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Reduction of Distress Intolerance With Salutotherapeutic Interventions: Results From a Randomized Controlled Clinical Trial.

ABSTRACT: Background:Distress tolerance is the ability to pursue one's goals in the presence of (chronic) stressors, hardship, adversities and negative internal states, and psychological distress. By contrast, distress intolerance is a transdiagnostic indicator of mental illness and a mediator in coping with problems in life, work demands, or stress in general. There is a lack of data regarding intervention strategies. The objective of the present study is to test the differential effects of two treatment approaches: "regeneration fostering" versus "resistance training." Methods:Inpatients of a psychosomatic hospital were randomly allocated to either a resistance training group therapy (n?=?65)-that is, active coping with demands and endurance-or a regeneration fostering group therapy (n?=?62)-that is, recovery, mindful indulgence, and creative activities. They were compared with a group of patients who received treatment as usual (n?=?43), without special treatments for distress intolerance, and the outcome was measured with the "Distress Intolerance Scale." One-way and repeated measure analyses of variance and paired t tests were used for the analysis. Results:The "regeneration" group showed a significant improvement in distress intolerance, whereas there was no significant change for the treatment-as-usual group and in the "resistance" group. Post hoc tests were conducted with paired sample t tests for pre-post comparisons for each group. No differences were found for the treatment-as-usual group (mean difference: 0.03, SD (mean difference): 0.89; t(42)?=?0.266, p?=?0.792, d?=?0.04) and for the resistance group (mean difference:-0.07, SD (mean difference): 0.73; t(63)?=?-0.736, p?=?0.464, d?=?0.08). The regeneration group showed a significant decline in distress intolerance (mean difference: 0.29, SD (mean difference): 0.72; t(61)?=?3.156, p?=?0.002, d?=?0.38). Conclusions:In the treatment of distress intolerance, it seems promising to focus on positive psychology interventions and resources. Limitations of the study are that it was conducted with psychosomatic inpatients only and that no follow-up data are available.

SUBMITTER: Otto J

PROVIDER: S-EPMC7219888 | biostudies-literature | 2018 Jan-Dec

REPOSITORIES: biostudies-literature

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Reduction of Distress Intolerance With Salutotherapeutic Interventions: Results From a Randomized Controlled Clinical Trial.

Otto Josephine J Linden Michael M

Chronic stress (Thousand Oaks, Calif.) 20180101

<h4>Background</h4>Distress tolerance is the ability to pursue one's goals in the presence of (chronic) stressors, hardship, adversities and negative internal states, and psychological distress. By contrast, distress intolerance is a transdiagnostic indicator of mental illness and a mediator in coping with problems in life, work demands, or stress in general. There is a lack of data regarding intervention strategies. The objective of the present study is to test the differential effects of two t ...[more]

PMID: 32440585

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Project description:Burnout is highly prevalent in residents. No randomized controlled trials have been conducted measuring the effects of Mindfulness-Based Stress Reduction (MBSR) on burnout in residents.To determine the effectiveness of MBSR in reducing burnout in residents.A randomized controlled trial comparing MBSR with a waitlist control group.Residents from all medical, surgical and primary care disciplines were eligible to participate. Participants were self-referred.The MBSR consisted of eight weekly 2.5-h sessions and one 6-h silent day.The primary outcome was the emotional exhaustion subscale of the Dutch version of the Maslach Burnout Inventory-Human Service Survey. Secondary outcomes included the depersonalization and reduced personal accomplishment subscales of burnout, worry, work-home interference, mindfulness skills, self-compassion, positive mental health, empathy and medical errors. Assessment took place at baseline and post-intervention approximately 3 months later.Of the 148 residents participating, 138 (93%) completed the post-intervention assessment. No significant difference in emotional exhaustion was found between the two groups. However, the MBSR group reported significantly greater improvements than the control group in personal accomplishment (p?=?0.028, d?=?0.24), worry (p?=?0.036, d?=?0.23), mindfulness skills (p?=?0.010, d?=?0.33), self-compassion (p?=?0.010, d?=?0.35) and perspective-taking (empathy) (p?=?0.025, d?=?0.33). No effects were found for the other measures. Exploratory moderation analysis showed that the intervention outcome was moderated by baseline severity of emotional exhaustion; those with greater emotional exhaustion did seem to benefit.The results of our primary outcome analysis did not support the effectiveness of MBSR for reducing emotional exhaustion in residents. However, residents with high baseline levels of emotional exhaustion did appear to benefit from MBSR. Furthermore, they demonstrated modest improvements in personal accomplishment, worry, mindfulness skills, self-compassion and perspective-taking. More research is needed to confirm these results.

Project description:BackgroundThe preliminary results of a randomised controlled trial are presented. The aim of the trial is to determine the efficacy, feasibility and acceptability of email-delivered psychological interventions with telephone support, for adults injured in a motor vehicle crash engaged in seeking compensation. The primary intention for this preliminary analysis was to investigate those who were psychologically distressed and to stop the trial midway to evaluate whether the safety endpoints were necessary.MethodsThe analysis included 90 adult participants randomised to one of three groups, who were assessed at baseline and post-intervention at 3 months. Cognitive behaviour therapy (CBT) or healthy lifestyle interventions were delivered over 10 weeks, involving fortnightly emailed modules plus clinically focussed telephone support, with the aim of reducing psychological distress. An active waiting list of control subjects received non-clinically focussed telephone contact over the same period along with claim-related reading material. Depression Anxiety Stress Scales (DASS) and Impact of Events Scale (Revised) (IES-R) were used to assess psychological distress. Psychiatric interviews were used to diagnose major depressive disorder and post-traumatic stress disorder. Aspects of acceptability and feasibility were also assessed.ResultsFor those diagnosed with depression at baseline in the CBT group, psychological distress reduced by around 16%. For those with depression in the healthy lifestyle group, distress increased marginally. For those in the control group with depression, distress also decreased (by 18% according to DASS-21 and 1.2% according to IES-R). For those without depression, significant reductions in distress occurred, regardless of group (P?<?.05). The results suggest that for those with depression, a healthy lifestyle intervention is contraindicated, necessitating the cessation of recruitment to this intervention. The interventions were reported as acceptable by the majority and the data indicated that the study is feasible.ConclusionsCBT with telephone support reduced psychological distress in physically injured people with depression who are engaged in seeking compensation. However, time plus fortnightly telephone contact with claim-related reading material may be sufficient to reduce distress in those who are depressed. For those who were not depressed, time plus telephone support is most likely sufficient enough to assist them to recover. The trial will continue with further recruitment to only the CBT and control groups, over longer follow-up periods.Trial registrationAustralian and New Zealand Clinical Trials Registry: Preventing psychological distress following a motor vehicle accident; ACTRN12615000326594 . Registered on 9 April 2015.

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Reduction of Distress Intolerance With Salutotherapeutic Interventions: Results From a Randomized Controlled Clinical Trial.

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Reduction of Distress Intolerance With Salutotherapeutic Interventions: Results From a Randomized Controlled Clinical Trial.

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