How loss affects anger and alienates potential supporters

Understanding and Addressing Mental Health Disparities and Stigma in Serious Illness and Palliative Care

Patients receiving palliative care experience stigma associated with their illness, personal identity, and healthcare utilization. These stigmas can occur at any stage of the disease process. Varying stigmas combine to cause palliative care patients to feel misunderstood, contribute to treatment barriers, and further negative stereotypes held by clinicians. Stigma surrounding palliative care patients stems from complex intersections of varied access to resources, familial and physical environment, socioeconomic status, mental health and disorders, and identity characteristics. This article examines the relationship between mental health stigma and palliative care through three pathways: stigma and barriers existing within healthcare, the tendency of this stigma to undermine social support, and the deferral of treatment-seeking in response to stigma. Recommendations to address and diminish stigmatization are presented, including advocacy, increased research and assessment, and contextual and intersectional awareness. Clinicians are also encouraged to turn to their colleagues for peer support and team-based care.

Weathering the storm alone or together: Examining the impact of COVID-19 on sole and partnered working mothers

Sole employed mothers and their families face numerous challenges. Yet, the unprecedented circumstances of the COVID-19 pandemic may be adding additional risk to the already precarious day-to-day reality of this population. Thus, we examine the implications of this crisis for the mental health and job-related well-being of both sole and partnered working mothers. Participants were 206 mothers who continued to work during the pandemic. A moderated mediation model was analyzed. Work-family conflict (WFC) during the pandemic differentially related to mothers' parenting stress, based on romantic partnership status; when mothers were sole parents, the relationship between WFC and parenting stress was exacerbated. Moreover, this stress mediated the relationship between WFC and both poor mental health and decreased work engagement for sole employed mothers. Findings broaden our understanding of the implications of the COVID-19 pandemic for sole and partnered employed mothers, and how this crisis may be increasing disparities between working sole-parent and dual-partner families.

Parental migration status moderates the link between parent-child relationship and children's well-being through psychological distress

The effects of parental migration on the well-being of left-behind children (LBC) are varied. Several studies demonstrated that parental migration reduces children's psychological health but other research showed contradictory results. This study sought to clarify this issue by examining the mediating role of psychological distress and the moderating role of parental migration status in the association between the parent-child relationship and children's psychological distress. A total of 743 LBC and 688 non-LBC self-reported their parent-child relationship, psychological distress, and well-being. Findings showed that psychological distress mediated the association between parent-child relationship and children's well-being. This denotes that greater parent-child relationship results into lowered levels of psychological distress, and in turn, increases children's emotional, psychological, and social well-being. Moreover, the link between parent-child relationship and psychological distress was found to be contingent to parental migration status. Specifically, the negative association between parent-child relationship and psychological distress was especially strong among LBC in contrast to non- LBC. This implies that children with higher quality relationships with their parents tend to exhibit decreased severity of psychological distress symptoms, especially in children whose parents are working overseas. These results underscore the dynamic role of parent-child relationship in the well-being of LBC, and suggest ways to develop intervention programs that include cultivating skills in managing psychological distress and improving the emotional, psychological, and social well-being of LBC.

Innovation in times of pandemic: The moderating effect of knowledge sharing on the relationship between COVID‐19‐induced job stress and employee innovation

The goal of this study is to examine knowledge sharing as a boundary condition under which employee innovation can be enhanced in response to the job stress induced by the COVID‐19 pandemic. We argue that when stressed employees share knowledge, they can expand their knowledge base and thereby enhance their innovative potential. Consistent with our hypothesis, multiple regression analysis results based on a sample of 61 R&D employees of UK and US technology‐based firms show that knowledge sharing moderated the relationship between COVID‐19‐induced job stress and employee innovation, such that the relationship was negative when knowledge sharing was lower but became positive when knowledge sharing was higher. These findings highlight the importance of investing in knowledge‐based resources to promote innovation behavior at work during a pandemic.

Trends of Anger and Physical Aggression in Russian Women During COVID-19 Lockdown

The effect of social lockdown during the COVID-19 outbreak on female aggressiveness is not well known. The strict measures of lockdown have resulted in millions of people, worldwide, confined to their homes during the pandemic. However, the consequence of lockdown strategies on females' psychological status including aggressiveness has not yet been investigated. We conducted a cross-sectional study on 31 Russian females' homemakers who are participants in an online fitness platform to investigate the immediate anxiety, depression, and aggression experienced under strict lockdown measures. The participants were surveyed using the hospital anxiety depression scale (HADS) and the Buss-Perry Aggression Questionnaire. We used descriptive and statistical methods to investigate the prevalence of these emotions among two age groups (20-35 and 36-65 years). We found that moderate anxiety prevalence was 77.4% in the entire group while mild depression was 54.8%. Interestingly, the whole sample showed a high level of angriness (p = 0.0002) and physical aggression (p = 0.019). These two emotions seem to be more prevalent than other negative emotions such as hostility, verbal aggression. This relationship was not dependent on age. Overall, there is a significant worsening in female aggression that could lead to higher chances of female victimization and being subjected to partner violence. Future policies designing lockdown strategies should consider this effect on active female homemakers. Due to the small size of our cohort, our results are only indicative of data trends. Larger studies are still needed to confirm the current findings.

Loss of resources and demoralization in the chronically ill

OBJECTIVE

The study examined whether the association between the severity of physical symptoms and demoralization is mediated by loss of resources in individuals with chronic conditions including conventional diagnoses, functional somatic syndromes, and medically unexplained symptoms.

METHOD

This cross-sectional study evaluated N = 194 patients (mean age = 46, 83.5% female) who reported at least 3 months of persistent physical symptoms using the following self-report instruments: PHQ-15 (modified), Loss of Resources Inventory, Psychosocial Questionnaire - Demoralization Subscale, and PHQ-8. The mediation hypothesis was tested by multiple regression analyses controlling for age, race, employment status, income, educational attainment, and depression.

RESULTS

Participants experienced M = 9.3 out of 16 possible health-related losses (SD = 4.4). Average to severe demoralization scores were indicated by 59.1% of individuals, of which only 17.1% experienced high demoralization. Loss of resources fully mediated the effect of symptom severity on demoralization, explaining 56% of the variance of demoralization and inhibiting the initially significant effect of symptom severity on demoralization to nonsignificant levels [from b = 0.67, 95% CI (0.26, 1.07) to b = 0.03, 95% CI (-0.27, 0.32)].

CONCLUSION

Early recognition of the loss of resources phenomena and interventions to reduce its progression through the introduction of resource gains may diminish, or even prevent, the installation of demoralization in individuals with chronic symptoms.

The Reciprocal Relationship Between Resources and Psychological Distress Among Unemployed Job Seekers

This study sets out to investigate the reciprocal relationship between resources and psychological distress in a sample of unemployed job seekers shortly after dismissal. This idea of reciprocal relationships is inspired by general resource-based theories, the conservation of resources theory, and the broaden and build theory in particular. We selected perceived availability of networks as a social resource and reemployment efficacy as a personal resource, and we distinguished between negative and absence of positive affect as indicators of psychological distress. We analyzed data of 610 unemployed job seekers who participated twice in a survey with a time lag of 6 months and using structural equation modeling. Results showed that negative affect (but not absence of positive affect) depleted both perceived availability of networks and reemployment efficacy. The path from resources to psychological distress was not significant. We discuss potential implications for research and practice.

Job demands and driving anger: The roles of emotional exhaustion and work engagement

This study aimed to examine the effects of both hindrance and challenge demands on driving anger within the framework of the job demands-resources (JD-R) model. We collected self-reported data from 411 office workers driving to and from work each day in five cities in China. The results from a structural equation modeling analysis indicated that both hindrance and challenge demands were positively related to emotional exhaustion, which was in turn positively correlated with driving anger. Moreover, work engagement was positively correlated with driving anger. Implications of the present findings regarding both the JD-R model and driving safety research are discussed.

When it Rains, it Pours: The Greater Impact of Resource Loss Compared to Gain on Psychological Distress

The authors prospectively investigated stress in 71, mostly European American, pregnant women. Conservation of Resources (COR) theory was applied to assess the impact of resource losses and gains that occur in women’s lives. Resources were defined as those things that people value or that act as a means to obtaining that which they value and include social, personal, object, and condition resources. The authors hypothesized that women’s resource losses would better predict postpartum anger and depression than their resource gains (in the opposite direction). They also predicted that earlier resource loss would accelerate the negative impact of later resource loss on postpartum distress. Resource gain was expected to be most salient when resource losses co-occurred, such that resource gains buffered the negative impact of resource loss. The hypotheses were generally supported and argue for the primacy of resource loss in the stress process.

Stress, Social Support and Coping in Pregnancy

The social support literature, despite its focus on women's strengths in relationships, has not fully addressed the social realities of women of diverse ethnic backgrounds and socio economic conditions. Specifically, the emphasis on marital relationships as primary sources of support during pregnancy marginalizes those women for whom these partnerships are unhelpful or unavailable. In addition, women's greater use of social support as a coping strategy is often portrayed in the coping literature as an ineffective approach to stress. Data from two studies of pregnant women are presented to illustrate these points and to present a new model of coping that reframes women's coping as prosocial, active and effective. Our article is designed to challenge researchers to examine the relevance of work on social support and coping to women of varying ethnicities and economic circumstances.

Resource Loss, Resource Gain, and Communal Coping During Pregnancy Among Women with Multiple Roles

We investigated stress, coping, and employment status in 92, mostly European American pregnant women. Conservation of Resources (COR) theory (Hobfoll, 1988, 1989) was applied as a specification of role-quality theory to examine the stressful influences of women's multiple roles. Women's resource loss predicted psychological distress better than either their resource gains or their employment status (i.e., multiple versus single roles). Full-time employed women were significantly more distressed under high loss conditions than were part-time or nonemployed women. Examining women's coping strategies based on a communal model of coping, we found that active, prosocial coping was associated with better emotional outcomes. A significant interaction was found for the effects of loss × cautious action such that loss was related to greater depression, but only among women who did not employ cautious action.

Impact of Marital Status on 20-Year Subjective Well-being Trajectories

BACKGROUND

It is well-known that marital status has a significant impact on subjective well-being (SWB). However, research examining the long-term influence of marital status on SWB after spinal cord injury (SCI) is limited.

OBJECTIVE

To identify the relationship between marital status and SWB trajectories over time, using 20 years of longitudinal data.

METHODS

We conducted a cohort study, including 1,032 participants surveyed 5 times in 1993, 1998, 2003, 2008, and 2013. Participants were identified from outpatient records of 2 Midwestern hospitals and 1 Southeastern specialty hospital. The Life Situation Questionnaire-Revised (LSQ-R) was used to measure multiple aspects of SWB. A multilevel model was applied to analyze the 5 repeated measurements.

RESULTS

The married or cohabitating participants enjoyed the best SWB at baseline, but their home satisfaction and global satisfaction declined over time and their social isolation increased slightly. For divorced, separated, or widowed people, the negative effects of marital loss attenuated over time. For single individuals, SWB, except for environmental barriers, did not change positively over time if they remained single.

CONCLUSIONS

Using longitudinal data with 5 repeated measurements, our study showed a complicated relationship between marital and relationship status with SWB and how these relationships change over time for people with chronic SCI.

The role of social support in anxiety and depression among Parkinson's disease patients

PURPOSE

To explore how social support is associated with anxiety and depression in Parkinson's disease (PD) patients controlling for gender, disease duration and disease severity.

METHODS

The sample consisted of 124 patients (52.4% male; mean age 68.1 ± 8.4 years; mean disease duration 6.3 ± 5.5 years). Anxiety and depression were measured with the Hospital Anxiety and Depression Scale, social support with the Multidimensional Scale of Perceived Social Support and disease severity with the Unified Parkinson Disease Rating Scale. Data were analyzed using linear regression.

RESULTS

Gender, disease duration, disease severity and social support explained 31% of the total variance in anxiety in younger PD patients but did not significantly contribute to the explanation of depression. In the older group, this model explained 41% of the variance in depression but did not significantly contribute to the explanation of anxiety.

CONCLUSION

PD patients experience the positive influence of social support differently according to age. In the younger group, disease duration plays the primary role regarding anxiety. In the older group, poor social support especially from friends is associated with more depression after controlling for the relevant variables. Implications of Rehabilitation PD is a disease of older age with a neurodegenerative character and treatment should focus on increasing quality of life. Anxiety and depression are common co-morbidities in PD patients. The support network should also be screened regularly and involved in enhancing the quality of life.

Interaction of asthmatics and their spouses: A preliminary study of individual differences

Some asthmatics show evidence of airways reactivity triggered by strong emotions. Six case studies of married patients with severe asthma are reported. The videotaped interactions of the asthmatic and his/her spouse were coded for affect and behavior. Repeated measures of pulmonary function and affective state were recorded before and after two interaction tasks. Over the course of the experimental period, two patients' pulmonary function improved and four patients' deteriorated. In general, decreased pulmonary function was associated with more self-rated hostility and depression. The results are discussed in terms of their implications for the intra- and interpersonal factors that are important in asthma management.

Reactions to allegations of discrimination

Purpose

The purpose of this paper is to examine alleged perpetrators' reactions to being accused of discrimination.

Design/methodology/approach

The paper examines how the mode of confrontation as well as the perpetrator's status relate to the alleged perpetrator's state of anger and the likelihood of providing a justification to the victim. To test the hypotheses, the authors conducted an experimental design using an organizational scenario.

Findings

The mode of confrontation predicts the likelihood of providing a justification to the victim. The paper also found that both anger and the likelihood of providing a justification for a charge of discrimination are higher when the mode of confrontation is indirect and the alleged perpetrator is the supervisor.

Research limitations/implications

An organizational scenario limits the realism of the study such that results may not generalize to actual organizational settings (Stone, Hosoda, Lukaszewski and Phillips). In addition, the response rate was low. Nevertheless, a full understanding of issues related to reactions to alleged discrimination will depend upon research conducted in a variety of settings under a variety of conditions.

Practical implications

It is unlikely that direct confrontations will be instrumental in correcting misperceptions of discriminatory behavior. Organizations need to provide training on how to manage confrontation episodes as an opportunity to mitigate perceived mistreatment.

Originality/value

Which mode of confrontation is best? Indirect confrontation is associated with a higher likelihood of the alleged perpetrator providing a justification for a charge of discrimination, particularly when the alleged perpetrator is the supervisor. However, anger is also higher when supervisors are confronted indirectly about allegations of discrimination.

Predicting cardiac patients' quality of life from the characteristics of their spouses

Recovery from surgery can be facilitated by personal and social resources such as perceived self-efficacy and social support. Moreover, the existence of a social network and the behavior of its members can also have a positive effect. Patients (N = 381; 302 men, 79 women) undergoing heart surgery were surveyed once before and twice after surgery. In addition, 114 social-network members (18 men, 96 women), most of them spouses, reported about their own perceived resources at Time 1. The patient-spouse dyad was chosen as the unit of analysis. It turned out that characteristics of spouses were related to those of patients. Recovery from surgery at Time 2 and readjustment to normal life after half a year (Time 3) could be partly predicted by spouses' perceived self-efficacy and social support as measured at Time 1.

Getting mad but ending up sad: the mental health consequences for African Americans using anger to cope with racism

Anger is a common reaction to stressful life events. However, little is known about anger’s use and efficacy as a coping strategy for racism. Is anger a coping strategy for racism that improves mental health? Or does anger operate in an opposing way, deteriorating mental health? The analyses for this research focused on a probability sample of African Americans who reported experiences of acute (n = 246) or chronic (n = 120) racial discrimination in a survey interview. General linear model results revealed that using anger to cope with racial discrimination negatively affected the general well-being and psychological distress of African Americans. These findings raise concerns about the effectiveness (or lack therefore of) of anger as a common coping mechanism for racism, given the deleterious effects it may have on African Americans’ mental health.

Parental maltreatment, bullying, and adolescent depression: evidence for the mediating role of perceived social support

The support deterioration model of depression states that stress deteriorates the perceived availability and/or effectiveness of social support, which then leads to depression. The present study examined this model in adolescent depression following parent-perpetrated maltreatment and peer-perpetrated bullying, as assessed by a rigorous contextual interview and rating system. In 101 depressed and nondepressed community adolescents between the ages of 13 and 18 (M = 15.51, SD = 1.27), peer bullying and father-perpetrated maltreatment were associated with lower perceptions of tangible support and of belonging in a social network. These forms of support mediated the association of bullying and father-perpetrated maltreatment with greater depression severity. In contrast, mother-perpetrated maltreatment was associated with higher perceptions of tangible support.

Caregiver mental health and potentially harmful caregiving behavior: the central role of caregiver anger

PURPOSE

Caregivers feeling stress and experiencing mental health problems can be at risk for engaging in abusive acts against elderly care recipients. Potentially harmful behavior (PHB) was used as a measure of caregivers' engagement in, or fear of engagement in, behavior that places dependent care recipients at risk of physical and/or psychological maltreatment and may be seen as an antecedent of, or a proxy for, identifiably abusive behavior. The study examined the ability of anger to mediate and moderate the relations of depression, resentment, and anxiety with PBH.

DESIGN AND METHODS

Data are from the first wave of the second Family Relationships in Late Life study of caregivers of community-dwelling elderly care recipients with whom they coreside. Caregivers (N = 417) completed face-to-face interviews.

RESULTS

Anger was found to mediate the relation between anxiety and PHB. Anger both mediates and moderates the relations of both depression and resentment with PHB in a dynamic way such that the mediating effect of anger increases substantially with increased scores on both depression and resentment.

IMPLICATIONS

Identifying anger levels among caregivers who report symptoms of depression is warranted. Reducing depression in caregivers who report high levels of anger may result in reductions of PHB. Screening for resentment is warranted, as the relation between resentment and anger is similar to that between depression and anger.

Loss of resources as mediators between interpersonal trauma and traumatic and depressive symptoms among women with cancer

We hypothesized that loss of interpersonal, financial and work resources would mediate the relationship between physical and sexual abuse, cancer-related Posttraumatic Stress Disorder (PTSD) symptoms, noncancer-related PTSD symptoms and depressive mood among women with cancer. Participants were 64 women with heterogeneous cancers (64.1% breast cancer) seeking outpatient treatment. Structured interviews were conducted to assess for pre-cancer interpersonal trauma, recent loss of interpersonal, financial and work resources, cancer-related PTSD symptoms, noncancer-related PTSD symptoms and depressive mood. Only interpersonal loss mediated the relationship between earlier interpersonal trauma and current PTSD symptoms and depressive mood. Implications of the findings are discussed.

Anger expression, partner support, and quality of life in cancer patients

OBJECTIVE

Family members are the most important source of social support for cancer patients. The determinants of family support, however, are not well understood. In this study, the associations of anger-expression styles of both patients and their partners with patient-perceived partner support and the impact of these variables on long-term health-related quality of life (HRQL) of the patient were examined.

METHOD

The baseline data were collected at the time of diagnosis; a follow-up survey was conducted at 8 months. Questionnaires included the Spielberger AX scale, the Family Support scale, and the RAND-36 Health Survey. The sample comprised 153 patients and their partners. The theoretical model was tested with a path analysis using structural equation modeling, and gender differences were tested using multivariate analysis of covariance.

RESULTS

Path analyses indicated that partner support was an important mediator, partly explaining the associations between anger-expression styles and HRQL. As hypothesized, anger control had a positive relationship with perceived partner support, while habitual inhibition of anger (anger-in) showed a negative correlation with partner support. Analyses by gender revealed some clear differences: for the male patients, the wife's high level of anger expression (anger-out) was significantly positively related to patient mental HRQL, whereas for the female patients, their husband's anger-out was negatively correlated with the patient's mental HRQL. In addition, patient's own anger-out had a more pronounced negative effect on HRQL for women as compared to men.

CONCLUSION

The anger-expression styles of both patients and their partners seem to modify the family atmosphere, and together, they are important determinants of the long-term quality of life of the cancer patients. Interventions for couples facing cancer should include a focus on ways of dealing with anger and thereby support dyadic coping with cancer.

The influence of finding meaning and worldview of accepting death on anger among bereaved older spouses

OBJECTIVES

The purpose of the study was to identify the course and the mechanisms of the experience of anger over a 4-year period after spousal death among older adults.

METHOD

The study used a longitudinal prospective design with three-wave panel data (6, 18 and 48 months after spousal death), utilizing the Changing Lives of Older Couples data.

RESULTS

Latent growth modeling analysis showed that conjugally bereaved older adults, on average, experienced a low level of anger at 6 months with a very slight decrease over a 4-year period, but individuals had a different level of anger at 6 months. Finding meaning in the death and worldview of accepting death were the significant predictors for a lower level of anger. Social support predicted a lower level of anger indirectly through finding meaning in the loss.

CONCLUSION

Although older adults are generally resilient to spousal loss, a substantial minority of people experience psychological distress. The relationships found suggest that it might be possible to reduce the anger of bereaved older spouses by supporting them to find meaning in the loss and by focusing bereavement support on those who have worldview of not accepting death.

Relationships among patient hostility, anger expression, depression, and the working alliance in a work hardening program

Hostility, anger expression, and depression may adversely affect the response of chronic pain patients to pain or functional restoration programs by hampering the development of good working alliances between patients and physical or occupational therapists. Measures of hostility, anger expression, and depression and the Working Alliance Inventory (WAI) were completed by 71 patients with chronic pain (stemming from work-related injuries) prior to starting a "work hardening" program. The physical or occupational therapist acting as any given patient's "program manager" completed the WAI, as well. Hostility and anger expression were correlated negatively only with patient ratings of the working alliance. Therapist ratings were predicted by the interaction of patient anger expression and depression, such that therapists reported their poorest alliances with patients who were both depressed and expressed anger. Results imply that hostility and the propensity to express anger may diminish a pain patient's capacity to foster a collaborative relationship with physical or occupational therapists, while therapists may readily become alienated from depressed and irritable patients.

Self-efficacy, social support and service integration at medical cannabis facilities in the San Francisco Bay area of California

In an effort to examine and possibly utilise the community-based, bottom-up service design of medical cannabis facilities in the San Francisco Bay area of California, 130 adults who had received medical cannabis recommendations from a physician were surveyed at seven facilities to describe the social service aspects of these unique, community-based programmes. This study used an unselected consecutive sample and cross-sectional survey design that included primary data collection at the medical cannabis facilities themselves. In this exploratory study, individual level data were collected on patient demographics and reported patient satisfaction as gathered by the Patient Satisfaction Questionnaire III. Surveys were filled out on site. In the case of a refusal, the next person was asked. The refusal rate varied depending on the study site and ranged between 25% and 60%, depending on the facility and the day of sampling. Organisational-level data, such as operating characteristics and products offered, created a backdrop for further examination into the social services offered by these facilities and the attempts made by this largely unregulated healthcare system to create a community-based environment of social support for chronically ill people. Informal assessment suggests that chronic pain is the most common malady for which medical cannabis is used. Descriptive statistics were generated to examine sample- and site-related differences. Results show that medical cannabis patients have created a system of dispensing medical cannabis that also includes services such as counselling, entertainment and support groups - all important components of coping with chronic illness. Furthermore, patients tend to be male, over 35, identify with more than one ethnicity, and earn less than US$20 000 annually. Levels of satisfaction with facility care were fairly high, and higher than nationally reported satisfaction with health care in the USA. Facilities tended to follow a social model of cannabis care, including allowing patients to use medicine on site and offering social services. This approach has implications for the creation and maintenance of a continuum of care among bottom-up social and health services agencies.

The Relationship Between Threat Appraisal and Social Constraints in Cancer Survivors and Their Spouses

: Social constraints stem from unsupportive social environments and are associated with reluctance to discuss stressor-related thoughts and feelings. Support deterioration and erosion models provide a framework for explaining how a cancer patient's threat appraisal contributes to a spouse's inadvertent constraint on the patient's emotional expression. Also, based on social comparison theory and the convoy model, a discrepancy in threat appraisal between patient and spouse may create social constraints. Contrary to social cognitive processing theories, we hypothesized that threat appraisals may be an antecedent of social constraints, rather than a consequence. Cancer patients (n=75) and their spouses (n=75) completed questionnaires assessing cancer-related threat appraisals and perceived spousal social constraints at two time points. Cross-lagged panel design results suggested that patient appraisal precedes and predicts patients' perception of social constraints. However, patient and spouse appraisals did not significantly interact in predicting spousal constraints. Limitations and implications are discussed.

Resource loss predicts depression and anxiety among patients treated with an implantable cardioverter defibrillator

OBJECTIVE

Many patients treated with an implantable cardioverter defibrillator (ICD) experience clinically significant depression and anxiety after ICD implantation. As ICD use continues to evolve, it is important to understand the correlates of depression and anxiety to identify patients at greatest risk of poor psychological functioning. Conservation of resources theory, a general theory of stress, states that people experience greater stress if they perceive that they are losing personal, social, and material resources. We hypothesized that perceptions of resource loss would be related to symptoms of depression and anxiety after controlling for other known predictors.

METHODS

One hundred patients treated with an ICD completed standardized depression and anxiety questionnaires along with questionnaires assessing social support, physical functioning, and resource loss. Clinical variables for patients were obtained from prospectively obtained medical records.

RESULTS

Over 20% of the sample exhibited elevated symptoms of depression and anxiety. Patients' depression levels were associated with poor social support, poor physical functioning, a history of depression, and a greater length of time since ICD implantation. Having experienced one or more clinical ICD shocks was related to depression but not anxiety. Higher levels of perceived resource loss were associated with higher levels of both depression and anxiety after controlling for all other predictors.

CONCLUSIONS

Resource loss may help to determine psychological distress after ICD implantation. Understanding how resource loss contributes to depression and anxiety may help to identify patients at greatest risk of poor psychological functioning and may suggest treatment strategies.

'Big build': hidden depression in men

OBJECTIVE

To investigate men's experience of depression.

METHOD

A sample of male and female teachers and students was recruited from four sites of a tertiary education institution to a series of focus groups. A grounded theory approach to qualitative data analysis was used to elucidate men's experience of depression. Content analysis was applied to the women's data to examine similarities and contrasts with the men. Standard measures of mood and dispositional optimism confirmed the non-clinical status of the group.

RESULTS

The findings suggest that some men who are depressed can experience a trajectory of emotional distress manifest in avoidant, numbing and escape behaviours which can lead to aggression, violence and suicide. Gender differences appear not in the experience of depression per se, but in the expression of depression.

CONCLUSION

Emotional distress, constrained by traditional notions of masculinity, may explain why depression in men can often be hidden, overlooked, not discussed or 'acted out'. There are implications for the types of questions asked of men to detect depressive symptoms.

Socioeconomic status, resources, psychological experiences, and emotional responses: a test of the reserve capacity model

The current study used ecological momentary assessment to test several tenets of the reserve capacity model (L.C. Gallo & K. A. Matthews, 2003). Women (N = 108) with varying socioeconomic status (SES) monitored positive and negative psychosocial experiences and emotions across 2 days. Measures of intrapsychic and social resources were aggregated to represent the reserve capacity available to manage stress. Lower SES was associated with less perceived control and positive affect and more social strain. Control and strain contributed to the association between SES and positive affect. Lower SES elicited greater positive but not negative emotional reactivity to psychosocial experiences. Women with low SES had fewer resources relative to those with higher SES, and resources contributed to the association between SES and daily experiences.

Anger management style, blood pressure reactivity, and acute pain sensitivity: evidence for "Trait x Situation" models

BACKGROUND

Anger management style is related to acute and chronic pain, but it is not clear whether anger arousal is needed for these associations to emerge or whether physiological mechanisms mediate these links.

PURPOSE

"Trait x Situation" models were examined to determine whether relationships between anger-out and pain and anger-in and pain depended on anger provocation's preceding pain induction and whether pain sensitivity variance explained by anger management style overlapped with variance in harassment-induced blood pressure reactivity.

METHODS

Healthy individuals (N = 53) underwent either mental arithmetic with harassment and then a cold pressor (MA/CP) or vice versa (CP/MA). The Spielberger Anger Expression Inventory assessed anger-out using the Anger-Out subscale (AOS) and anger-in using the Anger-In subscale (AIS).

RESULTS

AOS x Order and AIS x Order interactions for pain tolerance emerged, such that (a) AOS was related negatively to tolerance among MA/CP participants, whereas AOS and tolerance were not related in CP/MA; (b) AIS was related positively to tolerance in MA/CP, whereas AIS was related negatively to tolerance in CP/MA; and (c) tolerance variance accounted for by AOS in MA/CP overlapped substantially with tolerance variance accounted for by diastolic blood pressure reactivity.

CONCLUSIONS

Findings support the notion that anger management style affects pain and are consistent with evidence that deficient endogenous opioid functioning may be one mechanism through which anger-out is linked to both pain sensitivity and cardiovascular stress reactivity, a connection that appears most reliably when anger is provoked.

Predictors of posttraumatic stress among victims of motor vehicle accidents

OBJECTIVE

This study identified factors that predict individual vulnerability to psychological trauma by examining the relationships among situation and person variables and symptoms of posttraumatic stress disorder (PTSD) 1, 6, and 12 months after a serious motor vehicle accident (MVA).

METHODS

Background characteristics, exposure variables (ie, injury severity and accident characteristics), and psychosocial variables (ie, perceived loss of control, social support, and coping) were used to predict symptoms of PTSD and recovery in 115 injured MVA victims. All participants were injured during the MVA and provided data prospectively over the course of a year after their accidents.

RESULTS

Along with background and exposure variables, use of wishful thinking coping distinguished between victims with and without symptoms of PTSD.

CONCLUSIONS

Psychosocial variables such as wishful thinking coping can be used to identify MVA victims who are at risk of developing chronic posttraumatic stress and warrant further investigation.

Direct and crossover effects of prosocial and antisocial coping behaviors

The relationship of antisocial and prosocial coping behaviors to individual and relationship well-being was prospectively examined in a sample of fire-emergency workers (FEWs) and their marital or romantic partners (69 couples). Results of hierarchical multiple regression equations indicated that FEWs' antisocial coping was related to higher levels of depressive symptoms. Prosocial coping was related to decreased anger expression and increased relationship adjustment. Partners' prosocial coping was a significant predictor of FEWs' reports of better relationship adjustment. For partners, prosocial coping was positively related to their relationship adjustment. FEWs' coping was unrelated to partners' outcome. Results for the FEWs support the notion that coping has direct and crossover effects. Moreover, results indicate that prosocial and antisocial coping behaviors have differential effects on well-being.

Asthma patients and their partners: gender differences in the relationship between psychological distress and patient functioning

This study investigated gender differences in the association between partners' psychological functioning, and patients' perceptions of health functioning and healthcare utilization. Participants were 50 couples in which one person had mild to moderate asthma. Patients and partners completed several questionnaires. Male patients reported significantly greater psychological distress and utilized fewer physician services than female patients. Furthermore, female patients' perceptions of health functioning and their physician utilization were negatively affected by their partners' psychological distress. The findings suggest a need for an interdisciplinary approach to asthma management and the possible inclusion of partners in treatment, especially for female patients.

Psychosocial resource loss as a mediator of the effects of flood exposure on psychological distress and physical symptoms

This study used the Conservation of Resources stress model to examine the role of psychosocial resource loss in the aftermath of Midwest flooding. Questionnaires were distributed through churches and completed by 131 adults in flood-affected communities 6 weeks and 6 months after the flood's crest. Frequent psychosocial losses included losses of routine, sense of control, sense of optimism, accomplishing goals, and time with loved ones. Path analysis revealed that psychosocial resource loss mediated the effects of flood exposure on both psychological distress and physical symptoms at 6 months post-flood. The findings suggest that interventions designed to prevent psychosocial resource loss may reduce the long-term effects of disasters.