psychological distress

Anemia in pregnancy is associated with psychiatric symptoms and poor psychiatric symptoms, this study investigates the 6-month trends of anxiety and birth outcomes. Considering the controversies surrounding the impact of anemia on psychiatric symptoms, this study investigates the 6-month trends of anxiety and depression in anemic pregnant women with threatened abortion (TA).

A case-control retrospective cohort study conducted among 282 participants who enrolled in a registry of pregnant women with TA in Babol city from December 2022 to October 2023. Fifty individuals with anemia (hemoglobin < 11 g/dL) who were matched with 50 without anemia based on age, pregnancies, education, and gestational age, were included. The BSI-18 (Brief Symptom Inventory) was used to assess depression, anxiety, and psychological distress at the beginning, three and six-month follow-ups.

The prevalence of anemia among women diagnosed with TA was found to be 17.7%. At the beginning, compared to normal individuals, anemic women had higher rates of depression (32% vs. 14%), anxiety (34% vs. 22%), and psychological distress (66% vs. 48%). Moreover, at 3- and 6-month follow-ups, the frequency of psychiatric symptoms in anemic women was significantly higher. The Generalized Estimating Equations model showed that although both groups had a decreasing trend of frequency anemic women experience a slower rate of decrease in psychiatric symptoms compared to non-anemic women.

Anemia in women with TA is associated with high rates of depression, anxiety, and psychological distress, as well as a slow recovery rate.

Diabetic patients must be managed comprehensively to normalize blood sugar levels for a long time, as it has an impact on diabetes distress. Self-management is an essential intervention to keep the patient’s blood glucose levels stable. Moreover, people with diabetes who have poor self-acceptance may develop a negative view of themselves, which can affect diabetes self-management. Thus, this study aimed to determine the relationship between self-acceptance and self-management of diabetes distress among patients at Roemani Semarang Hospital. 

This quantitative study used an observational approach. The sample consisted of 52 respondents who were treated at the Roemani Semarang Hospital, in Indonesia. The sampling technique used was consecutive sampling. Self-acceptance was measured by the acceptance of illness scale (AIS), which consists of eight questions developed by Felton with a Cronbach’s α of 0.861. Self-management was measured by the diabetes self-management questionnaire (DSMQ) developed by Schmitt, which consists of 16 questions with a Cronbach’s α 0.628. Moreover, diabetes distress was measured by the diabetes distress scale (DDS), which consists of 17 items developed by William Polonsky with a Cronbach’s α 0.840. 

Most diabetic patients had moderate self-acceptance, with 41 respondents (78.9%), good self-management, with 39 respondents (75%), and moderate diabetes distress, with 32 respondents (61.5%). Therefore, self-acceptance and self-management had a relationship with the incidence of diabetes distress (P=0.001).

Diabetes distress must be treated in diabetes patients because it impacts self-management. Additionally, an approach to increasing self-acceptance is necessary, as it also affects diabetes distress. Further studies are needed to explore self-acceptance as a mediator between self-management and diabetes distress.

Regarding the effect of early maladaptive schemas (EMSs) on the psychological distress (PD) of diabetic patients, various factors can play a mediating role. This study was to examine the associations between EMSs, PD, and coping strategies in people with diabetes.

This descriptive correlational study was carried out on people with type 2 diabetes (T2D) referred to the diabetes clinic of Shariati Hospital in Tehran, in 2021. Here, 200 patients were included in the research and the selection method of people was convenient. Research tools included Kessler's Psychological Distress Scale, Young Schema Questionnaire (YSQ-SF) and Coping Strategies Inventory (CSI). Data analysis was performed by SPSS 25 software and Smart-PLS 3, and structural equation method (SEM).

The findings revealed that EMSs have a significant and direct association with PD. Coping strategies had a mediating role in relation to EMSs and PD in people with T2D. As a result, 37% of PD was explained by EMSs and coping strategies.

According to the results, in order to reduce the level of PD in people with T2D should be use of techniques aimed at enhancing EMSs and coping strategies.

ntroduction: Changes in health status and adjustments to new lifestyles during the pandemic have triggered societal psychological problems in society. This study aimed to explore the correlation between physical symptoms and psychological problems in Indonesian society during the COVID-19 outbreak.

 This cross-sectional study employed an online survey to gather data from 9425 participants in Indonesia between June and July 2020, which was selected using convenience sampling. The Self-Reporting Questionnaire (SRQ) instrument was employed to investigate psychological problems, the utilization of psychoactive substances, psychotic symptoms, and post-traumatic stress disorder (PTSD). Physical symptoms were assessed through self-reports indicating the presence or absence of experienced COVID-19 symptoms. The statistical analyses were conducted using Spearman-rank and Cramer’s V correlation.

 The findings suggest that the perceived physical symptoms during the COVID-19 outbreak are significantly associated with psychological problems, (including decreased energy, somatic symptoms, depressive moods, and depressive thoughts, the use of psychoactive substances, psychotic symptoms, and PTSD.

 Our study concluded that physical health is significantly associated with psychological problems. It is essential to eliminate factors that cause psychological problems by promoting the physical condition of the general population. Through promotive and preventive efforts, physical and psychological conditions should be improved in COVID-19 outbreaks

Given the profound effects of children’s behavioral disorders, particularly in children with autism, on families, the present study aimed to explore the association between mothers’ distress tolerance and marital adjustment and behavioral disorders (BD) in children with autism in Ahvaz, Iran. This descriptive-correlational study included all children with autism and their mothers registered at the Autism Association of Ahvaz, Iran in 2023. A total of 262 participants were recruited using a convenience sampling approach. Data were collected using the Child Behavior Checklist (CBCL), Distress Tolerance Scale (DTS), and Dyadic Adjustment Scale (DAS). Data were subjected to Pearson’s correlation analysis and stepwise regression analysis using SPSS version 27. The mean scores for child behavioral disorders, tolerance of distress, and marital adjustment were 34.95 (±8.14), 45.29 (±9.86), and 80.23 (±19.15), respectively. Pearson’s correlation analysis indicated a significant inverse relationship between children’s BD and mothers’ tolerance of distress (r=-0.36, P<0.001) and marital adjustment (r=-0.60, P<0.001). Additionally, a significant positive correlation was found between mothers’ tolerance of distress and marital adjustment (r=0.39, P<0.001). The results indicated that mothers’ tolerance of distress and marital adjustment are crucial in alleviating BD in children with autism. Interventions aimed at enhancing mothers’ coping skills and marital satisfaction may be beneficial in improving children’s behavioral outcomes.

Chronic pain (CP) is defined as persistent, severe pain lasting for more than three months and is often associated with psychological distress (PD) and learned helplessness (LH).

This study aims to explore the relationship between post-traumatic stress disorder (PTSD), PD, and LH in individuals with CP.

The research employed a descriptive, causal-comparative methodology. The study population consisted of patients referred to pain and physiotherapy clinics in Tehran between 2022 and 2023. From a pool of 300 CP patients, 150 with high-grade PTSD severity and 150 with low-grade PTSD severity were purposively selected. Participants completed PTSD (Blevins et al., 2015), PD (Lovibond & Lovibond, 1995), and LH (Quinnells & Nelson, 1988) questionnaires. Data analysis was conducted using SPSS-24 software, with multivariate analysis of variance used for data analysis (P < 0.005).

Among the 300 patients, 52.6% were married, 44.0% held a bachelor’s degree, and 37.4% had musculoskeletal disorders. The findings revealed significant differences in PD and LH levels between the two groups (P < 0.001). Chronic pain patients with high-grade PTSD exhibited greater levels of depression (F = 211.09), anxiety (F = 231.06), stress (F = 374.85), and LH (F = 457.79) compared to those with low-grade PTSD (P < 0.001).

This research highlights the significant impact of PTSD severity on PD and LH in individuals with CP. These results emphasize the need to consider psychological factors in the treatment and management of CP.

The link between individuals' perceptions of social class (PSC) and various forms of bullying, including cyberbullying, has not been extensively studied. Additionally, the mechanisms through which PSC impact aggressive behaviors like cyberbullying remain unclear. Therefore, this study aimed to explore the influence of perceived social class on cyberbullying, considering subjective vitality and psychological distress as serial mediators.

Utilizing a cross-sectional design, the research involved 584 Iranian students (Mage = 20.59, SD = 1.99) from several universities who completed questionnaires assessing Subjective Social Class (SSC), Subjective Vitality Scale (SVS), Psychological Distress Scale (K6), and Cyberbullying Involvement Scale (CIS). Hayes' PROCESS macro (Model 6) in SPSS was employed to analyze the chain mediation effects.

The Results demonstrated that the direct impact of PSC on cyberbullying was significant (Effect = -0.229, 95% CI: -0.294 to -0.164). Subjective vitality and psychological distress serially mediated the link between PSC and cyberbullying (Effect = -0.022, 95% CI: -0.035 to -0.012). In addition, both subjective vitality (Effect = -0.046, 95% CI: -0.080 to -0.017), and psychological distress (Effect = -0.09, 95% CI: -0.123 to -0.059), independently mediated the association between PSC and cyberbullying.

This research not only broadens the theoretical understanding of how individuals' perceptions of their social rank influence cyberbullying behaviors, but also provides actionable strategies for officials and experts to deploy effective interventions in higher education to mitigate cyberbullying.

Automatic negative thoughts have an important role in development of a persistent negative cognitive bias, which may ultimately result in suicidal ideation. The primary objective of the present study was to examine the relationship between automatic negative thoughts and experiential avoidance in relation to psychological distress.

The study sample comprised 441 individuals who had attempted suicide. Participants underwent interviews utilizing standardized questionnaires including Automatic Thoughts Questionnaire, Kessler Psychological Distress Scale, Acceptance and Action Questionnaire–II, and Cognitive Emotion Regulation Questionnaire along with its nine subscales. After internal relationships assessment among the research variables, outlier detection was done using the boxplot analysis and standard deviation distance metrics. To analyze the direct and indirect associations between the input and output variables, Structural Equation Modeling (SEM) was employed. In addition, SPSS-28 and Amos 29 software were used to analyzed the data.

The final model showed that automatic negative thoughts were significantly inversely associated with adaptive cognitive emotion regulation (β = -0.42, P ≤ 0.01) and significantly positively related to both maladaptive cognitive emotion regulation (β = 0.49, P ≤ 0.01) and psychological distress (β = 0.53, P < 0.01). Additionally, experiential avoidance showed a significant positive relationship with maladaptive cognitive emotion regulation (β = 0.22, P < 0.01).

This research demonstrated that automatic negative thoughts could worsen psychological distress through the regulation of cognitive emotion in those who had a history of suicide. By the clinical management of automatic negative thoughts and shifting individuals’ cognitive emotion regulation toward adaptive strategies, there is potential for a substantial reduction in suicidal ideation and attempts which can be evaluated in future clinical trials.

A low quality of life during pregnancy and lactation can elevate the risk of psychological complications, adverse pregnancy outcomes, and developmental issues in children. Gaining insight into the factors that affect the quality of life for pregnant and lactating women is essential for healthcare providers to create effective interventions. This study aims to evaluate the quality of life among pregnant and lactating women and to identify the factors influencing it, including sociodemographic characteristics, obstetric factors, and levels of psychological distress. This cross-sectional study was conducted online between February and March 2022, employing a chain referral sampling method to gather participants. A total of 409 women from Java (Indonesia) participated, comprising 249 pregnant women and 160 lactating women. The Depression Anxiety Stress Scale was employed to assess psychological distress, while the 36-item Short Form Health Survey measured quality of life. Data were analyzed using independent samples t-tests, one-way analysis of variance, and multiple linear regression. The mean quality of life scores did not show a significant difference between the two groups (pregnant: 67.64±13.78; lactating: 67.20±15.38; P=0.768), indicating a generally good quality of life for both. Multiple linear regression revealed that for pregnant women, significant factors affecting quality of life included occupation (P<0.05), depression (P<0.01), and anxiety (P<0.01). For lactating women, influential factors included ethnicity (P<0.05), duration of breastfeeding (P<0.05), as well as depression (P<0.01), anxiety (P<0.01), and stress (P<0.05). Both pregnant and lactating women reported a good quality of life; however, psychological distress, sociodemographic characteristics, and obstetric factors significantly influenced their overall well-being. It is crucial to address psychological distress through early screening and ongoing, comprehensive interventions.

Promoting adherence to treatment and self-efficacy in patients with coronary artery diseases helps to improve patient outcomes. The present study was conducted to explain the effectiveness of interventions based on information, motivation, and behavioral skills model on treatment adherence and self-efficacy in patients with coronary artery diseases.

This explanatory-sequential study was conducted on patients with coronary artery diseases in Shiraz, Iran. First, a quasi-experimental study was conducted on 112 patients who were randomly assigned to two intervention and control groups. The intervention consisted of ten motivational training sessions that were designed based on Information, Motivation, and Behavioral Skills (IMBS) model and continued with six months of telephone follow-up and counseling. Data were collected before, three months, and six months after the end of the intervention. Then, in the second phase, a qualitative study including 20 in-depth interviews with 18 participants from the intervention group was conducted. The data were analyzed by deductive and inductive qualitative content analysis. Finally, quantitative findings were explained with the help of qualitative findings.

The findings showed that the mean score of treatment adherence, medication adherence, and self-efficacy in the intervention group was significantly higher than the control group 3 and 6 months after the intervention (p<0.001). The results of the qualitative phase of the study also showed that the four main categories include receiving targeted information, encouragement to care, gained self-efficacy/doubt in care, and improvement/non-improvement of treatment adherence behaviors can explain quantitative phase results.

The results showed that receiving training with effective methods, strengthening the support system, self-confidence and positive attitudes about care, and promoting self-management and proper management of emotional distress contributed to the effectiveness of the interventions. However, receiving conflicting information, limited financial resources, and the inability to face challenges were among the obstacles to strengthening self-efficacy and adherence to treatment.

Threatened abortion (TA) is associated with adverse pregnancy outcomes. Despite the attention paidto the adverse outcomes of obstetrics, only a few studies have been conducted on the psychological status of womenwith threatened abortion. This study aimed to compare the symptoms of depression and anxiety in women with TAand those without threatened abortion. In a case-control study, 136 women with TA (the case group) and 136 women without TA(the control group), were matched with the case group in terms of gestational age, education level, age, and numberof pregnancies, were examined from Obstetric clinics of Babol University of Medical Sciences. Demographic informationand pregnancy history were obtained from all participants. Additionally, the women filled out the BSI-18questionnaire. Statistical analysis was performed using SPSS version 22 software. The results showed that in women with threatened abortion, the likelihood of experiencing depressionsymptoms was 1.9 times higher [odds ratio (OR)=1.91, 95% confidence interval (CI)=1.13-3.23, P=0.015], anxietysymptoms were 1.8 times higher (OR=1.83, 95% CI=1.08-3.10, P=0.024), and somatization was 2.6 times higher(OR=2.65, 95% CI=1.61-4.37, P<0.001) compared to pregnant women without threatened abortion. Additionally, inwomen with threatened abortion, the risk of psychological distress was 3.3 times higher (OR=3.30, 95% CI=1.96-5.56, P<0.001) than in women without threatened abortion. This study suggests that gynecologists, midwives, and healthcare providers, in addition to providingmedical care for women threatened with abortion, should identify women at risk of experiencing symptoms of depressionand anxiety. Providing appropriate psychological support should be prioritized in the management of women withthreatened abortion.

The COVID-19 pandemic has resulted in widespread physical and psychological challenges, including persistent psychological distress (PD). Research suggests that while some COVID survivors maintain satisfactory psychological functioning, others may experience long-term, severe PD. Addressing these challenges, along with associated sociodemographic determinants, requires a comprehensive, community-based approach.

This study aims to determine the prevalence of PD, including depression, anxiety, and stress, among Iranian COVID survivors by analyzing various regional, temporal, and sociodemographic determinants.

The study, conducted between July 2021 and February 2022, aimed to determine persistent PD among Iranian COVID survivors. Ethical approval and other necessary permits were obtained. The final sample size consisted of 300 participants selected from an initial pool of 11,337 medical records. Participants received questionnaires electronically, including the “Socio-Demographic Clinical Questionnaire (SDCQ)” and the “Depression, Anxiety, and Stress Scale 21 (DASS21).” The study used SPSS 26 for statistical analysis, calculating means, standard deviations, and frequencies. Relationships between determinants were examined using ANOVA and chi-square tests. Bayesian regression analysis was employed to explore correlations and predictive power between COVID-19, PD, and the various determinants.

The prevalence of depression, anxiety, and stress, considered collectively as PD among participants, was 49%, 53%, and 61%, respectively, with mean severity scores of 10.68 ± 2.16 for depression, 9.18 ± 1.84 for anxiety, and 15.93 ± 2.79 for stress. More severe manifestations of PD were observed in participants from Hospital III (P > 0.05, r ≈ 0.17) and during the temporal period of 12 - 24 weeks post-infection (P < 0.05, r ≈ -0.12). Additionally, significant correlations between PD and determinants such as sex, Intensive Care Unit (ICU) admissions, and intubation were noted (P < 0.05). Bayesian analysis further highlighted cross-correlations between PD and other determinants among Iranian COVID survivors (P < 0.05, BF < 0.1).

In conclusion, the study found that Iranian COVID survivors experienced mild levels of depression, anxiety, and stress, with prevalence rates ranging from 49% to 61%. The highest severity of PD was observed in participants from Hospital III and during the period of 12 - 24 weeks post-infection. Additionally, a network of cross-correlations was identified between PD and various other determinants among Iranian COVID survivors.