{
  "abstract": "Distress lies at the heart of supportive and palliative care. Yet emotional distress, psychiatric disorder, existential suffering, and spiritual struggle are often discussed as though they are interchangeable. While these domains overlap in lived experience, important conceptual and empirical distinctions have meaningful implications for assessment, research, and intervention.Beginning with a clinical case, this plenary will examine how distress is recognized, labeled, and addressed in serious illness. Emotional distress reflects affective states such as sadness or fear. Psychological distress refers to diagnosable psychiatric syndromes. Existential distress emerges when illness disrupts meaning, identity, and narrative continuity. Spiritual distress involves disruption in relationship to ultimate meaning, transcendence, or what is held sacred. These domains intersect but are not equivalent.Drawing on sociological and social psychological theories of the self, this session will propose that distress is relationally and socially grounded. Persons are embedded within relationships, social roles, and shared cultural narratives that shape identity and belonging. Meaning is constructed and sustained within these relational contexts. In addition, individuals inhabit moral frameworks that organize concepts such as duty, reciprocity, dignity, fairness, loyalty, and responsibility. Serious illness can destabilize not only mood or cognition, but also the moral order through which life is interpreted and valued. Experiences of burden, autonomy, and worth are mediated by these social and moral worlds and may vary across cultural settings.Empirical findings regarding prevalence, overlap, and measurement will be reviewed, highlighting the limits of relying solely on standard depression and anxiety instruments to capture relational, existential, and moral dimensions of suffering. By disentangling conceptual domains while recognizing the social and moral entanglement of persons, we may move toward more precise assessment and more ethically and culturally responsive care.",
  "authors": [
    {
      "affiliations": [
        "Duke University, USA"
      ],
      "name": "Karen Steinhauser"
    }
  ],
  "title": "L2 Disentangling distress: emotional, psychological, existential, and spiritual suffering in serious illness",
  "uid": "58e21cdc-d911-5ba4-9f50-5ccb3381291e"
}