This study examined the relationship between race and mental health among Canadian adults. The purpose was to assess how social organization contributes to the racial distribution of mental health. The study defined mental health as a multi-dimensional construct that includes negative, positive, and subjective facets. The empirical analysis compared East Asians, South Asians, Blacks, Aboriginals, and mixed race persons to Whites on major depression, psychological distress, psychological well-being, and self-rated mental health. Separate comparisons were made for women and men because the relationship between race and mental health could be conditional on gender. Using individual-level data from the Canadian Community Health Survey (CCHS) 1.2 and aggregate data from the 2001 Canadian Census, the study hypothesized that racial differences in mental health could reflect differences in stress exposure, socioeconomic status, social embeddedness, and neighborhood environment. The main assumption was that higher stress exposure, economic hardship, social isolation, and neighborhood disadvantage could compromise the mental health of racial minorities. The study also examined whether social support and coping behaviors protected racial minorities from these health-damaging effects. The findings do not present a straightforward or a consistent set of conclusions. Although there is a good rational to believe that racial minorities should have worse mental health than Whites, this is not always or even mostly the case. Only Aboriginal women have a consistent disadvantage. For the most part, racial minorities have similar mental health as Whites, and even have an advantage in a few instances. Since the analysis covered the negative, positive, and subjective dimensions of mental health, it provides robust evidence to support this conclusion. However, the findings also demonstrate that low socioeconomic status and insufficient social resources can indeed have health-damaging effects. These factors explain some of the observed disadvantages in mental health that racial minorities experience or suppress an advantage among them. / Graduate / 0347 / 0631

The onset of COVID-19 and cancellation of collegiate sports may have exacerbated student-athletes' psychological distress. Within a national sample of collegiate student-athletes (N = 5755; 66.7% women; 72.3% White), I determined how gender, race, and sport season related to rates of depression, stress, and counseling use. I used a cross-sectional methodology and collected data in April/May 2020. Overall, 26.5% (n = 1526) and 10.6% (n = 612) of the collegiate student-athletes endorsed clinical and high levels for depression and stress, respectively; 25.1% (n = 1443) and 69.7% (n = 4014) reported subclinical and moderate levels of depression and stress, respectively. Few student-athletes reported counseling use before (17.1%) or after (2.3%) the onset of COVID-19; those who reportedly used services endorsed higher levels of depression and stress than those who did not. Female student-athletes reported higher rates of depression, stress, and counseling use than male student-athletes. There were no race or sport season effects. Student-athletes who competed in spring sports endorsed higher levels of counseling use than student-athletes who participated in a fall season sport. Athletic departments must address their student-athletes' psychological distress by facilitating a higher use of mental health services.

The current study examined psychological distress in couples coping with a cancer diagnosis. Although it is widely recognised that spouses coping with a cancer diagnosis are at risk of psychological distress, debate exists within the literature regarding the amount of distress experienced by individuals, and about who is most at risk. Fifty-five couples coping with a cancer diagnosis completed questionnaires assessing psychological distress, social support and attachment style characteristics. Results indicated that partners psychological distress levels were more influenced by social support and attachment characteristics than patients were. Partners of those with cancer, who were higher on the insecure attachment dimensions, perceived providing and receiving less support and were less satisfied with support overall compared to less insecure partners. In addition to this, partner social support was significantly related to psychological distress, and attachment style was found to moderate this relationship. Specifically, partners were more vulnerable to psychological distress when they were higher on the insecure attachment dimensions and when support satisfaction was low or when they had a perception of low support receipt. Contrary to expectations, there were no significant findings for the patient group. Explanations and implications are discussed.

Aims: The experience of abuse in childhood can lead to psychological distress later in life. In particular the impact of trauma on the development of the self can render survivors more vulnerable to chronic feelings of shame and guilt. The aims of this research portfolio are twofold. First, a systematic review examines the impact of therapeutic interventions on depression outcomes for survivors of Childhood Sexual Abuse. Second, a research study explores experiences of shame and guilt for this population. More specifically, the study examines those factors in the therapeutic process which survivors find helpful in their changing relationship with these emotions. Method: To address the first aim a systematic review of the literature was carried out. The methodology employed strict inclusion criteria and ten Randomised Control Studies were identified and included in the review. A prospective longitudinal qualitative study was conducted to explore the experiences of shame and guilt for survivors of childhood abuse. Participants (n=10) were interviewed at two different time intervals whilst accessing psychological therapy. Data was analysed using the Framework Method. Results: Findings from the systematic review show existing studies are mostly of poor to medium methodological quality; but that therapeutic interventions do improve depression outcomes for survivors of Childhood Sexual Abuse. Results from the empirical study suggest feelings of shame more so than guilt are core emotions in the experience of psychological distress for survivors. Conclusion: Evidence-based therapeutic interventions for the range of complexities experienced by survivors of CSA are still to be established and more strong methodological trials are required. Shame is a core emotion in psychological distress for survivors and requires to be assessed and addressed routinely in therapeutic interventions.

This thesis examines the effectiveness of acupuncture therapy in the treatment of psychological and somatic distress in the context of medically unexplained symptoms (MUS). Also, it explores the role of psychological attachment and experiential avoidance in an effort to explain potential mechanisms of acupuncture’s effect. Existing literature demonstrates some level of effectiveness of acupuncture therapy for the treatment of depression, anxiety and somatic symptoms. However, a lack of experimental rigor in methodology means that existing results cannot be shown to be superior to a placebo and thus current treatment protocols for patients with MUS do not include a recommendation of acupuncture therapy. MUS are defined as any set of symptoms that cannot be explained by organic disease, these clusters of symptoms are theorised to be of psychological aetiology. Sufferers of MUS find themselves stuck in a perpetual loop of secondary care referrals with little or no treatment options being made available. Whilst there is some evidence that talking therapies, such as cognitive behavioural therapy, are effective, their availability, efficacy and stigma mean they are often not desired by patients who suffer with MUS. Previous research has shown that insecure attachment predicts higher instances of, psychological and somatic distress, as well as MUS. Previous work undertaken by the author of this thesis also suggests that there may be a moderating effect of attachment in acupuncture therapy outcomes. In order to investigate acupuncture’s efficacy a double-blind randomised control trial was undertaken; 63 participants were randomised to receive either five treatments of genuine acupuncture or a non-penetrating sham form of acupuncture using the Park sham acupuncture device. A rigorous procedure ensured participant and practitioner blinding to group allocation. Primary measures of psychological (GHQ) and somatic (BSI) distress were taken at pre, post and follow-up time points (8 weeks). Secondary measures included general attachment (RQ), experiential avoidance (MEAQ) and client attachment to therapist (CATS). Results showed a significant effect of acupuncture over placebo in the reduction of both psychological (GHQ) and somatic distress (BSI). This therapeutic effect was maintained at 8-week follow-up. Further results showed moderation effects of secure attachment on somatic symptoms in the treatment group but not placebo group. Experiential avoidance also moderated somatic symptom outcomes in the treatment but not placebo group. A subsequent study utilising a quasi-experimental multi-centre methodology, which used identical measures to the previous experiment, revealed the same significant reduction of both psychological and somatic distress. This study consisted of 184 participants across five clinics, each participant receiving five sessions of acupuncture. Similar results were observed regarding moderation effects of secure attachment on treatment outcomes of somatic symptoms. Results also showed differences in moderation effects between participant with a MUS diagnosis vs. those without. Findings of both studies suggest acupuncture is an effective treatment for psychological and somatic distress, as well as MUS. The differences in attachment moderation effects between treatment and placebo may indicate acupuncture’s ability to elicit endogenous opioid release in the brain. However, further neurological studies are required to confirm this hypothesis.

abstract: Factors of gender, marital status, and psychological distress are known to be related to help-seeking attitudes. This study sought to explore and understand the relations between gender, marital status, religiosity, psychological distress, and help-seeking attitudes among members of the Church of Jesus Christ of Latter-day Saints (Mormons). The moderating effect of religious commitment on psychological distress and attitudes towards seeking professional help was explored through an online survey of 1,201 Latter-day Saint individuals. It was predicted that gender and marital status would predict distress and helping seeking attitudes and that religiosity would moderate the relation between distress and help-seeking attitudes among religious individuals, with individuals who experience high distress and low religiosity being more likely to seek help than individuals with high distress and high religiosity. Participants completed the Kessler Psychological Distress Scale (K-10), Religious Commitment Inventory-10, and the Attitudes Toward Seeking Professional Psychological Help-Short Form online. Multiple hierarchical regressions were used to test the study hypotheses. Although the accounted for variances were small, gender was the most significant variable associated with both distress and help seeking. Females reported higher distress and being more willing to seek psychological help than did males. Religiosity did not moderate the relation between distress and help-seeking attitudes. These findings are discussed in light of previous research and gender role schemas as relevant to Mormon culture. / Dissertation/Thesis / Masters Thesis Counseling 2018

abstract: Psychological distress occurs at disproportionate rates among minority groups and individuals with lower socioeconomic status. This dissertation focuses on the relationship between living in a disadvantaged neighborhood and distress among Latinos, the formal and informal organizations that mediate the direct and indirect relationship between disadvantage and distress in this population, and the differences of social stress processes based on aspects of Latino social status, linguistic acculturation status, and the percentage of residents in the neighborhood that identify as Latino. This dissertation focuses its investigation on Latinos living in Chicago, specifically asking: In a metropolitan city, can the presence of formal and informal community organizations protect Latinos living in disadvantage neighborhoods from experiencing psychological distress? The findings demonstrate an indirect association between disadvantage and distress though objective disorganization and perception of disorganization. Both the density of community centers and block watch had an indirect protective effect, mediating the relationship between neighborhood disadvantage and distress, but did not decrease the indirect effect of disadvantage on distress through objective or perceptions of disorganization. The results of this dissertation suggest that changes to a neighborhood's environment may decrease population rates of distress in disadvantaged neighborhoods. / Dissertation/Thesis / Ph.D. Social Work 2014

Magister Artium (Child and Family Studies) - MA(CFS) / HIV patients face an array of social and psychological problems, such as depression, which can affect their quality of life. Moreover, HIV infection is also linked to psychological distress such as anxiety. In addition, avoidant emotion-focused strategies such as acceptance, wishful thinking and self-blame are associated with higher levels of psychological distress in persons with HIV. Current health services in the city of Cairo, Egypt, are not adapted to provide advice and psychological support to people living with HIV to aid in the development of problem-solving skills to cope with the stress of living with HIV. The purpose of this study was to examine the relationship between quality of life, psychological distress and the coping strategies of persons living with HIV/AIDS in Cairo, Egypt. A quantitative methodology with a cross-sectional correlational design was adopted in this study. Data collection entailed questionnaires that consisted of four sections: Demographics, Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q), Depression, Anxiety, Stress Scales (DASS) and the Cope Inventory. The sample consisted of 202 HIV/AIDS participants who access the National AIDS Program (NAP). The data were analysed using the Statistical Program for Social Science V23 (SPSS). The results are provided using descriptive and inferential statistics. The findings of the study show that in terms of the prevalence of psychological distress, the moderate scales were stress and depression, while the severe scale was anxiety. The most prevalent of coping styles was emotion-focused coping, specifically in terms of acceptance and religion. In terms of the prevalence of quality of life, the highest scores were for family and social relationships, while the lowest scores were for sexual drive and leisure time activities. The findings also show that psychological distress and certain coping styles such as substance use negatively predicted quality of life of patients with HIV/AIDS. Positive predictors included coping styles such as venting, positive reframing, humour, acceptance and religion.

Diabetes is associated with increased psychological distress which, in turn, is associated with poorer diabetes outcomes. This study examined the impact of a nine-week Internet based cognitive-behavioral therapy intervention that targeted stress and mood in people with diabetes. It was hypothesized that the intervention would decrease psychological distress and improve diabetes outcomes and adherence to diabetes treatment regimens. Participants with type 1 and type 2 diabetes were randomly assigned to the intervention (n = 103) or a waiting-list control group (n = 74). ANCOVAs demonstrated significant group effects for the reduction of perceived generalized stress (F (1, 105) = 7.06, p = .01; d = .84), diabetes-related distress (F (1, 105) = 13.45, p < .01; d = .54), depression (F (1, 90) = 7.06, p < .01; d = .40), anxiety (F (1, 89) = 6.78, p = .01; d = .41), and negative affect (F (1, 103) = 13.02, p < .01; d = .56). There were also significant group effects for the reduction of psychological fatigue (F (1, 98) = 7.34, p = .01; d = .40), cognitive symptoms (F (1,95) = 6.40, p = .01; d = .48), hyperglycemic symptoms (F(1, 95) = 11.16, p <.01; d = .41) and hypoglycemic symptom (F(1, 98) = 6.16, p= .02; d= .53). Further, there were significant indirect effects of the intervention on the above diabetes symptoms, through psychological distress. There was no effect of the intervention on hemoglobin A1c (F(1.43) = 0.28, p= .60), though this analysis was underpowered. The intervention also had no effect on adherence to diabetes treatment regimen. This study provides evidence of a convenient and effective way to reduce psychological distress and improve symptoms in those with diabetes. It also provides evidence of reduced psychological distress as a mechanism for improving diabetes outcomes.

Undesirable leadership behaviours such as workplace bullying, destructive or toxic leadership are reportedly on the increase with negative effects on both the well-being of employees and the organisation (Salin, 2003). Since there is limited empirical evidence regarding the relationship between destructive leadership and psychological distress, the purpose of this study was to determine whether such a relationship exists among employees in South African organisations. Furthermore, the study intended to investigate whether gender has a moderating effect on this relationship. Destructive leadership behaviour is defined as the systematic and repeated behaviour by a leader, supervisor or manager that violates the legitimate interest of the organisation by undermining and/or sabotaging the organisation's goals, tasks, resources, and effectiveness and/or the motivation, well-being or job satisfaction of his/her subordinates (Einarsen, Aasland & Skogstad, 2007). With a sample (n = 200) of South African employees, the study adopted a correlational design and used the Destructive Leadership Behaviour Scale developed by Aasland, Skogstad and Einarsen (2008) as well as the Hopkins Symptoms Checklist-45 developed by Derogatis, Lipman, Richels, Uhlenhuth and Covi (1974) to assess the relationship between destructive leadership behaviour and psychological distress as well as the moderating effect of gender. The results indicated that two of the six hypotheses were accepted. H2, there is a relationship between overall destructive leadership and psychological distress, has been accepted. Furthermore H5, there is a significant correlation between the participants’ overall destructive leadership scores and overall psychological distress, was also accepted. Finally H6, gender has a moderating effect on the relationship between participants overall destructive leadership scores and overall psychological distress scores, was rejected. / Dissertation (MCom)--University of Pretoria, 2014. / gm2014 / Human Resource Management / unrestricted