Social constraints, cognitive processing, and adjustment to breast cancer.

This cross-sectional study of 70 breast cancer survivors examined relationships among social constraints, behavioral and self-report indicators of cognitive processing, depression, and well-being. On the basis of a social-cognitive processing (SCP) model, it was predicted that social constraints would inhibit cognitive processing of the cancer experience, leading to poorer adjustment. Constraints were positively associated with intrusions, avoidance, and linguistic uncertainty in cancer narratives. Greater uncertainty, intrusions, and avoidance, as well as less talking about cancer were associated with greater depression and less well-being. Intrusions partially mediated the positive constraints-depression relationship. Talking about cancer partially mediated the inverse avoidance-well-being relationship. Findings support the SCP model and the importance of using behavioral indicators of cognitive processing to predict positive and negative psychosocial outcomes of cancer. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social comparison and adjustment to breast cancer: An experimental examination of upward affiliation and downward evaluation.

In a study designed to evaluate the divergence of social comparison activities under health threat, breast cancer patients (n?=?94) were assigned randomly to listen to an audiotaped interview in which the target's psychological adjustment and disease prognosis were manipulated to reflect good, poor, and unspecified psychological and physical health status. Results supported hypotheses regarding downward self-evaluative and upward affiliative comparison activity, as well as predictions regarding the influences of comparison dimension. With regard to desire for affiliation, participants demonstrated a greater desire for information and emotional support from the well-adjusted target than from the poorly adjusted target. Self-evaluation of adjustment and prognosis varied as a function of target characteristics, although a pervasive tendency toward downward comparison in self-evaluation also was noted. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social support and parental adjustment to pediatric cancer.

Assessed the psychosocial adjustment of 107 23–58 yr old parents whose children had cancer using the Psychosocial Adjustment to Illness Scale. Ss whose child had died showed poorer adjustment than Ss whose child was in treatment or had completed treatment. Ss over 30 yrs of age showed better adjustment than younger Ss. Different patterns of association between 11 sources of social support and adjustment were found. Psychosocial adjustment of Ss with a child in treatment was correlated more frequently with perceived social support than for other Ss. Results suggest that particular attention should be paid to the psychosocial adjustment of young bereaved parents. (7 ref) (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.     

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)     

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)     

Curvilinear associations between benefit finding and psychosocial adjustment to breast cancer.

Two previously studied cohorts of women with nonmetastatic breast cancer (Ns = 230 and 136) were reexamined. Participants were assessed during the year after surgery and 5-8 years later. Associations were examined between benefit finding (BF) and several indicators of psychosocial adjustment (e.g., perceived quality of life, positive affect, negative affect, social disruption, and intrusive thoughts). Significant curvilinear relations between BF and other outcomes were observed cross-sectionally during initial assessment and at long-term follow-up in both samples. Compared with the intermediate BF group, low and high BF groups had better psychosocial adjustment. Further analyses indicated that the high BF group reported higher optimism and more use of positive reframing and religious coping than the other BF groups. Discussion highlights the need to examine nonlinear as well as linear relationships. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attributions, beliefs about control, and adjustment to breast cancer.

Examined attributions for cancer and beliefs about control over cancer for their association with adjustment to breast cancer. 78 29–78 yr old females with breast cancer served as Ss. Ss were administered a battery of tests that included the Profile of Mood States, Rotter's Internal–External Locus of Control Scale, and the Rosenberg Self-Esteem Scale. Although 95% of the Ss made attributions for their cancer, no particular attribution (e.g., stress, diet) was associated with better adjustment. Analyses of attributions of responsibility for the cancer to the self, environment, another person, or chance yielded only a negative relation between adjustment and blaming another person. In contrast, both the belief that one could now control one's cancer and the belief that others (e.g., the physician) could now control the cancer were significantly associated with good adjustment. Of the different types of control, cognitive control was most strongly associated with adjustment, behavior control was less strongly associated with adjustment, and information control and retrospective control were unassociated with adjustment. (56 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Emotionally expressive coping predicts psychological and physical adjustment to breast cancer.

This study tested the hypothesis that coping through emotional approach, which involves actively processing and expressing emotions, enhances adjustment and health status for breast cancer patients. Patients (n ?=?92) completed measures within 20 weeks following medical treatment and 3 months later. Women who, at study entry, coped through expressing emotions surrounding cancer had fewer medical appointments for cancer-related morbidities, enhanced physical health and vigor, and decreased distress during the next 3 months compared with those low in emotional expression, with age, other coping strategy scores, and initial levels on dependent variables (except medical visits) controlled statistically. Expressive coping also was related to improved quality of life for those who perceived their social contexts as highly receptive. Coping through emotional processing was related to one index of greater distress over time. Analyses including dispositional hope suggested that expressive coping may serve as a successful vehicle for goal pursuit. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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.     

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)     

Psychological adjustment in breast cancer: Processes of emotional distress.

The process of psychological adjustment to breast cancer was examined at diagnosis and at 3- and 6-month follow-ups in a sample of 80 women with Stage I–Stage IV breast cancer. At diagnosis, symptoms of anxiety/depression were predicted by low dispositional optimism, and this path was partially mediated by use of emotion-focused disengagement coping. Younger age also was predictive of anxiety/depression symptoms at time of diagnosis and this relationship was fully mediated by magnitude of intrusive thoughts. At 3 months, changes in anxiety/depression symptoms were predicted only by intrusive thoughts. At 6 months, low dispositional optimism reemerged as a significant predictor of changes in anxiety/depression and again was partially mediated by the use of emotion-focused disengagement coping. Independent effects for problem-focused engagement and disengagement and emotion-focused engagement coping were also found at 6 months. Implications of these data for psychosocial interventions with breast cancer patients are highlighted. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Long-term effects of educational and peer discussion group interventions on adjustment to breast cancer.

The authors report a 3-year follow-up of the effects of 8-week support group interventions on the quality of life of women with early stage breast cancer. Shortly after diagnosis, women were randomly assigned to 1 of 4 conditions: control, education, peer discussion, and education plus peer discussion. The education group intervention focused on providing information to enhance control over the illness experience, whereas the peer discussion group intervention focused on providing emotional support through the expression of feelings. Consistent with the results that emerged 6 months after the interventions (V. S. Helgeson, S. Cohen, R. Schulz & J. Yasko, 1999), the authors found that the benefits of the education intervention were maintained over a 3-year period N?=?252) although effects dissipated with time. The authors continued to find no benefits of the peer discussion intervention, either alone or in combination with education. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social and institutional factors in adjustment to traumatic brain injury.

ABSTRACT. A longitudinal case study of a working-class heterosexual White man who sustained a traumatic brain injury in a motor vehicle accident is used to delineate social and institutional factors that play a role in adjustment to brain injury. Data gathered from multiple sources (e.g., medical records, neuropsychological assessment, participant observation, and interviews) and sustained contact with the participant and his family over a 10-month time span reveal a complex and multidetermined view of the adjustment process. The case illustrates the critical need for an advocate, a requirement that becomes particularly acute when cognitive disabilities interfere with a person's ability to function effectively on his or her own. The factors that people with brain injuries and advocates must face include shifting of responsibilities, time, paperwork, negotiation of finances, and issues related to class and disability status. Moving beyond the individual focus on deficits and impairments to looking at the institutional, social, and cultural factors that influence the adjustment process will give clinicians and researchers a broader context for understanding brain injury and helping patients adjust. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social adjustment and familial schema.

2 groups of 50 male undergraduates each with good and poor social adjustment as determined by a questionnaire freely placed figures of a father, a mother, a son, and a daughter on a field. As predicted, Ss with poor social adjustment placed the son closer to the father, while Ss with good social adjustment placed the son closer to the mother (p     

Social phobia and difficulties in occupational adjustment.

This study examined whether social phobics differed from nonanxious controls in occupational adjustment. Results indicated that generalized and nongeneralized social phobics, in contrast to controls, were underemployed and believed that their supervisor would rate them as less dependable. Nongeneralized social phobics and controls believed their supervisor would rate them higher in work role conformance and likelihood of advancement than did generalized social phobics. Generalized socially phobic women, in contrast to nongeneralized and control group women, were more likely to be employed in noninterpersonally oriented jobs. Generalized social phobics were more anxious than controls when starting their current job but did not differ in job satisfaction. Results are discussed relative to the nature of social phobia, subtype differences, and counseling services. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social support and adjustment in gifted adolescents.

We investigated the role of perceived social support in facilitating adjustment to a residential high school for the gifted in science and math. The relation between social support and adjustment appeared to depend on the sex of the student and the source of support, and the specific type of adjustment examined. Successful overall adjustment to the school environment was related to perceived support from family, whereas psychological adjustment showed a clear relation to perceived support in general. Perceived support from peers related to psychological adjustment only for male adolescents. Female adolescents appeared to seek other sources of support when they perceived support from a particular source to be low. Thus, adjustment problems for female adolescents appeared to result only when they were unable to locate other sources. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social adjustment in victims of sexual assault.

93 rape victims (aged 15–71 yrs) were seen approximately 2 wks after the assault and at 1, 2, 4, 8, and 12 mo postrape. A matched control group of nonvictims was seen at the same intervals. To control for the effects of repeated testing, 3 additional groups with 72 victims were assessed only once at either 2, 4, or 8 mo postrape. All Ss completed the Social Adjustment Scale–Self Report, which yielded a total adjustment score as well as subscale scores for 5 areas of adjustment: Work; Economic; Social and Leisure; Marital, Parental, and Family Unit; and Extended Family. Ss exhibited disruption in overall social adjustment and most of the subscale roles for the first few months following their assaults. By 4 mo postrape, most of the subscales had stabilized at levels similar to the nonvictims'. Work adjustment continued to be affected through 8 mo postrape. Single-testing control victims appeared to have more problems in social adjustment, particularly with regard to relationships with relatives. (14 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social problem-solving abilities and adjustment to recent-onset spinal cord injury.

ABSTRACT. Objective: To examine the relation of social problem-solving abilities to psychological and physical adjustment of persons with recent spinal cord injuries (SCIs). Design: Correlational procedures were used. Participants: One hundred eighty-six persons with recent SCI completed self-report measures during inpatient rehabilitation; 94 returned for an annual evaluation. Main Outcome Measures: Acceptance of disability, career needs, and pressure sore diagnoses. Results: Greater negative problem orientation predicted each self-report outcome variable; completeness of lesion was the best predictor of pressure sore diagnosis. Conclusions: The problem orientation component appears to relate to self-reported adjustment among persons with SCI in a theoretically consistent fashion. (PsycINFO Database Record (c) 2010 APA, all rights reserved)