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)     

Optimistic Personality and Psychosocial Well-Being During Treatment Predict Psychosocial Well-Being Among Long-Term Survivors of Breast Cancer.

In considering well-being among survivors of life-threatening illnesses such as breast cancer, 2 important questions are whether there is continuity between initial adjustment and longer term adjustment and what role personality plays in long-term adjustment. In this research, a sample of 163 early stage breast cancer patients whose psychosocial adjustment was first assessed during the year after surgery completed the same measures 5-13 years after surgery. Initial reports of well-being were relatively strong predictors of follow-up well-being on the same measures. Initial optimism and marital status also predicted follow-up adjustment, even controlling for earlier adjustment, which exerted a substantial unique effect in multivariate analyses. In contrast, initial medical variables played virtually no predictive role. There is substantial continuity of subjective well-being across many years among survivors of breast cancer, rooted partly in personality and social connection. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Role of Social and Dispositional Variables Associated With Emotional Processing in Adjustment to Breast Cancer: An Internet-Based Study.

Cognitive and emotional processing is seen as critical to successful adjustment to traumatic experiences, such as breast cancer. Cognitive and emotional processing can be facilitated by dispositional and social environmental factors. Emotional intelligence is a dispositional characteristic defined as the ability to understand, accurately perceive, express, and regulate emotions (J. D. Mayer & P. Salovey. 1997). This study investigated psychological adjustment as a function of emotional intelligence, social support, and social constraints in 210 patients recruited via postings to Internet-based breast cancer support groups. Regression analyses indicated high social constraints and low emotional intelligence were associated with greater distress. Evidence suggested high emotional intelligence could buffer against the negative impact of a toxic social environment. Results support a social-cognitive processing model of adaptation to traumatic events and suggest consideration of emotional intelligence may broaden this model. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relationship of Social Support and Social Burden to Repeated Breast Cancer Screening in the Women's Health Initiative.

Direct and interactive effects of social support, social burden (caregiving, negative life events, and social strain), education, and income on repeated use of breast cancer screening among a large (N=55,278), national sample of postmenopausal women participating in the Women's Health Initiative observational study were examined. Repeated screening decreased as emotional/informational support and positive social interactions decreased (ps     

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)     

Social Support and Adjustment After Spinal Cord Injury: Influence of Past Peer-Mentoring Experiences and Current Live-In Partner.

Objective: To compare the impact of 2 types of social support, past peer-mentoring experience (PME) and current live-in partner (LIP), on adjustment after spinal cord injury (SCI). Participants: Sixty-two individuals with SCI (mean age=42 years: 11.7 years since injury). Design: Cross-sectional survey. PME (yes vs. no) and LIP (yes vs. no) were nearly equally balanced, affording 2X2 factorial analyses. Outcome Measures: Craig Handicap Assessment and Reporting Technique, Brief Symptom Inventory, and Satisfaction With Life Scale. Results: PME, which typically concluded over 10 years ago, was associated with higher occupational activity and life satisfaction, whereas having an LIP was associated with greater mobility and economic self-sufficiency. Conclusion: PME positively complements more traditionally studied sources of social support, which is encouraging for the use of PME as a clinical intervention. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

United We Stand? The Effects of a Couple-Coping Intervention on Adjustment to Early Stage Breast or Gynecological Cancer.

Cancer diagnosis affects the psychological well-being of both patients and their partners, and effective coping has been suggested to be a conjoint process of mutual support. Ninety-four married women with early stage cancer and their partners were randomly assigned to couples-based coping training (CanCOPE), individual coping training for the woman, or a medical education control. Couples' observed support communication and self-reported psychological distress, coping effort, and sexual adjustment were assessed at diagnosis, after cancer surgery, and at 6- and 12-month follow-ups. CanCOPE produced significant improvements in couples' supportive communication, reduced psychological distress and coping effort, and improved sexual adjustment. Training in couples rather than individual coping was more effective in facilitating adaptation to cancer. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychosocial Factors, Gender, and Sleep.

Low social support may contribute to poor sleep, more so than adverse aspects of demand and control and more so for women than men. This study on 1,179 working individuals, 623 women and 556 men, from the Multinational Monitoring of Trends and Determinants in Cardiovascular Disease (MONICA) study investigated the association between sleep and psychosocial factors. Chi-square analyses investigated the associations among sleep and demand, control, social networks, and emotional support. A logit log-linear model analyzed interactions. More women reported poorer sleep when perceiving adverse psychosocial factors. Interactive effects were found between adverse scores on demand, control, and emotional support. A multivariate partial least square analysis showed that poorer health, pain, and adverse aspects of emotional support and social networks contributed significantly to the pattern of poor sleep. (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)     

Sources and Types of Social Support in Youth Physical Activity.

This study examines the influence of sources and types of social support on youth physical activity. The sample comprised 372 youth (mean age = 12.05 years, SD = 1.63). Youth were 76% White and 50.3% female. The annual household income for the sample was 20% under $30,000; 30% $30,000-$49,999; 25% $50,000-$69,999; 13% $70,000-$89,999; and 12% $90,000 and above. Results revealed that friends who support and watch youth engage in activities are significantly and positively related to youth physical activity. Significant correlations existed among the type factors. Future research should examine the sources and nature of support and the mechanisms through which social support influences youth physical activity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Influence of Social Support on Adaptation to Surgery.

The authors investigated the influence of patients' social support on subjective and objective stress indicators before, during, and after surgery. The sample consisted of 42 male and 42 female patients. Social support as perceived by the patients was measured by a surgery-specific inventory with the Emotional Support and Informational Support subscales. Perioperative adaptation was assessed by self-reported anxiety, the amount of narcotics needed for anesthesia induction, and the length of the postoperative stay. Results demonstrated that patients who scored high on social support showed less anxiety, received lower doses of narcotics, and had a shorter hospital stay than did patients with low support. However, gender was a moderator of some of these associations. Compared with men, women exhibited more relationships that were in accordance with the hypotheses. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social support as a mediator of optimism and distress in breast cancer survivors.

Breast cancer patients can experience emotional distress as a result of diagnosis and treatment. Higher levels of optimism and social support are associated with less emotional distress in cancer patients. This 12-month prospective study followed 69 women who had completed treatment for Stages 0-11 breast cancer. At 3-month intervals, participants completed measures of mood disturbance, optimism, and social support. As hypothesized, affective social support mediated the relationship between optimism and distress in early-stage breast cancer survivors at baseline and 6 months but not at 1 year. In contrast, confidant social support did not mediate the optimism-distress relationship at any time point. Clinical and research implications of these findings are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social Support and Social Strain Among Husbands and Wives: A Multilevel Analysis.

In response to recent calls in the literature for within-person examinations of social support processes over time, this study explores the relationships of spousal support, spousal strain, and well-being among husbands and wives, both within the same day and across days. Eighty-three couples were interviewed and completed a structured diary twice daily for 1 week. The results of multilevel hierarchical modeling suggest that both spousal support and spousal strain made significant, independent contributions to concurrent negative affect, although only spousal support was a significant predictor of next-day negative affect. Spousal strain interacted with spousal support to predict next-day negative affect. Direct and moderating effects of perceived marital adjustment on negative affect were discussed. (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)     

Social support and prognosis in patients at increased psychosocial risk recovering from myocardial infarction.

Objective: To compare the impact of network support and different types of perceived functional support on all-cause mortality or nonfatal reinfarction for patients with a recent acute myocardial infarction (AMI). Design: Participants were recruited from the Enhancing Recovery in Coronary Heart Disease (ENRICHD) trial; 2,481 AMI patients with depression or low social support were randomized to a cognitive-behavioral intervention or to a usual care control group. Data collection for certain measures of social support was limited: 2,466 participants completed the ENRICHD Social Support Inventory; 2,457 completed the Perceived Social Support Scale; 1,296 completed the Social Network Questionnaire; and 707 completed the Interpersonal Support and Evaluation List, Tangible Support subscale. Patients also completed the Beck Depression Inventory and were followed for up to 4.5 years. Main Outcome Measure: Time to death or nonfatal reinfarction. Results: Over the follow-up period, 599 patients (24%) died or had a nonfatal AMI. Survival models controlling age, sex, race, socioeconomic status, smoking, antidepressant use, and a composite measure of increased risk revealed that higher levels of perceived social support were associated with improved outcome for patients without elevated depression but not for patients with high levels of depression. Neither perceived tangible support nor network support were associated with more frequent adverse events. Conclusion: AMI patients should be assessed for multiple dimensions of perceived functional support and depression to identify those at increased psychosocial risk who may benefit from treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychosocial work characteristics and perceived control in relation to cardiovascular rewind at night.

This study examined the effects of psychosocial work characteristics on cardiovascular rewind at night. Ambulatory 24-hr recordings of blood pressure (BP) and heart rate (HR) of 75 borderline hypertensive and 74 normotensive men were related to diary ratings of perceived control (PC) and to scores of psychological demand (P), control (C), and social support (S) at work determined by an occupational classification system. Multiplicative interaction terms for job strain (P?×?C, isostrain (P?×?C?×?S), and Job Strain?×?Perceived Control (P?×?C?×?PC) were calculated. The P?×?C?×?PC interaction predicted diastolic BP at night but not at work. A delayed latency to attain the lowest systolic BP during the night was found for jobs with high job strain and isostrain. Low perceived control and social support were associated with higher HR at work and at night. A logistic regression analysis indicated that the interaction between P?×?C?×?PC and the body mass index was independently associated with borderline hypertension. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Recent Advances in Psychosocial Oncology.

The April 2005 issue of Journal of Consulting and Clinical Psychology presents 5 articles that address the cancer experience. In this commentary, Vicki S. Helgeson examines how the authors of these articles advance the field in important ways, in particular by using theory-based research, identifying mechanisms of change, identifying moderators of treatment effectiveness, incorporating partners in studies, moving beyond self-report measures of distress, using longer term follow-ups, extending studies to more diverse samples, focusing on sexuality, and using longitudinal designs. Helgeson concludes by identifying several challenges that researchers in this area face and by highlighting future avenues for research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attachment, Social Competencies, Social Support, and Psychological Distress.

In this survey study of 430 undergraduates, elements of the social competencies and interpersonal processes model (B. Mallinckrodt, 2000) were tested. Two social competencies were hypothesized to mediate the direct effects of 2 independent variables, attachment anxiety and avoidance, on 2 outcomes, psychological distress and perceived social support. Social self-efficacy was expected to be a significant mediator only for attachment anxiety. Emotional awareness, construed as low levels of alexithymia, was expected to be a significant mediator only for attachment avoidance. A bootstrap method was used to estimate the significance of indirect effects. Structural equation analyses suggested that, instead of specialized significant parings of one mediator with one independent variable, both social self-efficacy and emotional awareness served as significant mediators for both attachment anxiety and attachment avoidance. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Couple-Focused Group Intervention for Women With Early Stage Breast Cancer.

This study examined the efficacy of a couple-focused group intervention on psychological adaptation of women with early stage breast cancer and evaluated whether perceived partner unsupportive behavior or patient functional impairment moderated intervention effects. Two hundred thirty-eight women were randomly assigned to receive either 6 sessions of a couple-focused group intervention or usual care. Intent-to-treat growth curve analyses indicated that participants assigned to the couples' group reported lower depressive symptoms. Women rating their partners as more unsupportive benefited more from the intervention than did women with less unsupportive partners, and women with more physical impairment benefited more from the intervention group than did women with less impairment. Subgroup analyses comparing women attending the couple-focused group intervention with women not attending groups and with usual care participants indicated that women attending sessions reported significantly less distress than did women receiving usual care and women who dropped out of the intervention. (PsycINFO Database Record (c) 2010 APA, all rights reserved)