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)     

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)     

Role of health locus of control beliefs and expectations of treatment efficacy in adjustment to cancer.

Examined the effects of health locus of control beliefs (self-, doctor, and chance control) and expectations of treatment efficacy on short-term psychological adjustment in 137 18–86 yr old newly diagnosed cancer patients. The role of these beliefs and expectations in moderating the relation between perceived and actual disease severity and depression was also examined. Ss completed an intake questionnaire assessing the perceived severity of illness, the amount of pain or discomfort they were experiencing, how sad or depressed they were, and expectations about complying with medication instructions; Ss also completed items from Rotter's Internal–External Locus of Control Scale, the Multi-Dimensional Health Locus of Control Scale, and the Self-Rating Depression Scale. The relation between perceptions of disease severity and depression was weaker for Ss who believed that they could personally control their health and for those who held positive expectations about the effects of complying with medical treatment. Similar patterns were found when disease severity was defined in terms of prognosis for survival. Strong negative correlations between self-control/treatment expectations and depression were found for Ss who perceived that their illness was severe. The results for chance and doctor control were less consistent. The stability of health control beliefs and treatment expectations over the course of a serious long-term illness is discussed. (34 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)     

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)     

Spiritual health locus of control and breast cancer beliefs among urban African American women.

The present study examined the relationship between spiritual health locus of control, breast cancer beliefs, and mammography utilization among a sample of 1,227 African American women from urban public health centers. Spiritual health locus of control was conceptualized as having an active and passive dimension, empowering individuals in their health beliefs and behaviors or rendering them to rely on a higher power (e.g., God) to determine their health outcomes, respectively. The active dimension was negatively associated with perceived benefits of mammography and positively associated with perceived barriers to mammography. The active and passive spiritual dimensions are distinct from internal and external health locus of control. Further study of their associations with other health-related beliefs and behaviors is warranted. (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)     

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)     

Prospective teachers' sense of efficacy and beliefs about control.

We examined the structure and meaning of efficacy for a sample of 182 prospective teachers and related efficacy to beliefs about control and motivation. The two independent dimensions of teaching efficacy (TE) and personal efficacy (PE) usually identified in studies of experienced teachers were also found for these prospective teachers. Both TE and PE were significantly correlated with bureaucratic orientation, but in opposite directions. Neither TE nor PE was related to motivational style; only TE was related to pupil control ideology. Canonical correlations, however, revealed more complex relationships. Personal efficacy was positively related to a control orientation that rejects teacher control of students but accepts the schools' control of teachers. The interaction of TE and PE made unique contributions to the prediction of pupil control ideology and bureaucratic orientation. (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)     

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.     

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)     

Teachers' beliefs about interaction control and their observed behavioral correlates.

A teacher's perception of control over interactions with pupils has been suggested as a possible mediator of the expectation communication process. The present study tested some predictions based on this line of reasoning, with both between- and within-classroom analysis models. Participants were 204 3rd–5th graders from 5 schools and 17 teachers. The within-classroom analysis found, as predicted, that teachers viewed interactions with low-expectation pupils as less controllable than those with high-expectation pupils and that teacher initiations were perceived as more controllable than child initiations. In addition, a predicted (but nonsignificant) negative relation was found between the frequency of a teacher's ignoring a pupil's response and interaction control: Less relative perceived control over a pupil was associated with a relatively more frequent occurrence of no feedback. Reasons for the weakness in relations are discussed. Also, explanatory analyses involving control and the frequency of 6 types of classroom interaction are presented. (16 ref) (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)     

Meaning making and psychological adjustment following cancer: The mediating roles of growth, life meaning, and restored just-world beliefs.

Cancer survivors' efforts at meaning making may influence the extent to which they successfully make meaning from their experience (i.e., experience posttraumatic growth, find life meaningful, and restore beliefs in a just world), which may, in turn, influence their psychological adjustment. Previous research regarding both meaning making processes and meanings made as determinants of adjustment has shown inconsistent effects, partly because of the lack of clearly articulated theoretical frameworks and problematic research strategies. In a 1-year longitudinal study, the authors distinguished the meaning making process from the outcomes of that process (meanings made), employing specific measures of both. The authors tested pathways through which meaning making efforts led to 3 different meanings made (growth, life meaning, and restored just-world belief) in a sample of 172 young to middle-age adult cancer survivors, and they explored whether those meanings made mediated the effect of meaning making efforts on psychological adjustment. Cross-sectional and longitudinal path models of the meaning making process indicate that meaning making efforts are related to better adjustment through the successful creation of adaptive meanings made from the cancer experience. The authors conclude with clinical implications and suggestions for future research. (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.     

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)     

Teachers' and students' beliefs about punishment.

360 1st, 3rd and 5th graders and their 16 teachers from 3 school systems were interviewed in the fall and spring of the same school year to assess the developing relationship between teachers' and students' beliefs about punishment. Older children were less punitive than younger children. Teachers remained relatively punitive compared with 5th graders. Teachers with more punitive beliefs had students whose beliefs were more punitive when compared with students whose teachers had less punitive beliefs. Children and teachers thought that teachers should give more punitive responses than peers for the same misbehavior. The school systems that allowed corporal punishment had students with more punitive beliefs than the school system without corporal punishment. Results indicate that the school environment is perceived to be authoritarian and punitive by students and teachers. (18 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Agency, control, and means€nds beliefs about school performance in Moscow children: How similar are they to beliefs of Western children?

This study examined the development of school performance-related beliefs and their link with actual academic performance in Moscow children (Grades 2–6, N?=?551) using the Control, Agency and Means–Ends Interview (CAMI). Results revealed much intercultural convergence with Western samples, coupled with context-specific variations. Similarities involved (a) the CAMI factor structure, (b) the correlational nexus between beliefs and performance, (c) the developmental trends, and (d) the configuration of means–ends beliefs. Differences involved beliefs about teachers and ability, and gender differences, favoring girls, in the agency and control beliefs. In general, Moscow children displayed a Westernlike view of the causes of school performance and of themselves as being agentic and capable of personal control over their performance outcomes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perceived past, present, and future control and adjustment to stressful life events.

[Correction Notice: An erratum for this article was reported in Vol 100(4) of Journal of Personality and Social Psychology (see record 2011-05716-005). There is an error on page 758. In the sentence “Present control predicted later event-specific distress in Sample 1( β = .17, p