Psychological disease adjustment in breast cancer patients

In a prospective follow-up study, attention was focused on adjustment to disease in breast cancer patients one year after diagnosis. Prebioptic data was collected in the original patient group consisting of 95 women with mammary tissue findings that required clarification. Twenty-nine women with histological confirmation of breast cancer and 37 patients of the control group with benign histological findings were recontacted after an interval of one year. Data was collected by means of psychological test questionnaires (STAI, SVF, FPI, CIP-DS), the patients with breast cancer were given an additional problem-oriented questionnaire about coping with disease, compiled by the author. Most denied having disease-related fears-progression of the disease, premature death; instead, marked sleep disturbances, regularly, recurring nightmares, and depressed states of mind characterized the psychosomatic correlate of the mental burden. The psychological consequences of cancer are related to some extent to the stage of tumour growth at the time of diagnosis; the process of social reintegration appears to be facilitated in women whose biopsy operation did not involve removal of a breast. An clear characterization of breast cancer patients could not be established using psychological testing procedures one year after diagnosis of the disease.     

Conditioned emotional distress in women receiving chemotherapy for breast cancer.

This study investigated whether women undergoing outpatient chemotherapy for breast cancer can develop classically conditioned emotional distress. Women scheduled to begin chemotherapy were randomly assigned either to an experimental group (exposed to a distinctive stimulus before each chemotherapy infusion) or a control group. After repeated infusions of chemotherapy, patients' responses to the distinctive stimulus were assessed in a location not associated with chemotherapy administration. At the test trial, experimental group patients showed evidence of increased emotional distress (self-reported on a visual analog scale) after the presentation of the distinctive stimulus, whereas control group patients did not. Post hoc analyses indicated that these increases in distress were not secondary to other conditioned responses (e.g., nausea, taste aversion). Thus, results supported the hypothesis that the pairing of a distinctive stimulus with chemotherapy would result in the development of a conditioned emotional response. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological adjustment and cancer outcome: Levy versus Taylor.

In response to S. Levy's (see record 1985-25856-001) criticism of R. Taylor's (see record 1984-17824-001) proposed cognitive theory of adaptation to cancer, the present author argues that Levy's contention that psychological maladjustment is associated with positive biological outcome is unjustified and bears little relevance to Taylor's model and its testability. (4 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social comparison in adjustment to breast cancer.

Investigated 4 theoretical perspectives concerning the role of social comparison in coping with a threatening event, using 78 29–78 yr old females with breast cancer as Ss. It is noted that, according to the supercoper perspective, personal contact with comparison others is often unavailable to patients; in addition, contact with media supercopers (fellow victims presented as adjusting smoothly) may make patients feel inadequate by comparison. According to the similarity perspective, patients select comparison targets who are similar to themselves because those comparisons should be the most informative. The upward comparison perspective is predictive of comparisons to relatively advantaged or superior individuals. The downward comparison perspective leads to the prediction that, under conditions of threat, individuals make comparisons to people who are inferior or less fortunate in order to enhance their self-esteem. Ss were interviewed to determine which perspective had the most validity in terms of their experience with closed-ended questions. Ss offered spontaneous comparisons throughout the interview. Both closed-ended questions and spontaneously offered comparisons yielded a preponderance of downward comparisons. Findings support the value of using naturalistic methods for studying comparisons and suggest a more active and cognitive role for social comparison than is usually portrayed. (29 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological adjustment in adults with cancer: The self as mediator.

Investigated whether discrepancies between actual and ideal self-conceptions influence adjustment and mediate the effects of disease-related health problems on psychological well-being, in a cross-sectional study of 108 cancer patients (aged 26–86 yrs). Ss who had more symptoms and worse functional health and perceived their cancer as a chronic rather than an acute disease had higher levels of self-discrepancies and poorer adjustment. Self-discrepancy was a significant mediator of the effects of perceived health status on purpose in life, positive relations with others, and depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive specificity in emotional distress.

Cognitive approaches to emotional distress posit that specific cognitive factors are critically linked to the etiology, course, or treatment of dysfunction. Although a number of empirical studies have assessed cognitive factors in emotional disorders such as depression and anxiety, research has yet to assess these variables simultaneously and with identical cognitive measures. Using depression and test anxiety as models of dysfunctional affective states, we examined cognitive specificity on measures of information processing, attributions, automatic thinking, and cognitive interference. Results indicated a pattern of specificity showing several differences and similarities in depression and anxiety. Specifically, "purely" depressed individuals showed evidence of selectivity processing depressive information, making dysfunctional attributions, and engaging in more negative automatic thinking. "Purely" anxious individuals, on the other hand, showed evidence of selective anxious information processing and increased cognitive interference. Results are discussed in terms of a taxonomy for classifying depressive and anxious cognition. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological adjustment among African American breast cancer patients: One-year follow-up results of a randomized psychoeducational group intervention.

The effectiveness of support group interventions for cancer patients has been established among White patients but has been virtually unstudied among minority patients. The current study represents the 1st randomized support group intervention targeted to African American women with breast cancer. Participants (N = 73) with nonmetastatic breast cancer were randomly assigned to an 8-week group intervention or an assessment-only control condition At 12 months, the intervention resulted in improved mood as well as improved general and cancer-specific psychological functioning among women with greater baseline distress or lower income. Subsequent research is needed to address effective methods of enrolling and following women with fewer psychosocial and financial resources, as they were the most likely to benefit from this particular intervention. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Treatment decision making and adjustment to breast cancer: A longitudinal study.

This study monitored women (N?=?76) with breast cancer from diagnosis through 1 year, and tested constructs from subjective expected utility theory with regard to their ability to predict patients' choice of surgical treatment as well as psychological distress and well-being over time. Women's positive expectancies for the consequences of treatment generally were maintained in favorable perceptions of outcome in several realms (i.e., physician agreement, likelihood of cancer cure or recurrence, self-evaluation, likelihood of additional treatment, partner support for option, attractiveness to partner). Assessed before the surgical decision-making appointment, women's expectancies for consequences of the treatment options, along with age, correctly classified 94% of the sample with regard to election of mastectomy versus breast-conserving procedures. Calculated from the point of decision making to 3 months later, expectancy disconfirmations and value discrepancies concerning particular treatment consequences predicted psychological adjustment 3 months and 1 year after diagnosis. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychosocial adjustment to breast cancer in unmarried women

In this study the use of collagen-binding assay, recently recommended by the European Pharmacopoeia for the characterization of Factor VIII/von Willebrand Factor (FVIII/vWF) concentrates was investigated. The collagen-binding assay was optimized to decrease reagent variability and, to allow for interlaboratory comparison, standardized against the third WHO International Plasma Standard for vWF and factor VIII, with the assumption that 1 unit of vWF antigen = 1 unit of collagen binding activity. A study of clinical samples of patients with von Willebrand's disease established that a ratio of vWF antigen; Collagen-binding activity <1.4 was associated with normal multimeric distribution and a ratio >3.7 was associated with loss of high molecular weight multimers and a decrease in biological activity. The collagen-binding assay of vWF was used to monitor changes in the biological activity of vWF during the manufacture of FVIII concentrates. Two commonly used industrial procedures using either glycine/NaCl precipitation or ion exchanges with TSK DEAE column chromatography were investigated. Samples taken at individual stages in the purification of FVIII concentrates, at the laboratory and industrial scale, were monitored using FVIII coagulant activity:vWF antigen ratio, Collagen-binding activity:vWF antigen ratio, and sodium dodecyl sulfate-agarose vWF multimeric analysis. All three parameters showed a retention of multimeric structure and biological activity during manufacture, to yield products which were clinically relevant in the treatment of von Willebrand's diseases.     

Quality of couples' relationship and adjustment to metastatic breast cancer.

This study examined mood disturbance among women with metastatic breast cancer in relationship to partnership status, relationship quality, and partner's coping and mood disturbance. These associations were examined within a total sample of 125 metastatic breast cancer patients and a subsample of 48 of these patients and their partners. Partnered and single women were indistinguishable in mood disturbance when household income was statistically controlled. Results also showed that patients were less distressed when they rated the relationship higher in Cohesion-Expression and in Conflict and when their partners reported lower mood disturbance. One possible implication of these results is that in relationships in which a woman has metastatic cancer, she may benefit from open engagement of difficulties and conflict. Furthermore, alleviating her distress may be better achieved by focus on the couple relationship rather than her individual coping. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological adjustment to ostomy surgery.

Describes the anatomy and physiology of colostomy, ileostomy, and urostomy surgeries and reviews 16 studies regarding the outcome of these surgeries in terms of patients' health, employment, social activities, sexual functioning, marital relationships, and emotional status. Two studies of factors that influence outcome are also reviewed, and strengths and weaknesses of existing studies are evaluated. Recommendations for further research include grouping patients by diagnosis rather than by type of surgery; more precise labeling of surgical procedures; avoidance of positive bias in sampling by selecting patients from physician and hospital records, rather than from the members of mutual help groups; and use of longitudinal studies to investigate personality and situational variables that influence the process of psychosocial adjustment to ostomy. (31 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attributions, vulnerability, and psychological adjustment: The case of breast cancer.

Hypothesized that psychological adjustment would be positively associated with breast cancer victims' perceptions of invulnerability to a recurrence of cancer and that victims' causal attributions for cancer (e.g., self-blame, birth control pills, sexually demanding husband) would influence adjustment to the extent that the attributions contributed to or detracted from perceived invulnerability. A path model was developed based on the proposed association between invulnerability and adjustment, and attributions were tested for whether they directly or indirectly influenced adjustment. Responses from intensive interviews of 42 breast cancer victims (aged 23–81 yrs) who had undergone mastectomies within 2 yrs prior to being interviewed were used to test the path model. Ss were also administered the Beck Depression Inventory and another measure to assess emotional response to breast cancer at Ss' present stage of adjustment. Results support the hypothesized positive association between perceived invulnerability and adjustment and show that the relationships between specific attributions and adjustment were mediated by vulnerability beliefs. Follow-up data may be useful in ascertaining the role played by cognitions in the biological progression of cancer. (52 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Coping styles associated with psychological adjustment to advanced breast cancer.

The aim of this study was to determine whether psychological adjustment to advanced breast cancer was positively associated with expressing emotion and adopting a fighting spirit and negatively associated with denial and fatalism. Total mood disturbance on the Profile of Mood States was used as the measure of psychological adjustment. The Courtauld Emotional Control Scale measured emotional expression, and the Mental Adjustment to Cancer measured fighting spirit, denial, and fatalism. The sample included 101 women with a diagnosis of metastatic or recurrent breast cancer. Fighting spirit and emotional expressiveness were found to be associated with better adjustment. No association was found between mood disturbance and denial or fatalism. Because this was a cross-sectional study, no conclusions regarding a causal relationship between adjustment and emotional expressiveness or adjustment and fighting spirit were possible. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mediators of a brief hypnosis intervention to control side effects in breast surgery patients: Response expectancies and emotional distress.

Objective: The present study was designed to test the hypotheses that response expectancies and emotional distress mediate the effects of an empirically validated presurgical hypnosis intervention on postsurgical side effects (i.e., pain, nausea, and fatigue). Method: Women (n = 200) undergoing breast-conserving surgery (mean age = 48.50 years; 63% White, 15% Hispanic, 13% African American, and 9% other) were randomized to a hypnosis or to an attention control group. Prior to surgery, patients completed assessments of hypothesized mediators (response expectancies and emotional distress), and following surgery, patients completed assessments of outcome variables (pain, nausea, and fatigue). Results: Structural equation modeling revealed the following: (a) Hypnotic effects on postsurgical pain were partially mediated by pain expectancy (p p = .12); (b) hypnotic effects on postsurgical nausea were partially mediated by presurgical distress (p = .02) but not by nausea expectancy (p = .10); and (c) hypnotic effects on postsurgical fatigue were partially mediated by both fatigue expectancy (p = .0001) and presurgical distress (p = .02). Conclusions: The results demonstrate the mediational roles of response expectancies and emotional distress in clinical benefits associated with a hypnotic intervention for breast cancer surgical patients. More broadly, the results improve understanding of the underlying mechanisms responsible for hypnotic phenomena and suggest that future hypnotic interventions target patient expectancies and distress to improve postsurgical recovery. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Interdependence in women with breast cancer and their partners: An interindividual model of distress.

Objective: The aim of this investigation was to test whether interdependence in dyads living with breast cancer could account for person–partner crossover effects in distress outcomes. Method: The sample consisted of 95 dyads with early-stage breast cancer. By using reciprocal dyadic data from women with breast cancer and their partners, we fit a structural equation model of the actor–partner interdependence model to examine the interaction of participants’ depression and stress in predicting their partner’s health outcomes. Results: Results revealed a pattern of influence whereby the interaction of high levels of depression coupled with high levels of stress in women with breast cancer was associated with lowered physical health and well-being in their partners. Although depression seemed to be the key mechanism in predicting distressing outcomes, when depression was combined with any additional stress, the level of physical distress was significantly greater. Results provided preliminary empirical support for crossover effects in the physical well-being of close relational partners in a cancer-related context. Further, results showed that distressing outcomes need not be limited to emotional distress but can also include physical distress. Conclusions: The findings from this study illustrate why it is not sufficient to concentrate care solely on the patient with cancer. Monitoring the social well-being of patients as they go through the cancer process could be as important as assessing their psychological state or other peripheral biomarkers. This line of inquiry would be advanced by including methods other than self-report in assessments of psychological and physical health. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological and academic adjustment in adopted children.

Evaluated psychological and academic adjustment of 130 6–11 yr old adopted children and 130 age-matched nonadopted children using the Hahnemann Elementary School Behavior Rating Scale and a child behavior profile. Results show that adopted Ss were rated higher in psychological and school-related behavior problems and lower in social competence and school achievement than were nonadopted Ss. It is suggested that although the results support the position that the risk is greater for adopted children to develop emotional and school-related problems, the data should not be overinterpreted because the majority of adopted Ss were within the normal range of behavior. (50 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Marital conflict and child adjustment: An emotional security hypothesis.

An emotional security hypothesis that builds on attachment theory is proposed to account for recent empirical findings on the impact of marital conflict on children and to provide directions for future research. Children's concerns about emotional security play a role in their regulation of emotional arousal and organization and in their motivation to respond in the face of marital conflict. Over time these response processes and internalized representations of parental relations that develop have implications for children's long-term adjustment. Emotional security is seen as a product of past experiences with marital conflict and as a primary influence on future responding. The impact and interaction of other experiential histories within the family that affect children's emotional security are also examined, with a focus on parent–child relations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Irrational beliefs and the arousal of emotional distress.

Evaluated the extent to which endorsement of irrational beliefs as measured by the Irrational Beliefs Test (IBT) was associated with subjective, physiological, and cognitive indices (e.g., Trait scale of the State–Trait Anxiety Inventory and Fear of Negative Evaluation Questionnaire scores) of emotional distress in response to a stressful event delivered in a controlled experiment. 62 undergraduates served as Ss. Beliefs relevant to the stressor were more associated with negative cognitions than was either a belief less relevant to the stressor or general irrational thinking. However, a measure of the fear of negative evaluation was more frequently associated with measures of distress than were irrational beliefs. The equivalent and perhaps greater predictive utility of a more parsimonious, less inferential individual difference variable was interpreted as challenging the construct validity of the IBT and perhaps questioning the necessity of postulating the existence of irrational beliefs in accounts of the arousal of emotional distress. (48 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Impact of a dietary change on emotional distress.

Investigated the impact of a dietary change on the emotional state of 3 21–50 yr old females and an 18-yr-old male, using a single-S design. Ss were selected on the basis of scores on a behavioral index of metabolic imbalance and a subsequent interview. The dietary change for 3 Ss consisted of a high protein, low carbohydrate diet void of sucrose and caffeine, whereas only caffeine and sucrose were eliminated for the 4th S. The dependent variable used with the 1st S was a self-report of symptoms experienced, whereas the Minnesota Multiphasic Personality Inventory (MMPI) and the Profile of Mood State (POMS) were used with the other Ss. Ss reported many symptoms and/or presented a distressed profile during baseline assessment. However, following a 2-wk dietary change symptoms declined, and the MMPI or POMS profiles reflected a more stable and less distressed individual. Results suggest that a dietary change can remediate the emotional distress exhibited by some individuals, with the type of change affecting the emotional response. (33 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)