Concerns about breast cancer and relations to psychosocial well-being in a multiethnic sample of early-stage patients.

Much work on psychosocial sequelae of breast cancer has been guided by the assumption that body image and partner reaction issues are focal. In a tri-ethnic sample of 223 women treated for early-stage breast cancer within the prior year, the authors assessed a wider range of concerns and relations to well-being. Strongest concerns were recurrence, pain, death, harm from adjuvant treatment, and bills. Body-image concerns were moderate; concern about rejection was minimal. Younger women had stronger sexual and partner-related concerns than older women. Hispanic women had many stronger concerns and more disruption than other women. Life and pain concerns and sexuality concerns contributed uniquely to predicting emotional and psychosexual disruption; life and pain concerns and rejection concerns contributed to predicting social disruption. In sum, adaptation to breast cancer is a process bearing on several aspects of the patient's life space. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Regulatory concerns and appraisal efficiency: The general impact of promotion and prevention.

It was hypothesized that people's appraisals both of themselves and of other objects in the world are more efficient when the emotional dimension underlying their appraisals fits their regulatory concerns. Regulatory focus theory distinguishes 2 such fundamental concerns: promotion concerns with accomplishment that relate to cheerfulness- and dejection-related emotions, and prevention concerns with security that relate to quiescence- and agitation-related emotions. Five studies found that individuals with stronger promotion concerns were faster in appraising how cheerful or dejected the object made them feel, whereas individuals with stronger prevention concerns were faster in appraising how quiescent or agitated the object made them feel. These greater appraisal efficiencies were found for both chronic and situationally induced promotion and prevention concerns and were independent of both the valence and the extremity of the appraisals. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The existential model of perfectionism and depressive symptoms: A short-term, four-wave longitudinal study.

Perfectionistic concerns (i.e., negative reactions to failures, concerns over others' criticism and expectations, and nagging self-doubts) are a putative risk factor for depressive symptoms. This study proposes and supports the existential model of perfectionism and depressive symptoms (EMPDS), a conceptual model aimed at explaining why perfectionistic concerns confer risk for depressive symptoms. According to the EMPDS, perfectionistic concerns confer risk for depressive symptoms both through catastrophic interpretations that magnify relatively minor setbacks into seemingly major obstacles and through negative views of life experiences as unacceptable, dissatisfying, and meaningless. This investigation tests the EMPDS in a sample of 240 undergraduates studied using a 4-wave, 4-week longitudinal design. Hypotheses derived from the EMPDS were largely supported, with bootstrap tests of mediation suggesting that the indirect effect of perfectionistic concerns on depressive symptoms through catastrophic thinking and difficulty accepting the past is significant. Results indicated perfectionistic concerns are more an antecedent of, rather than a complication of, catastrophic thinking, difficulty accepting the past, and depressive symptoms. Consistent (but imperfect) support for the incremental validity of the EMPDS beyond either perfectionistic strivings or neuroticism was also observed. Overall, this investigation suggests persons high in perfectionistic concerns not only tend to catastrophize their life experiences but also struggle to accept their life experiences and to negotiate a sense of purpose, direction, and coherence in their lives. With both a catastrophic view of their present and a dark view of their past, this investigation also suggests persons high in perfectionistic concerns are at risk for depressive symptoms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Understanding concerns about interventions to promote forgiveness: A review of the literature.

A new area in psychotherapy practice and research has arisen addressing therapeutic interventions to explicitly promote forgiveness. There is wide variation in the response to this new area including enthusiastic acceptance, wary openness, and vigorous opposition. Unfortunately, these reactions are not often based on a thorough understanding of the empirical literature and result in concerns about using forgiveness interventions in therapy that may or may not be warranted. The authors identify these potential concerns, framing them as concerns about the impact on clients, concerns related to therapist skill or knowledge, and concerns about the effect on the therapy process. The authors address these concerns with a review of the relevant research on forgiveness in therapy. Based on this review, the authors conclude that some skepticism of the new "forgiveness interventions" is warranted, although serious consideration needs to be given to these interventions at appropriate times. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reconciling conflicting findings regarding postcessation weight concerns and success in smoking cessation.

Correlates of concern about weight gain following smoking cessation and self-efficacy about controlling weight gain were examined in 940 men and 1,166 women who were surveyed on 2 occasions as part of a randomized trial of work-site interventions for smoking cessation. Weight concerns were positively associated with female sex, body weight, dieting for weight control, nicotine addiction, and social encouragement to quit. Bivariate analyses replicated prior findings that elevated weight concerns are associated with a reduced likelihood of quitting smoking, at least in women. Analyses controlling for demographics, nicotine dependence, and social factors replicated prior findings that weight concerns are not negatively related to smoking cessation and that some measures of concern are positively related to cessation. These analyses suggest that conflicting findings found in this literature are due primarily to how weight concerns are defined and whether covariates like nicotine addiction are used in data analyses. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Are people acting irrationally? Understanding public concerns about environmental threats.

News stories about environmental events illustrate public concerns about environmental policy and regulations. Increasingly, public perceptions of risk and fear of cancer are influencing the development of public policy regarding the environment. Policymakers have often regarded these public concerns as irrational. The purpose of this article is to describe how psychological research can be used to understand the public's concerns about environmental threats and to discuss the "irrationality" of these concerns. Examples are drawn from research on perceived risk and fear of cancer, and roles are suggested for psychology and psychologists in informing environmental policymaking. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of increased physician–patient communication on patient anxiety.

50 medical patients completed the State–Trait Anxiety Inventory before and after a physical examination, during which they were encouraged or not encouraged to discuss their health concerns. Results suggest that encouraging patients to disclose their underlying concerns and then confirming or discrediting these concerns are effective ways to reduce anxiety. Findings also indicate that many medical patients overestimate the severity of their physical ailments. (15 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Help seeking and problem perception among Asian Americans.

Compared the presenting concerns of 3,050 counseling center clients (undergraduate and graduate students) as those concerns varied by ethnicity, gender, and previous counseling experience. Asian-American clients were much more likely to perceive themselves as having educational or vocational concerns, whereas White clients were disproportionately more likely to admit to personal or emotional concerns. The comparison among 7 different Asian-American groups revealed that Filipino-American and Asian-American/White mixed clients were more likely to endorse personal or emotional concerns than other Asian-American groups. Gender and previous counseling experience were found to be related to the presenting concern, but the effects were the same in each ethnic comparison. Results are interpreted with respect to (1) what counselors should be aware of in interacting with Asian-American clients and (2) how they differ both from White clients and among themselves. (21 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mental Health Courts: A Misguided Attempt to Address the Criminal Justice System's Unfair Treatment of People With Mental Illnesses.

Mental health courts have proliferated in tandem with rising concerns about large numbers of people with mental illnesses cycling through the criminal justice system. Although the goals of these problem-solving courts are laudable, they have flourished because of systemic failures in public mental health and the criminal justice system. In addition to raising various civil rights and public policy concerns, these specialty courts are inherently flawed, unintentionally signaling an acceptance of the rates at which people with serious mental illnesses are entering the criminal justice system. Their very presence makes it more difficult to generate political will to address the root of the problem. Alternative, evidence-based programs address the same concerns without raising the same civil rights and policy questions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Remarriage as a coping response for widowhood.

Consideration and use of remarriage as a response to cope with the death of a husband were examined in 39 women who had been widowed and had subsequently remarried, 192 widows who had considered remarriage but had not yet remarried, and 420 widows who had not considered remarriage. Controlling for age, we found that women who had remarried reported fewer current concerns than did the other two groups. Furthermore, we found that women who retrospectively recalled the most concerns immediately after the death of the spouse were the ones who eventually remarried. The remarried group believed that they were experiencing significantly fewer concerns now than they had after the spouse's death; the women who had not considered remarriage believed that they were experiencing the same number of concerns now as before; and those women who had considered remarriage believed that they were experiencing significantly more concerns. Implications for remarriage as a coping mechanism for widowhood and the relation of age to remarriage decisions are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-monitoring as an assessment strategy in behavioral medicine.

This article describes assessment issues in behavioral medicine and a typology of uses of self-monitoring in behavioral medicine assessment. Illustrative examples of the use of self-monitoring in behavioral medicine assessment are presented. Current issues, and methodological concerns, in self-monitoring for behavioral medicine assessment are described along with some ideas for solutions of these issues and concerns. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Disruptive Effects of Vigilance on Dominant Group Members' Treatment of Outgroup Members: Choking Versus Shining Under Pressure.

Three studies examined the hypothesis that evaluative concerns exert a disruptive effect on intimacy-building behaviors exhibited by dominant group members in intergroup interaction. The authors predicted that although evaluative concerns would lead individuals with a negative baseline response to outgroup members to shine (i.e., to exhibit warmer, more friendly behavior), such concerns would have a contrary, choking, effect on individuals with a more positive baseline response. Results were generally consistent with these hypotheses across 3 different operationalizations of evaluative concerns and regardless of whether individuals' orientation toward outgroup members was assessed in terms of prejudiced racial attitudes or racial ingroup identification. Implications for lower status group members' experience of intergroup interaction and for the prejudice-reduction process are considered. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Participatory action-research for health

Patients' reluctance to report pain and to use analgesics are considered major barriers to pain management. To explore this problem, 270 patients with cancer completed a 27-item self-report questionnaire (BQ) that assessed the extent to which they have concerns about reporting pain and using pain medication. The 8 specific concerns included fear of addiction, beliefs that 'good' patients do not complain about pain, and concern about side effects. Patients also completed a measure of pain severity and pain interference (the BPI). The percentages of patients having concerns assessed by the BQ ranged from 37% to 85%. Those who were older, less educated, or had lower incomes were more likely to have concerns. Higher levels of concern were correlated with higher levels of pain. Based on their reports of pain medications used in the past week and on their reports of pain severity, patients were categorized as under-medicated versus adequately medicated. Those who were under-medicated reported significantly higher levels of concern. The data are discussed in terms of implications for research and practice.     

Leprosy tests: diagnostic problems (apropos of 2 cases)

Two cases of reactional leprosy leading to wrong diagnosis are reported. The first one concerns a reversal reaction predominantly neuritic, initially taken for polyarthritis. The second one concerns an erythema nodosum leprosum with extensive cutaneous necrosis (Lucio's phenomenon or ulcerative lazarine leprosy). Main aspects and mechanisms of leprosy reactional states are reviewed. It is emphasized that errors or delays in diagnosis are often caused by failing to recognize cutaneous or neuritic symptoms.     

The burnt-out chairman.

Discusses what it means to be a department chairperson, based on the author's 6.5 yrs of experience in this position. The frustrations and compensations of the job are considered. It is noted that administrative concerns come to replace concerns about the direction of the department. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clinical intervention with bisexuals: A contextualized understanding.

Many clinicians, situated in a culture that privileges a dichotomous understanding of sexual orientation, are often challenged by the complex issues presented by bisexual clients. The aim of this article is to provide an expanded and contextualized understanding of bisexuality that will inform effective intervention with the clinical concerns presented by this frequently marginalized population. An overview of evolving perspectives on sexual orientation and bisexuality is followed by a discussion of treatment concerns relevant to bisexuals. A review of treatment approaches offers clinicians a fundamental framework to begin to effectively address the unique clinical concerns of bisexual clients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Stability and change in patterns of concerns related to eating, weight, and shape in young adult women: A latent transition analysis.

Although college women are known to be at high risk for eating-related problems, relatively little is known about how various aspects of concerns related to eating, weight, and shape are patterned syndromally in this population. Moreover, the extent to which various patterns represent stable conditions or transitory states during this dynamic period of development is unclear. The present study used latent class and latent transition analysis (LCA/LTA) to derive syndromes of concerns related to eating, weight, and shape and movement across these syndromes in a sample of 1,498 women ascertained as first-time freshmen and studied over 4 years. LCA identified 5 classes characterized by (a) no obvious pathological eating-related concerns (prevalence: 28%–34%); (b) a high likelihood of limiting attempts (prevalence: 29%–34%); (c) a high likelihood of overeating and binge eating (prevalence: 14%–18%); (d) a high likelihood of limiting attempts and overeating or binge eating (prevalence: 14%–17%); and (e) pervasive bulimiclike concerns (prevalence: 6%–7%). Membership in each latent class tended to be stable over time. When movement occurred, it tended to be to a less severe class. These findings indicate that there are distinct, prevalent, and relatively stable forms of eating-related concerns in college women. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Separation anxiety in mothers of latency-age fearful children

The hypothesis that mothers of children who have symptoms indicative of separation anxiety are themselves separation-anxious was tested by scoring mothers' TAT themes for separation concerns. The stories of 15 mothers of fearful children were compared to the stories of 26 mothers of children manifesting behavior disorders and 21 mothers of children having had no psychiatric contact. Different kinds of separation concerns were found to differentiate the groups of mothers. The stories of mothers of fearful children expressed significantly more concerns about abandonment and rejection and more often expressed a desire to stay near the loved one; the mothers of children expressed significantly more concerns about abandonment and rejection and more often expressed a desire to stay near the loved one; the mothers of children with behavior disorders were found to tell significantly more stories with nurturance-succorance themes. The results lend support to the theory of anxious attachment in that mothers of fearful children seem to share the same concerns that have been ascribed to their children. On the other hand, it seems that separation anxiety may not be a unidimensional construct as different components seem to be more relevant to some symptom clusters than to others.     

A burden of proof: Stereotype relevance and gender differences in math performance.

Three studies explored gender differences in mathematics performance by investigating the possibility that men and women have different concerns when they take standardized math tests, and that when these gender-specific performance concerns are made relevant, performance may suffer. Results of 3 studies supported these hypotheses. In Study 1, women who believed a math test would indicate whether they were especially weak in math performed worse on the test than did women who believed it would indicate whether they were exceptionally strong. Men, however, demonstrated the opposite pattern, performing worse on the ostensible test of exceptional abilities. Studies 2 and 3 further showed that if these gender-specific performance concerns are alleviated by an external handicap, performance increases. Traditional interpretations of male–female differences on standardized math tests are discussed in light of these results. (PsycINFO Database Record (c) 2010 APA, all rights reserved)