Conceptualization of Disease Timeline Predicts Posttreatment Distress in Breast Cancer Patients.

A sample of 69 breast cancer patients was assessed before and after cessation of treatment to determine the predictors of posttreatment distress. Patients were assessed approximately 6 weeks before completing chemotherapy treatment, 1 month after completing treatment, and 3 months after completing treatment. Results indicate that timeline beliefs are related to distress: Patients who conceptualize their cancer as a chronic or cyclic illness are more anxious, depressed, and worried about a recurrence than patients who conceptualize their cancer as an acute illness. These findings hold true even while controlling for disease stage. The way patients conceptualize their illness appears to be more influential in determining levels of posttreatment distress than objective indicators of the likelihood of recurrence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perceived Partner Reactions to Diagnosis and Treatment of Breast Cancer: Impact on Psychosocial and Psychosexual Adjustment.

Two studies examined breast cancer patients' perceptions of their partners' reactions to their diagnosis and treatment as influences on 3 aspects of patients' well-being: psychosexual adjustment, emotional distress, and marital satisfaction. Study 1, cross-sectional, indicated that partner initiation of sex, frequency of sex, a positive 1st sexual experience after treatment, and especially perception of the partner's emotional involvement in the relationship, were relevant to these outcomes. Study 2, longitudinal, confirmed many of these findings in prospective tests across 1 year of recovery after surgery. Partner involvement prospectively predicted all 3 outcomes. Partner initiation of sex predicted greater marital satisfaction; partner adverse reaction to the scar predicted less marital satisfaction. Rated quality of the 1st sexual experience after treatment predicted less distress. The pattern suggests that women's impressions of their partners' emotional involvement after surgery for breast cancer forecast their adjustment in sexual, marital, and emotional arenas over the following year. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adverse Life Events in Late Life: Their Manifestation and Management in Daily Life.

The purpose of this study was to investigate the relationships among major life events, chronic events, daily instrumental activities, and well-being. Fifty individuals between 73 and 93 years of age reported major life events, minor hassles and uplifts, and daily activities during 5 measurement periods. In addition, positive affect was assessed in situ 5 times per day on 6 consecutive days on the basis of a random time-sampling scheme. The effects of major life events on positive affect were transmitted through minor events. However, there was no evidence that the relationship between minor events and positive affect was moderated by the occurrence of a major event. The relationship between life events and positive affect, however, was moderated by change in instrumental activities. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Life stress and the long-term treatment course of recurrent depression: III. Nonsevere life events predict recurrence for medicated patients over 3 years.

Research has consistently documented the significance of severe life events for onset of major depression. Theory, however, suggests other forms of stress are relevant for depression's recurrence. Nonsevere life events were tested in relation to depression for 126 patients with recurrent depression in a 3-year randomized maintenance protocol. Life stress was assessed every 12 weeks and rated along dimensions of severity, focus, and independence. A significant interaction between specific types of nonsevere life events and medication was found. For medicated patients, subject-focused independent nonsevere life events predicted recurrence; for unmedicated patients, these events predicted fewer recurrences. Other nonsevere life events did not predict recurrence. The findings underscore the potential importance of specific stressors for triggering recurrences of depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A Longitudinal Analysis of the Course of Depressive Symptomatology in Geriatric Patients With Cancer of the Breast, Colon, Lung, or Prostate.

This study mapped the trajectory of depression and its components (depressive mood, somatic expression of depression, and lack of positive affect) for 1 year after an initial cancer diagnosis, revealing the complex nature of the psychological response to the cancer experience. The analysis was based on 4 waves of panel data from 860 older patients with incident breast, colon, lung, or prostate cancer. Predictors of depressive symptoms included cancer site; stage; comorbidities; sociodemographic characteristics; and indicators of physical functioning, symptom severity, and treatment. Patients' overall depressive symptoms declined, especially depressive mood and somatic indicators. By contrast, the sense of well-being did not recover; in fact, it would have deteriorated without improvements in physical functioning and physical symptoms. The present findings show the importance of psychological assessments and symptom management during cancer treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predicting posttraumatic growth in breast cancer survivors.

Wide variability exists with respect to how breast cancer survivors respond to common psychological and psychosocial challenges of their disease, ranging from posttraumatic stress disorder to posttraumatic growth. This cross-sectional study examined contextual, disease-related, and intraindividual predictors of posttraumatic growth in 224 randomly selected breast cancer survivors. A series of hierarchical regression analyses found that age at diagnosis, marital status, employment, education, perceived intensity of disease, and active coping accounted for 34%, 35%, and 28% of the variance in growth in relationships with others, new possibilities, and appreciation for life. These findings suggest that a more comprehensive model of growth will be helpful in understanding the various factors that play a role in breast cancer survivors' perception of psychological and psychosocial growth. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological and Physical Adjustment to Breast Cancer Over 4 Years: Identifying Distinct Trajectories of Change.

The goal of this study was to identify distinct trajectories of adjustment to breast cancer over 4 years as well as to distinguish among the different trajectories. The mental and physical functioning of 287 women with breast cancer who remained alive and disease free through 4 years of follow-up were examined. The majority of women showed slight and steady improvement in functioning with time, but subgroups of women were identified who showed marked improvement and marked deteriorations over time. Age successfully distinguished different trajectories of physical functioning. Indices of personal resources (i.e., self-image, optimism, perceived control) and social resources (i.e., social support) successfully distinguished different courses of mental and physical functioning. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Optimism, Perceived Risk of Breast Cancer, and Cancer Worry Among a Community-Based Sample of Women.

Optimism is frequently inversely associated with distress; however, less is known about the mechanisms underlying this relationship. Optimism can be defined as having a generalized positive expectancy about the future. The authors hypothesized that a specific expectancy might mediate the relationship between optimism and distress. That model was tested using perceived risk of breast cancer as a specific measure of expectancy and cancer worry as a measure of distress in a community-based sample of 1,366 women. It was hypothesized that optimism would be inversely associated with cancer worry and that perceived risk of breast cancer would mediate the relationship between optimism and cancer worry. Multiple regression analyses revealed that perceived risk partially mediated the relationship between optimism and cancer worry. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Is Finding Something Good in the Bad Always Good? Benefit Finding Among Women With Breast Cancer.

The correlates and consequences of benefit finding on quality of life were examined for 364 women (93% Caucasian, 6% African American, and 1% Hispanic) diagnosed with Stage I, II, and III breast cancer. Benefit finding and quality of life were measured 4 months postdiagnosis (Tl), 3 months after Tl (T2), and 6 months after T2 (T3). Women with lower socioeconomic status, minorities, and those with more severe disease perceived more benefits at baseline. Benefit finding was associated with more negative affect at baseline and also interacted with stage of disease, such that negative relations to quality of life across time were limited to those with more severe disease. Findings suggest there are qualifiers as to whether "finding something good in the bad" is good or bad. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ovarian Cancer Patients' Psychological Distress: The Role of Physical Impairment, Perceived Unsupportive Family and Friend Behaviors, Perceived Control, and Self-Esteem.

Although research has indicated that illness-related and interpersonal stress are associated with greater psychological distress among cancer patients, little empirical attention has been given to mechanisms that account for these relationships. In the present study, 2 mechanisms for the association between illness-related stress (physical impairment) and interpersonal stress (family and friend unsupportive responses) and psychological distress of 143 ovarian cancer patients were examined cross-sectionally. Separate structural equation models tested whether physical impairment impacted patients' distress via decrements in perceived control over their illness and whether unsupportive behaviors impacted patients' distress via decrements in patients' self-esteem. Results supported the proposed models and suggest that perceived control and self-esteem are 2 mechanisms for explaining how illness-related and interpersonal stress may be associated with psychological distress among women with ovarian cancer. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Presurgery Distress and Specific Response Expectancies Predict Postsurgery Outcomes in Surgery Patients Confronting Breast Cancer.

Prior to scheduled surgery, patients frequently experience particularly high levels of distress and expect a variety of postsurgery symptoms. Surgery patients who confront breast cancer are no exception. It has been suggested that such presurgery distress and response expectancies are predictive of postsurgery outcomes. To test the contribution of presurgery distress and expectancies to common postsurgery symptom outcomes (pain, nausea, fatigue, and discomfort), 63 female patients undergoing breast cancer surgery were recruited to a prospective study. Results indicated that presurgery distress uniquely contributed to patients' postsurgery nausea, fatigue, and discomfort; specific expectancies uniquely contributed to pain intensity, pain unpleasantness, and fatigue (ps     

Coping, Distress, and Life Events in a Community Sample.

Coping strategies represent behavioral and cognitive efforts to deal with stressful encounters (R. S. Lazarus & S. Folkman, 1984). This study aimed to assess the pattern of associations between demographic variables, problem-and emotion-focused coping, and distress. A representative sample of 510 adult Israelis completed coping and distress inventories. Emotion-focused coping showed strong positive associations with distress, whereas problem-focused coping was negatively related to this variable, although to a lesser degree. The effects of problem-focused coping on distress were more pronounced for participants who had experienced a recent life event. The conclusion to be drawn is that stressful conditions may enhance the effects of coping strategies on distress. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Project Genesis: Assessing the Efficacy of Problem-Solving Therapy for Distressed Adult Cancer Patients.

The efficacy of problem-solving therapy (PST) to reduce psychological distress was assessed among a sample of 132 adult cancer patients. A second condition provided PST for both the patient and a significant other. At posttreatment, all participants receiving PST fared significantly better than waiting list control patients. Further, improvements in problem solving were found to correlate significantly with improvements in psychological distress and overall quality of life. No differences in symptom reduction were identified between the 2 treatment protocols. At a 6-month follow-up, however, patients who received PST along with their significant other reported lower levels of psychological distress as compared with members of the PST-alone condition on approximately half of the outcome measures. These effects were further maintained 1-year posttreatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Unconscious Cost of Good Fortune: Implicit and Explicit Self-Esteem, Positive Life Events, and Health.

J. D. Brown and K. L. McGill (1989) found that positive life events were associated with better health only for people high in self-esteem. Among people low in self-esteem, positive life events were associated with poorer health. The authors of this study replicated this finding in a self-report survey of 61 male and 110 female college students. In addition, they showed that implicit self-esteem moderated the relation between positive life events and self-reported health in the same fashion as explicit self-esteem did. Whereas people high in implicit self-esteem reported being healthier when they experienced more positive life events, people low in implicit self-esteem reported being healthier when they experienced fewer positive life events. Moreover, the effects of implicit self-esteem were statistically independent of the effects of explicit self-esteem. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Finding Benefit in Breast Cancer During the Year After Diagnosis Predicts Better Adjustment 5 to 8 Years After Diagnosis.

Cancer patients experience positive as well as adverse consequences from diagnosis and treatment. The study reported here examined longer term reverberations of such experiences. A set of benefit-finding items along with measures of well-being were completed by 230 early-stage breast cancer patients in the year postsurgery. Four to 7 years later, 96 of them again completed measures of well-being. Controlling for initial distress and depression, initial benefit finding in this sample predicted lower distress and depression at follow-up. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Relationship Between Person-Organization Congruence, Perceived Violations of the Psychological Contract, and Occupational Stress Symptoms.

Along with rapid changes in the workplace have been changes in the workforce, including decreased congruence between personal and organizational values (P-OC), an increase in perceived psychological contract violations (PCV), and an increase in work stress. This study examined the relationship between these variables in the context of age, gender, and job tenure. Results indicated that employees reporting higher levels of PCV are more likely to experience low P-OC, be relatively older, and have been in their current jobs for a relatively shorter time. Employees reporting higher stress symptoms are more likely to be male, and to have been in their current jobs and with the company relatively longer. Study findings have implications for consulting and human resource management practices. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relationships Among Life Stress, Social Support, Academic Stressors, and Reactions to Stressors of International Students in the United States.

This study examined the relationships among 4 constructs--life stress (primary stressor), academic stressors (secondary stressor), perceived social support (stress mediator), and reactions to stressors (stress outcome)--among 143 international students. Structural equation modeling was used to assess the relationships among latent and measured variables in the conceptual model. Results indicated no significant difference in academic and life stressors by gender. However, women exhibited higher reactions to stressors than men. Higher levels of academic stressors were predicted by higher levels of life stress and by lower levels of social support. Higher academic stressors predicted greater reactions to stressors. All of the regression weights in the model were statistically significant, and the model's predictors accounted for 82% of the variance in reactions to stressor. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Couples' Support-Related Communication, Psychological Distress, and Relationship Satisfaction Among Women With Early Stage Breast Cancer.

This study examined associations between couple communication about cancer and psychological distress and relationship satisfaction of women diagnosed with early stage breast cancer. One hundred forty-eight couples completed a videotaped discussion of a cancer-related issue and a general issue. Patients completed measures of psychological distress and relationship satisfaction. Videotapes were coded with the Rapid Marital Interaction Coding System (R. E. Heyman & D. Vivian, 1997). Analyses focused on partner responses to patient self-disclosures. During cancer-issue discussions, patients reported less distress when partners responded to disclosures with reciprocal self-disclosure and humor and when partners were less likely to propose solutions. Fewer links between partner responses to patient self-disclosures and distress were found in general-issue discussions. Results suggest partner responses play a role in women's adaptation to breast cancer. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Therapeutic Norms and Patient Benefit: Cancer Patients in Professionally Directed Support Groups.

This study examines the relationship between cancer support groups' normative regulation and patient outcomes. Cancer patients (N = 289) in 54 groups were studied through the use of a cross-sectional, treatment dosage design. Outcomes were assessed by the Center for Epidemiological Studies Depression Scale and the Functional Assessment of Cancer Therapy, a quality of life measure commonly used in studies of cancer patients. The framework for assessing normative regulations was based on the degree to which patients matched leader norms. This approach to indexing members' perceptions of normative regulations proved to be a successful strategy. The more a participant view matched those of the leaders, the greater the likelihood they benefited from the group. The content of the norms added an independent effect on positive outcomes. Participants who saw their groups as approving of aggressive-competitive behaviors and the intense expression of emotions were less likely to show positive outcomes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Daily Processes in Stress and Smoking: Effects of Negative Events, Nicotine Dependence, and Gender.

The author used a multilevel daily process design to examine relations among daily negative events, perceived stress, smoking, and smoking urges. The moderating effects of gender and nicotine dependence were also explored. Fifty-one adult community-residing smokers recorded negative events, perceived stress, cigarette smoking, and urges to smoke 4 times daily for 14 days. Analyses of within-person relations showed that participants smoked more cigarettes and experienced more urges to smoke on occasions with higher numbers of negative events and higher levels of perceived stress. These relations were stronger for men than for women. Nicotine dependence did not interact with events or stress in predicting smoking or urges. These findings build on laboratory studies and cross-sectional surveys by showing that in naturalistic settings, occasions with negative events and perceived stress are associated with smoking and urges to smoke. (PsycINFO Database Record (c) 2010 APA, all rights reserved)