The full sentence:

People enter therapy hoping for a reduction in symptom distress.

Is "symptom distress" a noun+noun pattern or a noun+verb? Is it like the pattern "fight club", "banana club"? Does it follow any grammatical rule? I'd like to understand the meaning but my question is about the grammar which will help me hopefully to improve my English.

  • I don't know why, nor do I know the general rule, but this doesn't work for me. Maybe it sounds ok to someone else. I think the problem is "distress" - I don't think I've ever heard "X distress" to mean "distress from X". You could, on the other hand, say "symptom reduction" in the right context, since "X reduction" is often a way of saying "reduction in X". In any case, I would think someone would want to reduce their symptoms, and the suggestion that someone would seek therapy not for that but rather to reduce distress from their symptoms is just confusing.
    – cruthers
    Dec 17, 2021 at 18:47
  • There's not much point adding tags for both american-english and british-english. If you are happy to accept answers about both you don't need to mention either.
    – James K
    Dec 17, 2021 at 19:03
  • 1
    I found this definition: 'Symptom distress was defined as the degree of discomfort reported by the patient in relation to his/her perception of the symptoms being experienced'. I'd say that "symptom" is a noun modifying the noun "distress".
    – BillJ
    Dec 17, 2021 at 19:09
  • symptom distress=distress caused by symptoms.
    – Lambie
    Oct 21 at 17:23

1 Answer 1


This is a noun+noun pattern, with "symptom" a noun adjunct that modifies "distress".

"distress" can't be a verb. Grammatically a clause with a finite verb can't be used at that position in a sentence. What would the subject be? What would the object be. How would a clause fit with the rest of the sentence? There is no conjunction.

But noun+noun can form a noun phrase that can be the object of the preposition "in", and the prepostional phrase "in symptom distress" modifies the noun "reduction" and the modified noun phrase "a reduction in symptom distress" is the object of "hoping for", which forms a gerund/particple phrase "hoping for .... distress" and this phrase is a sentence modifier of the main clause "people enter therapy".

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