In the current literature, distress is typically described according to a unitary model: High levels of distress are conceptualized as a high level of negative affect while low levels of distress are typically conceptualized as a low level of negative affect. On the other hand, Albert Ellis (1994) and some of his rational-emotive and cognitive-behavioral professional colleagues have more recently described distress as a binary construct composed of two different components: functional negative feelings (e.g., sad) and dysfunctional negative feelings (e.g., worthless). In two studies using 55 U.S. breast-cancer patients and 45 Romanian breast-cancer patients, respectively, we compared hypotheses derived from unitary and binary models of distress. The results revealed that in a stressful situation (i.e., upcoming breast surgery) high levels of irrational beliefs were associated with a high level of both functional and dysfunctional negative feelings while low levels of irrational beliefs were associated with a low level of dysfunctional negative feelings and a high level of functional negative feelings. Thus, that support for the binary model of distress found in both U.S. and Romanian samples suggests both the robustness and the generalizability of the results. Theoretical and practical implications are discussed.