonotic disease in veterinarians.

Approximately one-third of U.S. adults are at increased risk for life-threatening diseases such as atherosclerosis and type 2 diabetes mellitus. Such individuals are considered healthy without any diagnosed cardiometabolic conditions but may have a constellation of cardiometabolic complications that include obesity, glucose intolerance, hyperinsulinemia, dyslipidemia, hypertension, insulin resistance, and hypertriglyceridemia. When most of these preclinical conditions comorbidly occur, the condition has been referred to as metabolic syndrome (MetS). MetS is considered to reflect one or more early pathophysiological processes in cardiometabolic disease; however, the extent to which these complications and their underlying pathophysiology interact with behavioral factors such as stress, diet, and physical activity have not been clearly established. For example, diet consisting of high total caloric intake and high fat composition is posited to contribute to obesity and other cardiometabolic risk factors, but research is inconsistent regarding the effect of psychological distress (i.e., anxiety, stress, depression, anger) on dietary intake and whether dietary intake mediates a relationship between distress and preclinical cardiometabolic disease risk. One factor that has been suggested to play a role in the distress – dietary intake relationship is eating style. Research on eating styles has identified four main types that may be related to distress and dietary intake: restrained, disinhibited, emotional, and external eating. Restrained eaters consciously restrict food intake to control body weight and body shape. Disinhibited eating refers to overeating that occurs following failure of restraint. Emotional eaters consume foods to reduce and alleviate negative emotions, such as anxiety. External eating occurs in response to immediate food-related external stimuli, regardless of internal physiological cues of hunger. Current evidence suggests each of these eating styles moderates the relationship between distress and dietary intake. There is also some research to suggest a relationship between eating styles and weight gain, body mass index (BMI), and development of obesity. However, no study has examined the interrelationships among psychological distress, eating style, and central obesity, and whether these relationships differ according to gender. Moreover, the extent to which distress and eating style may be associated with cardiometabolic risk beyond obesity is unknown. Thus, the main aim of the present study was to test a model of mediation and moderation to evaluate how psychological distress, eating styles, dietary intake, and gender are associated with measures of cardiometabolic risk in healthy individuals (Figure 1). Four hundred sixty-four participants contributed data from two different studies: Obesity, Metabolic Syndrome, and Meal-Related Glycemia (SUGAR) and Markers Assessing Risk for Cardiovascular Health (MARCH). All participants were aged 18-55 years, had no major systemic disease, were not using medications having a cardiovascular, carbohydrate, endocrine, or psychiatric effect, and had no history of substance or alcohol abuse or dependence. The study employed a structural equation modeling (SEM) approach to assess the following aims: 1) to develop composite, latent factors to reflect psychological distress, eating style, and dietary intake using confirmatory factor analysis (CFA) and to develop a hybrid model of cardiometabolic risk; and 2) to simultaneously test the interrelationships among factors in a comprehensive model so that the strength of direct and indirect effects can be evaluated while statistically controlling for the other factors and covariates in the model. Latent factor models of psychological distress and eating style fit the data and were statistically acceptable, and a hybrid model of cardiometabolic risk fit the data and its CFA components were acceptable. A latent factor model of dietary intake would have likely fit the data and been statistically acceptable given the high intercorrelations among dietary variables, but no such factor was created because dietary variables failed to confirm the hypothesized associations with other model components (e.g., waist girth, eating styles); thus, these measures were excluded from further SEM analyses. Final model results showed that psychological distress was positively related to restrained, emotional, and external eating styles, but only restrained eating was directly associated with greater waist girth. Distress was not directly related to cardiometabolic risk, but an indirect effect was found in which higher levels of distress led to greater waist girth via higher levels of restrained eating. Waist girth, in turn, served as a significant mediator between restrained eating and worse insulin sensitivity, higher blood pressure, diminished glucose tolerance, and greater dyslipidemia. These effects were significant when controlling for age, gender, education, and physical activity, and when analyzed in a comprehensive SEM model simultaneously including distress, eating style, and cardiometabolic risk variables. Of note, results suggest the possibility for a reversed effect such that waist girth leads to restrained eating. Findings also suggest that emotional eating may lead to distress. In contrast, the relationship between distress and the other two eating styles, restrained and external eating, appeared unidirectional such that distress leads to restrained and external eating but not the reverse. Future studies using longitudinal data are needed to better understand these relationships in regards to causality. Data from the MARCH subsample was excluded from the above final modeling analyses because eating style data were only available for the SUGAR subsample. Thus, the role of gender in how distress, eating styles, and cardiometabolic risk are interrelated could not be examined due to the small number of women in the SUGAR study (n = 38). It remains unknown whether the significant effect of distress on each of the eating styles found in the current study was driven primarily by men, women, or both equally. Similarly, the sample size would not permit the evaluation of whether gender moderated the effect of restrained eating on central obesity. Given that women in the current study reported more restrained, emotional, and external eating than men, future studies with larger samples should follow-up by assessing for potential moderating effects of gender. The present findings suggest that decreasing restrained eating style may lead to less central fat deposition and hence reduced cardiometabolic risk. Such “non-diet” interventions show potential for improved cardiometabolic health, but more research is needed. Particularly needed are studies examining prevention and intervention outcomes based on type of restrained eating – flexible versus rigid – to better understand how these different subtypes operate and how they can be altered effectively to improve health.

The overall aim of this thesis was to elucidate and investigate psychophysiological aspects and effects of acupuncture and needle stimulation. Within this framework emphasis was directed toward the effects of needle stimulation (acupuncture) on muscle blood flow in the tibialis anterior and trapezius muscles in healthy subjects and patients suffering from chronic muscle pain. This study also included evaluation of a new application of photoplethysmography in noninvasive monitoring of muscle blood flow. The evaluation was based on experiments known to provocate skin or muscle blood flow. The psychological aspects studied comprised the effects of manual acupuncture on pain in fibromyalgia patients and the effects of electro-acupuncture on psychological distress and vasomotor symptoms in postmenopausal women in the clinical context. The results showed that photoplethysmography have potential to noninvasively monitor muscle blood flow and to discriminate between blood flow in skin and muscle, although some considerations still have to be accounted for. It was further shown that muscle blood flow change in response to needle stimulation differed between healthy subjects and patients. Deep needle stimulation in the muscle of healthy subjects consistently increased muscle blood flow more than subcutaneous needle stimulation. In the painful trapezius muscle of FMS patients, however, subcutaneous needling was equal or even more effective in increasing muscle blood flow than deep intramuscular stimulation. Generally, needle stimuli had weak effect on blood flow in the trapezius muscle of the severely affected trapezius myalgia patients, possibly depending on older age and lesser number of patients included in the study. The different patterns of blood flow response to needle stimulation between healthy subjects and patients with chronic muscle pain might be a manifestation of altered somatosensory processing in the patients. The clinical studies showed that best pain relief of acupuncture in FMS patients was achieved in the neck-shoulder region, while the effect on the generalised symptoms was of short duration. Well-being and sleep was found to best predict treatment outcome. The results suggest that acupuncture treatment may be used for the alleviation of neck-shoulder pain, primarily, but it is not an alternative as the sole treatment. Electro-acupuncture, significantly decreased psychological distress and climacteric symptoms in postmenopausal women, but not better than a (near-) placebo control, implying pronounced non-specific effects. / Akupunktur ingår som en del i traditionell kinesisk medicin (TCM) och har använts i över 2000 år för att lindra sjukdom och symptom. I Sverige blev akupunktur godkänd som smärtlindringsmetod inom Hälso- och Sjukvården 1984. Sedan nästan 10 år är akupunktur jämställd med övrig behandling i sjukvården vilket innebär, att akupunktur kan användas även för behandling av annat än smärta. Förutsättningen är emellertid, att det finns tillräckligt med vetenskapliga belägg, s.k. evidens, för detta. I de allra flesta fall saknas det idag. För att säkerställa att evidens föreligger krävs omfattande forskning om effekter av akupunktur. Syftet med de olika studierna i avhandlingen var att belysa och studera psykologiska och fysiologiska aspekter och effekter av akupunktur och nålstimulering. Effekt på blodflöde i hud och muskel undersöktes på friska personer och på patienter med kronisk muskelsmärta. Normalt krävs ett mindre kirurgiskt ingrepp för att mäta blodflöde i muskel, men i dessa studier användes en mätmetod, som enkelt och utan ingrepp (icke-invasivt) i normala fall används för att mäta blodflöde i huden, s.k. fotopletysmografi (PPG, eng.). Med hjälp av ny teknik användes PPG i dessa studier för att mäta även muskelblodflöde. En studie för utvärdering av den nya PPG-tekniken ingick också i avhandlingen. Utvärderingen av mätmetoden visade goda möjligheter att mäta muskelblodflöde icke-invasivt med hjälp av PPG. Hos friska personer blev effekten på blodflödet störst vid djup stimulering i muskeln och där den s.k. DeQi-känslan framkallades (som vid klassisk akupunktur). Hos patienter med fibromyalgi var nålstimulering i huden lika, eller t.o.m. mer, effektiv att öka muskelblodflödet i skuldran än den djupa nålstimuleringen. De olika mönstren av blodflödesökning mellan de friska personerna och patienterna kan bero på ett förändrat reaktionssätt i nervsystemet som svar på smärtsam stimulering. I två kliniska studier studerades den smärtlindrande effekten av manuell akupunktur vid fibromyalgi och effekten av elektroakupunktur på stress och klimakteriebesvär hos kvinnor i övergångsåldern. Akupunktur vid fibromyalgi visade sig ha bäst smärtlindrande effekt i nack-skulderområdet, medan effekten på de generella symptomen var kortvarig. Patienter som mådde och sov relativt bra erhöll bäst effekt. Efter en behandlingsserie, bestående av elektroakupunktur, minskade stress och klimakteriebesvär påtagligt hos kvinnorna i övergångsåldern, men inte mer än hos en grupp kvinnor, som fick en kontrollbehandling bestående av mycket ytligt placerade nålar i huden. Detta tyder på att en betydlig del av behandlingsresultatet utgjordes av ospecifika effekter eller, s.k. eller placeboeffekter.

Objectives: To demonstrate that at 6-months post-cessation of cognitive behaviour therapy (CBT) adapted for acquired brain injury (ABI), (1) patients maintain psychological benefits, (2) coping strategy selection improves, (3) community integration is enhanced, and (4) benefits are observed in both face-to-face and telephone administrations. Methods: Participants. Seventeen ABI patients with elevated psychological distress. Outcome Measures. Pre-treatment, post-treatment and 6-month follow-up performance on the Symptom Checklist-90-revised (SCL-90-R), Depression, Anxiety Stress Scales (DASS-21), Community Integration Questionnaire (CIQ) and the Ways of Coping-Revised Questionnaire (WOC-R). Procedures. Eleven CBT sessions provided in group, face-to-face format or individually by telephone. Results: For face-to-face and telephone groups, psychological distress was significantly reduced from pre-treatment to 6-months follow-up: DASS-21 (t16= 7.32, p <.000); SCL-90-R (t16= 6.22, p <.000). Community integration (t16= -6.15 p<.000) and problem-focused coping (t16= -3.67, p<.01) were also significantly enhanced. Conclusion: CBT adapted for patients with ABI carries robust benefits even 6-months after treatment.

Objectives: To demonstrate that at 6-months post-cessation of cognitive behaviour therapy (CBT) adapted for acquired brain injury (ABI), (1) patients maintain psychological benefits, (2) coping strategy selection improves, (3) community integration is enhanced, and (4) benefits are observed in both face-to-face and telephone administrations. Methods: Participants. Seventeen ABI patients with elevated psychological distress. Outcome Measures. Pre-treatment, post-treatment and 6-month follow-up performance on the Symptom Checklist-90-revised (SCL-90-R), Depression, Anxiety Stress Scales (DASS-21), Community Integration Questionnaire (CIQ) and the Ways of Coping-Revised Questionnaire (WOC-R). Procedures. Eleven CBT sessions provided in group, face-to-face format or individually by telephone. Results: For face-to-face and telephone groups, psychological distress was significantly reduced from pre-treatment to 6-months follow-up: DASS-21 (t16= 7.32, p <.000); SCL-90-R (t16= 6.22, p <.000). Community integration (t16= -6.15 p<.000) and problem-focused coping (t16= -3.67, p<.01) were also significantly enhanced. Conclusion: CBT adapted for patients with ABI carries robust benefits even 6-months after treatment.

Research suggests that single mothers experience poorer mental and physical health than their partnered counterparts. This health differential has been attributed, in large part, to the chronic economic and social stressors to which many single mothers are exposed. Less research, however, has focused on the well-being of single mothers who are employed, despite their growing presence in the Canadian labour force. Using data from a telephone survey of employed parents in a mid-sized Western Canadian city conducted in 2005, the aim of this study was to: (1) compare the mental health of employed, single mothers relative to partnered mothers; and (2) explore the potential role of work-family conflict and psychosocial job characteristics as explanations for any observed differences in psychological distress. Analyses were restricted to 674 employed mothers (438 partnered and 236 single), who were 25-50 years old, with at least one child in the household under the age of 20 years. Bivariate analysis indicated that compared to partnered mothers, employed single mothers reported significantly higher levels of psychological distress, work-to-family conflict and family-to-work conflict. Single mothers were also more likely to be employed in a high-strain psychosocial work environment (i.e., high demand and low control). Multiple linear regression revealed that after adjusting for key sociodemographic characteristics, psychosocial work quality and work-family conflict, single parenthood was no longer statistically significantly associated with psychological distress. These findings suggest that being a single mother in and of itself need not result in poorer mental health, but greater attention needs to be paid to the economic and psychosocial work environment of single mothers, including policies to facilitate work-family balance.

Introduction: South Africa has an HIV-infection rate of 5 million people. Between 1995 and 2005, South Africa is expected to have the highest number of AIDS-related deaths on the African continent, a total of 2.7 million. Many infected individuals are women. However, there is very little research conducted with South African women examining the relationship between HIV-infection and psychological distress. Research conducted in the United States indicates that HIV-infection is associated with increased rates of depression and anxiety. This research project aims to explore the relationship between HIV-infection and psychological functioning in the unique socio-political context of South Africa. In addition, the aim is to begin identifying potential factors that moderate this relationship. Method: A group of HIV-infected Black South African women (N = 104) and a community control sample (N = 144) were recruited from both urban and rural areas in the Gautang Province. These women participated in a one-on-one verbally administered interview assessing for psychological distress and various material, personal, family, and social resource factors. Results: HIV-infection was associated with higher rates of depression, but not anxiety. In addition, women with HIV-infection reported more malnutrition risk, emotion-focused coping, stressful life events, powerlessness in relationships with male partners, HIV-stigma, and healthcare satisfaction, than the non-infected women. Variables that were directly associated with depression and anxiety included nutrition, stressful life events, powerlessness in relationships, family social support, and community agency access. HIV-stigma was also directly associated with depression. Furthermore, health-care access, emotion-focused coping, and family social support moderated the relationship between HIV-status and depression, and stressful life events moderated the relationship between HIV-status and anxiety. Discussion: This research study provides further evidence for the relationship between HIV-status and psychological distress among Black South African women. It also identified potential protective factors that could be directly addressed through community-based interventions in order to enhance the psychological functioning of these women.