Changes in risk perceptions in relation to self-reported colorectal cancer screening among first-degree relatives of colorectal cancer cases enrolled in a randomized trial.

Objective: This secondary data analysis was conducted to evaluate the applicability of the Risk Reappraisal Hypothesis, which has been proposed to explain the influence of performing a health behavior on perceived risk. Data were collected in the context of a randomized trial, which found that an individually tailored, multicomponent intervention was successful in increasing colorectal cancer (CRC) screening among first-degree relatives of CRC cases. Method: The ethnically diverse study sample (N = 841; 29% Latino, 21% African American, 20% Asian) consisted of adult siblings and children (40–80 years) of CRC cases, identified through the California Cancer Registry. Data were collected at baseline and at 6- and 12-month follow-up. Changes in self-reported risk perception (perceived likelihood of developing CRC) were examined over the study period in relation to study condition and screening status. Results: Greater increases in perceived risk were observed among intervention versus control-group participants over the study period, but increases were limited to intervention participants who had not been screened. We also examined trajectories of perceived risk in relation to timing of screening receipt (e.g., before 6 months, 6–12 months, never). Continued upward shifts in risk were observed during the study period among intervention participants not screened during the study. In contrast, participants screened by 6 months displayed a reduction or leveling off in perceived risk between 6- and 12-month follow-up. Conclusion: Results provide support for the applicability of the Risk Reappraisal Hypothesis within a high-risk sample enrolled in a CRC screening promotion trial. Future research is needed to explore the impact of short-term risk reductions on future CRC screening behavior. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Correlates of colorectal cancer screening compliance and stage of adoption among siblings of individuals with early onset colorectal cancer.

Concepts from the health belief, transtheoretical, and dual process models were used to examine how siblings of individuals diagnosed with colorectal cancer (CRC) before age 56 made decisions about CRC screening. Siblings (N=504) were assessed for CRC screening practices and intentions, pros, cons, processes-of-change, perceived risk of CRC, perceived severity of CRC, preventability of CRC, cancer-related distress, and sibling relationship closeness. Physician and family recommendation and knowledge were also assessed. Fifty-seven percent of participants (n=287) were compliant with CRC screening. Logistic regression indicated that perceived pros and cons, perceived risk, commitment to screening, health care avoidance, and sibling closeness were associated with screening compliance. Physician and family recommendation were also strong correlates. A similar set of factors was associated with stage of adoption of CRC screening. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relationships among health perceptions vary depending on stage of readiness for colorectal cancer screening.

Objective: We explored whether relationships among health perceptions differ depending on individuals' stage of readiness for colorectal cancer screening (CRCS). Methods: Data from the National Cancer Institute's Health Information National Trends Survey (HINTS) were used to stage adults over 50 years of age (N = 2324) using a modified version of the Precaution Adoption Process Model (PAPM) staging algorithm. Health perceptions examined included perceived risk of cancer, worry about cancer, fatalism, and beliefs about ambiguity of cancer prevention recommendations. Results: Meaningful differences in patterns of relationships among health perceptions by stage were found. Conclusions: The nonlinear patterns that emerged indicate support for the role of these health perceptions in screening, the idea that behavioral readiness may moderate the relationship between important health perceptions, and the use of the stage construct in this context. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Psychological impact of benign breast biopsy: A longitudinal, comparative study.

The impact of benign breast biopsy (BBB) on distress and perceptions of risk for breast cancer (BC) was examined. Interviews were conducted with 100 women shortly after notification of biopsy results and 4 and 8 months post-BBB. Compared with matched healthy comparison (HC) women without BBB, the BBB group evidenced greater BC-specific distress at baseline. BC-specific distress declined after BBB, remaining elevated relative to the HC group at the 8-month follow-up. Dispositional (optimism, informational coping style), demographic (education), clinical (family history of BC), and cognitive (BC risk perception) variables were associated with baseline levels of BC-specific distress or persistence of distress. Results support the monitoring process model (S. M. Miller, 1995) and the cognitive social health information processing model (S. M. Miller, Y. Shoda, & K. Hurley, 1996). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Increasing attendance at colorectal cancer screening: Testing the efficacy of a mailed, psychoeducational intervention in a community sample of older adults.

This article describes a trial of a psychoeducational intervention designed to modify negative attitudes toward flexible sigmoidoscopy screening and thereby increase screening attendance. The intervention materials addressed the multiple barriers shown to be associated with participation in earlier studies. Adults ages 55-64 (N=2,966), in a "harder-to-reach" group were randomized either to receive an intervention brochure or to a standard invitation group. Attitudes and expectations were assessed by questionnaire, and attendance at the clinic was recorded. Compared with controls, the intervention group had less negative attitudes, anticipated a more positive experience, and had a 3.6% higher level of attendance. These results indicate that psychoeducational interventions can provide an effective means of modifying attitudes and increasing rates of screening attendance. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological impact of an economic crisis: A Conservation of Resources approach.

This study examined the psychological effects of an economic crisis based on Conservation of Resources (COR) stress theory. It investigated how the loss of economic resources had a psychological influence on well-being and identified which of 3 variables (the loss of economic resources, demographic characteristics, or coping strategies) had the greatest psychological influence. Psychological well-being was assessed via levels of anxiety and anger. The study provided clear support for COR theory. The loss of economic resources had a strong and mostly positive relationship to anxiety and anger. The coping strategies were the most important of several predictors. Similar studies were proposed to increase confidence in generalizing to other populations and to identify the causal links between loss of economic resources, coping, and psychological well-being. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological Response to Test Results in an Ovarian Cancer Screening Program: A Prospective, Longitudinal Study.

To identify the psychological impact of receipt of an abnormal yet benign screening test result, the authors examined the response to a transvaginal ultrasound screening (TVS) test for ovarian cancer (OC) in asymptomatic women (N=540) undergoing an initial TVS screening test. Interviews were conducted prior to undergoing TVS screening and at 2 weeks and 4 months following this baseline. Women receiving an abnormal yet benign TVS test result (n=33) reported elevated OC-specific, but not general, distress at 2-week follow-up. Distress returned to baseline levels at 4-month follow-up. Consistent with the monitoring process and cognitive-social health information processing models, response to an abnormal TVS result was moderated by a monitoring coping style, low optimism, and a family history of OC. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effectiveness of Psychological Interventions for Child Maltreatment: A Meta-Analysis.

A meta-analysis tested the effectiveness of psychological treatments for child maltreatment (CM) using weighted least squares methods (e.g., L. V. Hedges & I. Olkin, 1985). A mean effect size of d+ = 0.54 (SE = .03, 95% CI = .39- .69) was observed, indicating that on average, treated participants were better off than 71% of those in control groups. Partitioning by type and target of outcome assessment yielded homogeneous effects within each of 5 different outcomes. Treatment effects were weakest when linked to objective behavioral observations of the family (d+ = .21) and strongest when associated with parent self-reported parenting attitudes and behaviors (d+ = .53). Results of other moderator analyses are presented, along with limitations of current CM treatment research; implications for future research, practice, and social policy are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological treatment of late-life anxiety: An empirical review.

This study provides a meta-analytic review of nonpharmacological interventions for late-life anxiety, focusing on treatment efficacy. Included in the analysis are studies in which a comparison was made either to a control condition or to another treatment. A total of 15 outcome studies, published or reported between January 1975 and January 2002, were identified involving 495 participants (mean age exceeding 55.0 years and a grand mean of 69.5 years) and providing 20 separate treatment interventions. The analysis indicated that psychological interventions were reliably more effective than no treatment on self-rated and clinician-rated measures of anxiety, yielding an effect size of .55. Maintenance of treatment gains (a minimum of 6 months follow-up) was insufficiently reported across studies to allow for a reliable demonstration of an overall estimate of long-term efficacy. It is concluded that psychological interventions produce significant improvements, but the analyses must be qualified by data limitations in the research synthesis. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological well-being in retirement: The effects of personal and gendered contextual resources.

Although prior research points to the gendered nature of work and private routines, surprisingly few studies have explored the influence of gender on the sources of psychological well-being in retirement. Drawing on resource theories and theories on the gendered division of labor, this study examines how preretirement resources relate to retirees' psychological well-being by using data from the Wisconsin Longitudinal Study. It is hypothesized that possessing key resources prior to retirement as well as losing or gaining resources in the transition to retirement influence retirees' well-being and that these effects are partially conditioned by gender. Results indicate that preretirement physical health, tenacity in goal pursuit, and flexibility in goal adjustment are beneficial for men's and women's well-being alike. By contrast, financial assets and job dissatisfaction are more strongly related to men's psychological well-being in retirement and preretirement social contacts to that of women. Thus, the study underscores the importance of considering gendered resources in retirement research. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Psychosocial adjustment among cancer survivors: Findings from a national survey of health and well-being.

Objective: The current study examined whether cancer survivors showed impairment, resilience, or growth responses relative to a sociodemographically matched sample in four domains: mental health and mood, psychological well-being, social well-being, and spirituality. The impact of aging on psychosocial adjustment was also investigated. Design: Participants were 398 cancer survivors who were participants in the MIDUS survey (Midlife in the United States) and 796 matched respondents with no cancer history. Psychosocial assessments were completed in 1995–1996 and 2004–2006. Main Outcome Measures: Outcomes including self-report measures of mental health and mood, psychological well-being, social well-being, and spirituality. Results: Findings indicated that cancer survivors demonstrated impairment relative to the comparison group in mental health, mood, and some aspects of psychological well-being. Longitudinal analyses spanning pre- and postdiagnosis clarified that while mental health declined after a cancer diagnosis, poorer functioning in other domains existed prior to diagnosis. However, survivors exhibited resilient social well-being, spirituality, and personal growth. Moreover, age appeared to confer resiliency; older survivors were more likely than younger adults to show psychosocial functioning equivalent to their peers. Conclusion: While younger survivors may be at risk for disturbances in mental health and mood, cancer survivors show resilience in other important domains of psychosocial adjustment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Understanding pregnant women's decision making concerning prenatal screening.

Objective: This study is aimed at enhancing understanding prenatal screening decision making through testing a hypothesized decision model based on decision theory and health behavior theory. Design: We obtained questionnaires from 1,666 pregnant women who were offered prenatal screening for Down's syndrome. Path analysis (using LISREL) resulted in a final model with reasonable model fit, which was verified by split-sample cross-validation. Main outcome measures: These included perceived probability, perceived severity, attitude toward termination, response efficacy, attitude toward prenatal screening, subjective norm, child-related anxiety, and intention to undergo prenatal screening. Results: Attitude toward termination of pregnancy, perceived test efficacy, and subjective norm regarding the desirability of having prenatal screening determined a woman's attitude toward having a prenatal test. Anxiety was influenced by perceived risk and perceived severity of having a child with Down's syndrome, and by subjective norm, but this appeared to be a weak predictor of intention to test. Pregnant women with a positive attitude toward prenatal screening, and who perceived a subjective norm in favor of undergoing prenatal screening, showed a greater intention to have prenatal screening done. Conclusion: These findings suggest that more attention should be paid toward the values and social context of pregnant women during the counseling process. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Treatment Utility of Psychological Assessment.

This article focuses on treatment utility. A definition of treatment utility was provided by S. C. Hayes, R. O. Nelson, and R. B. Jarrett (1987): "We propose to use the phrase the treatment utility of assessment to refer to the degree to which assessment is shown to contribute to beneficial treatment outcome" (p. 963). Various methodologies to examine the treatment utility of assessment are summarized. Treatment utility studies using various assessment procedures (i.e., diagnosis and functional analysis) and various disorders (i.e., unipolar depression, social or interpersonal problems, and phobic disorders) are described. Suggestions are made as to when elaborated assessment and/or treatment utility studies are needed. Limitations on the generalizability of results of any particular treatment utility study are presented. Despite progress, for most assessment procedures and devices, the treatment utility question remains: What is the degree to which assessment is shown to contribute to beneficial treatment outcome? (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Physical Activity and Psychological Well-Being in Advanced Age: A Meta-Analysis of Intervention Studies.

A meta-analysis examined data from 36 studies linking physical activity to well-being in older adults without clinical disorders. The weighted mean-change effect size for treatment groups (dC. = 0.24) was almost 3 times the mean for control groups (dC. = 0.09). Aerobic training was most beneficial (dC. = 0.29), and moderate intensity activity was the most beneficial activity level (dC. = 0.34). Longer exercise duration was less beneficial for several types of well-being, though findings are inconclusive. Physical activity had the strongest effects on self-efficacy (dC.= 0.38), and improvements in cardiovascular status, strength, and functional capacity were linked to well-being improvement overall. Social-cognitive theory is used to explain the effect of physical activity on well-being. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The necessary and sufficient conditions of therapeutic personality change.

This reprinted article originally appeared in Journal of Consulting Psychology, 1957(Apr), Vol 21(2), 95-103. (The following abstract of the original article appeared in record 1959-00842-001.) "For constructive personality change to occur, it is necessary that these conditions exist and continue over a period of time: (1) Two persons are in psychological contact. (2) The first, whom we shall term the client, is in a state of incongruence, being vulnerable or anxious. (3) The second person, whom we shall term the therapist, is congruent or integrated in the relationship. (4) The therapist experiences unconditional positive regard for the client. (5) The therapist experiences an empathic understanding of the client's internal frame of reference and endeavors to communicate this experience to the client. (6) The communication to the client of the therapist's empathic understanding and unconditional positive regard is to a minimal degree achieved." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Beyond Medical Risk: Investigating the Psychological Factors Underlying Women's Perceptions of Susceptibility to Breast Cancer, Heart Disease, and Osteoporosis.

The relationships of epidemiological (objective) risk indices, perceived disease characteristics, and cognitive heuristics to women's perceived susceptibility to breast cancer, heart disease, and osteoporosis in a community sample of 312 women ages 40-86 were examined. Epidemiological indices accounted for a small to moderate proportion of the variance in perceived susceptibility. Psychological factors (perceived similarity to women who contract the target disease and perceived disease prevalence) predicted perceived susceptibility above and beyond medical risk factors. Opposite to actual risk, age correlated negatively with perceived susceptibility to all 3 diseases. Exploratory analyses suggested that perceived similarity, perceived prevalence, and absent/exempt beliefs might mediate this relationship. Confirmatory factor analyses verified that measures of absolute and direct comparative risk assess the same underlying construct of perceived susceptibility. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of The psychological and social impact of physical disability (2nd ed.).

Reviews the book, The psychological and social impact of physical disability (2nd ed.) by Robert P. Marinelli and Arthur E. Dell Orto (1984). This book of readings is a substantial revision of the volume by the same title published in 1977. The editors, who are professors of rehabilitation counseling at West Virginia University and Boston University, respectively, have selected 18 new articles for inclusion in the second edition. Their criteria for selecting the new articles, as well as for retaining 11 articles from the first edition, were "practicality and utility for service providers." The topics addressed in the selected readings include legal rights, independent living, adolescence, family dynamics, psychological adjustment, attitude modification, sexual adjustment, self-help groups, women, and various helping strategies. Most of the new articles were originally published between 1979 and 1982, and only three of the retained articles were published before 1972; hence, the volume primarily represents recent writings about psychosocial aspects of disablement. All but five of the selections are reprinted from major rehabilitation journals. Because it does assemble many important articles in one place, this book is a useful reference source for courses on psychological aspects of disability. It cannot serve as the primary textbook, however, because it does not provide anything approaching an integrated, comprehensive treatment of the subject. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The impact of September 11 on psychologists.

A variety of recent research studies have investigated the psychological impact on victims of the devastating events of September 11, 2001. The present study adopted a different approach, instead focusing on the experience of caregivers through a brief survey of state psychological association members. Overall, practitioners described modest but significant changes in both their professional work and their personal lives. Not surprisingly, those respondents working closest to Ground Zero reported the greatest changes. The sample also reported more positive than negative feelings regarding their work in the post-9/11 environment. Although the survey return rate was only 15%, the findings shed light on several important professional issues related to disaster relief, including service utilization, preparedness, and vicarious traumatization. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological aspects of asthma.

Asthma can be affected by stress, anxiety, sadness, and suggestion, as well as by environmental irritants or allergens, exercise, and infection. It also is associated with an elevated prevalence of anxiety and depressive disorders. Asthma and these psychological states and traits may mutually potentiate each other through direct psychophysiological mediation, nonadherence to medical regimen, exposure to asthma triggers, and inaccuracy of asthma symptom perception. Defensiveness is associated with inaccurate perception of airway resistance and stress-related bronchoconstriction. Asthma education programs that teach about the nature of the disease, medications, and trigger avoidance tend to reduce asthma morbidity. Other promising psychological interventions as adjuncts to medical treatment include training in symptom perception, stress management, hypnosis, yoga, and several biofeedback procedures. (PsycINFO Database Record (c) 2010 APA, all rights reserved)