Emotional distress and urinary incontinence among older women

Objective: Examined appraisals of interference and personal tolerance in the prediction of distress among women experiencing urinary incontinence (UI). Design: lnterviewed women volunteering for a behavioral treatment for UI. Women were interviewed at baseline; follow-up assessments were conducted 6 weeks and 6 months later. Measures of perceived interference, tolerance, condition-specific emotional distress, symptom severity, general intelligence, and depressive symptoms were administered. Participants: 131 women (mean age = 66.6 years, SD = 8.4; range 55-90) with reported involuntary loss of urine at least once a week prior to participation. Main Outcome Measure: Emotional distress attributed to UI. Results: Path analyses indicated that greater tolerance was associated with less interference imposed by UI. Greater tolerance was also associated with less distress. Symptom severity (frequency of UI episodes, nocturia, and objectively determined fluid loss) indirectly influenced emotional distress through perceived interference. Cognitive appraisals of interference and tolerance were stable over time. Conclusions: These data indicate that appraisals of personal ability to tolerate the condition and interference of the condition on goal-directed behavior and expected activities have greater influence on emotional distress than does severity of condition-specific symptom.