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First responders and recovery workers are not only physically and emotionally tested during an emergency, but they also may have loved ones in the area for whom they are concerned. They also are often the last to seek help for work-related stress. First responders and recovery workers most at risk for emotional distress include those who have experienced:. For first responders, being prepared for the job and strengthening stress management skills before a disaster assignment is the best protection from stress.

Responder stress can be diminished by practicing for the disaster role, developing a personal toolkit of stress management skills, and preparing themselves and loved ones for a disaster. Disasters can be extremely disruptive to individual families and community routines, leading to stress and inviting all types of violent behavior, including intimate partner violence or family violence.

Women and girls can be particularly at risk. Following a disaster, resources for reporting violent crimes may be temporarily suspended or unavailable.

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For women and girls who have experienced intimate partner violence, sexual violence, or family violence, this can further heighten their sense of isolation and vulnerability. Before, during, and after a disaster, what may seem like fighting between intimate partners or family members may actually be a symptom of a larger pattern of abuse. Further, during the response and recovery phase after a disaster, the risk for violence against women and girls becomes greater. These disaster survivors may become displaced from their homes and moved to shelters or temporary housing, where they encounter overcrowded, co-ed living conditions and a lack of security, among other things.

If you or someone you care about is or may be experiencing intimate partner, sexual, or family abuse or violence, call the Disaster Distress Helpline. Other resources are also available:. Warning Signs and Risk Factors for Emotional Distress Learn about the common warning signs and risk factors for emotional distress that children, adults, and first responders often experience.

Common warning signs of emotional distress include: Eating or sleeping too much or too little Pulling away from people and things Having low or no energy Having unexplained aches and pains, such as constant stomachaches or headaches Feeling helpless or hopeless Excessive smoking, drinking, or using drugs, including prescription medications Worrying a lot of the time; feeling guilty but not sure why Thinking of hurting or killing yourself or someone else Having difficulty readjusting to home or work life For those who have lived through a natural or human-caused disaster, the anniversary of the event may renew feelings of fear, anxiety, and sadness.

Warning Signs and Risk Factors for Children and Teens Children are often the most vulnerable of those impacted during and after a disaster. Some warning signs of distress in children ages 6 to 11 include: Withdrawing from playgroups and friends Competing more for the attention of parents and teachers Being unwilling to leave home Being less interested in schoolwork Becoming aggressive Having added conflict with peers or parents Having difficulty concentrating For teens, the impact of disasters varies depending on how much of a disruption the disaster causes their family or community.

Although some teens may compete vigorously for attention from parents and teachers after a disaster, they also may: Become withdrawn Resist authority Become disruptive or aggressive at home or in the classroom Experiment with high-risk behaviors such as underage drinking or prescription drug misuse and abuse Children and teens most at risk for emotional distress include those who: Survived a previous disaster Experienced temporary living arrangements, loss of personal property, and parental unemployment in a disaster Lost a loved one or friend involved in a disaster Most young people simply need additional time to experience their world as a secure place again and receive some emotional support to recover from their distress.

Are clients potentially dangerous to themselves or to the community? Are any family members involved in the judicial system, on probation, or parole? Do they have representation? Are there issues around custody of the children? Are health care needs met? Does the family have access to any specialist services they may need? Does this family identify unmet spiritual needs? Do all family members have access to spiritual leadership if they desire it?

Warning Signs and Risk Factors for Emotional Distress

Are cultural differences present and being considered? Are any family members exhibiting behaviors which must be addressed if the quality of life for the family is to improve? Does the family have pressing financial needs which are not being met through employment or public support? Clearly, as this list shows, the development of a solid support system is a critical aspect of the care of children and adolescents with SED. Singer and Irvin have noted that respite care, child-focused education, parent training, and fiscal support are critical variables in reducing parental stressors.

Supportive interventions that focus on helping families to use cognitive and behavioral coping strategies, such as cognitive reframing, have been found to be very helpful to families. There is a growing literature on the need for family support services which shows that supportive interventions produce effective and lasting change in a family's ability to care for a child with SED. Sue-Huei Chen, Eugene K. Emory, in Comprehensive Clinical Psychology , Similar to the influence of social orientation on the manifestations of psychopathology, a family orientation may buffer individuals against psychological distress and thus decrease the frequency and type of psychological disorder.

The different prevalence rates of major depression in Taiwanese and Americans patients may also reflect different distributions of psychopathology under the influences of collectivism or individualism, respectively. Several studies of Chinese samples carried out in Taiwan Cheng, ; Compton et al.

Furthermore, as reported in several studies, Chinese depressives manifest more somatic symptoms e. This somatization tendency may thus contribute to the possibility of under-reporting or under diagnosing clinical depression in Chinese patients Kleinman, What tends to be overlooked by these studies, however, is that somatization may play a role in the illness process. Maintaining the mixed anxiety-depressive state may in turn prevent the less depressed patients from becoming the hopeless depressive Chen, In Taiwan, the whole family tends to take responsibility for a psychological problem in order to protect the individual from being singled out.

This buffering and shared responsibility may affect the revelation of a psychological disorder in the Western context. Taiwanese tend to express personal or social distress via somatization, which has been defined by Kleinman and Kleinman as the expression of personal and social distress in an idiom of physical complaints and medical help-seeking behaviors. Somatization may also be considered a reflection of basic cultural traits that discern Chinese society with a predominantly oral-hypochondriacal quality Lin, Note that within the traditionally social-oriented collectivist Chinese society, the individual is not the unit of social structure.

The individual's private emotions may be largely considered as a reflection of family matters. Public expression and discussing one's emotions, especially the negative emotions, may cause more social consequences and conflicts in the social milieu, thereby bringing more shame and guilt feelings to oneself and one's family or relatives.


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Thus a more stoic demeanor is generally adopted. Within the social-oriented system, somatization tends to have positive social consequences to the extent that both care-givers and receivers obtain affirmative evaluations in the helping process. Since psychological complaints did not have the same social efficacy that somatization had in generating support and care Kleinman, , it is thus more likely to find the somatic expression of depression in Chinese society. In the past, somatization had been commonly seen as an expression of psychological distress in Western society until psychological experience and its rationalization into discrete labels were regarded as one index of modernization.

Could the declining trend of social orientation in Westernized human societies account for the fact that major depression rates are increasing both in Taiwan and in several Western countries? Another factor that affects the manifestation of psychopathology may be the availability and acceptability of emotional expression. Taking depression as an index, Taiwan is in a progressive Westernization mode, and its rate of major depression is increasingly approaching statistics in the West.

In Chinese culture people were not used to expressing depression literally or verbally in colloquial speech. Younger people, however, seem to be conflicted between traditional values and contemporary Westernized culture. Again along with the declining trend of social orientation and collectivism among younger generations, one might associate this trend with the earlier onset of major depression in younger cohorts, both in Taiwan and in several Western countries.

James D. Physiological signs of anxiety or impaired performance were excluded from the scale.


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  • The SADS consists of 28 true-false items. Although the authors described two subscales social avoidance and social distress , these are rarely used in practice. Watson and Friend report data supporting the test-retest reliability and concurrent validity of the SADS. Turner, McCanna, and Beidel administered both the SADS and FNE to a large group of patients diagnosed with various anxiety disorders and found that persons with SAD could not be distinguished from those with other anxiety disorders by either instrument, thereby questioning their discriminative validity.

    Turner et al. Heimberg, Hope, Rapee, and Brunch , however, argued that these results do not necessarily lead to the conclusion that the SADS and FNE measure general distress rather than social anxiety because social anxiety may be manifested in other anxiety disorders, and individuals with social anxiety are highly heterogeneous. Turner and Beidel responded by reaffirming their position that the SADS—specifically, that the key for one of the items number 19 —was incorrectly reverse-scored. Hofmann, DiBartolo, Holaway, and Heimberg found that this error resulted in higher scores of central tendency relative to the correctly scored version, although the error does not appear to have significantly biased prior studies that have used SADS.

    The popularity of the SADS has declined over the past two decades, most likely due to the development of arguably better measures of social anxiety symptoms, and questions regarding its discriminant validity. Users of the SADS should obviously be aware of the error in scoring instructions in the original publication. Pamela Ebstyne King, While there is ample evidence to support religion and spirituality as a resource for PYD, it is important to recognize that they are multivalent constructs that do not always promote thriving Pargament et al.

    Distress | Definition of Distress by Merriam-Webster

    Central to thriving is optimal development of both the individual and the contexts in which they live. Both religion and spirituality have been documented to be a source of both significant personal and social distress Oser et al. Many of the assertions of this chapter are predicated on the assumption that experiences of transcendence are positive and nurture a positive self-concept and prosocial values. Religious or spiritual experiences that inhibit personal growth or that inculcate a negative sense of personal identity are not conducive to thriving.

    Extreme religious groups that may elevate the identity and the needs of the group while devaluing the individual can hinder adolescent development. Religious environments that do not allow for adequate exploration, such as questioning and expressing religious doubt, during adolescence may also thwart optimal development. In addition, negative worldviews and perceptions of God can cause significant personal distress Mahoney et al. Thriving is also dependent on a prosocial ideology that nurtures a sense of moral and civic identity Lerner et al.

    If the sources of transcendence do not engender a commitment to contribution to the greater good, they are negative spiritual influences. For example, religious or spiritual environments that use religion to encourage violence through ideology and example do not promote thriving.

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    Specifically, prejudice has been identified as a value that some religions endorse Hunsberger et al. The developmental systems perspective of religious and spiritual development proposed in this chapter provides a lens through which to understand when religion and spirituality may be deleterious. Specifically, we propose a relational spirituality that emphasizes the reciprocating relationship between an individual and the many contexts in which they live.

    When these relations between religious and spiritual contexts and the young person are not mutually beneficial, they are not conducive to thriving. Lynn L. Brandsma, in Social Anxiety Second Edition , Examples from the Web for distress I inherited the Arnold Family Thunder ThighsTM, which was a source of frequent teasing and distress for me as a child. Her Mother's Secret Emma D.

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    About Peggy Saville Mrs. Derived forms of distress distressful , adjective distressfully , adverb distressfulness , noun distressing , adjective , noun. Word Origin for distress C from Old French destresse distress, via Vulgar Latin, from Latin districtus divided in mind; see distrain. Mental or physical suffering or anguish.

    Severe strain resulting from exhaustion or trauma.