Magnitude and sources of distress in mid-life adults with chronic medical illness: an exploratory mixed-methods analysis

Abstract

Most mid-life adults have at least one chronic medical condition (CMC) and are at risk for developing additional CMCs. Stressors specific to this life stage may contribute to CMC development by hindering healthy behaviors. The goal of this study was to compare sources and intensity of distress, as they relate to health behaviors, between mid-life and non-mid-life adults with CMCs. We utilized a mixed-methods approach by analyzing quantitative self-report measures of psychiatric symptoms and psychological well-being, with in-depth, semi-structured qualitative interviews to identify sources of stress in three cohorts of patients with CMCs (heart failure, type 2 diabetes, and coronary artery disease). Between-group differences on self-report measures were compared via independent samples t-tests and relevant themes from interview transcripts were compared via chi-square analysis. We found that mid-life participants (n = 30) reported greater psychological distress (depression/anxiety) than non-mid-life (n = 62) participants (Hospital Anxiety and Depression Scale scores 13.8 [SD 7.3] vs. 10.6 [SD 6.6]; t(90)=2.13; p = .035), and qualitative analysis revealed several specific sources of stress significantly more common (p < .001) in mid-life adults. Interventions targeting the needs of this population could reduce distress, improve health behaviors, and have a major impact on public health.

Acceptance and Commitment Therapy Reduces Psychological Stress in Patients With Inflammatory Bowel Diseases

“…2 Along with interpersonal, home, family, work and social stressors, chronic physical disease can also result in stress and psychological disability. 3,4 Acute stress, such as that experienced during examinations and sporting events, can have positive benefits. However, the stress response may become maladaptive if continuously activated, potentially resulting in immunosuppression, autonomic and enteric nervous system alterations, intestinal permeability, and other inflammatory changes that may ultimately lead to chronic disease, including cardiovascular, respiratory, and immune-mediated disorders.…”

Melatonin Alleviates Neuroinflammation and Metabolic Disorder in DSS-Induced Depression Rats

“…More than 30% of IBD patients were accompanied with mental disorders, including anxiety and depression [3]. Chronic diseases can lead to psychological disorders along with interpersonal relationships, family, work, and social stress [4,5]. At the same time, sustained stress may induce physical dysfunction, which in turn leads to immunosuppression, gut permeability, and other inflammation changes that may eventually result in chronic diseases, including IBD [6,7].…”

A positive psychology–motivational interviewing intervention for patients with type 2 diabetes: Proof-of-concept trial

“…29,30 We chose to use a phone-based program based on interviews with medically ill patients, who preferred the combination of a personal connection via phone with the convenience of this modality. 31,32 In this article, we report the results of a proof-of-concept trial that examined the feasibility, acceptability, and initial impact of this novel PP-MI intervention. 31,32 We hypothesized that over 70% of all exercises would be completed, that participants would rate the activities as easy and beneficial (mean score > 7.0 on 10-point scales), and that there would be pre-post improvement on psychological and behavioral outcomes.…”