These binges must occur at least twice a week for at least six months and be accompanied by "marked distress" over the behavior.

Children with marked distress are in urgent need of counseling, the report notes.

Situations are avoided or endured with marked distress.

One of the paraphilias, characterized by marked distress over, or acting on, urges to indulge in sexual activity that involves animals.

The current DSM contains a diagnosis of "persistent and marked distress about one's sexual orientation."

Waitresses show marked distress.

If a person responds with marked distress or significant impairment in functioning, it is often assumed that the life event was an identifiable stressor.

However, the identification of a response that evidences marked distress or significant impairment also lacks specificity and is thus very subjective.

A Caesarean section may be performed if there is marked fetal distress or an increased risk of injury associated with macrosomia, such as shoulder dystocia.

More marked distress remained in the subjects with persisting partial sight.