A randomized trial of breast cancer risk counseling: Interacting effects of counseling, educational level, and coping style.

The authors evaluated the impact of individualized breast cancer risk counseling (BCRC) on breast-cancer-specific distress and general distress in 239 women with a family history of breast cancer. Following a baseline assessment of demographics, risk factors, coping styles, and distress, participants were assigned randomly to receive either BCRC or general health education (GHE; i.e., control group). After controlling for education level, women who received BCRC had significantly less breast-cancer-specific distress at 3-month follow-up compared with women who received GHE. A significant Education Level?*?Treatment Group interaction indicated that the psychological benefits of BCRC were greater for women with less formal education. In both the BCRC and GHE groups, participants who had monitoring coping styles exhibited increases in general distress from baseline to follow-up. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prognostic risk assessment in primary breast cancer by behavioral and immunological parameters.

Investigated the predictive power of an immunologic effector cell, the natural killer (NK) cell, as well as selected psychological and demographic factors, to breast cancer prognostic risk status. 75 women (aged 28–74 yrs) with Stage I or II breast cancer were interviewed about their perceptions, attitudes, and interpersonal support. Ss also completed the SCL-90 and the Profile of Mood States. Blood was then drawn to assay NK functional activity. All assessments took place after surgery. It was found that NK activity predicted the status of cancer spread to the axillary lymph nodes. Ss who had low levels of NK activity were rated as well-adjusted to their illness; Ss who had higher NK activity appeared to be distressed or maladjusted. Findings are discussed in the light of recent animal findings linking environmental stress and behavioral responsiveness to biological vulnerability via endocrine and immune pathways. (28 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Does paying a fee for psychotherapy alter the effectiveness of treatment?

76 undergraduates who expressed interest in having a therapy session were randomly assigned to an experimental group that paid for the session or to a control group that did not pay. Each client received individual counseling from a therapist who was unaware of the client's fee-paying status. Ss completed the Hopkins Symptom Checklist pre- and posttreatment. Following the therapy session, Ss who had not paid a fee reported reliably lower levels of symptom and problem distress. It is suggested that Ss who did pay a fee may have expected more from treatment. Findings may have important implications for public and private support of psychotherapy services. (41 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Receiving competence-relevant help: Effects on reciprocity, affect, and sensitivity to the helper's nonverbally expressed needs.

In 2 studies, 124 female undergraduates working on a series of problems received help on either all or none of the problems, only those for which help really was needed (appropriate help), or only those problems for which help was not needed (inappropriate help). Ss reported their affective and evaluative responses and were given an opportunity to reciprocate to their helper and, in the first study, to a 3rd person. Results show that Ss who received help on all of the problems reported more negative affect and more tension than did Ss who received no help at all. Ss who received appropriate help reported more positive affect and more liking for their helper than did Ss who received inappropriate help. The amount of help that Ss reciprocated varied directly with the amount of help they had received. Further, Ss who received appropriate help from their partners and were allowed to reciprocate to them immediately afterwards were more sensitive to their nonverbally expressed needs cues than were Ss who had received inappropriate help. Theoretical and applied implications are discussed. (45 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Distress, personality, and mammography utilization among women with a family history of breast cancer.

The authors examined the impact of psychological distress and the personality construct of conscientiousness (as measured by the Neuroticism, Extraversion, and Openness—Five Factor Inventory) on mammography utilization among women who were at increased risk for breast cancer. Participants were 200 women who had at least 1 first degree relative with breast cancer. Overall, 80% of the participants had obtained a mammogram in the previous year. Analyses controlling for potential confounders (perceived risk, decisional balance, and physician recommendation for mammography), revealed that distress was negatively associated with mammography utilization among participants who were low in conscientiousness. Distress was not significantly related to mammography utilization among highly conscientious women. The results are discussed in terms of their implications regarding interventions designed to increase mammography utilization in this population. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Anxiety as a predictor of behavioral therapy outcome for cancer chemotherapy patients.

Studied whether baseline anxiety levels are predictive of outcome on treatments designed to reduce the negative affect and conditioned nausea associated with cancer chemotherapy. 72 18–79 yr old patients classified as having low, moderate, or high anxiety received progressive muscle relaxation training, electromyograph (EMGH) biofeedback, and/or skin temperature biofeedback. Physiological, multiple affect adjective checklist, and postchemotherapy ratings were obtained during baseline, training, and follow-up sessions. Compared with moderate- and high-anxiety Ss, low-anxiety Ss reported less anxiety and depression before behavioral training but nonetheless exhibited significantly greater reductions in anxiety, depression, and diastolic blood pressure as a result of training. Baseline anxiety levels were not related to reduced nausea. Overall, these data suggest that cancer patients who have higher baseline levels of anxiety and who are perhaps most in need of an effective behavioral treatment may be the least likely to benefit from behavioral treatments aimed at reducing the distress associated with chemotherapy. (14 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of preparatory information about sensations, threat of pain, and attention on cold pressor distress.

Three experiments with 170 male undergraduates investigated pain experience conceptualized as a combination of stimulus sensations (e.g., aching) and emotional distress. In Exp I, less distress was reported to cold pressor stimulation by Ss first told about stimulus sensations than by Ss who were uninformed or were told about symptoms of bodily arousal (e.g., tension). Adding a pain warning to sensation information blocked distress reduction, presumably by eliciting an emotional interpretation of the stimulus. In Exp II, Ss attending only to hand sensations reported less distress than Ss attending to their bodies. This decrease in the power of the stimulus to provoke emotion is presumably mediated by a schema of hand sensations formed by attention. In Exp III, Ss attending to hand sensations early in the immersion and distracting themselves later reported the same low levels of distress as did Ss who attended to hand sensations throughout. Ss distracted throughout and Ss attending to hand sensations later showed no distress reduction. Therefore, stimulus schematization must precede distress reduction. (64 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Role of donor competence, donor age, and peer presence on helping in an emergency.

101 1st, 4th, and 6th graders were interrupted by the experimenter as they played a gambling game. Half the Ss believed they were playing in the presence of an unseen peer bystander; half believed there were no bystanders present. Similarly, half the Ss had received competency instructions regarding how to repair the game should it become stuck, and half heard no such instructions. The experimenter asked Ss to wait for her until she returned. During her absence an unseen, same-sex peer played with the game and emitted distress cues. Results indicate that older Ss helped more than younger ones, Ss helped more when alone than with a peer, and Ss helped more when they had received competency instructions. Interactions reported in past research of peer presence with age were not obtained; peer presence and competence influenced all ages similarly. Competence and peer pressure interacted; competence had a much greater impact on lone Ss than on Ss with a peer present. (26 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Women's theories of menstruation and biases in recall of menstrual symptoms.

In this study, the relation between women's theories of menstrual distress and their recollections of physical and affective symptoms was examined. Ss completed daily questionnaires in which they evaluated themselves on several physical and affective symptoms. Later, some Ss were asked to recall the ratings they had made on a day when they were menstruating; others recalled a day when they were not menstruating. At the time of recall, all Ss were in the intermenstrual phase. Finally, Ss completed a measure designed to assess their theories of how they are typically affected by menstruation. The recollections of Ss who recalled the menstrual state were biased so as to be consistent with their theories of menstrual distress: The more a woman believed in the phenomenon of menstrual distress, the more she exaggerated, in recall, the negativity of her symptoms during her last period. The recollections of women asked to recall the intermenstrual state were unrelated to their theories of menstruation. Daily questionnaire ratings revealed that physical symptoms varied with menstrual cycle phase, whereas affective symptoms did not. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Behavioral training of social skills in shy males.

31 college males who had reported themselves unable to interact with women in specific social situations were asked to record every interaction for 1 wk. Following this, a series of behavioral tests was given. When compared to a group of confident Ss, shy Ss interacted with fewer women, in fewer situations, and for less time outside of the laboratory. In laboratory test situations shy Ss rated themselves and were rated by Os as being more anxious. Pulse rate was monitored during the behavioral testing. Confident Ss had significantly less pulse rate change during the test situations. After pretesting, shy Ss were randomly assigned to either an assessment control group or an analogue treatment group, with treatment consisting of 3 sessions of behavior rehearsal, modeling, and coaching. On posttesting, Ss who had received treatment showed less physiological responsivity to the testing stimuli, reported less anxiety, and were rated as being more skillful in the test situations. Behavioral diaries revealed that following treatment Ss who received training changed more than control Ss on several measures of frequency and duration of interactions with women. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological adjustment to survival from Hodgkin's disease.

Compared the psychological adjustment of 60 male Hodgkin's disease survivors, aged 20–47 yrs, with an age-matched sample of 20 physically healthy men. Assessment included objective self-report, projective testing, observer rating, and interview. Measures included the Global Assessment Scale, Rosenberg Self-Esteem Scale, and Thematic Apperception Test (TAT). All Ss had received no treatment and had shown no evidence of disease for the previous 6–240 mo (median 2 yrs). On most measures, no differences were found between cancer survivors and healthy controls. However, the hypothesis of greater psychosocial dysfunction in the cancer sample overall was partially confirmed by significantly lowered intimacy motivation, increased avoidant thinking about illness, prolonged difficulty in returning to premorbid work status, and illness-related concerns. Conversely, patients were significantly more appreciative of life than nonpatients. Within the patient group, late stage (aggressively treated) Ss were at highest risk for psychological distress and psychosocial disruption during the 1st 2 yrs off treatment. (52 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of order of presentation, primacy, and physical attractiveness on attributions of ability.

Conducted 4 experiments with 720 undergraduates to determine if physical attractiveness interacts with or negates the primacy effect found by E. E. Jones et al (see record 1969-06853-001). Results demonstrate that attractive Ss received uniformly high attributions regardless of performance. Unattractive Ss, however, received attributions similar to those received by Ss who had no physical-attractiveness stimuli presented. Physical attractiveness had an effect only when presented before performance. When presented after performance, attributions received by attractive-stimulus Ss were not significantly different from attributions received by unattractive-stimulus Ss, as had been the case when attractiveness was presented before performance. Results support D. Newston (see record 1974-11048-001) and Newston and R. J. Rindner's (1979) hypothesis that perceivers may stop processing information once a point of sufficient subjective information is reached. (22 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)     

Self-disclosure in a simulated psychiatric interview.

Describes 2 experiments in which a total of 192 undergraduates received 49 items of personal information previously scaled in terms of their intimacy and presented according to the method of constant stimuli. For each item, Ss indicated whether they believed they would have withheld or revealed that information under actual psychiatric interview conditions. Exp. I manipulated the professional role of the interviewer, confidentiality of obtained information, and sex of the interviewee in a 4 * 3 * 2 design. Results indicate that (a) Ss avowedly revealed more personal information to mental health professionals than they would in a control employment interview situation, with no differences between the mental health professionals; (b) informing Ss that the interview was not confidential produced significant information loss from female but not male Ss; and (c) Ss who received no information regarding confidentiality behaved like Ss who were told the information was confidential. In Exp. II, Ss were asked to assume the motivational-attitudinal state of persons either coerced or voluntarily seeking a psychiatric interview because they had violated interpersonal norms. Significant information loss occurred in coerced Ss while confidentiality had no effect on self-disclosure. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Anxiety and cancer treatment: Response to stressful radiotherapy.

Conducted a study with 19 White female cancer patients (aged 23–78 yrs) to document the magnitude of anxiety Ss experienced in response to one particularly stressful form of radiation treatment. In addition, the change in anxiety responses with repeated exposures and individual differences among Ss was explored. As the time for internal radiotherapy treatment neared, subjective and physiologic indicants of anxiety and distress among the Ss significantly increased. By 24 hrs posttreatment, anxiety for all Ss remained elevated. A subset of the Ss who required 2 applications of radiotherapy continued to respond negatively during the 2nd treatment. Data on individual differences in anxiety responses suggest that those with low levels of pretreatment anxiety experienced considerable disruption posttreatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predicting adaptation to presymptomatic DNA testing for late onset disorders: who will experience distress? Rotterdam Leiden Genetics Workgroup

The first comparative study on predicting post-test distress (conceptualised by intrusion and avoidance, measured with the Impact of Event Scale) after presymptomatic genetic testing for Huntington's disease (HD, n=25), cancer syndromes (familial adenomatous polyposis (FAP, n=23)), and hereditary breast and ovarian cancer (HBOC, n=10) is reported. The variables with the highest predictive potential of post-test distress are presented. Participants who were depressed before the test were more distressed after testing, but we found that those who were anxious before the test were less distressed, that is, had less intrusive thoughts post-test. Other factors associated with a higher level of post-test intrusion were gender (being a woman), having children, and pre-test intrusion. Religion and being at risk for HBOC were associated with less post-test intrusion. Participants who showed avoidance behaviour before the test and those who had many people available for support showed more avoidance behaviour post-test. The test result did not additionally contribute to post-test distress. The prima facie simple notion that the test result, as such, determines the distress experienced seems to be a misrepresentation of the complex reality.     

Ethical discrimination ability of intern psychologists: A function of training in ethics.

Predicted that psychology interns who had completed a formal course in ethics would be able to discriminate the ethical problems or considerations in clinical practice at a rate significantly higher than interns who had received no formal training in ethics. Ss were 234 interns in clinical and counseling psychology programs. Results suggest that Ss who have completed formal training in ethics score significantly higher on the Ethical Discrimination Inventory than Ss who have received no formal training in ethics. Results appear to support the efficacy of teaching professional ethics in graduate training programs. (16 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effects of preoperative therapy with angiotensin-converting enzyme inhibitors on clinical outcome after cardiovascular surgery

PURPOSE: Quality of life of breast cancer survivors 8 years after diagnosis was compared with that among similarly aged women who had never confronted cancer (controls). METHODS: Survivors of a consecutive series of 227 breast cancer patients first treated in 1984 were approached for this study. Random-digit dialing was used to identify controls with the same age and residential distribution as the survivors. Quality of life was assessed in terms of physical health, functional status, psychologic distress, and social functioning. RESULTS: Participation was obtained from 96% (n = 124) of 129 eligible survivors and 61% (n = 262) of 427 potentially eligible controls. Consistently smaller proportions of survivors reported positive quality-of-life outcomes compared with controls, but these differences were generally small and nonsignificant statistically. When limited to women who remained free of disease over the entire follow-up period (n = 98), survivors' quality of life was similar to that among controls, with the exception of arm problems and sexual satisfaction for those women who lived with a partner. In contrast, survivors who developed recurrence or new primary breast cancer (n = 26) experienced a worse quality of life in all domains except social functioning. CONCLUSION: In most domains and for women without further disease events after diagnosis, quality of life does not seem to be permanently and globally impaired by breast cancer. Consequently, breast cancer survivors who remain free of disease probably do not need organized late psychosocial follow-up to improve quality of life. However, arm problems and sexuality are two areas in which additional effort may be still needed to improve quality of life of long-term survivors.     

Life events and personal causation: Some relationships with satisfaction and distress.

Hypothesized that Ss who engaged in more positive origin activities would rate their lives as more satisfying than Ss who engaged in fewer such activities, and both would be more satisfied than control Ss. After completing a series of questionnaires including a life-event inventory, 3 groups of college students were selected from a pool of 141 and given instructions either to (a) engage in 12 activities from a self-selected list of pleasurable activities, (b) engage in 2 activities from that list, or (c) return after 1 mo for retesting only. Ss were then given a pleasantness-of-events test, an event-frequency test, the Perceived Quality of Life Scale, the Beck Depression Inventory, and a 54-item Symptom Check List. Covariance analyses revealed that Ss instructed to engage in either 2 or 12 pleasurable activities reported greater pleasantness and a higher quality of life than controls; there were no differences between groups on reports of psychiatric distress. Prior negative life change was treated as a factor in the design and was found to interact with the activity instructions: Ss reporting many prior negative changes exhibited less psychiatric distress along with greater pleasantness when instructed to engage in 12 activities rather than 2 or none. Results suggest that pleasant activities increase positive aspects of well-being in general, but may reduce distress only for people experiencing considerable life stress. (28 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)